Inspection on 06/04/09 for Anglebury Court

This inspection was carried out on 6th April 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Anglebury Court 30/07/09

Anglebury Court 02/04/08

Anglebury Court 19/07/06

Anglebury Court 18/10/05

Anglebury Court 09/06/05

Anglebury Court 10/01/05

Anglebury Court 29/06/04

Anglebury Court 19/02/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Anglebury Court 21 Bonnets Lane Wareham Dorset BH20 4HB     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: Jo Johnson     Date: 0 6 0 4 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 31 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 31 Information about the care home Name of care home: Address: Anglebury Court 21 Bonnets Lane Wareham Dorset BH20 4HB 01929552585 01929551984 c.fairlie@dorsetcc.gov.uk 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) : Dorset County Council care home 36 Number of places (if applicable): Under 65 Over 65 0 36 dementia old age, not falling within any other category Additional conditions: 36 0 The maximum number of service users who can be accommodated is 36 The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) Dementia (Code DE) Date of last inspection Brief description of the care home Anglebury Court is a purpose built facility situated within level walking distance of the centre of the small town of Wareham which has shops, a cinema, library, churches etc. Anglebury Court is located next to the local Social Services Offices and a day centre. The home benefits from some of the day centre facilities, particularly transport for social outings. The home accommodates up to 36 older persons including 15 specialist dementia places, 31 in permanent beds and 5 short term care places. Care Homes for Older People Page 4 of 31 Brief description of the care home All accommodation is on ground floor level; there are 28 single bedrooms and 4 double bedrooms. All bedrooms have en-suite shower rooms with toilet and washbasin. The home is arranged on a unit basis incorporating 4 bungalows with a central service corridor known as The Street. Each bungalow has 7 single and one double bedroom, one bathroom and a lounge/dining room with kitchenette. There are 2 laundry rooms, each shared by 2 bungalows. Up to date fee information may be obtained from the service. Care Homes for Older People Page 5 of 31 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 focus of inspections undertaken by us is upon outcomes for people who live at the home and their views of the service provided. This process considers the homes capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. This report uses information and evidence gathered during the key inspection process, which involves a visit to the home and looking at a range of information. This includes the service history for the home and inspection activity, notifications made by the home, information shared from other agencies and the general public and a number of case files. Care Homes for Older People Page 6 of 31 The manager distributed surveys to people who live at the home, staff and professionals. Six surveys from people, eight staff and three professional surveys were returned. The findings of these surveys have been included in the report. This inspection visit was unannounced (we did not let the home know that we were coming) and took place on 6th April between 9.30 am to 5 pm. The inspection involved: observations of and talking with people who live at the home, relatives, the staff on duty and the management team. Five people were identified for close examination by reading their care plan, risk assessments, daily records and other relevant information. This is part of a process known as case tracking, where evidence is matched to outcomes for people. A tour of the environment was undertaken, and home records were sampled, including staff training and recruitment, health and safety, and staff rotas. This inspection was carried out by one inspector, but throughout the report the term we is used, to show that the report is the view of the Care Quality Commission. What the care home does well: What has improved since the last inspection? What they could do better: Since the last inspection in April 2008, there has been deterioration in the quality of the service provided by the home and on the outcomes and the safety and well being of some of the people who live there. Accurate full assessments need to be completed for people when they come for respite, move into or return to the home from hospital. Peoples care plans need to be reviewed, kept up to date, and include all the individuals needs identified in their assessments. Any areas of risk identified for an individual need to be assessed and these Care Homes for Older People Page 8 of 31 assessments must include nutrition, moving and handling, pressure areas, behaviour and falls. Accurate care records need to be maintained for people.This is to demonstrate that people are being provided with the care and support they have been assessed as needing. All allegations of abuse need to be referred to the local authority and the commission. This is to make sure that any allegations are appropriately investigated and actions taken to safeguard people living at the home. The overall management of the home needs to improve, and develop effective ways of assessing and monitoring the quality of the service. This is so that shortfalls are identified, are improved on and the quality of the service is kept under constant review. Regulation 37 notifications must be made for all events that effect the well being of people living at the home. This is to ensure that the home is effectively monitoring and reporting incidents in the home. 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 31 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 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are moving into or returning to the home cannot be sure that all of their needs will be assessed and planned for so they cannot be confident that the home can meet all of their needs. Evidence: The assessments for five people were looked at. This included the most recent permanent admission to the home and two people who were readmitted from hospital. The six surveys from people told us they had enough information about the home before moving in. The registered manager told us that they or a Senior Care and Community Services Officer (SCCSO) undertakes a pre admission assessment before determining whether they can meet someones needs. All of the people had assessments completed by Care Homes for Older People Page 11 of 31 Evidence: Dorset County Council care managers before they moved into the home. A preadmission assessment was seen for the last person who moved into the home. One person who has become much