Inspection on 10/03/09 for Hunter Hall

This inspection was carried out on 10th March 2009.

CSCI found this care home to be providing an Adequate 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hunter Hall 26/08/09

Hunter Hall 23/10/08

Hunter Hall 08/04/08

Hunter Hall 10/04/07

Hunter Hall 17/07/06

Hunter Hall 26/09/05

Hunter Hall 14/06/05

Hunter Hall 22/02/05

Hunter Hall 26/07/04

Hunter Hall 16/02/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Hunter Hall Kent Avenue Wallsend Tyne & Wear NE28 0JE     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 Charlton     Date: 1 0 0 3 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 30 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 30 Information about the care home Name of care home: Address: Hunter Hall Kent Avenue Wallsend Tyne & Wear NE28 0JE 01912639436 01912623633 hunter.hall@fshc.co.uk 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) : Tamaris Healthcare (England) Ltd care home 46 Number of places (if applicable): Under 65 Over 65 45 dementia Additional conditions: 1 The maximum number of service users who may be accommodated is 46. The registered person may provide the following category of service only: Care home with nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia Code DE, maximum number of places: 1 Dementia, over the age of 65 years of age Code DE(E), maximum number of places: 45 Date of last inspection Brief description of the care home Hunter Hall is a care home that provides residential and nursing care for older people with mental health needs. It is located in a residential area of Wallsend close to local shops and good public transport links. The home is owned and managed by Four Seasons Healthcare Limited, a large national care provider. Care in the home is provided by Registered Mental Nurses (RMNs) supported by care staff. Forty-six single bedrooms, all with en-suite facilities, are located at ground and first floor levels. On each floor there are separate lounge areas, a dining room, bathrooms and toilets. The home shares kitchen and laundry facilities with an adjacent home. There is a nice, enclosed garden and patio area at the rear of the home. Depending on the type of care provided fees are between £408 - £530. The home has a statement of purpose and Care Homes for Older People Page 4 of 30 Brief description of the care home service user guide that give people information to help them decide whether their needs can be met. 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 manager was given very late notice of this visit that took place on the 10 March 2009. A total of six and a half hours were spent in the service. The manager was present throughout the inspection. Before the visit we looked at Information we have received since the last visit on the 23 October 2008. The Annual Quality Assurance Assessment (AQAA) that gives CSCI evidence to support what the service says it does well, and gives them an opportunity to say what they feel they could do better and what their future plans are. How the service has dealt with any complaints and concerns since our last visit. The providers view of how well they care Care Homes for Older People Page 6 of 30 for people, and the views of people who use the service, their relatives, staff and other professionals who visit the service. We have also 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 the service are not put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. During the visit we Talked with people who use the service, staff and the manager. Arranged for an inspection of medicines and the medication administration systems to be carried out by the CSCI Pharmacist. Looked at information about the people who use the service and how well their needs are met, other records which must be kept, and checked that staff had the knowledge, skills and training to meet the needs of the people they care for. We looked around the building/parts of the building to make sure it was clean, safe and comfortable and checked what improvements had been made since our last visit. We told the manager what we found. What the care home does well: What has improved since the last inspection? A new activities organiser has been appointed and takes up their post at the end of March. This will help to promote the range of activities and social events and opportunities that people can join in. A new Care and Health Assessment Profile (CHAP) has been introduced to help with the assessment and recording of peoples needs and wishes. The environment and equipment in the home continues to improve for the benefit of residents and everyone who visits or works there. New specialist chairs have been bought for individual residents to make life more comfortable for them when they are relaxing. Staff handover meetings and managers reports have been introduced so that everyone Care Homes for Older People Page 8 of 30 is kept up to date with the changing needs of residents and to give people the opportunity to voice any concerns they may have. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 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 wish to move into the home are properly assessed, taking into account their differing needs and wishes, so that they can receive flexible, consistent and reliable care. Evidence: The organisation has introduced a new assessment tool called the Care and Health Assessment Profile (CHAP). This is being used for all new admissions to the home and will also be completed for those residents who have lived in the home for some period of time, updating the information about their needs. We looked at the records for the person most recently admitted to the home. The CHAP had been fully completed and we were also able to see a copy of the North Tyneside Council Health and Social Care Assessment for the new resident. Care Homes for Older People Page 11 of 30 Evidence: As well as the assessment documents, the home uses a range of professionally recognised tools to record a persons nutritional needs, tissue viability, mental health wellbeing and areas of risk. The assessments are used to put together the residents service user plan that sets out what a person needs support with, how this should be provided to meet their needs and wishes, what their preferences are and any communication needs. The home does not provide intermediate care. 