Inspection on 20/07/09 for Carr Green Nursing Home

This inspection was carried out on 20th July 2009.

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

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

Other inspections for this house

Carr Green Nursing Home 26/01/09

Carr Green Nursing Home 01/02/08

Carr Green Nursing Home 13/09/07

Carr Green Nursing Home 08/03/07

Carr Green Nursing Home 15/05/06

Carr Green Nursing Home 06/10/05

Carr Green Nursing Home 07/04/05

Carr Green Nursing Home 17/11/04

Carr Green Nursing Home 19/04/04

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Hawkhills

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Extracts from inspection reports are licensed from CQC, this page was updated on 12/10/2009.

Key inspection report Care homes for older people Name: Address: Carr Green Nursing Home Carr Green Lane Rastrick Brighouse West Yorkshire HD6 3LT     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: Lynda Jones     Date: 2 0 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 28 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 28 Information about the care home Name of care home: Address: Carr Green Nursing Home Carr Green Lane Rastrick Brighouse West Yorkshire HD6 3LT 01484710626 01484710626 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Flowertouch Limited care home 31 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category terminally ill Additional conditions: Can provide accommodation and care for seven named services users - category DE(E) Date of last inspection Brief description of the care home Carr Green provides both personal and nursing care for 31 older people in what was once a school. The home is located in Rastrick, close to local amenities. There is a small, safe garden area at the side of the home and car parking is available in the grounds. All of the accommodation is on one level and there is level access to the building. There are single and double bedrooms available. None of the bedrooms have en-suite facilities. Bathrooms and toilets are near to the bedrooms. There is one large lounge and a dining room. The kitchen and laundry are in the basement. In addition to the weekly fee there is an extra charge for hairdressing, chiropody and Care Homes for Older People Page 4 of 28 Over 65 3 31 2 0 0 0 2 6 0 1 2 0 0 9 Brief description of the care home personal newspapers. Care Homes for Older People Page 5 of 28 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: At our last key inspection of the service which was carried out on 26 January 2009, Carr Green was found to have a zero star quality rating. This means the people who use this service experience poor quality outcomes. Following this inspection we sent a warning letter to the provider asking them to provide us with a plan of how they were going to improve the outcomes for people living at Carr Green. The provider sent us this plan in May and told us how they were going to improve the service. This inspection has found that although improvements have been made in some outcome areas there are still further improvements that need to ne made to the service. This inspection was carried out by two inspectors to assess the quality of care provided to people living at the home. The inspection process included looking at the information we have received about the home since the last key inspection as well a seven hour visit to the home. During the visit we spoke to people who live in the home and to the staff on duty. We Care Homes for Older People Page 6 of 28 observed staff delivering care, looked at various records and looked around the home. 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 the service 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. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: The home needs a registered manager in post so that there is someone responsible for the day to day management of the home. Creams and lotions need to be signed for when they have been administered, to show that people are receiving their treatment as prescribed. There are still some staff who have not received any training about their role and responsibility to safeguard people in their care. This must be arranged as soon as possible. All staff must be provided with appropriate training that helps them to maintain the health, safety and well being of people living there. Many of the staff have not received training in mandatory areas such as basic food hygiene, moving and handling, first aid, fire safety, infection control and health and safety. Care Homes for Older People Page 8 of 28 The staff recruitment procedure must be improved to ensure that all staff are checked appropriately before they start work in the home. Any gaps in employment histories must be fully expolored with applicants. This is to make sure people living at the home are cared for by suitable staff. Important gas and electrical safety checks must be carried out to make sure that peoples health and safety is not placed at risk. 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 9 of 28 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 28 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. Information about the service is available for people to take away to read. People are assessed before they move in to make sure that their needs can be met and it is the right place for them to move into. Evidence: The acting manager told us that people are welcome to call at the home, have a look round and talk to staff and people already living there, an appointment is not necessary. There is a brochure, statement of purpose and service user guide in the entrance area which gives information about the service and accommodation provided. Copies of these documents can be made available for people to take away to read. Most people are referred to the home via the local authority and copies of their care Care Homes for Older People Page 11 of 28 Evidence: needs assessments are always requested before any agreements are made about moving in. The acting manager also carries out her own assessment. These assessments are important because they should indicate whether the home is suitable and can meet each persons needs. We looked at a care plan for someone who moved in recently. There was evidence to show that a pre admission assessment had been carried out. Care Homes for Older People Page 12 