Inspection on 05/05/09 for Alston House

This inspection was carried out on 5th May 2009.

CQC found this care home to be providing an Poor 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 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Alston House 22/06/09

Alston House 22/06/09

Alston House 04/06/09

Alston House 04/11/08

Alston House 03/06/08

Alston House 12/12/07

Alston House 19/09/07

Alston House 19/04/06

Alston House 12/12/05

Alston House 22/08/05

Alston House 22/11/04

Alston House 20/07/04

Similar services:

Applegarth

Trevayler Residential Care Home

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Alston House 380 Aylestone Road Leicester Leicestershire LE2 8BL     The quality rating for this care home is:   zero star poor 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: Diane Butler     Date: 0 5 0 5 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 32 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 32 Information about the care home Name of care home: Address: Alston House 380 Aylestone Road Leicester Leicestershire LE2 8BL 01162915601 01162915611 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Margaret Madden care home 19 Number of places (if applicable): Under 65 Over 65 19 19 19 2 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category sensory impairment Additional conditions: 0 0 0 0 Service user numbers. No person falling within categories OP, MD(E) or DE(E) may be admitted to the home when 19 persons of categories/combined categories OP, MD(E), DE(E) are already accommodated within the home. Service user numbers. No person falling within category SI(E) may be admitted to the home when 2 persons of categories/combined categories SI(E) are already accommodated within the home. The maximum number of persons to be accommodated at Alston House is 19. Date of last inspection Brief description of the care home Alston House is a care home for older persons, providing accommodation and personal care for up to nineteen residents some of whom have mental health needs, dementia and/or a sensory impairment. Care Homes for Older People Page 4 of 32 0 4 1 1 2 0 0 8 Brief description of the care home The home is situated on the Aylestone Road in Leicester approximately 15 minutes away from the city centre. There are shops within five minutes walking distance from the home and there is a small park nearby. Accommodation is on two floors with the upper floor accessed by lift or stairs. There are three lounges, two dining room areas and a conservatory on the ground floor. The home offers both single and shared bedrooms some of which come with ensuite facilities. A large parking area is to the front of the home and there is a wellmaintained secure garden to the rear of the home. Current charges range from £360.00 per week to £400.00 per week. Additional charges are in place for hairdressing, chiropody treatment and transport to appointments. Details of all charges can be found in the homes Statement of Purpose document, (a document which provides relevant information about the home) which is given to everyone living in the home and those interested in living in the home. A copy of the latest Inspection report is available at the home, or it can be accessed via the CQC website: www.cqc.org.uk. Further information about the home is available from the acting manager. Care Homes for Older People Page 5 of 32 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: zero star poor service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 0 star. This means the people who use the service experience poor outcomes. This key inspection took place over one day in May 2009. We (the Care Quality Commission or CQC) arrived at the home on Tuesday 5th May at 9.20am and completed the visit at 4.15pm. The inspection was unannounced and this means the service was not aware that we were coming. When undertaking key inspections CQC focuses on the outcomes for people receiving a service. In order to do this we case tracked three people receiving care and support. This means we checked records, spoke with them where possible and spoke to the care Care Homes for Older People Page 6 of 32 workers providing the care and support. Where communication was difficult observation was used to evidence whether care needs were being met. Surveys were sent to eight people living at the service and their relatives and six members of staff to gather further views of the home and the service provided. None had been returned prior to this report being written. Further planning for the site visit included checking the service history of the home and last inspection report and looking through the AQAA document (Annual Quality Assurance Assessment), which was submitted to the CQC prior to the visit. The AQAA document is the main way that providers inform us of how well their service is delivering outcomes for the people using it. We checked all the standards that the CQC has decided are key standards during this inspection. The information below is based only on what we checked in this inspection. We have kept details about individual people out of the report to make sure we respected their confidences. What the care home does well: What has improved since the last inspection? What they could do better: Ensure that care plans include all the needs of the people living in the home and the actions to be carried out by the care workers to meet those needs. Care workers need to know the tasks they are to carry out in order to meet the persons needs. Ensure that risk assessments contain all the risks presented to both the person being cared for and the staff. Care workers