Inspection on 27/02/09 for Cherry Acre

This inspection was carried out on 27th February 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cherry Acre 11/04/08

Cherry Acre 23/10/07

Cherry Acre 27/04/07

Cherry Acre 06/10/06

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Cherry Acre 21 Berengrave Lane Rainham Gillingham Kent ME8 7LS     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: Sue McGrath     Date: 2 7 0 2 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: Cherry Acre 21 Berengrave Lane Rainham Gillingham Kent ME8 7LS 01634388876 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) : cherryacre5@aol.com Uday Kumar,Kiranjit Juttla-Kumar care home 17 Number of places (if applicable): Under 65 Over 65 17 old age, not falling within any other category Additional conditions: 0 The maximum number of service users to be accommodated is 17 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender; Either whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Cherry Acre Residential Home provides personal care and accommodation for up to 17 older people and is owned and managed by Mr Uday Kumar. The home does not offer nursing or intermediate care. The home occupies detached premises and is located in a residential area, close to local shops and on a bus route. The premises are large with ample parking and established mature gardens to the front and to the rear of the property, which are easily accessible. Residents accommodation is arranged over two floors. There is no passenger shaft or Care Homes for Older People Page 4 of 31 Brief description of the care home stair lift to the second floor. A call bell is installed within each of the 17 single bedrooms to alert staff; all bedrooms have television aerial points. Telephone points can be installed if required at the individuals cost. No bedrooms have en-suite facilities. All bedrooms include a wash hand basin. The home employs care staff working a roster, which gives 24-hour cover. Ancillary staff for catering and domestic duties are also employed. Current fees range from £323 to £550 per week according to assessed personal need. Please contact the manager for further information. 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: 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 was a key unannounced inspection that took place on 27th February 2009 and was conducted by Sue McGrath and Anne Butts Regulation Inspectors for the Commission for Social Care Inspection. The key inspections for care home services are part of the methodology for The Commission For Social Care Inspection, whereby the home provides information through a questionnaire process and further feedback is gained through surveys sent to service users and relatives and information provided from professionals associated with the home, wherever possible. The actual date of the site visit is unannounced. Additional information was also obtained through the Annual Assessment Quality Assurance review, which all services registered with the Commission for Social Care Care Homes for Older People Page 6 of 31 Inspection must now complete on a yearly basis. At the site visit, service users and staff were spoken to, records were viewed and a tour of the environment was undertaken. Judgements have been made based on records viewed, observations and verbal responses given by those people who were spoken with. These judgements have been made using the Key Lines of Regulatory Assessment, which are guidelines that enable the CSCI to be able to make an informed decision about outcome areas. Further information can be found on the CSCI website with regards to information on KLORAs and AQAAs. The requirement made at the last inspection had not been complied with. The quality rating for this service is 0 star. This means the people who use this service experience poor quality outcomes. What the care home does well: What has improved since the last inspection? What they could do better: New care plan are in the process of being drawn up and these will be assessed at the next inspection. Evidence in the records kept by the home showed that all mandatory training had not been completed. This was a requirement from the last inspection and the enforcement pathway will now be follow and it is likely that further action will be taken. The lack of first aid training and incorrect following of procedures had a major impact on a recent accident in the home. The incident was not managed well and an investigation under the safeguarding of vulnerable adults is currently being undertaken. On the day of the inspection there were insufficent staff on duty. Care must be taken to ensure that all of the residents needs can be fully met as three of the residents without dementia complained of being disturbed by residents with dementia. All staff should be trained in dementia care if the home is to continue to offer services to resdients who develop dementia whilst in the home. Care Homes for Older People Page 8 of 31 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 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 10 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. Prospective residents are provided with the information they need to make an informed choice about where to live prior to admission and are provided with a statement of terms and condition of residency. People who live in the home benefit from an assessment of their needs prior to moving into the home to ensure their assessed needs can be met. People who live in the home and their families also benefit from the opportunity to visit the home prior to admission to assess the quality, facilities and suitability of the service. Evidence: Prospective residents and their families were provided with relevant information about the home prior to admission. One relative confirmed he had been given a statement of purpose before his father had been admitted to the home. The provider confirmed every resident had a written contract/statement of terms and Care Homes for Older People Page 11 of 31 Evidence: conditions with the home. Evidence was seen that all residents undergo an assessment of their needs prior to admission and again another relative confirmed this was completed prior to admission. The person completing the assessment must ensure that they do not admit residents with dementia as the home is not registered for dementia care. Evidence was seen that at least one resident was diagnosed with dementia very soon after