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Inspection on 28/07/09 for Alistre Lodge Nursing Home

Also see our care home review for Alistre Lodge Nursing Home for more information

This inspection was carried out on 28th 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

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

What the care home does well

The people spoken with and who completed questionnaires indicated that they were satisfied with the health and personal care provided at Alistre Lodge. Their comments included: `Pleasant surroundings and always very clean, including bed rooms.` `The staff are very pleasant. I like to go out every day. The food is good.` `I am very happy with the care my relative has here. If I had any problems I would talk to the staff who would sort it out.` `The staff are friendly, the home is clean and I think it is well run.` `I chose here because it was nice and clean and Mum was always very house proud, I knew it would suit her.` The pre admission process ensures that people have their needs assessed. People have enough information to make an informed decision before moving to the home. The home is able to provide a service for people who have nursing needs, and this has been beneficial for people who have experienced a deterioration in health as they can remain in familiar surroundings. There are opportunities for people to join in activities at the home. Visitors are made very welcome. The home is situated in easy reach of many community services. The home is furnished and maintained to a good standard. There is a variety of places for people to spend time alone or in company. The home has a pleasant front garden which can be used by the people living there. Staff are able to add to their skills through training opportunities. The staff feel they are able to complete their duties. There are ancillary staff who assist the staff team in the efficient running of the home.

What has improved since the last inspection?

The Service User Guide has been updated. The care records maintained about people have been brought together and are now kept in an individual file. An activities coordinator has planned a range of activities. People spoken with have had some opportunities to enjoy trips out and organised entertainment. The owner has continued to refurbish and redecorate parts of the home. There is a new bathroom fitted with an electric hoisting bath. There is a laundry assistant in pace and this has ensured that the laundry runs efficiently.All care staff have achieved a National Vocational Qualification in Care, this is the recommended qualification for people providing social care.

What the care home could do better:

