Key inspection report
Care homes for older people
Name: Address: Grace Lodge Nursing Home Grace Road Walton Liverpool L9 2DB 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: Patricia Thomas
Date: 2 5 0 6 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 27 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 27 Information about the care home
Name of care home: Address: Grace Lodge Nursing Home Grace Road Walton Liverpool L9 2DB 01515237202 01515237203 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ocean Cross Ltd Name of registered manager (if applicable) Miss Kim Alison Truscott Type of registration: Number of places registered: care home 65 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home with nursing - Code N. 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. The maximum number of service users who can be accommodated is: 65 Date of last inspection Brief description of the care home Grace Lodge provides nursing and residential care and support for up to sixty-five people. The home is purpose built and is situated off a busy residential and shopping area of Walton Vale Liverpool. The home is well served by public transport (bus and rail) and a motorway network is approximately ten minutes away by car. The home is built on two levels, is centrally heated and well maintained. A passenger lift and stairways access the first floor. There is a well maintained garden to the rear of the home. The home is staffed twenty-four hours each day with both trained nurses and Care Homes for Older People
Page 4 of 27 Over 65 65 0 0 3 0 2 2 0 0 9 Brief description of the care home care staff. A representative of the owner visits at least monthly to report on the running of the home. Care Homes for Older People Page 5 of 27 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: The quality rating for this service is one star. This means people who use this service receive adequate quality outcomes. During our visit we walked around the home and we checked various records to see what care people living there receive. We spoke with people who live at the home and they told us what they thought about it. We also spoke with staff who gave us their views about working in Grace Lodge. We have included their views throughout the report. We used a method called case tracking. This is a way of inspecting that helps us to look at services from the point of view of some of the people who use them. We track peoples care to see whether the service meets their individual needs. The weekly charge for the service ranges from £330 to £550. Care Homes for Older People
Page 6 of 27 Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: Staff need to make sure that peoples pre-admission assessment details are always added to their care care files and arrangements made to set up a care plan as soon as they move in. In meeting the requirements we have given, those who write care plans will have the information they need to give staff written guidance about how to support a persons full range of needs properly and safely from the time they move in. More attention is needed to maintain the medication storage rooms and medication Care Homes for Older People
Page 8 of 27 fridges at levels recommended by pharmacists and manufacturers. In meeting the requirement we have given, medication will be stored safely, the risk of drugs being rendered ineffective will be avoided, and people will receive their prescribed treatments safely. Staff need to ensure that all medical equipment used by people in the home is kept clean and well maintained and keep records of their actions. This is to keep such equipment safe and comfortable for the people who use it. Staff need to review arrangements for serving meals in the home. In the first floor dining room we saw that some people waited over half and hour after sitting down, for their meal to be served. This included some frail people who need a lot of assistance with their food. It may more pleasant and comfortable for people if two meal sittings were arranged on the first floor, to give staff the time they need to support people in a more timely and relaxed way. A review of the times meals are served to people living in Grace Lodge is recommended as they told us that their meals are served close together during the day. Providing a later evening meal will give people the opportunity to digest their food and build up an appetite between meals. People living in the home and staff told us that the temperature on the first floor is very hot, whatever the weather outside. Arrangements need to be made for temperature levels to be kept safe and comfortable for the people who live and work in this home. To ensure people have the equipment needed to support them properly and safely, a second stand aid should be supplied on the first floor. Staff told us that demands on this equipment mean that people who are frail may be left waiting for their care to be given. We have recommended that a training plan for staff be written based on the more specialist support needs of people living in the home. This is to enhance staff competency and skills and improve the service for people. To ensure the standards of service are maintained and improved, we recommend that in house audits of the service be carried out more frequently. Also, action plans should be set out following any audits or surveys carried out to make sure that any areas for improvement identified will be quickly acted upon for the benefit of those who live in Grace Lodge. 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 9 of 27 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 27 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. People have had their needs assessed before they move in to Grace Lodge, however all the information needed to inform care plans is not always available to staff who are planning peoples care and this could mean they are not getting all the support they need. Evidence: Before anyone moves in to Grace Lodge, they and their family visit the home. Staff meet with the person and carry out an assessment of their care needs and choices. This helps to establish if the home can successfully support the person and helps staff to plan how to provide support. However, we looked at records for a person who had recently moved in to the home and found their pre-admission assessment was not available on their care file. This lack of information could lead to staff not being aware of, or able to support the persons needs. Care Homes for Older People Page 11 of 27 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. There is a system in place for recording and reviewing peoples care needs to give staff guidance about how to support them properly and safely. People will be placed at risk if a care plan is not in place for them as soon as they move in to inform staff of their care needs and any risks to their safety and wellbeing. Evidence: The people living in Grace Lodge told us they get the care and support they need from staff, saying that they are all well looked after and that staff answer call bells quickly. They said they if they are unwell, they are given the help they need, such as being given painkillers as necessary. People we met looked well cared for with regards to their personal grooming and they said they have regular visits from a hairdresser. During our visit we saw staff supporting people discreetly and respecting their privacy. People told us they make decisions about their daily life, such as when they get up and when they go to bed. One person likes to get up early and said staff are always available to help her as is the case for a person who likes to have a lie in and late breakfast. This means that people have their choices respected and have a say in their lifestyle in the home.
