Inspection on 31/03/09 for Carrick Lodge

This inspection was carried out on 31st March 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Carrick Lodge 24/07/08

Carrick Lodge 13/08/07

Carrick Lodge 19/10/06

Carrick Lodge 09/02/06

Carrick Lodge 15/06/05

Carrick Lodge 05/11/04

Carrick Lodge 20/04/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Carrick Lodge Belyars Lane St Ives Cornwall TR26 2BZ     The quality rating for this care home is:   one star adequate 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: Ian Wright     Date: 3 1 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 31 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 31 Information about the care home Name of care home: Address: Carrick Lodge Belyars Lane St Ives Cornwall TR26 2BZ 01736794353 01736798621 carricklodge@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Ronald James Cottam Name of registered manager (if applicable) Mrs Lizabeth Helena Rutherford-Ainley Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 38. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Olda age, not falling within any other category (Code OP) - maximum 20 places Dementia (Code DE) - maximum 18 places Mental disorder, excluding learning disability or dementia aged 65 years and over (Code MD(E)) - maximum 18 places Date of last inspection Brief description of the care home Carrick Lodge provides care and accommodation for up to 38 older people of which 18 of whom may be diagnosed with dementia and or mental disorder. The registered Care Homes for Older People Page 4 of 31 care home 38 Over 65 0 18 20 18 0 0 Brief description of the care home provider is Mr R Cottam and the registered manager is Lizabeth Rutherford Ainley. Carrick Lodge is situated near the centre of St. Ives and is in an elevated setting with views of the bay. The house is a large three floor property with a two storey extension. There are two communal seating areas, a conservatory, the dining room, kitchen area, laundry and two offices. Two lifts and a stair lift are provided to assist access to the upper floors. A fenced garden is situated at the front of the home. At the time of the last inspection fees range from £300 to £400 per week. We have not received updated information for this inspection report. Additional charges are made for hairdressing, newspapers and personal items. A copy of this inspection report is available via the homes management or the Care Quality Commission website. Care Homes for Older People Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection took place in eight hours in one day. All the key standards were inspected. The methodology used for this inspection was: (1)To case track three people using the service. This included, where possible, meeting and discussing with the people their experiences, and inspecting their records. (2) Discussion with staff about their experiences working in the home. (3) Discussion with other people using the service, and their representatives. (4) Observing care practices. (5) Discussing care practices with management. (6) Inspecting records and the care environment. Other evidence gathered since the previous inspection, such as notifications received from the home (e.g. regarding any incidents which occurred), was used to help form the judgements made in the report. Care Homes for Older People Page 6 of 31 Care Homes for Older People Page 7 of 31 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 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 8 of 31 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a satisfactory process of issuing contracts of care / statements of terms of conditions of residency when people are admitted to the service. This ensures people are aware of their rights and responsibilities. Pre assessment procedures are satisfactory.This helps to evidence that pre admission procedures are comprehensive. Evidence: There have not been any admissions since the last inspection. We were satisfied with the assessment process at the time of the last inspection for example copies of pre admission assessments were maintained on peoples files, and senior staff would meet and assess people planning to move to the service prior to admission. Copies of a contract of care / statement of terms and conditions of residency were contained in the files for people using the service. These appeared to contain satisfactory information. Care Homes for Older People Page 10 of 31 Care Homes for Older People Page 11 of 31 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health and personal care needs of people living in the home seem satisfactorily promoted and met; for example in regard to care planning and the management of medication. Care staff are viewed positively by the people we spoke to. Evidence: A care plan was contained on the files we inspected. There is evidence these are reviewed. Care plans are accessible to staff. People who use the service, who we spoke to, were generally positive about the care they received. One of the inspectors discussed further necessary developments regarding care planning with the registered manager; for example ensuring care plans are signed and dated; improving the participation of people using the service and their relatives; and outlining peoples choices such as whether they want a bath or shower/ what time they wish to go to bed etc. People who use the service said they were satisfied with the health care support