The care planning system should be implemented fully. At the time of this inspection the new format had been established but most sections were not completed. Information gathered at the time of the pre admission assessment was not acted upon, for example areas of risk identified were not addressed. The care plans were not reviewed regularly, and where a review had taken place the care plan was not always updated to reflect changes. The records of treatment and other key areas, for example weight, were not consistently maintained. The activities at the home could be further enhanced by social histories, which would ensure the persons past life experience is appreciated and respected. The required checks and references must be obtained before people commence employment at Alistre Lodge. A record of staff training should be completed to ensure that staff have completed mandatory training, and an accurate record of training and qualifications can be kept.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Alistre Lodge Nursing Home 69 St Annes Road East St Annes on Sea Lancashire FY8 1UR     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Felicity Lacey     Date: 2 9 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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: Alistre Lodge Nursing Home 69 St Annes Road East St Annes on Sea Lancashire FY8 1UR 01253-726786 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: J Parker (Care) Limited care home 43 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home with nursing - Code N 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 The maximum number of service users who can be accommodated is: 43 Date of last inspection Brief description of the care home Alistre Lodge Nursing Home with Care offers personal care and nursing to 43 people over and under the age of 65 years. Accommodation is arranged over three floors on one side of the home and two floors on the other. There is a passenger lift at one side of the home and a chair lift at the other. Accommodation is in a mix of single and double rooms, most of which have ensuite facilities. There are a variety of communal rooms and a garden to the front of the home. The home is situated within ten minutes 0 Over 65 43 Care Homes for Older People Page 4 of 29 Brief description of the care home walk of the town centre of St Annes and is well served by public transport. Local shops and community facilities are within easy reach. Information about current fee levels can be obtained from the manager of the home. 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: This inspection included an unannounced visit to Alistre Lodge. Prior to the visit information was provided by the manager of the home in an Annual Quality Assurance Assessment (AQAA), this is a record of how the service provided at Alistre Lodge meets the standards set out in law and good practice guidance. Surveys were sent out to people living at the home. During the visit people who live at Alistre Lodge, their relatives, staff, the manager and the owner were spoken with. The last full inspection of the care home was on 14 August 2007, there was an Annual Service Review completed on 28 August 2008 and a Random Inspection carried out on 25 March 2009. Care Homes for Older People Page 6 of 29 What the care home does well: What has improved since the last inspection? The Service User Guide has been updated. The care records maintained about people have been brought together and are now kept in an individual file. An activities coordinator has planned a range of activities. People spoken with have had some opportunities to enjoy trips out and organised entertainment. The owner has continued to refurbish and redecorate parts of the home. There is a new bathroom fitted with an electric hoisting bath. There is a laundry assistant in pace and this has ensured that the laundry runs efficiently. Care Homes for Older People Page 7 of 29 All care staff have achieved a National Vocational Qualification in Care, this is the recommended qualification for people providing social care. 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 set out 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 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 9 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. The admission procedures of the home ensure that the needs of people are understood and can be met at Alistre Lodge. Evidence: The Service User Guide for the home has been updated. People who were spoken with during the inspection felt they had enough information prior to making a decision to move to the home. Some of the relatives spoken with had visited several homes in the area before choosing Alistre Lodge. One relative commented I chose here because it was nice and clean and Mum was always very house proud, I knew it would suit her. Prior to admission the person is visited by a senior member of staff from Alistre Lodge and an assessment is completed. The format in use is extensive and enables key information to be gathered. This is completed with the person or their representative and forms the basis of the care given at Alistre Lodge. The assessment covers personal and health care needs, social, religious and cultural needs. The information Care Homes for Older People Page 10 of 29 Evidence: gathered includes guidance on how people preferred to be assisted and supported. Care Homes for Older People Page 11 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. There is a lack of effective care planning and recording and this may mean that the health and personal care needs of people are not being consistently and safely met. Evidence: A new format has been introduced which, if completed properly, would ensure that all key information relating to a person is kept in one file. The care plans seen were not fully completed and did not provide the guidance and information needed to ensure that peoples health and personal care needs were being met in a consistent and safe way. The information gathered at the time of initial assessment should be used to build a care plan which identifies the needs of the person. The staff spoken with understood the needs of each person but they gained this knowledge through staff handover and being told about peoples needs. This is not a safe and consistent way to meet the needs of people. There were examples of incorrect information on care files, for example on one file it