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. Improvements have been made in the planning of care and support to meet peoples diverse needs. Privacy and dignity is promoted but medication systems do not always support the safe ordering, receipt, administering and disposal of medicines to help keep people safe and well. Evidence: Five staff sent back our Have your Say questionnaires. They told us that they always or usually got enough information to support residents and that communication worked well. Three staff felt there was always enough people on duty to meet residents needs, two said their usually was. One person said care plans are clear and readable. Handover gives up to date information. We also have a managers report to read if we have had holidays and this informs us of all changes/incidents. We looked at the records for four more residents. All are now kept in a standard way Care Homes for Older People Page 13 of 30 Evidence: and care plans are much clearer and let staff now about residents choices and needs. Some entries in records still refer to adequate food/fluid intake, which means staff could be unclear about what they should be doing or encouraging. The deputy manager has been carrying out and recording care plan audits. She had identified issues in December 2008 but these had not been dealt with by the next audit in January. One assessment we saw included information about covert medication. No Multidisciplinary team meeting had been held to formalise these arrangements, and the advice of a pharmacist had not been sought about whether medicines were suitable to be crushed and/or mixed with food. There was also no advice about what staff should do if a one off medication, for example an anti-biotic, was prescribed. For another resident an entry in the daily records said appears to have lost a significant amount of weight - to be commenced on food and fluid charts to monitor. This statement was not supported by entries that had been made on the monthly weight chart. The manager told us that there had been some problems with the weighing scales and that new ones were being purchased. Records for another resident whose blood glucose levels needed to be checked regularly did not include the frequency at which these checks should be carried out and recorded. Even though only a limited number of checks had been recorded the care plan evaluation stated no problems with sugar levels. We saw evidence of the involvement of a range of healthcare professionals to support residents as well as advice being sought from the pharmacist and the Speech and Language Therapy Team (SALT) about changing medication to a liquid form for a person who was having swallow problems. The manage told us that she had ordered additional copies of Deprivation of Liberty (DOL) information leaflet so that she could send them out to relatives with an explanatory letter so that they are aware of the changing legislation. Records in care plans and evaluations are seen to be more person centred and sensitive. The home has made some progress in addressing medication issues identified at the last inspection. The treatment room has been partially refurbished and the application of creams and ointments is now regularly recorded on the medication administration Care Homes for Older People Page 14 of 30 Evidence: record (MAR) charts. The date of opening of medicines with limited is regularly recorded for eye preparations but not for all liquid medicines. For example, a bottle of temazepam liquid for one person was dispensed in June 2008 and appeared to have not yet been used but had no expiry date on the label to confirm that it remained suitable to use. A number of gaps were noted on the MAR charts with no code or explanation added to confirm whether or not medication had been administered. Several people were prescribed medication to be taken as required but no written protocol was available to guide staff as to when medication should be offered to the person. Allergies to specific medicines are recorded in the care plan and on the MAR photograph page but not in the allergy box at the top of each MAR sheet. This means that staff may not be alerted to this when a new medication is added to the MAR sheet. One person did not receive six prescribed medicines for at least seven days and these were recorded on the MAR sheet as out of stock or none supplied. We were informed that there had been a problem in obtaining a new prescription and some delay in dispensing. A supply of Persantin Retard without a dispensing label was found in the medicines trolley on the first floor. On the day of the visit two nurses, one on each floor, were responsible for the administration of medicines and the morning round was completed in a timely and organised way. A discrepancy was noticed between the amount of temazepam liquid recorded in the controlled drug register and the actual amount remaining in the controlled drug cupboard and there was no evidence of any regular controlled drug stock checks being carried out. Two healthcare professionals also returned our Have your Say questionnaires. They told us that the home usually seeks advice and acts upon it, meets individual health care needs and respects privacy and dignity. They also said there is good communication between the home and myself, I observe most staff members acting respectfully towards patients, things have been a bit better since the appointment of new staff. Care Homes for Older People Page 15 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 who live in the home are being encouraged and helped to be more independent and make choices for themselves. Social opportunities are still limited but improving. Evidence: The home is still without an activities organiser but a new person is due to start work on the 30 March 2009, and will receive support from the homes manager and through the regional activities organisers group to help them understand what people need and want. The atmosphere in the home continues to be much more relaxed and people were seen clearly making choices about where in the home they spent their time, with whom and what they were doing. In one lounge a visitor told us that they had been dancing. The home and one of its residents recently featured in a television programme and are due to appear on the BBC later in March. The resident is re-launching a book about their life. They and their relative were keen to talk about this and are looking forward to the up and coming events. Care