Inspection on 11/05/10 for Ashton Manor

This inspection was carried out on 11th May 2010.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ashton Manor 08/03/10

Ashton Manor 04/03/09

Extracts from inspection reports are licensed from CQC, this page was updated on 04/09/2010.

Key inspection report Care homes for older people Name: Address: Ashton Manor 104 Aldwick Road Bognor Regis West Sussex PO21 2PD     The quality rating for this care home is:   zero star poor service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Sarah MacLennan     Date: 1 1 0 5 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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: Ashton Manor 104 Aldwick Road Bognor Regis West Sussex PO21 2PD 01243842196 01243842196 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Stargate Partnership Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users to be accommodated is 24. The registered person may provide the following categories of service only: Care home only - (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia (DE) Date of last inspection Brief description of the care home Ashton Manor is a care home offering personal care only to people with dementia. It is situated in Bognor Regis and can accomodate 24 people. It is owned by Stargate Partnership Ltd who registered with The Commission in September 2008. The responsible individual is Mr Ayaru Shandakumar; the home is currently without a registered manager. Accomodation is laid out on three floors with passenger lift access to the second floor Care Homes for Older People Page 4 of 28 Over 65 0 24 2 8 0 1 2 0 1 0 Brief description of the care home only. People are not currently accomodated on the third floor. There are 22 bedrooms all with ensuite facilities. 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: 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 Commission has developed the way it undertakes its inspection of care services. This unannounced visit formed part of a key inspection and was carried out on 11th May 2010. The acting manager and a representative of the company were present for some of the visit as representatives for the establishment. It was a thorough look at how well the service is doing. It took into account detailed information provided by the homes management and any information that the Commission has received about the service since the last key inspection. The home is subject to an investigation by West Sussex Social Services in line with Policy and Procedure for Safeguarding Vulnerable Adults and have place a suspension of admissions following issues in relation to the safeguarding of vulnerable adults. An additional unannounced visit was conducted on the 8th March 2010 by the pharmacist inspector, Suni Chotai. This additional visit was to assess the medicine Care Homes for Older People Page 6 of 28 management in the home; a copy of this report can be found on the Commissions website, www.cqc.org.uk On the day of this visit we met with some of the people who use the service and the staff on duty. Some of the comments made to us are quoted in this report. The home sent us their annual quality assurance assessment (AQAA). The AQAA is a self assessment that focuses on how well outcomes are being met for residents living at the home. It also gives us some numerical information about the service. The AQAA was brief and did not reflect the situation within the home. Residents care plans, staff recruitment and training records, menus, health and safety check lists, activity records, quality assurance monitoring audits, medication records and storage were all requested in order to make an assessment on the day of this visit. We looked at how well the service was meeting the standards set by the government and have in this report made judgments about the standard of the service. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents will be assessed prior to admission to the home. Evidence: Due to on going safeguarding investigations that are taking place at the home, no new residents are being admitted. At the key inspection that took place in March 2009, we found that the people who use the service were fully assessed prior to their admission to the home. Care Homes for Older People Page 10 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The medication practices within the home are placing the people who use the service at risk. Evidence: The care plans and files of all the people who use the service were sampled; four residents care plans, risk assessments and daily statements were looked at in detail. The care plans covered a range of needs; including aspects of personal care. The care plans contained some information regarding personal preferences including likes to wear trousers and top and likes short hair with a perm. Two residents care plans were found to contain information regarding their preferred time to get up. The residents daily statements were not always completed and did not provide evidence that the residents care plans were followed and the home was meeting the assessed needs of the people who use the service. All the residents care plans seen contained a Mental Capacity Assessment which had Care Homes for Older People Page 11 of 28 Evidence: assessed them as lacking capacity, one contained a Deprivation of Liberty assessment which stated that the resident had no capacity and would not be safe outside the environment as they have no perception of danger and that the front door is controlled by key pad. On arrival at the home we found the front door open placing the people who use the service at risk of leaving the home unsupported. The door was fitted with a self closing mechanism with a number