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Inspection on 13/07/09 for Charlotte Rose House

Also see our care home review for Charlotte Rose House for more information

This inspection was carried out on 13th July 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

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

Rooms are tidy, clean, comfortable and well personalised. People made comments such as "I hope I can end my days here" which show their satisfaction with the service provided. They told us that staff respected their privacy and they were of the opinion they received the medical care and support they needed. All knew how to raise concerns or complaints and felt they would be responded to. Information about this and the home is on display for people to refer to if they wish. There is a training programme in place to make sure staff`s knowledge and skills are kept up to date.

What has improved since the last inspection?

Some progress has been made to address matters which we raised at the last inspection for example someone has now been appointed to visit the service regularly to monitor and report on whether standards are being met. Staff have had more training opportunities in order that they have up to date knowledge and skills to provide care for people who live in the home. A raised garden area has been created in order that a resident can continue to participate in his hobby.

What the care home could do better:

We made some requirements at this inspection. These are matters which they must address to comply with the law and make sure standards are met. We said care plans must be reviewed so that they contain more person centred information to make sure all residents needs and wishes and how they are to be met are identified and well documented. This is so that residents can be confident that their needs are well known to staff. We also said they must make sure that the peoples personal records show more clearly the care provided so that they are better able to demonstrate what they say they are doing. We said they must make sure risk assessments of the safety of the environment are undertaken and if identified any necessary action taken to reduce risks so that people`s health, welfare and safety is well protected. For example, they must make sure that the bathroom and toilet doors can be easily accessed if they are locked, so that staff can gain entry in an emergency. We also said they must make sure that a requirement from the previous key inspection is fully addressed in relation to making sure they can demonstrate consistently staff employed in the home have undergone a thorough recruitment procedure which includes obtaining satisfactory checks such as criminal records bureau and protection of vulnerable adults checks prior to their employment in the home. This is to make sure residents are well protected.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Charlotte Rose House 1 Norwood Road Skegness Lincs PE25 3AD     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: Sue Hayward     Date: 1 3 0 7 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 30 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 30 Information about the care home Name of care home: Address: Charlotte Rose House 1 Norwood Road Skegness Lincs PE25 3AD 01754762119 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : pcoulson@chaucerhouse102.wanadoo.co.uk Lonrush Ltd care home 20 Number of places (if applicable): Under 65 Over 65 19 0 old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home 0 1 Charlotte Rose House formerly known as Chaucer House is a home providing personal care to people who are over the age of sixty-five. It is situated in a residential area of Skegness within a short car ride of the town centre. Local services are within walking distance of the home and include a hotel-restaurant, post office and shops. The home is a detached three-storey building with accommodation for people who use the service on both ground and first floor levels. There is a passenger shaft lift and stair lift for access to the upper floors. There are fifteen bedrooms, five of which are shared occupancy, although at present no one shares a bedroom. To the front of the premises there is a patio area for sitting out and a small lawn and seating area to the rear. There are no on-site parking facilities for cars although on-street parking is available at the front and side of the home. The home is registered to provide personal care for up to twenty people, nineteen Care Homes for Older People Page 4 of 30 Brief description of the care home older and one younger physically disabled person. Eight people were living in the home at the time of the inspection. The current fees for the home range from £360 to £446 per week with additional charges made for hairdressing, dry cleaning, social transport and personal effects. Information about the day-to-day operation of the home and fees, as well as a copy of the last inspection report, is available in the main entrance hall of the home. Care Homes for Older People Page 5 of 30 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: Throughout this report the terms we and us refer to the Care Quality Commission, which since the 1st of April became the new regulating body for all social and health care provisions in England and Wales. This visit was what we call a key inspection and was unannounced, lasting approximately 6 hours. We focused on those standards which we consider to be key in terms of the health, safety and welfare of people the service supports. One inspector carried out the visit and spent time talking to 5 people who use the service and 2 staff