Inspection on 27/04/09 for Ashwood Nursing Home

This inspection was carried out on 27th April 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ashwood Nursing Home 28/10/08

Ashwood Nursing Home 01/05/08

Ashwood Nursing Home 14/09/07

Ashwood Nursing Home 06/03/07

Ashwood Nursing Home 13/06/06

Ashwood Nursing Home 28/02/06

Ashwood Nursing Home 19/09/05

Ashwood Nursing Home 07/03/05

Ashwood Nursing Home 14/01/05

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ashwood Nursing Home Burwash Common Etchingham East Sussex TN19 7LT     The quality rating for this care home is:   one star adequate 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: Melanie Freeman     Date: 2 7 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 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 30 Information about the care home Name of care home: Address: Ashwood Nursing Home Burwash Common Etchingham East Sussex TN19 7LT 01435-883434 01435883091 ashwoodnh4@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Ashwood Nursing Home Ltd care home 19 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users to be accommodated is 19 The registered person may provide the following category of service: Care home with nursing (N) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category ; Physical disability (PD) Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Ashwood is a nursing home that provides care up to nineteen older people or those with physical disabilities over the age of 65 years. Ashwood is in the hamlet of Burwash Common and set in grounds with flat access for residents. A well-stocked and managed garden is available to be used by the residents. There is ample off road parking for visitors. The nearest town is Heathfield; the village of Burwash is two miles Care Homes for Older People Page 4 of 30 Over 65 19 0 0 19 2 8 1 0 2 0 0 8 Brief description of the care home away. The home is situated on the bus route and there is a railway station in Stonegate a nearby village. The home provides eleven single rooms, and four shared rooms over two floors, situated on the ground and first floors. Eight rooms provide ensuite facilities. Day space consists of a combined lounge/dining room. A passenger lift allows level access throughout the home. Current weekly fees range from 554 pounds to 950 pounds, excluding hairdressing, chiropody, physiotherapy, newspapers and aromatherapy. In-house activities are rather limited, some external entertainment is however scheduled. Ashwood Nursing home is owned by a limited company and Anne Morrissey is a Director of this company and the homes registered manager. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report those living at Ashwood Nursing Home will be referred to as residents. This was a key inspection that included an unannounced visit to the home by the allocated regulatory inspector and her manager. The visit was completed over a five hours and the homes registered manager facilitated this, and received the feedback at the conclusion of the visit. The registered manager is also the Company Director and will be referred to throughout this report as the manager. A tour of the premises was undertaken and a range of documentation was reviewed including the homes statement of purpose and service users guide, pre-admission Care Homes for Older People Page 6 of 30 assessment procedures, the systems in place for handling complaints and protecting residents from harm, staff training records, quality assurance systems and some health and safety records. The care documentation pertaining to three residents were reviewed in depth and the meal served to residents was tasted. At the time of the inspection 11 residents were living at Ashwood Nursing Home. All were met with and a more lengthy conversation was held with five of these residents. A visiting relative was spoken to on the telephone and following the inspection contact was made with two visiting health and social care professionals. Comments shared about the home during the inspection process included its very nice here, you can do as you like, the home is homely comfortable and clean the staff are all nice, this home suites my lifestyle. I am comfortable and well looked after the home is clean, Nurses are more than nice they are lovely staff show a commitment to a level of individual care that is specific to individual circumstances. The required Annual Quality Assurance Assessment (AQAA) was completed by the appointed manager and returned when requested and was used to inform this inspection report. What the care home does well: What has improved since the last inspection? What they could do better: Although there was clear evidence that the manager has re-established a stronger management role in the home. There still needs to be further sustained improvements in the home. Care Homes for Older People Page 8 of 30 All the care needs of residents are not currently clearly reflected within the plan of care. These need to be recorded to ensure that all care and support needs of residents are always taken into account and responded to. All residents need to have an assessment of their nutritional status so that staff are aware of any specific needs related to each individuals nutritional status.Clear individual guidelines for as required medicines need to be recorded and followed. So that all medicines are given in a consistent way. Staff training needs to be further developed to demonstrate that all staff receive appropriate induction, safeguarding, health and safety and appropriate specific training to meet the specialist care needs of residents. This will ensure staff have the skill and competencies to meet all the needs of residents in a safe way. Suitable quality monitoring processes need to be fully established to monitor and improve the service in response to residents and their representatives views. The home needs to be subject to regular risk assessment review and checking. This will ensure any risks are minimised, and any new risks are identified quickly and responded to. 