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Inspection on 22/07/09 for Belton Lodge Nursing Home

Also see our care home review for Belton Lodge Nursing Home for more information

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

What the care home does well

The people live in comfortable and homely accommodation. They are also offered choices about what they wish to do and to make decisions about how they spend their lives. People who live in this home told us they were happy with the facilities provided and the way the staff care and support them. They told us, "I am very happy here" and "the staff are kind". They are offered a varied menu that takes into consideration their likes and dislikes. People told us they liked the meals which suited their tastes.

What has improved since the last inspection?

A new standaid hoist has been purchased to enable people to stand more easily and remain independent. A new flat screen television has been provided in the lounge. They are in the process of introducing a new system for the recording of care in order to make it more individual. During our inspection visit they were in the process of building a large gazebo and making the garden more attractive to enable the people to make more use of the garden. They were also decorating inside the home. As a result of an inspection by South Kesteven Council in May 2009 they were awarded 5 stars "excellent" in recognition of their catering standards.

What the care home could do better:

There were 3 requirements from this inspection concerning the recruitment of staff including bank staff and ensuring that the people are involved in contributing to their care plan. Despite assurances from the owner the management of the home still needs addressing.

Key inspection report Care homes for older people Name: Address: Belton Lodge Nursing Home 213 Belton Lane Grantham Lincs NG31 9PW     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: Tobias Payne     Date: 2 2 0 7 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 26 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 26 Information about the care home Name of care home: Address: Belton Lodge Nursing Home 213 Belton Lane Grantham Lincs NG31 9PW 01476579798 01476579798FP dimplemotors@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: R S Medicare Limited care home 13 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Condition of Registration The maximum number of service users in the home with nursing does not exceed 10 and the maximum number of service users with personal care only does not exceed 3. Date of last inspection Brief description of the care home Belton Lodge is a care home providing personal and nursing care for 13 older people. The home is a converted bungalow situated in Belton, a village located on the outskirts of Grantham. There is a lawned garden at the rear of the home and there is car parking at the front of the property. All accommodation is situated on the ground floor. There are 7 single bedrooms one with en-suite and 3 shared bedrooms each with en-suite. The home has one lounge/dining room and an adjacent conservatory. The fees at the inspection visit on the 22/7/2009 ranged from £400 to £495 a week. Care Homes for Older People Page 4 of 26 Over 65 13 0 0 7 1 0 2 0 0 8 Brief description of the care home Extras are for hairdressing which ranged from £9 75p to £23 , chiropody £10, toiletries and personal newspapers and magazines. Information about the home including the statement of purpose, service users guide are available in a folder in each persons bedroom and copy of the last inspection report is available at request from the manager. Care Homes for Older People Page 5 of 26 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 inspection visit which was unannounced took place over 5 hours. The deputy manager was present and assisted us throughout our inspection and was given feedback at the end of the inspection. The main method of inspection used was called case tracking which involved selecting 2 people and tracking the care they receive through the checking of their records, discussion with them and the staff, and where more appropriate observation of interaction between the staff and the people living in the home and related care practices. We looked at a sample of care records, policies and procedures, equipment records and walked around the home to see the quality of accomodation and visited some of the bedrooms with the permission of the people living in the home. We spoke with 5 people living in the home, as well as 2 members of staff. An (AQAA) Annual quality assurance assessment was completed by the manager and sent to us prior to this report being completed. This is a self- assessment document completed by the manager of the care home. It sets out evidence from the provider to demonstrate that they are meeting the Care Home Regulations. Care Homes for Older People Page 6 of 26 We also sent out before this inspection 10 surveys to the people living in the home and 5 to staff. We received replies from 2 people living in the home and 2 from the staff. All were positive and their comments are reflected throughout this report. Where the use of we or us is used it refers to the Care Quality Commission. The previous key inspection took place on the 7th October 2008. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 26 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 26 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 coming in to the home receive information and support to help them make an informed choice of where to live. There are assessment processes in place, which ensure that individual needs can be met within the home. Evidence: There was a detailed statement of purpose and service users guide in each bedroom. A copy of our last inspection report could be made available at request to the manager. We noticed that the address and telephone number of our new National Contact Centre needed to be added to these documents. The acting manager told us that since the last inspection no new person had been admittted to the home. However where a referal was made to stay in the home the manager would visit each person and make a thorough assessment of their needs involving the person and any other person involved in their care and support. As a result she would then send written confirmation to them that based on the assessment they could meet their needs. We saw in the records that assessments take place before admission to the Care Homes for Older People Page 10 of 26 Evidence: home. The care home does not offer a dedicated intermediate care service. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person has a detailed care plan giving details about their care and support. Medication was given safely by staff who knew what they were doing. Evidence: Each person had a care plan. Records included an admission assessment of their needs, nutritional assessment, dependency assessment, risk assessment with the signature of the member of staff, specific care plan outlining the care and support, daily record and evidence of monthly review. We looked in detail at the care plans for 2 people. Care plans gave details about how staff can support and meet the needs of the people. The staff completed daily records so that the changing needs could be recorded and responded to. Care records now included a record of daily activities which each person was involved in and a monthly audit. We saw staff showing good knowledge of the particular needs of the people. We saw that the care plans also considered the capacity of people to make decisions about their lives. Staff also told us that they knew how important it was to respect each persons capacity to make decisions about their lives. Although there had been an improvement we could see no evidence that the people themselves had been involved in identifying their needs or at Care Homes for Older People Page 12 of 26 Evidence: reviews of their care. Staff were seen to attend to people promptly and with little fuss. We saw staff encouraging the people to remain independent and in control of their lives by being asked about what they wanted to do. Staff we spoke with told us that we want to help the people and not to hurry them. We did however notice in the minutes of a staff meeting on the 20/5/2009 a sentance requesting staff to shave gentlemen every alternative day. We were unable to find out from the gentlemen whether that was something they had requested and there was nothing in their care plans about this. The home had an electric hoist and a new standaid hoist had been purchased. There were also a variety of slings and pressure relieving mattresses and nursing beds whose height could be adjusted to suit the needs of people confined to bed. We saw a person who was nursed in bed. She was attended to every 2 hours and we could see their position was changed to relieve pressure every 2 hours and their fluid intake and output was monitored. We saw staff taking their time, talking to the person and explaining what they were going to do in a calm manner. There were plastic aprons, gloves and antibacterial hand wash in each bedroom. Where required, people living in the home were referred to their local doctor, community nurse, community psychiatric nurse, tissue viability nurse, continence nurse, physiotherapist, opticians, dentist and chiropodist. Registered nurses gave the medication. Each nurse was assessed by the manager and considered competent to administer medication. The deputy manager told us that although the people are encouraged by the staff team to self medicate each person needed some form of assistance in order to ensure that they took their medication safely. We observed this being done in a sensitive way. The nurse explained clearly and slowly how he was to provide suport to the person receiving the medication before he gave it. Medicines were given from a trolley, checked against the chart, given to the person and signed for after this. The home received a pharmacy inspection visit on the 21/7/2009. The report showed no concens. People we spoke with were satisfied with the way staff cared for them and had confidence in the staff. We saw throughout our inspection staff attended to the people in a warm, friendly and kind manner, knocking on doors before entering their bedrooms and asking whether they needed any help. The people told us the staff are so friendly and kind. Care Homes for Older People Page 13 of 26 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 encouraged to maintain and develop social interests and relationships of their choice. People receive a nutritious, varied diet, which meets their individual preferences and health requirements. Visitors are made to feel welcome and supported. Evidence: In entrance hall to home there was a very large poster with details of the menu over a 4 week period, programme of activities for the morning and afternoon, photographs of each person and of group activities with an example of the range of activities available. We saw details about each persons interests included in the care records. Since the last inspection they had included more information about what they liked to do and their interests. We saw an example for one person which showed the person liked to be involved in peeling potatoes, washing up, enjoyed painting water colours, setting the table jigswaws and making necklases. Efforts have continued to provide more stimulation in order prevent boredom for the people living in the home. We could see there was an activities programme and we saw there was a future Summer singalong on the 29/7/2009. We were also told that they had a person who provided actvities twice a week and a cooking club is to be introduced in the future. Other activities provided by the staff have included pass the ball, hand massage, gentle Care Homes for Older People Page 14 of 26 Evidence: movements to music and hairdressing every week. During our inspection we saw people being assisted to be active or choosing to be in their rooms. We were told that staff had been told to be more involved with the people. Where this was taking place we saw the people actively involved in conversation, laughing and smiling. Some were encouraged to sit with the staff and have a cup of tea during their breaks and we saw a member of staff carrying out a manicure for one of the people and talking and laughing with her. The people living in the home were offered 3 main meals a day plus snacks and drinks. The menu for the day