Inspection on 23/10/08 for Elliott House

This inspection was carried out on 23rd October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Elliott House 14/09/06

Elliott House 13/12/05

Elliott House 17/08/05

Elliott House 04/01/05

Elliott House 16/08/04

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 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Elliott House 22 Reculver Road Beltinge Herne Bay Kent CT6 6NA     The quality rating for this care home is:   two star good 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: Lisbeth Scoones     Date: 2 4 1 0 2 0 0 8 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. the things that people have said are important to them: They reflect 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 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Elliott House 22 Reculver Road Beltinge Herne Bay Kent CT6 6NA 01227374084 01227740750 michelle.guest@elliotthouse.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Linda Valerie Elks Type of registration: Number of places registered: Mr Ian George Nicoll care home 71 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 71. The registered person may provide the following category/ies 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 categories: Old age, not falling within any other category (OP) Dementia (DE). Date of last inspection Brief description of the care home Elliott House Home is registered to give care for up to 71 older people, and this currently includes (by special arrangement) one individual with a physical disability. Mrs Elks is the registered manager. The property is an impressive Listed building, comprising three floors, and situated in its own extensive, landscaped grounds. It was previously known as Heronswood, and was purchased by Mr Nicoll, the current Care Homes for Older People Page 4 of 26 Over 65 0 71 71 0 Brief description of the care home Registered Individual, in 1997. It then underwent a major re-furbishment programme, but retains many of its original period features, including a rotunda room. Each floor is characterised by its own colour scheme, and the floors are linked by two shaft lifts and four stairways. Elliott House has 49 single bedrooms, which have en-suite facilities, and six, which do not. There are also eight double rooms, all of which have en-suite facilities. Only two of the bedrooms are slightly undersize, but in one case, this is compensated for by the provision of an en-suite WC and basin. Many bedrooms far exceed the National Minimum spatial standard. In terms of access and scope for community presence, the home is one mile from Beltinge and two miles from Herne Bay. It is a short distance from the A299 linking it to London, Margate and Ramsgate. There are bus stops directly outside the front boundary, to Herne Bay, Whitstable and Canterbury with all the further transport links that implies. There is ample parking space along the circular driveway at the front, and an access road to one side to another parking area for trade and staff. The current weekly fees range from £475 (non en-suite) to £500-£600. Any shared rooms used as single rooms would be charged at £550 per week. Information on the homes services and the CSCI reports for prospective residents should be detailed in the Statement of Purpose and Service User Guide. The e-mail address for this home: elliotthouse@btconnect Care Homes for Older People Page 5 of 26 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: two star good 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 key inspection was carried out over two days on 23d and 24th October 2008. It comprised discussions with the registered manager, staff on duty and conversations with a number of residents during the visit. An accompanied tour of the premises was carried out, a lunchtime session joined and documentation examined in respect of care plans and risk assessments, staff rota, menus, staff and training files, training matrix and medication records. The manager was present throughout and a comprehensive feedback was given at the end of the inspection. Key Lines of Regulatory Assessment (KLORA) have informed the judgments made based on records viewed, observations made and written and verbal responses received. KLORA are guidelines that enable The Commission for Social Care Inspection Care Homes for Older People Page 6 of 26 (CSCI) to make an informed decision about each outcome area. The inspection was further informed by an AQAA (annual quality and audit) completed on 20th of August 2008 by the manager and by returned comment cards from one care manager, 6 residents and 4 members of staff. Information thus received is incorporated in the report. Since the previous inspection the home has become registered to care for people with dementia. The manager reported in the AQAA that the home had received 4 complaints, which were investigated and closed. A referral had been made to the safeguarding vulnerable adults team and this was investigated and closed. At this inspection, an immediate requirement was made in respect of service maintenance and staff mandatory training. The provider and registered manager responded promptly and provided evidence that the requirements were met. The last Key unannounced inspection was carried out on 14th September 2006 and an Annual Service Review (ASR) on 18th December 2007. What the care home does well: What has improved since the last inspection? Information in the AQAA confirms that all previous requirements and recommendations have been acted upon. As a result of listening to people, care plans are now more person-centred. Secure fencing has been placed around the grounds to provide freedom to residents and a sensory garden developed for people with visual problems. The home has grown tomatoes and some vegetables. Improvements have been made to the environment in respect of laminate flooring in the dining area. Lounge and dining chairs have been reupholstered. Catering arrangements have improved in respect of the times residents would like to eat. Staff have been provided with Dementia care training Care Homes for Older People Page 8 of 26 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 