Inspection on 27/08/09 for Laurels Retirement Home

This inspection was carried out on 27th August 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Laurels Retirement Home 22/08/07

Laurels Retirement Home 24/10/06

Laurels Retirement Home 27/01/06

Laurels Retirement Home 02/08/05

Laurels Retirement Home 14/03/05

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 25/11/2009.

Key inspection report Care homes for older people Name: Address: Laurels Retirement Home 195 Barrack Road Christchurch Dorset BH23 2AR     The quality rating for this care home is:   one star adequate 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: Martin Bayne     Date: 2 7 0 8 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 28 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 28 Information about the care home Name of care home: Address: Laurels Retirement Home 195 Barrack Road Christchurch Dorset BH23 2AR 01202470179 01202485200 info@laurels.uk.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Richard Kitchen,Mrs Elizabeth Kitchen care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users that can be accommodated is 20. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) Dementia aged 65 years or over (Code DE(E)) Date of last inspection Brief description of the care home Laurels Retirement Home is a residential care home registered for twenty places under the category of OP (Old Age) and DE(E). It is an older style property, with a more recent extension, situated on one of the main roads into Christchurch town centre. Mr and Mrs Kitchen took over as proprietors of the home in September 2004. The majority of bedrooms are for single occupancy with two providing en-suite facilities. One of the four double rooms is also en-suite. The home has a lounge and a dining room, which also has a small seating area that looks out onto the patio. There are stair lifts to the Care Homes for Older People Page 4 of 28 Over 65 20 20 0 0 Brief description of the care home upper floors. To the rear of the property is a secure, private patio area with seating where service users can entertain visitors. The fees for the home are detailed within the Service User Guide. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We, the Commission, carried out a key inspection of The Laurels Residential Care Home between 9:00am and 4:00pm on the 27th August 2009. The inspection was carried out by one inspector, but throughout the report the term we is used, to show that the report is the view of the Care Quality Commission. The aim of the inspection was to evaluate the home against key National Minimum Standards for older persons, and to follow up on the one recommendation made at the last key inspection in August 2007. A pharmacy inspection was also carried out by the commission in October 2007 at which one requirements and two recommendations were made. These requirements were also followed up inspection. Since the last key inspection the Registered Manager has stopped working at the home and an acting manager has been appointed to run The Laurels. On the day of our visit the acting manager was not on duty and we were assisted in Care Homes for Older People Page 6 of 28 the morning by the deputy manager. Later in the day the acting manager came in to assist with the inspection. Throughout the inspection we tracked records relating to a sample of three residents, which provided us with evidence of the homes record-keeping as required under the Care Homes Regulations 2001. We spoke with six residents about their experience of living in the home and also to some visiting relatives. We carried out a tour of the premises and looked at other records that provided us with evidence of how the home was managed. Additional information that helped form to the judgements contained within this report was obtained from the Annual Quality Assurance Assessment document completed by the home. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: Medication administration could be improved by; making sure that any hand entries on medication administration records are checked and signed by a second member of staff, by maintaining a list of a sample of staff signatures of staff trained to administer medication and by providing guidance in care plans as to when as required medication should be administered to residents who do not have mental capacity. It would be beneficial to gain more information about residents life histories from their relatives, so that residents individual social and recreational needs can be met. Better infection control standards would be achieved by making sure that communal bathrooms are supplied with paper towels, liquid soap and foot operated lidded bins; Care Homes for Older People Page 8 of 28 and also by making sure that residents towels and tablets of soap are returned to their bedrooms when not in use. The management of the home must ensure that no new members of staff start work in the home until such time as all the required recruitment checks have been satisfied. More attention should be paid to maintaining accurate records that tally with the balance of money held concerning residents money. Following the monthly visits by the Registered Providers, they must prepare a report on the conduct of the home. The manager must ensure that there is a visual inspection of the fire fighting equipment carried out each month. A visual inspection of the fire fighting equipment must be carried out each month. 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. 