indicated a hoist should be used to assist a person, but in discussion with staff it was evident that the hoist was not regularly used , and the person was transfered using other aids. In another Care Homes for Older People Page 12 of 29 Evidence: care plan it was indicated that a person was independent when eating, however looking at the daily notes it was clear that some staff were assisting this person at meal times to ensure that the person ate the meal provided. Another person had shown some challenging behaviours, however these had not been responded to by providing guidance for staff on how to manage these behaviours. These issues are of particular concern as they have been identified at the last Random Inspection of the home, and with the exception of introducing a format which ensures that all information is kept together, there has been little progress toward making the necessary improvements. The care records seen contained no completed risk assessments. This is of concern as this issue was highlighted at the last random inspection of the home in March 2009. There were checklists for mobility and nutritional needs, which indicated the level of risk, however this information was not them acted upon. When a risk is identified it is important that the care plan includes the steps put in place to manage and minimise risk. Bed rails are in use with a number of people and these need to be risk assessed and monitored to ensure they are safe to use and are maintained to the required standard. The manager and owner were advised to ensure that all care plans and risk assessments are completed and accurate without delay. The care plans seen contained a review sheet. Of the four plans looked at only one had been reviewed, and when considering the daily notes for this person it was clear that a change in support need had not been picked up on at the review, and the care plan had not been updated to reflect this change. The manager should ensure that reviews are carried out at least monthly and that all files are monitored to ensure they contain correct information and relevant up dates. The Random Inspection of March 2009 also highlighted the need to maintain accurate records of peoples weight. A format has been introduced but this has not been consistently completed. This is of serious concern for those people who have nutritional needs identified as a care need. This record must be maintained and its completion monitored by the manager. Any significant changes in a persons weight should be identified and acted upon with out delay. There was evidence of the health needs of people being met, however the recording of treatment was not consistent. There are records maintained of the dressings applied and the progress of wound care. There is evidence of the involvement of other health care agencies and the involvement of family with decision making. The people spoken with during the visit to the home felt that their health care needs were being met and confirmed that there was no delay in seeking medical advise should they feel unwell. Care Homes for Older People Page 13 of 29 Evidence: People register with the GP of their choice, and if possible retain the services of their own GP. There was evidence of people attending hospital appointments. There was also regular visits to the home by community health services, including the chiropodist and optician. The medication records seen were completed correctly. The manager has introduced additional recording to ensure that all medication received into the home is recorded. A record of returned medication is also kept, and a private company collects this medication. The visits for collection are over a month apart and consequently stocks of unused medication have built up at the home. All medication is administered by the trained staff. Some people self medicate and retain control over their medication. The storage arrangements at the home were satisfactory. The people spoken with during the visit felt that their privacy and dignity was respected. There were people who wished to remain in their own rooms for meals and during the day and their wishes were respected. People have mail delivered unopened and are able to make phone calls in private. There are a number of shared rooms at the home and screening is provided. Rooms are only shared with the agreement of the people using the room. Staff were seen to assist people in ways which promoted their dignity and afforded privacy. Care Homes for Older People Page 14 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. The activities on offer at the home could be improved by the compilation of social histories of the people living at Alistre Lodge this would ensure that people are able to continue with their hobbies and lifestyle they prefer. Evidence: The home has an activities coordinator who provides some planned activities. There has been an organised trip out to the Lake District which was enjoyed by some people. One person spoken with had enjoyed a recent entertainers visit to the home. There was little evidence on daily notes of activities that had been enjoyed by people, however the people spoken with felt that there was some activities on offer they could enjoy. Two surveys commented on the lack of trips out and entertainment. A small number of people are able to go out independently or have regular trips out with their relatives. Individual hobbies can be catered for, one person enjoys doing jigsaws and spends much time doing this, another person is a keen knitter and is able to carry on with this in the home. Following the last random inspection to the home it was recommended that social histories should be compiled with people at the home. In this way staff are able to have an insight into the persons life experience and social activities before coming to Care Homes for Older People Page 15 of 29 Evidence: the home. A format has been devised, but only one file looked at during the inspection had any entries on it. The manager has identified this as an area for improvement and it is planned that a diary of events for the next three months is displayed, this will make sure everyone knows what has been arranged and can choose whether to take part or not. The religious needs of people at Alistre Lodge are met in accordance with the individuals wishes. The home is visited by representatives of the local clergy. The home is near to several churches and places of worship. Visitors