Inspection on 20/10/09 for Ambleside Residential Home

This inspection was carried out on 20th October 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.

Other inspections for this house

Ambleside Residential Home 23/06/09

Ambleside Residential Home 19/05/09

Ambleside Residential Home 06/04/09

Ambleside Residential Home 07/03/09

Ambleside Residential Home 28/04/08

Ambleside Residential Home 21/11/07

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Fairfields Country Rest Home

Poldhu

Queensmount

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Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for older people Name: Address: Ambleside Residential Home 69 Hatherley Road Cheltenham Glos GL51 6EG     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: Adam Parker     Date: 2 1 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Ambleside Residential Home 69 Hatherley Road Cheltenham Glos GL51 6EG 01242522937 01242522937 pepwalsh@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: James Christopher Walsh,Perpetual Walsh care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 18. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Ambleside is a large, detached, Victorian house that has been extended and adapted to provide accommodation for older people. It is situated in a residential area of Cheltenham close to a few shops and the bus route into town, which is approximately a mile away. The railway station is within easy reach, together with a number of churches. The accommodation is located on three floors that are all served by a shaft lift and stairs. All the bedrooms have en-suite facilities, approximately five have a bath or shower. There are three bathrooms two of which have hoists. Ground floor communal facilities include a dining room and two lounges one of which has a piano. Care Homes for Older People Page 4 of 28 Over 65 18 0 2 3 0 6 2 0 0 9 Brief description of the care home The lounge at the rear of the property is an extension of the main building and gives an all round view of the large landscaped garden. A patio area provides a pleasant place for service users to sit in warmer weather. The provider supplies information about the home, including the most recent CQC report to current and prospective residents on request. The fees range from 250.49 pounds per week for local authority funded residents and 610 pounds per week for privately funded residents. Hairdressing, chiropody and any personal items are charged extra. The costs of these services are available as required. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. The visit to the service included a tour of the premises, examination of documentation and medication systems and discussions with residents, staff and management. The inspector was joined on the first day of the inspection visit by an expert by experience. A person who, because of their experience visits a service with an inspector to help them get a picture of what it is like to live in or use the service. As well as the manager the inspector spoke to two residents and two members of staff. The expert spoke to eight residents and one visitor to the home. The expert commented I found Ambleside Residential Home to be a place where some improvements have clearly been made. The manager has been in post since June Care Homes for Older People Page 6 of 28 of this year and is proactive in making changes in staffing, talking to clients and assessing the physical environment so safety and comfort is improved. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information from funding authorities has in the past been inadequate and has not been obtained in a timely fashion. Therefore the home has been unable to make a full assessment of the needs of some residents so that they cannot be sure they will receive the care they require. Evidence: Following previous requirements, a number of fees invoices were looked at. Improvements had been made to the information given to representatives of residents on invoices for fees payable to the home in terms of what the fees covered. No residents had moved into the home since the previous key inspection. The expectations regarding collecting information and making an assessment of the needs of any prospective future residents was discussed with the manager of the home during the inspection visit. Care Homes for Older People Page 10 of 28 Evidence: The home does not provide intermediate care and so standard six does not apply. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There has been an improvement in the quality of care plans and in the management of residents medication. However further work still needs to be done in terms of managing medication and personal care to ensure that residents needs are fully met. Evidence: Since the previous inspection there had been an improvement in care plans. All of the residents except for one had new care plans written. Generally these gave clear and detailed instructions for staff to follow to meet residents needs. A good example of a care plan for meeting a residents personal care needs took into account the residents preferences and detailed the number of staff needed to meet various care needs. Some care plans were clearer than others and checks should be made to ensure that they are all to the same standard. Members of staff spoken to commented on the improvement in the quality of the new care plans. Residents had been receiving input from health care professionals with visits and input recorded from General Practitioners (GPs), chiropodists and community nurses. A community nurse was giving residents influenza vaccines and GPs were visiting Care Homes for Older People Page 12 of 28 Evidence: residents in the home during the inspection visit. Residents were also attending hospital appointments although it was noted that two letters about individual hospital appointments we displayed on a notice board in the dining room. This was brought to the attention of the manager and these were removed. Risk assessments had been completed for a variety of risks to residents such as choking and falls. The condition of some residents fingernails was looked at and these were found to be clean although one resident had jagged fingernails that were in need of attention. The manager described a reluctance on the part of some care staff to cut residents fingernails as if these were cut too short this may be perceived as abuse. It was pointed out that where a residents fingernails were not attended to this could be seen as neglect. The manager