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 26 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. Residents are provided with a Statement of Purpose and Service User Guide, which outline the services the home provides. No resident is admitted to the home without a comprehensive pre-admission assessment. Evidence: There is a Statement of Purpose and Service User Guide, which detail the facilities, services and principles of care. Since the previous inspection the home is registered the provide care for people with dementia. The home should consider providing the guide in a user-friendly e.g. pictorial format. During the inspection it was ascertained that there is to be a reduction in the provision of activities and the provider should ensure that the Statement of Purpose and Service User Guide is updated accordingly. Care Homes for Older People Page 11 of 26 Evidence: The home carries out a preadmission assessment to ensure that it can meet the residents needs. The prospective resident or representative is invited to visit the home and meet the staff and residents. None of the residents spoken with were able to confirm this process as described, as they had entrusted the choice of home to the judgement of their representatives. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents personal, health and social care needs are recorded in a care plan which is regularly reviewed. The home is served by a range of healthcare professionals to promote good health and meet assessed needs. Residents are mostly protected by the homes medication procedures. Residents confirmed that staff treat them well and that their privacy and dignity are respected. Evidence: The pre-admission assessment covers the residents’ most critical health, personal and social care needs. This is then developed into a care plan, which is underpinned by a range of risk assessments. It further provides information on key personal / family history. Five care plans were examined. These are wel organised and provide staff with Care Homes for Older People Page 13 of 26 Evidence: good information as to how to care for the residents. Records confirm that care plans are reviewed monthly and formal reviews every six months. Relatives are encouraged to take part in the six months reviews and sign to that effect. Depending on residents ability, they would be involved in this process. The home accesses a range of health care professionals, but residents would need to pay for chiropody and physiotherapy. The home is served by five GP practices and nursing care is provided by visiting district nurses. There is a spacious clinical room which was visited. In general medication procedures are sound. However recommendations were made for improvement in respect of two signatures for handwritten transcriptions and the need for a written policy on prescribed creams and ointments left in residents rooms. This requires safe storage and a formal agreement as to how applications of these would be evidenced on the MAR charts as having been applied. Where residents refuse medication on a regular basis, this should be referred to the GP for a medication review. The medication is served from two trolleys. A medication round was observed and demonstrated good practice. The training matrix indicated that senior care staff are provided with training in medicine handling. Most bedrooms are single occupancy (only four are doubles), and have en-suite facilities thus ensuring that personal care and treatments can be given in privacy. Shared rooms have screening to afford occupants some privacy. Feedback from the residents confirmed that their privacy was respected and that staff treated them well. The manager reported that 5 members of staff are soon to be trained in all aspects of Death and Dying via distance learning course. An End of Life sheet is now inclcuded in the admission pack. Care Homes for Older People Page 14 of 26 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. Most residents are generally content with their lifestyles. Whilst a range of activities is provided, the provision of these may be affected due to fewer activities hours available. There are open visiting arrangements and the home is well placed for access to local shopping and seafront outlets. There is choice and control over most aspects of daily routines. Personal care is offered in a way, which protects residents’ privacy and dignity. Residents are provided with a good choice of wholesome and varied meals. Evidence: A monthly support group for residents and their relatives has been set up with input from the Alzheimer Society and Age Concern. Residents support meetings are also held where quest speakers are invited. Topics to date have included mental health issues, the benefits of the pat the dog scheme (PAT) and P.A.L.S (PCT). These have been well received. Care Homes for Older People Page 15 of 26 Evidence: In conversation with residents and one of the activities organisers, examples were given of any particular interests and hobbies. One resident likes making pictures; another likes knitting, yet other residents said they attend anything that is going. Some of the activities on offer include Bingo; films; Reminiscence; a regular Tuck Trolley, board games (snakes and ladders, Ludo, draughts). A notice was seen advertising the forthcoming bonfire party night. Throughout the home notice boards were seen with information of interest and local newspapers on display. For some of the residents excellent informative and illustrated Life History books were seen compiled with the assistance of the activities organisers. Residents said that they particularly liked the music and movement sessions every Friday. Whilst most residents indicated that they were generally content with their lifestyles, two residents said that they miss the local singers and entertainers who used to frequently visit. The inspector was advised that one of the activities organisers is leaving. It is unknown whether alternative arrangements have been made for a replacement. This currently provides 16 hours of activities, which may not be adequate for the diverse and specialist needs of the residents. As already referred to in standard 1, this change