Inspection on 15/06/09 for Green Bank EMI Care Home

This inspection was carried out on 15th June 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Green Bank EMI Care Home 27/06/07

Green Bank EMI Care Home 25/04/06

Green Bank EMI Care Home 19/10/05

Green Bank EMI Care Home 26/04/05

Green Bank EMI Care Home 07/12/04

Green Bank EMI Care Home 09/07/04

Green Bank EMI Care Home 29/07/02

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for older people Name: Address: Green Bank EMI Care Home 11 Hastings Road Bexhill-on-sea East Sussex TN40 2HJ     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: June Davies     Date: 1 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 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Green Bank EMI Care Home 11 Hastings Road Bexhill-on-sea East Sussex TN40 2HJ 01424211704 01424218281 Pillowatrick@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Judy Pillow care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is: 20 The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) Dementia (DE). Date of last inspection Brief description of the care home Greenbank is located close to Bexhill-on-Sea old town and about one mile from the seafront. There is access to local shops, public transport, churches and other community services. Greenbank is a long established family owned home registered to accommodate up to 16 older people with a Dementia type illness. The property was originally a two storey Victorian house, which has since been extended to accommodate residents on the ground floor of the building further improvements are in the process of be completed to offer further accommodation space. There are fifteen bedrooms, one of which may be used as a shared occupancy room but is currently Care Homes for Older People Page 4 of 29 20 0 Over 65 0 20 Brief description of the care home used as single occupancy. All bedrooms have en-suite facilities and there are toilets and bathroom/shower rooms located throughout the premises. The home has communal areas with pleasant views. There is a large well maintained garden to the rear of the property with patio areas to one side of the home. Potential new residents can obtain information relating to the home via Care Managers, Placing Authorities by word of mouth and by contacting the home direct. Current fee charges can be obtained from the Registered Manager, extra charges are made for hairdressing, chiropody, newspapers and toiletries. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection took place on Monday 15th June 2009 over a period of seven hours. During this inspection conversations took place with the Registered Provider, Mrs Judy Pillow, the Registered Manager, Mr William Pillow, two members of staff, four residents and a district nurse visiting the home, documentation relating to the key standards inspected were viewed and observation took place of communal space and some of the residents bedrooms, the external areas of the home, a lunchtime meal and medication. People using this service experience Adequate quality outcomes. Care Homes for Older People Page 6 of 29 What the care home does well: What has improved since the last inspection? What they could do better: Each resident has their own care plan, but there is no clear guidance for staff in regards to meeting residents personal, physical and social care needs, and risk assessments do not give staff clear guidelines as to how levels of risk can be reduced. Records of general practitioner visits is kept together collectively and other health care visits are recorded in the office diary. Relative comments on quality assurance questionnaires did show some criticism of dental and nail care, while another relative said the service was excellent. The management of medication in the home is not appropriate at the present time and improvements needs to be made to ensure that residents are not placed at risk. While the home offers residents some activities, they are rather repetitive from day to day, and do not necessarily meet the needs of residents suffering from dementia type illnesses. The home does not have a printed menu or menu in pictorial format, but records of daily meals are kept. The choices offered on a daily basis are not sufficiently different, for example a resident not liking beef curry would be offered a vegetable curry etc. Four residents said that they were not offered choices at mealtimes. At the present time the home is undergoing some extension work, but shortfalls were found in regard to dining room space in the home, decoration in some bedrooms, the cleanliness and risk factors on patio areas of the home. Adressing an offensive odour in a residents bedroom. There is a lack of attention to infection control procedures so that residents are placed at risk from cross infection. At the present time staff recruitment is not robust with new staff not being appropriately vetted prior to taking up employment in the home, leaving residents as possible risk of abuse. Under fifty percent of care staff have a NVQ qualification in Social Care, there is some evidence to show that this could in improve in the next six months. Many of the staff have completed their mandatory training, but it was noted that in some cases this training was carried out in 2004 and 2006 and has not been Care Homes for Older People Page 7 of 29 updated, further mandatory training has been organised by the registered manager but from the training matrix it is not clear if this includes staff who need to update their training. While this is a registered dementia care home thirteen staff have only received a four hour course in understanding dementia, which is not appropriate in giving the staff the skills and knowledge to meet the needs of residents with a dementia type illness. The quality assurance system in the home needs further development to ensure that throughout residents are offered a high quality standard of care appropriate to their needs. There are some aspects of health and safety in the home that needs to be improved upon to ensure that residents are not placed at risk of harm. 