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Inspection on 30/04/09 for Carshalton Nursing Home

Also see our care home review for Carshalton Nursing Home for more information

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

What the care home does well

As an older home this service would not meet current standards however, it aims to provide a homely environment for the people who live there. Although there is only one communal area which serves as a lounge, dining room and nurses station, some people tell us that they like that because it feels like they are living in a family. Most of the staff have worked at the home for some time and they have got to know the residents and their families well. As the majority of residents are quite confused this is important to them and provides them with familiarity and security. Visitors told us that they are always made to feel very welcome and they find staff very kind and caring. One relative told us "they always have time to talk to you and nothing is ever too much trouble for them".

What has improved since the last inspection?

We raised concerns about the home, especially with regard to its management and administration, during our last inspection visit and the homes providers gave us an action plan explaining how they intended to improve. However, they do not seem to have made any progress in addressing any of our concerns. We will be contacting The Commissions enforcement team for advice regarding any further action that we might need to take.

What the care home could do better:

Once again we have raised concerns about some aspects of this service, which appears to lack purpose and direction. It looks increasingly run down and would benefit from redecoration and refurbishment both internally and externally. There are limited activities arranged for people to take part in and some residents tell us that they find the days very long because of this. There are currently two issues being investigated in line with the local authority safeguarding procedures, one of which relates to the lack of regulation of the temperature of the hot water. We noted that there were inadequate staff hand washing facilities in the home and we have also asked the providers to confirm that fire fighting equipment has been checked in line with recommendations. The lack of a robust management structure has resulted in staff training and supervision not taking place. There is no quality assurance monitoring tool in use and people are not being encouraged to contribute their views and ideas in order to influence the services are are being provided. It would seem that the providers only visit the home infrequently to monitor the situation there.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Carshalton Nursing Home 28 Salisbury Road Carshalton Surrey SM5 3HD     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: Alison Ford     Date: 3 0 0 4 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 29 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 29 Information about the care home Name of care home: Address: Carshalton Nursing Home 28 Salisbury Road Carshalton Surrey SM5 3HD 02086692592 02086699558 sweethomes@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Sweet Homes Ltd care home 33 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 33 The registered person may provide the following category of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP (maximum number of places: 33) Dementia - Code DE(E) (of the following age range: 65 years and older) (maximum number of places: 10) Date of last inspection Brief description of the care home Carshalton Nursing Home is registered to provide care for up to thirty-three older people who may have dementia. 1 6 1 2 2 0 0 8 0 0 Over 65 10 33 Care Homes for Older People Page 4 of 29 Brief description of the care home As an existing care home the facilities would not meet the requirements of a newly registered home. A large proportion of the accommodation is provided in what were previously designed to be shared rooms, without en-suite facilities and others are smaller than would now be acceptable. There is only one lounge/dining area and this is in the form of a conservatory, which despite fans, is sometimes uncomfortably hot. There is a shaft lift to ensure accessibility throughout the home and the conservatory overlooks the rear garden. There is limited off-street parking however, the home is in a quiet road and close to public transport links. At the time of this inspection we were told that fees range from £525- £850 per week. Any extra charges payable for services such as hairdressing would be discussed prior to admission. A copy of the homes Statement of Purpose, Service User Guide and the latest inspection report can be obtained from the homes Registered Providers or the latter can also be obtained from the Commission For Social Care Inspection from their website. www.csci.org.uk Care Homes for Older People Page 5 of 29 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: This report follows an unannounced visit to the service undertaken as part of the inspection process for the current year. When writing the report we have also considered information that we have gathered since the last visit in February 2009. This includes notifications of complaints, accidents and other incidents and also things that other people have told us about the service. The home also sends us an Annual Quality Assurance Assessment which is their self assessment of the service they they provide and their plans for the future. During the visit we walked around the home and spoke to some of the people who live there. We also spoke with the staff and some relatives who were visiting. We looked at a sample of residents care plans and also some of the documentation that the home is required to keep as evidence of its commitment to the health and safety of the people Care Homes for Older People Page 6 of 29 who live there. 