Homes for Older People Page 16 of 30 Evidence: The kitchen is shared with the adjacent home. We sampled all the menu choices for lunch. Food was hot, well cooked and nicely presented and this included the meals for those people needing a soft diet. The choice for lunch was meatballs or chicken casserole with fresh vegetables, followed by ginger sponge and white sauce or tapioca. We saw evidence of care plans stating that food and fluid intake needed to be monitored and these were supported by food and fluid charts that were properly and fully completed. The dining tables were nicely set, covered with linen cloths, and residents were provided with dignity bibs when they needed something more protective than a napkin. People were seen being given support to enjoy their meal in a quiet and sensitive way. Care Homes for Older People Page 17 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. Systems and procedures are in place to support and encourage people to raise concerns and complaints. Staff are getting training in safeguarding adults that will help them to understand their responsibilities and keep people who live in the home safe. Evidence: Policies and procedures are in place to support the receipt, recording and investigation of complaints and concerns. The regional manager monitors complaints and concerns and the actions taken as part of her regular visits to the home. The programme of updating staff training in the Protection of Vulnerable Adults (POVA), continues. We were told that everyone is to receive refresher training in the near future and the manager agreed to forward the dates to CSCI as soon as they were known. Five staff sent back copies of our Have your Say questionnaires. They all told us that they knew what to do if a resident or their relative raised a concern or wanted to make a complaint. One person said I enjoyed the POVA training, I feel that staff who have more knowledge are always willing to offer support and knowledge. Care Homes for Older People Page 18 of 30 Evidence: No complaints had been received by the home or CSCI and there are no on-going safeguarding issues. A healthcare professional who returned our Have your Say questionnaire said they had not received any feedback about an issue they had raised some time ago. The inspector made contact with this person outside the inspection process to see if this needed to be followed up. Care Homes for Older People Page 19 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 homely environment that keeps them safe and gives them the chance to spend time privately. Areas of the home are more comfortable and pleasant for the people who live there and adapted equipment is provided when necessary. Evidence: The major refurbishment of the home continues. Corridors, lounges, dining rooms and some bedrooms have been redecorated and new floor coverings were due to be fitted week commencing 16 March 2009. New furnishings for the lounges have been chosen to co-ordinate with the colour schemes and specially sized chairs have been purchased to meet the individual needs of some residents. We were told that a bid had been forwarded for two further specialist chairs. We looked at six bedrooms, one of which had been newly decorated, and saw that equipment, including specialist beds had been provided to meet each persons individual needs. Two shower rooms are being refurbished and two new Arjo assisted baths are to be fitted into bathrooms to give people a realistic choice about how and where their Care Homes for Older People Page 20 of 30 Evidence: personal care is carried out. One bathroom on the ground floor has been regularly used for storage. We discussed the possibility of this room being refurbished as a hairdressing salon for the benefit of residents. In the refurbished dining rooms the old bars have been taken out to make them more spacious but an area is been provided where visitors will be able to make themselves tea and coffee to enjoy with their relative or friend. New curtains, bedding and dignity bibs for use at meal times have also been purchased. There are plans to provide areas of interest in the corridors. For example, a gardening area with a seat and items that people might have found or used in their gardens or garden sheds. As well as pictures, tactile wall decorations are being put up that people can touch and feel and may stimulate their imagination. All areas of the home were seen to be clean, tidy and odour free. Care Homes for Older People Page 21 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home are protected through recruitment and selection procedures that are properly followed and staff training. Staff are supported to do their job and to understand about peoples differing needs and how to meet them. Evidence: The organisation has policies and procedures in place to make sure that people are properly recurited. No new staff had been fully recruited since the last inspection so we did not carry out any checks on staff files. The newly introduced staff handover meetings continue and we have recevied positive feedback from staff about the benefit of these. Five staff sent back our questionnaires told us that their recruitment and selection had been properly carried out and that their induction covered everything very well. About their induction, one person also said I felt very supported but I feel it is a hands on job and takes time to get to know residents needs and personalities. All said that they got training that was relevant to their role, helped them to understand needs and that kept them up to date with new ways of working. Four people said they always got enough support to do their job and one said they ususally Care Homes for Older People Page 22 of 30 Evidence: did. Staff working in the home said: We are all involved in handover and are able to voice any concerns about residents. When asked what the home does well, staff said: I feel the team at Hunter Hall is now a solid one. The staff work well together and offer good support. This obviously helps to provide better care to our residents. I feel Hunter Hall has much improved over recent months and I come to work with a smile. I am proud to be part of a team which continues to improve. Four Seasons Health Care has re-structured the training department which has caused problems identifying what training has been done in each home. Work is being done to get records up to date. We were told that all staff