lock on the inside to prevent the residents from leaving the building; however the door was not closed properly making this ineffective. Four residents were unsupervised in the lounge, located near to the front door. After ringing the doorbell and not receiving a response, we entered the building unnoticed and were present in the building for 15 minutes before locating a member of staff. This potential risk to the people who use the service has been reported to West Sussex Social Services as part of their on-going safeguarding investigations. The homes medication storage facilities and administration records of all of the 11 residents were seen. We were informed that the morning medication is given at 9am; however on the day of this visit, the morning medication was still being given at 10.30. The lunchtime medication was then given two hours later at 12.30. The medication administration records contained several gaps and did not accurately reflect the medication being given. Some of the medication administration records had the prescribed medication times altered by the staff, without any explanation. The acting manager said that he did not know who had made the alterations or the justification for the changes. There was no evidence that the time had been altered with the knowledge of the residents GP. The home uses a monitored dosage system for medication. The medication stock was seen and all the morning and lunchtime blister packs still had all the tablets in for Monday and Tuesday of week one and for Wednesday of week 2, the teatime and night blister packs still had all the tablets in for Monday, Tuesday and Wednesday of week one. None of the staff on duty were able to offer any explanation. The medication trolley contained medication for one resident, dated 12th October 2009, which did not appear to be prescribed. The acting manager stated that he did not know why the medication was in the trolley and whether or not it was being administered. There was no guidance on criteria to use medicines prescribed on a when required basis. Two residents care plans stated that if the residents are sleepy or asleep, this Care Homes for Older People Page 12 of 28 Evidence: medication may not be required. The acting manager stated that all the staff had received training in the safe administration of medication, but was not able to provide any evidence of this. The medication administration records contained an audit form, entitled opening and closing checks to be carried out daily; this was last completed on 23rd April 2010. Care Homes for Older People Page 13 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The routine within the home does not promote independence and lifestyle choice for the people who use the service. Evidence: We were informed that the home employs a part-time activities assistant four days a week; however at the time of this visit this activities assistant was observed to administer medication and perform other care staff tasks. Their staff file did not contain an appropriate job description, but contained an unsigned care assistants job description. This was discussed with the acting manager who stated that he was unsure which job she was employed to do. The lifestyle and daily routine within the home were discussed with the staff on duty. We were informed that the majority, usually 8, of the residents up got up and dressed by the night staff. Comments from staff on duty included most of the residents are up when I get here. It was unclear whether this was at the residents request of for the convenience of the staff. This was discussed with the acting manager, who denied this practice was taking place. On arrival at the home at 10.15 four residents were seen to be still wearing bibs from Care Homes for Older People Page 14 of 28 Evidence: breakfast, two of which were asleep in the lounge and two were seated in the dining area. Some activities take place within the home including a sing-a-long to music which is organised by the staff. Comments from staff included activities take place if possible. We were informed by the acting manager that on occasions an entertainer visits the home. The routine within the home was task driven rather than based on the residents individual plans of care. We were informed that all the residents are toileted at 11.30 ready for lunch. There is currently only one full time cook is employed at the home, a second cook had recently left, the inspector received conflicting information regarding the date and reason for the previous cooks departure. There are no clear systems in place for the provision of food when the cook has a day off. The acting manager was asked who had cooked lunch on the cooks recent day off; to which he replied I dont know, that is a good question. Further investigation revealed that the meal had been cooked by a member of the care staff who does not contain a current food hygiene certificate. The evening meal is prepared by the cook and then heated and served by the evening care staff. The residents were observed to eat lunch during the visit, the residents seemed to enjoy the meal and the staff assisted in an unobtrusive manner. There is no set menu; the food eaten is recorded in a diary which provides evidence of choice. Care Homes for Older People Page 15 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are safeguarding concerns regarding the people who use the service. Evidence: The home had a simple complaints procedure. There was no information available to the inspector regarding any complaints that the home may have received. At the time of this visit a suspension of admissions to the home is in place following issues in relation to the safeguarding of vulnerable adults