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 30 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 30 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. The home provides prospective residents, with a good level of information about the home, its facilities, services and the costs involved. The admission procedure allows for the needs of prospective residents to be assessed by a competent person before admission. Evidence: The statement of purpose and service users guide was available on request along with previous inspection reports. These documents provided useful information, but need to be continually reviewed and updated to ensure it is up to date, and includes all the required information. The statement of purpose also needs to set out clearly, the care and support the home is able to provide, including any specialist care needs, and how these are to be met. The home has a brochure that is supplied to any one wanting basic information on the home, this contains relevant contact numbers. The manager confirmed that the statement of purpose and service users guide is given to each Care Homes for Older People Page 11 of 30 Evidence: resident, when they are admitted to the home. Contact with a relative confirmed that she was involved in the admission process and was made aware of the facilities, and fees of the home as part of this process. It was clear from residents spoken to that they chose Ashwood Nursing Home, based on personal experience, or recommendation. An assessment of the admission process included a review of the documentation used in respect of the last two admissions to the home. This confirmed that an assessment process is completed on all prospective residents. The assessment documentation recorded where and when, the assessment was completed and who else was involved. One admission was completed as an emergency and the manager had ensured as far as possible that the admission was appropriate, and had responded to an individual in need of help and support. Following the completion of the needs assessment the home writes to the prospective residents or their representatives, confirming the terms and conditions of residency and that the home is able to meet these assessed needs. Although the manager said that in the past staff had received some specialist care training including care of the dying person. A record of this training and the subsequent cascading training, was not recorded. so it was still not evidenced that the staff have received training in relation to the specialist care needs of residents like epilepsy, dementia or looking after a resident with a learning disability. Intermediate or rehabilitative care is not provided at Ashwood Nursing Home. Care Homes for Older People Page 12 of 30 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. The individual plans of care set out most of the residents personal and health care needs although the use of risk assessments needs to be more thorough. Residents health care needs are well met with the advice and support of community health care professionals. On the whole the homes practice ensure residents medicines are stored and administered safely. Care is delivered in such a way that promotes and protects the residents privacy, dignity and individuality. Evidence: The care documentation pertaining to three residents were reviewed as part of the inspection process, and each of these residents were met with during the inspection visit to the home. Following admission a full needs and nursing assessment is completed, this was full and focused on the residents individual needs, taking into account peoples choices and preferences. Base line observations are also completed and provide information on health care needs. All residents had a plan of care and Care Homes for Older People Page 13 of 30 Evidence: there was evidence that this was updated regularly, and at least on a monthly basis. These recorded the physical, health and social care needs of residents. Records confirmed that residents or their relatives are consulted on the content of the plans of care. Contact with a relative confirmed that this consultation had taken place. On the whole the plans of care were found to be comprehensive although some areas of care were not recorded. An example in respect to the documentation reviewed was the need for communication, and mobilisation within the plans of care. The documentation recorded community health care professionals input into care when contacted, and daily records are maintained and provide a record of residents activity, wellbeing, and medical condition. Each resident has an up to date photograph held within their care records. Routine risk assessments are usually completed and include those related to falls, pressure sore development, safe moving and handling. It was however noted that nutritional risk assessments not completed. Residents and relatives spoken to confirmed a high standard of care is provided at the home, and were able to say how the care they had received had improved their health and wellbeing. There was evidence that the care provided had improved resident mobility and had healed pressure sores that had developed prior to admission. Comments received from relatives and residents included before I came here I had sores since being here they have healed I could not stand but yesterday I walked with a zimmer I am getting better each day I have been impressed with the standard of care and the input from the physio, mother is much improved and I am very happy with the service. Visiting professionals also supported the view that the standard of care provided at the home was good. The home provides a community resource that meets the care needs of people staff show a commitment to care. The manager is committed to a level of individual care that is specific to individual circumstances. The medicine records examined were well maintained and accurate, and it was noted that a key for use when medicines are omitted has been written on the reverse of the charts. It was however noted that two ommissions on one chart had not been recorded with the use of these codes. The manager confirmed that staff had been trained on the new codes and were aware of the procedure to be followed. This procedure now needs to be embedded into daily practice. It was also noted that although general guidance is provided on the administration of as required medicines, individual guidelines specific to the medicine prescribed still Care Homes for Older People Page 14 of 30 Evidence: need to be provided for those residents on as required prescriptions to ensure these medicines are given in a consistent way. The home works closely with the residents doctor to ensure all medicines are appropriate and are used only when needed. All prescribed medicines were available in the home for administration. Residents spoken to felt that they have there privacy and dignity respected, one residents saying that the home was very good at respecting her own lifestyles. The relationships observed between residents and staff were seen to be positive with mutual respect. Care Homes for Older People Page 15 of 30 