Inspection on 03/10/08 for Hadley Place Residential Home

This inspection was carried out on 3rd October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hadley Place Residential Home 05/10/07

Hadley Place Residential Home 27/09/06

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Hadley Place Residential Home 301-305 Anlaby Road Hull East Yorkshire HU3 2SB     The quality rating for this care home is:   two star good 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: Beverly Hill     Date: 0 3 1 0 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. the things that people have said are important to them: They reflect 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 28 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 28 Information about the care home Name of care home: Address: Hadley Place Residential Home 301-305 Anlaby Road Hull East Yorkshire HU3 2SB 01482212444 F/P01482212444 glaing@thearchesltd.karoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Gaynor Louise Laing Type of registration: Number of places registered: Hadley Place Limited care home 29 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: Care to be provided for 6 named service users (names on CSCI files) in category MD who are under 65 years of age. One named service user under pensionable age can be cared for at the home . Date of last inspection Brief description of the care home Hadley Place is situated on Anlaby Road approximately a mile from Kingston upon Hull City centre, offering residential accommodation for a maximum of twenty-nine people including six people with a mental disorder who may be under the age of 65years. Accommodation is available over four floors and a passenger lift accesses three of these. The forth floor is accessed by stairs and is for more ambulant people. The home Care Homes for Older People Page 4 of 28 Over 65 29 6 29 0 0 0 Brief description of the care home has twenty-one single bedrooms and four shared rooms. A number of the single rooms are en-suite. Communal rooms consist of three lounges, two of which are situated on the first floor, a small sun room and a dining room. There is also an additional small room leading from the dining room set up with an extra table and chairs. The home has a walk-in shower room and two unassisted bathrooms. There are sufficient toilets throughout, which are close to communal areas. To the rear of the home there is a small patio area with garden furniture and a ramp for wheel chair access to the back door. There is secure car parking for approximately nine cars. The current scale of charges is #348.50 per week. Additional charges include hairdressing, chiropody, toiletries, newspapers/magazines and trips out. Information about the home is included in the statement of purpose and service user guide, which are located in the home and distributed to potential service users. Care Homes for Older People Page 5 of 28 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: two star good 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 2 star. This means that the people who use this service experience good quality outcomes. This inspection report is based on information received by the Commission for Social Care Inspection (CSCI) since the last key unannounced inspection on 5th October 2007, including information gathered during a site visit to the home, which took approximately eight and a half hours. Throughout the day we spoke to people that lived in the home to gain a picture of what life was like at Hadley Place. We also had discussions with the deputy manager on the day, the registered manager a few days later, and care staff members. Information Care Homes for Older People Page 6 of 28 was also obtained from surveys received from seven staff members and two visiting health professionals. Comments from the surveys and discussions have been used in the report. We looked at assessments of need made before people were admitted to the home, and the home’s care plans to see how those needs were met while they were living there. Also examined were medication practices, activities provided, nutrition, complaints management, staffing levels, staff training, induction and supervision, how the home monitored the quality of the service it provided and how the home was managed overall. We also checked with people to make sure that privacy and dignity was maintained, that people could make choices about aspects of their lives and that the home ensured they were protected and safe in a clean environment. We observed the way staff spoke to people and supported them, and checked out with them their understanding of how to maintain privacy, dignity, independence and choice. We would like to thank the people that live in Hadley Place, the staff team and management for their hospitality during the visit and also thank the people who completed surveys. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the services are not being put at significant risk of harm. In future if a requirement is repeated it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? Nearly all the requirements and recommendations issued at the last inspection had been met. The management of medication had improved a lot since the last inspection although there was an issue about consistency when staff had to hand write information onto the persons medication record. See below. The proprietor had made improvements to the environment. New tables and chairs had been purchased for the dining room and easy chairs for some of the lounges. Some bed room furniture had also been replaced. The corridors, apart from the upper floor, had been recarpeted. The dining room had been extended with an extra room leading off the main room and work is currently underway at the rear of the building to build a covered area for people that wish to smoke. The manager ensures that the Commission are made aware of any notifiable incidents and the way staff are supervised and consulted has improved. Care Homes for Older People Page 8 of 28 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 28 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 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home only admits people after a full assessment of their needs has been completed so that staff can be sure identified needs can be met in the home. Evidence: There was evidence that residents had had their needs assessed prior to admission to the home. We examined five care files during the visit, two of which were for new residents. The registered manager had obtained assessments and care plans completed by care management for people funded by the local authority. The home also had in house assessment documentation and used this to assess the needs of people self funding their care and also to check out that needs had not changed since care management had completed an assessment. The assessment documentation