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Inspection on 17/09/08 for Bassingham Care Centre

Also see our care home review for Bassingham Care Centre for more information

This inspection was carried out on 17th September 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

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

What the care home does well

The care home offers a clean and comfortable environment for people to live in. The people staying in the home told us they were well looked after and were happy with the services provided by the staff. Records provided evidence that the healthcare needs are being met by community health care services. People were happy with the menu and quality of food provided to them which they stated met their own individual dietary needs.

What has improved since the last inspection?

The care records have been reviewed since the last key inspection. The individual care files which have been rewritten contained greater detail of the individual person and more details regarding their choices and wishes. Staff supervision and staff meetings have been reintroduced. The care homes managers are now identifying training opportunities for staff.

What the care home could do better:

The care home needs a registered manager in post to ensure that there is continuity in the support offered to staff and the people staying in the home. Care records need to be written to the same standard and reviewed regularly to make sure people`s needs are always met. Accidents and incidents need to be monitored and risk assessments reviewed for people who have an accident. The company must ensure that they notify the Care Quality Commission of any incident which affects the safety of a resident. A staff training programme must be in place to ensure that staff are trained to answer the needs of the people staying in the home. Staff supervision should be provided as part of staff development. The company must make sure that people are able to raise concerns and that the complaints procedure is followed including the recording of outcomes. The medication procedure must be followed and medication stored at the recommended temperature.