frailer and dependent following a hospital admission did not have their assessment updated to reflect their current needs. The care records told us that the hospital had telephoned with their concerns that no-one from the home had been to reassess the individual before they returned home. Another person who had also recently been in hospital did not have their needs reassessed nor was there an updated assessment in their care records. The wording in the assessment format assumes that all people have a marital status. People may have partners and or different important relationships in their lives. This should be included in the assessment format so that peoples individual important relationships are acknowledged. Care Homes for Older People Page 12 of 31 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. Care plans and risk assessments do not identify and or consistently describe the actions necessary to meet the identified needs of people living in the home, which puts them at risk of not having their needs met. Evidence: Five peoples care records were looked at. Dorset County Council has a standard assessment, care planning, risk assessment and daily recording system. The information gained from the initial assessments should identify needs that must be risk assessed and planned for. The shortfalls identified mean that elements of peoples lives are not up to date, risk assessed or planned for in sufficient details for staff to be able to meet their needs. For example: One person who presents challenging physical and sexually inappropriate behaviours to other people and staff had no specific plan as to how to manage these behaviours. There was no clear analysis of incidents as requested by the Community Psychiatric Care Homes for Older People Page 13 of 31 Evidence: Nurse. The care plan did not detail how staff were to support this individual with personal care or include an accurate pressure area risk assessment. Two people had lost weight and nutrition charts had been started, it was not clear from care records what actions had been taken to follow up on this weight loss. One person recently discharged from hospital is dependent on staff for all aspects of their care and moving and handling. Their moving and handling and pressure area risk assessment had not been updated. Another person who uses a turntable and hoist did not have a risk assessment in place to reflect this. One person who is doubly incontinent and often refuses personal care had a risk assessment that identified them as low risk. They have since developed a pressure area. Overall the care plans and risk assessments seen were inadequate and did not detail the actions staff needed to take to care for people. However, one person who previously used cot sides did have an updated risk assessment to reflect their change in circumstances. The care plans seen had very little or no life history information about the individuals. The daily care records were seen. It was not clear in these records what actions had been taken to follow up on incidents or health concerns identified in individuals record. There were gaps in the fluid and nutrition charts seen. There was not any clear way of collating or monitoring the information for each individual to ensure that people are getting the care and support that they need. There was some evidence in some peoples care records that they have access to health care and relevant health care professionals such as GP, dietician, dentist and specialist consultants and chiropodist. However, for some people with dementia and or complex needs it was not always evident from daily care records if people had been seen by the GP or district nurses when care staff had raised concerns with managers or recorded ongoing health concerns. Two surveys from health professionals who visit the home told us that individuals health care needs are always or usually met by the home. Care Homes for Older People Page 14 of 31 Evidence: A new central recording system has been established so that the district nurses can record about who they who seen and what they have done. This new system is in place following safeguarding investigation into the care provided to one person with a pressure sore. The manager needs to ensure that the information that is recorded in these health professionals records is transferred or reflected into the individuals monthly care summary reviews. People spoken with and three surveys told us that they always or usually receive the medical support and care that they need. Peoples preference of gender of carer for personal and intimate care is not sought during the assessment or care planning process. This information should be sought so that people preferences for personal and intimate care can be met where possible. People were generally well groomed and cared for. People spoken with said that staff always take care to make sure people are well dressed and their appearance is cared for. Staff spoken with had a good understanding of recognising people as individuals and respecting their privacy and dignity. They were observed respecting peoples privacy and dignity, by knocking on their doors and offering personal care discreetly and in private. People spoken with and surveys told us that staff treat them well and that staff listen to and act on what they say. People said and surveys included the comments the staff are wonderful and the staff are lovely we all get on well. The medication systems and administration at the home are now well managed. Medication policies and procedures are safe, with medication being stored safely, labelled correctly and administered safely. Only the Senior Care Community Services Officers and night shift leaders administer medication. At the last inspection the controlled drugs records did not balance with the stock. Another manager from the organisation completed an investigation into the error. The investigation determined that the errors had been made when discharging peoples controlled drugs following respite stays. The current controlled drugs stock and records balanced. Care Homes for Older People Page 15 of 31 Care Homes for Older People Page 16 of 31 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 in the home are supported to maintain their independence, contact with important others and lifestyle, which enhances their quality of life. Evidence: There was a relaxed and friendly atmosphere through out the home with staff and people clearly enjoying each others company. People spoken with said that their visitors were made to feel welcome whenever they visited. The manager told us that they have arranged for people to be able to worship if they choose to. There is an activities co-ordinator at the home and there is a regular programme of social activities. On the morning of the