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 28 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 28 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. Residents benefit from having their needs assessed before being offered a place at the home; this procedure ensures that the home only accommodates people whose needs it can meet. Evidence: We saw that an up-to-date Statement of Purpose is kept at the front reception entrance to the home together with a copy of the last inspection report carried out by the Commission for Social Care Inspection. Relatives and residents are therefore well informed about the services that the home provides. We were told that prospective residents have their needs assessed by the manager before they are offered a placement at the home. We were also told that where a placement is arranged through care management arrangements, a copy of the care management assessment is also obtained to assist in assessing a prospective residents needs. We saw a copy of one of these assessments on file. Care Homes for Older People Page 11 of 28 Evidence: We looked at the pre-admission assessments of need that had been carried out for the three residents we tracked through the inspection. We saw that these assessments were recorded on a template that covered all of the topics detailed within the National Minimum Standards. The pre-admission assessment procedures of the home make sure that they only admit residents whose needs they can meet. The home does not provide an intermediate care service. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from their health care needs being met through the homes care planning system, by being treated with respect and dignity and by having medication administered safely. Evidence: We looked at the care plans and assessments for the three residents we tracked through the inspection. We saw good practice of a photograph and key information at the front of each persons care plan, as well as an information sheet about the persons needs should they have to be admitted to hospital. Care plans had been developed from various assessments such as a skin care assessment, a moving and handling assessment and a nutritional assessment. We saw that residents weights were regularly recorded. The care plans provided sufficient information for a new member of staff to provide care to that person. Due to the mental frailty of the residents accommodated at the home, we saw that care plans were sent to relatives so that they were informed of how care needs were being met. Care plans provided information about times residents normally wish to get up and go to bed, their food likes and dislikes, communication needs, personal care needs, any religious or cultural Care Homes for Older People Page 13 of 28 Evidence: needs, family involvement and medication. We also saw the records were kept of any GP or health professional visits. It was evident from the documents above that the health needs of the residents we tracked through the inspection were being met. We saw that GP visits were arranged appropriately and also district nursing intervention. We also saw evidence that the home had links with the community mental health team to meet some residents mental health needs. We also saw that chiropody, hearing and needs relating to eyesight were attended to. Some of the residents we spoke with were able to give feedback about their experience of living in the home. These residents told us that the staff were very kind and attentive and that residents were treated with respect and dignity. This view was also shared by the relatives we spoke with. We looked at how medication administration was managed within the home. Due to the mental frailty of all the residents, medication is administered by the staff. The AQAA informed us that all of the staff who administer medication have received training in safe administration of medication. The homes medication cabinet is kept locked with the person responsible for medication administration holding the key, the requirement was therefore complied with that was made at the last key inspection. When medication is administered the blister packs are taken to the dining room together with the medication administration records. Medication is administered to an individual and then their medication administration records are completed. We looked at the medication administration records for all of the residents. We saw that there was good practice of a photograph of the resident concerned at the front of their records, together with a record of any known allergies suffered by that person, thus meeting a requirement made at the last key inspection. We made some best practice recommendations concerning medication administration. We saw some practice of a second member of staff checking the records and signing when a hand entry had had to be made to the records, but not in all cases. We recommend this practice is adopted in all cases to make sure that there is no error made when transcribing information. We also saw that some residents were prescribed PRN (as required) medication. As the residents of the home do not have the mental capacity to ask for this medication, we recommend there is some guidance to staff as to when this medication should be administered. We also recommend that a sample of staff signatures of those staff who administer medication be kept at the front of the medication administration records so that one can determine who administered medication at what times and dates. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from their social and recreational needs being generally met, through being able to maintain contact with friend and family and through being provided with a good standard of food. Evidence: The home keeps a record of any activities undertaken with residents in an activities book. We saw that communal activities are arranged for residents such as a music activity held in the home each month, gentle armchair exercise sessions each week and a reminiscence therapy session held every four weeks carried out by an external provider. We also saw that the staff at the home provide some activities such as boardgames or puzzles on most afternoons in the care home. We also saw that occasional outings are arranged. As many of the residents have memory problems, the home should seek information from relatives about residents life histories so that staff can better understand the social needs of residents. The manager told us that she was currently sending out forms and consulting with relatives about residents life histories and we recommend that these are then used to provide individual and meaningful activities for the residents concerned. The residents we spoke with who are able to give us some feedback, told us in general that their leisure and