covered all aspects of personal, health and social care needs. The manager or deputy manager completed the assessments for new residents. Care Homes for Older People Page 11 of 28 Evidence: This process of assessment ensured that the home had full information about people prior to admission and helped staff decide if needs could be met in the home. In one of the homes own assessments examined the sections had been completed only briefly. This gave only minimal information and an improvement would be to give a fuller picture of the persons needs and tasks staff would have to complete to meet them. Following assessment the manager formally writes to the person or their representative stating the homes capacity to meet the identified needs. The home does not provide intermediate care services. Care Homes for Older People Page 12 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensured that peoples health and personal care needs were planned for and met. Evidence: Five care files were examined during the visit. Assessment information had been used to complete plans of care for people. There had been an improvement since the last inspection regarding care plans. Care plans were thorough and contained information about peoples needs and how these were to met by staff. They were signed by the person they were about, or their representative, as agreed and were checked on a monthly basis to ensure they did not require any changes. The care plans alerted staff to maintain peoples privacy, dignity and independence, for example by indicating clearly and consistently peoples preferences and what the person was able to do for themselves. In discussions staff were clear about peoples needs and the tasks they had to complete to meet them. Care Homes for Older People Page 13 of 28 Evidence: There was clear evidence that people had access to, and received support from, health care professionals. This was confirmed via discussions with people in the home, care staff members and a visiting district nurse, and also from daily recording. People had their weight monitored and appropriate referrals had been made to dieticians. Care staff members were aware of who to contact in emergencies during the day and out of hours. Staff had recently coped well and contacted the appropriate agencies during a situation that had occurred in the home. People stated that their health and personal care needs were met, the district nurse visits every day as I got a sore in hospital, its nearly healed now, Ive been to the dentist recently for a new set of teeth, oh yes we are looked after well, the staff consider my needs, I saw my optician in April and the staff help me get ready. People confirmed care was provided in ways that respected privacy and dignity. Risk assessments were completed and evaluated and updated when required. There had been some improvements made in the way medication was managed. Medication was signed into the home and when administered to people. It was stored appropriately and stock was controlled well. Medication was returned to the pharmacy when required. To improve the home needs to record the temperature of the fridge used to store medication and consistently have two signatures when handwriting instructions onto the medication administration records mid-cycle. Some people did not have a photograph in the medication folder to assist in their identification prior to administration of their medication. Care Homes for Older People Page 14 of 28 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. The home ensured that people had a good quality of life and enabled them to make decisions about as many aspects of their life as possible. Evidence: People spoken with confirmed the home had flexible routines and open visiting. Visitors were seen coming and going during the day. Comments from people about the homes routines and how independence and choice were promoted were made to us throughout the day from every person spoken with. It was very clear that this was an important issue for all staff members. People said to us, I look after myself, I wash, dress and shave myself, I can get up and go to bed whenever, the staff are very genuine, they help you and listen to you, Ive been in a couple of homes and this beats them, Ive been up since 6am, there is no pressure from staff, we get ourselves dressed whenever we want, we can make ourselves a drink, I like living here, all my friends are here, you can have a lie in if you want, I make my own decisions, there are no set times for visitors, Im happy doing my own thing, I dont go on the trips, I dont want to, I use the key to go in the main kitchen to make a cup of tea and I manage my own money. Care Homes for Older People Page 15 of 28 Evidence: There were plenty of activities to keep people occupied and sky television has been installed in the home accessible in bedrooms and the lounges. People enjoy watching sky sports and movies and are considerate to each others preferences. One person told us that they know a resident likes to watch particular movies during the day so always checks with them if there is a football match they want to watch. People told us they had weekly trips out, had visiting entertainers, theme nights, bingo sessions, exercise to music, hand and nail care, arts and crafts, and games such as dominoes and quizzes. People went out to local shops to buy newspapers, toiletries and sweets etc and enjoyed trips into the city centre shops. People with dementia care needs had one to one support for activities. Staff told us that local clergy visited particular residents and about six to eight people attended a weekly, over 55s session at the local pub. Four residents were going to Pickering for a long weekend with staff this month. People were very happy with the meals provided to them. They told us they had choice and alternatives and had plenty to eat and drink. Some people were more able and had access to a kitchen area to make their own drinks. Peoples nutritional needs were met and there was evidence of professional dietician input when required. Care Homes for Older People Page 16 of 28 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. People lived in an environment where they felt able to complain and were protected from abuse by staff adherance to policies, procedures and safe practices. Evidence: The home had a complaints policy and procedure that was displayed in the home. There was a form for complainants or staff to use to record issues people were unhappy with. As well as space for indicating what the complaint was and what action was taken to address it, the form guided staff to decide if a follow up review was required. The manager had also set up a file to record any complaints. Two complaints of a minor nature had been recorded since the last site visit and both had been addressed appropriately. People spoken with during the day