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Inspection on 22/12/08 for Hartcliffe Nursing Home

Also see our care home review for Hartcliffe Nursing Home for more information

This inspection was carried out on 22nd 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There is clear and detailed information available about the home and pre-admission assessment processes ensure that placement is only offered to those people whose needs can be met. Medications systems are safe. People who live here will be able to participate in a wide range of social activities, will be supported to maintain contact with family and friends and will be provided with good meals. The home has a clear complaints procedure and this is supplied to relatives plus a copy displayed in the main reception area. The home is comfortable, well equipped and clean. All bedrooms are for single occupation and have en-suite facilities. The staff team has stabilised and people who live here will be cared for by staff who have been carefully recruited, are well trained and are supervised regularly. The home is well run and the best interests of the people who live there are paramount. People`s health and safety is promoted.

What has improved since the last inspection?

The requirements and recommendations made following the last inspection have been met although there continues to be a need to improve the care planning process.

What the care home could do better:

Care planning processes must be improved so that each person has a plan of care prepared that meets their own specific individual care needs. The plans must detail how these needs are to be met and must be meaningfully reviewed on a regular basis. The staff team must always ensure that people get the healthcare support that they need and that they take appropriate measures to prevent the formation of pressure sores. People must be assured that any complaints they have will be listened to and acted upon. Staff must always act to safeguard people from being harmed.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Hartcliffe Nursing Home Murford Avenue Hartcliffe Bristol BS13 9JS     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: Vanessa Carter     Date: 2 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. 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 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: Hartcliffe Nursing Home Murford Avenue Hartcliffe Bristol BS13 9JS 01179641000 01179641100 ruth.andrews@mha.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Methodist Homes for the Aged care home 66 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: May accommodate up to 66 persons aged 65 years and over requiring nursing care May also accommodate up to 10 persons with physical disability under the age of 65 requiring nursing care Date of last inspection Brief description of the care home Hartcliffe Nursing Home is owned by Methodist Homes for the Aged and provides nursing care for up to sixty-six older people and 10 persons with physical disability under the age of 65 requiring nursing care. It is located in a suburban position and can be accessed by public transport. Transport is needed to reach local shops and amenities. The home itself is purpose built and has now been in operation for six years. 64 bedrooms are for single occupancy and there is one shared room. They are set out over two floors, with the upper floor accessible via a passenger lift. Communal space is offered in 4 lounges and there is a spacious dining room on each floor. There is a small garden and parking spaces for visitors. The cost of placement varies between 500 and 627 pounds and will be based upon assessed needs. Further costs for some Care Homes for Older People Page 4 of 29 Over 65 66 0 0 10 Brief description of the care home services may apply and these are detailed in the homes brochure. This can be obtained direct from the home. 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: We have inspected this service before we had planned to do so because we had received a number of complaints from people who were unhappy about the care their relatives had been provided with. We spoke with the registered manager, qualified nurses and care staff, a visiting healthcare professional, some of the people who live in the home, and some visitors who were in the home. We looked at the homes records, including those kept about people who live in the home and staff who work in the home. Care Homes for Older People Page 6 of 29 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: 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 8 of 29 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. There is clear and detailed information available about this home and pre-admission processes ensure that placement is only offered to those people whose needs can be met. Evidence: The Statement of Purpose and Service Users Guide (called the Welcome Pack) are kept under regular review and updated as necessary. Both documents provide a detailed and clear picture of what the home has to offer. We were told by one person that they had been visited in their own home by the manager and that they had been given information about the home to read. This means that people will know what to expect when they choose to live at Hartcliffe Nursing Home. Each person will be provided with a Residential Care Agreement. Information is included in this about how the charges are determined and who is responsible for Care Homes for Older People Page 11 of 29 Evidence: which parts. The fees are detailed in a separate schedule. One person told us that this had been explained to them by their social worker and again on admission to the home. Prior to any placement being offered, a pre-admission assessment will be completed by either the home manager or another appointed person. Documentation looked at for two people, verified that people are assessed prior to admission and these measures will ensure that peoples specific care needs can be met when they live at Hartcliffe Nursing Home. The assessment tool used is comprehensive and covers all aspects of personal, health, emotional and mental health, and social care needs. This assessment is used to form the basis of the care planning documentation. 