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Inspection on 04/03/09 for Bingley Wingfield Nursing Home

Also see our care home review for Bingley Wingfield Nursing Home for more information

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Bingley Wingfield Nursing Home Oakridge Court Off Priesthorpe Road Bingley West Yorkshire BD16 4ED     The quality rating for this care home is:   zero star poor service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Mary Bentley     Date: 0 4 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 32 Information about the care home Name of care home: Address: Bingley Wingfield Nursing Home Off Priesthorpe Road Oakridge Court Bingley West Yorkshire BD16 4ED 01274567161 01274566809 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Dr A T Ghoneim care home 48 Number of places (if applicable): Under 65 Over 65 48 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who can be accommodated is: 48 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 category: Old age, not falling within any other category - Code OP, maximum number of places 48 Date of last inspection Brief description of the care home Bingley Wingfield is registered to provide personal and nursing care for a maximum of 48 people. The majority of people living in the home are over the age of 65. The original Victorian building has been extended to incorporate a wing of single ensuite accommodation. The home offers both single and shared accommodation, ensuite facilities are provided in twenty-five of the single rooms. There are communal rooms on the lower ground floor, the ground floor, and the first floor. The home is situated near Bingley and is on a local bus route. The area has many shops and local amenities. The home has pleasant gardens that are accessible to Care Homes for Older People Page 4 of 32 Brief description of the care home people living in the home. Car parking is provided at the front of the building. The home has a second entrance via a ramp for wheelchair access. The home has a no smoking policy. In March 2009 the fees ranged from 398.00 to 585.00 per week. Additional services such as hairdressing and chiropody are not included in the fees. Care Homes for Older People Page 5 of 32 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: The last inspection of this service was carried out on 2 June 2008. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous 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 enforcement action will be taken. The purpose of this inspection was to look at how the needs of people living in the home are being met and to follow up on the requirements made at the last inspection. Care Homes for Older People Page 6 of 32 This was an unannounced visit carried out in one day between the hours of 9:15 and 6:30. We were accompanied by an Expert by Experience from the organisation Help the Aged. An expert by experience is a person who, because of their shared experience of using services, is able to help us get a better picture of what it is actually like for people using services. During the visit we spoke to people living in the home, visitors, staff and management. We looked at various records including care records and we looked at some parts of the building. Following the last inspection the home provided us with an improvement plan setting out how they would make the required improvements. This information was used in planning this visit. During this visit we found that in most cases the planned improvements are taking longer than anticipated and in some cases no improvements have been made. Of particular concern is the ongoing failure to carry out all the required checks before allowing new staff to start work in the home because this is potentially putting people at risk. On this occasion we did not ask the home to complete a self-assessment and we did not send surveys to people using the service. What the care home does well: What has improved since the last inspection? What they could do better: New staff must not start work until all the required checks have been completed and all the required documents are available. This is to make sure that they are suitable to work with vulnerable adults. This has been raised at previous inspections and has not been dealt with. More must be done to protect people from unnecessary risks. In particular, hot water temperatures must be maintained within the safe recommended limits to reduce the risk of scalding. More attention should be given to making sure that staff are using correct moving and handling procedures to reduce the risk of injury to people living in the home and themselves. Care Homes for Older People Page 8 of 32 More attention must be given to meeting the needs of people who are identified as being nutritionally at risk and this must include making sure that snacks are provided between meals. More attention should be given to organising meal times so that they can be a social occasion for people and food that is served to people in their rooms should be served at the correct temperature. Improvements are needed to the way peoples social care needs are dealt with. A more individualised approach is needed to make sure that everyone living in the home gets the support they need to follow their personal interests and make the most of their abilities. