Inspection on 14/09/09 for Beechwood Nursing Home

This inspection was carried out on 14th September 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 15 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Beechwood Nursing Home 07/10/08

Beechwood Nursing Home 15/11/07

Beechwood Nursing Home 28/11/06

Beechwood Nursing Home 16/03/06

Beechwood Nursing Home 29/11/05

Beechwood Nursing Home 14/10/04

Beechwood Nursing Home 22/04/04

Similar services:

Whiteley House

Tyndale Avenue

2-10 Norfolk Road

Bennfield House Nursing Home

Eastfield Residential Home

Sign Health

Springwood

Fairburn Mews

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: Beechwood Nursing Home Romanby Road Northallerton North Yorkshire DL7 8FH     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: Bridgit Stockton     Date: 1 4 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: Beechwood Nursing Home Romanby Road Northallerton North Yorkshire DL7 8FH 01609777733 01609780692 carole@premiernursinghomes.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Premier Nursing Homes Limited care home 60 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 60 The registered person may provide the following category of service only: Care Home with Nursing - Code N, To service users of the following gender: Either, Whose primary care needs on admission to the home are within the following categories: Dementia Code DE, maximum number of places 60, Mental Disorder, excluding Learning Disability or Dementia - Code MD, maximum number of places 60 Date of last inspection Brief description of the care home Beechwood is a purpose built home. It is registered to care for up to sixty people who have dementia and who need nursing or personal care. It is located close to the centre of the County Town of Northallerton and is convenient for the shops and other facilities. The home has its own enclosed garden area, and there are parking facilities provided at the front. Care Homes for Older People Page 4 of 31 Over 65 0 0 60 60 0 7 1 0 2 0 0 8 Brief description of the care home It was opened in October 2000. The accommodation is on two floors. People who need nursing care live on the first floor. Those people living on the ground floor have been admitted because they need personal care only. A passenger lift provides level access to the first floor. 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: 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: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations- but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Two inspectors were at the home for one day from 09:30hrs to 19:00hrs. We spoke to people who live at the home, staff, the operations manager and the area manager. We looked around the home, looked at care plans, risk assessments, daily records and staff records. We observed how staff interacted with people who live at the home. Feedback was given to the operations manager and area manager at the end of the visit. 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: Disappointingly, very little progress has been made in meeting with the requirements set in the previous inspection of the service and there have been numerous requirements made from this inspection. Care plans and risk assessments are not written in sufficient detail to ensure peoples assessed needs are met properly and safely. The way in which peoples medication is administrated puts some people who live at the home at risk. We found that sometimes it is not given in accordance with the prescribers instructions and the recording of medication administration is poor. Activities and social events provided for people who live at the home is limited and often depends on which members of staff are on duty. Staffing levels at the home are not always maintained, agency staff are used frequently to provide cover at the home. Staff have had little or no training in fire prevention, safeguarding vulnerable people, medication administration and moving and handling. This means that staff are not fully trained or updated in how to care for people safely. Some certificates to ensure that equipment had been maintained and was safe to use were not available for inspection. Some peoples finances that are looked after by the home are not managed properly, the associated documentation to support this was not up to date with recent transactions and the records did not tally with the money held on behalf of people. The quality of the service should be better monitored through the homes quality assurance system and by senior managers within the company.This will help improve the quality of the service and make sure the homes aims and objectives are being met. The home has been without a registered manager for a long period of time. The people who live at Beechwood Care Home would be better served by a competent manager being employed who has the skills and knowledge to manage the home. This will ensure that people who live at the home are kept safe and are cared for by a skilled and stable work force who can meet peoples assessed needs. Care Homes for Older People Page 7 of 31 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed prior to being admitted to the home, to ensure that peoples identified needs can be met. Evidence: The care plans we looked at showed that pre-admission assessments had been carried out before offering someone a place. This is to make sure that the home can meet the persons needs. A senior member of staff, usually the manager visits the person at home, or in hospital to discuss their care needs. Social Services assessments are also used to determine this as well; these were also available to look at. A relative who was spoken to at the inspection confirmed that their relative had been visited by a member of staff from the home whilst in hospital. The relative also said that they had taken the opportunity to come and look around the home before making a decision. Care Homes for Older People Page 10 of 31 Evidence: The home 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Lack of detailed accurate care plans, coupled with poor medication administration practices puts people at significant risk of harm. Evidence: At the last inspection we asked that peoples care plans be written in more detail in order that staff have clear instructions and can deliver the right care to people in a consistent way. During this inspection we looked at three care plans in detail and random sampled several others. We found the recording in the plans very poor and inconsistent with the actual care the person was receiving. Staff were able to describe care delivery to the inspectors but were unable to confirm that they had read peoples care plans. On the