Inspection on 17/09/08 for Bearwardcote Hall Residential Home Ltd

This inspection was carried out on 17th September 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bearwardcote Hall Residential... 26/09/07

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Bearwardcote Hall Residential Home Ltd Heage Lane Etwall Derby DE65 6LS     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Helen Macukiewicz     Date: 1 7 0 9 2 0 0 8 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. the things that people have said are important to them: They reflect 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 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Bearwardcote Hall Residential Home Ltd Heage Lane Etwall Derby DE65 6LS 01283734669 01283732810 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Jacqueline Thompson Type of registration: Number of places registered: Bearwardcote Hall Residential Home Ltd care home 38 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home The accommodation at Bearwardcote Hall was developed from a former private residence. Set within surrounding countryside near the village of Etwall, and approximately 8 miles from Derby City. There is an infrequent bus service nearby and some facilities such as G.P., shop and churches in the village of Etwall. The accommodation is over 2 floors and consists of lounges, kitchen, bedrooms and dining room. A passenger lift services the first floor. The Inspection report is kept in the Managers office and there is a notice informing people of its availability. 0 Over 65 38 Care Homes for Older People Page 4 of 29 Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was unannounced and lasted 7 hours during one day. 10 pre-inspection surveys were received from people living in the home and 6 from staff. Findings from these surveys are included in this report. The manager had completed a selfassessment of the service and this was also used in the writing of this report. Computer held records of all contact between the home and us since the last inspection was reviewed prior to this visit, and informed the planning of the day. During this Inspection discussion with people living in the home and their relatives took place, we also spoke with staff and managers. Three peoples care files were seen and their care was looked at in detail to see how well records reflected actual care practices in the home. Documentation such as service records and staffing rotas were also seen. Care Homes for Older People Page 6 of 29 A brief tour of the building was undertaken. An ‘expert by experience’ assisted with the inspection process. An expert by experience is a person who, because of their shared experience of using services, and/or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. The ‘expert by experience’ was present for three hours and spoke with service users, relatives and members of staff. Her findings are incorporated into the report. The last Key Inspection of this service took place on 26th September 2007. The deputy manager confirmed that the weekly fees for this home ranged between 375.00 to 420.00 with extra charges for hairdressing (9.00) and Chiropody (15.00). What the care home does well: What has improved since the last inspection? What they could do better: Care documentation did not always reflect the changing needs of people and needed more regular updates to ensure peoples care needs were not potentially overlooked. Hand written entries to medication charts needed a signature to identify the person entering the information should queries arise. Some of the bathroom and toilet areas would benefit from refurbishment and light shades to make them appear more homely and welcoming. The toilet off the large Care Homes for Older People Page 8 of 29 lounge had no privacy lock. A couple of bedrooms had an unpleasant odour due to the nature of the health problems of their occupants and needed further attention. Some potential infection control risks were noted in bathroom areas. Not all bedrooms had a place for people to store their items securely and this was advised for people who wished to remain independent in this area. The general risk assessment not been updated for some time, and was not specific to the individual characteristics of the homes environment so needed updating. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 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 29 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 have the information they need to choose a home that is appropriate to their needs. Admission assessment procedures ensure that people are not admitted inappropriately. Evidence: There was information about the home contained within 2 documents, the Statement of Purpose and Service Users Guide. The manager told us that she also provides information about the fees when giving these documents out. These documents provided a good level of information about the service but needed slight amendments to ensure people knew about current arrangements for smoking, to provide more up to date feedback from people living in the home and to ensure the contact details for us were accurate. In her completed pre-inspection self-assessment the manager wrote that over the last 12 months we have set up our website-having our own website is a great way for people to access information about the home. Care Homes for Older People Page 11 of 29 Evidence: In their completed pre-inspection questionnaires relatives told us they had enough information before moving in and all but one said they had a contract. We looked at the care files for three people who had recently been admitted to the Home. These supported that people were assessed when they moved in, and that a copy of the social services assessment of need was obtained. There were notices displayed around the home to inform people about how they could obtain a copy of our last Inspection report. Care Homes for Older People Page 12 of 29 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. People receive the care they need in a dignified way. Evidence: We looked at the care files for three people living in the home. We found that all had a plan of care that had been written with peoples involvement and signed by them. People had their needs assessed in all areas including risk assessments for moving and handling, skin care and nutrition. The documentation used prompted staff to update information and review care needs. There was