Inspection on 15/12/09 for Ashwood Park Residential Care Home

This inspection was carried out on 15th December 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ashwood Park Residential Care... 07/05/09

Ashwood Park Residential Care... 07/05/08

Extracts from inspection reports are licensed from CQC, this page was updated on 03/06/2010.

Key inspection report Care homes for older people Name: Address: Ashwood Park Residential Care Home Seaside Lane Easington Colliery Peterlee County Durham SR8 3XZ     The quality rating for this care home is:   one star adequate 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: Steve Tuck     Date: 2 2 1 2 2 0 0 9 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 31 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 31 Information about the care home Name of care home: Address: Ashwood Park Residential Care Home Seaside Lane Easington Colliery Peterlee County Durham SR8 3XZ 01915273300 01915273360 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): www.europeancare.co.uk European Care (England) Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 65 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is : 65 The registered person may provide the following category of service only: Care Home with Nursing - Code N to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other catgegory - Code OP - maximum number of places: 65, Dementia - Code DE - maximum number of places: 65. Date of last inspection Brief description of the care home Ashwood Park is a purpose-built home that provides residential care for 65 people over the age of 65 years. The accommodation is within two main units. The home is registered for 35 residential care places for older people, and 35 residential care places Care Homes for Older People Page 4 of 31 Over 65 0 65 65 0 Brief description of the care home for older people with dementia care needs. The home has been operating for about 9 years. It was purchased in November 2007 by European Care Limited, which is a large national company that operates many care services throughout the country. Ashwood Park shares the site with Birchwood Court, another residential care home owned by European Care Limited. The homes driveway is well kept with several parking spaces and access to colourful gardens with seating areas. All bedrooms are single occupancy with en-suite facilities. There is a good range of lounges and dining areas throughout the home, including a small library room. There is level access into the home, and the wide corridors and a passenger lift ensure that people who use a wheelchair can access all areas of the building. The single storey dementia care unit is built in a square design with a central garden patio area that offers a safe, private environment for residents to sit in. The home is situated off the main street that runs through the centre of the village. All local facilities are within easy reach. At the time of this inspection the weekly fees were £434.50 to £455.50. The weekly fees for people who are privately funded are £490 to £505.65 the higher rate is for people assessed as having dementia care needs. Items not covered by the fees include chiropody, hairdressing, toiletries and clothing. The actual fees paid depends on individuals circumstances. Please contact the home for further details. Care Homes for Older People Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: Before the visit we looked at: Information we have received since the last Key Inspection. This included, Notifications (Where the home manager/owner must tell us) Information about the home that has been given to us by other agencies or organisations such as the local council Durham County Council and Primary Care Trust. Information from members of the public who have visited the home. How the service dealt with any complaints and concerns. Any changes to how the home is run. Care Homes for Older People Page 6 of 31 The Visit Two unannounced visits were made on 15th and 22nd December 2009. During the visit we: Talked with the people who use the service the staff, the manager and visitors to the home. Observed life in the home. Looked at information about the people who use the service and how their needs are to be met. Looked at other records which must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around parts of the building to make sure it was clean safe and comfortable. We told the acting manager what we had found. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated it is likely that enforcement action will be taken. Care Homes for Older People Page 7 of 31 What the care home does well: What has improved since the last inspection? What they could do better: The owners, European Care, must make sure that the needs of people at this home are understood. There must be working care plans in the home at all times and these must not be put away without replacements being available for staff to follow. Care plans must set out the specific needs of each resident, including dementia care needs, and provide detailed guidance for staff in how to support those needs. Monthly evaluations must report a meaningful assessment of the progress or change in need. This is to guide staff in how to support people with their significant needs in a consistent, planned way and so that any changes in need are identified. The person responsible for the home must make sure that where assessments show a significant change to a residents health care needs (for example their pressure care needs) there must be a care plan in place that includes details of the action being taken by care staff and health professional input, to support and improve their health. Medication records must be improved so that they are are clear and accurate and can be used to reliably demonstrate that people are receiving the medication they have been prescribed. The way that