identified a member of night staff who had suitable skills to attend to the residents jagged fingernails. In addition a document looked at during the inspection visit described a visit by the registered provider in October 2009 where another resident was found to have dirty fingernails.The issue of caring for residents, fingernails has been raised previously with the home on still needs on going monitoring. Medication storage and administration records were looked at. Medication was being stored securely and records showed that correct storage temperatures were being maintained. Medication containers had also been dated on opening as an indication of their expiry date. Controlled medication was also stored correctly with appropriate record keeping. Apart from a topical cream for one resident there were no gaps in the recording of the administration of medication and where this had been omitted then codes explaining reasons were in use. Further investigation of the lack of recording for the topical cream by the manager found that the medication had not been ordered in a timely fashion. Some handwritten directions on the medication record had not been signed dated or checked and signed by a second member of staff although other examples were found where this practice had been followed. Medication audits were in place in the form of daily tablet counts which were recorded on the medication record and weekly checks. Staff who administer medication to residents have received training as well as competency checks. Some staff were currently undergoing medication training although no more staff had been added to the list of those assessed as competent to administer medication. The manager reported that there were no residents administering their medication at the time of the inspection visit. Residents spoken to during the inspection visits confirmed that staff knocked on doors before entering rooms and were polite to them. The home had one room that was shared by two residents and dividing curtains were in place as an aid to privacy. Care Homes for Older People Page 13 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents able to maintain contact with family and friends although there are limited activities provided and little contact with local community groups so that residents do not enjoy the levels of social interaction that they wish. Meals were clearly enjoyed by the majority of residents. Evidence: Activities in the home generally consisted of visits from musical entertainers, quizzes and bingo. The mobile library service had also visited the home, and one resident attended a day centre. Residents were spoken to about the activities and commented there is nothing to do, we just sit here all day, sometimes a music man comes in. they took me to feed the ducks once, I used to love walking and once the owner took us all out. The manager confirmed that with the exception of the delivery of daily papers, a twice weekly guitar session and the cook spending extra time doing crosswords with residents, no other organised activity is provided. In conjunction with relatives, social histories had been compiled for some residents, which may provide information for planning suitable activities. The Expert by Experience commented There is so much scope for activities to take place at Ambleside. And also the potential for residents to express their areas of interest and the space inside and out to provide fulfilling recreation. Holy Communion is provided in the home fortnightly Care Homes for Older People Page 14 of 28 Evidence: for residents who follow an Anglican faith and separately for those who follow a Roman Catholic faith. Since the previous inspection the knowledge of residents religious and spiritual needs has increased in the home and has resulted in more contact for some residents with representatives of their faith. In the dining area there was a notice board that contained information largely of value to staff, in addition another noticeboard was situated in a narrow corridor and right outside of a toilet. The positioning and content of these noticeboards should be reviewed in the interests of residents. The home has a policy of open visiting and residents were receiving visitors as well as spending time with family members outside of the home. The home had no contact with any local community groups, this was discussed with the manager who identified this as an area for improvement. The home has information about advocacy services available if this should be needed by residents. Individual rooms showed various degrees of personalisation where residents had brought in their own possessions. The home has a menu that runs on a four weekly basis. A cooked lunch is provided and in the evening supper consists of sandwiches. Residents who were asked gave positive comments regarding the meals offered although one described the meals as adequate. During lunchtime a member of staff was observed to be feeding a resident in an inappropriate manner. The staff member was standing over the resident rather than sitting alongside her. This took place immediately in front of the main door into the dining room. This was raised with the manager who was aware that this was not acceptable practice.The daily menu is displayed on a white board in the dining area. A staff member spoken to commented that the standard of meals in the home had improved. Care Homes for Older People Page 15 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Despite previous allegations of abuse towards residents, work has been carried out in the home to increase staff training, handle complaints correctly and to provide an environment where residents can feel safe. Evidence: Since the previous inspection complaints received by the home had been organised into a file with information about their investigation and outcome recorded on a document on the homes computer. This document was checked during the inspection visit and showed the investigation of five complaints from July to August 2009. The homes complaints procedure was clearly displayed in the entrance hall with the new name and contact details for the Commission added to the policy. One resident spoken to confirmed that they knew who to approach in the home if they were unhappy with anything. The manager had undertaken training in the Mental Capacity Act 2005 although at the time of the inspection visit no staff had attended this training. The homes adult protection policy was updated during the inspection visit to include the specific contact details of