Inspection on 14/01/09 for The Heatherfield

This inspection was carried out on 14th January 2009.

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

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

Other inspections for this house

The Heatherfield 30/01/08

The Heatherfield 31/08/07

The Heatherfield 18/10/06

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Heatherfield, The Lee Street Annitsford Northumberland NE23 7RD     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: Suzanne McKean     Date: 1 4 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Heatherfield, The Lee Street Annitsford Northumberland NE23 7RD 01912504848 01912502424 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): DAV Developments Limited Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 54 Number of places (if applicable): Under 65 Over 65 34 0 dementia physical disability Additional conditions: 0 20 Three people can be admitted between the age of 60 and 65 years within the DE category of registration Date of last inspection Brief description of the care home The Heatherfield is a purpose built home completed in 2006. Bedroom sizes are bigger than those stated in the current minimum standards. It is of traditional brick build design with a tilled apex roof. The home provides accommodation on two floors, both of which have lounges, dining rooms and bedrooms as well as toilet and bathroom facilities. The home is in Annitsford, North Tyneside which is a residential area of the small village between Dudley and Cramlington. There are shops in the village as well as public houses and restaurants. Access to the building is through the private car park in the reception area through Care Homes for Older People Page 4 of 29 Brief description of the care home eclectically controlled double doors. There are lifts to the upper floor are in the central area and at the cross section of the building. The outside of the home is turfed, paved and landscaped. The home is registered to provide care for two categories, dementia care for older people (on the first floor) and people who have a physical disability who are under 65 (on the ground floor). The home charges fees of between £395 and £684 per week depending upon the needs and requirements of the individual residents. As the home provides nursing care the free nursing care element of the funding is provided in addition to the costs charged to the resident. The home provides information about the service through the service user guide. A copy of the last inspection report from The Commission for Social Care Inspection is available in the entrance to 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: 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: 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 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 Summary: This is an overview of what the inspector found during the inspection. How the inspection we carried out:- Before the visit we looked at, the information we have received since the last visit on 30th January 2008. How the service dealt with any Care Homes for Older People Page 6 of 29 complaints and concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service and their relatives, staff and other professionals. The visit: An unannounced visit was made on 14th January 2000 it was started at 09:30 and was carried out over seven hours by two inspectors. During the visit we: Talked with people who use the service, relatives, staff, the manager and visitors. Looked at information about the people who use the service and how well their needs are met. Looked at the records which must be kept. Checked the staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building and parts of the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last visit. The home does not have a manager in post, we therefore told the Chief Executive, Mr Lamb, who was present throughout the the visit what we found. What the care home does well: What has improved since the last inspection? What they could do better: One requirements was made as a result of this inspection. This was to determine the source of the unpleasant odour in the home and take action to address it. The following recommendations were made. It would be beneficial for the staff on the dementia care unit to receive additional specialist dementia care training. This unit has a number of residents who present challenging behaviours and it would be beneficial for them to have more in depth specialist training in dementia care. Care Homes for Older People Page 8 of 29 Current best practice is to provide an environment which is targeted specifically to the dementia care needs of the residents and to make it more stimulating and give them opportunities to live more satisfying lives. It is acknowledged that the dementia care unit is decorated to the same high standards as the younger adults unit this could be reviewed for example by providing more items the residents could interact with in a positive way. Also by providing more prompts or signage to help those with memory loss find their way around would encourage them to retain a greater degree of independence. The use of small cloth pads (Kylie type) should be reviewed and alternative ways of managing continence should be found. The way that the meal times are organised should be reviewed to make sure that staff are able to give sufficient time to assist those who need support and that the meal time is a positive experience for all. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good admission assessments and information gathered before the placement makes sure that the home is prepared for the person moving in and that they can be confident that their needs will be met. Evidence: The home uses the company assessment document which is designed to give the staff in the home information a way of recording information about the needs of the people who are considering moving into the home or staying for a short period. The tool assists the staff to find out about all of the aspects of peoples lives and needs. The senior staff are confident that it gives the information needed to make the judgment about offering a place. The judgment to offer a place included making sure that they can not only meet the needs of the new resident but that they have considered the residents already in the home. Care Homes for Older People Page 11 of 29 Evidence: Potential residents can visit the home and spend time in the communal areas prior to making the decision to move in but those spoken to on the day had relied on their relatives to make the choice for them. 