to the home are made welcome. During the visit to the home there were many visitors and those spoken with said they were always made to feel welcome. The people who live at the home are encouraged to manage their own financial affairs. The manager does not act as an agent for residents. If people are unable to manage their affairs independently they are encouraged to have a representative to deal with these on their behalf. Advice and information is available on local advocacy services. Meals and meal times are seen as a social occasion. The dining room well presented. The tables are set with table clothes and napkins. The people who live at the home are offered a choice menu. The people spoken with thought the meals were well prepared and tasty. The menu is changed periodically. The main meal of the day is served at lunch time. Between mealtimes drinks and snacks are available. Staff were observed assisting people at a mealtime. Specialist diets can be catered for at the home. Care Homes for Older People Page 16 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The policy of the home promotes consistency and understanding when dealing with complaints and safeguarding which protects the welfare of people living at Alistre Lodge. Evidence: The people spoken with and their representatives knew how to raise a concern at the home. Relatives confirmed that any concern they had raised had been dealt with in a responsive and timely manner by the staff of the home. A complaints record is maintained and there was evidence of the recording and responding to of complaints. Staff spoken with were familiar with the policy of the home and were able to explain the actions they would take. People who completes surveys felt that staff always listened to what they had to say and that they were able to make their concerns known. Staff spoken with understood their duties under safeguarding procedures. They had not received formal training in Adult Protection, although all care staff have completed National Vocational Qualifications which includes consideration and understanding of safeguarding. The manager and owner are aware of the need to follow local procedures and have demonstrated their ability to protect the rights of people living at the home through working in partnership with other agencies when required. The manager is aware of new legislation regarding the Deprivation of Liberty and Care Homes for Older People Page 17 of 29 Evidence: safeguards which may need to be put in place. This legislation is in place to protect the rights of people who may have reduced capacity to make their own decisions. 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. The home is clean and well maintained, this provides a pleasant place for people to live. Evidence: The home is well decorated and furnished to a very good standard. The people spoken with found Alistre Lodge to be clean and comfortable. There is a range of communal areas and people move freely about the home. There are lifts at each end of the building. There are two large lounges, a small sun lounge, a large conservatory and a dining room. There is also seating around the home which provides a choice of where to spend time. The comments from people and relatives included : The home is always clean and smells nice. Pleasant surroundings and always very clean, including the bedrooms. My Mum has always been house proud, its important to her, and the standard at Alistre Lodge was very good. The home was warm and clean. A new assisted bath has been fitted at the home. There is a programme of on going maintenance and redecoration. Some of the bedroom furniture is in need of replacement. The manager is aware of the Care Homes for Older People Page 19 of 29 Evidence: improvements that need doing. There is a system to ensure all maintenance work is carried. Staff are provided with infection control gloves, aprons and alcohol hand wash. The anti bacterial hand wash has been placed at the entrance to the home and notices to ask visitors to use this on entering and exiting the home. Staff have received instruction during induction and from the manager about hand washing techniques. There has not been formal training for staff in infection control and this should be provided. 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. Staff are competent and able to meet the needs of people at Alistre Lodge. There were some required references and checks not completed on staff files and this does not safeguard the welfare of people living at the home. Evidence: The people spoken with during the inspection and those who completed questionnaires felt that the staff were always on hand and were approachable. People living at the home and their relatives confirmed that staff listened to what they had to say and acted on any request. The home is staffed to meet the needs of the people at Alistre Lodge, there is qualified nurses on each shift. The people spoken with confirmed that they thought there was enough staff on duty during the day. The night time staffing of the home has been changed and now there are two staff on wake and watch and a member of staff sleeping in. It is important that this staffing level is kept under review to ensure that the needs of people are safely met, this will be determined by the number of people who require two staff to provide personal care and the behaviours of people at the home during the night. There are ancillary staff employed including domestic staff, maintenance staff and laundry staff. The people spoken with felt that these people provided a very good level of service, and were pleased that the home was always clean and well looked after. Care Homes for Older People Page 21 of 29 Evidence: The laundry at the home is now well managed and this is important to people living there. All permanent care staff at the home have a National Vocational Qualification in Care at level 2 or above, this is the recommended qualification for staff in the social care sector. Staff spoken with confirmed that training was encouraged and that the home supported training in specialist areas. All staff have completed an induction programme and this was evidenced on staff files, and in discussion with new staff members. A training file has been set up for staff however this is not yet in use, a deputy manager has recently been appointed and she is to take the lead on training. Most staff have completed Moving and Handling