Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 17/06/09 for Clifton Lodge

Also see our care home review for Clifton Lodge for more information

This inspection was carried out on 17th June 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 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

The home has warm and friendly atmosphere. People spoke positively about the home and the staff. There are good quality and easy to follow care plans in place. The people living at the home have good relationships with staff and they are relaxed with them. People have good access to local District Nurses, General Practitioners and specialist health care when required. People enjoy the food provided by the home and specialist diets are catered for. People and their families know how to complain or raise their concerns about the home. Visitors are made welcome and people are encouraged to maintain contact with family and friends.

What has improved since the last inspection?

The sash windows have been repaired. The manager has achieved the Registered Managers Award. The daily records have improved and reflect how people are spending their time.

What the care home could do better:

Since the last inspection, there has been deterioration in the quality of the recruitment practices at the home. The monitoring of staffing levels and management arrangements in place need to improve to ensure the safety and well being of people at the home. Care plans and risk assessments must be reviewed and updated when peoples` needs change. This is so that staff know what care and support people need and how to minimise any identified risks. Eye drops must be dated when they are opened and medication administration records must signed for at the time of administration. This is to ensure that are eye drops are are disposed of 28 days after opening and that there is an accurate record of the administration of medication. POVA and CRB checks and two written references must be obtained before staff start living and or working at the home. The references must include their last care sector employment. This is to ensure that staff are suitable and safe to work and live with vulnerable people. The staffing levels at the home should be kept closely under review and increased if the needs of the people at the home increase. Regulation 37 notifications must be made for all events that effect the well being of people living at the home and any staff disciplinaries. This is to ensure that the home is effectively monitoring and reporting incidents in the home.There should be systems in place for covering the unexpected absence of the manager. This is to ensure the smooth running of the home and to make sure that care staff are free to care for people.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Clifton Lodge 16-18 Clifton Road Southbourne Bournemouth Dorset BH6 3PA     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: Jo Johnson     Date: 2 3 0 6 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: Clifton Lodge 16-18 Clifton Road Southbourne Bournemouth Dorset BH6 3PA 01202428598 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) : cliftonlodge@hotmail.com Beechrise Limited care home 16 Number of places (if applicable): Under 65 Over 65 16 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 Clifton Lodge is a large, detached property, situated in a quiet residential area of Southbourne in Bournemouth. Local shops are within level walking distance, with the main shopping area of Southbourne and all its amenities about half a mile away. Bus services are available a short walk from the home, providing transport to all parts of Bournemouth, Christchurch and beyond. The home is also situated fairly close to the cliff top where there are a number of pleasant walks. The property is set back from the road and approached via a short driveway with a small parking area for visitors. Additional parking is available on roads in the vicinity of the home. Clifton Lodge is registered to accommodate up to 16 older persons. The accommodation is arranged over two floors, with a passenger lift to aid access between the floors. There are three double and ten single bedrooms. None of the bedrooms are equipped with en-suite facilities. The dining room and two separate lounges are situated on the ground floor, one overlooking the front garden and the Care Homes for Older People Page 4 of 31 Brief description of the care home other with views over the well-maintained rear garden, with its large lawn and paved patio area, surrounded by mature trees. Twenty-four hour care is provided. Laundering of personal clothing etc is carried out on the premises. Activities and occasional entertainments are arranged. Meals are freshly prepared and cooked within the home. 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: The quality rating for this service is 0 star. This means the people who use this service experience Poor quality outcomes. The focus of inspections undertaken by us is upon outcomes for people who live at the home and their views of the service provided. This process considers the homes capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. This report uses information and evidence gathered during the key inspection process, which involves a visit to the home and looking at a range of information. This includes the service history for the home and inspection activity, notifications made by the Care Homes for Older People Page 6 of 31 home, information shared from other agencies and the general public and a number of case files. This inspection visit was unannounced (we did not let the home know that we were coming) and took place on 17th June between 9.30 am and 12 pm and on 23rd June between 9.30 am and 2 pm. The manager was present on the second day of the inspection. The inspection involved: observations of and talking with people who live at the home, relatives, the staff and agency staff on duty and the manager. Four people were identified for close examination by reading their care plan, risk assessments, daily records and other relevant information. This is part of a process known as case tracking, where evidence is matched to outcomes for people. A tour of the environment was undertaken, and home records were sampled, including staff training and recruitment, health and safety, and staff rotas. This inspection was carried out by one inspector, but throughout the report the term we is used, to show that the report is the view of the Care Quality Commission. What the care home does well: What has improved since the last inspection? What they could do better: Since the last inspection, there has been deterioration in the quality of the recruitment practices at the home. The monitoring of staffing levels and management arrangements in place need to improve to ensure the safety and well being of people at the home. Care plans and risk