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Inspection on 05/03/09 for Appleby Court Nursing Home

Also see our care home review for Appleby Court Nursing Home for more information

This inspection was carried out on 5th March 2009.

CSCI found this care home to be providing an Good 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.

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Appleby Court Nursing Home 173 Roughwood Drive Kirkby Merseyside L33 8YR     The quality rating for this care home is:   two star good 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: Claire Lee     Date: 0 6 0 3 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 28 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 28 Information about the care home Name of care home: Address: Appleby Court Nursing Home 173 Roughwood Drive Kirkby Merseyside L33 8YR 01515486267 01515486697 applebycourt@btconnect.com 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) : Regal Care (Liverpool) Ltd care home 60 Number of places (if applicable): Under 65 Over 65 60 0 old age, not falling within any other category physical disability Additional conditions: 0 8 The registered person may provide the following category/ies of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP (maximum number of places: 60) Physical disability - Code PD (maximum number of places: 8) The maximum number of service users who can be accommodated is: 60 Date of last inspection Brief description of the care home Appleby Court is a care home that provides nursing and personal care. The home is registered for sixty residents. The registered manager is Mrs Irene McLaughlin and the responsible person is Mr Mike Donegan. The main centre of Kirby is ten minutes away from the home. The home is purpose built on two storeys and provides a passenger lift to the second floor. There are fifty six single rooms, two double rooms and twenty one rooms providing ensuite facilities. There is communal space on each floor. There are gardens for the residents to enjoy which are accessed from the ground floor dining room. Parking is available to the front and rear of the home and there are main travel Care Homes for Older People Page 4 of 28 Brief description of the care home routes by bus that provide access to the area in which the home is located. The fees charged, range from 357.00 to 495.39 pounds a week. 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: two star good 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: A site visit took place as part of the unannounced inspection. It was conducted over two days for a duration of approximately fourteen hours. Fifty four residents were living at the home at this time. A partial tour of the premises took place and a number of care, staff and health and safety records were viewed. Discussion took place with six residents, one relative, eight staff and the manager. During the inspection five residents were case tracked (their care files were looked at and their views of the service were obtained). This was no to the detriment of other residents who were involved with the inspection. Case tacking helps to look at the service from the point of view of the people accommodated. All the key and other standards were inspected during the site visit. Care Homes for Older People Page 6 of 28 Satisfaction survey were distributed to a number of residents and staff prior to the inspection. A number of comments received are taken from interviews conducted and surveys received. The Commission for Social Inspections details were available at the home for residents and their families to access. This included copies of the most recent inspection reports for their information. The last key inspection was conducted on 3rd January 2008. An AQAA (annual quality assurance assessment) was completed by the manager prior to the site visit. The AQAA comprises of two self questionnaires that focus on the outcomes for people. The self assessment provides information as to how the manager and staff are meeting the needs of the current residents and a data set that gives basic facts and figures about the service, including staff numbers and training. This had been completed to a good standard by the manager and information from it is recorded in the report. What the care home does well: What has improved since the last inspection? The requirements set at the last key inspection have been met by the manager. Care Homes for Older People Page 8 of 28 The staffing levels are kept under review and extra staff are brought in to ensure the residents needs are met and that they receive a good standard of care. Financial records seen were kept in good order and showed what transactions had taken place on their behalf. An administrator is responsible for this and meets regularly with the residents to ensure their financial interests are protected. Work has been completed on the bathrooms and there are plenty of bathing facilities available for the residents to use in comfort. This includes shower rooms so that residents have a choice. Environmental risks were in place and these had been update by the manager so that the building was safe and well maintained. A programme of redecoration is ongoing and bedrooms haves been painted in pleasant colour schemes. New armchairs and a large widescreen TV have been purchased for the lounges. Residents interviewed thought the home was kept nicely and that the standard of equipment was good. Good practice recommendations made at the last key inspection have also been met and his will help to improve the service. This includes updating the Service User Guide (homes brochure) with details of the staffing numbers, updating polices and procedures and developing the activities programme. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 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 10 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents have access to information on Appleby Court and the staff undertake an assessment of need prior to admission. This helps to ensure they can provide the care and support residents need. Evidence: Residents and their relatives are provided with the homes Statement of Purpose and Service User Guide. These documents provide details of the service and what residents can expect when staying at Appleby Court. Following the last key inspection in 2008 the documents have been altered to include more details regarding the staffing numbers the company will commit to. This helps to ensure there are are enough staff on duty for the residents so they continue to receive a good standard of care. Prior to a resident residing at the home, the nurse in charge and/or the manager complete a care needs assessment. Four assessments seen provided details of the Care Homes for Older People Page 11 of 28 Evidence: care and support the residents needed and what they could do or could not do for themselves. The information is then used to form the basis for an individual plan of care. One assessment needed further detail in relation to assessing falls to highlight any risks that may affect their welfare. Copies of social services assessments had also been obtained as part of gaining more information from other professionals. Residents spoken with said that the staff had welcomed them warmly and that they had been given lots of support whilst settling in. Care Homes for Older People Page 12 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive health health and personal care according to individual need and this is given in a respectful manner. Evidence: As part of assessing the care, five residents were case tracked. This entailed looking at their respective care file and those seen showed that the residents care needs had been identified in an individual plan of care. This included details of the level of support needed by the staff to help provide positive outcomes for them. Daily life activities included areas such as, washing and dressing, eating and drinking, walking and communication. The systems in place ensured that all the care details were reviewed regularly so that accurate information was kept on each resident. The residents and/or their next of kin had been involved with drawing up the plan of care and residents said they were happy with the level of support they were receiving. Comments from residents included, The staff will always come when needed and The care is fine, the staff are very good. Care Homes for Older People Page 13 of 28 Evidence: The staff had completed other supporting documents to ensure the residents remained safe and well. This included a social life history, weight record, daily reports of the care given and medical appointments. If there is a potential risk to a resident then the staff record how to manage this. Discussion took place with the manager regarding specific risks identified for one resident. It was agreed that the risk management would be reviewed and more information recorded to ensure staff were fully aware for the potential problems and how best to manage them. General risk assessment for falls should also include more details regarding the time, frequency and any contributing factors as this will help staff to monitor them and reduce the risk of further injury. A number of care documents recorded month and year only when they were completed or reviewed. The manager was advised that the date should also be added to keep them accurate. This is stated under Standard 37 of this report. Residents have the use of a good standard of equipment which the staff were using. For example, moving and handling hoists and special beds. For those residents who need to stay in bed for long periods special mattresses were in place to make sure they were comfortable and to prevent their skin becoming red and sore. Feedback from residents interviewed, surveys returned, information in the AQAA and looking at care documents confirmed that residents could see their GP and other medical professionals when needed. The staff were found to be quick to arrange medical intervention and the records were detailed as to the treatment or changes needed in their care. This helps to keep the residents well. Records were seen in relation to visits by a dietitian, podiatrist, GPs, speech therapist, consultants and chiropodists. A resident said, They will get the doctor when needed. Likewise a relative reported, There is never a problem getting a medical appointment. Medications were stored in locked medication trolleys in a designated locked room. A list was available of staff authorised to administer medication and staff had access to a medicine policy to provide guidance on how to give out the medicines. A sample of medication records were looked at and these showed that medications entering the care home had been checked, signed in and dated on the medicine record. They evidenced staff signatures for medications given out. Of the medicine records seen there was only one omission and this was addressed by the manager at the time of the inspection. Residents can look after their own medicines if they wish and they had signed a form to agree to this. The staff must also complete a risk assessment to ensure residents are aware of the risks involved and they are able to take their medicines safely. Care Homes for Older People Page 14 of 28 Evidence: Staff were seen to help residents in a polite, caring and sensitive manner. For example, help with meals, walking, giving out medicines and taking part in activities. Residents were not rushed in any way and staff explained what they were going to do and offered reassurance at every stage. Staff were seen to knock on bedroom doors before entering and respected residents wishes as to whether they wished to stay in their rooms or to go to the lounge with other residents. The bedrooms have an ensuite facility and also residents can lock their doors to ensure their privacy is respected. Although Standard 11 was not assessed, the staff have recently introduced an accredited system for caring for residents who are approaching the end of their life in the community. This will help staff as they care for the residents as it is based around understanding residents wishes, beliefs and providing care and support to ensure quality of life. Staff are receiving training over a period of time as it is implemented. Care Homes for Older People Page 15 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities and meals are both well managed to provide daily variation and interest for residents at the home. Evidence: There was a pleasant and friendly atmosphere and the staff were seen chatting with the residents in the lounge and in their private rooms. Visitors were made welcome and could choose to see their relative in private if they wished. An activities organiser arranges a good social programme of events in house and also takes residents out for days to local attractions, shopping and tea parties. There is a lot of contact with a local community church for social gatherings which the residents enjoy. The activities organiser was enthusiastic regarding her role and had completed life histories of the residents with their permission. These detailed their preferred social interests and past life prior to taking up residency at the home. The records seen were informative and gave a good overall picture of the resident to help staff get to know them. Residents were being encouraged to join in with the activities so that they could Care Homes for Older People Page 16 