admission, so must have been showing signs of this condition. The provider confirmed that he endeavours to obtain assessments from Social Services if they are to fund the placement. One relative confirmed that as part of the admission process they were offered a four week trial and that this could have be flexible if needed. Several residents and their relatives said they felt well cared for and that staff were caring and friendly. The home does not provide intermediate care. Care Homes for Older People Page 12 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home have written care plans in place however their safety may be put at risk as some care plans do not reflect recent changes and not all risk assessments fully support their changing needs. Daily health care needs are met but medical intervention following falls must be improved. Evidence: Four care plans were reviewed and it was found that although some regular assessment where being carried out the changes highlighted were not always reflected in the care plans. Discussion took place with some of the staff as to how the review dates were recorded and it was noted that some of these dates were inaccurate. Some of the moving and handling needs had changed but had not been reflected in the care plans. Risk assessments need to be more robust. One relative did confirm she had been involved with the drawing up of the care plan for her relative and that she had Care Homes for Older People Page 13 of 31 Evidence: regular meetings with staff regarding these plans. However, the new manager was in the process of developing new care plans that appeared to be more comprehensive. As care plans are a working document these will be assessed again at the next inspection, when they will have been in place for some time. There was a high number of falls recorded with fourteen since the end of January. The home had a procedure in place for dealing with falls and emergencies but staff do not always follow it. This brings into question the possibility that some staff are not aware of these procedures. The new manager was aware of the high level of falls and had made referals to the Falls Clinic, however prior to this the manager confirmed this procedure was not being followed. A requirement will be made for the registered person to assess the needs of the people in the home and to ensure sufficient numbers of care staff are employed to meet their assessed needs at all times. The administration of medication was assessed. It was found that the home uses a monitored dosage system from a local Pharmacist. There were some errors in the recording when drugs were admitted to the home and one prescription was very late in being dispensed. The new manager stated that it was her intention to monitor the safe administration of medication in a robust manner. It is not suggested that any medication had been wrongly administered, but that recording must improve. The policy seen for PRN administration did not reflect actual practice and needs to be updated. The security of the keys to the medication storage areas met with best practice and was retained by the senior carer and handed over formally between shifts. The medication remains in a locked cabinet in the dining room. Spare medication is stored safely elsewhere in the building. Residents in the home confirmed that staff treated them with respect and that their privacy was maintained at all times. Staff were seen to be courteous and supportive to residents throughout the inspection. Care Homes for Older People Page 14 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. People who live at the home have their social and recreational interetst and needs mainly met with a range of activiteis. People who live at the home are supported to maintain contact with familiy and friends, which ensures they continue to receive stimulation and emotional support. Evidence: Evidence was seen that the home has a basic activities programme that staff tried to adhere to. Some residents complained of being bored and some complained that other residents with demetnia affected their day by constantly calling out. This was also observed during the inspection. The provider had arranged for outings recently and these had been enjoyed by all who participated. Some residents commented negativley on the music entertainement saying it was far too loud. This was discussed with the provider who was surprised at the comment. All of the residents spoken with commented that the food was of a good quality. Some Care Homes for Older People Page 15 of 31 Evidence: said they were given choices other said they were not. Two commented that tea was always sandwiches and confirmed that a supper was not generally offered unless asked for. Drinks were seen to be freely available. All of the visitors spoken with confirmed they were always made welcomed and could visit at any time. They also confirmed the home kept in touch with then on a regular basis regarding the health of their relatives. It was seen that staff always gave choices over daily living options and preferences. Staff confirmed that regular church services were on offer and that traditional days continued to be celebrated Care Homes for Older People Page 16 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home are protected by a robust complaints system and residents and relatives feel their views are listened to and acted upon. People who live at the home are put at risk from a lack of first aid and adult protection training and practices. Evidence: The homes had a complaints procedure in place and the provider said this was included in the statement of purpose. Residents said they were happy to raise any concerns with staff and felt any issue would be dealt with by the management team. The AQAA confirmed the home had received two complaints in the last twelve months and that both had been resolved within 28 days. The home is currently being investigated under safeguarding vulnerable adults procedures following a fall to a resident and the way it was managed. Evidence was seen on the day that the provider had a letter from a relative regarding resuscitation of his relative. The contents of the letter indicated that the provider had instigated the letter. This is not acceptable practice and these decisions must be made with the person concerned consent or as part of a multidisciplinary decision. If the person concerned does not have the capacity to make such a decision then a referral