Inspection on 14/12/09 for Eltandia Hall Care Centre

This inspection was carried out on 14th December 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

Eltandia Hall Care Centre 22/04/09

Eltandia Hall Care Centre 29/04/08

Eltandia Hall Care Centre 25/09/07

Eltandia Hall Care Centre 18/10/06

Eltandia Hall Care Centre 19/10/05

Eltandia Hall Care Centre 17/05/05

Eltandia Hall Care Centre 25/11/04

Eltandia Hall Care Centre 09/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 25/04/2010.

Key inspection report Care homes for older people Name: Address: Eltandia Hall Care Centre Middle Way Norbury London SW16 4HA     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Emma Dove     Date: 1 4 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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: Eltandia Hall Care Centre Middle Way Norbury London SW16 4HA 02087651380 02087651399 eltandia@schealthcare.co.uk www.schealthcare.co.uk Southern Cross (LSC) Ltd care home 83 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) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: As agreed on 19/06/2006, Service users with Dementia, age 60 years and above can be accommodated within the home. Date of last inspection Brief description of the care home Eltandia Hall Care Centre is a purpose built home arranged over two floors. It has two residential units on the first floor and two units offering nursing care on the ground floor. One residential unit provides a mix of respite and permanent care for older people and the other unit provides long term care for older people with dementia. The nursing units offer long-term care for older people and care for younger adults with physical disabilities. People living there are provided with their own single bedroom accommodation with en suite toilet facilities. The home is situated in a residential area of Norbury. Public transport in the form of local bus services are close by. 63 0 20 Over 65 63 63 0 Care Homes for Older People Page 4 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: This unannounced inspection was carried out over six and a half hours on the 14th December 2009. Three regulation inspectors visited, spoke with people who use the service and their relatives who were visiting, staff, the manager and the temporary manager and looked at records. We received an annual quality assurance assessment from the temporary manager when we asked for it. This gave us some good information about the service, how they are meeting the standards and areas they plan to develop to meet the standards. We looked at other information received from the service since the last inspection in April 2009 and at information received from stakeholders including two local authorities who place people at the home. Care Homes for Older People Page 5 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 6 of 29 following this report, you can contact them using the details 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 7 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 8 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. The service has developed good information to help prospective people decide whether to move in. Assessments are completed before anyone moves in. Evidence: We saw the Statement of Purpose and Service Users Guide give prospective and new people good information about the service provided, facilities and some key policies. These documents need to be updated to include details of the new manager. We still feel more work could be done to make the Service Users Guide more meaningful and accessible to people who use the service by using photographs of key people, the facilities and the local area. These documents need updating to reflect the name of the current manager to ensure people who use the service and their representatives have the correct information. The manager told us the Service Users Guide is given to all people who use the service. We saw a copy of the Guide in each bedroom. Care Homes for Older People Page 9 of 29 Evidence: We saw assessments completed before people moved in, although one assessment from a placing social worker was not fully completed. Care Homes for Older People Page 10 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. Care plans are in place and are generally reviewed every month, although details of changes in individuals needs are not always recorded. Care plans are quite task focused with little emphasis on goals and supporting people to maintain and develop daily living skills. These documents are generic and not person centred. Risk assessments are in place, although they do not all detail areas of risk and the balance between risk and people living fullfilling lives. Peoples health care needs are recorded, although information is not always up to date. Medication is well managed. Evidence: We saw care plans in place, developed from pre-admission assessments, with evidence that some people who use the service are involved in the process. There continues to be varied levels of recording in the different units in the home. Care plans have sections for the individuals communication, eating, personal hygiene, health, social activities, risk assessments and keeping a safe environment. The care plans we saw were generally task focussed and not person centred with more work required to ensure peoples needs and preferences are fully recorded and can be met Care Homes for Older People Page 11 of 29 Evidence: by staff. One care plan noted what the individual responds to when they are agitated. This is good information which staff can use to support the person. This level of information should be included in care plans, to help staff meet individual needs. Three care plans for personal care said to offer the person a bath or shower weekly or as required, this does not indicate to staff if the person prefers a bath or a shower, whether they want the bath or shower in the morning, afternoon or evening, if they like bubble bath or any personal information to make the experience good for the individual. One care plan did not include any information about a recent bereavement, which caused the individual to have to move out of their home and into residential care. This means staff