inspection there was a quiz with the activities co-ordinator and a volunteer. People actively participated in this and told us that there is a good variety of activities to suit their needs. Care Homes for Older People Page 17 of 31 Evidence: One person told us that they can join in activities if they want but that they respect that you might want to spend time doing your own thing in your room. Surveys from people told us that there are always or usually activities arranged by the home that they can take part in. There is a weekly timetable of activities and there are some photographs to show the different things that people have been doing. People spoken with said that they were free to come and go from the home as they pleased (if they are able to). They said that they made visits out to the shops, visited friends or family or other events in the community on their own if they were able or with the support of their relative or a member of staff. People spoken with and observed got up and spent their time how and where they chose. Some people chose to spend time in their bedrooms. The kitchen was well stocked with a variety of fresh and long-life foodstuffs. We joined people for lunch, the atmosphere was relaxed and there were enough staff to serve the meal at a suitable pace. All meals were served hot and any support needed from staff was given discretely and sensitively. People spoken with and surveys told us that they enjoy the food and said there are always choices available. People choose their meals the evening before. They told us that this means that they do not always remember what they have ordered. Menu boards or large print menus would assist people in remembering what they have chosen. Care Homes for Older People Page 18 of 31 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 poor 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 can be confident that their concerns will be listened to and acted upon. The staff and managers failure to recognise what constitutes abuse and not making adult protection referrals puts people living in the home at risk of not being protected from potential harm. Evidence: The complaints policy is in the service user guide and displayed in the home. From discussion with the manager and information provided in the AQAA, there have been no complaints in the last 12 months. Staff spoken with told us that they know what to do if a person living at the home or relative or friend has concerns about the home. The staff surveys tells us that do know what to do if a person at the home, relative, or friend has concerns about the home. People spoken with and surveys told us that they all knew whom they would talk to if they were unhappy or needed to complain. On person said if I had any worries or concerns I would talk to the staff and they always sort it out. Care Homes for Older People Page 19 of 31 Evidence: There have been two adult protection safeguarding referrals made to the local authority since the last key inspection. The local authority has investigated these allegations. As identified throughout the report, a number of serious concerns and incidents where identified that placed people at risk of harm to either themselves or others. One person has made inappropriate sexual contact and has been physically aggressive to people living at the home. The care records show that this person has also left the building on numerous occasions and has been returned to the home by police. Due to the poor record keeping in peoples records it was not easy to establish how many times these incidents had occurred with this individual and other individuals at the home. These adult protection and missing person incidents have not been reported to us or to the local authority under adult safeguarding procedures. The manager acknowledged the seriousness of these issues and that they had not been clearly recorded or reported. Care Homes for Older People Page 20 of 31 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 maintained and furnished so that people live in a homely, clean and comfortable environment. Evidence: This purpose built home is entirely on the ground floor. Aids and adaptations are available throughout the home e.g. grab rails, raised toilet seats, personal alarm system (to contact staff). People with particular needs have their own personal equipment to assist with their independence. We noticed that the alarm call system sounds throughout the home when someone needs assistance. There were periods of time when these call bells where not answered. The constant noise could have an impact on peoples well being and the delays in responding to or clearing the call bell system should be improved. People are encouraged to personalise their rooms with furniture and general belongings as they wish and in agreement with the home. Surveys and people spoken with told us that the home is always fresh and clean Care Homes for Older People Page 21 of 31 Evidence: On the day of the inspection the home was clean and there were no unpleasant odours. The laundry was clean and tidy and properly equipped. There was a very high standard of cleanliness throughout the home and there was evidence to demonstrate that basic training in infection control procedures are included within the initial induction programme and ongoing training plan for staff. Sluice rooms are available for staff to dispose of and clean equipment and these areas are kept clean with suitable ventilation. Care Homes for Older People Page 22 of 31 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 people living in the home are protected by robust recruitment practices and supported by a stable staff team. Evidence: Staff rotas were seen for a one-month period. The manager told us that the staffing at the home is as follows: In the mornings from 7 am there are five or six care staff. In the afternoons until 9.30 pm there are five care staff. From 9.45pm to 7.30pm there are two waking night staff. There is a duty manager on duty from 7am to 10pm and a night shift leader from 9.30 pm to 7.30 pm. In addition to this there are management, activity, catering and domestic staff. On the day of the inspection one person on respite was being supported by agency staff on a one to one basis. This was in addition to the usual staffing as the person was making repeated attempts to leave the home. There is a low staff turnover at the home and this means that people are supported by a stable group of staff that they know well. Care Homes for Older People Page 23 of 31 Evidence: Two staff files were seen including the most recently recruited staff. Files included evidence of CRB (Criminal Records Bureau) checks and PoVA (Protection of Vulnerable Adults) checks for those staff that had started work at the home. All files seen also contained two