have done moving and handling training, fire safety and customer care. Plans are in hand for people to receive health and safety and infection control. Infection Control handbooks have been printed and are due to be issued to staff who have also received information about Deprivation of Liberty (DOL) legislation. The manager is to talk to staff about DOL later in the month. The manager from another home is due to deliver POVA training to all Hunter Hall staff. This will take place over a period of three weeks, with 12 people being trained each week. Other training that people are undertaking is Medication Management for People with Dysphasia, Dementia: A Palliative Care Approach, falls awareness and wound care. Twenty seven per cent of care staff have achieved a National Vocational Qualification (NVQ) at a minimum of NVQ level 2. Nine staff are waiting to start this and another person is going to do their NVQ level 3. All the domestic and laundry staff are also completing an NVQ. Healthcare professionals told us - skills and knowledge are being gained through training initiatives. Care Homes for Older People Page 23 of 30 Evidence: About what the home does well, they said working hard to raise standards and support training programmes. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are living in a home that is now being run in their best interests, in an open and inclusive way. Policies, procedures and safe working practices are followed, helping to keep people safe and well. Evidence: The home is still being run by a temporary manager employed by Four Seasons Health Care. She is qualified and experienced to run the home and continues to adopt a very pro-active approach to improving the physical standards and the care and support that people receive. We received a copy of the homes Annual Quality Assurance Assessment (AQAA) for the previous inspection. This told us what was happening in the home, what they felt they did well and which areas needed to improve. Since the last inspection the home has signed up to the Pearl Homes scheme that is Care Homes for Older People Page 25 of 30 Evidence: being run in conjunction with Bradford Univeristy. This is assessment process that includes the manager, staff, environment and care. There are three levels of accreditation and the level a home achieves will dictate how often they are reviewed. The organisation has taken on additional staff to promote this project. The home will tell Bradford Univesity when they are ready for accreditation. Following this the University will carry out an unannounced visit. There are three levels of accreditation and the frequency of review is dependant on the level achieved. Throughout the inspection we saw that risk assessments had been regularly and properly completed. Servicing and maintenance contracts remain in place and all fire checks had been properly and regularly carried out and recorded. The organisation has clear policies, procedures and systems to support the safe handling of residents monies and the acceptance of fees. Regular audits are carried out to make sure that procedures are being followed. Records continue to improve but some gaps and contradictory information were seen. Both staff and healthcare professionals said that they felt communication worked well and had improved over recent months. About what the home does well, healthcare professionals said - the new manager is approachable and the deputy, I get the feeling they are trying to turn things around, I think that the manager has improved standards of care via the selection of staff and an emphasis on training. About how things could improve - Through strong management, mature staff team, enthusiastic carers, carer/fammily involvement group, written and verbal communication, particularly amongst qualified staff, needs to be improved. This has lead to considerable difficulties in an area of care for a lady I see at this home. Care Homes for Older People Page 26 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 9 13 The providers policies, 23/12/2008 procedures and best practice guidance must be followed when staff are dealing with medication. This will help to keep people who live in the home safe and well. 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 9 13 The administration of medication in a covert way must be formalised and proper checks carried out to make sure that the medication is suitable to be mixed with food. This will help to keep the person receiving the medication safe and well. 10/04/2009 2 9 13 Medicines must be given as prescribed and stocks kept to allow this. This will help people who live in the home to get the right medicines and to keep them safe and well. 10/04/2009 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 7 Care plans should contain clear information so that staff know when and how they should carry out checks to help Page 28 of 30 Care Homes for Older People keep people safe and well. 2 8 Accurate weighing scales should be available in the home so that the weights of residents can be accurately recorded and monitored, helping to keep them well. Detailed guidance on when to administer as required medication should be kept with the persons MAR chart. Liquid medicines without an expiry date on the label should not be used for longer than three months from the date of dispensing. Stocks of controlled drugs should be regularly checked and a record made in the controlled drug register. Any known allergies to medication should be recorded on the front of each persons MAR chart. The programme of activities and social opportunities should continue to be assessed and improved to make sure that people living in the home lead a stimulating and interesting life. CSCI should be provided with the dates that staff will receive refresher training in the protection of vulnerable adults. This will help to keep people who live in the home safe. Fifty per cent of staff should have a National Vocational Training qualification at a minimum of level 2. This will help them to do their job. A clear and up to date training matrix should be in place to show what training staff have recevied and when they need to have refresher training. This will help to protect people who live in the home. 3 4 9 9 5 6 7 9 9 12 8 18 9 28 10 30 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 © (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. 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