Inspection on 09/09/09 for Beecholme House

This inspection was carried out on 9th September 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Beecholme House 23/11/09

Beecholme House 14/10/08

Beecholme House 24/04/08

Beecholme House 31/10/07

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for older people Name: Address: Beecholme House 2-4 Beecholme Avenue Mitcham Surrey CR4 2HT     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: Elizabeth OReilly     Date: 1 0 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 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) 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 31 Information about the care home Name of care home: Address: Beecholme House 2-4 Beecholme Avenue Mitcham Surrey CR4 2HT 02086486681 02082889797 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Sharon Egbo Lartey care home 15 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 servie usres that can be accommodated is 15 The registered person may provide the following category of service only: care home only:Code PC to service users of the follwing 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 Demenia: Code DE 15 Date of last inspection Brief description of the care home Beecholme House is a registered care home for up to fifteen older people. The building is made up of two houses which have been joined together and extended. The home is situated in a residential area of Mitcham with a small number of shops within a short walking distance. Parking is to the front of the building. Public transport bus services are within a short distance of the home. Two double bedrooms and eleven single bedrooms are available. One bedroom has an en suite bathroom. Care Homes for Older People Page 4 of 31 Over 65 15 15 0 0 1 4 1 0 2 0 0 8 Brief description of the care home Weekly fees for this service are £550 to £700 per week. 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: This unannounced inspection was carried out by one regulation inspector over two days. The inspector had the opportunity to speak with the manager of the service, one of the service owners, four members of staff and six people who use the service. We looked at a sample of the records kept and the manager provided their own assessment of the service (AQAA) when we asked for this. Care Homes for Older People Page 6 of 31 What the care home does well: What has improved since the last inspection? What they could do better: The Service User Guide should provide more information on what people can expect from the service and include the complaints procedure. The hoist available in the service must be kept in good working order and regularly maintained. Staff must be provided with training on using the hoist to ensure the safety of people who use the service and staff. All staff need to be provided with training on safeguarding people. A training plan and record should be in place and up to date to make sure that the training provided meets the needs of the service. All staff who provide direct care should receive at least three paid days training each year. Care Homes for Older People Page 7 of 31 The complaints procedure needs to be up dated. More regular checks should be carried out on the health and safety records to make sure that staff are carrying out the right checks and that the records are kept up to date. Further work should be done to make sure that people who use the service are provided with meals which meet their needs and are aware of the choices available. A plan for the refurbishment of the premises over the next twelve months needs to be produced and provided to the Commission. Bathrooms which are at present out of order need to be attended to. Damaged furnishings need to be replaced. The garden is in need of more frequent maintenance to keep it tidy, safe and free from weeds. The organisation will need to inform the Commission of the arrangements in place for the management of the service and the date at which the present manager leaves the post. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 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 9 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A Service User Guide which provides information on what people can expect from the home is made available to everyone who moves into the service. This document could be more detailed and accessible. Assessments of individual needs are carried out before anyone moves into the service. Evidence: The service has produced a Service User Guide which provides some information on what people can expect from the home. This document needs to be reviewed on a regular basis. Consideration could be given to adding photographs, more detail and larger print to make the guide more accessible. The guide does not include a summary of the complaints procedure or the contact details of the Commission. The Annual Quality Assurance Assessment (AQAA) which was completed by the Care Homes for Older People Page 10 of 31 Evidence: manager informed us that pre admission assessments were carried out before anyone moves into the service. We looked at a sample of the records held for individuals and found assessments in place. Staff also have access to assessments carried out by Care Managers. These assessments assist in making sure that the service can meet the individual needs of people moving in and that staff have some information on the needs and wishes of individuals from day one of their stay. The assessment documentation used by staff from the home has been improved since the last inspection. These improvements could be continued to include more information on the personal preferences of individuals. This service does not provide intermediate care. Care Homes for Older People Page 11 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person is provided with a