pain relief medication is administered to people who are unable to say when they need it, should be improved. There should be better opportunities for people with dementia type illness to engage in individual social and leisure activities that ensure their individual social, physical and mental well-being is promoted. The involvement of a Dementia Champion should be considered to promote practices that support and promote the lifestyle, choice and rights of people living in the dementia care unit. There should be better ways of helping people with dementia care needs to choose the meals they eat and should have better access and wider choice of food types. There should be an up to date record of training that all staff have achieved so that this can be monitored by the manager and plans made to meet training priorities. The service must have management personnel who have been assessed by the Care Quality Commission as having the skills, knowledge, experience and qualities to be the Registered Manager of the home. Care Homes for Older People Page 8 of 31 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 9 of 31 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager or senior staff from the home find out and understand the needs of people who wish to live there before they move in. This information makes sure that peoples needs can be met at the home and should help to plan the ways in which staff are to support them. Intermediate care is not provided so this area was not assessed. Evidence: Information is made available in the Service Users Guide for people who are thinking about moving in the home and their supporters. The information is available to any visitors and can be posted out to enquirers if they wish. By looking at the record kept at the home we could see that each persons needs are assessed before they move to the there, either by health services staff, local authority social workers and the acting manager. This is so that the acting manager has an Care Homes for Older People Page 11 of 31 Evidence: understanding of peoples health and social care needs and that the home is going to be suitable for people who are going to live there. Where possible the person themselves or their representative is involved in the assessment process. The assessment includes dementia care needs as this is the main primary care service that this home offers. The acting manager confirmed that the assessment should be kept under review as part of the individual care plan and if persons needs change then a reassessment should be carried out and the care plan changed. However because care plans were not effectively in place at the time of this inspection this was not seen to be taking place. Care Homes for Older People Page 12 of 31 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person has an individual plan of care, which should set out in detail their preferences and how their assessed needs will be met. But these do not fully describe the measures which staff are to use therefore making it difficult for them to consistently meet peoples needs Evidence: Care plans are records that are used by all care services to show what sort of help each person needs and how staff will provide that care. At the last inspection there had been a slight improvement to care plans, however at the time of this visit the care plans were being changed again. As a result, previous care plans had been archived for four weeks but new care plan records were incomplete. In this way staff did not have immediate access to essential information about peoples needs and how they were to meet them. In the sample examined, there were no care plans about peoples dementia care needs, even though this is their primary care need. For example, there was no information for staff about how they should support someone with their behaviour Care Homes for Older People Page 13 of 31 Evidence: and/or memory loss. In this way staff may not be responding in the same consistent way to someones dementia care needs. The staff regularly complete a behaviour rating tool and the numeric scores are recorded. However staff said that they did not know what the scores mean, so even significant changes in the assessment scores do not lead to any specific or additional support. There is no guidance which tells staff about the actions they should take to help to support someone who is anxious or challenging to staff or others. The home has records of regular assessments of peoples health care needs, such as pressure care and nutritional needs. However staff said that they were unclear of what the assessment scores denote, so there is no guidance for staff about what to do if someone scores highly in these assessments. In this way the health care assessments are a meaningless, routine paper exercise. For example, nutritional assessments clearly show that one person has had significant nutritional needs for some time, and their monthly weight records and BMI (body mass index) scores indicate that they are malnourished. However the persons new care file has no plan of care about this significant area of need. When asked to staff brought their previous care file from the archives which did have a care plan about this need. The plan indicated that she should be offered finger foods at different times of the day to encourage her dietary intake. Due to their levels of need, most people who live at the home are not able to organise their own medicines, and appointed staff therefore help in this area. The home staff and manager have been supported by staff from the Primary Care Trust (PCT) so that people consistently get the medication they have been prescribed and mistakes are avoided. The manager and senior staff take responsibility for managing medication. Medication is stored securely, and records of the administration of medication were in place. A sample of records