Inspection on 12/12/08 for Greswold House

This inspection was carried out on 12th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Greswold House 12/12/06

Greswold House 14/10/05

Greswold House 13/05/05

Greswold House 11/11/04

Greswold House 15/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Greswold House 76 Middle Leaford Shard End Birmingham West Midlands B34 6HA     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Yvette Delaney     Date: 1 2 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Greswold House 76 Middle Leaford Shard End Birmingham West Midlands B34 6HA 01217831816 01217845194 sue.taylor@ygt.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Yardley Great Trust care home 29 Number of places (if applicable): Under 65 Over 65 29 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who can be accommodated is: 29 The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 29 Date of last inspection Brief description of the care home Greswold House is a purpose built residential home for older people situated within a residential area of the Shard End area of Birmingham. The premises are within close proximity to private households, a sheltered housing scheme and a nursing home. The accommodation comprises of 27 long stay places and two respite rooms. All bedrooms are for single occupancy and the long stay rooms have en-suite facilities consisting of toilet and wash hand basin and there are bathing facilities directly adjacent to the two respite rooms. The services are provided on three floors which are connected by stairs and two passenger lifts. There are lounge/dining area/kitchenette and bathing facilities on each level. The main kitchen provides meals to each floor and Care Homes for Older People Page 4 of 29 Brief description of the care home there are also dedicated laundry and hairdressing facilities. There are pleasant grounds to the rear of the premises that are accessible to residents via the ground floor lounge. A seating area is also available at the front of the premises. There is off road parking at the front of the building and the Home has its own mini bus. Security to the front of the building is maintained by close circuit television, this does not intrude upon the privacy of the residents and there is a secure intercom system at the front entrance. Assisted bathing and shower facilities are provided and staff are available to provide support in this area. There is a comprehensive and interesting in-house and external activities programme. A notice board displays forthcoming events and other information of interest to residents and their visitors. A copy of the most recent CSCI inspection report is available in the foyer area. The weekly fee to live at Greswold House is between 355 pounds and 380 pounds. Items not covered by the fee include hair dressing, newspapers, toiletries and private chiropody. 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: The quality rating for this service is 1 star. This means that people who use the service experience adequate outcomes. This inspection visit was unannounced this means that staff working in the home and people living in the home did not know we were coming. The Manager and Deputy Manager were present in the home. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people who use the service and their views of the service provided. The manager for the care home was asked to complete and return an Annual Quality Assurance Assessment (AQAA). The assessment requests further information related to the quality of the service provided by the agency. Some of the information contained within this document has been used Care Homes for Older People Page 6 of 29 in assessing actions taken by the home to meet the care standards. The focus upon outcomes and the information contained in the AQAA provides information, which considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development. The inspection focused on checking that systems and procedures are in place. Information was gathered from reviewing two staff files and a range of policies and procedures. Discussions with the Manager, Deputy Manager and care staff helped to inform this report. During the inspection residents and relatives were quite willing to talk to us and give their views on the services provided by the home. Two residents were case tracked. This involves establishing an individuals experience of living in the care home by meeting, talking or observing them, discussing their care with staff, looking at their care files, and focusing on outcomes. Records relating to the care of the people using the service, training and health, and safety were examined. Conversations were held with a number of residents who were able to make active contributions during the inspection visit. Information in this report is also gained from observing interaction between residents, staff and visitors to the home. What the care home does well: What has improved since the last inspection? The home has worked hard to improve and meet the requirements made at the last Key Inspection visit of the 12 December 2006. This means that people can feel safe and confident that they live in a home that meets its legal responsibilities. Improvements have been made in practices related to the safe administration of medicines in the home. An audit of practices, which include the receiving of medicines into the home, administration and disposal of medicines have been reviewed to ensure the safety of people living in the home. Staff have received training in the Protection of Vulnerable Adults and refresher courses have been planned. This will help to make sure that staff know what action to take if they suspect or witness abuse of people living in the home. Fluorescent lighting has been replaced in the lounge areas, this provides more suitable lighting to provide a homely setting. Individual risk assessments have been included in care plans to support the safety of people who like to help in the kitchenette areas of the home. Care Homes for Older People Page 8 of 29 Fire safety systems in the home have been reviewed to support safe practises related to fire prevention. This will protect and support the safety of residents and staff working in the home. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 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 10 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. Standards 1 and 3 were assessed. People thinking of using this home have the information they need to make an informed decision about if they want to live there. Evidence: A Statement of Purpose and Service User Guide is available to residents and other people who use the service. Both documents are available in an accessible format for people who use the service. We were told that the documents can be made available in other formats, for example large print or audio if needed. The two residents identified to be followed through the case tracking process were both able to confirm receiving information about the home. Residents and family members spoken with said that the information helped them when making decisions about the suitability of the home. One relative told us that they received a welcome pack, which gave them a lot of Care Homes for Older People Page 11 of 29 Evidence: information about the home. Examination of the two residents care files shows that a thorough assessment of their care needs had taken place before admission to the home. Assessments had involved the potential resident and their family in identifying their care needs. Family we spoke with said that they had visited the home before moving in. The manager told us that the assessment process involves the resident visiting the home and staying over night if necessary. This visit gives the opportunity for the prospective service user, their carer, other residents and staff to get to know each other, identify and assess care needs in the care home environment. Assessing the home in this way helps both parties to be sure that the home can meet the persons needs and provide the support required to ensure their safety whilst living in the home can be given. Staff at the home also visit prospective residents in their own homes or in hospital if it is easier for them. One of the residents spoken with said: I used to visit all the time because my husband was here. Everyone was so welcoming, it (Home) felt comfortable. She Resident) came to visit and did not want to leave. Care Homes for Older People Page 12 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. Standards 7, 8, 9 and 10 were assessed. Care plan documentation is well laid out. However they do not demonstrate clearly what action staff should take to meet residents care needs, which would make sure residents receive appropriate care and support at all times. Medication practices have improved, which will ensure that residents are protected at all times. Evidence: The two residents identified for case tracking were seen, spoken with and the interaction between them and staff were observed. Residents were comfortable and happy with the staff as they helped them with their care needs. Examination of two care files showed that the standard of care plan documentation was not consistent. Written details showed that they did not always contain clear or specific guidance for staff on what action they need to take to meet residents health and personal care needs. For example, the care plan for a resident identified as at risk Care Homes for Older People Page 13 of 29 Evidence: of developing pressure area damage did not indicate if equipment for example, special cushions which would help to relieve pressure when sitting down was needed. The resident was observed to have a cushion available and a suitable mattress on their bed. A further example was for a resident for whom concerns were expressed about their appetite in daily statements read. The care plan for this person identified following assessment that the person had a poor appetite. However there was no guidance for staff to describe what action they should take to support and manage the resident with their nutritional needs and to maintain their appetite. For example the plan of care did not show what foods the person liked to eat. Speaking with this resident they told us that their appetite had improved and they were enjoying the food in the home. Staff spoken with were knowledgeable about these residents. However it would be difficult for new staff in the home to determine from the care plans what care they should be giving to individual residents without asking other members of staff. Two further care plans briefly examined showed that they also lacked guidance on action staff should take to meet peoples care needs. The lack of documented information describing how residents care needs should be met means that there is a risk of people living in the home not receiving all the care they need. Risk assessments are carried out on all residents admitted to the home these include falls, moving and handling and mobility both in and outside the home. An example of this was for residents who wanted to take trips outside of the home, whether for shopping or visiting friends or relatives. Carrying out risk assessments will ensure residents take managed risks with support as required and protect them from potential harm. Entries in residents health records and comments by staff confirmed that people are supported to gain access to relevant health professionals where required, such as the GP, Optician, Dentist and Chiropodist. Conversations were held with the residents in the home they were very receptive and liked to talk about the care they received. Observations made during the visit showed that residents were relaxed in the house and integrated well with staff and other residents. Speaking with relatives and residents they told us that they had been involved in planning their care needs. Information contained in the AQAA confirmed that this approach is taken when writing care plans. People living in the home were well groomed and dressed. Residents personal care needs were met in their own bedroom, which have en suite facilities or in communal bath/shower rooms. Residents felt that care staff showed them respect and helped them to maintain their privacy and dignity when helping them to meet their personal care needs. Care staff were observed speaking to residents politely and in a friendly Care Homes for Older People Page 14 of 29 Evidence: manner. The management of medicines in the home was examined; procedures had been completely reviewed resulting in improved practices. The monthly stock of medicines is safely stored in locked cupboards. Staff receive training in the safe administration of medicines. The medication administration records for the two residents reviewed through the case tracking process show that they are well maintained. There were no omissions on the records. Improvements in medication practices should protect residents from the risk of harm. The medicine fridge temperatures are being monitored and information examined detailed the minimum, actual and maximum temperatures. The recordings show that the temperature is being effectively maintained to keep this below 8 degrees centigrade, which will ensure the stability of medicines. Care Homes for Older People Page 15 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 12, 13, 14 and 15 were assessed. Residents are able to live and maintain their daily and social life, which offers choice and control in how they spend their