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 9 of 32 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 32 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 given information about the range of services offered and peoples needs are assessed before they move in. Evidence: The home told us that peoples needs are always assessed before they move in. This is done to make sure the home will be able to meet the persons needs. We saw completed pre-admission assessments in the care records we looked at, however they were not always dated so it was not clear when the assessment had taken place. One person told us they had visited the home when looking for a place for their relative. They said the staff were friendly and welcoming and had spent time with them explaining the range of services offered. They said they are satisfied that their relative is getting the care they need. Care Homes for Older People Page 11 of 32 Care Homes for Older People Page 12 of 32 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. More needs to be done to make sure that peoples nutritional needs are met. To reduce the risk of peoples needs being overlooked the care plans must be kept up to date and accurately reflect peoples needs and preferences. Evidence: Last year there were concerns about the way the home managed the care of people with pressure sores. An investigation of these concerns identified areas where improvements were needed. The manager told us that since then improvements have been made. These include clarification of the criteria for referral to the Tissue Viability nurse specialist, improved recording of pressure area care and wound management and training for staff. When we visited there was only one person in the home with a pressure sore and the district nurses were dealing with this. During the visit we looked at care records relating to six people living in the home, Care Homes for Older People Page 13 of 32 Evidence: some in more detail than others. Last year we identified concerns about the way some peoples nutritional needs were being met. The manager told us improvements have been made and the number of people identified as being nutritionally at risk has been reduced. However, we identified similar concerns about the way these peoples nutritional needs are being dealt with. For example, one persons weight was recorded in March 09 as 43.2 kg and the records showed he has lost approximately 4 kg since Jan 09. The care plan had been reviewed but had not been changed to reflect this change. The persons care plan says he should be offered snacks between meals, however the food charts do not show that this is happening. The food charts for 3 other people identified as being nutritionally at risk showed a similar picture with no evidence of snacks being offered between meals. These peoples care plans said their weight should be recorded every week but this was not done. Their care plans relating to eating and drinking had been reviewed but had not been changed to take account of the fact that they were continuing to lose weight or were failing to achieve a weight that would reduce the risk of malnutrition. The care plans have information about peoples personal and health care needs. Information about peoples social care needs varied, with some records containing more information than others. The care plans do not always contain clear information. For example phrases such as needs assistance are used rather than more specific information about what people can do and what they need staff to do for them. People told us they are satisfied with the home and have no complaints. One person told us his/her needs are met. Another person said they sit in a wheelchair in the lounge all day. They said they have no chair in the bedroom so when they go there they have to go on the bed. One person told us they have a shower once a week, they said they didnt feel they could ask for more although staff said that was what they are there for. Another person told us they would love to have a bath. Most visitors told us they are happy with the care provided. One person said their relative does not always see the hairdresser and staff are not always prompt responding to requests for help. Care Homes for Older People Page 14 of 32 Evidence: People looked clean and nicely dressed. A visitor told us that their relative is kept nice and clean and helped to change their clothes if necessary. We saw some evidence that people or those close to them are involved in drawing up care plans. The relatives we spoke to said they are kept informed by the home but they said they have not actually seen the care plans. We saw evidence that people have access to a range of NHS services such as dentists and physiotherapists. There are suitable systems in place to make sure that medicines are managed safely and people get their medicines as prescribed. Some of the care plans have information about funeral arrangements but other than that there is no information about peoples wishes in relation to end of life care. Care Homes for Older People Page 15 of 32 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. There are some activities for people to take part in and people are supported in keeping in touch with their family and friends. However, more needs to be done to make sure that everyone living in the home is given the support they need to follow their personal interests and make the most of their abilities. Evidence: Several people told us they could go to bed when they wanted. One person said they are usually in bed by 7:00 pm and another person said that if they stayed in bed in the morning they did not get breakfast. Some people told us they prefer to stay in their rooms and are able to have their meals there. However, one person said that their meals, including morning and afternoon drinks, are always cold when they get them. There were no activities on the day we visited. We saw some people being given magazines to look at. The home told us they have a full time activities organiser. However, she works in the laundry on Wednesdays and we were also told she accompanies people to appointments and therefore is not always available to organise Care Homes for Older People Page 16 of 32 Evidence: activities