Inspection on 05/03/09 for Appletree Court Care Home

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.

Other inspections for this house

Appletree Court Care Home 19/04/07

Appletree Court Care Home 14/09/06

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: Appletree Court Care Home Carebase (Burnt Oak) Ltd 158 Burnt Oak Broadway Edgware Middlesex HA8 0AX     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: Julie Schofield     Date: 0 5 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 25 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 25 Information about the care home Name of care home: Address: Appletree Court Care Home Carebase (Burnt Oak) Ltd 158 Burnt Oak Broadway Edgware Middlesex HA8 0AX 02083813843 02089528704 patricia.waldron@carebase.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Carebase Ltd care home 77 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: Date of last inspection Brief description of the care home Appletree Court is owned by Carebase Ltd. Appletree Court is a purpose built care home designed to provide care for people with nursing and dementia needs. Appletree Court is located close to shops, local amenities and public transport links. There are three floors. All bedrooms are en-suite and there are sitting and dining rooms on each floor. The home has a small landscaped garden to the rear. The home aims to provide nursing and dementia care in a homely environment. The fees are between 550 and 850 pounds per week. This report is available through the internet. Copies may also be obtained from the provider of this service. 0 Over 65 77 Care Homes for Older People Page 4 of 25 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: The inspection took place on a Thursday in March 2009. Two inspectors visited the home as this is a large care home that provides a service to residents with nursing needs and to those with dementia. The home is divided into 3 units and each unit is located on a separate floor within the building. We saw each unit. During the inspection we spoke with the manager and with members of staff. We met and spoke with the residents and with relatives. We spoke with the activities coordinator, members of staff working in the kitchen and with those working in the laundry. Records were examined and the care of residents was case tracked. A tour of the building took place. We saw the preparation of the mid day meal. We would like to thank everyone for their assistance and for their comments during the inspection. Care Homes for Older People Page 5 of 25 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 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 6 of 25 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 7 of 25 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. Residents are assessed appropriately and are involved within the assessment process. Evidence: The pre admission assessments, which were examined, were noted to be appropriate and comprehensive. These assessments included details of the personal, mental, cultural and spiritual needs of residents. Risk assessments had also been prepared for residents admitted to the home. These were appropriate. A relative confirmed that they, and the prospective resident, had visited the care home prior to the admission and that they were able to meet the manager and members of staff and current residents. One of the residents that they met told them that they loved it at Appletree Court. The relative confirmed that they had been involved in providing information to the home about the resident to ensure that the assessment was thorough. The manager stated that the home does not currently have any contracts for intermediate care. Care Homes for Older People Page 8 of 25 Evidence: The certificate on display in the home was not accurate as it did not indicate that the home was registered for nursing care. However, the home had a previous certificate, which indicated that it was registered for nursing. The manager stated that she had been in contact with the Regional Registration Team regarding this. We confirmed after the inspection that the team are dealing with the matter. Care Homes for Older People Page 9 of 25 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. .Arrangements are in place for meeting the healthcare and personal care needs of residents and these are recorded in residents care plans. However, there are some deficiencies in the arrangements for the administration of medication. These may place people who use the service at risk and must be rectified. Evidence: Residents in the home were noted to be clean and appropriately dressed. Residents and relatives who were interviewed by us indicated that residents were well cared for and their care needs had been attended to. Comments made by residents and their relatives in interviews indicated that there is generally a pleasant and caring atmosphere in the home. Residents interviewed stated that they had been treated with respect by staff. The seven case records examined contained evidence that residents had access to healthcare professionals such as the optician, community nurse, physiotherapist and their GP. Progress in meeting the health and personal care needs are recorded in the daily notes and observation charts. This was evidenced in the case records examined. Care Homes for Older People Page 10 of 25 Evidence: A sample of seven care plans were examined and on the whole they were well prepared. Regular monthly care reviews had been carried out. The care plans were holistic and addressed the cultural and spiritual needs of residents. Nutritional monitoring and weight monitoring charts were evident. These had been completed monthly. Appropriate risks assessments had been prepared for residents. These were generally of a good standard. The care plan of a resident with dementia contained a detailed, appropriate and up to date dementia care plan. Members of staff interviewed were aware of how to care for such a resident. One member of staff said that it was necessary to give residents time and that she needed to be patient with residents. The arrangements for the management of pressure sores were examined. We noted that the appropriate assessments and care plans had been prepared. Pressure relieving mattresses had been provided. Members of staff interviewed were knowledgeable regarding the care of residents with pressure sores. The treatment room on the ground floor was inspected. The temperature records of the fridge where medication was stored had been recorded daily. The records were satisfactory. The medication charts of four residents were examined. These indicated that medication had been administered as prescribed and were