members. We also spoke to the manager. Care Homes for Older People Page 6 of 30 We looked at the care records of 3 people the service supports as well as other records kept, which help to determine whether standards and regulations are being met effectively. We saw some of the communal areas of the home such as the lounge and dining rooms, bathrooms, toilets and bedrooms of people who gave us permission to do so. We also checked the history of the service and any correspondence we had received prior to our visit. This included records we hold about the service of any significant events we have been been notified of and the annual quality assurance questionnaire (AQAA) completed by the manager, which gives us important information about the services own assessment of how well it is meeting standards and improving the service. We also sent out surveys to be distributed to residents as people who use the service prefer to be referred to (and to respect their wishes will be throughout the report). Surveys were also sent out to a sample of staff to obtain their views about the service . Information from all of these sources was used in the planning of this inspection and the production of this report. General feedback about the outcomes of the visit was given to the manager at the end of the visit. 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 Care Homes for Older People Page 8 of 30 following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 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 30 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. The assessment process helps to make sure peoples needs are identified and can be met prior to their admission to the home. People have the information they need about the service to decide whether or not it is suitable for them. Evidence: We checked the records of three people with a range of needs and included one person who had been admitted within the past year. All contained information to show there had been an assessment of need undertaken from which care plans had been developed. Records were well organised and showed that assessments had been undertaken covering areas such as personal hygiene, mobility, communication and medication. Records also include basic information such as date of birth, next of kin and doctors details. Care plans had been developed using this information although did not fully reflect some of the information obtained during assessment. For example, we saw that peoples wishes in respect of their funeral arrangements were not always Care Homes for Older People Page 11 of 30 Evidence: included nor was specific details as to how some identified risks may be minimised. For example, a care plan stated a person had had several falls at home but did not detail how these may be reduced in the service. We spoke to a staff member who told us the manager generally visits people to assess whether or not their needs can be met at the home and to make sure that they only admit older people, which is the category they have been registered to provide personal care for. Staff knew for example, that they could not admit people with dementia care needs. We spoke to a resident who told us they had come to have a look around for the day and had a meal before deciding to stay. Another resident told us I came to stay for a couple of weeks and Im still here. Another told us she was happy for a friend to look around on her behalf. We saw that the most recent copy of the inspection report was on display in the entrance hall for people to see if they wished. The manager also gave us a copy of the statement of purpose and service users guide, information which is given to people on admission. The manager discussed that she would like to develop this information in formats that is more accessible to people with a visual and hearing impairment, but confirmed it can be made available in larger print if needed. A resident told us he thought he had been given information about the home and was introduced to staff and residents when he came, which he thought was good. We saw information to show that people are given information about terms and conditions of residency when they enter the home, which state the range of fees and what is and isnt included in them. We noticed that the Care Quality Commission details are included in the information given out to people but as there have been recent changes to our address and contact details this needs further review, which the manager agreed to do. Residents told us they liked living at the home and surveys showed they always received the support and care they needed. Staff had a good knowledge of peoples needs. Care Homes for Older People Page 12 of 30 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. People are satisfied with the help and support they receive, but care plans and medication records are not sufficiently well maintained to make sure all peoples individual needs and how they are to be met are clearly identified. Peoples privacy and dignity is well respected. Evidence: Of the three people whose care we followed on this occasion all had care plans and risk assessments in pace. However, information in personal records varied in detail. For example, we saw a resident had a need for his leg to be dressed due to a medical condition. This was not recorded as part of his care plan. Care plans were not person centred enough although they had been signed by residents to show their involvement with them. We asked people whether they were aware of the records kept about them. Some were and some were not but those that were not did not have any wish to see their care plans. We also saw some references in care plans to