they Care Homes for Older People Page 12 of 31 Evidence: receive. This includes visits from GPs, district nurses, chiropodists, dentists and opticians. We inspected the medication system. Storage of general prescribed medication is satisfactory and medication records are appropriately maintained. Management of controlled drugs is satisfactory. There is satisfactory evidence people administering medication on the day of the inspection, had received appropriate training to carry out this task. We spoke to several people who use the service who were complimentary about the care they received. People said they felt their privacy and dignity was respected by staff. People said they were always referred to by their preferred name. Care Homes for Older People Page 13 of 31 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Routines, food and opportunities appear to meet the needs of the people living in the home Evidence: People using the service, who the inspector spoke to, said they could get up and go to bed when they wished. Routines in the home appear relaxed. An activities co-ordinator is employed at the home two and a half days a week. Activities currently on offer include quizzes, board games, exercise sessions etc. The member of staff appears to put a really good effort in helping people to have some organised activities. People living in the home who we spoke to said they could choose if they could spend their time in their bedroom or in the lounge. People can look after their own money if they wish. There are some people living in the home, who due to their dementia or physical needs, need more observation and support from staff. Subsequently these people spend waking time in the communal areas of the home. All people living in the home can bring their own belongings in to the home, and bedrooms seem individualised. Care Homes for Older People Page 14 of 31 Evidence: People said they are satisfied with the food provided, although we do think there should be more choice of food on offer at lunch time, and particularly at tea time. For example at tea time we think there should be a hot and cold option each night (presently there are sandwiches on some evenings, and a hot snack on others). We also think the menu for each day should be displayed e.g. in the lounge so people know, in advance, what they are going to eat, and also can make an informed choice of the options available to them. Care Homes for Older People Page 15 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints and adult safeguarding policies and procedures are generally satisfactory. However, the adult safeguarding procedure needs to be clearer so staff know what to do if they have a concern. Improvement in this area should assist in helping people who use the service to have more confidence about how adult safeguarding matters are managed by the registered persons. We have not had any concerns regarding complaints or allegations of abuse about this service. Evidence: The registered persons have not received any complaints regarding the home. The commission received one complaint which we referred to the provider. The provider responded to us, and we concluded we did not need to carry out any further investigation. There is a satisfactory complaints procedure in place. A summary of the complaints policy and procedure is contained in the service user guide. A copy of this is in each persons bedroom. It is recommended there are details regarding how people, who are funded by local authorities, can access the local authority complaints procedure, and details of how to contact the Care Quality Commission are also included in the policy. The home has an adult safeguarding policy. There is a lot of information regarding recognising abuse. However, there still needs to be a clear procedure what staff need Care Homes for Older People Page 16 of 31 Evidence: to do in the event of a safeguarding concern. There have been no safeguarding referrals regarding this service. There is a record that approximately half of the staff group have received training regarding an awareness of abuse. Care Homes for Older People Page 17 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environmental standards at Carrick Lodge have improved since the last inspection and it now provides an adequate environment for the people living there. There are some outstanding matters required to improve the environment, as outlined in the text. Addressing these matters will ensure the registered persons provide a safe and suitable environment for people living there. Evidence: The building was inspected. There is suitable shared space, for example, a large lounge and a second lounge. There is a conservatory, but this is currently out of use. There is a dining room adjacent to the kitchen. Toilet and bathroom facilities are suitable in size and facilities provided. The registered provider has recommissioned a bathroom on the second floor, and there is now a walk in shower on the ground floor. All facilities were clean on the day of the inspection. Bedrooms are generally decorated and furnished according to individual tastes. People who use the service said they were able to bring their own furnishings and belongings with them when they moved in. There have been many improvements regarding the property since the last inspection. Care Homes for Older People Page 18 of 31 Evidence: For example improvement to the provision of bathing