Inspection on 03/04/09 for Felmingham Old Rectory

This inspection was carried out on 3rd April 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Felmingham Old Rectory 28/08/09

Felmingham Old Rectory 20/07/09

Felmingham Old Rectory 07/04/08

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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: Felmingham Old Rectory Aylsham Road Felmingham North Walsham Norfolk NR28 0LD     The quality rating for this care home is:   zero star poor service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ruth Hannent     Date: 0 3 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 33 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 03000 616161 (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 33 Information about the care home Name of care home: Address: Felmingham Old Rectory Aylsham Road Felmingham North Walsham Norfolk NR28 0LD 01692405889 01692405528 felmingham@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Southern Cross BC OpCo Ltd Name of registered manager (if applicable) Mr Alistair Betts 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 Additional conditions: The maximum number of service users who can be accommodated is: 41 The registered person may provide the following category of service only: Care Home only - Code 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, Code OP - maximum number of places 41 Dementia Code DE, maximum number of places 41 Date of last inspection Brief description of the care home Felmingham Old Rectory is situated in the village of Felmingham, approximately 2 miles from North Walsham on the Aylsham Road. The building has two extensions and is registered as a care home to provide accommodation for older people with dementia. There are 31 single and 5 shared bedrooms, many with en-suite facilities. Care Homes for Older People Page 4 of 33 care home 41 Over 65 0 41 41 0 Brief description of the care home The home is situated within two acres of landscaped gardens, including an enclosed area. There is parking space to the front of the premises. The home provides information about the services it provides and a copy of the most recent inspection report in the entrance foyer. Felmingham Old Rectory is one of several homes in Norfolk owned by the proprietors. The range of weekly fees for the home is 402 pounds to 651 pounds according to need. Care Homes for Older People Page 5 of 33 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: zero star poor service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection report has been written following an unannounced visit to the home on 03/04/09. To complete the report evidence has been obtained from the Annual Quality Assurance Assessment (AQAA), completed by the Manager prior to this visit. We also checked all the information that had been sent to the commission notifying us of any events, accidents, serious illnesses or deaths. Information received from people involved with the home on compliments, concerns or complaints were also taken into account. On the day of this visit we looked at various records such as care plans, medication administration records, activities, maintenance records, training statistics for staff, personnel records, residents personal money, complaints records, fire systems checks and service records. 4 completed staff comment surveys had been returned to the Commission but no comment surveys were received from relatives, Care Homes for Older People Page 6 of 33 residents or health professionals. A tour of the building took place and the total time spent in the home was 7 hours. 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. Care Homes for Older People Page 8 of 33 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 –03000 616161. Care Homes for Older People Page 9 of 33 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 33 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 home does not accept a resident without and assessment of need being completed and that the service available can meet the need of the individual and that the needs are within the registration category of the home. Evidence: The Statement Of Purpose and Service Users Guide is offered to all interested people and a copy was seen in the entrance to the home that is up to date with the information printed. The Manager was able to show the forms used to take pre assessment details on when visiting a potential resident. The initial enquiry form was seen and completed on a possible resident who was coming to the home for an initial visit pending a respite stay. The person was welcomed on arrival and staff were noted to offer lots of support to help the settling process for this person. Care Homes for Older People Page 11 of 33 Evidence: Throughout observation on the day of the inspection it appeared that the residents in the home were suitable and no one appeared to be inappropriately placed. The AQAA completed by the Manager tells us that all residents are offered a contract and that these are held on their personal file in the office. Care Homes for Older People Page 12 of 33 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents health, personal and social care needs are not defined enough in the individuals care plan to show a person centred approach is carried out. Health and medication needs are addressed correctly. Residents are treated with respect and the rights to privacy is upheld. Evidence: Time was spent during this inspection observing, and talking with, staff about the care plans that are held in the central office. The home has been divided into coloured teams for staff to identify which team they are in and responsible for. It was noted that some of the care plans were more detailed than others but information is still quite basic. For