must be made under the Mental Capacity Act. Care Homes for Older People Page 17 of 31 Evidence: A lack of first aid training amongst staff had put residents at risk. Six staff had not received training in Adult Protection. Is is recognised that two of these staff are relatively new. One member of staff spoken with was able to demonstrate a good understanding of Adult Protection. Care Homes for Older People Page 18 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. People who live in the home have pleasant bedrooms but some of the communal areas could be improved. Evidence: At the last inspection is was noted that a lot of work had been undertaken on the internal environment, unfortuantely at this inspection it was noted that several of the new carpets were heavily stained and in need of a deep clean. The provider stated that they were regualrly cleaned as part of the domestic duties. Other areas of the home were fresh and clean. The furniture in the lounge was very low and residents were seen to be sitting on two or three cushions. One resident complained they were too low and that she and other residents had difficulty getting in and out of the seats. The provider must assess this risk and take appropriate action. At the last inspection the provider said that work had begun on covering all the radiators but this work had not been completed and needs to be urgently addressed. The provider was also advised to assess any hot pipework that may be exposed. The lighting in the lounge also needs to be assessed as several lightbulbs were not Care Homes for Older People Page 19 of 31 Evidence: working and a loose junction box was hanging off the wall in the alcove. Two radiators in this area were very hot to the touch and need to be covered for the safety of the residents. The heater in the conservatory also needs to be assessed as the label on the plug said do not use after 19/09/05. The heater felt warm and was clearly being used. The actual heater had a PAT test dated 05/07- 05/08. The exterior of the building was in need of redocoration and some of the windows needed to be replaced. Most of the bedroom were viewed and were mainly clean and tidy. Some bedside lamps were not working and several had radiators that were unguarded. One of the downstairs toilets was currently being used as a storage room and was not in use. Evidence was seen that the home had purchased sit on scales to weigh residents. The lift that has been discuused at several inspection has still not been fitted, this means that residents who are not fully ambulant can only occupy rooms on the lower floor. An environmental risk assesment had been completed on 09/07/08 and now needs to be implemented where possible. Some of the bedroom doors have had fire guards fitted and the provider is hoping to complete the fitting of these as required. There are plans in place to decorate the dining room and to purchase new dining chairs. Care Homes for Older People Page 20 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Low staffing levels have the potential to put people who live at the home at risk. Poor levels of staff training put the people who live in the home at risk. Evidence: The rotas indicated that at all times two care staff were on duty, however on the morning of the inspection only one care staff was actually on duty. This had the potential to put residents at risk and this must not be repeated. This meant that six residents had been assisted up by night staff and six remained in bed. The member of staff on duty stated that three residents were totally self caring and had got themselves up. The one care staff on duty was trying to serve breakfast and to administer medication. Again this has the potential to put residents at risk. The registered provider will be required to assess the needs of the people in the home to ensure sufficient staff are on duty to meet their needs at all times. The provider must ensure that with the high number of residents who have developed dementia in the home that there are sufficient staff on duty to meet their needs at all times. Staff training remains an issue as a requirement had been made at the last and Care Homes for Older People Page 21 of 31 Evidence: previous inspection that all staff receive mandatory training. It is recognised that three new members of staff this year but there remained serious gaps in first aid, fire awareness, moving and handling, adult protection, infection control and food hygiene. Due to the high number of residents with dementia it was disappointing to find that only three staff have received training in dementia care. Although it is recognised that the residents were not admitted with dementia, the home must be able to demonstrate it can continue to meet their needs at all times. There was conflicting evidence as to the levels of NVQ qualifications. The AQAA stated that seven of the thirteen care staff had completed an NVQ level 2 or above, but the training matrix provided by the provider stated only one had completed with five having recently enrolled on a course. The new manager did say that training has been planned but the compliance date for the last requirement was 31/07/08 and the enforcement pathway will now be followed. The homes induction procedure also needed to improve and again the new manager intended to update this. Two staff recruitment files were viewed and it was advised that more robust interview notes and risk assessments must be completed. The application form also needs to be expanded to gather further information on the applicant. The new manager confirmed this was in hand. 