for people. The hairdresser visits the home every Wednesday morning and some people had their hair done. The home told us there is a church service on alternate Wednesday afternoons. The televisions were on in all the lounges although no one seemed to be watching them. In the afternoon the televisions in the ground floor lounges both had childrens programmes on and none of the staff noticed that this might not be appropriate or of interest to people. People told us they play dominoes, cards and said they also do painting, drawing and quizzes. Staff and visitors had organised a baking group on the day before we visited. About 7 people had taken part, they said they made scones and enjoyed eating them. Some people told us they had been on outings organised by the home. We asked people about day to day life in the home and these are some of the comments we received, some weeks good and some nothing going off, doesnt do anything, nothing at weekends, more stimulation needed, nothing for you to do, not a lot going off, feels stale. Visitors told us they are made welcome and one said they sometimes have lunch at the home. The home told us there is always a choice of 2 hot meals at lunchtime and people are asked to choose the day before. However, during the morning when people asked what was on the menu for lunch staff did not know. At lunchtime we did not see anyone being offered an alternative meal although one person asked. Two people said the lunch was late and said it has been since the new chef started. Some people were waiting quite a long time before the meal was served. However, when the meal arrived it was nicely served and hot. People were offered drinks with their meals and staff were available and helped people discreetly where necessary. There was quite a delay before the pudding was served and some people were getting a bit agitated about this. When the pudding was served it was in small metal bowls and some people were obviously having difficulty managing it. One person was given a larger bowl but others continued to struggle. Overall, the mealtime was not very relaxed and was not a social occasion for people. One person told us the food is good, they said there is usually fresh fruit available and staff make milky drinks for them at night. Another person said there are bedtime drinks and supper at about 9:30 pm but someone else said there is nothing to eat Care Homes for Older People Page 17 of 32 Evidence: after the evening meal. Care Homes for Older People Page 18 of 32 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. The home has systems in place to make sure complaints are dealt with appropriately. The procedures that are in place to safeguard people are not always followed and this may put people at risk. Evidence: Two relatives told us that any concerns they had raised had been dealt with and one person added that they have confidence in the home. Two people living in the home told us they were not aware of the complaints procedure but said they would talk to staff if they had any concerns. Since the last inspection two people have contacted us with concerns about the home. In both cases the people involved did not want to approach the home directly. The information they gave us was used in planning this inspection. The home has policies and procedures in place to protect people from abuse. However, these procedures are not always followed. The home does not always complete all the required checks before new staff start work and this potentially puts people at risk. The majority of staff have attended training of safeguarding (adult protection) and training has been booked for the remaining staff. Care Homes for Older People Page 19 of 32 Care Homes for Older People Page 20 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and improvements are being made to the building to make sure it provides a comfortable and pleasant place for people to live. More needs to be done to protect people from potential risks. Evidence: The home was clean when we visited. There is an ongoing programme of refurbishment. For example, since our last visit the lounges on the ground floor have been decorated and improvements have been made to the entrance and front hall. Work was scheduled to start on the ground floor corridor in the week following our visit. The first floor has not yet had any work done. On this floor the corridor walls and door frames are showing signs of wear and tear and in some places the carpet is ripped potentially creating a trip hazard. Following our inspection last year we asked the owners to provide us with details of the refurbishment plan, including timescales. We have received information about work that has been done but we have not received details of planned work or the timescales. Although improvements are being made the work seems to be taking a long time and this was discussed during the visit. The home told that the management consultants they have employed have carried out a full audit of the building and will be working with them to make improvements. The manager said they would be putting an auditing system in place. This will include Care Homes for Older People Page 21 of 32 Evidence: checking rooms regularly to make sure they are clean and well maintained. The home has four lounges, one on the lower ground floor, two on the ground floor and one on the first floor. One of the lounges had a number of reclining chairs and people looked comfortable in them. The other lounges had armchairs and we didnt see any footstools available for people. There is no separate dining room. There are some dining tables in the lounges. At lunchtime we saw that a lot of people had their meals in armchairs with a table placed in front of them. The bedrooms were warm and we saw that people have personal