upstairs unit staff told the inspectors that they took their instructions from the qualified nurse on duty. The inspectors were shown a list of people who required two hourly changing of position and hourly fluids. We looked at the documentation in one persons bedroom whos name appeared on this list. Both the records for changing position and the fluid record were incomplete. Further fluid balance charts for the same person were inspected for the previous two weeks prior to the inspection. It was noted that none of the fluid balance charts for this period had Care Homes for Older People Page 12 of 31 Evidence: been tallied. On one of the fluid charts it was recorded that the person had taken very limited drinks over the twenty four hour period, however an entry into the daily statement for the corresponding day said Good diet and fluids taken. The inspectors found the plans to be inconsistent and important information surrounding peoples care, documented within the daily reports, had been omitted from the actual plan of care. For example in one care plan it was recorded that the District Nurse had visited a service user and had reapplied dressings to their foot and a burst blister. Whilst on the wound and skin integrity care plan the entry, skin remains intact had been recorded. Staff need further training in how to interpret documentation used to assess whether people are at risk of developing pressure damage. We saw several care plans where people had been assessed as being at low risk of developing pressure damage when in fact staff had misinterpreted the guidance and were actually at high risk of pressure damage. Staff also need to make sure that there are completed risk assessments for people who may experience risks in their daily lives. For example, how staff are to manage behaviour which can change quickly and challenge others. This way, people can be assured that staff will work consistently and safely in meeting their needs, because they are all following the same plan. We looked at how medication was administered at the home. It was evident that poor practice was taking place. There is inconsistency in the recording of the quantity of medication supplied and the date it had been received in to the home. In some instances the quantity of medication from one monthly cycle to another is not recorded on the new medication administration record. This means it is difficult to have a complete record of medication within the home and to check if medication is being administered correctly. One person was prescribed medication that should be given once daily. On two consecutive days this person had received the same medication twice. The nurse in charge of the unit during the inspection could not give a reason for this other than it had been an agency nurse working both of the shifts. No corrective action had been recorded either on the medication record or in the persons care plan. We checked another persons medication administration record against the label on a box of medication and found a discrepancy with the period of time the medication should be administered over. Upon further examination of this persons care plan a nurse had contacted the doctor five days prior to the inspection to ask about the correct length of time the medication should be administered for. The entry in the care plan stated that the doctor had confirmed it should be given over twenty four hours . This had not been altered on the medication administration record, indicating that the Care Homes for Older People Page 13 of 31 Evidence: person had not received the correct prescribed dose of medication for five days. People were seen to be treated with dignity and respect by the staff who were on duty during the inspection. A relative spoken with said that staff are gentle and kind. In the lounge area some people were assisted by staff to have a drink. Whilst staff sat down to assist the people, they were perched on the arms of chairs or else sat on coffee tables leaning over people in order to help. Staff need to be aware of how to observe and support people without being intrusive. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People would benefit from more stimulation on a day to day basis. This would help make sure people have a more varied lifestyle regardless of their abilities. Evidence: We spoke to some visitors. They told us they can visit anytime and are made to feel welcome. A relative told us that they are kept well informed and receive important information from the home, for example if the doctor has visited their relative, and what the outcome was. On the day of the inspection there was no planned activities. The operations manager said that at the moment the home did not have an activities organiser, but they were hoping to recruit one shortly. One member of staff told us I do implement a lot of activities on my shift. During the inspection we saw two people playing cards with a care assistant, but there was no other stimulation for the other people sat in the lounge areas. One member of staff said that they try to accommodate peoples routines and requests, for example we ask families about preferences if a person cannot tell us. Given the diagnosis of the people who live at the home is primarily dementia , the signage in the home is very poor, there are no identifying objects on bedroom doors or communal areas doors to denote who the bedroom belongs to, or Care Homes for Older People Page 15 of 31 Evidence: what communal activity takes place within the rooms. Corridors are all painted the same colour and there is nothing on the walls of the corridors to engage or stimulate people . We observed the lunchtime meal in the downstairs dining area. The tables were nicely set with table linen place mats and condiments. People were having to wait a long time before they were served lunch. Two people were sat at the dining table. they waited forty five minutes before they were given anything to drink, their lunch was served ten minutes after the drink. There was no menu choice displayed and it appeared that staff chose what people had for their lunch. The choice was mince, vegetables and potatoes or sausage casserole with chips, followed by chocolate sponge and white sauce. People said it tasted very nice. Staff sat next to people who needed help with eating and talked and interacted well with people while feeding. Plate guards and spoons were used by some people to help them eat independently. During the morning we saw people being offered hot drinks and biscuits. On the trolley were some bananas these were not offered to people or cut up and given out as an alternative to biscuits. Staff told us that there are plenty of snacks and drinks available during