care plan which addresses individual needs and these continue to be improved by staff. Individual plans could still be more person centred particularly on how the needs of individuals living with dementia will be met. Medication is well managed. Staff provide support to people in a sensitive and caring manner. Clear procedures should be in place should anyone be transferred into the service whos needs cannot be met and the organisation must make sure that staff have the equipment they need for safe moving and handling. Evidence: We looked at a sample of two care plans. Each plan was individualised and was being reviewed at regular intervals which should assist in making sure that people who use the service receive the support they need. We found staff have continued to improve the information available in the care planning with more detail on the personal likes and dislikes of the individual along with their needs. We saw good information for staff on how they would provide support to Care Homes for Older People Page 12 of 31 Evidence: individuals but also instances of more general details such as staff to support with shaving and bathing. This type of information could be expanded to give staff a clearer picture of the individual needs and preferences of the person. The information provided particularly in relation to working with individuals who are living with dementia could be more detailed and individualised. Staff are keeping good daily notes which provide information on individual daily activities and the support provided. Weekly key worker notes provide a good overview of what the week has been like for each person. Staff were found to have a good understanding of their role as key workers. Staff informed us that they feel more involved in care planning and meet with person every week for a chat about what they have done or would like to do and the food provided. Care plans have been reviewed monthly but those we looked at provided little information compared to the weekly key worker notes. All care plans should be signed by all those involved in the planning including the individual concerned or their representatives. Staff and the management of the service reported improved relationships between the service and other health care professionals. We saw in the records for one person that staff had taken swift action to contact the GP when a change was noted in their physical health. Staff were seen to be monitoring and recording the weight of each person. In one instance one person was showing a significant weight loss over one month. We found no evidence that the person who recorded the weight loss had taken any action. We requested this person be weighed again during this visit and this person was found not to have lost this weight. All staff will need to be reminded that should they note any significant weight loss this must be reported for further investigation. One incident has occurred in the service where a person was re admitted to the home with significantly higher support needs and the service struggled to meet these needs. Discussion with the manager and staff indicated that this had been of great concern for them and that they were now working on introducing clear procedures for re admitting people from hospital. The hoist must be made available to staff, be in full working order and professionally maintained so that staff do not need to lift individuals. Once back in service staff need to be provided with training on the safe use of this equipment. Care Homes for Older People Page 13 of 31 Evidence: We looked at a sample of the records kept for medication. These records were up to date and accurate. We observed staff working with people in a sensitive and supportive manner which protected their privacy and dignity. Staff were seen to offer advice and support in a discreet way. Care Homes for Older People Page 14 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are provided with a variety of activities within the home and opportunities for activities in the local community are sought by the manager and staff. Staff have a good knowledge of the individual interests of the people they support. Improvements have been made around meal times to make these a more relaxed and social occasion. Further work should be done to ensure that people who use the service are provided with clear information on what choices are available at meal times. Further work also needs to be done to ensure that the cultural needs of individuals in relation to food are clearly recorded and met. Evidence: We observed people who use the service engaged in a number of activities over the time of our visits. Individuals were seen enjoying reading newspapers, playing dominoes, feeding the fish in the garden, watching DVDs and actively listening to music. Staff informed us that people enjoyed games of Bingo, four people liked dominoes, three people particularly enjoyed being in the garden and feeding the fish. Key worker records noted individuals attending church, helping clearing up after meals, going out to the corner shop and picking fruit in the garden. As noted Care Homes for Older People Page 15 of 31 Evidence: previously, the garden area requires more frequent maintenance so that individuals can continue to enjoy this area of the service and perhaps become more involved. The manager was arranging for people who use the service to go out to a Caribbean lunch as part of the Merton Festival. Arrangements had also been made for two people to try out a local day centre. Staff reported that families and friends were welcome to visit at any time and that almost everyone using the service received regular visits. A Gospel choir visits the service on a regular basis and representatives of a local church visit to provide communion for those who with to take part. One person visits