appropriately signed by staff. Details of allergies were recorded. Photos of residents were provided in each of the case records. This ensures that residents can be easily identified. The arrangements for the administration of medication had also been inspected on 11 February 2009 by the homes pharmacist. His report was available for inspection. A number of deficiencies were identified. A requirement is made in this report that these will be rectified. This issue was discussed with the manager who reassured us that the home would put in place measures to rectify the deficiencies and that some matters had already been resolved. The pharmacist was of the opinion that the home would respond appropriately. We asked the manager to provide confirmation when all the deficiencies identified have been responded to and her letter of confirmation was received shortly after the inspection was completed. She has informed us that they continuously carry out medication audits, on a monthly basis, and that staff are well trained in the administration of medication. The care home is currently working towards accreditation for providing a good standard of end of life care. This involves having in place plans for end of life care, which incorporate the wishes of residents and their families. Care Homes for Older People Page 11 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The daily life, meal arrangements and routines of residents are well organised. The views of residents and their relatives are being sought when planning the homes activities and routines. People using the service are given the opportunity to take part in activities that are imaginative, appropriate and varied. They also have opportunity to maintain important family relationships. Evidence: The home has a varied and comprehensive programme of weekly social and therapeutic activities. The programme was available for inspection and could be found in a folder in the reception area on the ground floor. The activities organiser indicated that the programme of activities had been carefully planned to suit the preferences and needs of residents. She provided evidence that residents had been consulted and that the activities had been organised to meet their needs. Activities provided included exercise sessions, music, cookery, bingo, entertainment sessions and outings to places of interest. The activities organiser provided photographs of these activities. Residents who were interviewed confirmed that various activities took place in the home and that they could participate if they chose to. The activities organiser further informed us that the social and cultural needs of the residents had been discussed and efforts are made to meet these. She stated that various cultural days and religious Care Homes for Older People Page 12 of 25 Evidence: days are celebrated at the home. These included a Caribbean day, St Patricks day and an International Day. In addition, ministers of various religious denominations were welcomed at the home to conduct religious services. We discussed the need for an additional activities organiser with the manager. We note that the home is registered for 77 residents and it is difficult to provide activities across all three floors of the home with only one activities organiser. The manager explained that volunteers and care staff are also involved in providing activities. However, she agreed to review the need for a second organiser. The kitchen was clean and well equipped. The home was awarded a 5 star score on the door at the last visit by the environmental health officer. The chef who was interviewed was knowledgeable regarding her responsibilities and the special dietary needs of residents. The menu examined was varied and balanced and there was a choice of main dish. One of us was able to sample the lunch served. It was well prepared and presented. It was appetising and wholesome. It consisted of a starter of home made cauliflower soup. The main course was home made steak and kidney pie with a choice of sauteed potatoes or mashed potatoes, with carrots and peas. A home made tuna pasta bake was offered as the alternative. The chef had made chocolate profiteroles for dessert although an alternative was available for diabetic residents. We commented on the tenderness of the meat in the pie and the chef said that a number of residents wore dentures and that it was important that they were able to enjoy the meal. We noted that the chef prepares dishes from fresh ingredients rather than using ready made dishes. A pureed diet is available for residents that need this support and their meals are placed on the plate with care so that they are pleasing to the eye. In the evening there is a choice of home made soup, different to the one served at lunch time, various sandwiches or a light hot meal. Snack boxes are prepared for residents with dementia that are awake at night and are restless. Residents interviewed indicated that they were satisfied with the meals provided. Residents confirmed that they had been visited by friends and relatives. They told us that when visitors arrived the members of staff on duty made them feel welcome and offered refreshments. Residents are able to sit with their relatives in the communal areas or in the privacy of the residents own room. Relatives who were interviewed indicated that residents had been well treated and their care needs had been met. Care Homes for Older People Page 13 of 25 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. A complaints procedure is in place to protect the rights of the residents. Adult protection procedures help to protect the welfare and safety of residents. Providing members of staff with training in the protection of vulnerable adults assures residents that members of staff are aware of how to conduct themselves and how to provide care and support. Evidence: We looked at the policies and procedures manual and noted that it contained a copy of the homes complaints procedure. The policy included the stages in the process and had timescales attached. The record book was made available and we noted that 6 complaints that had been received during the 12 month period prior to this inspection. Records included details of an investigation into the complaint and of informing the complainant of the outcome of the complaint and of any action plan. Where the complaint or parts of the complaint had been upheld by the investigation the contact with the complainant included an apology. During this 12 month period the CSCI was made aware of one of the complaints made to the home, by the complainant. The CSCI has also received an anonymous complaint, which the manager has been asked to investigate. This was made