evidence that peoples needs had been reviewed at these prescribed timescales. However, changes to care needs that had occurred in between times were not always added to the care plan, with instructions for staff as to how they would meet these. There was plenty of evidence to support that people were able to access medical and other services such as chiropodist, dentist and optician. Such appointments were displayed in the office, and outcomes recorded in care files. In their completed preinspection questionnaires people told us they got the care they needed both medical, Care Homes for Older People Page 13 of 29 Evidence: and that provided by staff at the home. People told us that they are allowed privacy within their bedrooms and bathroom areas. They also confirmed that staff treated them in a dignified way. Care files written by staff identified the need to uphold peoples privacy and dignity. Where directly observed, staff were respectful in their communications with people living in the home. Prescribed medications were stored correctly and all records of administration were signed for. Some hand written instructions taken verbally from the G.P. had not been signed and this would help to identify the person who had made the changes should queries arise. Care Homes for Older People Page 14 of 29 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. People are able to lead a varied lifestyle of their choosing. Evidence: In her completed pre-inspection self-assessment the manager wrote that we have increased the entertainment we offer, residents expressed at meetings the desire for more visiting entertainers - we now have more entertainers throughout the year. We saw a list of activities on offer for September in the office and on the lounge notice board and doors. Comments recorded in care files, people living in the home and photographs on display supported that this was an accurate reflection of what activities were provided. One person told us she enjoyed the musical events and films shown at weekends. Another person told us they were having a cream tea that evening. In their pre-inspection surveys people told us there were usually enough activities provided by the home. An occupational therispt comes in and provides activities and/or tries to stimulate people through interactive conversation. On this visit, the OT was reading stories from the newspaper and recounting personal stoires and her trip to Althorp, Ancestral home to Princess Diana. The OT did try and include everyone in either conversation or by showing books and pictures around. There was quite a big group of people. These were of mixed ability, either with mental or physical Care Homes for Older People Page 15 of 29 Evidence: difficulties so some people where very responsive and others not very aware at all. There was also an information board advising people of the activities on offer. The other activity on offer was a selected film on Friday nights to view. The activities offered were mainly passive, watching films, looking at printed material, rather then anything very physically challenging, such as croquet on the lawn, or the large garden games available. Also because of the nature of the location (in the country, with county roads) it would be difficult to walk or scooter along to the nearest village. So people tended only to go out, if visitors came and take their relatives/friends out. As a suggestion, a trip to the local farm, some village or local school activity, may make people feel more part of the community at large and meet people outside the home, or have more organizations visit into the home for those housebound. However, one of the people did point out that incontinent problems may influence the desire of some people, to go very far. People told us they could come and go as they pleased. One person had gone into the local village for the day with friends. Another said they like to go out during fine weather within the grounds of the house. People told us they had freedom of movement within the home and this was observed by us throughout this Inspection. One person said they had their tea in their bedroom, at their request and could choose what time the rose and went to bed within reason. Some people had their own bedroom door keys and one person said they had been offered a key, but declined. Peoples individual preferred daily routines and social interests were recorded in their care files to assist staff in organising activities that people wanted. Care files seen identified the religious needs of people and the fact that they had been offered church services. In her completed pre-inspection self-assessment the manager recorded that they aimed to invite more representatives of diverse faiths into the home to meet the varying religious beliefs of our service users. People told us that the food was good. Comments received in pre-inspection questionnaires included good variety and quality of food, very good food - I enjoy all the meals. Staff were assisting people to eat in a dignified way and offered more food to those who wanted second helpings. People told us they had enough food and confirmed that a light supper was provided in between tea time and breakfast the next day. Fruit and vegetables were incorporated into the meal served during the Inspection, and a menu board accurately described what people would be receiving. There was no choice of main meal although people told us they were happy with the meal provided, and that there was a choice of dessert. Peoples individual dietary preferences were recorded in their care files on admission. Care Homes for Older People Page 16 of 29 Care Homes for Older People Page 17 of 29 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. People are kept safe through effective complaints procedures and staff training. Evidence: The managers pre-inspection self-assessment recorded that there had been one complaint received since the last Inspection. records of this complaint were seen and showed that the manager was willing to address shortfalls and provide people with a prompt response. Relatives told us that any minor issues were dealt with as they occurred and were satisfied with this process. In their completed pre-inspection questionnaire one person wrote prompt attention by the management when I have a problem. One person on the day said they were happy with the complaints procedures and that they were periodically asked if they had any