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 29 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 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Anyone who is admitted to the home has an assessment undertaken first to ensure that the home will be able to meet their needs. However, the information available to help them choose whether the home will suit them is misleading and not reflective of the daily lifestyle there. Evidence: At our last inspection we noted that the homes providers had developed a new Statement of Purpose Service User Guide and brochure. These are supposed to outline the philosophy of the home and reflect the daily life there, in order to help people decide if they would like to live there. They also help us to monitor how well they are delivering the services that they say they will provide. We consider that anyone using this information to help them in their choice of home might be disappointed to find that they were not reflective of the actual situation. This is particularly true of the activities programme which remains very limited. The Care Homes for Older People Page 10 of 29 Evidence: providers assured us that this was going to be addressed and improved however, to date this has not happened. People tell us that there is very little to do in the home and they are sometimes very bored. One resident is hoping to move into another home which they hope might offer more opportunities for stimulation. The majority of people living in the home are funded through care management arrangements. We saw that care managers had completed pre-admission assessments and also that a senior member of staff had visited the person to ensure that they would be able to meet their needs. Once the resident had been admitted a more thorough assessment is undertaken which then forms the basis of a care plan. This outlines the support and help that they would need and helps staff understand how they need to be cared for. Care Homes for Older People Page 11 of 29 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. Care plans generally provide enough information to ensure that staff are able to deliver appropriate care to residents although residents or their relatives are not able to influence how support is given. Residents are receiving their medication as it is prescribed however storage procedures are not always in line with current requirements. Evidence: The majority of the residents were sitting in the lounge when we visited the home. They looked clean, happy and well cared for. Those who could talk with us and some relatives that were visiting told us that the staff are always extremely kind and caring, and nothing was too much trouble for them. One told us you cant fault the staff here. Several residents have advanced stages of dementia and we saw that carers spoke with them in an appropriate way and tried to engage with them. Each resident has an individual plan of care, detailing the support that they need, and we looked at four of them. They were reasonably well organised and we saw that they Care Homes for Older People Page 12 of 29 Evidence: are reviewed regularly to make sure that any changing needs are identified. Advice is sought from other health care professionals as necessary. Equipment is in use to minimise the risk of residents developing pressure sores and predisposing factors are evaluated regularly. We did note that there was no indication that residents or their relatives are ever consulted about the way that they wish to be supported. This means that they are not ever able to influence the way that care is given or to voice their opinions. We were told that this would only happen at the time of a care managers review. While it is acknowledged that some residents would find it difficult to contribute, because of their advanced stages of dementia, this is not the case for all of them and others have relatives or representatives who visit. We would recommend that some consideration should be given to maximising the opportunities for them to be involved in the care planning process. We did see that one resident required dressings to a wound and that although it was recorded when this was done there was no indication of either how it was healing or the dressings that were being used. This information should be documented in order to show the effectiveness of the treatment and so that all of the nurses are aware of the dressings to be used. Some concerns were raised about medication practices in the home. We looked the at medication records and could see that people were receiving their medication as it had been prescribed by the doctor. However, we noted that the temperature of the medicine fridge is not always being monitored daily. It is important that this is done so that the home can be sure that all medication is being stored according to the pharmaceutical companies guidelines. We also saw that there were a substantial number of wound dressings being stored which had passed the manufactures expiry date. These must be disposed of to ensure that out of date stock is not being used. In some residents bedrooms there were topical preparations, such as creams which did not have their names on. In order to ensure that these are only being used by the people for whom they have been prescribed, all preparations must have a label, from the dispensing chemist, with the name of the resident on. Care Homes for Older People Page 13 of 29 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. The home is still not providing residents with a lifestyle which offers them interest and stimulation and there are limited opportunities for them to engage in any social activities. Meals that are served are nutritious and well planned and generally suit the needs of the people who live there. Evidence: Our last inspection visit highlighted the lack of organised activities and stimulation for the people who live in this home. The registered provider agreed to address this however, little seems to have been achieved so far. Some care staff do spend time trying to engage with people but there are very few organised activities or opportunities to go out of the home. Church representatives do not visit to meet peoples pastoral needs and there is no recognition of the beliefs and interests of those people who are culturally diverse. During the inspection it was evident that some people are brought in to the lounge in the morning and,other than being taken to the toilet, remain in the same chair until they are put to bed in the evening. Residents who were able to talk with us agreed that they would enjoy more to do and Care Homes for Older People Page 14 of 29 Evidence: told us the days often seem very long with nothing to do. One resident was in the process of transferring to another home, explaining that the lack of things to do was a contributory factor. Lunch was served during the visit. It was nicely presented and looked appetising. Most people eat from a small table in front of them, very few sit at the table. However, there was help available for those who needed it and people seemed to enjoy their meal. The cook has worked in the home for some time and has a list of peoples particular likes and dislikes. One resident told us that there were some things that she did not particularly like and yet she was not offered