recreational needs were met. We did speak to one resident who said that he would like Care Homes for Older People Page 15 of 28 Evidence: to go out from the home more often. This was discussed with the manager who told us that she was seeking to engage a befriender for this resident so that they could be taken out more often. We saw that when residents are admitted to the home their religious and cultural needs are assessed. We were told that a visiting clergy member visited the home once a month to conduct a service. We saw that there were no restrictions on visiting and the relatives we spoke with told us that they were made welcome and could visit at any time. They also told us that the home kept them well-informed about their relatives care. All of the residents we spoke with told us that the food was of a good standard and that their likes and dislikes are noted and met. We saw that the home keeps records of food provided to residents and these reflected that a wholesome and balanced diet was being provided with choice of menu each day. We saw that nutritional assessments were carried out and fluid and food charts would be put in place for those residents where there were concerns about their nutritional and fluid intake. Care Homes for Older People Page 16 of 28 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. Residents benefit from a well publicised complaints procedure and through the staff being trained in adult protection. Evidence: The complaints procedure for the home is detailed with homes Service User Guide and also within the terms and conditions of residence. Residents and relatives are therefore well-informed of how to make a complaint about the home. Since the last inspection and there have been no complaints made to the management of the home and none had been brought to the attention of the Commission. One safeguarding referral was jointly investigated with social services that also included they inspection by the commissions pharmacist. The AQAA informed us that the home has policies and procedures that dovetail with local authority arrangements for the protection of vulnerable adults. We also saw from training records that all of the staff have been provided with training in the protection of vulnerable adults. Care Homes for Older People Page 17 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Laurels provides a homely and well maintained environment for residents; however, some improvements could be made to minimise the risk of cross infection in the home and residents will be safer when window restrictors are fitted to all windows above ground floor level. Evidence: As part of the inspection we carried out a tour of the premises. In general we found the home to be clean, free from any unpleasant odours, in reasonable decorative order and with furniture and fittings in a good state of repair. The home has pleasant airy communal areas and residents have access through patio doors from the back lounge to a paved enclosed garden area. We saw that residents are able to bring their own furniture and possessions to personalise their rooms. We found in some of the bedrooms the wardrobes are not attached to the wall and some could pose a risk of being toppled over by residents. We recommend that the wardrobes are assessed as to the likelihood of being toppled, and any that pose a risk should be attached to the wall. We found on the first floor of one section of the building that all of the windows had no window restrictors fitted and could pose a risk of residents either falling or getting out of the windows. A requirement was made that window restrictors be fitted to all windows above ground level. We looked within the communal bathrooms and found that generally liquid soap Care Homes for Older People Page 18 of 28 Evidence: and paper towels were provided, however in some of the bathrooms cotton towels were also evident and paper towel dispensers were empty. We also found a tablet of soap in one bathroom. We recommend that in the interests of infection control liquid soap, paper towels and foot operated lidded bins be provided to reduce the risk of cross infection. Where residents use their own towels and tablets of soap, we recommend that the staff ensure that these are returned to residents bedrooms to reduce the risk of cross infection within the home. We saw within the bedroom of one resident who had memory problems, a tube of denture cleaning tablets. These products have been known to cause fatalities if ingested and we recommend that these are stored out of reach of residents with memory loss. The home has a laundry area that is equipped with machines and driers to meet the laundry needs of the home. Care Homes for Older People Page 19 of 28 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. Residents benefit from staffing levels that meet their assessed needs and through staff being well-trained; however recruitment procedures need to be more rigorously applied. Evidence: The returned AQAA informed that there are three care staff on duty between 8am and 2pm and then two care staff on duty for the rest of the daytime. During the night-time period there is one member of staff who carries out an awake night duty and one person who carries out a sleep-in duty. In addition the manager works in the home office hours on weekdays and there is on-call system for assistance out of hours. The home also employs domestic staff and a cook. We looked at staff rosters and found that these reflected the daytime hours. Since the AQAA was submitted, night-time staffing levels have been increased to two awake members of staff on duty, on account of one person needing the assistance of two staff at night. We saw that staff rosters included the hours worked by the manager has recommended at the last key inspection. We asked about staff sleep in accommodation and were told that the sleep in member of staff would either sleep in a vacant bedroom or if the home had full occupancy, in the residents lounge. Regulations require that sleep in accommodation be provided and so the current arrangements are not satisfactory. The management must either provide sleep-in accommodation if sleep-in