stated they were happy with their care and felt sure staff would sort out any problems for them. They were clear about how to complain and most quoted the manager by name as the person they would go to. Comments were, I would go to Gaynor, Ive never had to make a complaint, Gaynor would listen, I would ask her to shut the door and she would, I have no complaints and I would go to Gaynor or Jack (the proprietor). Care staff spoken with also knew what to do if someone raised a concern or complaint Care Homes for Older People Page 17 of 28 Evidence: with them. The home had access to the local authority multi-agency policies and procedures in safeguarding vulnerable people from abuse. Staff had received training in how to safeguard vulnerable people from abuse via a DVD and discussions in induction, and six senior staff had completed more comprehensive training with the local authority in March 2008. The manager had made a request to the local authority for this training to be given to nine other staff and was awaiting confirmation of dates. In discussions staff were able to demonstrate a knowledge of different types of abuse and the importance of making sure people were safe, and reporting any issues to their line manager. The registered manager had completed local authority training and was fully aware of referral and investigation procedures. The local authority had received a safeguarding alert in April 2008 regarding the actions of one staff member. It was investigated but the resident did not want to pursue it so it was closed without any further action. Care Homes for Older People Page 18 of 28 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 provided a clean and safe environment for people to live in and staff to work in. Evidence: Accommodation is available over four floors and a passenger lift accesses three of these. The forth floor is accessed by stairs only and is for more ambulant people. The house was well maintained and maintenance personnel dealt with health and safety and any repair issues quickly. Records continue to be maintained of when an item or job was reported as needing attention and also when it had been completed. There has been some improvements to the overall environment since the last site visit. An extra room has been created off the dining room and is set up with another table and chairs. This can be used for people with more independent living skills and the manager advised there were further plans to make it self contained so some residents could help themselves to coffee and tea and have access to their own crockery, cutlery and plates to set the table. At the moment some residents have access to part of the main kitchen to make their own drinks. New carpets have been fitted in the dining room, lounges and corridors apart from the upper corridor which was only re carpeted in 2005. New tables and chairs have been Care Homes for Older People Page 19 of 28 Evidence: purchased for the dining room and new comfortable chairs purchased for one of the lounges, the sun room and five of the bedrooms. Five additional chairs have been ordered for other bedrooms. Five bedrooms have had new wardrobes and chest of drawers and eight lockable cabinets have been installed. This told us that the proprietor was proactive in improving the environment for people. The home currently has two lounges on the second floor, one of which is for people wishing to smoke. Plans are in place to build a covered smoke area at the rear of the home and building work has already started for this. At the same time the rear entrance and corridor is to be widened to allow more space for people in wheelchairs to access. The rear exit at the moment is looking in need of refurbishment so the plans will address this shortfall. The home was clean and tidy and free from any malodours. The home had a laundry sufficient for its needs and a requirement issued at the last visit regarding installing paper towels instead of cotton ones in communal bathrooms and toilets had been met. People spoken with were happy with their bedrooms and the home in general. Those in shared rooms had privacy screens in place and the one room where one was seen to be missing was addressed straight away. Not all bedrooms had lockable facilities but a system of replacing bedside cabinets with a locked drawer had been started. All bedroom doors and bathrooms/toilets had privacy locks in place. Care Homes for Older People Page 20 of 28 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. A gap in training could mean that staff may not have all the required skills to support people with dementia. Employing people routinely prior to the return of full checks could place people at risk of being supported by unsuitable staff. Evidence: Staff members confirmed there was usually four care staff on duty in the morning as well as the manager, three in the evenings and two at night. There is a manager on call system for during the night. When fully staffed this is sufficient to meet the needs of people living in the home. There had been some issues recently due to holidays and sickness and staff reported that when the morning numbers dropped to three care staff people did not get the quality time they would like to give them. However it was reported that this did not happen very often. One staff member started work at 7am to help with preparing breakfasts for people. The home had information about staff training needs and it was clear the manager collated this via supervision and appraisals. The manager confirmed the training plan included mandatory training such as fire prevention, infection control, health and safety, basic food hygiene, safeguarding adults from abuse and first aid, and service Care Homes for Older People Page 21 of 28 Evidence: specific training such as mental health, the implication of mental capacity legislation, Parkinsons disease and epilepsy management. The training plan had been misplaced in an office move but we could see from correspondence to the local authority and staff files that training needs had been assessed and courses applied for and attended. The manager had completed training in moving and handling to enable her to train other staff. Her certificate had expired and this training needs to be updated to ensure she is still able to deliver current moving and handling training to staff. There were still some care staff requiring updates in moving and handling. Staff had not received any training in dementia care and as some residents have dementia care needs it is important that staff have the required skills and feel confident to support people with dementia. The home has fifteen care staff, six of whom have completed a national vocational qualification in care at level 2. This equates to 40 percent of care staff trained to this level and is a good achievement. The home needs to aim for 50 percent. New employees