of 28 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. There has been an improvement in the amount of detail in the care plans, which should help to ensure that peoles health and personal care needs are met. Evidence: We looked at a three care plans because we wanted to see what individual needs had been identified and what action staff have to take to meet these needs. When we last visited the home we said the plans lacked detail; they were not being reviewed regularly and they did not contain up to date information about the support that people require. In our last report we said the assessments in the care plans contained very basic information. We noted that the staff at the home are kind and caring, they know people well and they know what to do to support people. We said that important information is sometimes passed on verbally during shift handovers and is not always recorded in the care plans. This means that if the staff at Carr Green were unable to work for any reason and agency staff were required, they would not be able to provide any continuity of care because peoples needs are not always fully documented. This information is important because some of the people living at Carr Green would be unable to tell agency staff what they need. Care Homes for Older People Page 13 of 28 Evidence: On this visit,we found some improvements in the detail contained in the plans. We looked at a range of individual assessments relating to nutritional needs, continence, oral and personal hygiene, mobility and communication. We noted that the quality of information in the assessments has improved and more detail is now recorded. For example, the plans outline the sort of assistance people need to dress and undress, whether they need prompting to choose what to wear and they contain useful information about the order in which they like to dress. The records indicate when people prefer to bathe and how much support they require and whether people wear dentures or hearing aids. Individual moving and handling plans tell staff how to support people to move safely. Staff need to ensure that there is always a corresponding plan in place wherever an assessment indicates medium to high risk. We found a couple of examples to illustrate this point, for example, one nutritional assessment for a person with dementia indicated that this individual was underweight and at at moderate risk of malnourishment because of forgetting food if not prompted to eat, but there was no nutritional plan in place for staff to follow. We also looked at a falls risk assessment which indicated that one person was at high risk of falls. There was no information about areas of the home where the risk could be greater and the only advice to staff was to check footwear fits OK and watch all the time. We discussed these points with the acting manager at the end of the inspection. We observed the staff providing people with care and support throughout the day. They treated people with respect and ensured that personal care was always delivered with discretion, and in private. The staff were patient and always took time to explain what they were doing. For example, when they were assisiting people to move and using the hoist they talked through the moves they were about to make and they were all very positive and encouraging in their approach. Staff were equally vigilant in caring for people who spend the majority of time in their rooms. They called on people frequently to make sure they had everything they needed. We noted that food and fluid intake charts were being completed for people as indicated in their care plans. We could also see from the records that regular reviews of the plans are now taking place; this is also an improvement. In addition to the monthly reviews, the acting Care Homes for Older People Page 14 of 28 Evidence: manager told us that there are now plans to invite relatives to care plan reviews every three months and people will be invvited to comment on the care they receive and to say if it can be improved in any way. This is useful for people living at the home who want support from their relatives or friends at reviews and also for people who are unable to articulate their own views. People living at the home have access to a range of external health care providers. We could see from the records that people have contact with a range of health care providers such as GPs, district nurses, opticians and chiropodist etc. From talking to staff and from looking at the records there is evidence that staff seek advice from other practitioners when they need help to support people. We noted an improvement in the medication administration records (MAR) on this visit. Medication is being booked in correctly a when it is delivered to the home and the records indicate that people are getting their medication at the prescribed times. We found some gaps on the MAR sheets realting to creams and lotions. We talked to the acting manager about this at the end of the inspection and she agreed to look at how record keeping in this area can be improved. Care Homes for Older People Page 15 of 28 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. The staff have plenty of contact with people and they respect their preferred routines. The meals are good, the menu offers plenty of choice of and people say they enjoy all of the food presented to them. Evidence: None of the plans we looked at contained life histories. Information about peoples lives, their work experiences and their families is useful as a point of reference for staff to understand and engage with people. We found only very brief information in the records about next of kin and the frequency of visits from family and friends. The care plan reviews that relatives are to be invited to could be used to gather some of this information. We found some information about about peoples hobbies and interests and about the sort of daily routine that people prefer. This is useful because it helps staff to support people to pursue their interests and to follow the sort of day to day routine that suits them. We talked to one person about what was in her plan regarding social activities. She confirmed that she is able to pursue the interests that were listed. She reads the paper, likes to knit and sit outside (weather permitting) and enjoys taking part in Care Homes for Older People Page 16 of 28 