Inspection on 20/11/08 for Heron House

This inspection was carried out on 20th November 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Heron House 25/03/08

Heron House 01/05/07

Heron House 03/05/06

Heron House 23/11/05

Heron House 13/04/05

Heron House 10/01/05

Heron House 26/08/04

Heron House 26/11/03

Heron House 26/09/03

Heron House 19/11/02

Extracts from inspection reports are licensed from CQC, this page was updated on 29/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Heron House Coronation Close March Cambridgeshire PE15 9PP     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: Elaine Boismier     Date: 2 0 1 1 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 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 30 Information about the care home Name of care home: Address: Heron House Coronation Close March Cambridgeshire PE15 9PP 01354661551 01354657291 heron.house@fshc.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Four Seasons Homes (No 4) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Name of registered manager (if applicable) Mrs Susan Ann Ward Type of registration: Number of places registered: care home 95 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: 1 named individual under the age of 65 with DE A maximum of 36 places to provide nursing care under category OP. A maximum of 42 places to provide nursing care to category DE(E). DE service users to be accommodated in Wendreda unit only. Physical Disability (PD) PD(E)) only in association with Dementia (DE DE(E)). Up to 17 places to provide nursing care to category DE. Date of last inspection Care Homes for Older People Page 4 of 30 Over 65 42 36 36 17 0 17 Brief description of the care home Heron House is a purpose built home situated off a main road in a residential area of the market town of March. It is owned by Four Seasons Healthcare Ltd and provides care and support for up to 95 service users between the ages of 18 and 65 years of age. Most of the bedrooms are used for single occupancy rooms only and ensuite facilities are available. Resident accommodation is on one level. There are a variety of communal areas available to service users and the home provides bathing and additional toilet facilities with aids and equipment to enable the needs of service users to be met. Service users can access the gardens and courtyards throughout the home. The home is situated approximately 1 mile away from the centre of March, where there is a range of shops, pubs and a post-office. Fees for the home range between £347and £791 depending on the needs of the residents. Additional costs include those for private chiropody, toiletries and newspapers. Further information about fees can be obtained from the care home. Copies of our CSCI inspection reports are available on request, from the home, or via our CSCI website at www.csci.org.uk Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last key unannounced inspection took place on the 23rd March 2008. Since this last key inspection we carried out a random unannounced inspection on the 12th August 2008 and, as a result of this inspection, we made two immediate requirements regarding medication and fire training for the staff. There were two other requirements made and these were regarding medication. We, The Commission for Social Care Inspection, carried out this key unannounced inspection, by three Inspectors, taking 6 hours to complete. We spoke with the staff, including the Manager, residents and their guests. We also looked around the building and examined some of the documentation. Care Homes for Older People Page 6 of 30 Some of the people living at Heron House are not able to say what it is like living there. So an Inspector spent some time observing and recording the experience of some of the people using the service. This activity is called short observational framework for Inspection (SOFI). We received, before the inspection, surveys from residents and from some of the staff. For the purpose of this report people, who live at Heron House, are referred to as people, person or resident/s. What the care home does well: What has improved since the last inspection? What they could do better: A requirement has been made regarding care plans. A requirement has been made regarding residents accessing health care professionals. A requirement has been made to respecting peoples dignity, with particular regard at meal times. A requirement has been made with regards to the level and range of suitable activities in the home. Other areas that we expect the home to improve, rather than we make any requirements on this occasion are as follows: People must be offered what they would like to eat and drink. Care Homes for Older People Page 8 of 30 The menus are to include the choice of vegetables. The carpets in the communal areas must be cleaner. The standard of staff recruitment practices must improve. The standard of staff training must also improve. The overall management of the home must improve to benefit those people living at the home. 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 30 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 30 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 a good standard of information to assist people in their decision where to live and there are good systems in place to ensure the home can meet the needs of any person who moves into the home. Evidence: Fourteen of the 15 residents surveys said the person had enough information about the home before they moved in. One of these surveys said The Manager was excellent and gave lots of useful advice when looking for a suitable home... The Statement of Purpose has been revised and this is also in a format that some of the people who might have communication difficulties, easier to understand. Examination of some of the peoples care records indicated that there is a preadmission assessment system in place to ensure the home can meet the needs of any Care Homes for Older People Page 11 of 30 Evidence: person before they move into the home. Since our key inspection, in March 2008, the home has looked at what is required for the home to continue to offer an intermediate care service. Following this research the home has made the decision not to offer such a rehabilitation service. Therefore Standard 6 is no longer applicable. Care Homes for Older People Page 12 of 30 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. People are at some risk to their health and wellbeing due to the standard of records and standards of some of the care practices. Evidence: Fourteen of the 15 surveys, from residents, said that the person always/usually received the care and support, including medical support, that they needed. The remaining survey said that there was a Long time waiting