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 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users move into the home knowing that their needs can be met. Evidence: All prospective residents have a pre admission assessment carried out by the Registered Manager or the Deputy Manager. These assessments take place in either the residents own home or in hospital. Further information is gathered from the funding local authority or other external health care professionals. From these pre admission assessments the Registered Manager is able to assess if the home can meet the prospective residents needs. Prior to admission the prospective resident and or their relatives are invited to visit the home to meet with the staff and other residents and obtain a flavour of the home prior to making a final decision. This home does not offer intermediate care. Care Homes for Older People Page 10 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care planning system does not adequately provide staff with the information they need to satisfactorily meet residents needs. The systems for medication need improvement to ensure that residents are not placed at risk. Personal support in this home is offered in such a way as to promote and protect residents privacy and dignity. Evidence: Each resident has a care plan, but these do not show specific steps that staff need to take to ensure that all aspects of the residents health, personal and social care needs are met. Risk assessments again do not give staff clear guidelines in the steps they need to take to reduce the level of risk. There was evidence in the two care plans viewed that reviews take place on a regular monthly basis. Neither the care plans or the reviews have evidence that they are drawn up with involvement from the residents and or their relatives or representatives. The care plans and daily records do Care Homes for Older People Page 11 of 29 Evidence: give not evidence as to how the oral hygiene or personal hygiene care of residents is maintained by staff. The office diary does have records of chiropody, dental and optician visits but these are difficult to case track. At the present time a record is kept of all visits to and from the general practitioner, but it was noted that residents names are kept collectively on this record and this contravenes the Date Protection Act 1998. There is a recently updated policy and procedure for the receipt, recording, storage, handling, administration and disposal of medication, but no policies and procedures for the administration of PRN as required medication or homely remedies. Not all medication administration records had been completed properly and there were no dividers between residents medication administration records to prevent errors occurring. There was no evidence that any medication allergies are recorded for the residents, eye drops were still being used three months beyond their 28 day opening date and it was noted that eye drops and liquid medication bottles were not dated on the day of opening. These issues could cause considerable risk to the residents. Three staff spoken to during the inspection said that they had received medication training, and the training matrix indicates that 13 care staff in total have received medication training. Staff were observed during this inspection to be respecting the residents rights to privacy and dignity ensuring that doors to communal bathrooms and toilets were shut when in use. Staff were talking to residents in a kindly and professional manner. Care Homes for Older People Page 12 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Further improvements need to be made in respect of residents day to day living choices, and the activities provided both within the home and out in the community to ensure that residents are able to maintain their independence. Visitors are welcome into the home at any time. The home has made limited progress to improve the provision of a varied menu and the residents using the service are not able to exercise choice and control over their diet and what they eat. Evidence: There is no detailed evidence in care plans to show that routines of daily living are set around residents personal preferences. The home does have an activities rota which is displayed in the home, and there was evidence on the day of this inspection that activities do take place. Further work needs to be done in ensuring that activities are appropriate to meeting the needs of residents who have a dementia type illness. Staff do take some of the residents out into the community either to a local gardens or into town. A local non denominational minister visits the home regularly to carry out a Care Homes for Older People Page 13 of 29 Evidence: short church service. The visiting policy and procedure states that visitors are welcome into the home at all times. Due to their dementia type illnesses none of the residents in the home are able to manage their own financial affairs and have elected either a relative or representative to manage finances for them. There is evidence within the home that residents are able to bring small personal possessions into the home with them and this was demonstrated in some bedrooms. At the present time the home has no formal menus, therefore it is difficult to ascertain as to how residents are able to make informed choices in regard to what they eat. Four residents spoken with stated that they are not offered choices in regard to food or drink. Menus must be produced in a format that residents with dementia type illnesses can easily relate to. There is evidence that one resident who is vegetarian has their needs catered for. On the day of this inspection the lunch time meal was shepherds pie and the choice was vegetable shepherds pie. Orange juice placed in jugs was already on the tables prior to residents sitting down to eat. Care Homes for Older People Page 14 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a satisfactory complaints system with some evidence that residents complaints will be listened to and acted on. Some staff have a good knowledge and understanding of Safeguarding Vulnerable Adults, but further improvements are needed in the robust recruitment of new staff so that residents are not placed at risk