Inspection on 11/05/09 for Forest Manor Nursing Home

This inspection was carried out on 11th May 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Forest Manor Nursing Home 23/07/08

Forest Manor Nursing Home 20/06/07

Forest Manor Nursing Home 10/05/06

Forest Manor Nursing Home 14/10/05

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 12/10/2009.

Key inspection report Care homes for older people Name: Address: Forest Manor Nursing Home Mansfield Road Sutton In Ashfield Nottinghamshire NG17 4HG     The quality rating for this care home is:   zero star poor 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: Lesley Allison-White     Date: 1 1 0 5 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 32 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 32 Information about the care home Name of care home: Address: Forest Manor Nursing Home Mansfield Road Sutton In Ashfield Nottinghamshire NG17 4HG 01623442999 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Hallmark Healthcare (Sutton in Ashfield) Ltd care home 40 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: The maximum number of service users who can be accommodated is 40 The Registered Persons may provide the following categories of service only: Care Home with Nursing - Code N to service users of the folowing gender: Either whose primary care needs on admission are within the following categories: Old Age, not falling within any other categoriy - Code OP Dementia - Code DE Physical Disability Code PD Date of last inspection Brief description of the care home Forest Manor Nursing Home provides personal and nursing care to older people, people with a physical disability and people with dementia. The home is situated between the town centres of Mansfield and Sutton in Ashfield. Care Homes for Older People Page 4 of 32 Over 65 0 40 0 40 0 40 Brief description of the care home The home has a well-maintained patio and garden area and car parking space. There are three lounges and a spacious dining room. The home has 36 single bedrooms and 2 shared bedrooms. None of the bedrooms have en-suite facilities. People who need wheelchairs to get around can access all areas within Forest Manor. Mobility aids are available such as hoists, transfer belts and strategically placed handrails. A wheelchair accessible shower and bath area is available. A vertical lift is also available to allow easy access to the first floor of the home. Information about the home, including the Care Quality Commission (previously known as CSCI) inspection reports, is available in the main entrance area of the home, or from the acting manager. The fees currently charged range from £294 to £594 per week. There is an extra charge for hairdressing and podiatry services. Care Homes for Older People Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: zero star poor service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of inspections undertaken by the Care Quality Commission is on outcomes for the people who use the service and their views of the service provided. The quality rating for this service is 0 star. This means the people who use this service experience poor quality outcomes. This key inspection took place on a week day and was unannounced. All the key standards were inspected. These were not met and requirements for improvements to take place have been issued. An enforcement notice was served for improvements to take place and will be monitored. As part of the preparation for this inspection a review of the information about the service was conducted. This included new safeguarding issues raised by the local authority also. Care Homes for Older People Page 6 of 32 The primary method of inspecting used was case tracking. This involves speaking with people who use the service provided, looking at two peoples care plans and making observations. A total of eight people were closely observed and four individuals who were able to speak, spoke with the inspector. The inspector also spoke with staff members to gain an overall picture of the care provided. There were no relatives or visitors on the day of inspection to speak with. A partial tour of the premises also took place to observe if door stops were still being used. There were none being used now. Communal areas and some bedrooms were also seen. Care Homes for Older People Page 7 of 32 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 32 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standard 3 and Standard 6 Individuals have an assessment made prior to being admitted to the care home. Assessments are not always completed by the staff. This will affect the care provided. Evidence: Two people were case tracked and other people observed and spoken with. Pre assessment information was seen. We saw that Social Services complete their assessments however, further follow-up within the assessments done by the home was not available. Evidence shows assessments may not be acted on once identified. Standard 6 intermediate care is not offered at the care home. Care Homes for Older People Page 10 of 32 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. Standard 7, Standard 8, Standard 9 and Standard 10 There is evidence that staff in the home treat individuals in a way, which does not respect their privacy and dignity. Evidence: The two people were case tracked in detail were from two different categories of registration. Other people were also observed and information about them was requested as required. One of the individuals was capable of being involved in the planning and care process there was no evidence of their involvement or of them having been consulted not to be involved. This person said that they had a lonely day with no activities provided on a one to one basis and this was needed due to their care circumstances. When the individual was repositioned in bed they were unable to watch their television and as the room