was displayed on a large notice board outside the kitchen. There was a set menu but an alternative could be arranged to suit the needs of the person. South Kesteven District Council awarded the home 5 stars (excellent) following an inspection in May 2009, in recognition of the catering service provided. We looked at the records for food served, temperatures, menus and cleaning rotas and found them well maintained and up to date. Meals were served in the dining room which was part of the lounge. Tables were set with tablecloths and place mats. Information provided in the AQAA and what people told us showed that the menus were varied and choice was offered. People we spoke with told us they enjoyed the food. We saw breakfast and lunch being served. Breakfast included a cooked option if requested. Information provided in the AQAA and what people told us showed that the menus were varied and choice was offered. People we spoke with told us they enjoyed the food. We saw breakfast and lunch being served. Breakfast included a cooked option if requested. Comments included, I like the food, it is very nice and hot. We saw staff were assisting those people who needed assistance in a dignified and sensitive manner. They sat by the side of them and helped them. Care Homes for Older People Page 15 of 26 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 know how to make a complaint and feel that staff will listen to their views. The care team know how to respond to a complaint and how to act in order to protect people from abuse. People are recruited in an inconsistent manner which could pose a risk to the people living in the home. Evidence: Each person received a copy of the complaints procedure in the service users guide and statement of purpose. The information was also dsplayed on the wall by the visitors book at the entrance to the home. However the service users guide and statement of purpose did not contain our new name, National Contact Centre telephone number and address. We and the home have received no complaints or safeguarding adults issues since the last inspection. The service had a copy of Lincolnshire County Councils adult protection procedures but we noted we could only find a copy dated May 2007 rather than October 2007. Most of the staff were correctly recruited including a check by the criminal records bureau (CRB). However we looked at the records for a person who worked on the homes bank of staff and saw that the person had started before they had received a CRB check and the manager had not obtained a reference from their employer. We could see that during their induction each member of staff received information about abuse. Two staff were asked what abuse was and only one could tell us what it was and what they should do if abuse was suspected. We saw records later Care Homes for Older People Page 16 of 26 Evidence: that the person along with other staff had received abuse refresher training on the 17/7/2008. None of the people we spoke or the staff had any complaints about the home and felt they could discuss any concerns with staff or the manager. Staff also knew what to do if they received a complaint from a person living in the home. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in clean, comfortable, safe and well maintained accommodation. The infection control policy is followed and a safe environment is maintained. Evidence: Since the last inspection the environment in the home has continued to improve. During our inspection visit we could see improvements were taking place in the garden to make it more attractive and accessible for the people to use. A new gazebo was being built with other improvements to the garden and inside painting was also taking place. The staff explained they wanted to ensure the work was done during the day so that they did not disturb the people living in the home. New wooden flooring had been laid in both the lounge and dining area. There was now a new standaid hoist and an electric hoist with a variety of slings and there were a number of beds with pressure relieving mattresses. People we spoke with told us they felt the home was clean, tidy and odour free throughout. Comments included I like my room and the home is always clean. There were antibacterial hand washes in each bedroom and there was an infection policy which staff used to reduce the risk of cross infection. There were also gloves and aprons and alcohol rubs which we saw being used by staff. There were 2 commercial washing machines and one commercial tumble dryer being used to make sure peoples personal clothing was cleaned regularly. The laundry room was clean and tidy. Facilities were available to ensure clinical waste was well managed. In shared rooms there were privacy screens. Care Homes for Older People Page 18 of 26 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. There is enough staff on duty to meet the needs of the people living at the home. Procedures for the recruitment of staff are not robust and therefore do not offer protection for people living at the home. Staff have access to training to help them meet the needs of the people they care for. Evidence: People we spoke with felt the home was adequately staffed with people who were experienced and competent to care for older people. People we spoke with did not express any worries about the level or availability of staff. During our inspection visit we saw staff attended to the needs of the people promptly and in a calm and friendly manner. There were separate registered nurses, care and catering staff. Staff rotas were available and throughout our visit we saw staff promptly attend to the needs of the people living in the home. We examined the files for 2 new members of staff. Records were clear and detailed but showed that one of the members of staff working for their bank had not been safely recruited in accordance with the regulations including receiving 2 references one from the persons current employer and no recent check by the Criminal Records Bureau (CRB). We were told each person received a supported induction programme. We were told Care Homes for Older People Page 19 of 26 Evidence: that the manager encourages and supports care staff to study for a care qualification to National Vocational