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 activity is mainly focused around the daily life activities in the home, and residents receive a wholesome and appealing diet. Links with friends, relatives and the community are encouraged and choices made are respected. Evidence: At the time of this inspection visit eleven residents were living in the home and benefit from a close and regular contact with the staff, and most have regular visitors. Visiting is not restricted and anyone who comes to the home are welcomed and have the opportunity to stay for meals, spending long periods of time in the home, if they wish. One resident has a daily visit from a husband who stays the afternoon. Structured daily activities do not take place, leaving residents to spend their time as they wish to. Three residents spoken to said that they preferred their own company and liked staying in there own room, where they listened to the radio, watched television, had visitors and read. One resident was very pleased with the home as it allowed her to maintain her own autonomy you can please yourself here, you can do as you like, this Care Homes for Older People Page 16 of 30 Evidence: home suites my lifestyle The AQAA confirmed that the home maintains strong links with the community around the home and that a choral society visits the home yearly and seasonal occasions are celebrated. Ashwood is seen as as a community resource and people who become residents often have had links with the home or its staff before. Residents said that they liked their own rooms and it was noted that they were able to have their own possessions around them. Residents religious needs are explored and responded to along with other lifestyle choices. Comments received from residents confirmed that the food provided in the home was of a good quality and reflected individual preferences. Residents comments included I enjoy the meals I shall miss the food when I leave I do not eat meat but I like fish to eat and they always give me some form of fish. The regular cook was spoken to, she has worked in the home for many years and has all the necessary qualifications. She demonstrated a good understanding of residents needs and took into account residents individual preferences when planning meals. The meal eaten confirmed a high standard of provision and a commitment to home made food with fresh ingredients. Records seen confirmed that what and how much residents are eating is being recorded. Although residents have the opportunity to eat communally most choose to eat in their own rooms. Care Homes for Older People Page 17 of 30 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. The home has a complaints procedure and residents and their advocates feel that their comments are listened to and acted on. The home has relevant policies and procedures around Safeguarding Vulnerable Adults and most staff have received appropriate training to ensure residents are safeguarded against all forms of abuse. Evidence: The home has a clear complaints procedure and a copy of this is available within the service users guide, and displayed on the wall in the entrance hallway. The AQAA recorded that one complaint had been dealt with using this procedure since the last inspection. A resident spoken to confirmed that she would have no hesitation in raising a concern if she had one with the homeowner. She felt that this would be listened and responded to. The home has a safeguarding Vulnerable Adults and Whistle blowing procedure in place and the most recent local procedures are available in the home. Most staff have received training on this now although there are a few staff that have not attended. The manager confirmed that this was being adressed and had a good awareness of new legislation and the implementation of the Metal Capacity Act. Care Homes for Older People Page 18 of 30 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 an attractive home like environment, that is well maintained and clean. Evidence: Ashwood Nursing home is a converted premise that has retained a home like environment. The home was found to be clean with many of the residents rooms being very personalised. Residents rooms are viewed as there own space and reflect the interests of the person occupying the room. Residents confirmed that the home was clean and and suitable for meeting peoples individual needs. very nice here, the home is homely comfortable and clean I am comfortable and well looked after the home is clean. Ashwood Nursing Home was found to be attractive and well maintained, the AQAA confirmed that required checks are maintained on all lifting equipment in the home. There is a large well-maintained garden at the rear of the home for residents to enjoy in good weather. The communal space available is located on the ground floor and consists of one room that is used as a lounge and a dining room. Although this room is large enough for the current occupancy and current use, this facility needs to be kept under review to ensure continued suitability when the occupancy of the home increases. Care Homes for Older People Page 19 of 30 Evidence: The laundry facilities were seen and were appropriate for the size of the home, the manager has in the past confirmed that the two washing machines have sluice cycles that can be used for any soiled laundry. Care Homes for Older People Page 20 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing arrangements and qualified staff numbers ensure that residents health and personal care needs are met although staff training needs to be improved to ensure they have the necessary skills to meet all care needs. The homes recruitment practice ensures that all the necessary checks are completed in respect of all staff, to safeguard residents. Evidence: During the inspection visit the staff were found to be attentive and kind, and residents were responsive and happy to be with them. A duty rota was available and this recorded that suitable staffing arrangements for the 11 residents living in the home were in place. This included a registered nurse working in the home over the whole 24 hours. The manager is recorded on the rota and works 3-4 shifts in the home on a weekly basis. In addition she confirmed that she popped into the home most days and was contactable on the telephone. The staffing provision has become more stable over the last six months and no new staff have been recruited since the last inspection visit. The recruitment records were therefore not checked at this inspection, and the AQAA stated that all the required records are held within each staff members file. Although there was