example Mrs x requires toileting every 2 hours. There was no information on how the tasks happens, how many staff were needed, what equipment was required, where in the home the task takes place. On discussing this person with the staff team, it was identified that two staff are required, a certain hoist and sling Care Homes for Older People Page 13 of 33 Evidence: and that the task takes place in the bedroom with a commode. The person centred information is missing in the care plans that would assist members of staff to carry out the job correctly and suitable for the individual. A number of the residents were noted to be unshaven and in need of a hair cut with nails that were long and dirty. Some ladies had whiskers on their chins and their hair looked lank and in need of washing and styling. The care plans were not detailed enough to show if the men wished not to be shaved with most of the care plans saying on admission needs help to shave. The number of baths is limited and according to staff this is mainly due to not enough staff available to offer baths/showers as often as would be liked by the residents. The care plans also contained many blank clinical style forms that were not relevant for each resident and makes the looking for information difficult. Information on residents weights are in place but again the forms were mixed up and although the originals were coloured coded the information when looked for was recorded in a weights book and then on a white sheet and some on a coloured sheet creating confusion as to where the recording should be. Time was spent talking to two staff members about person centred care plans. Both stated they did not understand what was expected even though they had been told to rewrite the plans and although a new care plan had been written and was seen during this inspection, it was still very basic. Dates were noted of the reviews of the care plans and that families are encouraged to be involved with any reviewing process. All the residents are registered with various medical centres for their health support. The staff talked of the GPs who visit the home and how residents are visited by other health professionals. The home has no records of anyone having any pressure sore areas and this was confirmed by the Manager as accurate. Records were seen of visits from the chiropody and district nurses and details were written on the correct form in the care plan folder. The medication is stored in two trolleys in the central office and both are attached to the wall for extra security. Boots supply the medication that is held in blister packs. The doors hold some loose medication that all were dated when opened. The medication administration charts (MAR) were looked at in detail. Some residents photographs were not in place but the records themselves were up to date with signatures of staff who had administered the medication and all PRN administration had been recorded fully. The home does not hold any controlled drugs at present but the staff member Care Homes for Older People Page 14 of 33 Evidence: responsible for medication on the day of this inspection showed us the process used for controlled drugs and the register seen was completed correctly. The staff were observed throughout the day talking and interacting with people in a positive and dignified manner. Any personal care tasks were carried out in the privacy of the persons room or bathroom. No one appeared rushed and there was a calm atmosphere. The residents did not present as clean and as presentable as they may have preferred, giving a picture of there not being enough time given for personal care tasks. Care Homes for Older People Page 15 of 33 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The recreational support for residents is very limited and due to the kind of people cared for in this home, activities need to be developed that are more suitable to meet the individual requirements. Families and friends are encouraged into the home and the home does involve the local community in the day to day lives of the residents. The meals are wholesome and balanced but are not offered in pleasant surroundings or supported by enough staff. Evidence: The activities within the home on the day of this visit were very limited. Many people were noted to be doing nothing and had nothing available that would stimulate them so many people were asleep. The activities staff have compiled some life stories with residents but these were all in a folder in the office and not in use to date. One was read in detail and gave a very comprehensive picture of this persons life. On talking to this resident the same information was relaid to us and could inspire lots of activities to suit this person but nothing recorded was found. A few people were wandering, but Care Homes for Older People Page 16 of 33 Evidence: aimlessly as they had nothing to do. The environment does not offer stimulation to encourage people to want to look, feel, smell, taste and talk about with areas of plain painted walls and limited amounts of pictures on walls for residents to look at and discuss. The AQAA tells us of the involvement of the local community with the pre school group entertaining the residents and the trip to the nativity play. The residents do have there own minibus but according to the Manager, there needs to be more competent drivers to take people out on a regular basis. The home does display the activities on offer and one to one time was seen with some residents but the majority were left without anything to do. Some residents were noted for a period of three hours to be in the same place, around a table and sitting in their wheelchairs with nothing to do. The visitors book was noted to be filled in with regular visitors coming and