for staff and Some issue with the medication and how it is given. Examination of some of the peoples care plans indicated that some of these do not meet this Standard 7. The care plans provided evidence that risk assessments were carried out for areas such as falls, development of pressure sores, risks for malnutrition and risks for moving and handling. However not all of these risks had been reviewed each month, although these documents said that these risks were to be reviewed each month. For example we saw in one persons care file that their risk assessments had not been reviewed since March 2008. Their care plan for prevention Care Homes for Older People Page 13 of 30 Evidence: of the development of pressure sores said that this risk assessment was to be carried out each month. This indicates that the care plan was also not updated. The evaluation of the care plans was carried out but not each month. For example one persons care plans had not been evaluated since October 2007 and another persons care plans had not been evaluated since March 2008. Dependency assessments were carried out and, according to the documentation, these were to take place each month. For one person their dependency assessments was initially not dated; the following assessment was dated October 2007 and there were no further entries. We expected the home to consult people in their care plans but we found no recorded evidence that this consultation had taken place. In our report, of the inspection of March 2008, we also recorded our expectation that triggers would be identified, that caused people to become agitated. We saw there was some evidence that there was progress in this area. For example we saw that a person became agitated when they were helped with their personal care and what the staff should do (i.e. leave the person and to return to them later). The same care plan stated, however, that sometimes there were no triggers that caused the person to become distressed. We discussed this with the Manager who agreed that, although staff might not always know what caused the person to become distressed, there was always something to cause such an emotional response in a person. There are some people prescribed medication on a when required basis but there is no guidance for staff to follow to make sure the medication is used properly and to safeguard residents. We have made a requirement about care plan documentation to ensure that peoples needs are being assessed and monitored and that the care provided is appropriate and informs the staff what safe care they need to provide to the people. One of the peoples care records indicated that appropriate action had been taken, in contacting a general practitioner, in response to a persons significant increase in weight, due to a medical condition. We found some evidence that people have access to health care professionals such as a general practitioner, dieticians, opticians and community psychiatric services. According to the Manager no current resident has a pressure sore. Where a person had a record of unintentional weight loss, action had been taken to monitor the persons weight and increase their calorie intake. There was also recorded evidence that a dietician had been consulted when the person was found to have unintentional weight loss. The SOFI observation found evidence that the wellbeing of some of the people was not always considered. For example, out of 24 time slots we recorded that one person had only 4 interactions from the staff. For another person the staff interacted with the person 6 out of the 24 time slots (5 minutes = a time slot). Care Homes for Older People Page 14 of 30 Evidence: One person we spoke with said that they had a tooth that had become decayed. They pointed to the tooth and it looked black. Examination of the assessment, for the persons oral health, indicated that the person had their own teeth, some of which were missing, but there was no record of any tooth decay. In addition Tthere was no record if the person had been asked if they wanted to be seen by a dentist and their relative told us that they could not recall if this question had been asked. Examination of another persons care records indicated that they had last been seen by a chiropodist in August 2007. Another persons care records said that the person had mental health issues and was showing aggressive behaviour directed toward the staff. The person told us that they were unhappy and felt lonely and isolated. There was no recorded evidence that the persons mental health had been reviewed by the general practitioner or the community psychiatric services. We have made a requirement about the protection of peoples health and wellbeing. A pharmacist inspector examined practices and procedures for the safe use and recording of medication. Medication is stored securely for the safety of residents and the main storage areas are now temperature controlled using air-cooling units. Regular monitoring of temperatures is undertaken as is the temperature of the fridge used to store medicines, and these are satisfactory. The requirement made on the last inspection that medication must be stored under suitable environmental conditions has therefore been met. Some medicines which require special storage were not stored properly. We expect the home to manage this rather than make a requirement on this occasion. Records are made when medicines are received into the home, when they are given to residents and when they are disposed of. These were of good standard and provide a good audit trail to demonstrate people recieve the medication prescribed for them. The requirement made on the last inspection for records made when medicines are given to residents to be accurate and complete has therefore been met. We watched some medicines being given to residents both during the morning and at lunchtime. This was done safely and with regard to individual personal choice. The requirement made on the last inspection that medication must be given to residents in a hygienic way and as prescribed has therefore been met. A requirement was made with regards to ensuring that at mealtimes peoples dignity was respected. During our SOFI we saw that the staff were assisting people with their food and were respecting their dignity. We also observed the staff knocking on Care Homes for Older People Page 15 of 30 Evidence: peoples room doors before they went in. During our SOFI we saw that a person was taken in to the dining room at 12:20 and waited until their lunch arrived at 13:03. Whilst waiting for their food, the person was banging on their table with their hand and they were ignored by the staff. For another person their food was put in front of them with no information about what it was and they were not asked if they