facilities; decoration of some of the communal areas; carpets have been replaced in some bedrooms; the laundry floor now does not present a trip hazard and the registered provider said it would be replaced; there is improvement to lighting on some of the staircases; a kitchenette has been developed near the lounges. The registered provider also said significant financial investment has occurred to repair roofing, replace the passenger lift etc. However there are some outstanding issues from the last report which need to be addressed: (1)Automatic closing devices need to be purchased so fire doors are not propped open. (2) Bleach (and other cleaning materials) where necessary need to be kept in a locked cupboard in line with COSHH regulations. (3) Repairs need to be completed to the conservatory, so it is available to people using the service. (4) Blinds need to be fitted to sky light windows in bedrooms, so people are not woken up when it gets light very early in the summer. This needs to be addressed as a priority now the mornings are getting lighter. (5) Alot of the gloss paintwork gets scrapped by wheelchairs. It would be a good idea if the maintenance man went around on a monthly basis to touch up damage. (6) Importantly some call bells were disconnected in some bedrooms. It is essential all people using the service have access to the call bell system. Subsequently it is important staff regularly check people have access to the system. (7) Some windows did not have restrictors for example the new shower room and rooms 34 and 35. The registered persons need to check each window to ascertain if restrictors are fitted where this is necessary. This will minimise intruders entering the building (ground floor) or people falling (upper floors e.g room 17). Where necessary risk assessments need to be completed to minimise any risks. (8) The outside of the building needs some work to make it more presentable. In addition on this inspection we noted: (1) The water was very hot from some taps. Water temperatures need to be thermostatically controlled or a risk assessment needs to detail how any risks of scalding to vulnerable people who use the service are minimised. (2) Bedrooms should have a lock on the door, people should be offered a key if they have the capacity to use it, and there should be a lockable space in each bedroom. The building was clean and hygienic on the day of the inspection. A cleaner is employed in the home. Laundry facilities are satisfactory although floor covering needs replacing as outlined above. Care Homes for Older People Page 19 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels appear satisfactory to meet the needs of people currently accommodated at the home. Appropriate recruitment checks are in place. Improvement is required to staff training. It is essential there is a satisfactory number of first aiders on duty at all times. Urgent action is required regarding this matter and the current shortfall puts people using the service at serious risk. Improvement in staff training will help to ensure staff have appropriate skills and knowledge to meet the needs of people accommodated at the service. Evidence: On the day of the inspection there were four care staff on duty from 08:00 to 13:00, three care staff on duty from 13:00 to 19:00, two care staff on duty from 19:00 to 20:00, and two waking night staff on duty from 20:00 to 08:00. An activities worker was also working on the day of the inspection. In addition there are ancillary staff working at the home each day (an administrator, cook, cleaner, laundry person, maintenance person). The registered provider is based at the home, and the registered manager came in especially for the inspection. Staffing levels appear currently satisfactory to meet the needs of people living in the home. Personnel records were inspected for nine staff (i.e. staff on duty during the 24 hour Care Homes for Older People Page 20 of 31 Evidence: period on the day of the inspection). Personnel records were satisfactory for these people, although each person should have a more thorough self declaration regarding their physical and mental fitness to work in a care setting. There was suitable evidence appropriate checks were completed regarding the fitness of staff before they commenced employment; for example a Protection of Vulnerable Adults First check, a Criminal Records Bureau check, two written references etc. However, a photograph of the member of staff should be contained on each file. Staff have satisfactory opportunity to obtain a National Vocational Qualification in care. For example six of the nine peoples files we inspected had a copy of an NVQ certificate in care (at either level 2 or 3). We checked records of training staff have received. By law staff require the following training: (1) Regular fire training in accordance with the requirements of the fire authority. (2) There must always be at least one first aider on duty (at appointed person level) (3) All staff must have manual handling training and regular updates of this (e.g. annually) (4) All staff must have basic training in infection control. (5) Staff who handle food receive food hygiene training. (6) All staff must have an induction and there needs to be a record of this. (7) People need to receive training regarding dementia and the needs of people who are diagnosed with a mental health problem (as this home is registered to provide care for these