a choice. We asked the nurse in charge to ensure that this was addressed. We have recommended that the cook should tell people in the morning what she is intending to serve for lunch that day in case anyone would prefer something different. Hot suppers options are available for those who would like them. Visitors are always made welcome in the home and say that staff are warm and friendly toward them. They tell us that they like the homely atmosphere and the fact that people are all together in the sitting room.Some residents told us that they felt that staff shortages influenced the choices that could be made by residents regarding getting up in the morning and going to bed at night. Care Homes for Older People Page 15 of 29 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. There is a complaints procedure in place and any issues are acted upon however, the home does not actively encourage people to raise any concerns or suggestions in order to improve the service that it is providing. There are measures in place to ensure that people who use the service are protected from abuse. Evidence: There is a complaints procedure in place in the home and it is included in the Statement of Purpose and Service user Guide. There is a book available in the entrance hall for anyone to write any concerns in. It is in a plastic holder on the wall but there is no indication as to what this folder is and on the day we visited the holder also contained various bits of rubbish. The procedure is not available in any alternative format which would make it easier for residents or their representatives to read. We consider that people should be encouraged to raise any concerns that they might have and that the providers should view them in a positive way, helping them to improve the service that they are providing. Therefore we have recommended that they should consider ways of making the procedure available to all of the people who use the service or visit the home. Staff have an understanding of the issues around recognising and reporting incidents Care Homes for Older People Page 16 of 29 Evidence: of adult abuse and residents say that they feel quite safe in the home. There are currently two issues being investigated by the local authority, in line with their safeguarding procedures, one of which includes concerns relating to the health and safety of residents. We looked at the staff file of the member of staff that has been employed since the last inspection. There was no evidence that all of the necessary checks had been undertaken however, we were told that the paperwork was all held in the companys head office. We have recommended that copies of this documentation are held in the home to be available for inspection. Care Homes for Older People Page 17 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is warm and clean however it would benefit from considerable redecoration and refurbishment to make it a a more pleasant place for the people who live there. Basic measures in place to control the spread of infection are inadequate. Evidence: This is an older home and as such would not meet many of the standards that would be expected of a newer facility. Room sizes would not comply with current standards and there is only one communal area. Often people with dementia who are mobile like to walk around however, in this home this is very difficult for them due to its layout and lack of space. It is now looking very dilapidated and would benefit from a significant amount of investment in order to improve its appearance both externally and internally. To the front of the home brickwork, plastering and paintwork is chipped and cracked and the garden is full of weeds. The rear garden needs to be made a more pleasant place for residents to use in the warm weather. Inside the home would also benefit from decorating. As this is a home for people with dementia there should also be more effort to introduce measures to help with reality orientation. This might include increased signage, colour coordination, clocks and Care Homes for Older People Page 18 of 29 Evidence: pictures that have a relevance to the age group of the residents. Bathrooms are not relaxing or well appointed. Although equipment in them is functional it is old and worn. Some of the furniture in use in the bedrooms needs repairing. A lack of storage space has lead to spare equipment such as hoists and air cushions being kept in residents bedrooms. The communal area in the home which serves as the dining room, lounge and also the nurses station could be improved by decorating and also providing better storage for folders and files needed by the nurses. After our previous inspection the registered provider agreed to address some of these issues however, to date no progress has been made. On the day of this visit we noted that although it appeared to be clean, some areas of the home were quite malodorous. Concerns were also raised about the lack of adequate hand washing facilities available for staff. None of the soap dispensers that we tried contained any soap. This included the one in the staff toilet. Elderly people are particularly susceptible to infections such as MRSA and Clostridium Difficile and hand hygiene is generally acknowledged to be the single most important activity for reducing the spread of infection. Staff must be made aware of the importance of this and provided with suitable facilities which should include liquid soap. Care Homes for Older People Page 19 of 29 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. Staff in the home are kind and caring however there are not always enough of them on duty to meet residents needs and they cannot always access the training that they need. Evidence: On the day of this inspection the morning staffing levels were adequate to meet the needs of the eleven residents in the home. There were two trained nurses with three care staff, supported by domestic and catering staff,although in the evening there would be one trained nurse with two care staff. The majority of residents are very dependent and some relatives have raisedconcerns about the fact that residents go to bed quite early because there are not enough staff. We have raised this as an issue in the past and it does not seem to have been addressed. Staff turnover in the home is very low, many of them have been there for some time. This provides a good level of continuity for residents, many of whom are very confused. More than 50 of staff have attained an NVQ qualification to at least level 2 some have progressed beyond that. However, staff tell us that no training has taken place for almost a year. We have made