need to be aware of all the current risks to the people living in the home and the actions to take to minimise those risks. Ensure that all medication records are appropriately maintained, kept up to date and are accurate People living in the home need to be protected by robust polices and procedures within medication management. Ensure that daily records are kept up to date and are accurate. People need to be protected by accurate and up to date records, including care plans, risk assessments Care Homes for Older People Page 8 of 32 and fluid and food charts. Ensure that the areas of the home identified as of need of decoration are done so in a timely manner. Recommence the quality monitoring systems that are in place including questionnaires for people living in the home and their relatives in order to get their views of the service provided. Provide liquidised meals in an attractive and appealing manner to maintain appetite and nutrition. When assisting people with their nutritional needs staff need to be aware of the name of the person they are assisting in order to treat them as an individual and promote their dignity. Involve care workers with the monthly reviews of the care plans. Care workers would benefit greatly from being involved in this process. Ensure that all staff are aware of the importance of people using their own toiletries and not sharing with others. Ensure that the complaints file is accessible. The acting manager needs to be aware of any concern made. Give people access to the conservatory so that they can enjoy this space on a daily basis and not only when visitors call. Ensure that people can access money and valuables held on their behalf at any time and records kept are up to date and accurate. Ensure that there is a robust recruitment proceedure in place which includes the appropriate retention and storage of pre employment checks. 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 9 of 32 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 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are assessed before they move in, in order to identify their individual care and support needs. Evidence: People interested in living in the home are provided with relevant information before they move in. They are invited to look around the home to see what it has to offer and each person is given a copy of the Statement of Purpose/Service User Guide. This document tells the reader about the facilities the home has to offer and relevant charges for both living at the home and extra charges made for things like hairdressing and toiletries. One person spoken with explained that they had been able to visit the home prior to moving in, they explained, I came and looked around before hand, I looked at two places and this seemed more homely. Care Homes for Older People Page 11 of 32 Evidence: We were told that peoples needs are assessed before they move into the home so that their individual needs and preferences can be met. We found the relevant assessments in place both from social workers and those completed by a member of the homes management team. People are given a copy of their terms and conditions of residency. This document provides information on how much they are to be charged to live at the home, what assistance they can expect to receive and how to make a complaint if they are not happy about something. Care Homes for Older People Page 12 of 32 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Shortfalls within care plans and risk assessments result in care and support needs not being identified and ultimately not being met. Evidence: Care plans are developed for everyone living at Alston House. These are developed from information received form the persons social worker and from information obtained during the assessment process. We found care plans for the people we spoke with and all had recently been reviewed. Not all care plans looked at were accurate and not all included all the actions the staff need to take to meet the needs of the people in their care. One care plan showed that the person required supplements as they had been refusing their food. The GP had been contacted and the person had been prescribed supplements up to three times a day. There was no information within the care plan to instruct the care workers as to when these should be given, i.e if refuses breakfast Care Homes for Older People Page 13 of 32 Evidence: give supplement, if refuses lunch give supplement,if refuses tea give supplement. We looked at the fluid and food charts being kept to see if supplements had been given and we found that they had been offered on an inconsistent basis even though it was evident that the person was refusing their food on a regular basis. A second care plan checked had been reviewed but some of the information had been duplicated and some information had been missed off, causing confusion to the reader. We saw risk assessments within the files we looked at, though not all included all the risks presented to the people living in the home or the actions staff needed to take to minimise the risks. For one person a risk assessment hadnt been completed for one of their main health care needs. Another risk assessment had identified that the person had diabetes and that blood sugar levels should be taken, but details of when and how often these checks must be carried out were not included. This shortfall was also identified at the last two key inspections in December 2007 and June 2008. The acting manager stated that she would amended the risk assessment to reflect this information. Within one risk assessment, the action to minimise the risk