Inspection on 21/04/09 for Elizabeth House

This inspection was carried out on 21st April 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Elizabeth House 12/01/09

Elizabeth House 09/06/08

Elizabeth House 20/11/06

Elizabeth House 25/10/05

Elizabeth House 25/05/05

Elizabeth House 15/03/05

Elizabeth House 31/08/04

Elizabeth House 12/02/04

Similar services:

Applegarth

Trevayler Residential Care Home

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Elizabeth House Perth Avenue New Parks Estate Leicester LE3 6QR     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: Linda Clarke     Date: 2 1 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Elizabeth House Perth Avenue New Parks Estate Leicester LE3 6QR 01162871031 01162871031 elizabeth-house@leicester.gov.uk socis209@leicester.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Leicester City Council care home 37 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability sensory impairment Additional conditions: Service User Numbers DE(E) & MD(E) No one falling within category DE(E) or MD(E) may be admitted into Elizabeth House when 20 persons who fall within categories/combined categories DE(E) or MD(E) are already accommodated within the home Service User Numbers PD(E) No one falling within category PD(E) may be admitted into Elizabeth House when there are 8 persons of category PD(E) already accommodated within the home Service User Numbers SI(E) No one falling within the category SI(E) may be admitted Care Homes for Older People Page 4 of 29 Over 65 20 20 37 8 10 0 0 0 0 0 into Elizabeth House where there are 10 persons of category SI(E) already accommodated within the home Date of last inspection Brief description of the care home Elizabeth House Residential Home provides accommodation for thirty-seven older people and is owned by Leicester City Council. The Home is located in a quiet residential area. Public transport services can be accessed near to the Home. The Home is ten minutes car ride from the city centre, Fosse Park and the M1 motorway. Elizabeth House is a large purpose built property. Accommodation is offered on the ground and first floor, which can be accessed by a passenger lift. Bath/shower and toilet facilities are located throughout the Home. Car parking space is located to the front of the Home. There is a large patio area to the centre of the building. All areas of the Home are accessible to people using mobility support, aids and equipment. Information is located on site detailing the range of services offered, which includes the Statement of Purpose. Elizabeth House has copies of Inspection Reports, which are located in the foyer along with the displayed registration certificate. The maximum weekly fee is available by contacting the Registered Manager and an individuals financial contribution to their care is dependent upon a financial assessment. There are additional individual expenditure such as hairdresser, chiropodist, newspapers, magazines and personal toiletries and the fee will dependent upon the services received. 1 2 0 1 2 0 0 9 Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: We as it appears throughout the Inspection Report refers to the Care Quality Commission. The inspection process consisted of pre-planning the inspection, which included reviewing the Annual Quality Assurance Assessment (AQAA), which is a selfassessment tool completed by the Registered Manager, reviewing previous Inspection Reports, and any information we have received. The unannounced site visit commenced on 21st April 2009, and took place between 08:30 and 15:30. The focus of the inspection is based upon the outcomes for people who use the service. The method of inspection was case tracking. This involved identifying people with varying levels of care needs and looking at how these are being met by the staff at Elizabeth House. Four people accessing services were chosen, and discussions were Care Homes for Older People Page 6 of 29 held with two of them, along with other people who live at the home. Staff members were spoken with along with the Registered Manager. We also sent surveys to some people living at the home, and their relatives. Surveys were also sent to health and social care profesionals, and a selction of staff who work at the home. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Elizabeth House enables people who require residential care to make an informed decision as to whether the home is appropriate for their needs by encouraging people to visit the home before making a decision, and through is assessment process. Evidence: We sent surveys to people who live at Elizabeth House and their relatives and friends, information in surveys told us that they had been provided with information about the services the home provides before they moved in. We spoke with two people whose records we looked at, and three other people who live at the home. Everyone told us that either they or someone they knew had looked around the home before they moved in. In some instances people had chosen the room they wanted and had been involved in choosing the decor of the room before they moved in. One person said I visited and chose this room and the wallpaper before i moved in. Whilst someone else told us I wasnt able to visit as I was ill, but my friend visited. Care Homes for Older People Page 10 of 29 Evidence: We looked at the records of four people, and found that everyone had had their needs assessed by a Social Worker, this provides information so that the Registered Manager of Elizabeth House can determine whether the home can meet the needs of the individual, before they move in. Care Homes for Older People Page 11 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and care needs of people are generally met but the quality of care people receive would be improved by staff training and the number of staff on duty. Evidence: We undertook a Random Inspection of Elizabeth House on the 12th January 2009, this took place following a safeguarding referral, this is made when concerns are raised about the care and welfare of a person who is receiving care. We found that care plans and records of people staying at the home for respite care were not comprehensive and that risk assessments had not been undertaken to reduce the potential risks to them. Since the Random Inspection we were notified of a second safeguarding referral with regards to the care and support of someone living at Elizabeth House, in this instance a Social Worker advised us that the care plan of the person was insufficient and did not provide staff with information as to how they were to support the person, this meant the person was not supported appropriately by