going. The Manager holds regular meeting, encouraging relatives to attend and minutes were seen. Very few people appear to attend. The date of the next meeting was displayed on the hall notice board. No relatives were seen on the day of this inspection and the Commission had not received any comments from any relatives or residents prior to the visit. A relative did contact us after this visit with some concerns of the care service offered at this home. We sat with the residents throughout the lunchtime process and ate a meal of fish, chips and peas and ice cream or prunes. Residents were ready to eat by the time everyone was in the dining room at 12.10 (some had been sitting there all morning), but the meal did not arrive until 12.20. By this time three residents were up and wandering and one resident was showing signs of anger. The meal arrived with no finger style fish and noted were at least four people using their fingers, dropping the large piece of fish on the floor. One resident drank from the water jug and other peoples glasses, staff were standing over residents helping them with their meals moving from table to table to ensure that all those who needed assistance got their food. One person, who on reading his care plan, is diabetic, was eating inappropriate food off someone elses plate. A choice of drinks was offered from different juices to milk shake and although the staff were very busy trying to meet everyones needs there was not enough staff in the dining room to ensure all needs were met with dignity or that appropriate food was available for those who do not use their knife and fork. Tomato sauce was eated straight from the dish by one resident. There were no napkins available and many hands were used by the residents and in need of wiping. The menu is available on the wall in the dining room but is not in a place that is easily read. It should follow a healthly diet for older people but this is not always followed as stated by a relative who gave details of visits around mealtimes and samples of what Care Homes for Older People Page 17 of 33 Evidence: is offered to the residents. Care Homes for Older People Page 18 of 33 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints to the home are managed correctly and timely. Residents are protected from potential abuse. Evidence: The home has a close monitoring process for any complaints that are brought to the attention of the Manager. In the main office the records of complaints are available and were seen at this inspection. The Manager has given clear details in the AQAA of the whole process of dealing with complaints and how a complaint will be investigated and it what timescale. On display in the entrance hall and available in the literature about the home is a copy of the complaints procedure for anyone to have access to. We have received a complaint following this inspection visit regarding the care practise that has also been identified during this inspection visit by us and has evidenced the observation seen and mentioned earlier in this report. There has been one investigation by the the home into potential abuse and the Commission has been kept informed. An internal investigation did take place in 2008 which has since been resolved with no further concerns raised. The staff are aware of the whistle blowing procedures and two staff spoken to said they would always report on to management any concerns they may have. The homes training statistics tells us that 85 of staff have had the POVA training and that all Care Homes for Older People Page 19 of 33 Evidence: staff have a CRB enhanced disclosure on file before commencing employment unsupervised. Care Homes for Older People Page 20 of 33 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. The home environment is maintained correctly but needs to be more dementia friendly. The home appears clean but some areas of infection control could be improved. Evidence: The home is a converted old property that has had extensions added on at various times. Although the home appears to be maintained correctly the environment is not ideal for residents with dementia. Inside there is no clear signage or colours to direct people to various rooms when moving in the long corridors such as bathrooms or toilets. One corridor has poor lighting that alters the balance of light as you move along and can be visually confusing. There are limited pictures around and limited stimulus to attract attention and stimulate conversation. The outside grounds are being improved to make a much more accessible garden that will be secure and safe for residents to enjoy in the better weather. Trees have been removed and an enclosed garden is planned. Care Homes for Older People Page 21 of 33 Evidence: The fire records were looked at and all the checks were ticked as carried out and up to date. (The fire alarm was checked while the inspection was taking place). The home has received a visit from the Environmental Health Officer who, according to the Manager, has given the home 4 stars for the main kitchen. The report was not available as yet as the inspection had only happened recently. The bathrooms are internal rooms that are very plain with no natural light and again are lacking in anything inviting or stimulating to encourage residents to want to use the room. The home does have a number of blue painted bathrooms making the room feel cold. Individual bedrooms are being decorated as and when a new resident moves in and the Manager is asking the person what colour they would like the room painted. A success story was shared of a resident whos mood lifted greatly when the bedroom was decorated in a favourite colour. Rooms do hold personal pocessions and are suitably furnished. The Manager has introduced a checking system