a requirement to ensure that the registered provider ensures that all of the staff receive regular training, appropriate to the work that they do, so that their practice remains up to date and they are able to meet the needs of the people that they support. Care Homes for Older People Page 20 of 29 Evidence: One new member of staff has been employed since the last inspection. We looked their staff file and it did not contain copies of all the relevant documentation that should be obtained prior to employment. We were told that this is all kept at the companys head office. A requirement is made to ensure that copies of employees clearance from the Criminal Records Bureau and all of the information required by schedule 2 of The Care Standards Act should be kept in the home until it has been checked as part of the inspection process. Care Homes for Older People Page 21 of 29 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 lack of a robust management structure may be putting residents at risk in this home. Evidence: This home has had no robust management structure in place for some time. There is no registered manager, the providers visit infrequently and seem to have a limited involvement in the control of the home. No records were available of any visits that they have made in line with regulation 26. The training development and supervision of staff is not consistent. Staff have not received training for some time and do not receive clinical supervision to ensure that their practice is safe and up to date. The last Annual Quality Assurance Assessment that we received did not accurately reflect the situation in the home. The provision of activities for residents is poor and there is very little recognition of any cultural diversity of the residents. Care Homes for Older People Page 22 of 29 Evidence: We have been informed that equipment and services are regularly maintained however labels on fire extinguishers stated that they had not been checked for two years.We have asked for documentary evidence that these have been more recently checked. After our last visit the provider agreed to fit an alternative lock to the rear fire door so that it did not need a key, in line with current guidelines, but this has not been done. We also noted that a hoist in the home has not been in working order for some time. Previous omissions in the checking of the hot water temperatures and a failure to maintain the water at a safe temperature, resulted in an incident occurring in the home. Temperatures are now being checked regularly and the hot water system has been serviced. We are not always being informed of incidents happening in the home that affect the welfare of residents. We use these notifications to monitor the home and plan our future inspection activity however, staff that we spoke with were not aware of the importance of sending them to us. There is no formal quality assurance tool in use in the home. Therefore people have limited opportunities to comment on the standard of care that they receive or to influence what happens in the home. Some money is held on behalf of residents. We were able to see this and the records were accurate and up to date. Care Homes for Older People Page 23 of 29 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 24 of 29 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 9 13 Dressings which have passed their expiry dates must be disposed of according to current guidelines. So that out of date products are not being used for residents. 30/05/2009 2 9 13 The temperature of the medication fridge must be monitored daily. To ensure that medication stored there is being kept according to the manufacturers instructions. 30/05/2009 3 9 13 All topical preparations must 30/05/2009 be labelled with the name of the resident for which they have been prescribed. To ensure that residents only receive medication that has been specifically prescribed for them. Care Homes for Older People Page 25 of 29 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 4 19 23 A planned programme of redecoration and refurbishment must be started. In order to ensure that the home is a safe well maintained place for the people who live there. 30/06/2009 5 26 16 Hand washing facilities for staff must be improved. In order to help with infection control within the home. 30/05/2009 6 30 18 Staff must receive regular training appropriate to the work that they perform. So that they are kept updated and are able to meet the needs of the people that they are caring for. 30/08/2009 7 31 26 There must be records available to show that The Registered Provider visits the home. As evidence to show that they are happy with the standard of care being provided by the home. 30/06/2009 Care Homes for Older People Page 26 of 29 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 8 38 13 Evidence must be available 30/06/2009 to show that all equipment and services in the home are being appropriately maintained and serviced. In order to minimize the risk to residents and staff 9 38 13 Equipment in use in the 30/06/2009 home for moving people must be reguarly mainatined and repaired or replaced promptly In order to avoid unnecessary risk to people who live or work in the home. 10 38 37 The Care Quality Commission must be informed of any incident affecting the health and safety or wellbeing of anyone in the home. In order to monitor the situation in the home and plan any future inspection activity. 30/06/2009 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 8 Wound care practises should be documented in more detail. So that all staff are aware of the treatment to be Care Homes for Older People Page 27 of 29 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 undertaken and the current stages of healing. 2 8 Care plans should be compiled with input from residents or their representatives to ensure that support is being given in the way that they prefer. It is recommended that residents should be told about the lunchtime menu in the morning to give them the opportunity to choose something else if they would prefer it. It is recommender that the complaints procedure should be made more accessible to the people who use or visit the service Quality assurance and quality monitoring systems should be put in place to ensure that people who use this service are able to influence the way that it is delivered and offer their opinions as to how it might be improved for them 3 15 4 16 5 33 Care Homes for Older People Page 28 of 29 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. 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. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!