evidence that induction training is provided, it did not identify that it not only covered the basic Care Homes for Older People Page 21 of 30 Evidence: training requirements of the home, but addressed the common induction standards and adequately follows the Skills for Care training specifications for the provision of social care. The home has started a training Matrix this demonstrated that some training has started but this still needs to ensure all staff have appropriate staff training that ensures safety, and that the needs of residents can be met. All feedback received about the staff was positive and comments received included I am comfortable and well looked after the nurses are more than nice they are lovelystaff are friendly and very kind I will be sorry to leave but I know that I can come back. Care Homes for Older People Page 22 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered manager has the relevant skills and experience and currently is able to provide direction and leadership to the home. Quality assurance processes need further development to ensure and demonstrate that the home is run in the best interests of residents. Residents financial interests are safeguarded. The health, safety and welfare of residents and staff are generally promoted although staff training and risk assessments need to be maintained and acted on. Evidence: The homes manager is a Registered Nurse and has attained the Registered Managers Award and has owned and run Ashwood Nursing Home for over 20 years. It was demonstrated through records and contact with residents, and their relatives, that the manager is far more involved in the homes management, and in all decision made Care Homes for Older People Page 23 of 30 Evidence: around care. This input and commitment now needs to be maintained over a period of time that can demonstrate a sustained improvement to the homes management. The manager is supported by an administrator responsible for the accounts and further support is provided by a friend who is setting up systems and procedures in the home to meet the requirements, of the Care standards Act 2000. The manager said that she had daily contact with the home and is currently working as the registered nurse in the home for 3 to 4 shifts a week. The time she spends in the home does not allow a great deal of time for management duties. She accepts that the paper work is not something that she likes spending time doing, so this does not get completed as well as it should do. She has good organisational skills and promotes an individual and high quality care provision for residents as she knows and understands them well. Although the manager completed the AQAA as required this focused on the shortfalls identified at the last key inspection and did not reflect on all the standards or regulations, and so was not used fully as a quality monitoring tool. It was however noted that questionnaires had been used to gain residents and their representatives views on the service provided at Ashwood. These recorded mostly very positive feedback and highlighted that the friendly kind atmosphere in the home is very much appreciated. The surveys completed however had not been reported on, and there was no evidence that comments raised within these had been responded to. The registered manager confirmed that she does not have any involvement with residents monies and all residents have an identified person who deals with their finances. Systems for providing regular staff supervision have been established and records seen in the home confirmed that this is being completed in a formal way with associated records. Although staff training is being progressed some staff still need to attain all the necessary training in respect of health and safety issues in the home and those related to individual care provision. The home has suitable systems in place to ensure the home and the equipment is suitably maintained and that regular checks on equipment are maintained. Evidence of this was mostly recorded within the AQAA although verbal confirmation from the manager was sourced to ensure that the necessary checks had been completed on the electrical portable appliances and the gas supply. The home has had a full environmental risk assessment completed by a risk management company some years ago. This has not been followed up with regular Care Homes for Older People Page 24 of 30 Evidence: checks to review and respond to changing and new risks in the home. This was discussed with the manager for her to address. Care Homes for Older People Page 25 of 30 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 30 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 7 15 That all the care needs of residents are clearly reflected within the plan of care. This will ensure that all care and support needs of residents are always taken into account and responded to. 01/07/2009 2 7 15 All residents need to have 01/07/2009 an assessment of their nutritional status. So that staff are aware of any specific needs related to each individuals nutritional status. That individual guidelines for those people prescribed medicines on an as required basis are written and availble to staff. This will ensure that as required medicines are given in a consistent way 01/07/2009 3 9 13 Care Homes for Older People Page 27 of 30 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 and in accordance with the individual prescription. 4 30 18 Staff training needs to be further developed to demonstrate that all staff receive appropriate induction, safeguarding, health and safety and appropriate specific training to meet the specialist care needs of residents. This will ensure staff have the skill and competencies to meet all the needs of residents in a safe way. 5 33 24 Suitable quality monitoring processes need to be fully established to monitor and improve the service. This should include a written report and address the quality of nursing in the home. representatives views. This will ensure that the service is assessed taking int account residents and their representatives views. 03/08/2009 03/08/2009 Care Homes for Older People Page 28 of 30 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 6 38 13 The home needs to be subject to regular risk assessment review and checking. This will ensure any risks are minimised, and any new risks are identified quickly and responded to. 01/07/2009 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 Care Homes for Older People Page 29 of 30 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 30 of 30 - 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!