Care Homes for Older People Page 12 of 27 Evidence: Individual care plans are in place for people living in Grace Lodge and we found the majority to be satisfactory. We saw assessments of peoples needs in areas such as socialising and culture, general health, mobility, pressure areas and nutrition. This means that staff have obtained a lot of information on which to base each persons care plan. Peoples care plans had been regularly reviewed by staff and changed in accordance with their changing needs. There were updated risk assessments in place, for example for mobility, pressure care and nutrition which means that staff have current guidance about how to give support properly and safely. There were records of the support people are given when they are unwell through contact with doctors, district nurses and other relevant health services. This means people will receive the specialist support they need to keep them as healthy as possible. People are weighed every month, records are kept and any significant and sustained weight loss is referred to the GP and dietician. Measures are taken as soon as a risk is identified, to supplement the diets of those at risk. This help them maintain a healthy weight through receiving the nutrition and support they need. We observed part of the medication rounds on the ground and first floors at Grace Lodge during the midday meal. Staff were making sure that medication was dealt with safely and in line with current best practice. Staff took their time in giving out medication, so that people were not rushed. Medication was given out in a way which did not disrupt the meal. People were given a drink and staff remained with each person until they had taken their medication, to ensure that drugs were not left unsupervised to pose a risk of the wrong person taking them. There are medication rooms on the ground and first floors of Grace Lodge and we looked at a sample of medication on both floors. The temperature in the ground for room was 28 degrees and records showed that for several days the temperature had been maintained above 25 degrees. On the first floor, the thermometer recorded a temperature of 29 degrees. Manufacturers instructions for many medications state they should be stored at a temperature of below 25 degrees. The high temperatures in these medication storage rooms may impact on the efficiency of the medications people are taking. We were advised that an air conditioning unit was due to be fitted in the ground floor room to help regulate the temperature. Similarly in reading the records, we noted the fridges used to store medication in both rooms were consistently over 8 degrees, which is the recommended safe storage temperature for some medication. We could see no evidence that staff had taken any action to ensure that fridge temperatures were being maintained at a safe level to avoid adverse affects on medication being refrigerated. Care Homes for Older People Page 13 of 27 Evidence: We noted that medication was stored securely and records fully maintained to provide a clear audit trail of medication accepted into the home and returned to the pharmacy. Records showed us that staff have received training recently in managing medication which is to help ensure they are able to manage peoples medication safely and quickly identify and act upon any issues. We looked at medication equipment in use for one person and found that this was dusty. A relative advised that the family currently ensures this is regularly maintained (for example regarding changing filters). It is important that records are in place for any medical equipment people use to ensure it is cleaned regularly and parts changed as necessary. This will help to ensure that equipment is working as efficiently as possible. Care Homes for Older People Page 14 of 27 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. People have been consulted about meal choices but the routines in the home do not enable a relaxed environment during their meals. The times meals are served appear to be arranged around the rosters of catering staff so they met the arrangements for staff rather than the needs of those living in the home. Evidence: We observed the midday meal on the ground and first floors. On the ground floor dining tables were nicely laid with condiments, glasses and jugs of juice. We saw that staff took time to give people their personal cups when they asked. This attention to detail gave a relaxed mealtime that people can enjoy. In the first floor dining room we saw that there were nineteen people seated and five members of care staff serving meals, a kitchen assistant serving drinks and a senior care assistant giving out medication. As in the ground floor dining room, attention had been given to the way tables were laid to make a pleasant environment. The meal on the first floor was less relaxed than downstairs. Staff who were serving the meals appeared rushed. The senior care who was giving out medication however was concentrating and not rushing, and was giving people time to take their medication before signing the administration record. On the first floor we saw that some people had chosen a chicken dinner and others were having omelette and salad. One person was given a