for the home to ensure all areas are kept as clean as possible. The Housekeeper was spoken to during this inspection and showed us the checking system used. There were no unpleasant odours noted during this inspection and areas did appear clean. The laundry is a small area housing two washing machines and two tumble dryers. There did appear a large amount of sluice washing waiting to be put into the machines that were piled on the laundry floor and should have been in a suitable container keeping it off the floor to promote good infection control. They were in the correct red bags and there was no unpleasant odour. Care Homes for Older People Page 22 of 33 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home does not have enough experienced and knowledgeable staff to care appropriately for the residents in this home who have dementia. Recruitment procedures for staff are followed to ensure residents are cared for safely. The training given is not always evident and delivered in practise to show that the correct learning is being used to meet the needs of the residents. Evidence: During this visit it was noted that staff were busy at all times with care tasks. Four carers and one senior were on duty who all appeared courteous and respectful as they carried out tasks but were trying to support a large number of people who had high levels of need, requiring more staff time. There were not enough staff around during the observed meal time and looking at the appearance of the residents not enough time had been given over personal care. The home had the Manager, one Housekeeper, one Laundry Assistant, one Maintenance Officer, one Cook, one Kitchen Assistant, one Activities Organiser and one Administrator also in the building. The anxillary staff support the home well but these numbers are not around at all times, especially at the weekends when care staff also have to work in the kitchen or do cleaning tasks which dilutes the number of staff available for care. The majority of Care Homes for Older People Page 23 of 33 Evidence: residents at Felmingham are in need of high staffing levels to meet their needs appropriately and an increase of knowledgeable staff is required. This has been required in past reports and must now be addressed. Over the past few months the home has increased the number of staff who are about to, or are already registered to gain the NVQ qualification. The AQAA tells us that Senior Carers are now registered to complete their NVQ 3 and the homes administrator is also completing the suitable NVQ award. Records found show out of the 29 staff at the home only 7 had the NVQ award. A further 8 are now in the process of completing. The home has a good procedure for ensuring staff are recruited safely. Two recently recruited staff members personnel files were looked at. The correct documentation for both were up to date and no staff member had been left unsupervised until the CRB disclosure had been returned and only if the POVA first had come back as clear. The Manager gave an example of not being able to continue with recruitment of one person due to poor references and this person was no longer deemed suitable and had not been employed. The home has a training record programme. The staff spoken to all reflected on the training available and that they are regularly updated on all statutory courses. A copy of the training statistics dated 31st March 2009 was given to us that show the percentage of staff who have attended the various training courses. The course for staff on care planning show that 100 of the staff who complete care plans have been trained yet this was not reflected in the care plans seen. The Manager also told us that the staff have recently been through a meal experience training but this was not evident during the meal time witnessed on this visit. Care Homes for Older People Page 24 of 33 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 home is managed by a suitable person who has good leadership skills . The quality outcomes for residents needs to be measured and acted upon in more detail to ensure the quality for people with dementia is clear. Residents money is managed safely. The staff need regular supervision to ensure they are carrying out their job correctly. The home does have safe working practises in most areas to protect the health and welfare of residents and staff. Evidence: The Manager of this home has just been through the interview process for the Registered Manager and has been deemed suitable. The new certificate to show his Care Homes for Older People Page 25 of 33 Evidence: name as the Registered Manager has not been received at the home as yet. The qualifications of the Manager are suitable and on discussing and reading through the AQAA it is evident that this person has good management skills. He has only been in the home a few months and has some hard work ahead to improve the home. The staff spoken to feel able to approach the Manager and talk through concerns, as does the one relative spoken to. The office at present used by the Manager is not central to the home and he has plans to move the office to the middle of the building to create an even more open door policy to be more visible to anyone who wants to talk to him. On display in the hall of the home is the recently completed quality assurance survey involving all parties of the home. The results are being looked at in depth by the management and improved outcomes are aimed to be acheived. The home also has regular visits from Southern Cross to complete a quality check of different areas of the service on a monthly basis. These visits need to be monitored more indepth to ensure the quality of a dementia service is evident. On the day of this inspection the administrators line Manager from