Evidence: organised activities within the home. She also confirmed that outside entertainers visit the home regularly and this is something that most people join in with and enjoy. The atmosphere in the home is pleasant and people are very friendly. Throughout the day the staff were available where people were sitting. They chatted with people, helped with a crossword, looked at books with people, offered manicures and asked people to choose whether they wanted to watch TV or listen to music. In the afternoon a lively karaoke session took place. People told us they liked the staff. There was plenty of good humoured banter and it was clear that everyone gets on well together. We talked to the acting manager about some comments that were made regarding a couple of staff that were said to be abrupt and asked her to investigate. People told us they enjoy all the meals at the home. They said the catering staff are very good and they listen to peoples comments about the menu. They told us they have plenty to eat and confirmed that there is a good variety of dishes on the menu. On one of the care plans we looked at we noted that a friend of one person brought some tripe in for her which the cook then prepared and served. The menu for the day is on display in the dining area, copies on menus are included with the information about the service that is available on request from the home. Since we last visited the decor dining room has been upgraded and the lighting has been vastly improved in this area. People living at the home and staff on duty commented favourably on the improvements. When we last visited we found the kitchen poorly equipped in terms of cooking utensils and crockery. So we talked to the responsible individual (this is the person who acts on behalf of the company that owns the home) about this after the last inspection. The acting manager informed us that suitable equipment is now available and this issue is now resolved. Care Homes for Older People Page 17 of 28 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. Complaints and adult protection issues are being dealt with properly. This means that staff are listening to people and keeping them safe. Evidence: There is a complaints procedure on display in the home and it is outlined in the statement of purpose and service user guide. There has been an improvement in the facility to record details of complaints. We noted that one complaint had been logged since our last visit but this was not specifically about the service provided to people living at the home. We have not received any complaints since the last inspection. After our last visit the responsible individual showed us certificates confirming that twelve of the staff received training on Safeguarding Vulnerable Adults in in July 2008. This is important training because it tells staff about their responsibility to ensure that people in their care are safe and protected from harm. We talked to the acting manager about the need to ensure that everyone on the team receives this training and also takes part in training updates in this area to keep their practice up to date. We have not been notified of any incidents that have occured at the home where people have been placed at risk of harm. Care Homes for Older People Page 18 of 28 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 a clean, comfortable home. Evidence: The home is registered to accommodate 31 people, when we visited there were only 20 people in residence. In recent years the the home has not been fully occupied because the double rooms in the home are now all used as singles, unless two people make a positive request to share a bedroom. None of the bedrooms have en suite facilities although all of the rooms are in close proximity to toilet facilities. Most of the bedrooms are spacious and all of them are at ground level. People have personalised their rooms with assistance from staff and relatives and every room is set out to meet each persons needs. Although we didnt look at every room we could see that people have brought their own furniture, ornaments and pictures to make them theirs. The lounge is spacious and comfortably furnished and there is some additional seating on the wide corridors. The home is clean and odour free throughout. Care Homes for Older People Page 19 of 28 Evidence: The acting manager told us there is now a monthly improvement plan for the home. This includes repairs, refurbishment and equpment replacement. This is an improvement; it should ensure that the home is better maintained and is a comfortable place for people to live. Care Homes for Older People Page 20 of 28 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 homes recruitment practice is unsafe and staff are not receiving the training they require to carry out their work safely. This puts the safety and welfare of people living at the home at risk. Evidence: The home is appropriately staffed to meet the needs of the number of people living there at the present time. We looked at the staff rota and we talked to the acting manager about staffing levels. The acting manager assured us that staffing levels would be adjusted to meet any changes in individual needs or if the number of people accommodated increased significantly. There were sufficient staff on duty to meet peoples need when we visited, staff had time to talk to people and spend time with them rather than just focusing on tasks that they had to perform. At the last inspection the staff training records were not up to date, making it impossible to get a picture of what training staff have had and what they still require. On this visit we looked at a training matrix that the acting manager had recently compiled. This shows significant shortfalls in all areas of mandatory training that must Care Homes for Older People Page 21 of 28 Evidence: be covered to make sure that the staff provide care and support in a safe manner. For example, out of 24 staff only 15 have received any moving and handling training. Out of these 15 staff, 10 undertook the training in 2006 and 2007, only 3 staff have up to date training. Only 3 members of care staff out of 24 have had any training in basic food hygiene and some of this training took place in 2002. According to the records, only 5 out of 24 members of staff have had any fire safety training; only 2 out of 24 have had any health and safety