may not be aware of the loss and may not offer appropriate support and comfort to the person. The manager told us that all care plans are updated at least once a month. We saw care plans are reviewed regularly, although in three instances there were some changes in individuals needs which were not reflected in the care plan. This means peoples care needs may not be fully met. We saw one care plan was written in 2007 indicating no changes in the individuals needs during this time. One person confirmed they are involved in reviewing their care plan. We saw daily records to note all care given which does not describe the care and support individuals receive and is not useful to help staff review the care provided and any changes in need. People who use the service told us we are well looked after and said staff help when needed. One relative told us their relative is well looked after. We saw risk assessments completed around falls and equipment needed, including hoists. The care plan for one person indicated they are at risk of falling, daily records indicated some recent falls with no review or changes to the care plan. The manager told us in the annual assessment that all people who use the service have access to health services including the dentist, optician, chiropodist and tissue viability nurse. We saw that staff have made appropriate referrals to health care professionals when required. We saw varied levels of recording on nutrition assessments. One assessment identified that the person is at high risk, the nutritional intake record sheet was blank and daily Care Homes for Older People Page 12 of 29 Evidence: records indentified the persons appetite and food intake is improving. In one care plan the individuals weight was not recorded and the food preferences section was not completed. This lack of information means staff will not know if the person gains or looses weight and may not be able to provide meals the individual likes. The pain assessment for one person was not complete this could lead to the individual being in pain and staff not knowing and not providing appropriate pain relief. We saw that people are getting the right medication at the right time. Records are signed and medication is kept securely. All quantities of medication corresponded with the records kept. We saw staff respecting peoples privacy and dignity when providing support with personal care. The end of life preferences and resusitation information were not complete in two of the eight care plans we looked at. Care Homes for Older People Page 13 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. There are opportunities for people to join in with group activities and outings but not much for people to do in the nursing unit. People have a choice of food that meets their medical and religious dietary requirements. Mealtimes are quick, task focussed events which could be developed to be a more positive experience for the people who use the service. Evidence: We saw most people sat in the lounges in the different units, talking with staff, playing dominoes, doing jigsaw puzzles or drawing, some people were asleep, with the televisions on and in some units music also on. Some people were in their rooms, meeting with visitors and other people were in the activities room. Comments from people who use the service varied from theres enough to do to I get bored sometimes. The record of activities noted there has been a film show, arts and craft sessions, a coffee morning, board games, ball games, opportunities to watch television, quizzes, crosswords and a sing along. It was not always clear how many people were involved with these activities and what was provided for people who are unable to go to the lounge or activity room to participate. We could not see how many people had left the Care Homes for Older People Page 14 of 29 Evidence: building on outings in recent months. Photographs displayed in the units indicated people had been on a number of outings including going for a meal, to a museum and to a garden centre, although these were seen during our visit in April 2009. The manager told us that peoples personal and social needs are documented in their care plan. We saw brief information in two care plans detailing activities the individual likes to participate in. In the assessment for one person and three care plans there was no information on the individuals social preferences, no social profile and little information to assist staff with providing appropriate activities and outings. The social profile for one person noted they like doing crosswords and we saw staff give the person a crossword to complete. One care plan noted the individual wanted a daily and Sunday newspaper, although there was no evidence to show they were receiving a paper. One care plan indicated that the person wanted to see a priest every month but there was no evidence that this is happening. The manager told us they encourage people to maintain contact with family and friends and invite representatives from the local community to the home. People who use the service confirmed that they can have visitors. One person told us my daughter visits nearly every day. One person said they have regular visits from family members and friends. Staff record when people have visitors. We saw a meal during our visit, in all units it was a task focussed, quick event which could be developed into a more social activity for the people who use the service. Staff deliver plated meals from the kitchen, with no opportunity for people to serve themselves. Staff wear plastic aprons. We saw some people who use the service wearing tabbards to protect their clothes which is an improvement on bibs although this should be reviewed and people offered serviettes. We saw staff give out medication at the beginning of the meal and would suggest this practice is reviewed to ensure all staff are available to make mealtimes a positive experience. We discussed with the manager protecting mealtimes, so all staff are available to help serve meals, sit down and offer support and just talk to people. Peoples comments about the food included: the food is very nice; its nothing to rave about; nothing to dislike; fine, I eat it and its not too bad. People told us that the cook comes around to see them and check that the meal was ok and ask for any suggestions. The menu is varied and provides a choice to meet peoples preferences and any Care Homes for Older People Page 15 of 29 Evidence: medical and dietary needs , although the menu for the day was not displayed in an accessible format or was incorrect. People who use the service were not aware of what the meal was and more work should be done to ensure the menu is displayed and accessible to people. This is a simple task and is outstanding from the last inspection in April 2009. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has developed a complaints procedure which is given to everyone living at the home. People who use the service and their representatives are aware of how to make a complaint. The service understands the procedures for safeguarding vulnerable adults and staff have completed training and are aware of their responsibilities. Evidence: The organisation has a clear complaints procedure which is included in the Statement of Purpose and Service Users Guide. This should be made fully accessible to all people who use the service by using pictures. People who use the service and visitors confirmed that they were aware of who to speak to and how to make a complaint. Peoples comments included, no complaints, nothing to grumble about and I have no complaints. One visitor said that they had recently raised an issue with the unit manager and the issue was quickly resolved. Records are kept of complaints received and actions taken. We looked at the response to one complaint, which was completed in good time and was concluded to the complainants satisfaction. The manager told us staff have completed training in safeguarding. We saw staff training records include sessions on safeguarding for staff. Most staff confirmed that Care Homes for Older People Page 17 of 29 Evidence: they have completed training in protection, one new member of staff said they had not completed safeguarding training with the organisation but had at a previous place of employment. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides an appropriate environment to meet the specific needs of the people who live there. Bedrooms are single and have ensuite toilet and wash hand basin. More should be done to give people things to do in the lounges and corridors. The bathroom and shower rooms need redecorating to make them more relaxing and user friendly for the people who live there. All areas of the home were clean and fresh. Evidence: Eltandia is a purpose built service, separated into four units. Each unit has a lounge, dining room, a small kitchen, single bedrooms and bathrooms. The two units on the ground floor have doors to the garden. On the first floor there is an activities room, a reminiscence room and a snoozelan (relaxation room with music). The entrance area has an administrators office and the managers office. There is a swimming pool which is not used, this area could be developed into an adapted kitchen for people who use the service to use and develop their independant living skills. We saw that the snoozelan did not have any chairs in and some comfortable relaxing furniture may be useful to enable people who use the service to use this room. We saw some bedrooms have been personalised to the individuals preference with pictures, ornaments and items of furniture. Some bedrooms are very clinical with no evidence of the individuals likes and preferences and no items to make them feel at home and settled. Care Homes for Older People Page 19 of 29 Evidence: Memory boxes have been placed outside bedrooms in three units, this is a good initiative and will help people who use the service to find their bedroom and keep their past alive for them. Although these boxes were only being partially used in two units and not being used in the nursing unit. There are sufficient bathrooms and toilets to meet the needs of the people who use the service. We saw one shower room to have paint peeling off the walls, no shower curtain and to be in a poor state. Generally the bathrooms are very stark and need attention to make them more pleasant for people who use the service. All areas of the home were clean and fresh and we saw domestic staff working hard to keep the home at this good clean standard. 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. Staff levels restrict the service from delivering person centred care and providing appropriate support to meet individuals needs some of the time. Staff have good training opportunities, giving them the skills to meet the needs of some people who use the service. They should have more specialist training for the more common conditions people who use the service have including dementia, parkinsons, multiple sclerosis and stroke. Evidence: We saw some good interactions between staff and people who use the service, with staff responding to peoples needs, talking to people as they walked through the lounge and demonstrating knowledge of individuals needs. Staff are enthusiastic and want to provide a good service. Staff feel they could improve the services provided with more activites and stimulation for the people who use the service. Comments about staff from people who use the service included: the staff are alright, could do with a few more; fine; they like to have a laugh; very nice and staff are good. Some staff told us they are busy, and made comments including we cant have the time to give people attention and we do what we can. This lack of staff, particularly qualified nurses could be impacting on the care planning process, with nurses not having enough time to review and update care plans and monitor individuals health needs and complete food and fluid monitoring charts. We saw the Care Homes for Older People Page 21 of 29 Evidence: shortage of care staff could be impacting on the opportunities for activites and making staff very task focussed and less person centred in their approach. We saw the published staff rota to show some vacancies for registered nurses in two units and carers in all units. The manager told us some of these vacancies were recent and said they are trying to recruit to vacant posts. The published rota in the nursing