a church accompanied by a member of their family. Staff are developing life stories which can assist in engaging people in activities and or conversations of interest. Knowledge of the previous life experiences of the people they support can assist staff in understanding individuals as people with a diverse history. We noted that in some instances this work had produced quite detailed information but for others there were very little information. The manager informed us that this was work in progress. Care planning reminded staff to offer choices in day to day activities and services. We observed staff offering alternatives and discussions with staff indicated that they understood the importance of tailoring their support to the individuals wishes. The menu for the day was seen to be on display in one of the lounge areas. It was noted that the menu for the whole day was written up. This made the information difficult to read. Consideration should be given to displaying the menu for each meal, including the alternatives available and up dating this throughout the day. Consideration should also be given to increasing the opportunities for making choices around meals with the production of a pictorial menu. In one of the care plans we looked at it was stated that the person likes a cultural diet, which the cook provides. This did not give details of the type of diet or any further preferences. We were informed by the cook that this person likes a Caribbean diet. However discussions with the cook and examination of the record of food indicated that this was not on offer every day. Records showed a Caribbean option was available once a week. We observed staff taking time to sit and talk with people who use the service during meal times. Certain items were provided in serving dishes which allowed for more choice and independence at meal times. Meal times were seen to be relaxed with Care Homes for Older People Page 16 of 31 Evidence: people eating at their own pace. Fresh fruit was seen to be available in lounge areas. We found the cook to have a good knowledge of the individual preferences of people who use the service. Food is now delivered on a weekly basis which assists in ensuring consistency in the menu. Breakfast is served throughout the morning to cater for those people who prefer to get up later in the day. 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. A system is in place for the recording of any complaints. The information provided on how to make a complaint is not up to date and could be more accessible. In order to make sure that people who use the service are safe all staff will need to be provided with training on safeguarding people. Evidence: Systems are in place for any complaint to be recorded along with actions taken and outcomes. The complaints procedure was not included in the Service User Guide provided to the Commission. The information on complaints provided in the Statement of Purpose for the service is not up to date. The contact details of the Commission will need to be updated. The information provided to individuals should also include their right to take complaints to their placing authority along with the contact details. Consideration should be given to making the complaints procedure more accessible to individuals who use the service and or their representatives. We looked at a sample of staff training records and discussed training with staff during our visit. Staff are provided with a copy of the policy and procedure relating to safeguarding people and are expected to read these. Staff spoken to confirmed that they had been provided with this information. However staff have not been provided with training on this subject. At the last inspection of the service it was recommended that staff should be provided with information on safeguarding people as part of their induction and then be provided with training on the local authority process. Staff Care Homes for Older People Page 18 of 31 Evidence: spoken to at this inspection had not been provided with training and records seen did not include training on safeguarding people. At the time of this inspection the service was working with the local authority and health care professionals to investigate one safeguarding issue. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A number of improvements have been made to the environment since the last inspection. The rearranging of the communal rooms has provided more space for people who use the service. The improvements need to be continued, particularly the bathrooms and damaged furniture should be replaced as soon as possible. The garden needs more regular attention to keep it weed. Evidence: We found a number of improvements have been made to the environment since the last inspection of the service. A ramp has been installed to one of the front doors to the home which allows for easier access. The communal areas have been rearranged with the dining room having been moved to the conservatory area. Staff reported that these changes have resulted in lounge and dining areas been better used. We observed people who use the service using all of these areas throughout our visits. A small bathroom on the ground floor has been taken out of action and we were informed that this area would be upgraded in the near future. The shower room on the first floor is in poor condition and also needs refurbishment. The door to the shower does not close properly, there is lime scale to the walls and a step into the shower base makes this more difficult to use. A bathroom on the first floor is fitted out with a domestic style bath. Staff informed us that this bathroom is used by only one person. This should be taken into account when planning future improvements. Consideration Care Homes for Older People Page 20 of 31 Evidence: should be given to installing