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. People living in the home have their health and personal care needs met in a planned way, and the care is given by staff who are friendly and respectful toward the residents. Evidence: Each person living in the home has an individual care plan which is developed from the detailed admission assessment and added to throughout their stay. These care plans show that the personal and health care needs of the resident are being met and how that is being achieved. The staff spoken to were knowledgeable about the contents of the care plans. They were able to describe the needs of the residents and were clear about the way that they had to record the care given and the need to report any relevant issues to senior staff. There are care plans for both the physical needs and the social care needs of the people living in the home. Necessary risk assessments are completed for a selection of areas including falls, nutrition and deterioration in skin condition. These were being Care Homes for Older People Page 13 of 29 Evidence: reviewed and the reviews were detailed and up to date. There were examples where there were gaps in the evaluations of the care plan, this occurred during a period when there was a change in staff and has now been addressed. Some areas of the care plans were particularly comprehensive in there level of detail, an example of this being around those residents who show challenging behaviours where they clearly show triggers and identify what the behaviours are, what the triggers might be, any management strategies, monitoring and recording arrangements. The care plans are person centered, one in particularly around communication was very well completed and easy for staff to follow. People living in the younger adults unit are particularly involved in developing their care plans. This was shown clearly in the documentation and the residents views confirmed this. The care plans showed that they are being supported to continue with their life goals including education and they are assisting them to adapt to their changing personal needs. They were able to describe the contents of their care plan and confirmed that they are offered the opportunity to discuss how they are supported. Residents are supported to access NHS services and facilities as and when they need to. The care plans showed that the specialist advisors are used for individual people living in the home and their advice is followed. The Community Matron visits the home to assist the staff to make good judgements about the way they meet residents needs make good clinical decisions. The home employs a physiotherapist, this is a positive service and unusual for a care home. He provides a service to both the older people in the home and those on the younger adults unit. The information in the care plans show that he is involved in both providing one to one intervention and in planning the care being provided by the other staff. The residents and their representatives are supported to take part in the review of their care. Residents said that they felt well cared for by the staff and an example of this was the staff are really good and there is always someone around to give us a hand. Residents were dressed for the activities they were undertaking and looked comfortable and tidy. A number of residents were positive about the care they were being given and were very complementary about the staff. Care was given in a discreet manner taking into account the individual residents Care Homes for Older People Page 14 of 29 Evidence: previous lifestyles and the way they want to spend their time. An example of this was when a resident needed personal care and needed to have his clothing changed staff were very discreet about how they approached this and he was gently assisted without him feeling uncomfortable. On the dementia care unit there were small cloth pads (Kylie type) being placed on lounge chairs, this is not good practice as it identifies the the occupant as being incontinent. Staff are knowledgeable about residents preferences and needs. They were being kind and polite with cheerful banter taking place throughout the day. The residents are encouraged to maintain contact with their families, friends and visitors and can use either their own rooms or the communal areas. The relatives are given good assistance to help them to be as involved in the care as they feel comfortable. Current best practice is to provide an environment which is targeted specifically to the dementia care needs of the residents and to make it more stimulating and give them opportunities to live more satisfying lives. It is acknowledged that the dementia care unit is decorated to the same high standards as the younger adults unit this could be reviewed for example by providing more items the residents could interact with in a positive way. The dementia care unit has little in the way of prompts or signage to help those with memory loss find their way around and encourage them to retain a degree of independence. The staff could also have more training in ways they can encourage residents to participate in purposeful activities. The home manages the administration of prescribed medication appropriately. There are appropriate systems in place to arrange for the ordering of the residents medication and the records were up to date and in good order. The home has a contract for the disposal of the medication which is no longer required and the records of this were in place. Controlled drugs are managed appropriately. Specific routes of administration are followed and any omissions or changes to the way that the medications are given are recorded. 