belongings such as photographs and/or ornaments in their rooms. Jugs of juice and water are available in the communal rooms but we did not see any jugs of juice/water in peoples bedrooms. The home has 3 hoists to help people with moving. One of them is a manual hoist and staff said it is not as good as the other two. Staff said the hoists are usually available when people need them and people dont often have to wait for help. We saw staff using other aids such as handling belts to help move people safely. The hot water temperatures in two of the bathrooms were considerably higher than the recommended safe temperature (43 degrees C plus or minus 2). The wash basins in bedrooms have signs saying the water temperatures may be very hot and in some bedrooms the water was very hot to the touch. These signs may not be enough to reduce the risk of scalding if people are frail or confused. The home told us they have valves fitted to control hot water temperates, however the water temperature remain well above the recommended safe limit. We discussed these concerns when we visited last year and they have not been dealt with. The home has been given a 3 star rating (the maximum is 5) by the Environmental Health Department for its standards of food safety and hygiene. There are suitable systems in place to reduce the risk of cross infection. People did not raise any concerns about the laundry and peoples personal clothing looked well cared for. Care Homes for Older People Page 22 of 32 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. The home does not always carry out all the proper checks on new staff before they start work and this potentially puts people at risk. Evidence: We asked people about the staff in the home and these are some of the comments we received; nice, do anything for you, good, some better than others, some nicer than others, staff busy, not all as good as might be, girls very good, staff nice enough. One person who prefers to stay in their room said they didnt see staff much but said staff answered the buzzer quickly when they rang for help. Visitors said staff do sit and chat to people when they have time, they also said staff seem to change a lot and they thought the home might be short staffed at times. There were 30 people in the home when we visited. At the last inspection we were concerned that there were not enough staff on duty between 7:00 and 9:00 pm which meant that people could not always choose the time they wanted to go to bed. This has now been increased and there are usually a total of 5 staff, one nurse and 4 care assistants, on duty until 9:00 pm. The duty rotas showed that there are usually one or two nurses on duty in the morning with 5 care assistants. Care Homes for Older People Page 23 of 32 Evidence: We looked at the files of four newly appointed staff. One was satisfactory. Two of the files showed that PoVA First (Protection of Vulnerable Adults) checks had been done before the staff in question started work but no references had been obtained. In another the PoVA First and the references had not been obtained until approximately 3 weeks after the person started work. These checks are required to protect people from possible abuse by staff that are not suitable to work with vulnerable adults. By not completing these checks the home is putting people at risk. This has been discussed at previous inspections and has not been dealt with. At the last two inspections the manager told us they are working on bringing the training records up to date. This has not been done. Therefore it is difficult to get an accurate picture of what training people have had. Staff told us that the availability of training is not consistent. Staff confirmed they have recently had training on Moving and Handling and the manager told us fire training took place last week. The nurses are booked on training on the prevention and treatment of pressure sores and other staff are booked on training on safeguarding (adult protection) over the coming months. The home told us that 10 (43 ) of care staff have an NVQ (National Vocational Qualification) in care at level 2 and 7 more staff are doing NVQ training. Care Homes for Older People Page 24 of 32 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 consistently providing good outcomes for people and some practices are putting people at risk. Evidence: Following the last inspection the providers gave us an improvement plan with details of the actions they would take to make the required improvements to the service. They told us they would be taking action to strengthen the management structure. They have employed a management consultancy to help them with this. The management consultancy has carried out a full audit of the service and has agreed an action plan with the homes management. Work on putting this plan into action was due to start in the week following our visit. However, at the time of our visit some of the requirements from the last inspection had not been dealt with. Of particular concern is the continued failure to follow the correct recruitment procedures by making sure that all the required checks are Care Homes for Older People Page 25 of 32 Evidence: completed before new staff start work. Since the last inspection the owners told us they have been taking a more active part in the day to day running of the home. However, they have not been doing the formal monthly reviews of the service which we have asked them to do on previous occasions. The reason for these reviews is to monitor the quality of the service and to provide support to the manager. They said they have now asked the management consultants to do this. The home holds meetings for the people who live there and their representatives. The most recent meeting was in January this year. In