show that peoples capacity to make decisions and choices had been considered. We saw that people had an end of life care plan in place, which was detailed but did not clearly show Care Homes for Older People Page 13 of 30 Evidence: residents involvement. The manager agreed to address this. Every resident we spoke to felt that they received the help and support they needed and staff had a good knowledge of their needs. For example a resident commented you have only to ask and staff will see to your request. One person said you dont need to ask as staff often give you a choice. We saw for example, that staff knew a resident was tired and gave her the choice of having her meal in the lounge rather than the dining room without her having to request this. We saw that staff record whether care plans are met through a numbering system which does not show clearly the care and support given e.g. care plan 1a, 5c. The manager agreed to review ways in which information is recorded to show clearly the care provided and how it is delivered. People told us they received their medication regularly on the whole. We saw that the records kept to show when medication had been administered were well maintained. Staff told us as, did the records we checked, that they have had training about the handling of medicines. We saw that they have satisfactory storage arrangements for medicines and that they use a system were most medication is pre-dispensed by a pharmacist. We saw that they have a contract with a local pharmacist who visits the service and offers advice and guidance. The last visit report we were shown took place on 13th May 2008 and included the comment very well organised and no issues were raised on that occasion. From two of the personal records we checked we saw that information had been obtained showing medicines which people were allergic to e.g. penicillin and aspirin. We noticed that this information was not cross referenced in medication records although staff took prompt action to update the medication records when it was drawn to their attention and the manager agreed to contact the G.P. and pharmacist to confirm the accuracy of the information. They told us and we saw that there are policies and procedures in place for staff to follow in order that medication is handled safely. People also told us that they saw doctors or district nurses as needed. One person told us she had been able to continue with the same G.P. that she had prior to her admission to the home which she was pleased about. Well maintained records were in place to show when other health professionals had been consulted or visited and residents told us they had a choice of whether or not they visited the surgery or had a visit arranged in the home. Residents told us that staff respected their privacy and they were of the opinion they received the medical care and support they needed. Care Homes for Older People Page 14 of 30 Care Homes for Older People Page 15 of 30 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. Residents are able to make choices and their independence is promoted. The opportunities provided for people to be involved in recreational and leisure activities are generally meeting peoples needs and visitors are welcomed. People who use the service are provided with meals which cater for their individual preferences and specific dietary needs but records are not kept in sufficient detail to show that they are nutritious and well balanced. Evidence: Residents told us that their independence is promoted and they are able to make choices and decisions about their lives. For example, they told us they could get up and go to bed when they wanted and had a choice of where they ate their meals. Comments about the meals provided where positive e.g. its like food you would have at home and theres plenty of it. We saw that menus of the main meal are kept and peoples inidvidual preferences and specific dietary requirements are catered for. We were not shown any records of the breakfast and tea time meals although comments from people we spoke to indicated that they had choices e.g. one person told us they had prunes and weetabix for their breakfast and this preference was recorded in their personal records. Residents told us they were offerred drinks and we noticed that staff Care Homes for Older People Page 16 of 30 Evidence: brought them a drink whilst they were sitting out in the garden. We saw that the the tea time meal consisted of sandwiches and cake. We also saw that they have achieved a food hygiene rating of 3 stars/excellent from East Lindsey District Council. We asked people about how they spent their day. They told us that there are occasional entertainers who visit the home, they could go out locally and a communion service is held once a month in the home if people wished to attend. We noticed that records are kept of the activities that people participate in although there was not a wide range showing. However, people told us that there was generally enough going on for them. We saw and a resident confirmed that a raised garden area had been made in order that this hobby could be pursued. People told us they could have visitors whenever they wished. Care Homes for Older People Page 17 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know how and are confident any concerns or complaints raised will be listened and responded to. Evidence: We checked the records in place which they keep of any complaints. None had been recorded as received since 4th August 2005, although we saw that there were some cards of thanks and gratitude on display in the entrance hall. We have not received any complaints although we were made aware