day-to-day lives. Evidence: Residents said that activities take place in the home and they have a choice whether they join in. On the day of the inspection, most residents were up sitting in the lounges. There was a social atmosphere especially in the ground floor lounge where residents were actively listening to and singing carols. Residents were talking to each other, knew each other by name and were very willing to speak to us. A couple of residents chose to stay in their bedrooms. Bedrooms have sufficient space for residents to have a comfortable chair where they can sit in their room and watch television, listen to the radio or receive their visitors in private. Relatives, friends and other visitors are encouraged to visit throughout the day and maintain contact and involvement in the care of their relative. Visitors were observed to visit the home at the time of inspection. Relatives visiting the home were able to Care Homes for Older People Page 16 of 29 Evidence: make themselves a drink. They were very relaxed, chatting with residents and staff. Residents spoken with said that they were free to come and go from the home as they pleased. Residents said that they made visits out to the shops, visited friends or family or other event in the community with the support of their relative or a member of staff. Residents spoken with described the home as Home from home and some residents simply said that they enjoyed living in the home. There was a nun visiting the home at the time of the inspection. The nun is involved in helping residents to meet their religious and spiritual needs and church services are held at the home. Residents looked forward to their meal at lunchtime and were able to tell us that it was fish and chips day. The inspector had a meal this was tasty and well presented. Mealtime was a social occasion residents sat in the dining rooms to eat their lunch. Residents said that they had enjoyed their meal. One resident said that the choice of food available was very good and they looked forward to mealtimes. Residents were asked if they were able to have different types of food such as Chinese or Indian dishes, people told us that they are but preference was for ordinary food. One resident summed it up be saying I like plain old fashioned cooking. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 16 and 18 were assessed. Complaints are investigated and staff have access to training and procedures related to the protection of vulnerable people. This practice increases residents feeling of safety and quality of life in the home. Evidence: Policies and procedures are in place to support staff in managing any complaints received by the home. Speaking with residents and relatives at the inspection they told us that they have not had to make any complaints. People living in the home said that they found it easy to talk to the care staff. Residents told us: I like living here. I feel safe living here and that The staff always listen when I am talking to them. There have not been any complaints made to the home since the last inspection. One complaint was made directly to Social Services and reported to the Commission. This was related to concerns about poor standards of care. The complaint was investigated and has been satisfactorily resolved. Staff spoken with were aware of the complaint procedure and was able to comment on the action they would take if they received a complaint. A policy and procedure detailing the action to be taken by staff to ensure the Care Homes for Older People Page 18 of 29 Evidence: protection of vulnerable adults was examined. Training records show that staff had attended training related to the protection of vulnerable adults in the last year. Discussions with two members of staff demonstrated that they are aware of their role and responsibility in reporting any suspicion of, or actual harm to residents. Information in the AQAA and confirmation from the deputy manager told us that the home has not had to make any referrals related to concerns about abuse of people in their care. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 19 and 26 were assessed The internal and external surroundings of the home provide a comfortable and safe environment, which should have a positive effect on residents wellbeing. Evidence: We were shown around the home by the deputy manager. The homes presents a homely environment and was observed to be fresh and clean. Bedrooms are located on the ground, first and second floor of the home. Residents with the support of their relatives and staff have personalised their bedrooms with some of their own possessions. The bedrooms of the residents followed through the case tracking process were observed to be individual, homely and looked comfortable. Comments received from residents spoken with include: I like my room. My family have helped by bringing some of my things in. Its comfortable. Care Homes for Older People Page 20 of 29 Evidence: Lounge/dining areas are available on all three floors. Residents were sitting in all three lounges in suitable chairs that they felt comfortable in. The home provides equipment necessary to assist residents to maintain their mobility and independent access around the home. Grab rails are positioned throughout the home. Most of the residents use Zimmer frames to help them move around the home safely. Residents said that they felt it was easier and safer when they used their Zimmer frame. The laundry in the home is sufficient to meet the needs of the residents and the size of the home. The laundry room was seen to be organised and clean. The member of the staff working in the laundry was aware about safe working practices. She was able to tell us about the temperatures for washing clothes, storage of chemicals to ensure safe practices and how soiled linen and clothing are washed in special bags that dissolve to prevent cross contamination and the spread of infection. The member of staff took good care when laundering residents clothing. Care Homes for Older People Page 21 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 27, 28, 29 and 30 were assessed. Information related to the training and recruitment of staff ensures that skilled and sufficient staff are available to support meeting the health and personal care needs of residents. Evidence: Examination of duty rotas, the number of staff seen on duty at the time of the inspection and comments from residents such as staff are available when I need them showed us that there was sufficient staff to meet the needs of people living in the home. Discussions with one of the care staff told us that there is one care staff on duty on each floor. There is a fourth carer available to work where they are needed most in the home. Duty rotas did not show the