Care Homes for Older People Page 15 of 27 Evidence: nutritional supplement to drink before the meal, as was written in his care plan. We saw that some people waited over half an hour for their meal to be served. Staff who were serving appeared under pressure to get the meals out and help those who needed assistance. We saw staff were not sitting beside those who needed their food cutting but were standing up while doing this, before moving on quickly to the next person. Those who could not feed themselves and needed a lot of assistance had to wait until others had been served and staff were free to help. We looked at how people are offered a choice of meals in Grace Lodge and found that staff inform people of the following days menu, which is also displayed in the home. Their meal choices are written down by staff and passed on to the chef who prepares what people have asked for. We received mixed opinions from people who live in Grace Lodge about their meals. Some people thought the food was excellent, others said it was bland and could be improved on. People told us that they think meals are served too close together, the evening meal being served at 4.15pm., having finished their main meal after 1pm. They said they are served tea and cake at around 3pm, have their evening meal, and a drink and toast at supper time and then nothing to eat until the next morning (although drinks may be requested at night). An activities co-ordinator is employed at Grace Lodge four days a week and records kept about what activities have been taken part in to make sure people are doing the things they like. During our visit, many people living in Grace Lodge were sitting in the garden taking part in a quiz and listening to old time music. The atmosphere was lively and pleasant and it was clear that people were enjoying themselves. Others had gone out with family or preferred to stay in the lounges or their bedrooms and staff were serving them with tea and cake. Records in the home showed us that people are asked about their spiritual and cultural needs before they move in and staff told us arrangements will be made for them to continue to receive support from religious ministers or attend local churches as they prefer. One person told us that his beliefs have always formed a very important part of his life and that staff respect and support this. Others told us they have visits from family and friends and they are left in private and offered a drink by staff. Care Homes for Older People Page 16 of 27 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 complaints and safeguarding procedures in the home are understood well by staff to make sure that the people who live at Grace Lodge are protected and their concerns are listened to. Evidence: Grace Lodge has a complaints procedure, which is given to the people who live there and displayed in the home so they know about their right to complain and that their complaints will be looked into. To protect people from abuse, there are safeguarding procedures and staff told us they have received training on this in the past and updates had been arranged. Three of the staff who were spoken with were aware of the safeguarding and whistle-blowing procedures in the home which means they are aware of their role in protecting people from abuse. The manager has always kept us informed about any issues arising in the home and has managed them well to protect the people who live in the home. Care Homes for Older People Page 17 of 27 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 is clean and well maintained, however peoples comfort and support needs were not always being met by environmental conditions during the visit. Evidence: Grace Lodge is a purpose built two storey home with an enclosed back garden and off street parking at the front. Domestic staff are employed and we found that the home was very clean during our visit. There are procedures for infection control and storing cleaning materials safely. Staff told us there are always plenty of protective gloves and aprons for them to use to control infection. People living in the home have single bedrooms and these contained many personal items they had brought in with them to make the bedroom their own personal space. There are bathrooms, showers and toilets on both floors for convenience, and these were in good condition. There are dining rooms on both floors, a central kitchen and a laundry. A range of mobility aids is in place for those people who are frail, including a passenger lift, hoists, supported baths and grab rails. Staff told us there is one standaid upstairs and as more than one person needs assisting with this equipment, there have been delays in people receiving the support they need. We found the home to be very warm on the day of our visit. Staff and people who live there told us that whatever the weather outside, it gets very warm upstairs in general in Grace Lodge, particularly in the shower rooms.