were seen which showed that some were overwritten making it difficult to tell if medication had been administered or not; dates had been changed on one record which made it difficult to tell which days medication had been administered; one hand written record of medication taken into the home should have been signed by two staff instead of one to show that this has been checked; one checked medication (out of five) had one more tablet in stock than the record said should be there. The acting manager confirmed that senior staff were all receiving or had received training in the safe administration of medicines. The acting manager said that he was continuing to monitor the medication to make sure that records were correct. Care Homes for Older People Page 14 of 31 Evidence: This home provides specialist support for people who have dementia type illness. Because of this, some people who live at the home can not express when they are experiencing pain or discomfort. Ways of working which help staff to decide if someone is experiencing pain, for example by monitoring expressions, responses or mood changes were not seen to be taking place at this home and there were no records in peoples care plans which showed how this was to take place. Staff were helpful and supportive towards residents and their visitors. There was clearly a good relationship between residents and staff, and residents enjoyed spending time in staff company. One resident said, The girls are lovely with me. They are a good help. Relatives said they felt comfortable about joining staff in the office to discuss their relatives care. One visiting relative said, The staff are very approachable and friendly. Care Homes for Older People Page 15 of 31 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Some people who live at the home are encouraged and supported by the staff to lead fulfilling lives. But this could be improved if staff had a better way of supporting the lifestyle needs of people who are more needy or have a dementia type illness. Evidence: Most social events take place in the main part of the home, though staff said that residents from the dementia care are invited to join those events. In the dementia care unit there are some activities provided on some mornings. There is also an activities room which has some puzzles and games on tables for resident to use if they wish, and if they can get to this room unaided. Some people spent much of the day in their own rooms or watching television in the lounge. Two people spent most of the day walking round the unit and in the central garden area. A visiting relative said,I have never seen her engage in any activity since she moved here. She often wanders round the unit but is never taken out and she used to love walking. All the corridors in this unit have been provided with pictures, tactile collages and Care Homes for Older People Page 16 of 31 Evidence: items of familiarity and interest, such as musical instruments and washing pegs and lines. These provide visual and tactile stimulus for residents who can get around by themselves. However there are no other stimulating items for people who are not so mobile, for example rummage boxes, paper and crayons or reminiscence books. Another relative visiting the dementia unit said,This is 80 a good home, but the 20 missing is stimulation. There are limitations to residents opportunities to make their own choices and decisions. For example in the dementia care unit there are no written or picture menus for residents so that they can make an informed decision. People are verbally asked for their main lunchtime meal choice the day before. Given their dementia care needs, some people would not be able to process the verbal information, and it is likely that most people would have forgotten their choice by the next day. All the residents who took part in discussions made positive comments about the quality of meals. The quality of meals on this day was good. The meals were nicely presented and appetising, and most main meals are home- made. In the dementia care unit it was clear that staff were empathetic in their practice and are very familiar with peoples menu preferences, but seem unable to influence the choice of menu to meet peoples needs. For example, staff stated that one person does not like a hot lunchtime meal but that is what the home offers everyday, so the person always leaves their lunchtime meal. However the person is not offered a lighter snack, which staff state that they would prefer. This persons records show that they are at significant risk of malnutrition and have been prescribed fortifying supplementary drinks by a doctor; but there is no communication or cohesion between catering and care staff in order to support the persons nutritional health. Care Homes for Older People Page 17 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home and their families can make a complaint if they are unhappy, have a grievance or dispute which can help them to have control over their lives. Workers at this home have not been clear about their responsibility to protect people from harm or neglect which has resulted in concerns about the quality of care delivery. Evidence: There is a clear procedure in place at the home which tells people how to complain and the length of time a response will take. People living at the home and their visitors said that they would feel comfortable about approaching the manager if they had any concerns, and most were confident that these would be dealt with. However, one persons relative who was spoken to at the inspection said that she was still dissatisfied with the way her complaint(s) were responded to. The homes senior managers informed us that they continue to try to satisfy everyone who makes a complaint at the home. There is an adult protection procedure which should safeguard people who