Inspection on 24/11/09 for Hunningley Grange

This inspection was carried out on 24th November 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 13 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hunningley Grange 30/03/10

Hunningley Grange 17/02/10

Hunningley Grange 30/07/09

Hunningley Grange 11/07/07

Hunningley Grange 10/07/06

Hunningley Grange 30/11/05

Hunningley Grange 25/05/05

Hunningley Grange 23/09/04

Hunningley Grange 21/07/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for older people Name: Address: Hunningley Grange 327 Doncaster Road Stairfoot Barnsley South Yorkshire S70 3PJ     The quality rating for this care home is:   zero star poor service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Valerie Hoyle     Date: 2 4 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Hunningley Grange 327 Doncaster Road Stairfoot Barnsley South Yorkshire S70 3PJ 01226287578 01226245348 none NONE Mr Azad Choudhry care home 36 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Hunningley Grange is a detached residence with a purpose built extension, registered to provide personal care for 36 residents. All accommodation and services are on the ground floor. The home is located in the centre of Stairfoot, approximately two miles from Barnsley Town centre and situated on a main bus route. The home is within walking distance of a full range of shops e.g. chemist, newsagent, hairdressers, dentist, supermarkets, post office, health centre, cafes and fast food outlets. There is car parking at the front and side of the home. The home provides information to people and their relatives prior to admission into the home. Service User Guides are available in all bedrooms or on request from the manager. The last published inspection report is available on request and a copy is available in entrance for visitors to read. Care Homes for Older People Page 4 of 30 Over 65 36 0 3 0 0 7 2 0 0 9 Brief description of the care home Information gained on the 30th July 2009 indicates the current weekly fees are 356 pounds and 51 pence. Additional charges include private chiropody, hairdressing, newspapers and transport. 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: zero star poor service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 0 star. This means that the people who use the service experience poor quality outcomes. This unannounced inspection took place over 6.5 hours starting at 09:00 finishing at 15.30. The visit included a partial inspection of the home. six people who use the service, the operations manager and manager, three staff and two relatives were spoken to during this inspection, their views are included within this report. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous reports may have been deleted or carried forward into this report as recommendations but only when it is considered that the people who use the service 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. Care Homes for Older People Page 6 of 30 20 Surveys (10 for service users, 5 staff, 5 Health Professionals) were sent to the service. One survey was returned from staff and 1 service user survey was returned. We telephoned the district nursing services for their views on the service. Their comments can be found in the health and personal care section of this report. Occupancy at the home on the day of this inspection was 21 which included 1 person receiving respite care. Three peoples care plans were looked at. policies relating to medication, complaints, protection and handling of peoples money were looked at. Five recruitment and training records were looked at to assess how people were protected from harm. Procedures and risk assessments relating to health and safety were looked at and discussed with the manager. The Annual Quality Assurance Assessment (AQAA) was sent to the home and returned in time for the previous inspection dated 30th July 2009. An AQAA is a self-assessment and a dataset that is filled in once a year by all providers whatever their quality rating. It is one of the main ways that we will get information from providers about how they are meeting outcomes for people using their services. The AQAA also provides us with statistical information about the individual service and trends and patterns in social care. Care Homes for Older People Page 7 of 30 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Older People Page 8 of 30 You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 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. People who use the service were assessed before moving into the home, to ensure staff can meet their needs. Evidence: The home has an assessment document that was used to assess the needs of people who use the service, prior to admission into the home. A number of completed assessments were looked at and they contained basic information about the needs of the individuals. The placing authority also undertakes a needs assessment and the home uses the information from both assessments to make decisions about meeting the persons needs. The manager said she was the person who would undertake the assessment either in the persons home or in hospital. She has the skills and knowledge to make a judgement about meeting the person needs.Staff said the information was used as a base to establish a care plan. People said their relative had been to look around several homes before choosing Care Homes for Older People Page 11 of 30 Evidence: Hunningley Grange. Visitors said their relative always appeared to be happy which was important to them. 