training and only 11 out of 24 staff have received any training about infection control. We asked about staff training and we were told that the company does not routinely pay for staff to go on training courses. We were informed that some staff who took part in some recent training had to take a days holiday to attend, otherwise they would not have received any pay for their time spent out of the home. We were told that staff and management have to find free courses, which makes it difficult to organise essential mandatory training. The lack of training in these important areas means that the health and safty of people living at the home and the staff is placed at serious risk. We looked at a sample of staff records because we wanted to see if new staff had been appropriately checked before taking up post, this is done to make sure that people living at the home are safe and that new staff are suitable to work with potentially vulnerable individuals. Criminal Records Bureau (CRB) checks and references had been obtained before staff started work on the the staff records that we looked at. We were concerned to note that in some instances people have been recruited and have started work at the home with unsatisfactory CRB checks. A question on the staff application form requires staff to declare if they have any previous convictions. We found that some staff failed to fully disclose details of convictions on their application forms. There was no evidence that gaps in employment history had been suitably explored and once the unsatisfactory checks were received by the home, we could find no record on their staff files to show that these areas had been fully discussed and appropriately risk assessed. This is poor practice which places people living at the home at risk. Care Homes for Older People Page 22 of 28 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. People are being consulted informally about the service provided and their views are being taken on board. Peoples health and safety is placed at risk because staff have not received the training they need to carry out their work safely and important gas and electrical safety checks are not up to date. Evidence: The home does not have a registered manager at the present time. The last registered manager resigned from the role in May 2009 and is now working at the home on nights as a member of bank staff. The current acting manager has previously been working at the home as deputy manager, she has a number of years experience of working with older people and been employed at Carr Green since 1989. Care Homes for Older People Page 23 of 28 Evidence: The responsible individual (who acts on behalf of the company that owns Carr Green) told us that the company is actively seeking to recruit a permanent manager. It is important that the home has a registered manager because this means that there is someone responsible for the day to day management of the home. The responsible individual visits the home every week and each month he completes a monthly report on the conduct of the home. We could not find any evidence of any formal quality assurance system in operation. We did note that the home holds residents and family meetings periodically throughout the year where people have the opportunity to comment on the service provided. According to the minutes of the last meeting held in April 2009, discussion took place about plans for trips out, in house and visiting entertainment, a plan to hold a cream tea event in August and the re-introduction of a small shop within the home selling sweets and drinks. We mentioned earlier in this report that people will be asked about the care they receive and whether it can be improved, during their care plan reviews. The home holds small amounts of money for safekeeping on behalf of people living there. This is money that is usually depositedby relatives to cover the cost of hairdressing and sweets etc. Evidence indicates that the health and safety of people living at the home is placed at risk because servicing is not taking place at the required intervals. For example, we looked at the Periodic Inspection Report for an Electrical Installation, this is an that is carried out every five years for health and safety purposes. The last report held at the home was dated October 2003, which means the next inspection is overdue. The most recent UK Gas Safety Certificate held at the home was dated April 2008. This is an annual test of gas appliances, which means that the latest test is overdue. We found up to date records of the servicing of lifting equipment that is used in the home eg. hoists. The last servicing was carried out in June 2009. The current certficate of Employers Liability Insurance is on display in the home. Care Homes for Older People Page 24 of 28 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 25 of 28 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 29 19 The recruitment procedures must be improved to ensure that all staff are thoroughly checked to make sure they are suitable to work at the home. This is to make sure people are not at risk of being cared for by unsuitable staff. 19/09/2009 2 30 18 A plan must be in place with 30/09/2009 appropriate timescales for all staff to receive appropriate health and safety training. A copy of the plan must be sent to the Commission by 30/9/09. To help them to maintain the health, safety and well being of people living in the home. 3 38 13 Up to date records must be provided showing that gas appliances and electrical wiring have been inspected and approved. 18/09/2009 Care Homes for Older People Page 26 of 28 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 This is to ensure that peoples health and safety is not placed at risk. 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 7 When a risk to health is identified, there must always be a corresponding plan in place to tell staff what action they must take to monitor and reduce the risk. Creams and lotions should be applied as prescribed and signed for when administered. This will show that people are receiving the correct treatment. A permanent manager needs to be appointed so that someone has day to day responsibility for the management of the home. 2 9 3 31 Care Homes for Older People Page 27 of 28 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. 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