completed skills for care induction standards and the manager signed off their competence. The work books did not show the evidence of their competence and although the manager confirmed discussions took place with each care staff member this was not documented. For good practice new staff should complete designated skills for care workbooks that evidence their completion of the standards. Part of the induction of new staff also includes an orientation to the home and ways of working. New staff were recruited in a generally safe way with application forms, references obtained and povafirst checks made against the adult protection register. Interviews were held and criminal record bureau checks completed. It was noted that staff started work routinely, after the povafirst, but before the full criminal record bureau check was returned. This must only be done in exceptional circumstances and reasons for this clearly documented with staff under strict supervision. Staff confirmed they always worked with experienced staff until full clearance was obtained. Care Homes for Older People Page 22 of 28 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. The home was well managed and was a safe place for people to live in and staff to work in. Evidence: The registered manager had completed a national vocational qualification in care at level 4 and had two units to complete of the management section of the registered managers award. She has had many years experience working in care homes and in a managerial role. She has completed various training courses in the last year including moving and handling, safeguarding adults from abuse, health and safety, mental health issues and epilepsy awareness. Updates in basic food hygiene and first aid have been applied for with the local authority. Briefings on mental capacity legislation is planned for November 2008. Staff spoken with described the manager as, approachable and stated that things are looked into once mentioned to her. Staff meetings take place and staff reported they Care Homes for Older People Page 23 of 28 Evidence: felt able to bring up issues. There was certainly a relaxed atmosphere in the home with visitors seen coming and going and good interaction was noted between the manager, staff and residents. Residents knew the names of the manager and deputy manager, which told us they were not office based all the time and were accessible to people. The home had a system for assessing the quality of the care provided that included monthly audits, which followed a timetable for the year. Surveys had been sent out to people and action plans produced to meet any shortfalls. The manager then completed a further check to make sure the action plan was carried out and had completely resolved the issue. People spoken with were happy with their care and confirmed they had the opportunity to express their views about the home. There were policies, procedures and guidelines for the management of residents finances. Relatives or people themselves manage finances including personal allowance and lockable facilities were available if required. The home managed some personal allowance for several people for safekeeping or to support them with budgeting. Individual records were maintained and receipts obtained when staff supported people to the shops to make purchases. On joint outings for several residents or when joint purchases were made, for example chiropody and hairdressing, the total receipt was held in only one residents file. This made spot auditing difficult and the home was advised to keep the receipt in one separate file but with clear reference to whom it referred in addition to recording the purchase as usual on the persons individual file. The registered manager had completed a staff supervision plan and the staff were on target to receive the required six, formal, one to one sessions per year. Supervision covered key worker role, residents files, care plans, changes to practice and ways of working and issues affecting residents. Some supervision sessions had been observation of practice whilst completing particular tasks. The home was a safe place for people to live and work in. The requirements issued at the last inspection relating to health and safety had been met. General equipment was serviced and fire alarm checks and drills completed so staff could familiarise themselves with emergency procedures. Staff received training in health and safety and first aid. There had been an incident when a resident was able to exit the home unnoticed. Since this episode alarms have been installed on the doors to alert staff. Care Homes for Older People Page 24 of 28 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 25 of 28 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 29 19 New staff must only start 30/11/2008 work after all checks have been completed. Starting staff after a povafirst but before the return of the criminal record bureau check must only be done in exceptional circumstances and not as a matter of routine. This will help to ensure vulnerable people are not supported by inappropriate care staff. 2 30 18 Staff must be provided with training to meet all the needs of people living in the home in line with the homes statement of purpose. This will ensure staff have the right skills and knowledge to care for people with dementia. 31/03/2009 Recommendations Care Homes for Older People Page 26 of 28 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 3 Staff completing in house assessment documentation should make sure that all sections are completed comprehensively to give a full picture of the persons needs and the impact this has on them. Staff should consistently use two signatures when handwriting instructions on medication administration records. This will evidence that safe practice is taking place on checking in new medication not already on the medication administration record. Staff should record the temperature of the medication fridge rather that just completing a visual check of the thermometer. This will evidence medication is stored at the correct temperature and that any problems with the temperature are identified and addressed. Menus should be on display so people can see what is on offer for the day and arrange alternatives if required. The home should continue to work towards 50 percent of care staff trained to national vocational qualification in care at level 2. Staff should receive training in dementia care to provide them with sufficient knowledge and skills to care for people with dementia. The registered manager should continue to progress through their registered managers award and renew their moving and handling train the trainers certificate. 2 9 3 9 4 5 15 28 6 30 7 31 Care Homes for Older People Page 27 of 28 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). 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