of abuse. Evidence: The complaints policy and procedure is up to date and clearly displayed in the home. One complaint received by the home was appropriately managed and the complaints files showed that the complaint was recorded, investigated and outcomes reported back to the complainant. The home has an up to date Safeguarding Policy and Procedure as well as Sussex Multi-Agency Policy and Procedures for Safeguarding Vulnerable Adults. Two members of staff said that they had received Safeguarding Vulnerable Adults training. The training matrix showed that seven staff last received this training in 2006 and 2007. Three staff personnel files viewed showed that two members of staff had not been appropriately vetted prior to taking up employment in the home. Lack of training and not vetting new staff prior to deployment could leave residents at risk of abuse. Care Homes for Older People Page 15 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Recent investment will significantly improve the appearance of the home but further work needs to be done to ensure that residents live in a comfortable environment free from hazards and risks. Evidence: This home is undergoing major extension work to provide a larger kitchen, five more bedrooms and a new laundry area is already in use. A shaft lift has been fitted but will not be in working order until the building and refurbishment work has finished. At the present time the first floor of the home is not being used by residents. Green Bank home provides residents with two communal lounge areas, and one small dining area in the conservatory. One of the two communal lounge areas is not being used at the present time, there is a bedroom off this lounge. Because dining space is at a minimum a gate leg table is pulled out in the centre lounge at mealtimes. It was noted that this table is broken and one leaf cannot be used, making it uncomfortable for the resident who has to sit at this position as they are unable to get their legs under the table. Three bedrooms were visited and furniture and fittings were good, all bedrooms were in need of decoration, and one bedroom had an offensive odour. The patio areas of the home are not safe for residents to use several tripping hazards were identified, Care Homes for Older People Page 16 of 29 Evidence: and one area was found to be dirty with used disposable gloves, toilet paper and dog excrement laying around. Throughout the building communal toilets, bathrooms and laundry room did not provide either liquid soap, paper hand towels or both, and could leave residents as risk of cross infection. Care Homes for Older People Page 17 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are cared for by sufficient numbers of staff to meet their needs. Staff qualifications and training needs to be improved upon to ensure that residents are receiving care from skilled and knowledgeable staff. Recruitment policies have not been consistently followed resulting in residents receiving care from staff that have not been appropriately vetted. Evidence: At the present time there are 16 residents residing in Green Bank Care Home, both morning and afternoon shifts have three care staff on duty, and there are two waking night staff. One resident said that there is always a member of staff around to give assistance when needed. On the day of the inspection 40 percent of staff had obtained their NVQ qualification in Social Care, two staff are about to complete this course, and another three staff are waiting to sign on to the course. Three staff personnel files viewed showed that not all staff are appropriately checked prior to being employed in the home. At the present time application forms do not Care Homes for Older People Page 18 of 29 Evidence: require a full employment history. Two files were found to have only one written reference, two Protection of Vulnerable Adults register and Criminal Records Bureau checks had been obtained after staff had started work in the home, this could lead to residents being left at risk of abuse. Two staff said that they had received all their mandatory training. From viewing the training matrix there is evidence that while most staff have completed mandatory training some of this training is out of date having taken place between 2004 and 2006. Only thirteen staff have undertaken a four hour Dementia Care Awareness course. As this is a registered Dementia care home, more in depth training should take place to ensure that staff have the knowledge skills and competency to meet the residents needs. Care Homes for Older People Page 19 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of this home is satisfacotry overall but records are not well managed. This practice could place residents at risk. The quality assurance system needs to be developed further to ensure that residents are receiving a good standard of care. Some aspects of health and safety are not appropriately managed and this could leave residents at risk of injury. Evidence: The registered manager Mr William Pillow has obtained the NVQ qualification in Social Care and the Registered Managers Award he has been in post since May 2008. He regularly works hands on with residents and is involved in preparing residents supper meals when on duty. Staff have free access to the office, where they are able to ask for advice. Care Homes for Older People Page 20 of 29 Evidence: The quality assurance system is in the process of being developed at the present time views of residents and relatives are sought, but there are no quality assurance questionnaires for external stakeholders. While the registered manager checks on bedrooms from time to time and ensures that residents have received appropriate personal care in that they are appropriately dressed and men have been shaved. There is no recorded monitoring in place for other systems used in the home to ensure that residents are offered a good quality standard of care. The registered provider Mrs Judy Pillow spends time in the home when the registered manager is not on duty, and writes monthly regulation 26 reports. There is evidence that recent fire, health and safety risk assessments have been carried out in the home. At