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People generally had their health and personal care needs met, although medication systems were poor which may put people at significant risk of harm. Privacy and dignity principles were not put into practice. Evidence: The manager told us that she had started to update the details in peoples care plans, although only five of the twenty-one had been completed. We looked at four care plans to assess how peoples needs were met. It was clear that some evaluations had not been undertaken and assessments relating to the nutritional needs and skin care were not followed. Risk assessments need to be developed on most care plans. There was no social care plans on the any of the plans looked at, although the manager showed the inspector a grid which will be introduced to record when activities have taken place. Staff have responsibility for writing on care plans and the manager had developed a new document to record daily intervention. The record was comprehensive although staff said the task was very time consuming which means they are away from meeting the needs of the service. Care Homes for Older People Page 13 of 30 Evidence: Staff were able to take advice from the district nursing services to meet peoples healthcare needs. District Nursing services confirmed that staff follow instructions and they contact the nursing services for early intervention. The nurse said there have been improvements over the last four months. Staff appeared more aware of peoples conditions and they record details of their visits. They told us that staff escort them to the people who receives treatment in their own room. Medication procedures were extremely poor. There were several gaps in the recording of medication administered to people (MAR). The records and stock showed some essential medication had not been given which could affect the health and wellbeing of people. Some medication required to assist with peoples mental health was not administered which was a serious concern. This was discussed with the manager and area manager for urgent attention. The returns book confirmed that medication was not administered as prescribed which poses a significant risk to peoples health. The manager must contact peoples doctors to undertake a review on their medication to ensure peoples healthcare needs are met. There was a controlled drug cupboard, although the inner lock had been removed. The controlled drug book identified one persons medication as still on the premises, although it had been discharged from the home and the medication returned with them. The fridge was not locked and the temperature of the fridge was not taken daily. The staff required refresher training as their competencies had not been checked. The manager said the training had been arranged and staff had registered to commence the training in November. People were not always treated with respect as staff were over familiar and were overheard speaking to people in an inappropriate manner. Staff talked about personal care in a way that did not maintain their dignity. One person said staff talked over them while they were being bathed which they did not like. People said staff addressed them using the first name and they were in agreement with that. Care Homes for Older People Page 14 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People had limited opportunities to take part in meaningful activities, mealtimes were organised although choice was limited. Evidence: People had limited opportunities to take part in activities, as there is no staff designated to undertake the role. Relatives said that they have not observed activities taking place although they were given information that activities would be offered on a regular basis. One relative said they had attended a Halloween party which was enjoyed by everyone. People said they could join in bingo although this was the only activity they joined in. Care plans looked at confirmed the lack of social stimulation, as none of the care plans looked at had a social care plan. Relatives said they were always made to feel welcome and staff were kind and caring. They said they visited at various times of the day and staff always seemed to be very busy. Breakfast and lunch were observed and staff were seen supporting people during the meal. A number of people were left in their wheelchairs which made it difficult for them to get close to the table. The cook said menus were arranged around the likes and dislikes of the people, although there was no evidence to confirm people had a choice of meal. People said they did not know what was on the menu for lunch, Care Homes for Older People Page 15 of 30 Evidence: which was displayed on a notice board in the dining room. People said they enjoyed the lunch which was liver and onions and vegetables followed by rhubarb crumble and custard. However one person said they did not like liver, although this was served to the person. The inspector had to ask for an alternative to be provided for the person. Meals served to people in bed was accompanied by a drink although the meal was not covered, which was not hygienic and may have been cold before it was given to the person. The dining area was untidy and dirty. Table clothes had food from previous meals and place mats were dirty with sticky marmalade. Plastic beakers were used for soft drinks, although there was no reason why glasses could not be used. The carpet was dirty and requires deep cleaning. Care Homes for Older People Page 16 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints and safeguarding procedures were followed although staff require training to recognise signs of abuse. Evidence: The home has a complaints procedure which was looked at during this inspection. The manager confirmed that no complaints had been received since the last inspection. People said they were aware of the complaints procedure, and they said they would speak to the manager if they had any concerns. There is a comprehensive safeguarding adults procedure and staff follow the procedures to ensure people are safe and protected from harm. The manager told us that there have been one referral to the safeguarding adults team, although this had been investigated by the home and was upheld. Disciplinary action taken against the staff has been taken. The training matrix has identified that a number of staff have not received training to ensure they are alert to the signs of abuse and the action they must take