unit varied from showing five staff in the morning and three in the afternoon to two staff in the morning and afternoon and we were not sure if this was an accurate reflection of the staff on duty. Staff in all units feel they work well together, as a team offering support to each other to provide a good service at the home. The manager told us staff have good training opportunities, with nearly half the care staff completed or in the process of completing an NVQ programme. Staff training records identified staff have completed training in fire evacuation and been involved in a fire drill, infection control, nutrition awareness, challenging behaviour and medication administration using a monitored dosage system. A training session for staff on the Mental Capacity Act was booked for December 2009. Wa saw there was a lack in training around caring for people with dementia, parkinsons disease, people who have had a stroke and have multiple sclerosis. Staff told us these are the main conditions that people who use the service have. Training must be provided to ensure staff are aware of how to manage these common conditions and to keep up to date with current good practice. 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. There is no registered manager, although the service has made appropriate arrangements to cover this position in the short term and by recruiting a new manager. The organisation has quality assurance systems which look at the services provided and ask people who use the service and stakeholders for comments. Health and safety is generally well managed with most checks up to date. Evidence: The registered manager left the home in October 2009 and a temporary manager was brought in to cover most days. A new manager started at the home in mid November 2009 and has spent time with the temporary manager and is getting to know the people who use the service, staff and how the home operates. He is working to the action plan submited to us after the key inspection in April 2009 and is aware of the areas that need addressing and is prioritising the work. There are quality assurance systems in place which include monthly visits to the service by a senior manager to check on the quality of care and support provided and Care Homes for Older People Page 23 of 29 Evidence: look at records. Work needs to continue with developing the residents and relatives meetings, to make these useful in seeking feedback from people who use the service and their representatives. We could not access records of individuals finances during our visit but saw a list of balances for people. We saw receipts for money received from relatives. Monies are kept in one account and interest is accrued individually. The manager said he is trying to have weekly meetings with senior staff and has minutes from two meetings. The manager said he visits the units each day for an update. Most staff said they have not had supervision recently, although feel supported and able to go to the manager. Health and safety checks have been carried out at the required intervals on the fire alarm and electrical supply. The temporary manager told us in the annual assessment that hoists were tested in January 2009, they should also have been tested in July 2009. The gas safety was tested in March 2008 and this should be done every year. 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 15 Care plans must be updated to reflect changes in need. This will ensure that any changes in need are recorded and can be met. 30/04/2010 2 8 12 Pain assessments must be 30/04/2010 completed, particularly for people who are not able to express their discomfort and pain. This will ensure peoples health needs can be fully met. 3 21 23 Shower rooms and 25/06/2010 bathrooms must be decorated and maintained to a good standard. This will ensure the home is at a good standard for the people who live there. 4 27 18 There must be sufficient nurse trained and care staff at the home. 30/04/2010 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 To provide appropriate care and support to the people who live there and ensure care is person centred and peoples health needs are fully recorded. 5 28 18 Training must be provided on the common conditions experienced by people who use the service. To ensure their needs can be fully met and ensure staff are up to date with current good practice. 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 30/04/2010 1 1 Further work could be done to make the Service Users Guide more meaningful to the people who use the service and the document should be updated to include details of the current manager. Consideration should be given to developing goals for people who use the service, that they are supported to achieve, to make their lives more meaningful. Further work is required to make care plans more person centred and less task focussed, including peoples life history and preferences around care and support. Consideration should be given to how people who use the service can be more involved in the daily life of the home as a part of the activity programme, including laying tables, preparing drinks and snacks and some light cleaning. The menus must be produced in picture format to make 2 7 3 7 4 12 5 15 Care Homes for Older People Page 27 of 29 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 them accessible to people who use the service and be displayed where they can be seen. 6 16 Considerations should be given to developing the complaints procedure in pictorial format and displaying it around the home so it is fully accessible to all people who use the service. More work should be done to provide items in all areas of the home for people who use the service to interact with, including rummage boxes, dressing tables with hair brushes, hats and other similar articles. Consideration should be given to using the memory boxes by bedroom doors, particularly in the nursing unit. The service should look at providing comfortable chairs in the snoozelan on the first floor, to enable people who use the service to use it. 7 19 8 9 19 20 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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. 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