section read, xxxxx [the person] is to be encouraged to ask staff for assistance, even though their mental health risk assessment showed that they had no capacity to make their own decisions or know what they needed with regards to their care. Another risk assessment in place did not include the specific actions to be taken to minimise risks with regards to not drinking correct amount of fluids, dehydration. The likelihood of the risk was shown as very likely though the actions to be taken states To encourage fluids at all times. Staff need to be guided as to how many times and what fluids should be given. Fluid and food charts were being completed for the people we chose to look at. Not all of these were being completed accurately. For one person dates were omitted from the records and for another there were no records between 28th April and 3rd May 2009. We checked medication records and storage during our visit and a number of shortfalls were found. These included: One persons medication hadnt been signed into the home and no record of the stock Care Homes for Older People Page 14 of 32 Evidence: held was in place. We found a number of errors within the medication administration records where staff had given medication but not signed to say that it had been given and some medication had not been given but had been signed for as given. For one person who has diabetes there was no evidence of their blood sugar levels being monitored even though their risk assessment stated that these should be monitored. Some of the current medication administration records have the wrong dates printed on them,this means that staff are signing on the wrong days. This was identified by the acting manager and rectified, but this meant that there were large gaps between signatures, again very misleading for the reader. One of the people we spoke with was helped to have a shower during the visit. We saw that the care worker had clean towels and the persons own razor but no shaving cream or soap. Once at the bathroom we asked where these toiletries were and we were informed that there was normally some in the bathroom cupboard and was shown a can of shaving gel. When questioned further we were told that the person may have their own soap but may not. This was discussed with the acting manager as we were given the impression from the care worker that the use of shared toiletries was quite normal. We saw that health care professionals are involved in peoples care including the GP, District Nurse and Chiropodist. The person spoken with explained that they had settled in the home and was treated well. They explained, The carers are good though the youngsters can be a little brusque. I feel i have settled, they treat me well and i usually have a shower. We saw staff going about their work in a relaxed manner and heard them speaking to those living in the home in a friendly and respectful manner. Care Homes for Older People Page 15 of 32 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 living at the home are provided with a healthy balanced diet. Evidence: Choices are offered every day including when to get up and go to bed, what to have for lunch and whether to join in activities offered. One person spoken with explained: If you want to go to bed early you can, if you want to go to bed at ten you can do that as well. An activities coordinator is employed to provide activities two afternoons a week at other times staff provide activities such as ball games and cards. During the visit people were able to join in a ball game provided by the senior member of staff in the morning and gentle exercise and card and calendar making with the activities coordinator in the afternoon. We were told that the food served in the home was very good and the meal seen during the visit was hot, looked nutritious and was well presented. One person Care Homes for Older People Page 16 of 32 Evidence: explained The food is excellent, its home cooked and theres more than enough. You can always have more if you want it. For those unable to eat a solid diet, food is liquidised to enable them to enjoy the same diet as other people living in the home. The liquidised meal seen during the visit had been liquidised all together, which didnt look very attractive. If the components of the meal were to be liquidised separately this would provide a more appealing looking meal. During lunch time a number of people were assisted with their meal, as some people werent able to help themselves, they were assisted by care workers, some needed little help, whilst others needed the care workers to place the food into their mouths. A person on work experience was asked by the senior care worker to assist one of those people, which they did. When asked the name of the person they had helped the person on work experience informed us that they didnt know their name. Care Homes for Older People Page 17 of 32 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. By providing staff with up to date information on safeguarding, the acting manager has further protected the people living in the home. Evidence: We found a complaints procedure in the reception area of the home and details of how to make a complaint is included in the information given to people living at the home. The person we spoke with was aware of who to talk to if they werent happy, we were told, I would talk to the manageress, she is very pleasant, very nice. The acting manager told us that she had not received any complaints since she took up post in February this year. We asked for confirmation of this, though the complaints record was not available for checking. A concern was