references. People spoken with and surveys told us that staff are always or usually available when they need them. Peoples surveys show that staff listen and act on what people say. Staff training records demonstrate that staff complete an induction programme. The training matrix shows that staff have attended a range of training programs. The manager informed us that all staff are to attend dementia care training within the next month. The staff and management team should receive some further training in the following areas: adult protection and safeguarding, pressure area care, moving and handling and nutrition risk management, care planning and record keeping. This is to make sure that the staff and management team have the skills and knowledge to improve on the shortfalls identified during this inspection. Care Homes for Older People Page 24 of 31 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. People who live at the home do not benefit from or live in a home that is consistently managed or that has effective monitoring systems Evidence: There were clear lines of accountability in the home, the management team comprises the manager, and senior care community services officers. The current monitoring and quality assurance systems of the management team and organisation have not identified the shortfalls we have reported and these systems must be improved. There are a number of serious shortfalls in the assessment of risks and care plans for people living at the home or who have been admitted or readmitted in to the home from hospital. The care plans and monitoring of the care provided to people already living at the home and poor record keeping are all having an impact on the quality of Care Homes for Older People Page 25 of 31 Evidence: care that people at the home receive. A requirement was given at the last inspection regarding risk assessment and management and this has not been met. The non reporting of adult protection issues is also a matter of serious concern and again highlights shortfalls in the management of the home. As identified throughout the report the record keeping is poor and it is not clear whether all accidents and incidents are recorded or reported. This means that the management cannot sure whether they are capturing and monitoring everything that is happening at the home. Information provided before the inspection, by the manager in the AQAA (Annual Quality Assurance Assessment) shows that relevant Health and Safety checks and maintenance are being carried out at the home. The manager told us that they do not manage anyones finances but hold personal spending monies for people. These records and monies have recently been audited independently of Dorset County Council. Care Homes for Older People Page 26 of 31 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 8 13 (4) The registered person shall 06/07/2009 make arrangements to ensure that unnecessary risks to the health or safety of people are identified and so far as possible eliminated. This means that there must be evidence of the assessment and care planning of each persons needs and circumstances, to ensure staff have sufficient information in order to meet each persons care needs. Care Homes for Older People Page 27 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 3 14 Accurate full assessments must be completed for people when they come for respite, move into or return to the home from hospital. This is to make sure that peoples needs are identified and staff know how to care for them. 06/07/2009 2 7 13 Any areas of risk identified for an individual must assessed and these assessments must include nutrition, moving and handling, pressure areas, behaviour and falls. This is so that any risks are minimised and staff know what action to take to keep people safe 06/07/2009 3 7 17 Accurate care records must be maintained for people. This is to demonstrate that people are being provided with the care and support 06/07/2009 Care Homes for Older People Page 28 of 31 they have been assessed as needing. 4 7 12 Peoples care plans must be reviewed, kept up to date, and include all the individuals needs identified in their assessments. This is so staff know what care and support people require to make sure that all their needs are met and they are well cared for. 5 8 13 People must be referred to health professionals when any health issues are identified. This is to make sure that peoples health care needs are met. 6 18 13 All allegations of abuse must 01/06/2009 be referred to the local authority and the commission. This is to make sure that any allegations are appropriately investigated and actions taken to safeguard people living at the home. 7 33 24 The overall management of the home must improve, and develop effective ways of assessing and monitoring the quality of the service. This is so that shortfalls are identified, are improved on and the quality of the service is kept under constant review. 01/10/2009 01/06/2009 06/07/2009 Care Homes for Older People Page 29 of 31 8 37 37 Regulation 37 notifications must be made for all events that effect the well being of people living at the home. This is to ensure that the home is effectively monitoring and reporting incidents in the home. 01/06/2009 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 People may have partners and or different important relationships in their lives. This should be included in the assessment format so that peoples individual important relationships are acknowledged. Personal profiles in care plans and or Life History books should be developed that include details and photographs of their history such as family, friends, where they have lived, pets, work etc. These profiles or life history books will assist staff to have a greater understanding of them as an individual. The information that is recorded in the health professionals records should be transferred into care records or be reflected in the individuals monthly care summary reviews. Menu boards or large print menus should be used to assist people in remembering what they have chosen for their meals. The delays in responding to or clearing the call bell system should be improved as the constant noise could have an impact on peoples well being. The staff and management team should receive some further training in the following areas: adult protection and safeguarding, pressure area care, moving and handling and nutrition risk management, care planning and record keeping. This is to make sure that the staff and management team have the skills and knowledge to improve on the shortfalls identified during this inspection. 2 7 3 8 4 15 5 19 6 30 Care Homes for Older People Page 30 of 31 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 31 of 31 - 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!