Inspection on 24/07/09 for Hanford Manor

This inspection was carried out on 24th July 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hanford Manor 06/08/07

Hanford Manor 30/08/06

Hanford Manor 18/01/06

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Key inspection report Care homes for older people Name: Address: Hanford Manor 85 Church Lane Hanford Stoke on Trent Staffordshire ST4 4QD     The quality rating for this care home is:   zero star poor service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Peter Dawson     Date: 2 4 0 7 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: Hanford Manor 85 Church Lane Hanford Stoke on Trent Staffordshire ST4 4QD 01782642144 01782262956 hanfordmanor@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Hanford Care Homes Ltd care home 25 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 who can be accommodated is: 25 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: Dementia (DE) 5, Old age, not falling within any other category (OP) 25 Date of last inspection Brief description of the care home Hanford Manor is a large detached Georgian property set in its own grounds in the village of Hanford. The home is on a `bus route with easy access to Stoke and Newcastle. There are good parking facilities. The building has been extended and provides accommodation for up to 25 people. Accommodation is on 3 floors and there is a shaft lift providing access to all floors. All bedrooms are for single use and 10 have en-suite facilities. There are 2 lounges overlooking the garden at the front of the building and other recessed areas also providing seating suitable to receive visitors. Care Homes for Older People Page 4 of 29 5 0 Over 65 0 25 Brief description of the care home One room is the nominated smoking area. There is a large separate dining area and 13 bedrooms also on the ground floor, the remaining bedrooms are on the first floor and 3 on the second floor. There are adequate numbers of bathroom/toilet areas throughout the building. In recent years most areas have been redecorated and refurbished, this includes communal areas and bedrooms. This process is ongoing. The grounds are large, pleasant, peaceful and private. There are patio areas surrounding the building used extensively in the summer months. The weekly fees charged can be obtained directly from Hanford Manor. 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: zero star poor service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last key inspection of this service was on 6th August 2007 An annual service review was completed on 5th August 2008. This was based upon our knowledge of the service and ongoing information we received about it, including a service self-assessment and written feedback from users of the service. We were satisfied that the 2 Star rating was still applicable to the service at that time. This unannounced Key Inspection was carried out by one inspector on one day from 08:30 - 17:00. The service completed the AQAA (Annual Quality Assurance Assessment) prior to the inspection. This a legally required self-assessment document, containing information about what the service think they do well, what progress they have made over the past year, what they think they could do better and their plans for improving the service Care Homes for Older People Page 6 of 29 over the next year. Some information from the AQAA is included in this report. Five people using the service and three members of staff sent us written feedback about their experience of the service prior to the inspection. During the inspection most people were seen and several spoken with individually and together. Two visiting relatives were also spoken with and expressed their views about the quality of the service. We inspected all the communal areas of the home and a sample of bedrooms. Records inspected included: Care plans, risk assessments, daily notes, medication records, staffing rotas and staffing records as well as other documents relating to the inspection process. There were 23 people in residence on the day of this inspection. There were 2 vacancies. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: A range of activities are provided but there is no written evidence of this. Efforts to record individual activities provided should be made. Care plan reviews have gaps, some many months. They should be reviewed monthly. Care Homes for Older People Page 8 of 29 As a means of increasing feedback about the service, relatives meetings could be considered. Written feedback from professionals should be sought as a means of improving information about the level of service provided. This could include: GPs, District Nurses and other health care professionals as well as Social Workers, Advocates and others providing a service to the home. There is no formal supervision for staff. This should be established on a regular basis, although annual staff appraisals have commenced. It is important to refer all matters to the Safeguarding team where there is suspected abuse of vulnerable people. All incidents of aggression between people using the service must be referred in a timely way under Safeguarding procedures where this results in harm or injury to a person. A copy of the current Safeguarding procedures should be obtained and made available to all members of staff. Creams in use in the home should be prescribed where possible and their use recorded on Medication Administration Records as evidence of treatment prescribed or needed. The current infestation should have been dealt with sooner to avoid the serious actions that are now having to be taken. This presents a risk of infection and puts people using the service at some risk. The Manager must work closely with the Environmental Health Officer to resolve the issue of rodent control in the home. This matter should have been notified to us under Regulation 37 of the Care Home Regulations - we must be notified, without delay, of any event affecting the lives of people using the service - this did not happen on this occasion. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 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. People can be sure their needs are properly assessed and that they have adequate information about the home, before making a decision to live there. Evidence: There is a statement of purpose/service users guide, a copy given to each person and available in all bedrooms. This information is not readily available in the home to people who may call and need information about the home - a copy was printed off for the purposes of this inspection. The information is satisfactory and informative, although it is important that fees are included in the statement of purpose so that people have all the information to make a judgement about the suitability of the home for them. A copy of the last inspection report is available in the reception area of the home. The AQAA states: Prospective service users are encouraged to visit if possible and if they wish they are welcome to spend some time at Hanford Manor for a meal, Care Homes for Older People Page 11 of 29 Evidence: overnight or a short stay. This was confirmed in discussions with a person recently admitted who had visited the home with her family before making a decision about the suitability of the home. Samples of records of people recently admitted showed that pre-admission assessments had been carried out in the persons current setting and also that a copy of the Social Workers Multi-disciplinary assessment had been provided before admission. In the past year the home have sought feedback from prospective and new people admitted to the home. The Registered person must also inform the person in writing, prior to admission, that the home can meet assessed needs. This is required under regulation 14. All people are given contracts/statement of terms and conditions. A random sample of a person funding their own care showed that a contract directly with the home had been provided at the point of admission. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and social care needs are known and met. More regular reviews of care plans and management of creams would further improve those outcomes. Evidence: A sample of care plans were seen for both recently admitted and longer-term people living in the home. Care plans contained details of health and personal care needs. There are nutritional assessments with details of diet, weight and support required for eating and drinking and waterlow to indicate the risk of pressure damage. We saw assessments for continence, moving and handling and the support required for personal care. Interventions by the GP and other health care professionals are recorded. Although some gaps were noticed these were generally satisfactory. Records relating to a highly dependent person cared for in bed were seen. Many interventions by the GP and district nursing service were recorded. This person is on a soft foam mattress, an alternating mattress requested but not provided. Staff turn the Care Homes for Older People Page 13 of 29 Evidence: person every 2- 3 hours in bed, records confirmed this. A fluid intake chart has been established for this person as a means of ensuring adequate daily intake. The charts recorded all inputs and it was suggested that they are recorded daily on a separate sheet and totalled, this will allow clarity for monitoring. Food supplements have been prescribed by the GP. The District Nurse is monitoring progress closely. She was seen in the home and confirmed that staff are providing a good standard of care for this person and work closely with nurses and follow all required actions/instructions. A District Nursing Team Leader was also seen later in the day visiting to administer insulin. She confirmed that there were good and positive working relationships with staff and had no concerns about health care issues in the home. Care plans are not reviewed monthly, although efforts are made to achieve this. There were some gaps but one care plan seen was last reviewed 9 months previously. A requirement was made at the time of the last inspection to review and monitor people closely following falls. There was evidence that this has happened. A person spoken with in the lounge who had a facial injury following a fall said that she now had a bed guard and felt safe at night. Bed guards with protectors were seen in her bedroom and also a review seen, following the fall. The home have a good record of safe administration of medication. No one selfmedicates at this time. Two people have insulin provided by the nursing service who visit twice daily for this purpose. Creams presented some concerns on this visit. A cream in one bedroom had no prescription label or name. In another room a tub of cream without prescription label or name, had exceeded the life of the product the use by date was 12 months previously. This was removed by staff immediately. Some prescribed creams and food supplements on MAR (Medication Administration Records) had not been signed for. Creams should be prescribed where possible and recorded and signed when applied. Care plans should include medication including creams and supplements prescribed, for what purpose and when and where to be given so that there is no confusion. All forms of treatment should be recorded. Creams should be dated when opened and disposed of in accordance with the homes policies and procedures and never exceed the expiry date on the product. No contraventions of dignity were noticed during the inspection, however written feedback sent to us by a relative and received after the inspection stated Residents dignity could be improved i.e. residents using commodes in bedrooms with the door open. The Manager should share this information with staff who must be diligent in Care Homes for Older People Page 14 of 29 Evidence: this area. The Manager said during the inspection that she had intended to discuss with staff some training in Dignity in Care at the next staff meeting - an opportunity to raise this matter with all staff. 