did not have automatic fire closures on the room door. It was kept closed. Instructions were not followed as directed by another healthcare professional. This Care Homes for Older People Page 11 of 32 Evidence: resulted in reduced comfort for this individual and reduced care. For example information about the pressure relieving mattress and bed used was not recorded in the care records and so the appropriateness of the equipment used would be difficult to evaluate. Any problems with the equipment would take time to find the contact details for the company who provided it. Nutritional intake was poorly recorded and food supplements were not recorded on the intake and output charts as having been given by the staff. When drinks were left for the individual to have, it was not accurately recorded. A paper towel was used to cover the top of the jug as no lid had been provided. The evaluation of information about the care given and received for this person was and often incomplete for anyone to follow. This included specialised nursing care instructions such as dressings, pressure areas identification and improvements or deterioration of the pressure areas. The care plan failed to identify how this person would ask for help given their disabling condition. In another person case tracked again aspects associated with pressure areas were not completed in a manner that would ensure the continuity of care by all staff members. The weight, diet and nutrition was poorly recorded and had not been monitored since February 2009. An assessment evaluation indicated that the needs had changed but again the change in care was not well recorded and follow-up action was unclear. Medications were also checked for the two people case tracked. A different persons records for controlled drugs was checked.(Controlled drugs are medicines that need special monitoring during administration and documentation). This was satisfactory. However a safeguarding alert had been made to the Care Quality Commission and it included poor observance of medication documentation and subsequent practise. The inspector was informed by the Project Manager that the Pharmacist from the Primary Care Trust had visited recently and changes were in progress. Privacy and dignity needs were not met. One person did not have a lid on the jug of fluid and the contents were left exposed to the environment. One person was observed being placed in a restrictive chair that prevented their movement the care staff when asked were unable to explain why they used this chair for this person. When asked, the person said that they wanted to sit in another chair and was later seen by the inspector moving freely around the lounge. Another person had a very full leg bag. The nurse noticed this and asked the care staff to empty it before the person was taken for their lunch the care staff did this at once. The nurse took the doctor to see an individual. The individual was not moved and the consultation took place in the lounge area. The care staff were seen using the same sling from person to person. This may have cross infection implications as some people were being taken to the toilet from their Care Homes for Older People Page 12 of 32 Evidence: seated position before lunch and may have been incontinent. The same sling was reused for the next person. Care Homes for Older People Page 13 of 32 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. Standard 12, Standard 13, Standard 14 and Standard 15 The lifestyle and experiences of individuals at the home varies and this includes being involved in activities inside and outside the homes environment. Staff are available to help individuals who need assistance with eating and try to make the meal times a pleasant occasion for everyone. Evidence: During the inspection we saw that the lifestyle and experiences of individuals living at the home varied. For some people this appears to be good and for others not as good. One younger adult said that they enjoyed living at the home and was very involved in activities that took place there. This person took part in 1 to 1 gardening. In their activities plan they had attended the film shows, went out for meals and took part in quiz day activities. For someone else their experience of life at the home was one of little involvement and they did not receive any one to one activity. Visitors came when they were able to. When they were moved they were repositioned in a way that left them unable to watch TV and the radio was not put on either. No one recorded visiting the room between care duties. Care Homes for Older People Page 14 of 32 Evidence: Another person who had dementia had their life story sheet completed but not dated or signed. They were encouraged to take part in weekly activities such as film shows the inspector was told but this was not recorded in the activity record for them. This person had physical ailments this affected their ability to take part in certain activities it was not recorded on their sheet. This person was unsteady on their feet and had leg problems. They became aggressive and distressed at times as they wandered around the home due to their mental state. An activities coordinator is employed at the home for 20 hours a week and it was noticed that this is unlikely to meet the different needs within the variety of conditions at this care home. The activities coordinator also spoke with the inspector and was present to help for one and a half hours a day to help to assist individuals at meal times. She told the inspector that she enjoyed being able to spend one to one time assisting and talking with different individuals in this way. People who were able to speak with the inspector said that their family members could visit and they were made welcome by staff. Information taken from the compliments folder kept by the home included a thank you to the staff for their thoughtfulness making the family