Care Homes for Older People Page 18 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Grace Lodge are supported by a well trained staff team who have gone through a thorough recruitment process, so peoples needs are met and they are safe from possible harm or poor practice. Evidence: The people living in Grace Lodge told us they like the staff who work there. They also said there are enough of them to support them when they need it. During our visit, we noted that staff were polite and had the ability to communicate well with people living there. We looked at a sample of staff files during our visit. These were for staff who had different roles and for long-term or recently employed staff. These records showed us that before anyone starts to work in Grace Lodge, a series of checks are carried out. This includes obtaining two references, checking the criminal records bureau (CRB) and protection of vulnerable adults register. These checks help to ensure that staff are suitable to work in the home. Records show that staff have undertaken training in a variety of areas in the past few months. This includes basic areas of care, health & safety, protection of vulnerable adults, fire safety, medication and moving and handling. Staff have also received training in more specialist areas such as the Mental Capacity Act and on how to support people with their behaviour. The training provided helps to ensure that staff have up to date knowledge on how to successfully support the people who live in this
Care Homes for Older People Page 19 of 27 Evidence: home. Building on more specialist training in areas such as deprivation of liberty and nutrition will enhance this further. Care Homes for Older People Page 20 of 27 Management and administration
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Grace Lodge is being run in the best interests of people who live there and their welfare is promoted and protected. Evidence: A new manager has been employed at Grace Lodge since our last visit to the home. The people living at Grace Lodge were positive about her, saying she is very nice. They told us she takes time to talk with them and help them if needed. Several systems have been put in place to check the quality of the service they provide in Grace Lodge and plan any improvements. A senior manager from the organisation visits the home regularly and writes a report on the findings. Whilst there, they talk with the people who live, work in and visit the home for their comments on the service. They also check the building and records relating to peoples care, health and safety and staffing. These visits provide a clear way for the organisation to find out how the home is operating, check the quality of service provided and plan future improvements. Some internal quality checks are also in
Care Homes for Older People Page 21 of 27 Evidence: place. Examples we saw were checks by senior staff in the home of care plans and medication management. However, these had been carried out in March 2009 and it was unclear whether actions to be taken which had been identified in them had been checked. The views of relatives were sought via surveys in March 2009. Although there was a low response rate to this in returned surveys, those received contained both positive comments and suggestions for improvements to the home. Several of these had been acted upon. For example, the conservatory has been changed to a non smoking room and picture aids put on peoples doors so they can more easily identify their bedrooms. Although the manager has displayed a letter saying the outcomes of surveys will be analysed, there was no overall action plan to show all the actions taken in response to the suggestions for improvements. To ensure peoples best interests are protected, we looked at how their personal allowances are managed in Grace Lodge by checking the records for three people chosen randomly. Where money is held for them in safekeeping in the home, they have easy access to it and records are kept of debits and credits to individual accounts. Each transaction had the signature of the person or their next of kin, and the accounts are regularly audited by staff from the organisations head office. The records we checked were in order. People told us they had no concerns about how access to their money is arranged and said they are able to buy what they need. We saw that charges over and above the fees are clearly stated through the billing system, and receipts are retained for any purchases made on behalf of people living in the home by staff. This is to ensure all their money is accounted for. To check that the home is fit for its purpose, we looked at health & safety checks on the building and equipment. The records and certificates were up to date, including those for fire safety and bed rail checks. There is a system for monitoring accidents which may occur in the home and carrying out risk assessments to eliminate hazards to peoples health and safety. Care Homes for Older People Page 22 of 27 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 23 of 27 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 3 14 Pre admission assessment information must be made available on peoples care files when they move in. In meeting the requirement, staff will have the information they need to plan people care to meet their needs. 17/08/2009 2 7 15 A system must be put into place to ensure a basic care plan is in place for each person as they move in to Grace Lodge. In meeting the requirement staff will have the guidance they need to support people properly and safely from the time they move in to the home. 17/08/2009 3 9 13 Action must be taken to ensure the temperature in the medication rooms and medication fridges are 17/08/2009 Care Homes for Older People Page 24 of 27 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 maintained at a safe level at all times. In meeting the requirement medication will be managed and stored as safely as possible. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 9 Written records should be in place for the cleaning, parts replacement and maintenance of medication equipment in use in the home. This will help ensure that equipment is working safely and is clean and as comfortable as possible for the person using it. A review of meals on the first floor should take place and consideration be given to two meal sittings for the main meal. This will give staff time to support people who need a lot of assistance in a more relaxed manner and avoid people having to wait for unacceptable periods for their meals to be served. The times meals are served in Grace Lodge should be reviewed and arrangements made to give reasonable periods between each meal so that people have time to digest their food and build up an appetite for their next meal. The first floor was uncomfortably warm during the visit and arrangements should be made to regulate the temperatures to make the home comfortable and safe for the people who live and work there. To avoid delays in people receiving care and support, a second stand aid should be provided for the first floor. A training plan for staff should be compiled based on the more specialist needs of the people living in Grace Lodge and on new legislation, such as deprivation of liberty. 2 15 3 15 4 19 5 6 22 30 Care Homes for Older People Page 25 of 27 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 7 33 In house audits of the service should be carried out more frequently and action plans set out following these. This will help to ensure that any areas for improvement identified are quickly acted upon for the benefit of people who live in Grace Lodge. Care Homes for Older People Page 26 of 27 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 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