the present time no annual report is developed to show how the home is meeting a good quality standard of care. The home does not manage residents personal allowances. Where expenditure is made on the residents behalf, receipts are kept and residents relatives or representatives are billed at the end of each month. Health and safety mandatory training has been covered earlier in the report under the staffing section. The inspector did find that fire call points and hot water delivery are not checked on a regular basis, this would leave residents at risk if there was a fire, or if hot water is delivered at more than 43 degrees centigrade. Staff confirmed that they do use a wheelchair in emergencies that does not have foot rests fitted, this practise could lead to residents suffering injuries to the legs, ankles or feet. The hoist only has one medium size sling, many of the residents are slight in build and should the hoist sling be used for these residents, they could be at risk of slipping and injuring themselves. There are health and safety policies and procedures in place. All accidents are recorded in accident book. Care Homes for Older People Page 21 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Unless it is impracticable to carry out such consultation, the registered person shall, after consultation with the service user, or a representative of his, prepare a written plan (the service users plan) as to how the service users needs in respect of his health and welfare are to be met. Care plans need to describe in detail how the residents physical, mental, personal, social care needs are going to be met. 30/07/2009 2 8 12 The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. 13/07/2009 Care Homes for Older People Page 23 of 29 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recording administration of medication must not place residents at risk 3 8 12 The registered person shall 30/07/2009 ensure that care home is conducted so as; to promoted and make proper provision for the health and welfare of service users; to make proper provision for the care and, where appropriate, treatment, education and supervision of service users. Daily records must show that personal hygiene needs of residents are being met. There should be evidence in each care plan in regard to how the resident health care needs are being met by external health care professionals, this information should not be kept collectively. 4 12 16 The registered person shall having regard to the size of the care home and the number and needs of the service users; consult service users about their social interests, and make arrangements to 30/07/2009 Care Homes for Older People Page 24 of 29 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action enable them to engage in local, social and community activities and to visit, or maintain contact or communicate with, their families and friends; consult service users about the programme of activities arranged 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 and fitness. Residents choices, wishes and feelings must be recorded and followed to ensure that their rights to equality and diversity are met. 5 15 16 The registered person shall 17/07/2009 having regard to the size of the care home and the number and needs of service users; provide, in adequate quantities, suitable, wholesome and nutritious food which is varied and properly prepared and available at such times as may resonably be required by service users. Residents must be offered a Care Homes for Older People Page 25 of 29 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action varied menu in a format that they can relate to and taking into account the likes and dislikes so that a balanced diet it available 6 19 23 The registered person shall 31/07/2009 having regard to the number and needs of the service users ensure that: external grounds which are suitable for, and safe for use by, service users are provided and appropriately maintained. Residents should not be placed at risk from tripping or infection control hazards in outside space. 7 23 23 The registered person shall 31/07/2009 having regard to the number and needs of the service users ensure that: there is adequate sitting, recreational and dining space provided seperately from the service users private accommodation. Residents must be provided with suitable dining space so they are able to eat meals in comfort. 8 26 13 The registered person shall 31/07/2009 make suitable arrangements to prevent infection, toxic conditions and the spread of Care Homes for Older People Page 26 of 29 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action infection at the care home. The registered person shall ensure that: unnecessary risks to the health or safety of service users are indentified and so far as possible eliminiated. Residents must not be placed at risk of cross infection. 9 29 19 The registered person shall 31/07/2009 not allow a person to work at the care home unless; the person is fit to work at the care home; the employer has obtained in respect of that person the information and documents specified in paragraphs 1 to 9 of Schedule 2. All new staff must be appropriately vetted prior to being employed in the home so that residents are not placed at risk of abuse. 10 30 18 The registered person shall, 28/08/2009 having regard to the size of the care home, the statement of purpose and the number and needs of service users: ensure that at all times suitable qualified, competent and experienced persons are working at the care home in Care Homes for Older People Page 27 of 29 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action such numbers as are appropriate for the health and welfare of service users; ensure that the persons employed by the registered person to work at the care home receive; training appropriate to the work they are to perform including structured induction training. Staff must have the appropriate up to date skills and knowledge to meet all personal, physical, mental and social care needs. 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 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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