of a safe guarding adult matter. This was referred to the local authority to look into but has since been closed as there was no evidence to conclude it was a safe guarding matter. Some recommendations were made about however about the services record keeping systems. Residents told us they knew who was in charge and would feel comfortable to tell staff or the manager if they had a problem or concerns. Residents told us they had no complaints and felt safe in the home. The manager has told us there are policies and procedures in place about complaints and safeguarding matters and that they follow Lincolnshire County Councils safeguarding adults procedures. A staff member knew of her responsibility to report such matters both within the home and externally if necessary and had a good knowledge of the forms abuse may take. The sample of staff records we checked Care Homes for Older People Page 18 of 30 Evidence: showed that safeguarding adults training is part of the staff training programme. Care Homes for Older People Page 19 of 30 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 comfortable, tidy and well maintained home and are able to make their rooms more homely with their personal effects if they wish. Evidence: We saw the rooms of four people who said we could. They had all been able to make them more homely with their own personal effects. They were well decorated and maintained and residents told us they were comfortable. We noticed that where needed equipment had been provided such as specialist beds. Bedroom doors were lockable and accessible from the outside. We saw radiator guards were in place on some radiators and a window restrictor had been installed in a residents room. All communal areas of the home were clean, tidy, well maintained and smelt fresh. We noticed that whilst bathrooms and toilets were lockable they were unable to be unlocked from the outside and discussion with the manager indicated that risk assessments of the environment had not been completed about this. She agreed that they would be done and if needed action taken to make sure any locks respect peoples privacy but enable staff access in an emergency (see also standards in relation to management and administration). Some bedrooms have a toilet within them and privacy screening is provided where these facilities are not separate en-suite rooms in peoples bedrooms. Care Homes for Older People Page 20 of 30 Evidence: People we spoke to looked well cared for and their clothes were well laundered. The laundry facilities checked were satisfactory. We saw there are policies and procedures available for staff to refer to about good hygiene practises and staff records showed that this is included as part of their training programme. We saw reports of the most recent visits by an environmental health officer and fire safety officer( although the latter had not visited since 2005). Both reports were satisfactory and did not raise any issues. Care Homes for Older People Page 21 of 30 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. There are sufficient well trained staff to meet peoples needs however the recruitment process is not sufficiently thorough to make sure people are well protected. Evidence: People told us that they got on well with staff and that there were few changes to the staff team. We saw that staff were courteous and polite when speaking to residents and residents told us they were of the opinion they got the help and support needed from staff. One person said if they needed to call staff for support you dont have to wait many moments. There are eight residents currently living in the home. Staff told us that there are two staff on duty during the day and at night one wakeful and one staff member sleeping in. The manager also confirmed this to be the staffing levels. The manager works additionally to the rota and there is a cook as well. Care staff have some domestic tasks. The manager confirmed there are two part time staff vacancies but people had been interviewed for these posts. We saw that one person was visiting the home to commence his induction programme into the work. The records of three staff employed where checked on this occasion. They showed that proof of identity, references, criminal records bureau (CRB) and protection of vulnerable adults (POVA) checks had been sought. A resident told us they had been introduced to a new staff member the night before and she was lovely. We asked the Care Homes for Older People Page 22 of 30 Evidence: manager to confirm whether a CRB had been obtained but the manager said not and neither had a POVA check been obtained, although the person she said had been supervised and not involved in any personal caring tasks as the purpose was for her to start her induction training. The sample of staff records we saw showed that staff do have training opportunities which includes some mandatory courses such as fire safety and manual handling and training which is more specific to residents needs e.g. parkinsons disease. Some staff have also obtained a nationally recognised vocational qualification (NVQ) in care at level 2. Staff told us they felt well supported by the manager and she was always available if they had a problem. Care Homes for Older People Page 23 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is generally being managed so that the health and welfare of people who live at the home is promoted and there are satisfactory systems in place to obtain the views of people the service supports about the quality of the service obtained. However, the lack of risk assessments in relation to the environment may mean peoples health and safety is put at risk. Evidence: There have been no changes to the management arrangements since the last visit. People told us they knew who was in charge and felt they were consulted about any changes to the home. The rapport between the manager and residents was relaxed and friendly. We saw records to show that residents meetings are held at which they were asked whether they had any matters to raise and whether they were satisfied with the service. Records were also in place to show that staff meetings are held although none had Care Homes for Older People Page 24 of 30 Evidence: occurred since 3rd January 2007. It is however recognised that there is a small staff team and staff comments showed that they felt well supported by the manager and she was approachable. We also saw that they use questionnaires with people who use the service, relatives and other professionals although not all the questionnaires had been dated to show the frequency this occurs and some records such as residents questionnaires were dated as being completed 2 years ago. We had raised an issue at the last visit that there must be visits from a representative appointed by the company to monitor the quality of the service. We saw that these had commenced in February this year on a monthly basis and included discussions with residents to ascertain their satisfaction with the service. Most of the issues we raised at the previous key inspection have been addressed but one in relation to the recruitment procedure had only been partially addressed. Whilst the manager confirmed a staff member was being supervised and was not involved in personal caring tasks, records were not available to show that the staff member had been thorough a thorough recruitment procedure. (See also comments and requirements made in respect of staffing standards.) They told us that they have a range of policies and procedures in place for staff to follow to make sure peoples health and safety is well promoted. Staff said and training records we saw confirmed that health and safety is incorporated in the programme although some staff need to renew their first aid training. The manager confirmed that six courses had been arranged to take place this year with an external training agency and first aid was included in this as was manual handling. We were not shown any records to show that aspects of the home environment had been assessed for any areas of risks it may pose to residents, although we did see from the personal files we checked of residents that risk assessments had been carried out regarding matters such as use of bed rails, mobility and risk of falls. For example, we saw that bathroom doors had a lock which was not accessible to staff should access be needed. The manager agreed to make sure this matter was addressed. We checked a sample of the certificates in place to show that equipment had been serviced regularly. We saw that the call bell system was last serviced in 2007 and we heard it to be in working order. People told us that when they used their call bell it was not many moments before staff arrived. The manager was unable to provide us with an up to date certificate to show when the lift was last serviced but agreed to do so the following day. We have since received confirmation that the lift was serviced on the 20th July 2009. We saw that fire equipment in the home had been serviced on Care Homes for Older People Page 25 of 30 Evidence: 14th August 2008. People told us they felt safe in the home and hoped they would not have to move. Care Homes for Older People Page 26 of 30 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 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Care plans must be reviewed 30/09/2009 to make sure they reflect accurately peoples needs and how they are to be met. This is to make sure peoples needs and wishes are fully identified and known. 2 15 17 Records of meals must be kept in sufficient detail to show the full range of meals provided. This is to make sure that it can be demonstrated that the meals provided are well balanced and nutritious. 30/09/2009 3 29 19 A thorough recruitment 24/09/2009 procedure must be followed for all staff, which makes sure they are employed only after all necessary checked have been completed including obtaining satisfactory POVA and CRB checks. Staff must not be employed prior to a CRB check being received unless Page 28 of 30 Care Homes for Older People there are exceptional circumstances, which put the health, safety and welfare of people who use the service at risk, in which case CQC must be notified. This is to make sure people who live in the home are well protected. 4 38 13 There must be records in 30/09/2009 place to show risk assessments of the environment have been carried out. Where identified actions must be taken to reduce any risks identified. This is so peoples health and safety is promoted. 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 It is recommended the way in which care records are being kept are reviewed so that they contain sufficient detail to show the care given and how peoples needs are being met. It is recommended that records of medication clearly reflect peoples circumstances identified in care plans about their specific needs, for example any medications to which they are allergic. This is so that peoples health and safety is properly protected and records are consistent. It is recommended that quality assurance surveys are dated so that they show peoples views about the quality of the service are regularly sought and monitored. 2 9 3 33 Care Homes for Older People Page 29 of 30 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. 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