staff. Care Homes for Older People Page 12 of 29 Evidence: We looked at the care plan of this person, and found that since the safeguarding referral the care plan has been reviewed which now supports the specific needs of that person, and includes guidance for staff on how to manage difficult situations. We also looked at the care plans of three other people living at Elizabeth House, we found that care plans now contain more information about the needs of a person and provide staff with information about the persons life before they moved into Elizabeth House, such as their work and family life, hobbies and interests, which enables care staff to understand what is important to the people that they care for. Care plans include the preferences and wishes of individuals, such as what time they wish to get up or go to bed, where they like to spend their day, what perfume they like to wear, and whether they want to have their bedroom light on and night. This information enables people to be supported in an individualised way. Care plans include information about the support people require and the role of staff in providing the support, along with guidance on specialist equipment or managing difficult situations. Care plans had been signed by the person and their key worker. Since our visit to Elizabeth House we have been advised of a third safeguarding referral, which involves someone who stayed at the home for respite care. The relatives of the person have advised a Social Worker that they sat with a member of staff and had discussed in detail the needs of their relative, but on visits to the home found that the information they had provided was not being followed. For further information refer to the section Complaints and Protection. We asked people whose records we looked at for their views about the care provided at Elizabeth House, one person told us 110 , the support is unbelievable. I have good access to health care. Whilst someone else told us I love living here, its the best decision I have made, everyone here is helpful, and they look after me. We looked at staff training records and found that very few staff have received training on how to support and care for people with dementia or a mental disorder and those who require support to manage their behaviour. Care plans and information supplied by the Registered Manager states many people living or staying at the home require support in these areas. Training needs to be provided in these areas in order that people are supported effectively and appropriately. Records we looked at told us that people have access to a range of health care professionals, and surveys we received from people living at the home along with people we spoke with when we visited the home, told us that they have good access Care Homes for Older People Page 13 of 29 Evidence: to health care professionals. We looked at the medication and medication records of two people along with medication and medication records of two people who were prescribed Controlled Drugs. We found the medication to be in good order, and that the home had purchased a new cabinet for the purpose of storing Controlled Drugs. We sent surveys to health care professionals, the information provided told us that health care professionals are satisfied with the care provided by the staff at Elizabeth House, one health care professional to the question, what do you feel the service does well, wrote attentive staff, who accompany the doctor to see the patient. and good communication with G.P. Care Homes for Older People Page 14 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Opportunities are available for people to engage in activities, but these are not far ranging and are dependent upon the availability of staff to provide them, and the ability of people to participate. Elizabeth House provides a wholesome and varied diet. Evidence: We wanted to find out about how people spend their day, and how the staff working at the home support people to make decisions and stay in contact with relatives and friends, we did this by observing people throughout the day, talking with people living at the home and by looking at the care plans and records of four people. We sent surveys to people who live at the home and their relatives, whilst some said that they joined in activities organised by the home, many wanted outings and trips to be organised by the home. Two people made comments in their survey:People who are unable to get out could be taken out from time to time even if it is just someone pushing them in a wheelchair for an hour by a carer. Would like to get out more when weather is suitable but need a member of staff with me and this is not often possible. Care Homes for Older People Page 15 of 29 Evidence: This was confirmed by surveys which were distributed by the Registered Manager of Elizabeth House, as part of the homes quality assurance process. The Registered Manager in the information they provided before we visited the home, told us of their intention to employ an Activities Organiser. The home does not have access to transport, and therefore impromptu day trips cannot be organised. Records we looked at told us that some people join in bingo sessions organised by the home, and that some of the service users had attended the Easter Bonnet Parade. During our site visit, a member of staff put on some music and encouraged people to sing along. Our observations were that people who were able to occupy themselves by watching television or reading did so, whilst others sat in communal rooms or in their own room, some snoozing. A member of staff took one person out for a walk around the local area. Relatives are encouraged to visit the home, and take people out. One lady told us my son and daughter visit often, and they take me out, sometimes for a meal. We saw one person returning with their relative, after a morning out, with gardening tools so that they could make up a vegetable garden, in a raised bed which the Registered Manager was in the process of organising. When we arrived in the morning, breakfast was still being served with people coming to the dining room when they had gotten up, everyone was offered a choice of cereals and toast, and we saw one person eating a cooked breakfast. Tea and coffee were served, along with fruit juice. At lunchtime we sat with a group of people, they told us that they very much enjoyed the food at Elizabeth House, there were two choices for the main course and four choices for dessert. We observed that where people required specialist diets these were provided by the home. Everyone was offered a glass of Beer, Port or Sherry to accompany their meal, soft drinks were also served. One person said