if they suspect an incident has occurred. This remains outstanding from the previous report with a compliance date of 5th October 2009. Staff spoken to said they would feel comfortable at speaking to the manager if they observed poor practise. This was confirmed when we received information that a whistleblower reported a safeguarding incident to the manager, who took appropriate action, by reporting the incident to safeguarding adults. Care Homes for Older People Page 17 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment needs considerable investment to improve the health and hygiene outcomes for people who use the service. Evidence: The environment was looking rather tired. Bedrooms require decorating and the bathrooms need refurbishment. There is no sluicing facilities at the home and the operations manager said commodes are washed in the baths used by people who live at the home. Bathrooms were generally untidy with commode bowls and drying racks. The kitchen needs refurbishment as it lacks ventilation, this was identified during the last environment health report, there is no dishwasher or sterilising sink. The manager told us that the registered providers have agreed to renew the kitchen, fit a sluice and refurbish one of the bedrooms to create a walk in shower facility. The dates to commence the refurbishment was not available, although it could commence before the end of the year. Staff have not had training in infection control and the issues identified in the previous paragraph reflects the judgement for this outcome group as poor. Care Homes for Older People Page 18 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff lack the skills and knowledge to keep people safe, as most training is out of date. Recruitment procedures were not sufficiently robust to ensure people are safe from harm. Evidence: Staff were employed in sufficient numbers to meet the needs of people who use the service. Senior staff have added responsibility to organise the shift and ensure medication is administered safely. Some seniors have just been registered to undertake training in the safe management of medicines. The home has recruitment procedures and a number of staff files were looked at to assess how staff are employed. All files had a Criminal Records Bureau (CRB) check although one file did not have the required two references. A further file only had one reference. They must be obtained immediately and they should not work unsupervised until they have been obtained. The induction and training records were looked at. The induction programme was dated and had not been completed on one of the files looked at. It was basic and did not meet the Skills for Care standards. Training records were extremely poor, they contained little evidence to confirm essential training had taken place. There is gaps in training in first aid, infection Care Homes for Older People Page 19 of 30 Evidence: control, moving and handling, food hygiene, health and safety, fire and safeguarding adults. This poses significant risk of harm to people who use the service, as staff may not have the skills and competencies to keep people safe. The gaps in staff training was identified in the previous inspection report with a compliance date of 2nd November 2009. Training to ensure staff have an understanding of the Mental Capacity Act 2005 and the Deprivation of liberty safeguards should be arranged as soon as practicable.The numbers of staff who hold National Vocational Qualifications (NVQ) are not at the required levels of 50 Care Homes for Older People Page 20 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home was ineffective and fails to keep people safe from harm. Evidence: The manager was appointed in September 2009. She holds the Registered Managers Award and has some previous management experience, although she has not been registered with the Care Quality Commission. She has made some progress with improving the service, although progress has been limited due to the number of occasions that she has worked undertaking care duties. If the home is to make significant sustained progress to complie with the requirements in this report she must work off rota. There has been a number of changes to the staff at the home, and staff morale appears to be extremely low, which could affect the way care is delivered to people. The home has quality assurance systems although audits have not been completed over recent months. The home has surveys which are used to gain the views of people Care Homes for Older People Page 21 of 30 Evidence: who use the service. The manager and the operations manager could not confirm when the surveys were last used, or if the data had been collated. The operations manager undertakes monthly quality audits (Regulation 26) on behalf of the registered providers. The reports were available although they only contained brief details about the quality of service provided at the home. People who use the service were able to manage their own finances, although some prefer the manager to assist with dealing with their personal monies. Records were looked at and they were an accurate reflection of the accounts held on behalf of people. Records only had the signature of one person, which was highlighted in the previous inspection report and has not been addressed. Maintenance and service records were looked at and most were up to date including fire, and gas safety checks and portable appliance testing. However checks to ensure the risk of Legionella is minimised had not been undertaken since May 2006. Accident and incident records were recorded and analysed by the manager to ensure fall risks were identified. Training records identified significant gaps in areas of health and safety, first aid, infection control, food hygiene, moving and handling and fire. The gaps were identified in previous inspection reports and remain outstanding which raises extreme concern about how the home can keep people safe from harm. Care Homes for Older People Page 22 of 30 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 7 15 Care plans must contain 02/11/2009 sufficient detail to enable staff to deliver appropriate care. Risk assessments and evaluation of care plans must be underatken at regular intervals. To ensure peoples needs are met. 2 8 12 People must have the required healthcare checks. This must include checks undertaken at the required frequency. To ensure their needs are met. 05/10/2009 3 9 13 Medication must be recorded, administered, and discharged from the home. This helps to confirm that medication is being given as prescribed and facilities are suitable for storage. To ensure people receive their medication safely. 