concerns, by a person who was semi-independent of the management of the home. People were informed about the complaint procedure in the information about the home (Service users Guide) and on notices on bedroom doors. This included information about how they could contact us if an issue could not be resolved internally. Not all people who were asked were aware of how to raise a concern either formally or informally and how to see this through to satisfactory conclusion. People could be re-advised of the process to raise a concern or ask for information. The managers pre-inspection self-assessment recorded that in the next 12 months we intend to review our complaints procedure, while we feel the system we currently have Care Homes for Older People Page 18 of 29 Evidence: is safe and effective, there is a lot to be gained by regular reviews and assessments that test the efficacy of all such procedures. in light of the above comment this would be a positive initiative. There had been no safeguarding issues since the last Inspection. Staff training records showed they were receiving training on abuse and local safeguarding procedures were kept in the managers office. Staff were able to describe the actions they would take to keep people safe if they suspected abuse. In her completed self-assessment the manager wrote by constantly updating staff training and teaching vigilance in the detection and awareness of abuse it is hoped that we can go on improving this area. The manager had information and guidelines for assisiting people with making decisions in line with the Mental Capacity Act and said she recognised the need for staff training in this area within the forthcoming year. At the time of this inspection there was no use of equipment that had the potential to provide a degree of restraint. Care Homes for Older People Page 19 of 29 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. People live in an environment that is suited to their needs although management of cleanliness and infection control has the potential to affect peoples wellbeing. Evidence: In their completed pre-inspection questionnaires people told us that the home was clean. One person wrote its lovely and Im very happy with it. In the managers preinspection self-assessment she wrote while we feel the home environment currently represents a very high standard, we are always on the lookout for ways to improve-we are aware that this directly affects the quality of life of our residents. We were given a tour of the home by one person who lives there, all areas were accessible and people using wheelchairs were able to do so with minimal obstruction. People told us they were pleased with their bedrooms and many had telephones, televisions and small items of furniture from home to personalize them. We noticed that there had been some new floor coverings provided. Some of the bathroom and toilet areas would benefit from refurbishment and lightshades to make them appear more homely and welcoming. The toilet off the large lounge had no privacy lock. Some of the light pulls had the end pull missing so people may find these hard to grip and operate independently. Care Homes for Older People Page 20 of 29 Evidence: There were some flies buzzing around in both lounges and other communal areas. It was pleasing to see that the larger lounge contained a cage with birds to interact with. However, with four budgies and two smaller birds in the one cage, the cage and surrounding carpet, needed cleaning. Both lounges where of the modern ‘sealed window’ type and window sills and corners did seem to have several small died flies and active spiders. The two rooms may benefit also from regular airing. Staff already seemed busy and had multiple duties. It is worth considering whether a separate cleaner could help out with these duties and to take responsibility for the bird cage, which may help this situation. Also, smokers have the patio to smoke on and cigarette butts were noted all around and between the decking. Sand buckets or similar might better contain the butts and be easier to clean out. A couple of bedrooms had an unpleasant odour due to the nature of the health problems of their occupants, which the past provision of new floor coverings and regular cleaning programmes had not been successful in eliminating. This had the potential to impact on the dignity of people living in both these rooms and surrounding areas. In her completed pre-inspection self-assessment the manager wrote over the past 12 months we have replaced many carpets and totally refurbished rooms. Over the next 12 months we plan to replace the windows in one of the small lounges and buy a new washing machine for the kitchen. The laundry facilities were suitable for cleaning of soiled laundry and equipment for the maintenance of hygiene was available to staff. Some potential infection control risks were noted. Some of the grab bars in toilets had their plastic coating worn off so reducing efficiency of any cleaning and leaving sharp surfaces. The light pull cords in some toilets were visibly stained and needed replacing. Access to soap and towels in some toilet areas required a higher level of dexterity than some people may be able to achieve independently. Some bar soap and toiletries were found in bathrooms leaving the potential for use by more than one person. Some pots of cream such as E45 were stored in bathrooms, one had the lid off. These were not labeled upon opening or for individual use, leaving the potential for use by multiple people. Incontinence pads were also stored in 2 ground floor bathrooms, as these areas can become humid, this can reduce the absorbency of such products and lessen the sterile nature of them. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are kept safe and have their needs met through sufficient numbers of suitable and appropriately skilled workers. Evidence: Staffing rotas showed there were at least 4 care staff provided each day and additional support from both managers and administrators through the week. Catering and domestic staff were also included on the rota. People who completed pre-inspection questionnaires told us that there were always enough staff around when needed. One wrote staff are always around and willing to answer a request. Another described staff as very helpful. During the day people also confirmed they were happy with the staffing. One said the nurses are very good-all of them look after me, another commented that they felt there were sufficient staff on duty and that they were quick to respond to the staff call bell. All but three staff had completed National Vocational Qualifications to at least level 2. Many staff had progressed to level 3 and all but one member of the remaining staff had enrolled on the level 2 course. The deputy manager produced training records that supported there was a regular programme for staff training. Staff told us they had received mandatory training in areas such as COSHH, abuse and fire safety. They also said they had received medication and dementia training. Certificates of training Care Homes for Older People Page 22 of 29 Evidence: received by staff were on display or kept in personnel files that we saw. This means that people receive care from well trained staff. We looked at the recruitment files for three recently recruited staff members. These showed that staff were being recruited safely and that all necessary pre-employment checks were being carried out. A completed induction programme was recorded on each file, and all staff were enrolled to commence national vocational training once their induction was completed. This means that people were being looked after by suitable workers. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of the home ensures that the service is run in the best interests of the people living there and that they are kept safe. Evidence: The manager remains in place, she had the qualifications that we expect and her hours of work each week were shown on the staffing rota. A second deputy manager had been appointed from within the existing staff group and further staff given senior care roles. One deputy manager confirmed that she and the two administrators were doing their registered managers awards level 4. The other deputy was doing a management qualification at national vocational qualification level 3. One senior carer had been enrolled on a level 2 team leading course. This meant that there were well qualified people in charge of the running of the home at all times. The manager told us that she had not attended any formal training herself in the past year, but had been able to access our website for updates. In her completed pre-inspection self-assessment she recorded that she needed to be as open to training updates as her staff and told us Care Homes for Older People Page 24 of 29 Evidence: she was aware that she needed to attend some forthcoming training. The manager had sent out satisfaction surveys to people living in the home. One person confirmed they had been asked to complete a questionnaire. They also said that a person who was semi-independent of the running of the home had met with them and asked for their opinions directly. In the managers pre-inspection selfassessment she recorded over the last 12 months we have reviewed and changed our residents questionnaire making it easier to use and consist of questions that are geared to wards the gaining of valuable insights into how we can adjust the workings of our service so that it more accurately reflects the changing needs of our residents. The manager also completed the self-assessment when we asked for it. This provided us with a complete picture of the service, any improvements that were needed, and any that had taken place in the past year. The systems for handling peoples money were seen. Money held on behalf of people was safely stored and accounted for in records kept. People we spoke to said they were happy with the way the staff handle money on their behalf. We observed that not all bedrooms had a place for people to store their items securely and this is advised for people who wish to remain independent in this area. We saw records to show that staff were being supervised at intervals of about 3 months. Staff told us in their completed pre-inspection surveys that they felt appropriately supervised and supported. One wrote there is good communication between staff and supervisions every 3 months. There were records to show that the equipment around the home and for use by people was being regularly services and maintained. There was a general risk assessment of the homes environment kept in the managers office. This had been provided through an external company. It provided a broad summary of risk with useful safety advice, but had not been updated for some time, and was not specific to the individual characteristics of the homes environment so needed updating. Care Homes for Older People Page 25 of 29 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 29 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 2 b) Care plans must be updated as peoples needs change. This is to ensure that care needs are not overlooked. 31/10/2008 2 19 16 2(k) Action must be taken to 30/11/2008 eliminate unpleasant odours from bedrooms. This is to ensure the dignity of people is upheld. 3 26 13 3) Bathrooms must be maintained in such a way so as to maintain infection control. This is to ensure the wellbeing of people living in the home. 31/10/2008 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 1 The Statement of Purpose and Service Users Guides should be updated so people have the correct information about Page 27 of 29 Care Homes for Older People the services provided. 2 9 Hand written instructions taken verbally from the G.P. should be signed on the MAR chart to identify the person who had made the changes should queries arise. Activities that engage people more physically and take them outside the home should be considered so that people are more active and better integrated within their community. Cleaning of the bird cages and decking should be given higher priority, to improve peoples general environment. Bathrooms and toilet areas should be subject to redecoration/refurbishment to make them more homely and to assist people to be more independent. A privacy lock should be provided in the toilet off the main lounge to ensure peoples need for privacy can be met. 6 35 People should be provided with a safe place within their bedroom in which to store valuable items, to ensure they can maintain their independence and still have security. The general risk assessment of the environment should be updated to ensure all areas of risk are identified and eliminated. 3 12 4 5 19 21 7 38 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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. 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