the day if people are hungry. Care Homes for Older People Page 16 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Safeguarding practices are not robust and leave people exposed to risk of harm. Evidence: We looked at how complaints are handled by the home. The home has a complaints procedure that is on display in the home. Since the last inspection their has been three complaints that have been recorded . Two had been investigated and had associated documentation detailing the outcomes of the investigations. One we were told by the area manager had been resolved informally however there was no documentation to support this. Visitors told the inspectors that they knew how and who to complain to if they had a problem. The area manager told us that he has made himself available one afternoon a week as an open door session if any visitor to the home wishes to speak to him to raise any concerns or querys, however the visitors who were spoken to during the inspection were not aware of this arrangement. Some staff have been trained in the protection of vulnerable adults, this is mainly domestic staff. From the training matrix that was provided to the inspectors it would appear that none of the senior nurses who work at the home have received training in this area to date. Upon inspection of some care records we found that safe guarding situations had arisen. No action had been taken by the staff at the home to keep people safe or report these incidents to the local authority, who are the lead investigator in these matters. This is very poor, with some people being put at unnecessary risk of harm. Care Homes for Older People Page 17 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst people live in a clean comfortable environment, their safety and welfare is not protected. Evidence: The home was clean and comfortable. Peoples bedrooms are decorated regularly and the main communal areas were bright, clean and tidy. A painter is employed at the home, he said that he refreshers paintwork continually in the home, and bedrooms are painted on a regular basis. He said that if people wanted to they could choose the colour the bedroom was to be redecorated in. Some new flooring has been fitted to some bedrooms since the last inspection and the outside garden area developed, however it was reported that area is underused by people. We looked at the records that were kept for making sure that staff are trained in fire and rescue procedures. The records were in disarray the weekly fire alarm test was last recorded as being done on 28/07/09 and before that 30/09/08 . There was no records for the regular testing of the emergency lighting. We spoke to staff who said that there had been management problems recently and that they had been unclear whos responsibility it had been to undertake the tests and arrange fire lectures. The training matrix that was provided to the inspectors at this inspection did not cover fire and rescue training and therefore the inspectors were unable to confirm if staff had received training. Care Homes for Older People Page 18 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whislt there appeared to be sufficient staff on duty, people are not supported by permanent, suitably trained or competent staff which has led to peoples needs sometimes not being properly met. Evidence: On the day of inspection we were told that there were two registered nurses on duty, supported by two senior care assistants and six care assistants. In addition to this there was a selection of ancillary staff on duty. The regional manager told the inspectors that staff are deployed over the two floors. During the inspection it felt that staff were continually busy and had very little time to spend with people. A relative commented the staff are very good but they never really get chance to tell us properly whats been going on, they are always busy on the go. One member of staff told us that staffing is sometimes down but that the levels have improved over the past few weeks. Staff told us that agency staff are regularly on duty in the home. From the duty rota it was difficult to ascertain who was on duty. Some people were referred to by first name and some shifts that were to cover did not appear to have been covered. From the training records it would appear that staff have not received training on a regular basis to keep their knowledge and skills updated. We asked at the previous inspection that all staff who assist in the administration of medication receive further training. On the training matrix only five members of staff had completed this. Care Homes for Older People Page 19 of 31 Evidence: Staff files were examined, people are recruited properly and all checks such as references, and criminal record bureau checks are done, prior to the person starting work at the home. Care Homes for Older People Page 20 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is not being managed effectively putting peoples welfare and safety at risk. Evidence: From our observations and speaking with the operational manager it was clear that problems at the home had been identified , and she has started to take action to put some things right. The operational manager is very experienced and has a good understanding of what systems should be introduced to address the problems. Staff told us the operational manager and area manager had so far been very supportive . The home has not had a registered manager for some time and several acting managers have been in post. The company has quality assurance manuals in place with audits completed by previous managers and the area manager. However, in light of the findings at our inspection it is evident that the systems have not been effective. We looked at peoples personal allowances that the home manages. The home handles Care Homes for Older People Page 21 of 31 Evidence: small amounts of personal money. We checked three peoples personal allowances, the system for recording personal allowance transactions was poor. The records detailing transactions did not tally with the amount of money held at the home for the individual. We did not see evidence that accidents and safeguarding incidents are being properly managed properly. A number of people have had accidents and it is unclear whether they have received appropriate medical attention or appropriate action has been taken to prevent further accidents and keep them safe. The home must tell us about important events and incidents involving the people who use their service which includes any serious injury that results in a consultation with a medical practitioner. The home has failed to do this on some occasions. We were concerned because staff had not received appropriate