Whats the special occasion, is it a party? Care Homes for Older People Page 16 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People residing at Elizabeth House are confident in raising concerns. Policies and procedures for the protection of vulnerable people are not always put into practice which has the potential for people to remain at risk. Evidence: We wanted to find out how the staff of Elizabeth House promote the safety and welfare of people who use the service. We undertook a Random Inspection of Elizabeth House on the 12th January 2009, to follow up on issues discussed at a meeting, which was held following a safeguarding referral, this happens when concerns are raised about the care and welfare of someone who receives care. Since the Random Inspection there has been a further safeguarding referral with regards to someone who lives at Elizabeth House. Social Services as the lead agency are looking into this, and have suspended two members of staff, whilst the process is ongoing. For further information refer to the section Health and Personal Care. Since the site visit as part of the Inspection we have been informed of a third safeguarding referral, about someone who stayed at the home for respite care, which is being investigated by Social Services Care Homes for Older People Page 17 of 29 Evidence: At this Key Inspection, we wanted to find out what measures had been put into place to improve the recording and communication of information, which was highlighted as part of the first safeguarding investigation and by the Random Inspection. The Registered Manager has held meetings with staff, and minutes detail that staff have been reminded of the importance of recording and communicating information, and the need to record in detail. Care plans for people living at the home have been reviewed, and are now more detailed. We looked at records and found that the recording of information within Elizabeth House has improved, including the quality of information recorded. We found some instances where information was being recorded in different locations, which has the potential to impact on decisions made, this was discussed with the Registered Manager. The Registered Manager at a meeting with Senior Staff in the afternoon, addressed this issue. We found when we looked at records in the home that people who live or receive respite care have been involved in incidents involving other people receiving a service, these incidents should have been referred under safeguarding policies and procedures. We looked at the training records of staff and found that a majority of staff have received training in safeguarding adults from abuse, and care staff we spoke with were aware of their role and responsibilities in reporting incidents of concern to a Manager, the information recorded regarding incidents is not being acted upon, which has the potential for people to remain at risk. Information provided by the Registered Manager prior to our site visit states that the home has received two complaints in the last twelve months, of which one was upheld. The Care Quality Commission and its predecessor the Commission for Social Care Inspection has not received any complaints or concerns in the last twelve months, but has been advised of the three safeguarding referrals. Surveys we received from people who live at the home and their relatives told us that they are aware of how to make a complaint or raise a concern, and information in staff surveys told us that staff know how to respond to concerns expressed to them. Care Homes for Older People Page 18 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Elizabeth House provides a welcoming environment, which would benefit from improvements to its furnishings. Evidence: We had a tour of Elizabeth House, all communal areas of the home were decorated to a reasonable standard, however carpets in communal rooms and corridors were dirty and stained. In some areas squares of carpet had been replaced by a piece of carpet which did not match the pattern of the existing carpet. A programme for the cleaning or replacement of carpets needs to be put into action, so that people living at the home, can live in a homely environment. Elizabeth House has a dining room and two lounges on the ground floor and designated lounge for people who wish to smoke, with a further two lounge / dining rooms on the first floor. A majority of people living at the home choose to sit in the small lounge next to the dining room or use the smokers lounge, which means the carpets in these room and surrounding corridors experience more wear than other areas of the home and require cleaning or replacing. Individual rooms are reasonably decorated and have been personalised by its occupants with furniture and personal belongings, all rooms have a sink, there are no en-suite facilities available. Care Homes for Older People Page 19 of 29 Evidence: Discussions with the Registered Manager and information provided prior to our visit, told us that Elizabeth House provides respite care for several people, but that separate accommodation and staffing is not provided. The number and needs of people who receive respite care is continually changing, but we found no evidence that staffing levels were reviewed to meet these changes. The Registered Manager advised that initially Elizabeth House was to have an area dedicated within the home to people on respite care, and that this would be staffed separately, this has not happened. Elizabeth House has a small garden in the centre of the building, which is overlooked by a patio area. The patio area is accessible and has tables a seating area and potted plants. The garden cannot be accessed as it is on a significant slope, but could be improved to provide a more attractive area for those sitting on the patio to view. Care Homes for Older People Page 20 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Elizabeth House are supported by qualified staff but they do not have training in specialist areas nor are staffing levels reviewed to reflect the needs of people. Evidence: We found on the day of the site visit that staffing levels are able to meet the needs of people living at the home, but are not always timely or sufficient to observe people. The Registered Manager and staff expressed concerns that when the home has a large number of people staying at the home for respite care, that staff find it difficult to meet the needs of everyone, as often the needs of people staying at the home for respite care are significant as staffing levels have not been reviewed. The layout of the home means that it is difficult for staff to continually observe people living at the home. The second