relevant agencies such as the local authority adult protection unit and the Commission. There had been no referrals to the local authority adult protection unit since March 2009. Care Homes for Older People Page 16 of 28 Evidence: All staff had received adult protection training although it was reported that some staff were due refresher training in this subject. Staff spoken to confirmed the training that they had received. Care Homes for Older People Page 17 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although residents have the benefit of living in a generally well-maintained and clean environment, improvements in a number of areas would be of benefit to residents. Evidence: A tour of the premises revealed that the home was generally clean, well decorated and well maintained. There was an odour in one room although the manager described how the resident was moving to another room on a temporary basis while new flooring was being fitted. Work was also to be carried out to improve the situation with heat in the room which was situated over the central heating boilers and laundry. The resident was spoken to and was happy with this arrangement. Communal areas consisted of a lounge at the front of the home, a dining room adjacent to the kitchen and a rear lounge that was particularly light and overlooked the extensive rear garden. The front lounge had been improved since the previous inspection with the addition of net curtains a mirror and pictures. This lounge was not used by residents as much as the rear lounge although one resident described how she liked to make use of it on some afternoons. Consideration should be given to removing the home telephone from this room which due to its loud ring tone would interrupt the use of the room by residents. Outside there were two patio areas accessible to residents. The large garden beyond was not easily accessible by most residents and consideration should be given to future arrangements that would make this area more accessible. Care Homes for Older People Page 18 of 28 Evidence: Since the previous inspection,communal toilets on the ground floor had been clearly marked with pictorial signs. Residents individual rooms had also been marked with their names. Individual rooms showed various degrees of personalisation and were clean. The blinds in one of the rooms on the top floor had been repaired since the previous inspection. Rooms had locks fitted on the doors suitable for residents use and lockable drawers were available. One resident spoken to had been unhappy about the cleanliness of their room although some action had been taken to remedy this. The same resident was also awaiting redecoration of her room and was unhappy that this was taking a long time to organise. In addition it had been identified that alterations to the en suite facilities would aid the residents capacity for self car. Work had not started although some marks had been made on the wall where the washbasin would be repositioned.The importance of this work was discussed with the manager on the first day of the inspection visit. By the second day the manager reported that the registered provider had indicated that the work would go ahead. It was also found that the lighting in the room was not strong enough for the resident to read in the evening. The manager was advised to look at the lighting in the room. A review should take place of the lighting in all residents rooms to check that it is bright enough for residents needs. Radiators in residents bedrooms were covered as well as two radiators in communal areas that had been covered to protect residents from accidental burns. The laundry was tidy and well organised. Hand washing facilities were available in the laundry and in a number of other locations in the home. Care Homes for Older People Page 19 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Despite an improvement in recruitment practices and staff training there is still some work to do to ensure that residents are fully protected and cared for by a fully competent staff group. Evidence: Staffing in the home is arranged so that on a typical day there are three carers from eight am until five pm with the manager. At five pm there are two care staff until eight pm when there are two waking night staff. Ancillary staff consist of a cook, a cleaner and a maintenance man who is employed on a sessional basis. Based on information supplied during the inspection visit the home had six out of fifteen care staff trained to NVQ level 2 or above. Records for recently recruited members of staff were examined. Staff had been recruited with Criminal records bureau checks and written references although other information had not been obtained before some staff were employed in the home. This included full employment histories, medical checks and photographs. A recruitment audit was in place and had picked up on a number of these shortfalls. However the information was missing when staff were being considered for employment and must be obtained before they are employed in the interests of protecting residents through robust recruitment procedures. Since the previous inspection there had been an Care Homes for Older People Page 20 of 28 Evidence: improvement in the approach to information on Criminal Records Bureau Checks with risk assessments in place and appropriate action being taken in the case of one person employed by the home. As at the previous inspection new staff had still not received induction training to the nationally recognised Common Induction Standards. However training to these standards was planned for November 2009. One resident stated that staff are kind and helpful; another said they always do their best. Care Homes for Older People Page 21 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although the management of the home has improved, further development of quality assurance systems and some safety checks will ensure that the home is being run in the interests of residents safety and wellbeing. Evidence: The manager started work at the home in 2009. He has previous experience of managing care homes for people with a learning disability and has achieved the registered managers award. There had been a delay in submitting an application to register as manager of the home. At the time of the inspection visit the home has been without a registered manager for over two years. Quality assurance in the home consisted of a number of audits. In addition reports of visits by the registered provider under the care homes regulations had