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. People who live in the home can be confident the philosophies of the home are sound but some practises have the potential to put the residents at risk. Evidence: The registered provider is also the registered manager but has now employed a manager with the intention of her becoming the registered manager in his place. The new manager had only been in post for a couple of weeks at this inspection but was already showing that she had the skills to manage the home. Unfortunately a serious error of judgment by the current registered manager had put a resident at serious risk and this has to be reflected in the score given for management. Staff and residents confirmed they felt supported by the manager. The home can hold a small amount of money on behalf of the residents for the purchase of small personal items and this is managed in an appropriate way with good Care Homes for Older People Page 23 of 31 Evidence: records maintained. Staff say they receive regular supervision and this will become part of the new managers responsibilities in the near future. The quality assurance process is still ongoing and the questionnaires have recently been sent out. Some have been returned and give positive feedback. It is the new managers intention to compile a report and to act on any of the required outcomes as soon as possible. The new manager stated that she is using her time as new in post to gain feedback about both positive and negative aspects of the home so that she can pinpoint where improvements need to be made. The new manager is also hoping to hold residents meetings where relatives can be invited so they are able to give feedback. A file was maintained that kept all certificates in place to show that the appropriate maintenance checks had been carried out. Care Homes for Older People Page 24 of 31 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 30 18 1(a) Staff are to receive training 31/07/2008 in all aspects of care and safe practice and this is to include: Fire Training First Aid Moving and Handling Care Planning Health & Safety & COSHH Risk assessment Infection Control Food hygiene. With refresher training and assessment of competency within good practice guidelines This requirement has not been met from the previous inspection. An improvement plan detailing how the service will address this must be forwarded to the Commission within the timescale indicated There is evidence that this is being addressed but there are still some gaps for core training. Training Certificates must all be available as evidence of compliance on staff files. This has been carried over from two previous reports Care Homes for Older People Page 25 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 7 15 The registered person shall 23/06/2009 ensure that service users plans are kept under review. In that any changes in needs are reflected in the service users plan. 2 18 12 The registered provider shall 30/04/2009 ensure that the care home is conducted so as to promote and make proper provisions for the health and welfare of service users. In that service users are protected from neglect. 3 19 13 The registered person shall 30/04/2009 ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety. In that the furniture in the main lounge is of a suitable height to enable service users to safely get in and out of. Care Homes for Older People Page 26 of 31 4 20 23 The registered person shall having regard to the numbers and needs of the service users ensure that ventilation, heating and lighting suitable for service users is provided in all parts of the care home which are used by service users. In that lighting in the lounge is sufficient. 30/04/2009 5 21 23 The registered person shall 30/04/2009 having regard to the number and needs of the service users, ensure that there are provided at appropriate places in the premises sufficient numbers of lavatories. In that the toilets that are currently out of use are reinstated. 6 25 23 The registered person shall 31/03/2009 having regard to the number and needs of the service users ensure that ventialtion, heating and lighting suitable for service users are provided in all parts of the care home which are used by service users. In that the wall heater in the lounge is assessed by a professional person as safe. 7 26 18 The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of 30/04/2009 Care Homes for Older People Page 27 of 31 service users ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. In that an assessment is carried out to ensure there are sufficient skilled staff on duty to meet the needs of the people in the home with dementia. 8 26 18 The registered person shall, 30/04/2009 having regard to the size of the care home, the statement of purpose and the number and needs of service users ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. In that a member of staff should not be working on her own at any time 9 26 18 The registered person shall, 30/04/2009 having regard to the size of the care home, the statement of purpose and the number and needs of service users ensure that persons who work at the care home receive training appropriate to the work they are to perform. Care Homes for Older People Page 28 of 31 In that the correct levels of NVQ training are submitted to the Commission. 10 37 20 The registered person shall, 30/05/2009 having regard to the size of the care home, the statement of purpose and the number and needs of service users ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users In that an assessment is carried out to ensure there are sufficient skilled staff on duty to meet the needs of the people in the home with dementia. 11 37 18 The registered person shall, 31/05/2009 having regard to the size of the care home, the statement of purpose and the number and needs of service users ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. In that a member of staff should not be working on her own at any time. 12 38 18 The registered person shall, having regard to the size of 30/05/2009 Care Homes for Older People Page 29 of 31 the care home, the statement of purpose and the number and needs of service users ensure that the persons employed by the registered person to work at the care home receive training appropriate to the work they are to perform. In that the correct levels of NVQ training are submitted to the Commission 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 9 It is recommended that medication receipt and recording is improved and that regular audits are undertaken by an experienced senior member of staff. It is recommended that dedicated hours be allocated to arranging and organising activities for the residents. It is again strongly recommended that all radiators and pipework are guarded or have guaranteed low temperature surfaces It is recommended that the application form is improved and that more in depth interview notes are maintained. It is recommended that all the soiled carpets are professionally cleaned or repalced as needed. It is recommended that the application form is improved and that more in depth interview notes are maintained. 2 3 12 25 4 5 6 26 26 31 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. 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). 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