members feel welcome at a relatives birthday party. Part of the thank you mentioned an enormous thank you on a daily basis for the care that the person who lives at the home receives from everyone each day. Another relative wrote to say thank you to the staff who have become our friends and to the residents at Forest Manor. I will miss you all. Another relative wrote A big thank you to every one who looked after my relative over the years. I know that my relative was loved by you all. Some of the people who live at the home told us that they were able to exercise control and make choices over their own lives and they had assistance as needed. However, for the less able people who live at the home this was not always evident in practise. The lunch time meal was seen. Meal times were conducted in two sittings. More able people ate first lunch with the staff serving them and they were able to eat independently of help in the majority of cases. This allowed the staff to also eat their meal on a separate table. The meal seen was wholesome, appealing and seemed balanced in dietary terms. The portions were satisfactory. People were encouraged to talk and enjoy their meal time. Care Homes for Older People Page 15 of 32 Evidence: The second sitting was also observed. People who needed more help and assistance with their meals in terms of feeding were moved to the dining area. We saw that it encourages the physical movement of each individual, but not every one was taken to the toilet before their meal and they did not always have the capacity to ask for this. Meals that were liquidised were sometimes mixed all together and did not always look appetising. However the care staff did attempt to give each person one to one care and assistance at meal time. The dining room was well lit and pleasant. It was noticed that one of the earlier diners sat in the doorway allowing a draft to enter whilst the slower eaters dined. A member of staff did notice this after a while and asked the person to either go outside or return back inside. The individual was happy to go back outside to enjoy their cigarette. We highlighted that it is important for staff to ensure that the slower eaters are protected in this way at all times so that they can also enjoy their meals, without interruption. Care Homes for Older People Page 16 of 32 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standard 16 and Standard 18 The rights of the individual are not always considered during the care processes . Links with external agencies are not always satisfactory. Policies are in place that generally meets the standards of the national minimum standards and regulations. Evidence: The Care Quality Commission has received information about the service that there are problems at the home. This will be addressed by the home and monitored with the assistance of the external agencies related to the welfare of the individuals living at the care home. At inspection there was evidence in the homes complaints records to show that complaints are dealt with by the home in a satisfactory manner. However, the lack of written information and lack of awareness surrounding practises in care by the care staff can lead to staff inadvertently not protecting individuals living at the home in a safe manner. For example records showed that pressure area care has not been well monitored. There have been a number of safeguarding issues around this area as a result of this. Care Homes for Older People Page 17 of 32 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. Standards 19 and Standard 26 People who live at the home live in a clean and well maintained environment. Evidence: During the visit we observed that the organisation continues to make improvements to the various parts of the building. A new shower area downstairs was in the process of being completed to be able to offer individuals more choices as to where they prefer to receive a wash. Public areas viewed by the inspector had facilities in them to ensure that the hygiene needs of the individuals living at the home can be met. Bedrooms seen were kept tidy and nicely decorated. Individuals and their families were encouraged to personalise their bedroom. A pleasant well maintained environment is provided. Care Homes for Older People Page 18 of 32 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. Standard 27, Standard 28, Standard 29 and Standard 30 The skill mix and numbers of staff does not appear to be meeting the needs of the people who live at the home. In this way individuals are being put at risk. Evidence: This home caters for people who are younger and older adults with physical disabilities, dementia and old age. However at inspection it was discovered that there were three people who have been admitted out of category. Staff are expected to provide care for them but there are no records to show how staff have been trained to provide specialist care for these people when the need arises. There were thirty three people at the home this included two people in hospital. The staff rota was seen. There is one Registered Nurse on each shift. The shifts are divided into three to cover the twenty four hour period of care. On an early shift a nurse is supported by one senior carer, and two or three other care staff. On a late shift the nurse is supported by one senior care staff and three other care staff. At night, the nurse is supported by two or three night staff. The rota shows that shortages in staffing levels take place. It is not clear from the rota if agency cover is provided. A requirement was made at the last inspection for staffing levels to be reviewed to Care Homes for Older People Page 19 of 32 Evidence: meet the needs of all the people who live at the care home. As there is no clear evidence of this need having being met by increased staffing levels further action is necessary. An enforcement notice known as a code b notice