Southern Cross was in the home checking the finances and ensuring all records balanced. We asked the adminstrator to talk through the procedure of handling residents personal money. The step by step procedure and records held show that residents money is safe. Records, signatures and receipts are kept and money is banked and interest added monthly. The staff supervision file was seen in the office and some supervision sessions have started as required at the last inspection. Some staff spoken to have not had supervision for at least 6 months and so regular patterns for staff are not in place as yet. The Manager also explained about the difficulty in getting some anxillary staff in for supervision. These need to be handled through the disciplinary procedures if staff are not attending planned supervision sessions. Although these sessions are beginning there is still the need for improvement. The practises observed in the home to ensure infection control is in place was not always evident and could put health and safety for all parties involved at risk. For example the pile of red bags placed on the floor in the laundry waiting for a sluice wash. The lack of hand washing facilities in the room where medication is stored for staff to wash there hands between tasks. Staff having to carry out care duties, then kitchen tasks and back to care tasks. Records of servicing of equipment was seen and dates noted to all be in timescale with Care Homes for Older People Page 26 of 33 Evidence: equipment such as fire extinguishers and hoist all with current date stickers on the side. The water temperatures were checked by hand in a number of rooms and all ran at a suitable temperature. Accident reporting is taking place and records are held in the home. The Housekeeper showed us the COSHH safety data folder and all the correct information, if an accident was to occur, was available from the company that supply the cleaning chemicals to the home. Care Homes for Older People Page 27 of 33 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 22 23 (1) (a) (2) The premises and any (a, c, e) specialist equipment used must be suitable for the assessed needs of the residents. 18 (1)(c)(i) 31/10/2008 2 30 Staff must receive suitable 31/08/2008 training in dementia care to ensure that the mental health needs of people using the service are met. Staff at the home must be formally supervised. 31/05/2008 3 36 18(2) Care Homes for Older People Page 28 of 33 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 The home must complete a full detailed care plan on how the residents needs are to be met. To ensure that the persons own needs are detailed for staff to follow clear direction. 01/06/2009 2 12 16 The residents should have available activities arranged on behalf of the home that meet the needs of the residents. To ensure that residents have the opportunity to take part in activities that are suitable and stimulating for them as individuals. 01/06/2009 3 15 18 The home need to have arrangements in place for residents to be able to eat their meal properly and appropriately with the support required by competent and experienced staff. 01/06/2009 Care Homes for Older People Page 29 of 33 To ensure that residents have their meals by staff assisting in a dignified manner. 4 15 16 The home should provide food in suitable forms and with correct utensils that suit the needs of the residents. To ensure that residents can eat the meals in the manner that they appear to prefer. 5 25 23 The home needs to ensure that suitable light is in all areas of the home. To ensure that the residents are moving around in clearly lit areas. 6 26 13 The home must ensure that 01/06/2009 practises are in place to prevent any potential spread of infection To ensure that all good infection control procedures are in place. 7 27 18 The home must, according to need, have suitable numbers of competent staff on duty at all times. This is a repeated requirement which has not been met and enforcement action is now being considered. To ensure the care required is met. 01/06/2009 01/08/2009 01/06/2009 Care Homes for Older People Page 30 of 33 8 30 18 The training offered to staff must be suitable and appropriate to meet the needs of people with dementia. This is an outstanding requirement which has not been met. Enforcement action is now being considered. To ensure the outcomes for each resident is achieved correctly. 01/07/2009 9 33 24 The home must ensure that the quality of the care service is measured appropriately. To ensure the reviewing and improving of the service meets the outcomes for residents requiring this specialist service 01/07/2009 10 36 18 The Manager must ensure that staff are regularly supervised in all departments of the home. This is an outstanding requirement which is still to be met. Enforcement action is now being considered. To ensure that all staff are carrying out their responsibilities correctly. 01/06/2009 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 Care Homes for Older People Page 31 of 33 improving their service. No. Refer to Standard Good Practice Recommendations 1 2 3 7 12 27 Staff need to understand what person centred care means to be able to complete the care plans fully. The home needs to look at the life books written and develop activities/stimulation that suit the residents. Levels of care and outcomes for residents should be monitored and checked against care plan reviews to ensure the person is receiving the care correctly. Training given to staff should be evaluated and practise observed in depth to ensure training is suitable and that knowledge is used appropriately. 4 30 Care Homes for Older People Page 32 of 33 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. 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