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. Care planning processes are not adequate and this could mean that people would not receive the specific and individual care that they require. Improvements are required in respects of end of life care planning processes too. Medication systems are safe. Evidence: Each person will have a plan of care prepared and three of these were looked at during the inspection. One of these plans was for a person who had recently been admitted to the home, whilst another was for a person with wound care needs. The third plan was randomly selected. Our judgement following examination of all three plans is that significant improvements are required in the way in which care plans are prepared, and this shortfall was acknowledged by the manager and other staff spoken with. Despite the fact that the assessment documentation covers a comprehensive range of needs, the information recorded is often not related to the assessed need or is written up in the wrong place. Examples of this include one spirituality plan where the assessment says not interested and the plan says what must happen. One persons Care Homes for Older People Page 13 of 29 Evidence: health promotion plan consisted of details regarding their daily personal care needs, despite there also being a personal care plan. Wound care planning was wholly inadequate. For one person a wound care dressing assessment had only been recorded on one occasion in a 12 day period, and the document was undated and unsigned. For another person with multiple wounds, although each wound had been care planned separately, the evaluation process was in respects of all wounds and provided no real review of wound progress or deterioration. Records should also be kept in date order, so that it is easier to monitor progress or deterioration. The person this related to was spoken with during the inspection and stated that their wounds have made a remarkable improvement since their stay in the home. Care plans are supported by a number of risk assessments - these are in respects of falls, moving and handling tasks, nutrition and the likelihood of developing pressure sores. The moving and handling risk assessment result in a safe system of work being devised and this is good practice although some could do with more information recorded in them. When the likelihood of developing pressure sores is identified, a preventative plan of action is not always prepared - this must be included on what is referred to as a tissue viability plan. This shortfall has the potential to mean that people who are at risk, will not be prevented from developing bed sores. We have been contacted by relatives who were concerned that appropriate pressure area care had not been delivered to their loved one and from what was seen during this inspection, appropaite care planning is not done to prevent pressure sore deveolpment. This must be addressed as a matter of urgency and was discussed with the manager and other staff during the inspection. Care planning documentation is generally reviewed on a monthly basis however the records made are meaningless and can be incorrect. Care plan reviewed No changes was frequently written and this does not evidence who was involved in the review process or whether the plan remain effective. For one person their elimination plan referred to a urinary catheter, the review referred to no changes and yet the catheter has been taken out some months before. This is not acceptable. Despite care planning and reviewing not being of an acceptable standard, those people who were spoken with during the inspection said that they were well looked after and received the care and support that they need. The staff are always very helpful and nothing is too much trouble, I am in better health since I have been here and that is because of the care I receive and my relative can be difficult but the nurses are always so patient with him were comments we received about the standard of care given. Records are kept of all contacts with GP practices and other healthcare professional. Care Homes for Older People Page 14 of 29 Evidence: Examples of healthcare professional who may visit the home include community nursing staff, chirpodists, dieticians, physiotherapists, opticians and dentists. One person who contacted us complained that there had been a delay in their relative receiving the appropriate medical attention. The homes investigation has supported this and the appropriate action has been taken with the staff involved. Medications systems are safe and there are robust procedures in place for the ordering, receipt, administration and disposal of medications. Signage is in place where oxygen cylinders are stored and in use. During the course of the inspection, the staff team were observed going about their duties in a kind and professional manner. Staff spoke with people who live in the home and visitors to the home is a courteous manner, but at the same time there was a lot of friendly banter. End of Life care planning issues were discussed with the manager. GPs must be involved in making clinical decisions about resuscitation and it is not good enough for staff to record that relatives have said they would not want their loved one resuscitated. This applies even when a person has been admitted for terminal care. 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. The people who live in this home will be able to participate in a wide range of social activities, are supported to maintain contact with their family and friends, and will be provided with good meals. Evidence: The home employs an Activities Organiser who works for 30 hours each week. This person has been helping prepare life histories for each person so that information is gathered about what people would like to do with their time. A range of activities are provided and people are able to choose which events they would like to participate in they can choose not to participate if this is their wish. One person said group activities are not for me but I am always told what is going on. Another person said I watch what is going on but dont want to join in. A lively game of bingo was held during the afternoon of the inspection. Since the inspection took place in the run up to Christmas, a Carol Service had recently been held, and each of the lounges and the main reception area were decorated for Christmas. There is church service held each Sunday and in addition people are able to see the visiting chaplain. The activity organiser keeps a record of all activities