was served. This was served so that improvements for staff training, competency and improvements in the staffing levels to meet the needs of the individuals seen at the home will be made. Staff were observed moving and handling individuals at the home. When staff were asked about the use of a specialized chair for one person. Neither of the staff were able to explain why the person was sat in the chair and when they asked the person if they wanted to sit somewhere else they said yes. The staff assisted them to do so. Staff who spoke with the inspector also said that they did not get involved with the reading or writing of care plans and left information updating to the senior staff. This can result in care staff who are unaware of important issues for specific individuals, and this could put some individuals at risk. Manual handling guidance seen at inspection was not always followed by all staff. Staff were seen using inappropriate moving and handling techniques.We saw that this could lead to individuals being put at risk from unsafe practises. However, some staff did follow good moving and handling techniques and spoke with the individuals as they did so. Recruitment documentation seen by the inspector and was satisfactory. Two staff records were seen they had recent supervision records in them (March 2009). The Criminal Records Bureau check information was available or sent later for the inspector to see. They each had two satisfactory references in them. There was evidence of an induction process and a number of courses provided by the company for each of the staff members. This included Principles of care, an e-learning course, Abuse/neglect, Health and Safety, development as a worker, communication, emergency first aid, working with vulnerable adults, Safeguarding vulnerable adults, food hygiene, medications handling, one of the carer records showed a National Vocational Qualification at level 3 in care. There was also evidence of Dementia training and Infection control. There was no training for mental disorder conditions yet there were three people at the home with this condition who sometimes had specific behavioral problems. One person had refused or not been given their medication for a period of three days. Recruitment documentation seen by the inspector and was satisfactory. There was no evidence of the staff using wedges to prop doors open at this inspection. Care Homes for Older People Page 20 of 32 Evidence: The staff were pleasant and friendly to each other and seemed to work together well. Individual encounters with the residents also seemed friendly. Care Homes for Older People Page 21 of 32 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standard 31, Standard 33, Standard 35 and Standard 38 There is no regular leadership at the home and the acting managers have failed to register with the Commission. The interests of the individuals who live at the home has not been safeguarded and is evidenced by the number of safeguarding issues. Quality monitoring has not been effective. Evidence: This care home does not have a registered manager one year later from the last inspection and there have been acting managers at this care home. The changes in management and lack of clear leadership has lead to the staff drifting in their care practices. The registered persons although having met with the Regulation 26 compliance of visiting the home on a regular basis may not have spotted the need for greater support for the staff at the home. At inspection it was discovered that the previous manager had admitted three people out of the homes permitted registration category. Staff are expected to provide care for them but there are no records to show Care Homes for Older People Page 22 of 32 Evidence: how staff have been trained to provide specialist care for these people when the need arises. It is also clear from the number of health and personal care issues that the service is struggling to meet the many different needs of all the people who live at the home. In this way the needs of many people with complex needs have not been met in a satisfactory manner. Where issues have been identified in care plans they have not been followed up successfully. One person was admitted to the home for Nursing care yet treated as residential as per list shown to inspector. There is a clear need for improvements to be made with the support of all agencies to do so. In this way the outcomes for all the people who live at the home will be improved. An immediate requirement was served so that the registered person can review how they intend to meet the continued needs of the people admitted out of their registration category by having a reassessment followed by contact with the registration team if they decide to keep these people. The finances of two people was checked and this was satisfactory. The acting manager and project manager for this service were able to verify that the health and safety needs at the service were met. Care Homes for Older People Page 23 of 32 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 32 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 1 33 14 The registered person has 14/05/2009 confirmed in writing to the service user that having regard to the assessment the care home is suitable for the purpose of meeting the service users needs in respect of his health and welfare. A reassessment of the three people admitted out of registration category is required. In this way a further assessment can be made to ensure that the home has the skills within the staffing levels to meet these service users needs as well as those of the other individuals who live at the care home. 72 hours given for complaince. 