needed any help with their meal. Another person was given no encouragement to remain as independent as possible with eating their food. We have made a requirement about respecting peoples dignity. Care Homes for Older People Page 16 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have opportunities to live an adequate quality of life that could be better. Evidence: We expected, following our inspection of March 2008, for the home to take action to provide meaningful activities for the residents. Three of the 15 residents surveys said the home always/usually provided suitable activities; 9 of these said sometimes the home provided suitable activities;one of the surveys said the home never provided suitable activities and the two remaining surveys were not completed in this section. Comments received included, Activities are poor. The home has put up a list of activities for Oct. Nov & Dec presumably for your inspection. Residents rarely taken out if at all and There are no activities suitable for this service user. Examination of the activities programme indicated that there are outside entertainers coming into the home and there are games of bingo and dominoes available although the frequency and range of activities could be better. Examination of peoples care records indicated that, for example, one person was taken out into the garden, in January 2008, but there was no record of any other activity the person took part in since this date. Another person was described as enjoying taking part in dancing Care Homes for Older People Page 17 of 30 Evidence: activities, in January 2008, although there was no other record following this, of what activity, if any, the person took part in. Examination of other peoples care records provided a similar picture in that the care plans did not provide what activities the person took part in, if at all. During our SOFI we saw that the television was turned off and there was no activity happening, with many of the residents remaining in a passive state. In other areas of the home we saw no activities taking place. A requirement has been made about activities. People told us that they could bring in their possessions if they wanted to and the rooms, where we visited, had the peoples photographs and ornaments. We saw people receiving their guests and some of these told us that they visited at least once a week. The record of visitors was seen and this indicated that people can receive visits, from families and friends, at any time of the day. Eight of the 15 residents surveys said that the person always/usually liked their meals;7 of these surveys said that the person sometimes liked their meals; the two remaining surveys said that the person did not know. Comments included The meals are very good and The meals are sometimes nice and I sometimes need help with eating and drinking and they dont have time to help. We received a range of views about the food from being good to poor. We expected the home to improve how choice of food is offered and for hot food to be served at the acceptable temperature. One person said that their food was hot whilst one person said that their food was cold. During our SOFI no person was offered a choice of what they would like to eat or drink. We saw copies of the menus that showed there is a range of food provided such as traditional roasts, meat and potato pie, casseroles and fish cakes. All of these were followed by a dessert. There was no record of what choice of vegetables was available. We expect the home to manage this, rather than we make a requirement on this occasion. Care Homes for Older People Page 18 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are generally listened to and there are systems in place to ensure people are protected from abuse. Evidence: Thirteen of the 15 residents surveys said the person always/usually knew who to speak to if they were unhappy about something whereas the remaining two surveys said the person sometimes knew who to speak to in such instances. Thirteen of these 15 surveys said that the staff listened to the person and acted on what was said to them. However the two remaining surveys said that this was not the case. One of these surveys said, Sometimes they (the staff) speak fast and I dont understand. Eleven of the 15 residents surveys said the person knew how to make a complaint whereas the remaining 4 surveys said the person did not know how to make a complaint. People we spoke with said that they knew who to speak to if they were unhappy about something. We have received no complaints since our random inspection, of August 2008, and we have received no allegations of abuse against any of the residents. The staff we spoke with said that they knew what to do if they witnessed or suspected any incident of Care Homes for Older People Page 19 of 30 Evidence: abuse against any of the residents. The staff training matrix was seen and this showed that some of the staff have attended training in safeguarding awareness and, according to the Manager, arrangements are in place for other staff to receive this training. Care Homes for Older People Page 20 of 30 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. People live in a comfortable home that is becoming safer. Evidence: Progress continues with improving the external grounds of the home, to make sure that they are safer and accessible for residents and their guest to visit. According to the Manager the Health and Safety Executive has assessed that these areas are safe and considered that the arrangements to improve these areas meet the Health and Safety legislation. We saw that the enclosed garden for Eastwood unit has a mock pond and there are pots of herbs for people to smell. The Manager stated that there is, in response to our random inspection of August 2008, a risk assessment for people to go out into the garden areas of the home. We did not examine this risk assessment, on this occasion. The majority (14) of the residents surveys said that the home was always/usually clean and fresh. Comments included Very occasionally there is an odour and Carpets & rooms sometimes smell. We found no offensive smells and the majority of the areas were clean with the exception of the stained and grubby looking carpets in the corridor of the Wendreda unit and in the lounge area of the Eastwood unit. We expect the home to manage this rather than we make a requirement on this occasion. Care Homes for Older People Page 21 of 30 Care Homes for Older People Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are at some risk to their health and safety unless the staff recruitment process and the training of the staff improves. Evidence: We received positive comments about the staff, to say how kind and caring they were. During our SOFI we saw that the