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 living in the home are well supported to live active and fulfilled lives in line with their choices, abilities and previous lifestyles. Evidence: There are planned to activities arranged by the quality of life co-ordinators who are supported by the staff in the home. There is a diary of events and these are advertised in the home on a monthly basis and there is an annual events diary. There is an activities group who meet together to plan the way that the programme will be organised. Staff also make residents aware of what is happening on a day to day basis. They offer variety and although they are arranged for particular days and time there was a degree of flexibility, which suggests that the residents have choices within the programme. There are specific events such as the coffee shop which is offered on Saturdays. There is also a monthly restaurant night which is for both residents and guests which gives people living in the home the opportunity to have a restraint experience in the home while being supported as necessary. This is a three course meal and usually has a theme, a recent example was Burns night. Care Homes for Older People Page 16 of 29 Evidence: The social part of the care plans is detailed and the staff are aware of how they plan to develop this further so that it is fully individualised for each resident. This looks at individual resident needs to make sure that they have their social needs met regardless of their physical limitations. The menus are well developed and there is always an alternative main course and pudding. The food being was well presented and the the residents and visiting relatives were very complementary about the food being provided. On the first floor the small dining room / lounge the tables were not set. People were sat at the table for a while before the meal was served. The meal had to be brought plated from the main dining room which meant staff were going backwards and forwards throughout lunch. Also drinks were not available until halfway through the meal. Staff were really busy trying to serve the food and then make sure at least three people were given assistance. This meant that some people had to wait resulting in the risk of food becoming cold. The main dining room was also very busy and noisy throughout the meal with staff again going backwards and forwards serving various meal choices and then trying to give assistance to several people. Some people had to wait for one to one assistance and three people left the table thinking the meal was finished when in fact they had not had any dessert. This was because of the time span between courses. Staff gently assisted them back to the table. The tables in main dining room did have tablecloths, cutlery, condiments and napkins. Choices for drinks were offered throughout the meal but cups did not have saucers and everyone had a plastic beaker. Staff assisted in a discreet and sensitive manner. They asked would you like milk and sugar in your tea, would you like salt and pepper and for some who found it difficult to manage asked quietly would you like me to help you. The staff did ask what people wanted from a three course menu which was varied and included soup as a first course, chicken korma, steak and mushroom pie,ratatouille, cheese omelettes, and various sandwiches. Desserts included pear crumble, fruit cake,cherry and almond sponge with custard. The meal time on the ground floor was quiet, well organised and a positive experience for the people living in the home. The atmosphere was good and people were being supported to be as independent as they were able to be. Those who needed assistance Care Homes for Older People Page 17 of 29 Evidence: were being supported in a very discreet and friendly manner and there was pleasant exchanges of conversation between residents and with the staff. The meal time was flexible and residents could eat either in their own rooms or in the dining room. Care Homes for Older People Page 18 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good policies and procedures in place which are followed by the staff to make sure that complaints are dealt with effectively and that residents are safeguarded from harm. Evidence: The complaints procedure is made available to residents and relatives through the service user guide. Relatives confirmed that the staff listened to their views and opinions. The senior staff are committed to responding to any concerns raised, even those that are minor in nature. There is a good system for the management of complaints. The records of complaints were particularly well organised and identified the level of satisfaction of the complainant and the action taken in response to any investigation. There is an appropriate protection of vulnerable adults policy and staff were aware that any events effecting the welfare of the residents must be looked at with reference to the safeguarding guidance and CSCI need to be informed. There is a whistle-blowing policy which is made known to the staff very early in their employment through the induction process. 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. The home offers accommodation which is clean and well maintained and has design features to help people of this client group and to promote their dignity, comfort and welfare. Evidence: The building has been constructed to a very high standard. The corridors and room sizes are larger than the National Minimum Standards suggest, and there is an emphasis on using natural light particularly in the lounges and dining rooms. The lounges and dining rooms are very well designed with large open windows making the best of the surrounding views. Bedrooms are large, well decorated and furnished and offer a good personal space. The residents and relatives who were asked about the bedrooms said they were very happy with the decoration and that they were kept clean by the staff. It continues to be well maintained and the staff are aware of health and safety issues so are vigilant about ensuring there are no risks to the people living in the home. The home is clean, well decorated however there was some evidence of an odour on the first floor. The cleaning schedule is good however this odour remained throughout the day and surveys returned also mentioned that this is a problem, although the Care Homes for Older People Page 20 of 29 Evidence: domestic staff work very hard to address it. There is a good standard of furnishings in the home and these are in keeping with the design of the home and needs of the residents. There is a programme for replacement of worn furnishings and a redecoration plan to make sure that it remains of a high standard. The laundry was clean, organised and well equipped. The laundry staff use gloves and aprons as necessary. There are sufficient washers and dryers, for the number of residents in the home. The washer has a sluice facility. The laundry is equipped with a roller press and domestic type iron. The sluices were tidy and clean and the disinfectors operational. Staff follows infection control policies and use appropriate equipment. There are now facilities in all of the bedrooms for staff and residents to wash and dry their hands using liquid soap and disposable hand towels. Flip top bins are also now available. There are two bathrooms and one shower on each floor and there were tidy and clean. 