Key inspection report Care homes for older people Name: Address: Bassingham Care Centre The Old Rectory 2 Lincoln Road Bassingham Lincs LN5 9HE     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: Ken Hague     Date: 2 1 0 9 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 30 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) 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. 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: Bassingham Care Centre The Old Rectory 2 Lincoln Road Bassingham Lincs LN5 9HE 01522788215 01522788509 bassingham_sherry@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Cornward Limited Name of registered manager (if applicable) Type of registration: Number of places registered: care home 61 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 61 The registered person may provide the following categories of service only: Care Home with Nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Date of last inspection Brief description of the care home Bassingham Care Centre is situated in its own grounds in a village location, which has a church, shops and public house. Parking is available at the front and side of the building. The home is registered to provide care and accommodation for people over 65 years, offering nursing and personal care for up to 61 people. Care Homes for Older People Page 4 of 30 Over 65 0 61 61 0 1 0 0 6 2 0 0 9 Brief description of the care home Accommodation is provided in two areas. The main house was a former rectory and has been adapted and extended to provide accommodation for residents on two floors. The first floor is accessed by a shaft lift. Rooms are shared or single and some have en-suite facilities. The second area consists of bungalow style units, which are currently unoccupied; the manager stated that it is the providers intention to sell these. There is a large garden, which has a lawn with flowerbeds and seating for people to use in fine weather. There is a copy of the statement and purpose for the care home in the office which is made available to new residents. A copy of the service users guide is also made available to people considering staying in the home. The care home charges a weekly fee of £360-£655 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: 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: This is an overview of what the inspector found during the inspection. Throughout this report the terms we and us therefore refer to the Care Quality Commission. The service has been awarded a zero Star Rating. This means that the outcomes for people are poor. The service did not know we were coming to carry out an inspection: this is referred to as an unannounced inspection. We visited on 17th of September and returned for a second day on 21st of September. The inspection lasted 12 hours. The inspection was carried out by two inspectors. The purpose of these visits is to establish how the care home is functioning and the outcomes for people who use the service. We also check that the practices are safe and that staff understand how to recognise abuse and report this appropriately. Care Homes for Older People Page 6 of 30 Any previous information held by the Commission for Social Care Inspection about the care home was taken into account. Before the visit the provider returned the Annual Quality Assurance Assessment (AQAA). This document enables us to have additional information about how the home is meeting the needs of people using the resources of the service. We did not send out surveys to people who use the service as there was insufficient time before the planned inspection. The views of residents however were obtained at the site visits their comments and opinions are reflected within this report. The method of inspection used is called case-tracking and this involves selecting a proportion of the people who use the service and tracking the care they received. For this visit we case-tracked six people who used the service. This is done by the checking of records, discussions with them and the staff who care for them, and observations of care practice. During the visit we spoke to people using the service, relatives, the staff and senior management. This gives us an overview of the service and enabled us to make a judgement and award the star rating as shown above. Care Homes for Older People Page 7 of 30 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 Care Homes for Older People Page 8 of 30 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. People know that their needs can be met, because they have had a thorough assessment prior to moving into the home. Good information is provided to people to enable them to make a choice about moving into the home. Evidence: An up to date statement of purpose and service user guide was seen to be displayed in the reception area of the home. The Quality and Development Manager who was in charge on the day of the site visit stated that individual copies of the service user guide are given to every person who stays in the home. The companys manager stated that no person is admitted into the care home until a full assessment including a risk assessment has been completed. Staff confirmed the statement to be correct. The assessments seen had been completed before the person had been admitted to the home. Care Homes for Older People Page 11 of 30 Evidence: The assessment identified peoples social and care needs. The assessments contained details essential to provide safe care which included medical history and current medication. The details of relatives and professionals involved with each individual were recorded on current assessments. Assessments contained the wishes and choices of each person in the way they wished their social and care needs to be answered. The information recorded on assessments was found to be accurate when checked out with individual people at the site visit. Pre-inspection information also shows that a trained and competent assessor visits people who have been referred to the home, to make an assessment of their needs. Six files were looked at and each contained an assessment of needs, which include personal hygiene, advocacy, risk taking, social activity, religious and cultural needs and mental health. The assessments also refered to the end of life wishes of individuals. Signatures on the assessment documents indicate the involvement of individuals in the process. Personal files also contain letters to potential residents, confirming whether or not their needs can be met by the home. People confirmed that in their opinion the assessments set out the help they required and ensured that staff meet these needs in a safe manner. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal care needs of people are being met in a dignified way. However the failure to follow the updated medication procedure and the incomplete review of care plans placed people at risk. Evidence: Care plans are in place which linked to the identified assessed needs. They set out the care required for needs such as mobility, relationships and personal hygiene. Records show that the plans are now reviewed monthly. People say that staff talk to them regularly about their care plans and they sign their individual records. Maintaining privacy and dignity is referred to in the statement of values for the home. Risk assessments are individualised and are in place for things such as the use of bed rails, self-medication and trips and falls. Care plans set out the tasks required, and inform staff how they should be carried out while maintaining the privacy and dignity for the person. People said that we have Care Homes for Older People Page 13 of 30 Evidence: keys to our rooms which allow us to maintain our privacy. Staff talk to us with respect and are courteous all of the time. For example, staff on duty were observed talking to residents in private about their needs, making sure they knocked on residents doors before entering, and using the residents preferred forms of address. People told us that staff know how to help them and will remind them when it is time for