relatively close to the inspection and the manager showed us a copy of her response that she was about to forward to the CSCI. We noted that the response was comprehensive and addressed the issues raised. We looked at the policies and procedures manual and noted that it contained a copy of the homes protection of vulnerable adults policy and procedure. The policy contained Care Homes for Older People Page 14 of 25 Evidence: a link to the whistle blowing procedure. The manager confirmed that during the 12 month period prior to this inspection no allegations or incidents of abuse have occurred. The home has a copy of the local authority multi agency policy and procedures in the event of abuse, which can be used for reference. When we looked at staff files we looked at what training members of staff have received about the protection of vulnerable adults (pova). We saw that although most staff files contained evidence of this training the date on the certificate in one file was 2005. The manager confirmed that this member of staff attended further training in 2008. It is recommended that this training is updated every 2 years. One file belonged to a new member of staff and did not contain evidence of completing pova training. Care Homes for Older People Page 15 of 25 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. Residents live in a home, which is comfortably furnished and provides a pleasing environment in which they can relax and enjoy themselves. Generally good standards of cleanliness provide residents with hygienic surroundings. Dealing with blood spillages promptly would assure residents that infection control procedures are in place. Evidence: The care home consists of 3 floors and each floor is a separate unit. Each unit is self contained, with its own lounge and dining areas and its own bathing facilities. The property was well maintained and the decor and furnishings were of a good quality. The garden outside was attractive and there was a pathway for residents to walk around. There are many shrubs and plants that have been donated by family members in memory of a loved one. There is a large swing that is suitable for elderly persons. We walked around the home and looked at the facilities on each floor. Communal areas were spacious and offered residents a choice of where they sat. Each resident had their own single bedroom with an en suite toilet. Bathrooms, shower rooms and toilets were conveniently situated in the unit. The kitchen is in the basement. On the ground floor there is an attractive reception area and offices. Care Homes for Older People Page 16 of 25 Evidence: We saw that the home was clean and tidy and free from offensive odours. However, we did note that in one of the communal toilets there were 2 spots of blood on the floor and that the inside of the toilet bowl needed cleaning. We brought this to the attention of a member of staff on duty. We also spoke to the manager who said that bathrooms were checked during the day. It is recommended that checking is carried out at regular and recognised times and with a record kept. We spoke with relatives that were present in the home during the inspection and they confirmed that the care home was kept clean. Relatives of a resident that had recently been admitted to the care home said that the resident had a nice room that was tidy and that it was kept clean, including the bedding. The laundry is situated in the basement. We talked with the members of staff working there. There were 3 large commercial washing machines and 3 commercial tumble driers. They were all in use. We were told that clothing and bedding is washed daily. We saw that in the minutes of a staff meeting in 2008 a member of staff had raised concerns about stains on bedding that had come from the laundry. The manager said that as a result of this the temperature of the washing cycle and the products used had been reviewed. Members of staff were instructed not to use bedding if it has a stain that has not come out during the laundry process. We saw sheets that had been washed, dried and pressed and they were stain free. Care Homes for Older People Page 17 of 25 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. A programme of NVQ training for members of staff assures residents that care practices are based on an understanding of the residents needs. Staffing levels in the home assure residents that there are sufficient members of staff on duty each day to support the residents and to meet their needs. Recruitment practices promote the welfare of residents. Residents benefit from support given by members of staff that are skilled and trained. Evidence: A copy of the staffing spreadsheet was provided for the month of March. We discussed staffing levels with the manager. As the client group on each floor is different the staffing levels reflect the needs of the residents. On the ground floor, where nursing care is provided, there is a trained nurse and 4 carers during the day. On the first floor, where nursing with dementia care is provided, there is a trained nurse and 4 carers during the day. On the second floor, where residential with dementia care is provided, there are 5 carers during the day. We noted that on certain shifts an additional carer is provided when support is needed outside the building or when activities are taking place. At night 2 nurses and 5 carers are on duty. In addition to the carers and nurses working in the home there is a chef, assistant chef, laundry person and a housekeeper on each floor on duty on each day of the week. On five days per week a person carries out a carpet cleaning programme. There Care Homes for Older People Page 18 of 25 Evidence: is also an activities coordinator and a maintenance manager. The registered manager is supported by a deputy manager, whose duties included 20 hours clinical practice each week, and an administrator. Six members of staff were interviewed regarding the care of residents and other areas associated with their work. They were noted to be knowledgeable regarding their roles and responsibilities. One resident stated that a couple of the staff appeared lacking in manners. He said that they sometimes walked away after attending to him without saying anything or telling him what they intended to do next. The manager explained that some staff may have communication problems. She stated that she was aware of this matter and effort has been made to ensure that staff improve their communication skills. She stated that English language classes had been organised for staff whose first language is not English. The staffing spreadsheet records the NVQ achievements of the carers and we noted that of the 25 carers listed on the rota. 