must be referred to in the Statement of Purpose and Service User Guide. Residents religious and spiritual needs are promoted. On the day of the inspection there was a communion service attended by a number of residents. The home has open visiting arrangements and visitors are welcome to have a meal with their relative. The daily routines are flexible and residents confirmed that they could choose when to get up and go to bed. Residents can choose where to take their meals (there is a choice of attractive dining facilities as well as bedrooms) and also have some choice over meal times. Almost all of them said they were satisfied with the meals. One resident said that the food was sometimes tasteless and overcooked. Lunch on offer looked appetising and choices were provided. Menus were seen in display and it was agreed that these could be produced in larger print. The manager also said that these would be produced in a pictorial format. Photographs of food items are already used to assist residents in making choices. as well as monthly taste testers. A member of staff was observed taking orders for the next day. This was done in a patient manner allowing the residents plenty of time to make their choice. The manager proudly said that following an EHO inspection, the home was awarded Five Stars. Care Homes for Older People Page 16 of 26 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. Residents feel that their complaints are listened to. Residents feel well cared for and protected from abuse. Evidence: The home’s complaints procedure is on display and describes the process and timeframes involved. The procedure is further referred to in the Statement of Purpose. Residents spoken with and those who completed a CSCI survey said that they feel comfortable to talk to staff and the manager if they had any issue of concern. The CSCI has not received any complaints and the last entry in the formal complaints book was in March 2008. Residents spoken with said they felt safe at the home. In conversation with staff it is ascertained that they are aware of the protection of the vulnerable adults procedures and would know what to do if abuse of any kind ever occurred. The training matrix confirmed that staff receive appropriate training. A recent event was investigated under the Safeguarding vulnerable adults procedures and satisfactorily concluded. Care Homes for Older People Page 17 of 26 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 layout of this home is generally suitable for its stated purpose. Residents confirm this is an attractive and homely place to live. Not all records confirm it is being maintained and regularly inspected for safety. Residents have a choice of communal areas and furnishings tend to be domestic in character. There are homely touches throughout. Lavatories and washing facilities are accessible to bedrooms and communal areas. A range of equipment and adaptations support residents and staff in safety in their daily routines and maximises residents’ independence. Most residents have access to the privacy of their own bedrooms and most rooms have en-suite facilities. Residents can personalise them with their own possessions and items of furniture The home is generally well maintained and all areas inspected were free of any unpleasant odours. However, a universal precautions issue needs to be addressed to protect residents and staff. Care Homes for Older People Page 18 of 26 Evidence: The home provides a safe, well maintained and decorated environments for its residents, which is suitable for purpose. Each floor has its own colour scheme - pink, apricot, yellow. The floors are linked by two shaft lifts and four stairways. A key pad has been installed on the front door and on the fire door in the first floor lounge. This improves the security of the building but does not affect the access out if the fire alarm goes. Upstairs windows have restrictors fitted. All areas are linked with a call bell system and there is adequate specialist equipment and adaptation. There are 49 single bedrooms which have en-suite facilities and six which do not. There are also eight double rooms, all of which have en-suite facilities. All accommodation seen was comfortable and personalised with the residents’ possessions and, in some cases, pieces of their own furniture and there were homely touches throughout. Residents may lock their doors and lockable facilities have been provided for the safekeeping of personal effects. Th ensure that residents are protected from the risk of scalding, hot water checks are carried out by the maintenance person. Records seen did not always evidence that baths and shower are included. The manager said this would be addressed. There are five lounge areas (including a library on the ground floor and a quiet room on the 1st floor) as well as a choice of dining areas. All furnishings within the communal areas are domestic in character and of good quality, suitable for the residents needs. All areas seen were clean, well maintained and in satisfactory decorative order. There are sufficient bathrooms (two of which have Parker baths) and toilets. A Dignity shower room has been installed. All facilities are conveniently situated to bedrooms and communal areas. The home has a well equipped laundry. Where able, residents would be supported to do their own washing of small personal items if they wish. Clinical waste is appropriately managed. In respect of hand wash facilities, not all communal areas had been provided with liquid soap and no paper towels were noted. It is recommended that paper towels are always available. Due to the client group at Elliott House it is further recommended that liquid soap containers are wall mounted. Care Homes for Older People Page 19 of 26 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. Residents are currently cared for by inadequate numbers of well trained, supervised and supported staff. Staffing numbers must be kept under review due to staff sickness and residents fluctuating dependency levels. NVQ training is offered to all eligible staff and many staff have completed their training. Residents are protected by robust employment procedures, which include CRB and