Qualification standards. The deputy manager told us that despite this only 20 of staff had an NVQ. Training records we saw showed that the training provided since our last inspection had included dementia awareness, safeguarding adults, fire safety, moving and handling and health and safety. During our inspection we saw staff applying their training outcomes to their daily work. In view of previous concerns about some of the staffs command of the English language the owner arranged and supported staff to attend classes on numeracy,literacy and English language to give them more confidence when speaking to and caring for the people in the home. Observation of care practices at the home showed us that the staff were caring for people in an appropriate manner. They were visible in communal areas and responded well to peoples needs. The day seemed unrushed with staff having time to chat and spend time with the people. The people we spoke with commented They look after my needs well, I am quite happy and some of the staff are very kind but some do shout at me as they do not speak English very well. Care Homes for Older People Page 20 of 26 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 home is lead by a competent, experienced manager. People living in the home have confidence in the staff. Staff received regular supervision and feel supported. The service however is affected by disorganised management systems which affect the overall quality of the service. The management uses feedback from questionnaires from people living in the home to make improvements. Evidence: The manager is a registered nurse and has extensive care and management experience in the care and support of older people. She had completed study for a management qualification to NVQ level 4. She is assisted by a a registered nurse who is also very experienced and knows about the needs of the people living in the home. Before we made our inspection visit we were informed by the owner that he had recruited a new acting manager who started in post in July 2009 and was to work alongside the existing manager and then apply to us to be the registered manager. However despite having looked at the duty rota, discussed this with the deputy Care Homes for Older People Page 21 of 26 Evidence: manager, phoned the manager and owner on the day of our inspection we were unable to find out the current position. After our inspection we spoke to the owner who confirmed this was taking place but the person was not yet working in the home. The owner also told us she was sorting out the office and management records as well as introducing a new care record system. He would be arranging for addtional storage to be provided elsewhere in the home. On the day of the inspection we found the office in a disorganised state with records duplicated and difficult to find. There were policies and procedures but we could not find any up to date clinical procedures. Staff told us they received regular formal supervision and notes were being kept. Staff told us that they felt the management were supportive. They told us we have regular meetings and are kept informed about what is going on. The service had quality assurance procedures which included monthly visits from the owner but we could not find records were being made of these visits every month. In addition there was an environmental audit and quality audit in November 2008. Questionnaires were sent out to the people living in the home in June 2009 and 5 surveys were completed and returned. They rated the service good to excellent. Comments they received included if the garden could be made over it would benefit the residents and Whenever I visit we feel welcome at any time. The people told us I like living here, I have no complaints. We saw there was a detailed equal opportunities policy, which referred to discrimination, disability and victimisation. Staff who had poor command of the English language have been encouraged and supported in attending English, numeracy and literacy classes. There was a comprehensive and detailed health and safety policy together with risk assessments covering all aspects of daily living activities. Records also showed there were regular tests of the fire system as well as regular fire drills. Records were available, up to date and well maintained. Information provided in the AQAA, demonstrated that regular checks on equipment such as hoists and fire fighting equipment had taken place. Records also showed that essential equipment was regularly serviced. Care Homes for Older People Page 22 of 26 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 23 of 26 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 12 Time must be spent with 22/08/2009 each person to find out their wishes regarding bathing, washing and in the case of men shaving and this information is contained in the care plan and the manager should ensure that the staff know of each persons wishes. This will ensure that the views and needs of the people are met. 2 7 15 Each person must wherever 22/08/2009 possible be involved in their care plan and in indentifying their health and welfare needs and their care plan agreed and signed by them This will ensure the care and support provided meets their needs. All people employed by the service including bank staff 22/08/2009 3 29 19 Care Homes for Older People Page 24 of 26 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 have 2 written references including where applicable a reference from the persons last period of employment. This will ensure that they have confirmation about the persons suitability to be employed in the home. 4 29 19 All people employed in the 22/08/2009 home including bank staff must not work unsupervised until a satisfactory enhanced Criminal Records Bureau check has been carried out to the satisfaction of the owner. This will ensure that all staff have been checked and found to be safe to deliver care. 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 37 The manager should provide up to date clinical procedures in order to ensure that nursing practice is up todate and reflects current practice. Care Homes for Older People Page 25 of 26 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. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!