assessments must be reviewed and updated when peoples needs change. This is so that staff know what care and support people need and how to minimise any identified risks. Eye drops must be dated when they are opened and medication administration records must signed for at the time of administration. This is to ensure that are eye drops are are disposed of 28 days after opening and that there is an accurate record of the administration of medication. POVA and CRB checks and two written references must be obtained before staff start living and or working at the home. The references must include their last care sector employment. This is to ensure that staff are suitable and safe to work and live with vulnerable people. The staffing levels at the home should be kept closely under review and increased if the needs of the people at the home increase. Regulation 37 notifications must be made for all events that effect the well being of people living at the home and any staff disciplinaries. This is to ensure that the home is effectively monitoring and reporting incidents in the home. Care Homes for Older People Page 8 of 31 There should be systems in place for covering the unexpected absence of the manager. This is to ensure the smooth running of the home and to make sure that care staff are free to care for people. 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. People who are considering moving into the home benefit from having their care needs assessed so that they can be sure the home can meet their needs. Evidence: The manager told us that people and or their families come and visit the home before making a decision about moving in. One person who had recently moved into the home told us that they had come to look around before moving in. Six of the seven surveys from people told us that they had enough information before moving into the home. The manager undertakes a pre admission assessment before determining whether they can meet someones needs. A fuller assessment, risk assessments are completed with people as soon as they move in. From this a care plan is developed. The assessments for the last two people to move into the home were seen. Information was sought from care management assessments, and where appropriate Care Homes for Older People Page 11 of 31 Evidence: other health professionals. People spoken with, surveys and records seen told us that they have a contract. 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. In the main care plans and risk assessments identify and describe the actions necessary to meet the identified needs of people living in the home. Medication systems in place are largely safe. Evidence: We looked at four peoples care records and care plans. Each person had a care plan, daily records and monitoring records. Care plans were based on information gained during the initial care needs assessment and were being developed as staff got to know the individuals. The care plans seen were generally of a good quality and were easy to follow. Risk assessments were completed for falls, tissue viability, mobility, and nutrition. People were weighed on admission to the home and this was recorded in their plans. There were some elements of peoples care plans and risk assessments that needed updating. For example: Care Homes for Older People Page 13 of 31 Evidence: One person who was nutritionally at risk had consistently gained weight since moving in to the home over six months ago. Their plan specified that they were to be weighed fortnightly. However, as they had gained and maintained their weight they were now weighed monthly. One person who has bed rails on their bed had a blank consent form and risk assessment in their care records. One person who had deteriorated recently had an updated care plan in place detailing how staff were to care for them. However, they had started to have a lot of falls and the falls risk assessment had not been updated. At the time of the inspection there were two people who were being cared for in bed who needed to be turned every two hours throughout the day and night. They were also being supported by the local district nursing team. One other person was very frail and was choosing to spend time in bed. Daily records were written for each person and reflected how they have spent their time and the care and support they have received. There were no photographs of the last two people who moved into the home in either their care records or the medication records. People living in the home looked well cared for and were clean, their hair had been combed and nails were trimmed and clean. They were well presented and wore clothes that were suited to the time of year. Garments were clean and well maintained. People spoken with said that staff take care to make sure they are well dressed and their appearance is cared for. Staff observed had good relationships with the people living at the home and were patient and encouraging. Staff respected peoples privacy and dignity, by knocking on their doors and offering personal care discreetly and in private. Discussion with the manager, staff, and observation of care plans and daily records tell us that people living in the home have access to health professionals such as GP,dietician, dentist and specialist consultants and chiropodist. The medication records for four people were looked at. There were a number of gaps Care Homes for Older People Page 14 of 31 Evidence: in the medication administration records. There were also a number of months records in the medication file which made it difficult to easily follow what was the current medication record. The manager told us that only staff that are trained administer medication. She said that she checks the medication but does not record these checks or reassess the competency of the staff administering medication. At the time of the inspection there were no controlled drugs at the home. Care Homes for Older People Page 15 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Some people who live at the home are able to independently participate in social activities and are given choices to maintain their quality of life. People who are not so able are not receiving the stimulation they need. This means there may be long periods of time when they are unoccupied. Evidence: People spoken with said that their visitors were made to feel welcome whenever they visited. There is not a structured weekly or monthly activity programme in place. Clifton Lodge provides occasional organised activities such as concerts from visiting musicians, exercise classes and various games such as bingo. The care staff also organise a few activities. The manager told us that feedback form relatives form surveys told them that they were not aware of what activities were on offer. It is recommended that any planned activities are displayed on a notice board so people living at the home and visitors can