appointments such as chiropody, dentist or opticians. They also said that staff help them to see their doctors. Equipment is made available where required, such as specialist mattresses. During the visit staff were observed to provide help to individuals in a calm and efficient manner. The medication records for three residents were looked at and all were completed in full. Lockable storage facilities are provided in bedrooms for people who selfadministered medication. Records show that staff who administer medication had received formal training in the administration and storage of medication. Staff confirmed this training had taken place. Medication records, and care plans for the people being case-tracked contained photographs to ensure that staff could match care records and medication records to the individual person. Not all administration procedures were however found to be carried out satisfactorily. The room in which medication was being stored was found to be at a higher temperature than that required to ensure the medication did not deteriorate. Staff had checked and recorded the room temperature and knew that the temperature was too high. The managers had taken no action to address this issue. Unused medication remained in the home and had not been returned to the pharmacies. Controlled medication was being kept on the premises for people who were no longer living in the home. Action was taken immediately by the company to address these issues. Care Homes for Older People Page 14 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The limited range of social and cultural opportunities does not ensure that peoples needs are met. Evidence: The home has no activity organiser in post and no system to develop or provide social activities. A relative stated there doesnt seem to be any activities going on. We found no evidence of ongoing activities. One person stated I stay in my room because there is nothing to do in the lounge area most of the time. Another person stated I do not feel I get the best out of my social life because of the lack of activity. Staff told us that there is no activity organiser and though we try and give people opportunities for social activities they are restricted at this time. Relatives stated that they are made welcome when they visit. Staff stated we do all we can to make visitors welcome. People living in the home stated the home does encourages us to maintain links with our families and the community. The dietary needs of people were recorded within their care records. This includes their likes and dislikes, any special diets and any allergies. Staff stated that a choice of menu is offered. Staff stated that they talk individually to people on a daily basis to establish what is their choice from the menu of the day. Alternative meals are provided if the Care Homes for Older People Page 15 of 30 Evidence: menu does not match residents individual choices. One person stated the food here is excellent there is plenty to eat and I enjoy each mealtime. Staff were seen to help people with feeding difficulties in a sensitive and dignified manner. A relative stated I am impressed with the food there is a good variety. staff ensure my relative has a choice. She states that she enjoys her meals. Care Homes for Older People Page 16 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The updated policies and procedure to help protect residents have not been followed which placed residents at risk. Evidence: The complaints policy and the local authority safeguarding adult guidelines are available to staff, and people staying in the home have a copy of the complaints policy within their service user guide. Another copy of the complaints procedure is in the reception area of the home. People confirmed that they understood this procedure and have personal copies. The overall monitoring of accidents and incidents is not caried out and some complaints have not been dealt with. People said that they feel safe living at the home and the staff look after them very well. They said that if they had a complaint they would speak to the manager; they felt that they would have no difficulty raising any concerns and feel staff do listen and try and help you. Records show some staff have received training in safeguarding adult protection procedures. The staff interviewed demonstrated knowledge and understanding of protecting people from potential abuse situations. The records for the management of residents finances is incomplete. There is no evidence of audits being carried out and double signatures are not always obtained. Care Homes for Older People Page 17 of 30 Evidence: There are four safeguarding incidents being investigated at this time; the outcomes of these investigations will be detailed in the next report. The company has procedures to protect the finances of the residents but these are not being consistently followed by all staff. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well-maintained and provides a comfortable environment. Risk assessments are not detailed enough to protect residents. Evidence: The home is well-maintained, and clean throughout. The area outside the home is maintained and safe. People are encouraged to bring possessions into their rooms and to make them homely. Each room is individually furnished, and people stated that they are fully supported to personalise their individual rooms. There are enough bathrooms and toilets to meet the needs of the residents and appropriately serviced equipment is in place to support residents physical needs. Window restrictors were seen to be made of light chains. The Quality and Develoment Manager stated new restrictors will be fitted as she accepted that the present ones were not substantial enough to protect residents. The air temperature in the drug storage room was found to be too high for the medication stored. Staff had recorded this high-temperature but the managers had taken no action to address this problem. We brought this to the attention of the manager on our visit to the home. Action was taken by the company immediately to address this problem by putting in a cooling fan. Consideration is being given to installing air conditioning in this room. Care Homes for Older People Page 19 of 30 Evidence: Staff confirmed they regard the needs and safety of residents as central to their role. The staff interviewed confirmed that the fire alarms are tested weekly, and were able to describe the appropriate action they would take in order to evacuate residents safety in the event of a fire. Staff confirmed a fire drill had been carried out recently. All areas of the home were clean and smelled fresh. People stated their satisfaction with the environment of the care home. One stated the home is always clean and smells fresh, I am very happy with my room which is lovely. A second resident said I couldnt find a better home to live in. 