and the home is subject to an investigation by West Sussex Social Services in line with the Sussex Multi-Agency Policy and Procedures for Safeguarding Vulnerable Adults. The potential risks to the people using the service identified as part of this visit have been reported as part of the on-going safeguarding investigations. Care Homes for Older People Page 16 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The security of the building placed the people who use the service at risk. Evidence: We toured areas of the home. It was seen to be clean, tidy and free from offensive odours with evidence of on-going decorating. The areas identified as in need of repair at the previous visit have now been attended to. The domestic rubbish bin located in one of the bathrooms did not to contain a bag and was seen to contain clinical waste mixed with the domestic rubbish. Some areas in need of minor maintenance were identified during the visit. These were discussed with the acting manager, who was unaware if there was a system in place for reporting areas in need of maintenance. The people who use the service were able to access all the communal areas of the home. Bedrooms reflected the individual style of the service users and contained their own possessions. The decor was domestic in nature. Concerns were identified during the visit regarding the security of the building. Care Homes for Older People Page 17 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service are placed at risk by insufficient staff numbers and inadequately trained staff. Despite training in the Safe Handling of Medication this is not translated into the practices within the home, placing people at risk of harm. Evidence: We were informed that the homes normal staff levels are four in the morning, three in the afternoon and two at night. The day staff rota was only available for the current week. When the acting manager was asked for the night staff rota, after a period of looking for it, the cook then completed another rota, the acting manager did not appear to know which night staff were on duty. The acting manager stated you see what Im up against here, I knew it was gone, the staff steal everything, they are out to discredit the management, I saw someone had taken it when I looked yesterday it was unclear why the acting manager had spent time searching for the rota if he knew it was missing. The acting manager stated that he did not know who was currently responsible for completing the duty; the member of staff whose job it was, was suspended following allegations and the task of completing the rotas had not been re-assigned. Care Homes for Older People Page 18 of 28 Evidence: Concerns were identified regarding the cooking arrangements when the cook had a day off, details of which are contained within the Daily Life and Social Activities section of this report. Two staff files were seen during the visit and found to contain the required information and documents specified in paragraphs 1 to 9 of Schedule 2 of The Care Homes Regulations 2001 (as amended by the Care Standards Act 2000 (Establishments and Agencies) (Miscellaneous Amendments) Regulations 2004). One of the staff files seen contained evidence of training; which included Moving and Handling, Challenging Behaviour, Adult Protection, Health and Safety, and Food hygiene. The acting manager was not able to locate any other staff training certificates and could not provide information regarding the training undertaken by the staff. Discussion with the staff on duty evidenced that they had received training in the Safe Handling of Medication and in Challenging Behaviour. The staff who had cooked the meal in the absence of the cook had not received training in Food Hygiene. Despite the staff receiving training in the Safe Handling of Medication, this has not been put into practice; as evidenced by the shortfalls noted in the homes medication practices which are detailed in the Health and Personal Care section of this report. Care Homes for Older People Page 19 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service are placed at risk by the lack of clear leadership and much needed good management practices. The failures place people at real risk of harm to health and wellbeing and this is a serious concern. Evidence: The homes Registered Manager resigned her post on 8th March 2010; there is an acting manager is in post. The staff on duty did not appear to know that the Registered Manager had resigned her post as manager and were expecting her to return to manage the home following a period of sick leave. At the time of this visit the management arrangements of the home were discussed with the staff on duty. The staff on duty did not know who was in charge of the shift. One staff member stated that they felt put upon as no one had turned up to manage the shift and they were just left to get on with it; other comments from the staff included there is no one, they have not turned up and there is a stand-in manager who is about sometimes. The inspector was informed by the acting manager and the Care Homes for Older People Page 20 of 28 Evidence: representative of the company that the acting manager was present in the home between 9am and 6pm every week day and also visited the home at other times; there was no record maintained of the acting managers visits. This was contrary to the information we received during the visit from the staff on duty. On the day of the visit the acting manager did not arrive until after 11am. During this visit concerns have been identified regarding the management of the home. The management of the home has failed to provide adequate staffing numbers and has failed in the organisation of staff