safeguarding referral which involved someone living at the home, occurred when their were no staff observing the person, and staff were summoned by a visiting relative, when they observed something of concern. The third safeguarding referral was brought about by relatives of the person staying at the home, their concerns included an incident when they has visited their relative and found them on the floor requiring personal care, with no visible staff presence. We sent surveys to people who live at the home which asked them if they receive the care and support they need, two surveys contained comments:Care Homes for Older People Page 21 of 29 Evidence: Occasionally staff have more urgent call to attend to. This is difficult for me when needing hoisting for the toilet. Response times sometimes slow due to staff shortage. Elizabeth House has had three referrals under safeguarding procedures, with regards to the quality of care people receive, including the lack of information in care plans, and comments that personal care was not to the standard expected by the person or their relatives. The Registered Manager advised that initially Elizabeth House was to have a designated facility within the home to people on respite care, and that this would be staffed separately, this has not happened. Information provided by the Registered Manager prior to our site visit, told us that 91 of staff have attained a National Vocational Qualification (NVQ) in Care, we looked at the training records of staff and found that staff have received training which promotes the health and safety of people, including moving and handling, food hygiene and health and safety, but very few staff have received training in dementia, mental disorder and managing challenging behaviour. Care Homes for Older People Page 22 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management team are not sufficiently reactive to ensure that the home does not have a detrimental effect on the health and welfare of some people using the service. Evidence: The Registered Manager, Mr Phillip ODell has been the Registered Manager of Elizabeth House for eighteen years, and has attained the Registered Managers Award, and holds a CQSW (Certification of Qualification in Social Work). There have been three safeguarding referrals since the last Key Inspection, which have alleged that managerial systems in the home are not sufficiently robust, and that information has not been communicated or recorded effectively. As a result of the first two referrals the Registered Manager has held meetings with staff to discuss with them the need to improve the quality and accuracy of information recorded, and records we looked at found that recording was more detailed. We found when we visited as part of this Key Inspection, that the welfare and safety Care Homes for Older People Page 23 of 29 Evidence: of people are not always protected, and that information recorded is not being reviewed. We found instances where staff had recorded incidents involving people who live at the home, which had not been reported using the policies and procedures which are there for the protection of vulnerable people this has the potential for people to remain at risk. For further information refer to the section Complaints and Protection. We spoke with staff who said that the Management Team were generally supportive, but that in some instances they felt that their concerns were not acted upon. Staff meetings are regularly held in the home, and staff confirmed that they receive regular supervisions from their line manager. The Annual Quality Assurance Assessment (AQAA) which is a self assessment tool completed by the Registered Manager provided little information as to how the service plans to improve over the next twelve months. The Registered Manager had sent a selection of surveys to people who live at the home, to gain their views about the care they receive, he advised that when all of them were completed they would be analyzed and issues raised would be addressed. Information provided by the Registered Manager states that systems within the home including central heating, fire systems and electrical systems are regularly maintained, and staff training records told us that staff receive training in topics related to health and safety, but that staff did not receive training in areas which are specific to the needs of people they care for. Care Homes for Older People Page 24 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 18 The Registered Person to develop a programme of training, which enables care staff to provide good quality care and support for people with dementia, a mental disorder and who have behaviours, which can be challenging. To ensure that the needs of people living or staying at Elizabeth House are met by knowlegeable and trained staff. 29/05/2009 2 12 16 The Registered Person to consult with people living at the home about their individual wishes and expectations as to their recreational and leisure interests, and to develop a plan of care supporting this. To enable everyone living at Elizabeth House to live a rewarding life in a manner 20/07/2009 Care Homes for Older People Page 26 of 29 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action which reflects their lifestyle choices. 3 18 12 The Registered Person to ensure that the policies and procedures for the safeguarding of vulnerable adults from abuse are implemented. To promote and protect the rights of people who receive care. 4 19 23 The Registered Person to develop a programme for the replacement or cleaning of carpets in communal rooms and corridors. Elizabeth House to provide a homely and clean environment for people to live. 5 27 18 The Registered Person to review staffing levels to ensure that their are sufficient staff on duty to meet the needs and the fluctuating numbers of people accessing the service for respite care, whilst balancing the continuing needs of those living at Elizabeth House. To ensure that staffing levels are sufficient to meet the needs of people in 29/05/2009 20/07/2009 22/05/2009 Care Homes for Older People Page 27 of 29 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action receipt of care at Elizabeth House. 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 19 The garden area to be landscaped to provide an attractive view for those who sit outside, or can see the garden area from a window. The Registered Person to consider whether Elizabeth House meets the needs of people living and staying at the home, and consider the introduction of a seperate unit for those accessing respite care. 2 20 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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