and events for the year but these were not inspected on this occasion. Care Homes for Older People Page 16 of 29 Evidence: There is an open policy of visiting and anyone is able to visit at resonable times. One relative told us that they like to visit over the lunch time period so that they can help feed their loved one. One person who lives in the home said that their family was able to visit whenever and that they had been supported to have some home visits. Observations made during the inspection visit and comments made by people who we spoke with confirmed that every opportunity is given to ensure that they are able to make their own decisions. People are asked about where they want to spend their time, what they would like to eat and what time they would like to get up and retire to bed. The home has a rolling menu plan and offers a choice of midday meal. People spoken with about the meals said that they were generally good but one person felt that the portions should be larger. This information was passed to the manager. A healthcare professional commented that the meals were always nicely presented and observations were made of staff supporting people to have their meals in an appropriate and unhurried manner. Drinks and homemade cakes are provided mid afternoon. The kitchens have had an environmental health officer visit in the last six months and have been awarded the top five star rating. 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 home has a clear complaints procedure but people must be assured that any complaints they have will be acted upon. Staff must always act to safeguard people from being harmed. Evidence: The homes Complaints Procedure is included in the Statement of Purpose and Welcome Pack and is also displayed in the main reception area of the home. Those people and the relative spoken with during the inspection said that they were aware of how to make a complaint and would feel happy about raising any concerns. One person said there is nothing to complain about whilst another said the staff always do try and put things right but sometimes I have to raise concerns again. Since the last inspection we have received three direct complaints from relatives who have been unhappy about the service has dealt with their complaints. The first complaint we asked the home to respond to again and their actions were deemed satisfactory. We discussed the second complaint with the manager during the inspection and were told about the investigation that had been carried out and how they were going to address the short comings that they had identified. We were also told of the measures that the manager had in place prior to this complaint being made, but that not all parties had co-operated. The complainants main concerns have been upheld and we will be asking for a summary and action plan of lessons learnt. Care Homes for Older People Page 18 of 29 Evidence: The third complaint initiated this inspection being brought forward and was in respects of lack of care by the staff in preventing pressure sore formation. This has already been referred to in the health and personal care section. The home has a protection of vulnerable adults (POVA) policy. Those staff spoken with during the course of the inspection demonstrated good awareness of safeguarding adult issues and of their responsibilities in protecting the people who live in the home. Staff will receive POVA training as part of their induction training programme and also on a regular refresher basis. However, despite these measures there have been a number of occasions when people have not been protected. The manager is already dealing with these incidents under disciplinary procedures. The registered persons must ensure that the staff team, and the actions that they take, always safeguard people from being harmed. The manager must also ensure that staff report any incidences of bad practice so that the appropriate actions can be taken and the appropriate agencies be advised of such incidents. 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. Hartcliffe Nursing Home is a comfortable, well equipped and clean home and people are cared for in single bedrooms that each have en-suite facilities. Evidence: Hartcliffe Nursing Home is a purpose built two storey care home. It is well maintained and provides private and communal facilities on both floors. Car parking for visitors is available to the left of the home and there is level access into the main reception area. Access to the upper floor is via a passenger lift, making the whole home fully accessible for people who have impaired mobility. All areas of the home are well decorated and appropriately furnished. There is access out in to the garden and the courtyard from the ground floor lounges - the doors are alarmed so that staff can be alerted to any person wandering out unaided. There are two lounge/dining areas on each floor and in addition one quiet room, used by the chaplain or for consulting with relatives. There are further plans to change one unused room into a multi-sensory room. In the lounges there are a variety of different types of armchairs in order to meet peoples different needs. Toiets and communal bathrooms with assisted baths or level access showers are located throughout the home in sufficient numbers to meet the needs of the maximum number of people who live there. Care Homes for Older People Page 20 of 29 Evidence: There are hoists, stand aids and other items to assist with moving and handling tasks. All beds are specialist profiling nursing beds, and the corridors are wide and fitted with grab rails. Specific items of equipment have been obtained for those people with particular care needs. There are 64 bedrooms for single occupancy, plus one shared room. Each bedroom is fully furnished, has en-suite facilities of a wash handbasin and toilet, and privacy screening is available in the shared room. Most of the bedrooms were seen during the inspection - people are encouraged to personalise their rooms and to bring in any small items of furniture and other items. The home was nice and warm on the day of inspection and well lit. The building works on the retaining wall to the right of the property have now been completed and the shuttering has been removed from the affected bedroom windows (this was referred to in the last inspection report). The home was clean throughout and there were no unpleasant odours. Those people who live in the home and relatives, spoken with during the course of the inspection, all confirmed that the home is kept nice and clean - my room is cleaned every day, the cleaners work very hard were examples of comments received. 