received by social services and CQC with regard to the general care of some of the people living at the home. This was fully investigated and the registered provider and acting manager have put in place further measures to ensure that the appropriate care and support continues to be provided. All staff have recently received information about safeguarding adults and they are currently working through a work book to ensure that they have the knowledge to Care Homes for Older People Page 18 of 32 Evidence: identify any act of abuse or neglect. We spoke to a care worker on duty during the visit and they were aware of the actions they should take should they suspect any form of abuse was taking place. We were told that all staff working at the home were to receive a copy of the whistle blowing policy to further strengthen their understanding of safeguarding adults. Care Homes for Older People Page 19 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with a comfortable place to live, which will be further enhanced by the decoration of the shower area and personal rooms of the people living there. Evidence: We looked at the communal areas of the home and found them to be appropriately furnished and decorated. There is one main lounge and a further two smaller lounges available for people to use and a conservatory at the rear of the home is currently used for visitors to meet privately with their relatives. We visited one persons room who had recently moved in to see what it was like. They were satisfied with the accommodation explaining, I had a choice of room and chose the one i wanted, its big enough for me. We did note that the room hadnt been redecorated before the person had moved in. The acting manager acknowledged this and explained that this was something that they were addressing. The room included an ensuite toilet and wash basin, this area would also would benefit from a repaint. We checked the bathroom that was being used and found that this area needed some attention. Mouldy bath mats and stained sponge were found in the shower area and Care Homes for Older People Page 20 of 32 Evidence: the flooring needed attention. The acting manager agreed that this area needed looking at and attending too. A new floor covering has been laid in the main lounge and this area has also been redecorated. There is a small secure garden to the rear of the home which people can enjoy. Care Homes for Older People Page 21 of 32 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. The acting managers commitment to training will ensure that staff have the knowledge and experience to carry out their roles effectively. Evidence: Four new members of staff have started working at the home since our last key inspection visit in June 2008. We looked at three files to see if the necessary checks had been carried out. All included a POVA (Protection of Vulnerable Adults) check. These are completed to make sure that the person is suitable to work with older people. On checking the dates we saw that two were dated prior to the care workers start date but one was dated two days after their start date. The staff rota also showed that the person was on duty prior to the date on the POVA check. We were told that the POVA had in fact been received prior to this but the confirmation email had been accidentally deleted.Therefore a second POVA request was requested which was dated two days after the persons start date. No written evidence was available to support this. We saw that new staff had been provided with induction training so that they had the knowledge needed to carry out their roles effectively and a number of training courses Care Homes for Older People Page 22 of 32 Evidence: have been sourced, these include dementia awareness, infection control, safe handling of medicines and healthy eating. Of the sixteen care workers currently employed, twelve have completed their NVQ level 2 (National Vocational Qualification) and the acting manager explained that the remaining care workers were signing up to complete this qualification shortly. On the day we visited there were three care workers and the acting manager on duty. One care worker spoken with told us that they felt that there were sufficient numbers of staff to provide the care and support needed and staff went about their work in a relaxed and unhurried manner. Care Homes for Older People Page 23 of 32 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. Not all records required by regulation for the protection of the people living at the home are up to date or accurate. Evidence: At the time of the visit the home was without a registered manager. The acting manager has many years experience as a care manager and has completed her National Vocational Qualification level four and Registered Managers Award. We were told that the acting manager was supportive and always available to talk too should anyone have a concern. One person explained, I would talk to the manageress about any concern i had. We tried to look at the money currently held on behalf of the people living in the Care Homes for Older People Page 24 of 32 Evidence: home, however we were informed that the key to the safe had been misplaced and so we couldnt get access to it. The acting manager explained that the records would not currently tally with the money held due to not being able to access the money. A locksmith had been contacted and they were hoping to have access in the next day or two. Not all the records seen on this occasion were up to date or accurate, these included care plans, risk assessments and fluid and food charts. Care workers are provided with fire safety