addition to the general meeting the home has a committee. This is made up of relatives and staff and has various functions which include making suggestions for improvements to the service and providing practical help with activities and outings. The home sent questionnaires to people involved with the service last in October last year. The responses to the questionnaires have not been analysed and no feedback was given to people about the results. In order for the questionnaires to be an effective part of the quality assurance systems the results should be analysed to identify areas of good practice and areas where improvements are needed. The home does not collect pensions for people but does hold some small amounts of personal money for people. A recent audit identified some problems with the way this was being managed and this was being dealt with when we visited. We identified some concerns about the way health and safety is managed. These included concerns about the way hot water temperatures are controlled and moving and handling practices. During the visit we saw staff helping one person to move using a handling belt and they carried out the task safely. However, the persons care plan showed that the physiotherapist had advised that this person should always be helped to move using a hoist. A relative told us they had seen staff moving people without using any equipment and in a way that was likely to cause discomfort or possibly injury. This was discussed with the manager. Care Homes for Older People Page 26 of 32 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 8 16 & 17 Sch 4 People living in the home must be provided with adequate quantities of suitable, wholesome, and nutritious food and where necessary food must be provided outside of set meal times. Records of food provided to people must be sufficiently detailed to show that people are receiving a satisfactory diet. This is to make sure that people?s nutritional needs are met. 19 31/07/2008 2 29 New staff must not start 31/07/2008 work until all the required checks have been completed and all the information and documents specified in Schedule 2 are available. This is to make sure that people protected. Previous timescale of 31/08/07 not met. 3 29 19 When new staff start work, having received a satisfactory PoVA First but pending receipt of a satisfactory CRB disclosure there must be appropriate supervision arrangements in 31/07/2008 Care Homes for Older People Page 27 of 32 place to make sure that people are protected. Care Homes for Older People Page 28 of 32 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 17 People living in the home must be provided with adequate quantities of suitable, wholesome and nutritious food and where necessary food must be provided outside of set meal times. Records of food provided to people must be sufficiently detailed to show that people are receiving a satisfactory diet. This is to make sure that peoples nutritional needs are met. 29/05/2009 2 25 13 Hot water temperatures must be maintained within the recommended safe limits. To reduce the risk of people being injured by scalding. 17/04/2009 3 29 19 When new staff start work, having received a satisfactory PoVA First but pending receipt of a satisfactory CRB disclosure 29/05/2009 Care Homes for Older People Page 29 of 32 there must be appropriate supervision arrangements in place. This is to make sure that people are protected. 4 29 19 New staff must not start 29/05/2009 work until all the required checks have been completed and all the information and documents specified in Schedule 2 are available. This is to make sure that people are protected. 5 30 17 Records of all training undertaken by staff must be maintained, kept up to date and be available for inspection. To make sure that staff get the training they need to care for people properly. 6 33 24A The Commission must be provided with a written improvement plan setting out how the service will be improved and this must include details of the what action is to be taken, the person responsible for the action and the timescale within which it will be done. This is to make sure that action is taken to protect people from unnecessary risks and to make sure that people using the service experience good quality outcomes. 01/06/2009 29/05/2009 Care Homes for Older People Page 30 of 32 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 12 A more individualised approach to social care should be developed so that people are given the right support to follow their personal interests and make the most of their abilities. More attention should be given to the way meal times are organised to help make them a more relaxed and social occasion for people. The way meals and drinks are served to people who stay in their rooms should be reviewed to make sure that people are able to enjoy their food at the correct temperature. 2 15 3 4 19 27 The Commission should be provided with detailed plans, including timescales, for the refurbishment of the home. Staffing levels should be kept under review to take account of the changing needs of the people living in the home and the layout of the building. This is to make sure there are always enough suitably trained and competent staff on duty to meet peoples needs in a timely way. The results of quality assurance questionnaires should be analysed and an action plan put in place to deal with areas where improvements are needed. People using the service should be given information about the results of the questionnaires. More attention should be given to making sure that staff are following the correct moving and handling procedures. 5 33 6 38 Care Homes for Older People Page 31 of 32 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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