28/09/2009 4 18 13 All staff must receive training 05/10/2009 to recognise the signs of abuse. To ensure people who use the service are safe and protected. Care Homes for Older People Page 23 of 30 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 5 26 13 Suitable arrangements must 05/10/2009 be made to ensure good hygiene practises take place. This includes approprite sluicing facilities, laundry facilities in good working order and suitable ventilation in the kitchen. To control the risk of infection and maintaining a clean, hygienic environment. 6 30 18 Staff must receive refresher training to ensure they have the required skills and competencies. To ensure they can meet the needs of people who use the service. 02/11/2009 7 38 13 Health and safety checks must be undertaken. To ensure people are safe and protected. This includes fire safety training and regular audits of fire safety equipment, and health and safety training for staff. 05/10/2009 Care Homes for Older People Page 24 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 reflect the social and emotional needs of people. So that staff can support them to follow their interests 04/01/2010 2 7 15 Care plans must contain 04/01/2010 sufficient detail to enable staff to deliver appropriate care. Risk assessments and evaluation of care plans must be undertaken at regular intervals. To ensure peoples needs are met. (timescale 02/11/09 not met) 3 8 12 Care plans must follow 04/01/2010 assesssments regarding skin care and nutritional needs. To ensure their healthcare needs are met. (timescale 05/10/09 not met) Care Homes for Older People Page 25 of 30 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 4 9 13 The controlled drugs record 04/01/2010 must be a true reflection of the medication held at the home. The storage of controlled drugs must complie with the Misuse of Drugs (Safe Custody) Regulations 1973. The medication fridge must be locked and the temperature of the fridge must be checked and recorded daily. This will ensure medicines are stored correctly. 5 9 13 Medication procedures must 04/01/2010 be followed to ensure people receive their medication as prescribed. This will ensure that people receive their medication safely. (timescale 28/09/09 not met) 6 10 12 The principles of respect, privacy and dignity must be respected at all times. This means talking to people in an approrpriate manner. 04/01/2010 7 18 13 Staff must be alert to the signs of abuse and must be familiar with the procedures to follow if they suspect any incidents has taken place. 04/01/2010 Care Homes for Older People Page 26 of 30 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 This will help to protect people who use the service from harm. (timescale 05/10/09 not met) 8 26 23 Suitable arrangements must 04/01/2010 be made to ensure good hygiene practices take place. This includes appropriate sluicing, bathing and kitchen facilities, To control the risk of infection and maintain a clean, hygienic environment. (timescale 05/10/09 not met) 9 29 19 Staff must not be employed without two satisfactory references. This mean that the right staff are employed to keep people safe from harm. 10 30 18 Staff must receive induction and foundation training that meets the Skills for Care Standards. To ensure they have the skills and competencies to meet the needs of people who use the service. 11 31 26 The registered provider must send the monthly quality audit (Reg. 26 report) to the Care quality 04/01/2010 04/01/2010 04/01/2010 Care Homes for Older People Page 27 of 30 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 Commission until further notice. So that we can assess the progress of the home in meeting the requirements listed in this report 12 38 23 Health and safety and 04/01/2010 maintenance checks must be undertaken at the required frequency. To ensure people are protected from the risk of being affected by Legionella. 13 38 18 Staff must receive refresher 04/01/2010 training in health and safety, food hygiene, infection control, first aid, moving and handling, and fire safety. To ensure they have the required skills and competencies to meet the needs of people and keep them safe from harm. (timescale 02/11/09 not met) 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 12 Social activities should be improved to ensure people can engage in activities of their choice. The care plan should reflect the activities that have taken place. Care Homes for Older People Page 28 of 30 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 2 15 People should be given a choice of meal, and the menus should be clearly displayed to enable people to make an informed choice. the home should review the seating arrangements in the dining area to ensure people can sit comfortably at the table. Clean table linen should be put on the table after each meal and meals served to people in their bedroom should be covered to ensure it is delivered to the person in a appetising condition. Quality assurance systems should be implemented to ensure people have the opportunity to give their views on the service provided. Peoples financial records should be regularly audited and should include two signatures for all transactions. 3 33 4 35 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 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. 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!