17 of these have achieved an NVQ level 2 or 3 qualification. An additional 3 carers are due to be enrolled for their NVQ training soon. The home has exceeded the target of a minimum of 50 per cent of carers achieving an NVQ level 2 qualification. NVQ training appropriate to the duties carried out is also available to other members of staff and the administrative officer and a kitchen assistant will be starting a relevant course soon. We looked at 6 staff files. We saw that they each contained an application form and a photograph. Application forms contained a statement regarding cautions and convictions and included a declaration of health form. Files contained 2 references, passport details and an enhanced CRB disclosure. Where necessary the right to remain in the UK had been established and residence permits were valid. We saw that one permit mentioned working as a domestic in a private household and it is recommended that the home checks whether this includes working in a care home. Two of the members of staff are employed as nurses and their PIN numbers have been verified and were valid. Files contained evidence that all appointments are subject to a probationary period. Files also contained a statement of terms and conditions of employment. We were provided with a copy of the training matrix for 2008 to 2009. We saw that members of staff have access to training in safe working practice topics. Training is also available in medication, dementia care and death dying and bereavement. Care Homes for Older People Page 19 of 25 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. The manager demonstrates her competence and commitment to a quality service by continuing to develop her understanding, skills and knowledge through further training. Systems are in place to gather feedback on the quality of the service provided to enable the service to develop in ways that meet the changing needs of the residents. The financial interests of residents are safeguarded by the procedures in place in the home. Training in safe working practice topics enables members of staff to safeguard the health, safety and welfare of the residents. Regular servicing and checking of equipment used in the home ensures that items are in working order and safe to use. Evidence: Since the last key inspection a new manager, Ms Patricia Waldron, has been appointed as manager of the home and has been registered with the CSCI. She has had considerable experience of managing services in a residential and hospital setting. Her qualifications include a BSc and an MSc. She is a registered nurse. She has completed counselling, management and teaching courses. Her most recent achievement has Care Homes for Older People Page 20 of 25 Evidence: been a Diploma in Dementia. She is currently leading the home in working towards the Gold Standards initiative, which is in respect of end of life care. Staff stated that there was good teamwork and that the manager and her deputy were approachable. The minutes of residents and relatives meetings were examined. These indicated that residents had been consulted and informed of changes affecting the running of the home. We were given information about new initiatives that are being introduced in the home and some of these have involved the views of residents and their relatives. We discussed whether the home had any involvement in residents finances. The manager said that no money is held on the premises for any resident. If money is spent on behalf of a resident e.g. for hairdressing or chiropody appointments an invoice for this amount is forwarded to head office, accompanied by receipts. They are responsible for contacting the next of kin so that the company can be reimbursed for the money it has spent. We discussed health and safety arrangements in place in the home with the registered manager and with the maintenance manager. Servicing and inspection records were made available. There were valid certificates in respect of the fire extinguishers, the electrical installation, the Landlords Gas Safety Record, the lifts, and the portable electrical appliances. The hoists are inspected every 6 months and the last inspection had taken place in August 2008. We were told that the home was in the process of changing the company responsible for carrying out this work. The home was also waiting for an inspection of the assisted baths, which is carried out on a 6 monthly basis. There was evidence that the fire alarms are tested on a weekly basis and that the testing is up to date. Fire drills take place every 2 months and the last fire drill took place in February 2009. There was evidence that members of staff received training in safe working practice topics. Care Homes for Older People Page 21 of 25 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 22 of 25 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 Deficiencies in the 11/04/2009 administration of medication, identified by the homes pharmacist must be rectified. This is to ensure that medication is properly administered and residents welfare is safeguarded. 2 18 13 Each staff file must contain 01/06/2009 evidence that the member of staff has completed pova training. This is to ensure that members of staff are aware of how they must conduct themselves and of how to respond in the event of a disclosure being made or an incident being witnessed. 3 38 13 When the certificate for the six monthly servicing of the hoists and of the assisted baths are received a copy of 01/05/2009 Care Homes for Older People Page 23 of 25 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 each is forwarded to the CSCI. This is to ensure that the home demonstrates that servicing and inspection of equipment used in the home is carried out according to accepted frequencies. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 12 The appointment of a second activities organiser should be reviewed. This is to ensure that all residents have access to a wider range of activities. That pova training is updated on a 2 yearly basis so that knowledge is based on current best practice. That bathrooms are checked at regular and recognised times during the day and that a record is kept of this. If assistance is needed from a domestic, the matter is dealt with promptly. That all carers are reminded of the importance of speaking with residents to reassure the resident and to make them feel comfortable and at ease with the carers. That the home checks whether the wording on a residence permit entitles the person to work in a care home. 2 3 18 19 4 27 5 29 Care Homes for Older People Page 24 of 25 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 25 of 25 - 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!