live at the home from abuse. Staff should use these procedures if they are concerned, suspect or witness abuse taking place. When asked, staff said that they would report abuse to a senior or the acting manager who they see as being responsible for, sorting it out as one staff described. Some staff have received training as part of their National Vocational Qualifications and further training for new staff was planned. Care Homes for Older People Page 18 of 31 Evidence: Since the last inspection there have been two instances where peoples care was investigated by a multi agency safeguarding team which is led by Durham County Council, which checked to see if they had been neglected by staff at the home. Care Homes for Older People Page 19 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a homely environment, which promotes their privacy, independence and comfort during their stay at the home. The home is clean, pleasant and hygienic which supports the health and lifestyles of people living there. Evidence: All communal areas and some of the bedrooms were viewed during the inspection. The home has had recent repairs and there is ongoing maintenance taking place. The home has been designed so that all the people who live there can have safe access to the areas where they live. Everyone is able to lock their bedroom doors so that they can have privacy and there are areas where people can meet and talk in private. There are garden areas which are accessible to everyone when the weather is good. The bedrooms are pleasant areas, which have a useful range of comfortable furniture and fittings. Most people have decorated their rooms with their items, photographs and keepsakes. There are enough toilet and bathrooms available, all of which have been designed to help people who have mobility needs to use them. Care Homes for Older People Page 20 of 31 Evidence: The home is kept clean by staff who take effective steps make sure that there are no unpleasant odours. However, a childs dummy (left by a visitor) and some discarded foodstuffs were found in one room. There are laundry facilities are in place to make sure that that peoples clothing and linen is hygienically cleaned and the risks of passing on any infections is reduced. Arrangements are in place to make sure that clean clothing is returned to their owner and mistakes are avoided. There is a large well equipped kitchen, which has good facilities for the storage of foodstuffs and the production of meals. The home is inspected by the Fire Prevention Authority and Durham County Council to make sure that the building and safety systems are suitable for the protection of those who live and work there. Care Homes for Older People Page 21 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are usually enough staff working at the home to meet the needs of the people who live there but this could be improved where residents need more support. Evidence: The acting manager makes deliberate attempts to recruit staff from similar cultural backgrounds as the people living at the home. In some cases they share the same community and social links, which helps to ensure that people are confident with the way in which they are supported. One person living at the home said, The staff are the best. Another said, You wont find any better. The acting and senior managers have organised the home so that under normal circumstances there are sufficient staff available to meet the needs of the people who currently live there. The home is split into two separate areas with specific staff supporting people in each area. Staffing levels have been adjusted since the last inspection to take into consideration the reduced numbers of people living at the home and the services senior manager has justified these and demonstrated that the levels of staff meet the minimum standard. Care Homes for Older People Page 22 of 31 Evidence: The acting manager reported that staff had achieved National Vocational Qualifications at Level 2 and Level 3 and that some staff had enrolled on this training programme. The organisation also has a training and induction programme for new staff along with a range of individual courses in areas such as medication administration and caring for people with dementia. Unfortunately the homes training records had not been kept up to date which would have shown the entire staff teams qualifications and training. However individual records were up to date and could verify that training was taking place. Examination of files for staff newly appointed in the home confirm that checks are carried out before they are employed to work in there. This includes receiving appropriate references and completing the necessary criminal record check to make sure that staff are suitable to work with people who are vulnerable. Care Homes for Older People Page 23 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The acting manager has attempted to make sure that the home is run properly, and make sure that people living there get good quality care. But this would be improved if the home was better organised and residents have their needs consistently met. Evidence: The acting manager has worked at the home since August 2009. He is a Registered Nurse and has a background in services for older people and people who have sustained head injuries. He has worked in residential care services for the past 8 years including 18 months as a deputy manager. The acting manager has demonstrated that he recognises that the home needs to improve and the owners European Care, have given their full support. People who live at the home are asked for their views and these are acted upon. The local authority (Durham County Council) and Primary Healthcare Trust have supported this home so that they can improve. The organisation who owns the home has considerable experience of running a variety of residential