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. There are skilled, well trained, and competent staff employed in sufficient numbers to make sure that they can provide very good care to the people living in the home. Evidence: Good records are in place for recruitment and selection of staff. These were in line with the company policies, and contain the necessary information including, Police check, two references, a completed application form, and proof of identity. The homes employment policy are compliant with equality and diversity principles. There is a record of the process undertaken to interview and also one to offer the post should the applicant be successful. There has been a full review of the training programme and there are a number of sources used to access training for the staff. These include both statutory and clinical training. The home uses Northumberland Care Alliance for some of the training, some is delivered in house by the staff and other courses are sourced from the Primary Care Team or independent training companies. This gives the home flexibility in making sure that the staff can be given the training needed to meet the needs of the residents. The training programme for first aid, moving and handling and fire training is up to Care Homes for Older People Page 22 of 29 Evidence: date. Where a few staff have missed the training it is being dealt with on an individual basis. The staff have received the appropriate training to make sure they can undertake their roles safely. It would be beneficial for the staff on the dementia care unit to receive additional specialist dementia care training. This unit has a number of residents who present challenging behaviours and it would be beneficial for them to have more in depth specialist training in dementia care. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good management arrangements in place which take into account the views of the residents. The appointment of a manager will give additional leadership and make sure that there continues to be good outcomes for the people living there. Evidence: There is currently no manager in the home. However, there are good arrangements in place which involve a number of staff who each take responsibility for a section of the management process. We therefore gave the feed back form the inspection to Mr Lamb who is the Chief Executive of the company. The proprietor of the home is aware of the need to have a permanent manager appointed and in post and that they would need to register with the Commission of Social Care Inspection. There has been a period of change and the plan is to appoint a new manager when the most suitable candidate can be found. The individuals who are covering the management processes were competent and understood the tasks they Care Homes for Older People Page 24 of 29 Evidence: needed to undertake. There has been good progress to address the areas of concern identified at the last inspection all of which have been met. There is a system and records to review health and safety, it involves the staff. There are records of staff meeting and the contents suggest that there is a broad spectrum of relevant issues discussed. The management team consults the residents, staff and other interested parties to review the service provided and manage the staff in a way to improve care delivered. There are plans to undertake resident and relative satisfaction and a survey has been carried out with others planned for the future. The chief executive regularly tours the building however he relies on the clinical staff to make sure that quality indicators are looked at as part of their role. There is an extensive audit programme including care plans, medication administration and the kitchen, as well as accident analysis for each of the units. Regular staff meetings are conducted for the qualified nurses and the care staff as well as the other ancillary staff. There is a procedure in place for undertaking staff supervision. The new documentation is comprehensive and includes a supervision contract this has objectives and an agreement as to what the supervision will include. the supervision performance form. Training is being provided to staff so that they can carry out supervision on staff they have day to day responsibilities to supervise. The programme up to date. There is also a personal development plan which looks at individual training needs and information about the performance of the staff. Staff confirmed that they received supervision and they understood the purpose of the sessions. The personal records kept in the home of residents who are receiving assistance to manage their finances was examined and was appropriate. The records were up to date and there was details of the debits and receipts for individual residents. There were receipts for purchases made on behalf of the residents and signatures of either two staff or one and the service user were in place. 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 19 16 The home must take action to make sure that there is no offensive odours in the home. The residents should be able to live in a home which is pleasant and free from odours. 11/04/2009 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 8 It is recommended that the home look at ways of enriching the environment to make it more stimulating and give residents the opportunities to live more satisfying lives. Also the provision of more prompts or signage to help those with memory loss find their way around and encourage them will retain a greater degree of independence. The use of small cloth pads (Kylie type) should be reviewed and alternative ways of managing continence should be found. The way that the meal times are organised should be reviewed to make sure that staff are able to give sufficient time to assist those who need support and that the meal Page 27 of 29 2 10 3 15 Care Homes for Older People time is a positive experience for all. 4 27 It would be beneficial for the staff on the dementia care unit to receive additional specialist dementia care training. This unit has a number of residents who present challenging behaviours and it would be beneficial for them to have more in depth understanding of dementia. 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!