of 28 Evidence: maintain and make new friends. Notices were displayed to provide the residents with details of the daily activities and the bingo afternoon was very well attended during the inspection. A trip to a safari park was taking place on the weekend and other activities included, music, pamper days, film shows and board games. A monthly newsletter is published with points of interests around Liverpool and information on the home. Residents can vote for employee of the month and also purchase items from a sweet trolley once a week. A resident said, There is lots going on and I really enjoy the bingo. A number of residents go out with their families and also attend local churches. Holy Communion is offered to ensure residents can continue to practice their chosen faith. The AQAA reports that another wide screen TV has been purchased and also computer games are available for residents to enjoy. The hairdresser was visiting and this service was provided in the hairdressing salon. Residents said the hairdresser came each week. Feedback from the residents was good regarding the choice of food. The following comments were made, The food is satisfactory, I alway enjoy my meals and We get different meals each day. The kitchen was well stocked and this included plenty of fresh fruit and vegetables. The menu is set over four weeks and subject to change according to what the residents would like. The menu offered wholesome, nutritious meals with plenty of light refreshments and drinks throughout the day. The cook had a list of what residents enjoy and foods they would prefer not to be served. Special diets had also been recorded. The majority of residents have their meals in the dining rooms and the tables were attractively laid for lunch with table clothes and flower arrangements. The manager is looking to order new dining room chairs as some of their are old and scratched. Lunch was served by the staff in an unhurried manner and they were patient in their approach with residents who needed extra help. Care Homes for Older People Page 17 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. Residents are confident their complaints will be listened to and systems in place protect them from abuse. Evidence: A complaint procedure was displayed in the main entrance for people to see. Details were also available in residents bedrooms and in the Service User Guide. This helps to ensure residents have all the information they need should they wish to raise a concern. Residents interviewed said they had no concerns at this time. A relative commented that issues raised with the staff were alway dealt with promptly. The AQAA reported that two complaints had been received since the last key inspection. The complaint record showed that that both were investigated and upheld. The Commission for Social Care Inspection have not received any complaints. Staff comments included, Our manager is always available and approachable to discuss all aspects of the work, concerns or problems and when dealing with a concern a staff member said they would Log and document concerns in the concerns book. Staff receive training in safeguarding people to make sure residents are protected and kept safe. This is provided during the induction for new staff and also as part of the training programme instigated by the manager. The AQAA reports that the manager ensures all staff receive regular updates to enhance their knowledge. Staff interviewed were aware of what abuse is and how it should be reported. The manager has made Care Homes for Older People Page 18 of 28 Evidence: two safeguarding referrals however these did not require investigation by the agencies involved with the safeguarding team. Care Homes for Older People Page 19 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Appleby Court provides a safe, clean, comfortable and well decorated home for the residents who live there. Evidence: Following the last key inspection in 2008 a lot of work had been carried out to improve the accommodation for the residents. This includes painting bedrooms, refurbishing bathrooms and the purchase of new lounge chairs and carpets for communal areas and bedrooms. The decoration plan showed that this is a rolling proramme to ensure the home is well decorated. The residents have a choice of bathing arrangements and special showers and baths ensure maximum comfort and dignity for them. All areas seen were clean and there were no unpleasant odours. A resident said, The home is always kept clean and another resident commented on the painting that was always taking place to make sure the home looked nice. Domestic staff are employed so that the home is kept clean and hygienic at all times. Residents bedrooms were pleasantly decorated and they had brought in items from home to make their rooms feel special and homely. The bedrooms had a good standard of furniture and fittings with lockable drawer space for keeping valuables. The following comments were made by the residents, I like my room and I like the bed and furniture. Care Homes for Older People Page 20 of 28 Evidence: Wheelchair access is available at the front entrance and the AQAA reports that plans for improvement include wider wheelchair access at this entrance with a canopy to protect people from the weather. The equipment to help residents with their mobility included, hand rails, raised toilet seats and moving and handling hoists. Staff said there was sufficient equipment in the home so that residents could be encouraged with their independence and to feel safe. Documents seen and details in the AQAA confirmed that the staff have access to policies and procedures regarding infection control. Staff were seen to wear gloves and aprons to lower the risk of cross infection. Liquid soap and paper towels were also available thus promoting a good standard of hygiene. Emergency lighting had been regularly tested to help protect people against fire and hot water was regulated to bathe residents at a safe and comfortable temperature. Care Homes for Older People Page 21 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive care and support from staff who are recruited safely and who have the skills to support them. Evidence: Residents were being cared for by sufficient numbers of staff at the time of the inspection. The staffing rota showed that two registered nurses and a senior carer were on duty with six care staff. The senior carer is responsible for overseeing the care of residents who need personal care and support. At night there is one registered nurse, a senior carer and three care staff on duty. A new deputy manager has been appointed and she has now been given supernumerary hours to help the manager with administrative work. The staffing levels