training. Significant shortfalls were noted in the care practices, documentation and the security of the building; this provided evidence of poor management and leadership. It was unclear whether quality assurance systems were in place. The representative of the company who was present for some of this visit stated that the monthly visits required by Regulation 26 were taking place by either him self or the Responsible Individual and that either one of them were at the home every day. The acting manager later informed us that this was not the case and that Regulation 26 visits did not take place. The medication administration records contained an audit form, entitled opening and closing checks to be carried out daily; this had not been completed. We were informed by the staff on duty that supervision did take place, but they were not sure of its benefit. There were no supervision records available for inspection. The inspection continued to identify shortfalls, some of the requirements made at the previous key inspection and pharmacists visit 8th March 2010, remain un-met. Care Homes for Older People Page 21 of 28 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 9 13 The registered manager must ensure that a there is clear documented evidence for any treatment changes showing that there was professional input. To ensure that healthcare needs of residents are met. 30/04/2010 2 9 13 To ensure medicine are given 30/04/2010 using safe methods and records are true and accurate. So that people get the the correct dose of medicine and there is written evidence of medicines given which is true and accurate including recording reason for when medicines are not given 3 9 13 To have a Care Plan on the use of medicines that are to be given only when needed. So that there is consistency in the use of this medicine 30/04/2010 4 27 18 In line with regulation 28/02/2010 18(1)(a) the registered person must ensure that suitably qualified staff are on duty at all times, with particular attention to night shifts. Care Homes for Older People Page 22 of 28 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 This must happen to safeguard residents from harm. 5 36 18 The registered person must ensure that all staff working in the home receive supervision. To ensure staff are supported in their role. 30/04/2009 Care Homes for Older People Page 23 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 8 13 The registered person must ensure that all staff administering medication receive appropriate training and that this traininig is translated into practice. This must happen to ensure the residents needs are met and they are safeguarded. 11/06/2010 2 8 13 The registered person must ensure that all medication no longer required is safely disposed of. This must happen to ensure the residents are safeguarded. 11/06/2010 3 8 13 The registered person must ensure that all medication is given at the prescribed times. This must happen to ensure the residents needs are met and they are safeguarded. 11/06/2010 Care Homes for Older People Page 24 of 28 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 4 10 12 The registered person must ensure that the home is conducted to protect and promote the dignity of the the residents at all times. This must happen to ensure the residents needs are met and they are safeguarded. 11/06/2010 5 10 12 The registered person must 11/06/2010 ensure that the residents daily routines including rising and bed times are recorded and staff adhere to them at all times. This must happen to ensure the residents are given choice and flexibility and their needs are met. 6 12 16 The registered person must 11/06/2010 ensure that a planned programme of activities based on residents interests is devised and implemented. This must happen to ensure the residents needs are met. 7 15 16 The registered person must ensure that all staff who handle food are appropriately trained and hold a current food hygiene certificate. 11/06/2010 Care Homes for Older People Page 25 of 28 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action This must happen to ensure the residents needs are met and they are safeguarded. 8 15 16 The registered person must 11/06/2010 ensure that suitable catering arrangements are made in the absence of the cook. This must happen to ensure the residents needs are met and they are safeguarded. 9 19 13 The registered person must ensure that the security of the building does not place the residents at risk of harm. This must happen to ensure the residents are safeguarded. 10 26 23 The registered person must ensure that clinical waste is appropriately disposed of as according to policy and procedures. This must happen to ensure the residents are safeguarded. 11 27 18 The registered person must ensure that the staffing levels are reviewed and a record is maintained of staff on duty. 11/06/2010 11/06/2010 11/06/2010 Care Homes for Older People Page 26 of 28 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action This must happen to ensure the residents needs are met and they are safeguarded. 12 30 18 The registered person must ensure that the staff recieve training approprite to their work, specifically training in Moving and Handling, Adult Protection, and Health and Safety, and a record is maintained of staff training. This must happen to ensure the residents needs are met and they are safeguarded. 13 32 10 The registered person must ensure that the home is appropriately managed. This must happen to ensure the residents needs are met and they are safeguarded. 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 11/06/2010 11/06/2010 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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!