staff are to be employed, or provide two awake members of staff on duty at night. Care Homes for Older People Page 20 of 28 Evidence: The home has a stable, longstanding staff team. Since the last key inspection there has been some turnover of staff and we looked at the recruitment records for two members of staff recruited to the staff team since that time. Generally we found that all of the requirements of Schedule 2 of the Care Homes Regulations 2001 had been complied with; such as taking up of two references, a criminal record bureau check, a check against the register of adults deemed unsuitable to work with vulnerable adults, a full employment history and a health declaration. We identified one technical anomaly. One member of staff had been employed by an employment agency covering a full time post vacancy and had been subject all the recruitment checks by the agency. This member of staff was then recruited to the full-time team at the Laurels to fill this vacancy, but was entered onto the payroll of the Laurels before a new Criminal Record Bureau Check had been returned and a returned clear check against the register of unsuitable care workers. It is acknowledged that there were no additional risks to residents as there was continuity of this worker are being employed at the home, however, in such circumstances the home must ensure that a worker is not started on the homes payroll until such time as all the recruitment checks of Schedule 2 are satisfied. We saw that new members of staff are provided with induction training and that subsequently core mandatory training was provided in such areas as; fire safety, health and safety, moving and handling, infection control, first aid, and training in the protection of vulnerable adults. The home has achieved a level of greater than 50 of the staff trained to NVQ level 2 or above. Care Homes for Older People Page 21 of 28 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. Residents benefit from a home that is generally well managed and run in the interests of residents, however, there are some improvements that could be made. Evidence: As reported earlier, the Registered Manager has ceased working in the home and a new manager has been appointed by the Registered Provider to manage the home. The current manager has deputy manager experience and is currently undertaking the Leader and Management course. It was agreed that an application form would be submitted to the Commission by October 9th 2009 for registration of the current manager. We saw that the home had conducted a quality assurance survey and we looked at the responses that had been returned. These reflected a high satisfaction with the service and validated that the home is run in the interests of the residents. The Registered Providers visit the home unannounced every two weeks; however, reports on the conduct of the home as required under Regulation 26 were not available. Care Homes for Older People Page 22 of 28 Evidence: The home looks after small sums of money for some of the residents. We looked at the records concerning two residents. The records detailed money deposited, withdrawn and the balance of money held with the residents signing transactions. We recommend that the staff also sign the records. We found in one case that the balance of money did not tally cash held, by a samll margin. We require however that accurate records are kept that tally with the balance of money held. We looked at the fire logbook and found that tests and inspections of the fire safety system were generally taking place with the exception of a record of the visual inspection of the fire fighting equipment. This inspection must take place each month and be recorded to make sure that fire extinguishers are sited as detailed within the homes fire risk assessment. Care Homes for Older People Page 23 of 28 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 24 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 23 We require that any windows above ground floor level be fitted with window restrictors. To ensure that residents do not fall from windows. 09/10/2009 2 27 19 You are required to provide two awake members of staff during the nigt time period, or provide sleep-in accommodation (Reg 23 (3) (b)) if sleep-in staff are provided. To make sure assessed needs of residents are met. 09/10/2009 3 29 19 You are required to comply with all of the requirements of Schedule 2 of the Care Homes Regulations 2001. To make sure that suitable staff are employed. 09/10/2009 4 31 26 Following unannounced visits to the home made by 09/10/2009 Care Homes for Older People Page 25 of 28 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 the Registered Providers a report must be written on the conduct of the home each month. To ensure good management of the home. 5 35 25 Accurate records must be maintained of money held on behalf of residents that tallies with the balance of money held. To ensure that residents finances are protected. 6 38 23 You are required to carry out 09/10/2009 and record a visual inspection of the fire fighting equipment each month. To ensure that fire prevention strategies are maintained. 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 09/10/2009 1 9 We recommend that: a) where hand entries have to be made to the medication administration records, a second person checks and signs that the record has been entered correctly. b) a sample of staff signatures is maintained on the sheet at the front of the medication administration records. c) where a variable dose of as required medication is Care Homes for Older People Page 26 of 28 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 prescribed, some guidance to the staff is detailed in the residents care plan as to when this should be given. 2 12 We recommend that you seek information about residents life histories from relatives and this information is used to inform care plans about meeting residents social needs. Care Homes for Older People Page 27 of 28 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 28 of 28 - 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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