an assisted bath which would offer a choice of bathing or showering for everyone who uses the service. We found the main ground floor bathroom in need of further cleaning, particularly in the corners of the room and the toilet paper dispenser. As this is likely to be the most frequently used bathroom and toilet consideration should be given to introducing more frequent cleaning in this area throughout the day. Bathrooms were found to be plain and clinical in appearance which does not match other areas of the service. In order to provide a relaxing and inviting areas for people to shower or bathe consideration should be given to improving the decor in these areas. The majority of bedrooms we saw during our visits were seen to be comfortable and homely. However the furnishings in room 9 were found to be damaged. The furniture in this room needs to be replaced. A number of notices on the walls in one sitting room were providing information and instructions for staff. Care should be taken to put these in more discreet areas or in folders so that they do not lessen the domestic style of the service. The registered person should provide the Commission with a copy of their development plan, with timescales, for the up keep of the environment. People who use the service were seen to enjoy spending time in the garden area. However the garden and the small planted area to the front of the building were in need of further maintenance. This would reduce the number of weeds seen at the time of these visits and could provide space for individuals who use the service to participate in growing their own plants or vegetables. 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. People who use this service made positive comments about the staff group. Staff have worked to improve their skills and knowledge through taking part in training on dementia care. The record of training needs to be kept up to date and an annual training plan needs to be in place to ensure that staff are kept up to date and that the training provided meets the needs of the service. The record of training should evidence that staff are provided with at least three paid days training each year. Evidence: A minimum of two members of staff are on duty at any one time. During the night one person is awake throughout the night with another member of staff sleeping on the premises who can be called upon for assistance if needed. The manager, domestic and catering staff are also available during the day. Since the last inspection of the service a number of staff and the manager have enrolled on NVQ training in Dementia Care. Staff we spoke to were enthusiastic about improving their knowledge and skills through training. The record of training was not up to date and staff who had taken part in moving and handling training last year had not received their certificates of attendance. The manager informed us that moving and handling training had been booked to take place in the near future. All staff need to take part in safeguarding training so that they understand the local authority Care Homes for Older People Page 22 of 31 Evidence: contacts and procedures. To make sure that staff are provided with statutory training and up dates and that training is in line with the needs of the service a training plan needs to be complied for each member of staff and the service as a whole. We found no evidence that all staff providing direct care and support have been provided with at least three days paid training each year. We looked at a sample of staff files. Evidence of appropriate checks being carried out on staff before they started work in the service was seen to be available in all but one instance. In this instance the organisation carrying out checks on behalf of the home had checked a list of people not to work with children rather than the list relating to vulnerable adults. We were informed that the service is now using a different organisation to carry out these pre employment checks. We observed good relationships between staff and people who use the service. People who use the service told us that staff were very good, lovely, hard workers and very nice. Staff were described in relatives surveys as attentive, patient and very friendly. 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 manager in post at the time of this visit had the skills and knowledge to run the service. However we were informed that the manager would be leaving within a few weeks. The organisation will need to provide to the Commission, in writing, the arrangements in place for the continued management of the service. Systems are in place to consult people who use the service and their representatives on a regular basis. The service has received good feedback from surveys sent out this year. Staff carry out checks on the building to ensure the health and safety of people who use the service. However these need to be checked more frequently by senior staff. Evidence: The manager in post at the time of these visits had a significant amount of experience and appropriate knowledge. We were informed by the manager that they would leaving the service in the near future. The home owner told us that action had been taken to look for a new manager. Care Homes for Older People Page 24 of 31 Evidence: Staff told us they feel well supported by the manager with regular staff meetings and individual supervision. Staff felt that there had been marked improvements in the service over the last six months. People who use the service and their representatives were seen to be consulted on how the service operates through regular meetings. The last meeting for people using the service was held the month prior to this visit. Records showed discussions centred on places of interest people would like to visit and the food provided as well as day to day issues