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although residents are satisfied with the care they received, the supervision, management and training of staff is inadequate and puts residents at risk. Evidence: The Quality & Develoment Manager said that it has been necessary for the home to use a large number of agency hours in the past few months to ensure the staffing rota was maintained. Two members of staff were found to have been working for a large number of hours. The company has now taken action to avoid this situation in the future. New staff are being recruited. Staff training records showed some training has been provided but not all staff have completed essential core training. The training records showed that eleven staff had not completed health and safety training. There were five members of staff who have not undertaken fire training. There were five members of staff who have not been trained in the protection of vulnerable adults. There was no evidence to show that any staff had taken COSHH training. The training records and Annual Quality Assurance Assessment (AQAA) show that four members staff have not received any infection control training. Specialised training has been limited with dementia training being recorded. Members of staff told us that training opportunities have been limited recently. A Care Homes for Older People Page 21 of 30 Evidence: member of staff confirmed that they had not completed any training in the protection of vulnerable adults although they knew training was planned in the future. The staff team told us that they feel there are sufficient staff on duty to meet peoples needs in the day time period. They did express concerns about staffing levels at night. There are only two members of staff on duty in the night period. The Annual Quality Assurance Assessment (AQAA) states eleven residents need two staff to provide care safely. There are fourteen residents who had some form of visual impairment. Eleven residents are doubly incontinent and seventeen residents suffer from dementia. Peoples bedrooms are spread over a large area within the home. Staff stated that they have to rely on the nurse call system to monitor peoples safety at night. They added if we are helping one resident in one part of the building who needs two carers there is no one left to answer the needs of the other residents. Staff stated there is one person on the first floor who has poor mobility. In the event of a fire they could need the help of two members of staff. There would be no staff left on duty to assist other residents. The people living in the home said that their needs are being met promptly and in a sensitive manner by the homes care staff. The Quality and Development Manager stated that from November 2008 to September 2009 formal supervision, appraisals and staff meetings had not been provided. Staff confirmed this statement to be correct. Staff meetings have been re-established and the company states that supervisions and appraisals have now been reintroduced. The records for 2 new members of staff were seen. They had been recruited using the updated procedure of the care home. The individual files for each person contained recruitment information such as application forms and criminal record bureau checks; and there was evidence of induction training being provided. People living in the home said that they feel their care and nursing needs are being met in the manner in which they would wish. They did not have to wait for help which they said is provided in a sensitive and professional way. A relative interviewed had no negative comments about staffing except for the lack of an activity organiser. 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The failure to consistantly manage staff and update records resulted in peoples needs not being met. Evidence: The home has not had a registered manager in post since the end of 2008. We have been told that a new acting manager who Kay Mumby has worked as a registered manager in a care home for older people will be taking up her post in November 2009. There are three outstanding requirements from the last key inspection. These relate to poor record-keeping, the absence of a registered manager and the failure to consult with people staying in a care home as part of the quality assurance system. A deputy manager has been appointed who will commence her employment in October 2009. There was no evidence to show that the provider or a representative of the company Care Homes for Older People Page 23 of 30 Evidence: had visited on the required monthly basis and completed the regulation 26 report. There was no evidence to show that the provider has sent notifications to the Care Quality Commission as they are required to do so from October 2008 until July 2009, Medication stocks have not been monitored or managed resulting in a large amount of prescribed medication being found in the home which should have been returned to the pharmacist. This included controlled drugs. Staff supervision has not being carried out consistently. Only one supervision session has been provided for staff in 2009. A relative stated communications are poor, I do not know who owns this home. I made a complaint to a member of staff but I dont know the outcome. Nobody discussed the problem with me. Residents and staff stated that residents meetings have not taken place this year. Staff training records show that only 5 members of staff hold an NVQ two in care or the equivalent award. The quality assurance manager and chief executive of the company confirmed that staff have still to be trained in new legislation which covers the Mental Capacity Act 2009 and the Deprivation of Liberty Safegaurds. The homes risk assessment had not been updated and established that the window restrainers were not strong enough to protect residents. There was a period from January 2009 until March 2009 when there was no registered manager in post and the registered individual was ill and unable to work. We were not informed of the management arrangements for the home during this time period. The company were not aware that they had a legal responsibility to inform the Care Quality Commission of the situation. A Quality & Develoment Manager has been working at the home since the begining of September 2009. There has been a major improvement in management and record keeping made in that time period. All care records have been updated and reviewed. A management structure has been established but this requires the use of agency staff in the short term. Training has been organised for some staff including specialised training. Equipment has been purchased to ensure that the needs of residents can be met safely. Care Homes for Older People Page 24 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 25 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 9 13 A procedure must be in place which instructs staff how to store and administer medication. The medication records must show the correct stock levels of medication held for residents. This is to ensure prescribed medication is always available. Medication must be stored at the recommended room temperature to avoid deterioration. 20/10/2009 2 12 16 A range of daily activities must be provided for residents. People must be able to take part in a range of activities which offers social stimulation. 02/11/2009 Care Homes for Older People Page 26 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 3 16 22 A complaints procedure must be in place which is accessible to residents. It must be monitored and outcomes recorded. Residents must be confident that they can raise any concerns with the care home. The provider must show that complaints are investigated. 02/11/2009 4 18 13 Staff must be trained to protect residents from any potential abuse. To ensure that residents are protected from any potential abuse. 02/11/2009 5 30 18 Staff must be provided with ongoing training courses which provides essential training and specialised training. To ensure that staff have the skills and knowledge to help residents. 26/11/2009 6 31 8 The registered person must appoint an individual to manage the care home. The individual must apply to the Care |Qaulity commission to become the registered manager. 26/11/2009 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 This will ensure continuity of management and the smooth running of the care home 7 33 26 A written report (section 26) 01/12/2009 must be completed monthly and made available at the home for inspection. This report shpild be is part of a quality assurance procedure and demonstrates that the registered individual is monitoring the services provided by the home. 8 35 16 A procedure must be in 11/11/2009 place which instructs staff how to manage any money and valuables deposited for safekeeping with the care home. This should include written records of any items or money return to residents This is to protect residents from financial abuse. 9 36 18 Care staff must receive formal supervision at least six times a year. This is to monitor their personal development and care practice. 01/12/2009 Care Homes for Older People Page 28 of 30 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 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. 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