see what activities are on offer. Care Homes for Older People Page 16 of 31 Evidence: The manager told us that no-one is supported to worship at the moment. It is recommended that people be consulted about their spiritual needs and whether they want to be supported with this. During the inspection the manager followed this is up for one person who would like to go to church on a Sunday. One person who is cared for in bed under the direction of the district nursing team told us that they were bored and fed up and would like to be able to spend time with her friends in the lounge. This individual spends two hours lying on on either side. When we spoke with them they were looking at blank wall they said theres nothing to look at. It is recommended that in consultation with the individual their bedroom walls be made more interesting so they have something to look at whilst being cared for in bed. People spoken with and surveys told us that there are always or usually activities arranged by the home that they can take part in. One person said some entertainers are better than others. Menus showed that the people who live there have a choice of meals through the day. The menu was varied and meals appeared nutritious. The chef speaks to every person before each meal to ask them what they would like to eat. People spoken with said they enjoy the meals and stated that they are always offered choices. The surveys told us that they always like the meals at the home. Care Homes for Older People Page 17 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints procedures make sure that peoples, relatives and representatives concerns and complaints are listened to and acted upon. A staff team who have a good knowledge of how to respond to any suspicion of abuse and to keep people safe from harm support the people living at the home. Evidence: The complaints policy is in the service users guide and displayed in the home. From discussion with the manager and information provided in the AQAA, there has been one complaint in the last twelve months. This complaint was also made to the commission in the last twelve months. This complaint was investigated by an independent consultant who made recommendations for improvements at the home to ensure that the issues do not reoccur. People spoken with and a majority of the surveys told us that they all knew whom they would talk to if they were unhappy or needed to complain. One person said, if Im not happy I talk to the manager. Staff spoken with and surveys told us that they know what to do if a person at the home or relative or friend has concerns about the home. Staff have attended training in the Protection of Vulnerable Adults (POVA) and completed a work book so that they are aware of the different ways vulnerable people are at risk of abuse, and would know how to respond. Care Homes for Older People Page 18 of 31 Evidence: There has been one adult protection safeguarding referral made to and coordinated by the local authority since the last key inspection. The home has cooperated fully with the investigation and taken action where necessary. The manager has been given verbal confirmation that the allegation was unsubstantiated and is awaiting written confirmation from the local authority. The manager has recently completed training on the Deprivation of Liberties and the Mental Capacity Act. The manager told us that she has not needed to undertake any Deprivation of Liberty assessments for anyone living at the home. Care Homes for Older People Page 19 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is maintained and furnished so that people live in a homely and comfortable environment. Evidence: The home has a warm and relaxed atmosphere. We looked at some of the bedrooms of the people involved in case tracking. They were clean and well furnished. The rooms were personalised with their own belongings. Equipment is available to assist people and staff in the delivery of personal care, which includes assisted baths, accessible showers and moving and handling equipment including hoists. The laundry room was clean, tidy and well organised. All of the washing machines were in working order. Hand washing facilities and protective clothing was available. Systems are in place to reduce the risk of infection. Disposable gloves, aprons are available and used by staff when handling soiled linen and when supporting people with personal care. There was handwash and paper towels in most of the communal toilets and bathrooms. It is recommended that handwash and paper towels be Care Homes for Older People Page 20 of 31 Evidence: available in all toilets, bathrooms and in peoples bedrooms who receive personal care. The surveys from people living at the home show that the home is fresh and clean. Care Homes for Older People Page 21 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. There are not always enough staff on duty at peak times to fully meet the needs of the people living at the home. The poor recruitment practices at the home potentially place people at risk of harm from staff that have not been been checked whether they are suitable to work with vulnerable people. Evidence: On the days of the inspection there were 14 people living at the home. There are two staff on during the day and one waking and one sleeping night care worker. In addition to this there is a chef and ancillary staff. The manager is also available throughout the week and weekends if necessary. At the time of the inspection two people were being cared for in bed and one person was very frail and was choosing to spend time in bed. On the first day of the inspection the manager was unavailable due to ill health. This just left two care staff, the chef and an agency cleaner to operate the care home and provide the care to the people at the home. One of the two care staff was an agency worker. Care Homes for Older People Page 22 of 31 Evidence: People spoken with during the inspection told us staff in the evenings is a problem, only two on duty. One is doing medication and one is in the kitchen. We have to wait an awfully long time, there have been some staff changes, we could do with more staff, there are not always enough on duty. The surveys from people and the staff told us that there always or usually enough staff. When we returned for the second day of inspection the manager had taken action to address the care staff being unavailable at tea time by changing the working hours of the chef. We raised with the manager our concerns about the lack of management cover or structure to cover in unforeseen absences. There are arrangements in place to cover for the manager when she has a holiday. We also raised concerns how the two people who are cared for in bed and turned every two hours are managed during the night. The manager explained that the individuals have slight builds and are turned by one member of staff by a slide