time of shifts worked by some staff showing either am and pm. Producing duty rotas in this way does not make it clear that the home was suitably covered by staff at all times of the day. The Manager and Deputy Manager were able to explain the procedures they have followed to recruit staff. The files of two recently employed staff examined confirmed that robust and safe recruitment procedures are followed to ensure that residents are protected. The staff files showed that application forms were completed, two Care Homes for Older People Page 22 of 29 Evidence: references were obtained and Criminal Records Bureau checks had been carried out. The interview process showed that set questions were asked and records of the candidates answers were maintained. This would provide evidence of fairness and equality during the recruitment process. However interview records examined showed that the individual comments and marking criteria had been crossed out and changed on the original records. We were told that this is the process followed when the interviewers discussed whether the candidate was suitable to be employed in the home following the interview. Separate documentation was not available to show what discussion and decisions had been made to say whether the candidate was suitable. New staff have an induction period, which involves a basic introduction to the home and is designed to support staff to move onto starting the National Vocational Qualification (NVQ) in care. Training records demonstrate that staff are up to date with training. In discussion staff said that they had received training in fire safety, infection control and Moving and Handling. Other training evidenced as attended by staff includes medicines management, challenging behaviour, continence awareness, adult protection and falls awareness. Ensuring that staff attend training means that they should have the appropriate skills and up to date knowledge to be able to carry out their role when meeting the care needs of people living in the home. Residents spoken with told us that: The staff are very nice. They (staff) show that they care. Care Homes for Older People Page 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 31, 33, 35 and 38 were assessed. Management arrangements in the home support meeting the needs of residents and promote the quality of service provided to them. Evidence: The Registered Manager and her deputy were present at the inspection. The deputy manager was involved throughout the inspection. The manager was busy having returned from sick leave, it was agreed that the deputy manager would be available through-out the inspection. The home manager was available if needed and was able to join us towards the end of the inspection and was present for the feedback. Both were knowledgeable about the residents living in the home. The Home Manager and her Deputy are both suitably qualified to run the home and have a number of years experience in caring for older people. Care Homes for Older People Page 24 of 29 Evidence: Information in the AQAA confirmed conversations held with residents that regular residents meetings take place. Issues discussed are related to developments planned for the home. Staff feel that residents involvement and feedback are a key part of their work and the success of the home. Monies are held by the home on behalf of a number of residents for safekeeping and are stored safely and securely. The records of residents followed during the case tracking process were examined. The system is robust and evidence of good practice was seen. Residents money is held separately in individual envelopes. Manual records are held of financial transactions and these were suitably maintained. Accounts are suitably audited every two months. Staff are supervised at least six times per year this includes an annual appraisal. Staff files showed that the outcomes of supervision sessions are consistently recorded. Topics discussed and action or activity that staff would be undertaking before their next supervision to demonstrate any progress made were identified. Records examined and a tour of the home show that servicing of fire fighting equipment, electrical appliances and hoists takes place on a regular basis. Fire safety management includes regular testing of fire alarms, emergency lighting, and all records relating to fire safety management were up to date and in good order. Examination of maintenance records for the passenger lift showed that at the last service work had been identified as needed to be carried out. The Manager told us that the work had been done, but was unable to produce appropriate documentary evidence to confirm this. The lift was seen to be working on the day of the inspection. Care staff used the lift when supporting residents to move from one floor to another and we also used the lift. The Manager agreed to provide us with documentary confirmation that the work had been completed. This would confirm that the lift is safe for use. This information was received by us on 30 January 2009. A record is maintained in the home of any accident or incident that happens to a service user. Records show that instigating first aid measures or accessing medical aid if necessary appropriately manages the outcome of any accidents to residents. Practices show that health and safety measures are addressed to ensure the protection of people using the service. Care Homes for Older People Page 25 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 26 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 12 Care plans must provide 22/01/2009 staff with clear guidance on how to meet the care needs of people living in the home. This will make sure that residents receive care which meets their assessed individual health and personal 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 1 27 Duty rotas should show the time staff working in the home are intended to start and finish their shift. This will help to provide accurate information to show that people living in the home have staff available to meet their needs over a 24 hour period. Original records that show the outcome of the interview process as indicated by individual interviewers should not be changed. This will make sure that robust information of how the interview was carried out in respect of fairness and equality. The home should forward documentation to the Page 27 of 29 2 29 3 38 Care Homes for Older People Commission that confirms that the work required on the passenger lift has been completed. This will provide evidence that the lift is safe for people to use. Care Homes for Older People Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - 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. 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