interaction of some of the staff, toward individual residents was attentive and warm although some of the other staff we considered that their interactions were less person centred but rather more task orientated. Comments in the residents surveys, about the staffing levels, included, Standard of care has been variable directly related to staffing levels.... Thirteen of the 15 residents surveys said that the staff was always/usually available when the person needed them although the two remaining surveys differed on this view. One of these two surveys said Very short staffed at Heron House. Buzzers ring in rooms 20 mins or more....Needs more male carers. Both of the staff surveys said that there was enough staff on duty to meet the needs of the residents. During our inspection we saw that there were enough staff and there were both male and female staff on duty. According to the Manager, due to a reduction in the use of agency staff, there is a better team work of staff. Care Homes for Older People Page 23 of 30 Evidence: The home has 37 of care staff with a National Qualification of Care (NVQ) level 2. This is an increase in the percentage, since our inspection in March 2008, when the home had 34.7 of care staff with NVQ level 2 in care. This Standard however, Standard 28, remains unmet. We looked at three staff files and all the required information was available with the exception of an unexplored gap in a persons employment history of three months, between June 2005 and the following month of September. For another person they had one satisfactory written reference although the 2nd written reference was unsatisfactory. According to the Manager she had made contact with the second referee to gain back ground information about the less than satisfactory reference, although there was no record of this contact. We expect the home to take action to ensure that the recruitment of staff meets the associated regulation, rather than we make a requirement on this occasion. Both of the staff surveys said that the member of staff had received a satisfactory induction training programme and that they had attended (unspecified) training that kept them up to date so that they were able to meet the individual needs of the residents. Examination of the current staff training records indicated that staff have attended training in dementia care and taking samples of peoples blood (phlebotomy) in 2008, care planning (2006) care of people with swallowing difficulties (2007) and care of people with artificial feeding (2007). According to the Manager there is no current record of when staff attend training at a local hospice. She also stated action is being taken to update the staff training records. There was insufficient recorded evidence and insufficient evidence from the staff to indicate that they have attended ongoing training to ensure that they can meet the needs of the people they care for, such as managing peoles challenging behaviours and how to provide care of the younger person with mental health needs. We expect this to be managed by the home rather than we make a requirement on this occasion. Care Homes for Older People Page 24 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe and adequately managed home. Evidence: The Registered Manager, a Registered General Nurse (RGN), has the Registered Managers Award and is supported by administrative staff and a Deputy Manager, who is also an RGN. Due to the those Standards that we have assessed as not we consider that this reflects the current overall standard of the management of the home. Copies of the last two monthly reports, of visits, made by a representative of the registered provider, were seen and these contained audits of documentation, complaints and views of some of the residents. Results of a survey (undated) were seen although we did not scrutinise these due to no date being provided. According to the staff the majority of the residents have their personal monies kept by the home. Individual records of the balances and receipts and records of these receipts Care Homes for Older People Page 25 of 30 Evidence: were seen and all of these were satisfactory. At our inspection, in August 2008, the Manager explained the two different methods of recording hot water temperatures. Examination of these records, at this inspection of November 2008, indicated that there remain the two different methods of recording although action is being taken to reduce such confusion. The records were satisfactory as hot water is being delivered at a safe temperatures. Records for fire alarm tests, portable appliance service checks, checks on fire fighting equipment and emergency lights were seen and these were satisfactory. In October 2008 the home was awarded 4 stars, from the local district council, for the standard of food hygiene. An email response, dated the 3rd September 2008, from the home to the fire safety officer (FSO), was seen and action is being taken in response to the FSOs report of the 28th August 2008. An immediate requirement, made at our inspection of August 2008, has been met as the staff have attended training in fire safety. Some of the staff told us that they have attended training in safe moving and handling and, during our SOFI, the staff were seen carrying out safe moving and handling techniques. The Manager stated arrangements are being made for staff to attend training in basic food hygiene and infection control. Care Homes for Older People Page 26 of 30 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 27 of 30 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 Care plans must be up to 28/02/2009 date and accurate and drawn up in consulation with the resident wherever possible. To ensure that the residents changing an ongoing needs are monitored and that the care they receive is safe and up to date. To ensure that the staff have clear guidance in how to meet the residents assessed needs 2 8 13 Residents must have access to health care advice and treatment. To ensure that residents health care is delivered in a proactive way to promote health care and prevent any deterioration in their health 18/12/2008 3 10 12 Residents must have their dignity respected. To ensure that residents welfare is safeguarded. 05/12/2008 Care Homes for Older People Page 28 of 30 4 12 16 Residents must be offered meaningful activities. To ensure that residents do not suffer from isolation, depression and increased incidents of challenging behaviours 01/04/2009 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 Care Homes for Older People Page 29 of 30 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 © (2008) 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 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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