groups of people). Induction and training delivered to staff working at the home has improved since the last inspection in July 2008. However, of the nine staff records assessed for people on duty during the 24 hour period of the inspection some improvement to ensure compliance with the regulations is still required. For example: (1) There must be a satisfactory number of first aiders on duty at all times. Although during the day of the inspection there was satisfactory first aid cover, on either the night before the inspection, and the night following the inspection, none of the night carers had a record they had received first aid training. It is essential staff have this training, as people using the service could be at serious risk if there was an emergency situation. Urgent action needs to occur regarding this matter, and the registered persons should confirm in writing what action will take place and when this will occur. (2) Most staff had fire training although there was no record that two staff had received this training, and one person appeared to only have received this training in 2005. (3)Food hygiene-two staff did not have a record of receiving this training. (4) Moving and handling- one member of staff did not have a record of receiving this training. (5)Infection control- Five people did not have a record of receiving this training. (6) There was satisfactory evidence of staff induction for three of the four people in the sample who had commenced employment since the last inspection. Care Homes for Older People Page 21 of 31 Evidence: However we could not find a record of induction for one carer who commenced employment in December 2008. (7)Only one person has received any training regarding dementia. There is no record any staff have received training regarding mental health. The registered provider said a manager at another care home owned by him has been trained to train staff regarding dementia awareness (by the Alzheimers Society) and staff training will commence soon. The registered manager has developed a training record for the staff team. This should assist the registered provider in monitoring what staff have received, and arranging training that needs to be delivered according to the needs of people living in the home, health and safety and other regulatory requirements. Care Homes for Older People Page 22 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We note a number of improvements have occurred to the home since the last key inspection. However the registered persons need to complete outstanding action, required by the commission, as outlined in the report. Satisfactory systems need to be in place for example through the registered providers quality assurance system. This should help to ensure improvement is sustained. Although we are encouraged by the improvement which has occurred, we remain concerned that some of outstanding actions put people who use the service at risk. For example health and safety precautions have improved, but there are still some matters (e.g. regarding ensuring the electrical hardwire being deemed safe) which must be addressed if people using the service can be assured the home is safe. Evidence: The registered provider, Mr Cottam employs a registered manager to manage the home on a day to day basis. The standard of care is satisfactory, and we note improvement in a number of areas since the last key inspection in July 2008. However, Care Homes for Older People Page 23 of 31 Evidence: there are still some outstanding statutory requirements where there has now been non compliance with the regulations for a significant period of time (for example regarding staff training, and environmental standards). Some of the matters still requiring action could put people using the service at significant risk and it is essential these matters are addressed within the timescales we have issued. However, we are pleased with some of the progress made by the registered persons and are encouraged by this. We will monitor compliance with the outstanding statutory requirements. However, if necessary the commission will take enforcement action. We inspected the registered providers Quality Management Policy. This appears to be an off the shelf policy which does not relate to actual practice at the service. Subsequently the policy needs to be rewritten to reflect current practices, and also to guide current practice in order to improve current standards (for example to ensure improvements which have occurred since the last inspection are sustained, outstanding regulatory requirements are addressed etc.) Since the last inspection the registered persons have completed the a survey of stakeholders. Subsequently, the results have been collated and a suitable action plan has been developed. We also received an improvement plan following the last inspection, and there has been some progress which has occurred regarding specified actions since the last inspection. We assessed arrangements regarding the management of the finances of people who use the service at the last key inspection in July 2008. The standard was met, and the administrator confirmed there had been no changes in the system since the last inspection. Therefore we did not check monies or records on this occasion. The registered provider has a health and safety policy. There is a fire risk assessment. Testing of fire extinguishers and the fire system appears to have been completed