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. People indicate that their chosen lifestyles are known and met that activities they can enjoy are available to them and the food is to their satisfaction. Evidence: The AQAA summarises the activities provided: A range of activities are on offer, such as newspapers, magazines, entertainers, social activities, art, craft and music. Contact with the local community is maintained via local schools and churches and groups such as indoor bowling, lunch clubs and exercise classes. Two residents attend their local church and social event on a weekly basis. Local concerts and theatre trips are provided on an ad hoc basis to meet demand. Unfortunately there was little written evidence of the range of stated activities enjoyed. Some people said that they were taken to church and clergy do visit the home. Two people have regular visits from Roman Catholic clergy. Pastoral care needs, important to several people were being met. Several visitors were seen and spoke positive about the care provided. Written Care Homes for Older People Page 16 of 29 Evidence: feedback we received prior to the inspection was similarly positive and included Hanford manor is a beautifully clean, homely place. The residents are well fed and extremely well looked after. The staff (from top to bottom) are very caring, treating the residents as individuals, looking after their welfare and giving them a loving environment to live in. We saw evidence of chosen lifestyles including few people up at 8.30 a.m, some arriving during the morning for breakfast, others had breakfast served in their bedroom. People accessed their bedrooms throughout the day, one seen in her bedroom prefers to stay in her room having her own daily routines and has all meals served there. People spoken with during the inspection said that they were happy with the activities provided. This was supported in written feedback from 3 people using the service who said that a range of activities were always available to them. A similar response was provided about the food provided, people were satisfied with the quality and quantity available to them, although in written feedback to us two staff said improvements could be made to cater for diabetics and people with swallowing difficulties and something better at teatime instead of a selection of sandwiches. We looked at menus that indicated a varied diet and choice at each mealtime. The menu of the day on the menu board simply stated sandwiches and cakes were available, although the weekly menu stated otherwise. Menus showed there was always a hot choice at teatime in addition to sandwiches. Staff had also indicated that a cooked breakfast in in the morning instead of cereal and toast should be provided. At the time of the last inspection a breakfast buffet had been introduced including cooked items. The Manager said that this has been discontinued due to falling interest and demand from people using the service. We checked and found that special food was available to diabetics and a soft-food diet provided for a person with swallowing difficulties. A person visiting her 97 year old mother who has been at Hanford Manor for over a year said her mother loves the food and has gained half a stone in weight and I am very happy with her care. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The safeguarding referral processes do not protect people using the service. Evidence: The home have received 6 complaints in the past year. They have been satisfactorily addressed. These relate to use of domestic equipment, relatives not informed of health care matters and lengthy response to call system. Two other complaints were made by neighbours when a person using the service was found wandering near to the home. The complaints procedure is available in the reception area of the home and there is a copy in all bedrooms. Four referrals have been made to the Safeguarding team in relation to the protection of vulnerable adults. One related to an allegation of physical abuse by staff. This was investigated but not substantiated. The home had referred the matter to the Safeguarding team but had been told (incorrectly) to make a direct referral to the police. Another related to a member of staff who assaulted a person using the service. She was suspended and dismissed. This was not referred to the Safeguarding team. Another concerned a referral to safeguarding in relation to a person assaulting another person using the service. It was found that an earlier similar incident had not been reported. Another Care Homes for Older People Page 18 of 29 Evidence: incident when injuries were observed on Saturday - was not referred to the Safeguarding team until Monday and not checked over the weekend. Out of hours incidents of suspected abuse should be reported to the Social Service Emergency Service. It is important that any suspected or actual incidents of abuse to a vulnerable adult is referred under the safeguarding procedures. The home do not have a current copy of the Staffordshire and Stoke on Trent Safeguarding procedures. This should be obtained. Staff have previously had training in Safeguarding Vulnerable Adults as evidenced by the staff training matrix and also confirmed in discussions with staff. Referrals under Safeguarding procedures have been initiated by staff. 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Close working with the Environmental Health Officer is vital to resolved the current problem of vermin present in the home. Evidence: There has been a continual programme of improvements and upgrading of the environment over recent years. Maintenance and improvements with a 5 year plan have been carried out. The improvements have been noticeable in all areas of the home including all the communal areas the majority of bedrooms, the kitchen, dining area and bathing areas. Upgrading has included necessary replacement of furniture and equipment. The external area of the home has also been improved. The grounds are extensive and provide a pleasant, private area where people can sit or walk. A summerhouse has been provided since the last inspection and been used extensively during the summer months. The AQAA states: We have promoted the use of the summerhouse and external seating areas. All areas of the grounds are accessible to all including those with wheelchairs. We have recently been informed by the Environmental Health Officer (EHO) that, following a complaint vermin have been found extensively throughout the building. Upon advice from the EHO a contractor has been commissioned to deal with this problem. During this inspection there was evidence in the communal and bedroom areas that this work was in the early stages. The EHO is monitoring the situation Care Homes for Older People Page 20 of 29 Evidence: closely and we will be informed of the outcome. The extent of the outbreak is serious and compromises the infection control measures in place, as well as presenting some risk to people using the service. 