training and First Aid. The home is making use of the Lancashire Workforce Development Partnership which provides training for people working in social care. The home has a recruitment policy which includes the required checks and references. Whilst in the main this policy has been followed at the time of the inspection the three most recent recruitment files were looked at and it was found that these people had not had the required checks fully completed. The people were not working unsupervised however their Criminal Record Bureau check had been applied for but had not been returned. The home took immediate action to obtain POVA First checks and are aware of their responsibility to obtain these checks in advance of people commencing employment. Criminal Record Bureau checks must be applied for by the home and a check undertaken by another employer cannot be accepted. There were also some references that were not on file, although a verbal reference had always been obtained, it is important that written references are in place. Staff spoken with confirmed that they had completed an application form and been interviewed. It is important that when completing an application form people are asked to give a full employment history, including the months and years of employment, in this way any gaps can be identified and accounted for. 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. The management of the home should be improved by appointing a registered manager who is able to ensure that the required improvements are made and maintained at Alistre Lodge, in this way the people at the home will receive a consistent service which can demonstrate how their needs are met in a safe way. Evidence: The home is without a registered manager at present. A manager is in post who is a trained nurse, and a deputy manager has been appointed to assist her. The owner has many years experience in social care and is keen to appoint a manager who is confident in managing the demands of the care home. People spoken with during the inspection considered the current manager to be approachable and fair. It is important that a registered manager is in place at the home, who is able to bring about the required improvements in care planning and administration at the home. The home has recently renewed its Investors in People Award which is an external quality assurance award. The people spoken with and who completed questionnaires Care Homes for Older People Page 23 of 29 Evidence: felt that their views were sought and listened to. The homes policies and procedures are kept under review. In the past the home has been quick to respond to any requirements and recommendations, although the requirements of the most recent inspection which took place in March 2009 have not been fully implemented and monitored. The owner is keen to ensure these are now fully actioned and that the home meets all requirements. At present the manager of the home is not an appointee for any person living at Alistre Lodge. There are systems in place, including an inventory, which ensures safe keeping of valuables on behalf of people living at the home. The information provided by the home indicates that all required health and safety checks are up to date. The electrical certificate was seen and the lift maintenance record and this showed that routine servicing is being carried out. There is a record of accidents maintained. A new staff member spoken with confirmed she had completed an induction which covered heath and safety, but as yet had no formal training in Fire Safety. The owner must ensure that all staff receive regular training in health and safety topics. 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 7 15 Care plans must be kept under review. This will ensure that the care plan accurately reflects the persons health and social care needs. 03/05/2009 2 7 13 The registered person must 03/05/2009 make suitable arrangements to provide a safe system for the moving and handling of people living at the home. Any unnecessary risks to the health or safety of people living at the home must be identified and so far as possible eliminated. This will promote the health and safety of people living at the home and ensure that staff assist in safe ways. 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 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 7 15 Each person must have a plan of care which is kept under review. The health and personal care needs of each person must be clearly identified in a care plan and guidance provided to ensure care needs are met in a consistent and safe way. The care plan must be kept under review and updated as needed. 29/09/2009 2 7 13 The registered person must 29/09/2009 identify any unnecessary risks to the health and safety of people living at the home and so far as possible eliminate these risks. This will promote the health and safety of people living at the home and ensure staff have guidance to provide a safe environment in which 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 risks are effectively monitored and managed. 3 8 12 The registered person must 29/09/2009 ensure that the care home is conducted so as to make proper provision for the care and treatment and supervision of people living at Alistre Lodge. The treatment received by people should be kept up to date and should ensure that people receive the treatment they need as prescribed or indicated by their care plan. 4 29 19 The registered person must 29/09/2009 ensure that the information and documentation required is in place before a person commences work at the care home. Written references and a satisfactory Criminal Record Bureau Disclosure or POVA First check must be obtained before a staff member commences employment at the home. 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 12 Care plans should contain a social history which recognises 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 life experience of people who come to live at Alistre Lodge. 2 29 A full employment history should be obtained and any gaps in employment satisfactorily accounted for before employing a member of staff. The registered person should appoint a manager who can be registered, who will ensure that the required improvements are actioned and monitored. The registered person should ensure that the required action is taken in response to CQC reports. 3 31 4 33 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!