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. Substantial changes have been made with the staff team and this has improved the way in which staff work together. This means that the people who live in the home will be cared for by staff who are committed to meeting their needs appropriately. Recruitment procedures are safe and staff are well trained and supervised regularly. Evidence: There has been a major change in the staff team following the last inspection, and several new registered nurses and care staff have been recruited. Both the manager and the deputy reported that the changes have brought about a positive effect on the staff team and that they are working together better. The home has an almost full compliment of staff with currently just one registered nurse vacancy. Agency staff will only ever be used as a last resort. This means that people who live in this home will be cared for by staff who are familiar with their care needs. Staffing levels are based upon peoples needs and the manager explained that currently staffing numbers were greater because a number of people had high dependency needs. A team of housekeeping, laundry and catering staff are supervised by the Hospitality Manager, plus there are administrative staff, maintenance and activities staff, employed to provide support in meeting peoples daily living needs. Care Homes for Older People Page 22 of 29 Evidence: Some staff have achieved at least an NVQ Level 2 in Care whilst others are working towards the award. All new recruits are expected to undertake NVQ training after they have completed their initial training and probationary period. A training log is kept for each staff member and a number of these were looked at to see what training staff have received. A range of training is arranged for both care staff and registered nurses and these include health and safety, risk assessment, infection control, first aid and staff management. All staff have to attend mandatory training and this consists of fire safety, manual handling, abuse and neglect training and health and safety. This committment to training ensures that the staff are competent, and have the necessary skills to meet peoples needs. Staff recruitment procedures are robust and the procedures followed for the last six new recruits were checked. For each person there was a written application form, two written references with at least one from a previous employer, a health declaration, and CRB and POVA1st clearance. These measures will ensure that only suitable staff are employed to work at Hartcliffe Nursing Home. 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. Hartcliffe Nursing Home is well managed and run in the best interests of the people who live there. Their views will be sought to ensure that the home meets the stated aims and objectives. Peoples health and safety will be promoted Evidence: Mrs Ruth Andrews is the registered manager at Hartcliffe and has been in the post for many years. She is a registered nurse and has many years experience in the care of the elderly and management of a care service. She is supported in this role by a deputy manager and a team of qualified nurses. The last Standards and Values Assessment was completed by Methodist Homes for the Aged in January 2008 and showed a significant improvement in the scoring achieved from the previous year. The home scored 100 customer satisfaction in the care section and an overall score of 87 . This quality assurance process will be completed again at the beginning of 2009. Care Homes for Older People Page 24 of 29 Evidence: The practice of storing care planning documentation for people who live in the home, in unlocked cabinets in the main communal areas of the home , mean that private information about people could be read by others. This must be reviewed urgently and alternative arrangments be made. All personal information should be kept secure at all times. Safe working practices ensure the safety of both the people who live in the home and the staff team. All the necessary environment and equipment checks are completed regularly, the fire log evidenced that the alarm system and fire fighting equipment is tested regularly, water temeratures are monitored, and the home is well maintained throughout. No health and safety concerns have been raised during this inspection. 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 15 The registered person must ensure that each persons plan is reviewed and revised as needed. Care plan reviews must be meaningful, evidence who was involved in the review and the plans must be revised as necessary 27/02/2009 2 7 15 The registered person must ensure that care plans are based upon assessed needs Care plans must be clear, detail what action staff are to take and take account of all their care needs 27/02/2009 3 8 12 The registered person must ensure each person has access to the healthcare services that they need Staff must make proper provision for healthcare matters to be addressed. 27/02/2009 Care Homes for Older People Page 27 of 29 4 18 13 The registered person must 07/02/2009 ensure that all staff are trained to prevent service users being harmed or being placed at risk of harm. Staff must make sure their actions do not harm service users and that the appropriate action is taken to report concerns about bad practice. 5 36 17 The registered person shall ensure that service users records are kept securely in the home They should not be stored in unlocked cabinets in communal areas. 07/02/2009 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 7 Safe systems of work devised following manaual handling risks assessments,should always provide specific instructions for staff to follow Decisions about resuscitation status must only be made by GPs and the appropriate records kept. This decision should be reached in consultation with the person, their relatives and the home. Provide CSCI with a summary of the findings following one specific investigation and an action plan as to how any improvements will be implemented. 2 11 3 16 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. 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!