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. People using the service are supported by sufficient numbers of wll recruited and trained staff. Evidence: At the time of the last key inspection we were concerned about inadequate staffing levels at peak times of the day and specifically in the evenings when only two staff were on duty. We had received complaints about this from people living in the home and from relatives. We made a requirement that adequate numbers of staff must be deployed at all times. This has been actioned. There are now 3 staff on the afternoon shift which includes evenings. Additionally, the number of staff on duty on the morning shift has been increased from 3 to 5 on a phased basis - 5 people were seen on duty on the day of this inspection. The staffing levels of the home over the 24 hour period are 5:3:2. This is a vast improvement and will ensure greater safety and an improved service for people. Staff training has been a positive feature in this home. The AQAA states Investments in staff training and development is seen as essential and important. The staff training programme has constantly improved staff skills. NVQ training is an integral part of the programme - all staff either have, or are involved in, NVQ training. Care Homes for Older People Page 22 of 29 Evidence: A member of staff spoken with privately spoke of the many training courses she had attended and confirmed that training is readily available and improves the care we are able to give to residents. Staff recruitment procedures have shown room for improvement in the past and has been gradual. A requirement was made at the time of the last key inspection to ensure all references were appropriately obtained prior to employment. We saw a sample of staff records during this inspection and improvements had been made. All required checks, references and documentation required were present in records. These improvements mean that people are protected as far as possible from potential harm. 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Manager must taken timely action to ensure the health, safety and welfare of people using the service is paramount. Evidence: The Registered Manager takes a positive lead in the home and she is readily available to people using the service and visitors on a daily basis. Continuous improvement has been a key part of the approach of the Manager with investment in staff training, the building and quality of care. The Manager is also a Director of the company owning the home. The views of relatives are sought on a 6 monthly basis, the response rate has been around 30 . More recently the views of people shown around the home and those not admitted have been sought. The results of surveys are summarised in a 6 monthly Newsletter the home produces. Residents meetings are reported to be arranged but there is a poor response. Care Homes for Older People Page 24 of 29 Evidence: It as suggested the home considers arranging relatives meetings as a means of further feedback. It was also suggested that a range of professionals could be given questionnaires/asked to comment on the service. There is no formal supervision in the home, this was confirmed in feedback from staff. The Manager has commenced staff appraisals and is aware of the need for formal supervision for all staff. At the time of the last key inspection some areas of recording were considered poor, particularly in relation to the quality and quantity of daily notes. Some improvements were noticed in records seen during this inspection. Just prior to this inspection the EHO informed us of the serious infestation in the home. The Manager has not informed us of this in writing as she is required to do under Regulation 37 of the Care Home Regulations, or even verbally. Staff and people using the service have been aware of the infestation and have reported it. These reports have not been dealt with appropriately or recorded as complaints. Action should have been taken by the Manager to deal with the complaints as a matter or ugency. The actions taken were not proportionate to the seriousness and extent of the problem that existed. The existence of vermin seriously breaches the infection control procedures that are in place. This puts people as risk of potential harm and has created anxiety for people using the service, staff and visitors, many of whom have been aware of the problem for some time. This is unacceptable. The matter is being dealt with by the EHO who will take the approriate enforcement action. The continued co-operation and involvement of the Manager, working closely with the EHO is vital in resolving the problem. We are in contact with the EHO and will be monitoring the situation closely. 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 18 13 All incidents of suspected abuse must be referred swiftly under Safeguarding procedures This will ensure people are protected from further harm. 31/07/2009 2 19 23 The Registered person shall 31/07/2009 undertake appropriate consultation with the Environmental Health Officer to resolve the current infestation. This will ensure people are safe from infection. 3 38 37 The registered person must notify us without delay of any event which adversly affects the wellbeing or safety of any person using the service. This will ensure that the well-being of people is monitored closely. 31/07/2009 Care Homes for Older People Page 27 of 29 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 2 4 7 People should be informed in writing prior to admission, that their assessed needs can be met by the home. Care plans should be reviewed monthly and updated to reflect peoples changing and current objectives for health and personal care. All forms of treatment must be recorded including prescribed creams and supplements. Creams must be dated when opened and never used after the expiry date on the product. This will ensure people have the the medication prescribed to sustain good health. A record of activities for each person should be kept as a means of evaluating whether the social and recreational needs of people are being met. A copy of the local Safeguarding procedures must be obtained. This will provide guidance for staff in making Safeguarding referrals. Care staff should received formal supervision at least 6 times a year. This will provide them with the support they need to meet the needs of people using the service. 3 9 4 12 5 18 6 36 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. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!