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 3 14 The registered person shall 11/08/2009 ensure that the assessment of the service users needs is - a) kept under review; and b) revised at any time when it is necessary to do so Care Homes for Older People Page 25 of 32 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 having regard to any change of circumstances. Anyone who is staying at the home is expected to have an assessment of their care needs made and for the assessments to be updated as needs change. 2 7 15 (2) The registered person 11/08/2009 shall c)where appropriate and, unless it is impracticable to carry out such consultation, after consultation with the service user or a representative of his, revise the service users plan; and d) notify the service user of any such revision. As service users needs change they should be consulted and re-assessed so that the individual will benefit from the changes made. 3 8 13 The registered person shall ensure that c) unnecessary risk to the health or safety of service users are identified and so far as possible eliminated. Uncovered drinks, the sharing of hoist slings between individuals, the 11/08/2009 Care Homes for Older People Page 26 of 32 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 poor recording of information can all lead to service users being placed at unnecessary risk. By reviewing practices at the home service users should benefit. 4 9 13 The registered person shall 11/08/2009 make suitable arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. Information relating to medications must be accurately recorded. This also includes information about allergies when needed. 5 10 12 4) The registered person 11/08/2009 shall make suitable arrangements to ensure that the care home is conducted a) in a manner which respects privacy and dignity of service users. Staff must be able to demonstrate at all times that they give consideration to the privacy and dignity needs of service users. In this way they will be able to show that they respect them as individuals. Care Homes for Older People Page 27 of 32 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 6 12 16 The registered person shall 11/08/2009 having regard to the size of the care home and the number and needs of service users (n) consult service users about the programme of activities arranges by or on behalf of the care home, and provide facilities for recreation including, having regards to the needs of service users, activities in relation to recreation, fitness and training. This is to ensure that every one at the home has the opportunity to take part in activity that is meaningful and enjoyable to them. In this way their health and welfare will be promoted. 7 14 16 The registered person shall 11/08/2009 having regard to the size of the care home and the number and needs of service users- (m) consult service users about their their social interests, and make arrangements to enable them to engage in local, social and community activities and to visit, or maintain contact or communicate with, their families and friends. Care Homes for Older People Page 28 of 32 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 This will demonstrate that the home is acting in the best possible interests of the individuals who live there. 8 15 16 The registered person shall having regard to the size of the care home and the number and needs of the service users provide, in adequate quantities, suitable, wholesome and nutritious food which is varied and properly prepared and available at such time as may reasonably be required by service users. All portions of food must be served in an attractive way. Seperate portions for liquidised meals will ensure this. 9 18 13 (6) The registered person shall make arrangements, by training staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. This is to ensure that staff are fully aware of their actions. This also includes actions that they have failed 11/08/2009 11/08/2009 Care Homes for Older People Page 29 of 32 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 do to safeguard the service user. 10 27 18 The registered person shall 11/08/2009 having regard to the size of the care home, the statement of purpose and the number and needs of the service users- (a) ensure that at all times suitably qualified, competent and experienced person are working at the care home in such numbers as are appropriate for the health and welfare of service users. The number of staff and the way they are deployed must be based on an assessment of the holistic needs of the people who live at the care home. In this way the needs of individuals wellbeing, health and safety will be met. 11 28 18 The registered person shall, 11/08/2009 having regard to the size of the care home, the statement of purpose and the number and needs of the service users (c) ensure that persons employed by the registered person to work at the care home receive (i) training appropriate to the work they are to perform. Care Homes for Older People Page 30 of 32 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 By ensuring that suitable qualified staff care for the different types of needs at the home individuals can expect to have all their needs met in a safe and satisfactory manner. 12 31 7 The registered provider is an 11/08/2009 organization and i) the organization has given notice to the Commission of the name, address and position in the organization of an individual who is a director, manager, secretary or other officer of the organization and is responsible for supervision the management of the care home and that the individual satisfies the requirements set out in paragraph (3) For the continuity in service provision this company must provide a suitable candidate to be registered with the Care Quality Commission. 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 31 of 32 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. 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. Care Homes for Older People Page 32 of 32 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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