training when they start working at the home and the acting manager is currently completing a five day moving and handling train the trainer course so that she can provide on the spot moving and handling training to all the staff. We were told that quality assurance questionnaires are not currently used to gather the views of the people living at the home.This is something that the acting manager is looking to relaunch so that everyones views can be gathered and acted on. Care Homes for Older People Page 25 of 32 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 13(4)(C) The registered person shall ensure that: Unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. The registered person must ensure that risk assessments are thorough in content and include all the possible risks associated with the identified task/risk. Care workers need to be aware of all the current risks to the residents and the actions to take to minimise those risks. 18/06/2008 2 7 15 (1) The registered person shall, after consultation with the service users, or a representative of his, prepare a written plan as to how the service users needs in respect of his health and welfare are to be met. The registered person must ensure that all care plans show the assessed needs of the residents and the actions to be taken by the staff to meet those needs. 18/06/2008 Care Homes for Older People Page 26 of 32 Care staff need accurate information in order for them to meet the needs of the residents in their care. 3 9 13(2) The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. 1. The registered person must ensure that all medication received into the home is appropriately recorded and medication records are up to date and accurate. 2. The registered person must ensure that all medication is stored in line with legal requirements. Residents need to be protected by accurate medication management, storage and record keeping. 18/06/2008 4 37 17(1) The registered person shall maintain in the care home the records specified in Schedule 3. and ensure that these are kept up to date. The registered person must ensure that daily records are up to date and accurate. Residents need to be protected by accurate and up to date records including daily records and accident records and staff need to be 18/06/2008 Care Homes for Older People Page 27 of 32 made aware of accidents that happen in the home. Care Homes for Older People Page 28 of 32 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 Ensure that all identified needs are included in the care plan documentation Care workers need accurate information in order for them to meet the needs of the people in their care. 22/05/2009 2 8 13 Ensure that all risks presented to people are included in the risk assessment documentation and specific actions to be carried to minimise the risk out are recorded. Care workers must be aware of all the current risks people face and the actions they need to carry out to minimise those risks. 22/05/2009 3 9 13 Ensure that all medication received into the home is appropriately recorded and medication records are kept up to date and accurate. 22/05/2009 Care Homes for Older People Page 29 of 32 People need to be protected by accurate medication management and record keeping. 4 9 13 Ensure that only trained and 22/05/2009 competent people administer medication. The provider must be confident and ensure that those responsible for the administering of medication are suitably trained, knowledegable and competent in the tasks they are to perform. 5 15 13 Ensure that when people are 22/05/2009 prescribed food supplements instructions for use are included in care plan and risk assessment documentation. Care workers need direct information to ensure that supplements are given consistently. 6 19 16 Attend to the decoration in the downstairs shower room. People need to be cared for and supported in areas that are clean homely and well maintained. 7 35 17 Ensure that access is available to money and valuables held on behalf of the people living in the home and records kept are up to date and accurate. 22/05/2009 22/05/2009 Care Homes for Older People Page 30 of 32 people need to be confident that they can access any items held on their behalf at any time. 8 37 17 Make sure that daily records 22/05/2009 are up to date and accurate. People need to be protected by accurate and up to date records. 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 7 Involve care workers with the monthly reviews of the care plans. Care workers should be fully involved in all aspects of a persons care. Ensure that all staff are aware of the importance of people using their own toiletries and not sharing with others. Provide liquidised meals in an attractive and appealing manner to maintain appetite and nutrition. Ensure that those assisting people with their nutritional needs are aware of their name in order to treat them as an individual and promote their dignity. Ensure that the complaints file is accessible. The acting manager needs to be aware of any concern made. Ensure that all the areas of the home are well maintained and appropriately decorated. Give people access to the conservatory so that they can enjoy this space on a daily basis and not only when visitors call. The registered provider should recommence the quality monitoring systems that are in place including questionnaires for people living in the home and their relatives in order to get their views of the service provided. 2 3 4 10 15 15 5 6 7 16 19 20 8 33 Care Homes for Older People Page 31 of 32 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. 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