appropriately by external contractors. In regard to fire precautions emergency call points are tested weekly. Suitable checks have been completed on fire doors and fire drills have been completed appropriately. Emergency fire lighting is being tested. Portable electrical appliances have been tested. The registered provider said some improvements have been carried out to the electrical hardwire circuit, but a full retest of the circuit has not yet been completed. Subsequently documentation still deems the circuit unsatisfactory. The circuit must be retested and a certificate deeming it satisfactory obtained. There are satisfactory records to state moving and handling equipment is deemed as Care Homes for Older People Page 24 of 31 Evidence: safe and has been tested recently. A new lift has been installed. The nurse call system has been tested in July 2008 and is deemed satisfactory. There is a satisfactory system of accident reporting in place. Gas appliances have been serviced. There is a system regarding the prevention of legionella, although testing needs to be more frequent (i.e. last tests 24/11/09 then 2/2/09 only). The registered provider has started to redraft health and safety risk assessments- and this task needs to be completed and satisfactory control measures put in place within the timescale set. The statutory requirement regarding this matter is therefore renotified. Staff training regarding health and safety issues needs to be improved-as outlined in the staffing section of the report. An insurance certificate was displayed in the office. Care Homes for Older People Page 25 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 13 The registered provider must have a suitable adult safeguarding procedure. Having an appropriate procedure will help to give people who use the service, and other stakeholders, more assurance that agreed multi agency procedures will be followed when necessary. Previous timescale of 01/10/08 not met. Third Notification 01/07/2009 2 19 16 The home must be kept in a 01/09/2009 good state of repair externally and internally. For example the issues outlined in the text of the environment section of the report need to be addressed. This will ensure the homes environment is maintained to a satisfactory standard so it provides a safe and comfortable environment for the people living there Care Homes for Older People Page 27 of 31 (Previous timescale of 01/12/08 partly met. Third notification) 3 30 18 Staff must receive suitable 01/09/2009 training. For example: (a) As required by regulation for example infection control, food hygiene, fire training, manual handling and first aid. (b) Training regarding people with dementia and mental health needs. (c) A record of staff induction. This will help to ensure people who use the service are supported by suitably trained and skilled staff (Previous timescale of 1/1/09 not met -[staff induction 01/09/08]. Third notification) 4 30 18 There must always be 01/06/2009 satisfactory numbers of staff with a first aid certificate on duty (e.g. at least one person with an appointed person level in line with the registered persons first aid risk assessment). The registered persons need to confirm what action they will take regarding this matter, and when the action will occur. This will ensure there is always a first aider on duty in an emergency situation to Care Homes for Older People Page 28 of 31 assist people using the service who need emergency first aid. 5 33 24 The registered persons must 01/07/2009 ensure: (1) There is a quality assurance policy which reflects quality assurance procedures in the home. (2) Quality assurance processes ensure regulatory requirements are met (eg. health and safety requirements; CSCI/CQC requirements) in a timely manner. This will help improve service quality and help minimise risks to staff and people who use the service Previous timescale of 01/10/08 not met 4th Notification 6 38 13 The registered persons must 01/07/2009 ensure satisfactory health and safety standards are maintained. The registered persons must: 1. Where necessary, introduce procedures to check the temperature of hot water (e.g. when people are bathing). Records of this need to be maintained. Due to the needs of people who use the service thermostatic valves should be fitted, and procedures introduced to check these work correctly. Any checks must be documented. This appplies Care Homes for Older People Page 29 of 31 to all bathing facilities. 2. Ensure remedial action regarding the electrical circuit is completed. A copy of certification to state the electrical hardwire circuit is safe must be obtained and available for inspection. 3. Health and safety risk assessments need to be reviewed and updated. These measures will help ensure the home is a safe place for vulnerable people to live. (Previous timescale of 01/10/08 not met. Third Notification (Risk assessments: Second Notification) 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 15 Provide a greater choice of main meal at lunchtime. Ensure there is a choice of hot and cold food at evening time. Display what meals will be available; for example on a notice board Within the services complaints policy, include information regarding how people can access local authority complaints procedures. 2 16 Care Homes for Older People Page 30 of 31 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. 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