sheet. This is detailed in their care plans. The staffing levels at the home must be kept under review and increased if more people need to be cared for in bed. We looked at the staff files for the last four recruited staff at the home. All of the staff files included included CRB (Criminal Records Bureau) and PoVA (Protection of Vulnerable Adults) checks. However, two of the staff live in accommodation on the second floor of the home. They moved into the home in August 2008 and started work in September 2008. The staff both lived and worked at the home before POVA and CRB checks were received. Both staff had references to whom it may concern and references were not sought from a previous care home placement for one of the staff. This means that there were people both living and working in the care home with no satisfactory way of establishing their fitness and whether they were suitable to work and live with vulnerable people. There is a staff induction in place that is based on skills for care standards. Staff spoken with and surveys told us that the induction and staff training covered everything they needed to know. From discussions with the manager, the training programme, discussions with staff and surveys there is a training programme in place that focuses on mandatory training and the specific needs of the people living at the home. Care Homes for Older People Page 23 of 31 Care Homes for Older People Page 24 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 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 do not benefit from or live in a home that is consistently managed or recruits some staff safely. Evidence: During the visit staff appeared confident in their roles, the home was relaxed and people appeared at ease and comfortable. Staff spoken with commented positively about the manager, their job role and the people living at the home. The manager acheived the Registerd Managers Award in 2007. The manager completed the AQAA (Annual Quality Assurance Assessment) and was able to demonstrate where they had improved the home over the last year and identify some areas for improvement. There is a quality assurance system in place. This includes surveys for people living at the home and relatives, residents meetings, regulation 26 visits by an independent Care Homes for Older People Page 25 of 31 Evidence: consultant and the owner and audits of accidents/incidents. The manager has acted on all of the recommendations following the complaint and adult protection investigation at the home. The manager told us that they do not manage or keep any monies for people living at the home. As identified in the staffing section there were serious shortfalls in the recruitment practices at the home that placed people at risk at harm from staff who may have been unsuitable to live or work with vulnerable people. The staffing levels need to be kept under review whilst people at the home are unwell or being cared for in bed. There need to be systems in place for covering the unexpected absence of the manager. This is to ensure the smooth running of the home and to make sure that care staff are free to care for people. The acting manager has notified us of any deaths. However, there have been a number of incidents, accidents, hospital admissions and staff disciplinaries that have not been reported to us. Following discussion with the manager, she has agreed to notify us of all these events that effect the well being of people living at the home and any staff disciplinaries. Information provided before the inspection, by the manager in the AQAA (Annual Quality Assurance Assessment) shows that relevant Health and Safety checks and maintenance are being carried out at the home. A number of Health and Safety records were checked, including the fire safety log. These records showed that health and safety matters are well managed. Staff training in mandatory areas, including fire safety, health and safety, moving and handling, emergency aid, and basic food hygiene, is ongoing. Care Homes for Older People Page 26 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 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 19 POVA and CRB checks and two written references must be obtained before staff start living and or working at the home. The references must include their last care sector employment. This is to ensure that staff are suitable and safe to work and live with vulnerable people. 01/08/2009 2 13 Eye drops must be dated when they are opened. Medication Administration records must signed for at the time of administration. This is to ensure that are eye drops are are disposed of 28 days after opening and that there is an accurate record of the administration of medication. 01/09/2009 Care Homes for Older People Page 28 of 31 3 7 12 Care plans and risk assessments must be reviewed and updated when peoples needs change. This is so that staff know what care and support people need and how to minimise any identified risks. 01/09/2009 4 37 37 Regulation 37 notifications must be made for all events that effect the well being of people living at the home and any staff disciplinaries. This is to ensure that the home is effectively monitoring and reporting incidents in the home. 01/10/2009 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 A tenancy agreement should be in place for the members of staff who live in the staff accommodation at the home. This agreement should specify how and if this relates to the employment of the individuals. The manager should be able to demonstrate how they safeguard people living at the home from people who may also live in the home who are subject to suspension and or disciplinary action. 2 The staffing levels at the home should be kept closely under review and increased if the needs of the people at the home increase. 7 Personal profiles in care plans and or Life History books should be developed that include details and photographs of their history such as family, friends, where they have lived, pets, work etc. These profiles or life history books will assist staff to have a greater understanding of them as an 3 Care Homes for Older People Page 29 of 31 individual. 4 5 6 7 19 26 Care records should include a photograph of the individual. This so that staff are able to recognise each person. More stimulating environments should be developed in peoples bedrooms if they are cared for in bed. It is recommended that handwash and paper towels be available in all toilets, bathrooms and in peoples bedrooms who receive personal care. There should be systems in place for covering the unexpected absence of the manager. This is to ensure the smooth running of the home and to make sure that care staff are free to care for people. 7 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). 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 31 of 31 - 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!