are continually reviewed so that enough staff are on duty according to the needs of the residents. Extra staff are brought in for escort duties or also if residents require extra care or time allocated them to due to frail health. Feedback from the residents was good regarding the care and support they receive. This was talked about in relation to help with washing and dressing, meals, meeting visitors, the general routine and also taking part in social activities. Their comments included, I get all the help I need, The staff work hard and Someone will always come and help. Staff were seen to have time for a chat with residents in the lounge Care Homes for Older People Page 22 of 28 Evidence: and residents opinions were sought regarding news items on the television. A number of staff have worked at the home for a long time and this helps to provide continuity of care for the residents. The AQAA reported that recruitment practices protect the residents and this was confirmed when looking at four staff files. These staff were new in post and their files included police checks and references. A recruitment policy ensures that all staff are recruited fairly and without any discrimination. All new staff receive an induction which is given at a local college. This is given in accordance with the Skills for Care Standards to give staff a good insight into social care and what is expected from them. The manager had also completed an in house booklet for the staff and this had details of working for the company and the resident group they would be caring for. A staff member said, On my induction various members of staff were available to instruct and guide me about all aspects of the care home with relevant information. National Vocational Qualifications (NVQ) in care are ongoing for all staff and certificates were available in the staff files seen. The AQAA reported that 100 staff have obtained an NVQ in care and other NVQ courses such as food preparation and business and administration have also been accessed. An external trainer said that the staffs commitment to NVQ was very good and the manager was willing to book staff on courses when available. Staff receive training which consisted of fire prevention, moving and handling, food hygiene, first aid and infection control. The training is delivered by a local college and staff interviewed said training dates were arranged regularly. Care given to the residents is personalised however there has been no specific equality and diversity training. The manager said this would be looked at to help staff with meeting the diverse needs of people. Other courses included dementia, medicine management and end of life care for residents. The good standard of training helps to provide the staff with good knowledge on how to care for older people. Certificates were on file for courses attended and a training plan is kept in the office for staff to see. Care Homes for Older People Page 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Appleby Court is well managed so that it is run in the best interests of the residents who live there. Evidence: The manager is a registered nurse and has completed the necessary managerial qualifications to manage the home. She has worked at the home for fourteen years and the staff and residents spoken with were complimentary regarding her approach and commitment to the service. There are a number of systems in place to ensure the home is run in the best interests for the residents. This includes visits by senior management who complete reports of their findings, resident and staff meetings, surveys and reviews of health and safety and care documents. The staff have also obtained Investors in People, which is an external quality award. Minutes were available to confirm meetings held and residents said they could talk to the staff and suggest things that they would like in the home. Care Homes for Older People Page 24 of 28 Evidence: Feedback from resident surveys seen was complimentary regarding the care and facilities. Accident audits had been completed to highlight causes for residents falls and how these could be reduced. Staff spoken with said they received supervision of their work and training needs. Comments included, I get good support from my manager, We have hand overs each day to tell us about the care the residents need and The nurse in charge updates us with present care needs, any changes or additional information. A number of financial records held on behalf of the residents were looked at. These were found to be well managed with records in place of expenditures. The records were easy to follow and they are made available to residents and their families on request. A number of policy documents were looked at and these promote safe working for the staff and this given good guidelines regarding current legislation in a number of areas. For example, infection control, food hygiene, smoking and record keeping. These are being reviewed by the manager to ensure they are up to date. Records kept in relation to managing the service and care documents were available for the staff and residents to view. This was confirmed by a relative. A number of care documents recorded month and year only when they were completed or reviewed. The manager was advised that the date should also be added to keep them accurate. The AQAA gave details of various heath and safety policies and procedures and contracts for maintenance and services. A spot check of a number of these confirmed that they were in date to keep the residents safe. Fire records were also seen and the fire alarm system had been checked weekly. Staff receive fire training so that they know how to respond in the event of a fire. The manager had completed risk assessments with regard to keeping the environment safe and well maintained. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 26 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 12 A risk assessment must be completed for resident who administer their own medicines. To ensure they are competent and capable of undertaking this practice safely. 06/05/2009 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 Residents assessments should include more details in relation to falls. This will help highlight any risks that may affect their welfare. Risk assessments should be completed in more detail to ensure staff are fully aware of the risk and the action to be taken to keep residents well and safe. The manager was advised that all documents should be dated accurately. accurate. 2 8 3 37 Care Homes for Older People Page 27 of 28 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 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. 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!