POVA checks and tw written references. Staff are provided with a comprehensive training programme. However some statutory training was overdue. Evidence: There are not enough staff is the message that came through loud and clear. In conversation with staff it was evident that they are committed to the welfare of the residents. They said that due to staff sickness there was a shortage of staff. Staff on comment cards said there are not enough staff. A care worker commented that if there were more staff they would be able to do their job properly. A district nurse spoken with said that staff are good but there are not enough staff. The manager reported and staff spoken with confirmed that staff sickness is an ongoing problem. Staff are supportive and do extra shifts but this can only be acceptable as a short-term Care Homes for Older People Page 20 of 26 Evidence: solution. Due to the fact that the home is now registered for people with dementia and that fewer hours available for the provision of activities, additional staff resources should be made available. The staff turnover was reported as an issue of concern at the previous inspection. It was said that agency staff are not used but this may have to be considered to ensure adequate staffing levels. It is evident that the home is trying to recruit staff. A banner to that effect is displayed outside the home. Residents praised the staff for their kindness and patience. They do a good job, said a resident. Another, The staff are always friendly and cheerful and call me by my name. They make my visitors feel welcome. Staff said that the key worker system was working well. The home currently does not have full occupancy and the following staffing arrangements are in place: In addition to the person in charge, 7 care staff in the morning, 6 in the afternoon till 18.00, 5 between 18.00 and 21.00 and 4 at night. Domestic and laundry, catering, maintenance, activities and secretarial staff are employed. Staff files evidenced that a robust recruitment procedure is in place. Excellent records of induction programmes were seen. Staff confirmed that their induction had been thorough and enjoyable. I learned a lot, said a member of staff, I was well supported, said another. Staff reported that they receive regular supervision, which was further evidenced in records seen. The staff training matrix confirmed that staff are provided with the training relevant to their job. Staff reported recent dementia care training. Additional challenging behaviour and communication training is to be provided in the near future. However, as already referred to, 4 elements of the 5 statutory training programme were overdue. The provider has taken steps to address this. See also standard 38. Care Homes for Older People Page 21 of 26 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 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 well managed by an experienced and competent manager. Roles and responsibilities need to be more clearly defined to ensure that the home is run in the best interests of the residents. Staff are well supervised. Systems in place ensure that residents monies are dealt with safely. Residents health and safety are protected but systems need to be developed to ensure that staff receive all statutory training and that services are maintained within set timescales. Evidence: The manager has run the home since 2000. She has achieved the registered managers award. She operates an open door policy and makes herself available for Care Homes for Older People Page 22 of 26 Evidence: staff and residents. The manager is supported by a secretary (we work well as a team), a deputy manager and a number of senior care staff. A care manager reported, both the manager and deputy present as helpful, knowledgeable and caring at reviews. There is good communication between the home and social services about hospital admissions and change of room for resident. As part of her own professional development and in order to lead her team, the manager said that she is to undertake further training in all aspects of dementia care. Whilst there is no recognised quality assurance system in place, there is an annual development and business plan. Satisfaction surveys are carried out yearly and responses collated and acted upon. The home encourages relatives to use the email service to keep in touch. A number of audits such as in relation to care planning and medication procedures are carried out to ensure compliance and effectiveness. Residents’ meetings are organised every 4-6 weeks. The manager said that attendance was disappointing. Regulation 26 reports are carried out but not as frequent as the Regulation requires. The last record on file dated July 2008. The previous report identified that the reports did not show the level of detail to would enable anyone authorised to inspect them to judge compliance with the provisions of this regulation. An improved system to deal with residents personal allowances has been introduced. Expenses are invoiced at the end of the month. Accident records are well maintained. Risk assessments are in place. Whilst equipment and services are checked and inspected when due, at this inspection it was noted that the service of the gas supply and gas appliances was overdue. Following an immediate requirement made on the day of the inspection, the provider demonstrated that this was addressed without delay. Roles and Responsibilities in respect of managerial tasks including budget control were discussed and should be formalised. For requirement re staff statutory training, see standard 30. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 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 27 18 That at all times there are sufficient staff on duty to care for the residents in a timely manner Staff said that there are not enough staff on duty. The manager said that staff sickness is a problem 01/01/2009 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 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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 © (2008) 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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