and nursing care services. The manager Care Homes for Older People Page 24 of 31 Evidence: meets with his senior manager at least once per month and there is thorough management scrutiny taking place. However despite all of these measures, progress to improve the way that care is delivered at the home has been slow. The overall management approach at the home lacks clear vision. Staff at the home help some people who live there to manage their money. Records are kept of peoples day to day finances and where staff have supported them to make purchases. Information is also available to people who live at the home and others who support them which shows the fees they have paid for their care. There were no noticeable hazards at the home throughout the inspection and arrangements are in place to minimise risks for people living there and the staff who support them. The home has been subject to inspections by the Fire Prevention Authority and local authority environmental health officers to make sure that the home is safe. Care Homes for Older People Page 25 of 31 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 7 15 Care plan monthly evaluations must report a meaningful assessment of the progress or change in need. This is to guide staff in how to support people with their significant needs in a consistent, planned way and that any changes in need are identified. 01/08/2009 Care Homes for Older People Page 26 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 The person responsible for 15/02/2010 the home must make sure that Care Plans set out the specific needs of each resident, including dementia care needs, and provide detailed guidance for staff in how to support those needs. Monthly evaluations must report a meaningful assessment of the progress or change in need. This is to guide staff in how to support people with their significant needs in a consistent, planned way and so that any changes in need are identified. 2 8 16 The person responsible for 15/02/2010 the home must make sure that the nutritional needs of residents are managed by a clear, co-ordinated approach involving care staff and catering staff, and this must Care Homes for Older People Page 27 of 31 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 be outlined in a specific plan of care. This is to ensure that peoples nutritional wellbeing is fully promoted by all staff. 3 8 15 The person responsible for the home must make sure that where assessments show a significant change to a residents health care needs (for example nutritional or pressure care needs) there must be a care plan in place that includes details of the action being taken by care staff and health professional input, to support and improve their health. 15/02/2010 This is to make sure that people receive the right support with any changing health needs. 4 9 13 The person responsible for the home must make sure that medication records are clear and accurate. This is to make sure that people get the treatment they have been prescribed and mistakes are avoided. 15/02/2010 Care Homes for Older People Page 28 of 31 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 5 18 11 The person responsible for the home must make sure that everyone who lives there is protected from abuse. This is to make sure that vulnerable people who live at the home have their health and welfare properly protected. 29/01/2010 6 31 9 The person responsible for the home must make sure that there is a manager who has been assessed by the Regulator (CQC) as having the skills, experience, knowledge and qualities to effectively run the home. This is to make sure that the home has accountable management and staff have leadership to direct their work so that residents get a good quality of care. 31/07/2010 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 8 The person responsible for the home should make sure that copies of peoples nutritional care plans are kept in the kitchen for catering staff to follow. The person responsible for the home should make sure that there are strategies in place which help to identify when 2 9 Care Homes for Older People Page 29 of 31 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 people who have dementia type illness are experiencing pain and these are recorded in the care plan. 3 12 The person responsible for the home should make sure that there are opportunities for residents in the dementia care unit to engage in individual social and leisure activities that ensure their individual social, physical and mental wellbeing is promoted. The person responsible for the home should consider the involvement of a Dementia Champion to promote practices that support and promote the lifestyle, choice and rights of people living in the dementia care unit. The person responsible for the home should make sure that people who have dementia care needs are shown the menu options at the time of the meal so that they can make an informed choice. The person responsible for the home should make sure that all staff are properly trained to recognise and their own role in protecting people from abuse (including neglect). The manager should make sure that routine cleaning of specific areas takes place where this has been identified as someones individual need. The person responsible for the home should make sure that there is a record of which staff have been allocated / deployed to work with individual residents where this has been identified as their priority area of need. The person responsible for the home should make sure that there is a combined record of all the training that staff have either achieved or are currently undertaking. 4 12 5 14 6 18 7 19 8 27 9 28 Care Homes for Older People Page 30 of 31 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. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. 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