resumed. Reports dating from April to September 2009 were looked at, these reports covered a number of areas about the operation of the home although they did not specifically demonstrate that residents, their representatives and staff had been consulted during Care Homes for Older People Page 22 of 28 Evidence: the visits. Further quality assurance was under development with the introduction of satisfaction surveys. The manager described how one survey had been recently tested with the relative of a resident. There were also plans for the monitoring of accidents in the home. The arrangements for looking after residents money in secure storage was looked at and were satisfactory. A check on the money held for two residents showed this to be accurate in relation to their records. Staff had received training in fire safety, first aid, manual handling, food hygiene, infection control and health and safety. However some of the newer staff had not yet had training in infection control or fire safety and the manager stated that this was to be arranged. Window restrictors are fitted to windows on the first and second floor of the home and although it was reported that checks on these were made there were no records of these. There were also no records available of checks on the temperatures of hot water outlets. It was reported that the central heating system had been serviced in 2009 although the manager was having some trouble obtaining the relevant documentation from the heating engineer. Portable electrical appliances had been checked in March 2009 and hoists in December 2008. The electrical wiring was due for a check and the manager reported that he had obtained a quote for the work to be done. Work had been carried out in respect of any potential risk to residents from Legionella with the latest test on the water carried out in August 2009. The home has kept a regular check on hot water temperatures both in individual rooms and communal bathrooms. The manager had recently completed a fire risk assessment for the home. The home had received a recent visit from the environmental health department of the local authority although no documentation relating to this was looked at during the inspection visit. The home did not have a security risk assessment,this was discussed with the manager and is recommended following recent criminal activity in the area affecting care homes. The storage of cleaning materials was checked apart from one bottle with a handwritten label, all containers displayed their correct original labels. Care Homes for Older People Page 23 of 28 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 29 19 The registered person must ensure that before a person starts work in the home, all the information and documents specified in Schedule 2 of the Care Homes Regulations are obtained. This is to safeguard people from possible harm. 17/04/2009 Care Homes for Older People Page 24 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 Residents medication must be ordered in a timely fashion. This is so that residents can always be given the medication that they are prescribed. 31/12/2009 2 22 23 Priority must be given to completing any adaptations to the environment that assist a residents own ability for self care. This is to promote residents independence. 31/12/2009 3 29 19 The registered person must ensure that before a person starts work in the home, all the information and documents specified in Schedule 2 of the Care Homes Regulations are obtained. This is to safeguard people from possible harm. 31/12/2009 Care Homes for Older People Page 25 of 28 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 4 33 26 Reports of visits by the registered provider under regulation 26 must demonstrate that there has been consultation with residents, their representatives and staff. This is so that the registered provider can check that the home is being run in the interests of residents. 31/12/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 3 Full information should be received from any funding authority before consideration is given as to whether the home can meet the needs of any prospective resident. Care plans should be checked to ensure that they set out in detail how residents needs are to be met. Information about individual residents medical appointments should not be displayed on noticeboards. There should be closer monitoring of the condition of residents fingernails so that appropriate care can be given. Handwritten entries on medication records should be checked and and countersigned by a second member of staff. Medication records should be checked for any gaps in the recording of medication administration and if any are found these should be investigated. Review the positioning and content of noticeboards in communal areas of the home to provide suitable information for residents. 2 3 4 5 7 8 8 9 6 9 7 12 Care Homes for Older People Page 26 of 28 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 8 9 12 13 A wider range of activities should be provided for residents both inside and outside of the home. Consideration should be given to involving local community groups in the home taking into account residents, preferences. Checks should be made that all staff are aware of the homes expectations about how residents are assisted to eat meals. Staff should receive training in the Mental Capacity Act 2005. The garden should be made more accessible to residents. Give consideration to removing the home telephone from the front lounge. Review the lighting in all residents rooms to ensure that it is bright enough for their needs. Continue to work towards improving the level of staff NVQ training in the home. New staff should receive induction training to the nationally recognised Common Induction Standards. Continue to develop the quality assurance system in the home to ensure that it is robust enough to check that the home is operating in the interests of residents well being. Keep a record of checks on window restrictors. Check that all cleaning materials are stored in their original or in correctly labelled containers. Keep a record of checks on hot water temperatures. Complete a risk assessment for the security of the premises. 10 15 11 12 13 14 15 16 17 17 19 20 25 28 30 33 18 19 20 21 38 38 38 38 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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. Care Homes for Older People Page 28 of 28 - 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. 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