such as individuals wanting their windows open at night. In addition to these meetings the organisation has sent out surveys to the relatives of people using the service. Returned surveys for this year were seen to provide positive feedback. When asked what the service does well people said, communicates well, improved greatly over last six months, people are treated with respect, pleased with the communication and management and that they look after father brilliantly. Although the views of others on the service have been sought, an annual development plan for the service, to which this information should be included has not been produced. We looked at a sample of the records for money held for people using the service. These were found to be up to date and accurate with receipts kept for any expenditure. The records of health and safety checks carried out on the building were not complete. Discussion with staff and the manager indicated that staff were not clear as to what they should be recording in relation to baths and showers. These records need to be more closely monitored to ensure that staff are checking the right things and keeping up to date records. We found hot water being supplied to sinks on the ground floor at above 50 degrees centigrade. the water to the shower on the ground floor was very low temperature 26 degrees. This was pointed out to staff and action was taken to fix this that day. Care Homes for Older People Page 25 of 31 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 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 8 13 Staff must be provided with a fully operational, professionally maintained hoist. To protect the health and welfare of people using the service and staff. 09/11/2009 2 18 13 All staff must be provided with training on safeguarding people. To make sure that staff can recognise abuse, understand their role and responsibilities in reporting any suspicion or allegations and know who to contact. 04/01/2010 3 19 23 The service provider must supply to the Commission a copy of the programme for the maintenance, replacement of worn furnishings and refurbishment of the premises. This programme 01/12/2009 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 must include timescales for completion. To ensure that people who use the service are provided with the appropriate facilities and that the service is well maintained 4 31 38 The organisation must 26/10/2009 inform the Commission in writing of the date the present manager leaves, the arrangements in place for the management of the service and the name and date of appointment of the new manager. To ensure that people who use the service live in a well managed service. 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 Service User Guide should include information on the complaints procedure, information on where a copy of the most recent inspection report can be obtained and the service users views of the home. The Service User Guide will need to be updated with information on the new management of the service. The improvements made in making care plans more individualised and detailed should be continued particularly around how the needs of individuals living with dementia will be met. 2 7 Care Homes for Older People Page 28 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 3 8 Staff should be provided with clear procedures to be followed should anyone move into the service whos needs cannot be met or should the needs of any person living in the service become such that they cannot be met. The cultural needs of individuals in relation to food should be clearly recorded along with details of how these needs will be met. Consideration should be given to providing a more accessible menu which improves the opportunities for individuals to make choices. Written menus could be made more accessible and consideration should be given to also providing a photographic menu. The complaints procedure should be up dated, be provided in the Service User Guide and include the contact details of the placing authority. Consideration should be given to providing the complaints procedure in more accessible formats. In order to keep the grounds tidy, safe and attractive more frequent maintenance should be carried out on the gardens. Bathrooms and toilets in the service are in need of refurbishment. Consideration should be given to installing an assisted bath which would offer people who use the service the choice of a shower or bath. Consideration should be given to improving the environment in bathrooms. Furnishings throughout the service should be checked on a regular basis to make sure that people who use the service are provided with a safe and well maintained environment. Furniture found to be damaged should be replaced without delay. To make sure that the main bathroom and toilet is kept in good order more frequent cleaning of this area should be carried out throughout the day. Evidence that all staff are provided with at least three days paid training each year should be available in the service. An annual training plan should be produced to make sure that staff receive statutory training and appropriate up dates of their training. 4 15 5 15 6 16 7 19 8 21 9 24 10 26 11 12 30 30 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 13 14 30 33 The record of training needs to be kept up to date to ensure that staff recieve appropriate training. A quality monitoring system should be developed along with an annual assessment of the care provided and development plan. Senior staff should make regular checks on the records kept in relation to health and safety to make sure that staff have understood what records they need to maintain and where they are to be recorded. 15 38 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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