fire and manual handling training. During this inspection we observed staff transferring a person inappropriately and had to intervene so that the person did not come to any harm. The health and safety records were disorganised. The inspectors were unable to tell if all the regular health and safety checks for the home had been carried out. It did not appear that all of the staff have received basic health and safety training. Therefore the health, safety and welfare of the people who live at the home is not being promoted or safeguarded. Care Homes for Older People Page 22 of 31 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 7 15 Care plans must be written in 09/11/2009 sufficient detail to instruct staff on how people needs are to be met to ensure people receive proper planned care Time scale of 01/01/09 not met and remains outstanding Care Homes for Older People Page 23 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 The care plans must be 09/11/2009 more detailed and individual to the person they have been written about, including their personal preferences, abilities and wishes. This will make sure that staff have clear guidance about how to meet individuals identified and assessed health, safety, personal and social care needs. The manager must make sure that if a safety risk assessment identifies the need to use bed rails that clear and detailed records are kept which include the following information Why they were being used. Who is responsible for checking that they are the correct type for the bed, that they are fitted correctly, in good working order. How often 09/11/2009 2 8 13 Care Homes for Older People Page 24 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 they should be checked and where the results are to be recorded. This risk assessment must be kept under review. To keep people safe and reduce risk of harm. 3 8 12 The manager must make 09/11/2009 sure that where risk assessments identify people as being at risk of falling, developing pressure sores or losing weight, advice is sought from appropriate health care professionals and detailed care plans put in place. If assessments and care plans identify that there is a need to monitor food and fluid intake or care provided, steps must be taken to make sure that appropriate, accurate records are kept as these will help to identify when further input from other health care professionals may be needed. This is to make sure that peoples healthcare needs are identified and met. 4 9 13 Steps must be taken to make sure that the systems 09/11/2009 Care Homes for Older People Page 25 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 for dealing with medications are safe. Accurate records must be kept of all medications received into the home and when they have been given to people. In order that people receive their medication correctly and safely and the treatment of their medical condition is not affected. 5 12 16 The information gained from 11/12/2009 individuals life histories should be used to plan activities that take peoples preferences and abilities into account. So that people have choice and can engage in meaningful activites. 6 18 13 Steps must be taken to 09/11/2009 make sure that all staff have received training around abuse awareness and adult protection. This will make sure staff will know how to recognise abuse and know what to do if they see or suspect it. 7 19 23 All staff must be trained in fire prevention. All records associated with the prevention and detection of fire must be kept in good 09/11/2009 Care Homes for Older People Page 26 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 order and demonstrate that fire detection and fire fighting equipment has been maintained. In order that people live in a safe environment. 8 27 17 The duty rota must detail all staff who are on duty and what shifts they have been rostered to work. This must include the first and surnames of all staff. So you can determine which members of staff are on duty and a accurate record is maintained 9 27 18 There must be sufficent staff 09/11/2009 on duty at all times. The dependacy of the people,who live at the home should be taken into account when determining this. This will make sure that peoples health, safety and well being is monitored and maintained and that their personal, social and psychological care and support needs are met. 10 30 18 All staff should be 14/12/2009 appropriatly trained to help them to maintain the health, safety and well being of people living in the home 09/11/2009 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 and themselves. This must include training about the specialist needs of people such as dementia care. To ensure that staff are qualified and competent for the job they are doing. 11 31 9 The home should have a registered manager that is qualified, competent and experienced in the management of running a care home. So people benefit from a well run home. 12 33 24 The quality audits on the home must be carried out properly and demonstrate that action has been taken to rectify the failings of the service So that people who use the service can be confident that they are in receipt of a good service. 13 35 17 An accurate record of all financial transactions must be kept for people who deposit money with the home for safe keeping. The ammount of cash held must tally with the record of transactions. 09/11/2009 14/12/2009 14/12/2009 Care Homes for Older People Page 28 of 31 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action To protect vulnerable people from financial abuse. 14 38 37 The Care Quality 09/11/2009 Commission (CQC) must be notified of significant events that affect the health and welfare of people who live at the home. To ensure the regulatory authority receives appropriate information and can monitor the health and welfare of people who are living at the home. 15 38 13 Any accident must be 09/11/2009 recorded in sufficient detail, monitored and appropriate healthcare support provided. So people who live at the home are safe and have all their needs met. 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 10 The use of all the communal lounges areas in the home should be considered, this would give people a less crowded and cramped environment to sit and relax in, and staff have more space in which to observe and support people without being intrusive of peoples personal space Routines around mealtimes should be reviewed so that people are not sat at the dining table for excessive lenghts 2 15 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 of time, waiting to be served or for assistance. 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. 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