Inspection on 27/02/09 for Linden Lodge Residential Home

This inspection was carried out on 27th February 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Linden Lodge Residential Home 12/10/06

Linden Lodge Residential Home 13/12/05

Linden Lodge Residential Home 01/06/05

Linden Lodge Residential Home 29/09/04

Linden Lodge Residential Home 22/04/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Linden Lodge Residential Home Browns Lane Dordon Tamworth Staffordshire B78 1TR     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Martin Brown     Date: 2 7 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Linden Lodge Residential Home Browns Lane Dordon Tamworth Staffordshire B78 1TR 01827899911 01827899922 chaynes@lindencarehomes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ms Deborah Frances Leyland,Mr David Charles,Mr Donovan Charles,Dr Alan Roy Gummery,Ms Patricia McDon care home 34 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 23 34 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 0 The home is purpose built and is registered to provide care for older people with dementia (34 beds). The accommodation is provided over three floors. The majority of the service user accommodation is provided in single rooms. All rooms have en suite facilities. Lounge, dining and assisted bathing facilities are provided on each floor. There is also a conservatory on the ground floor. The home is located opposite a small number of shops and close to the village amenities. There is an accessible enclosed garden area designed to meet the needs of people who live at the home. The current fees for the service range between £416 and £500 per person per week. This does not include person items, such as clothing that people are required to purchase from their personal monies. Care Homes for Older People Page 4 of 29 Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This report has been made using information that has been gathered by the Commission for Social Care Inspection. The inspection visit took place on 27th February, 2009, between 9am and 4:30 pm. The home did not know we were coming. All or most of the people living in the home were seen over the course of the inspection, and many were spoken with about their experience of living at Linden Lodge. Care and ancillary staff were spoken with, as was the manager and one of the owners. A tour of the premises was made, relevant documentation was looked at, and observations of the interactions between residents, staff and their environment were made. Policies and procedures, and care records were examined, and the care of three people living at the home was case tracked, that is, their experience of the service provided by the home was looked at in detail. At least six visiting relatives were spoken Care Homes for Older People Page 6 of 29 with. The Annual Quality Assurance Assessment, containing information about the service, completed by the service, and returned before the inspection, also informed the inspection. The AQAA provides information about what the service does well, what it intends to do to improve in the future. The home is now primarily a service for people with varying degrees of dementia. People living at the home were able to offer views, in varying detail, on the care and support they received. With one exception, they were all very positive. All the visiting relatives were extremely positive about the home, the manager, and the staff. Staff and residents were welcoming and helpful throughout. 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 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 8 of 29 Care Homes for Older People Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with information to help them make an informed choice in moving to Linden Lodge, and can be confident that the service assesses their needs sufficiently to ensure they can be met at Linden Lodge. The small number of residents at Linden Lodge without dementia are at risk of being isolated, now that the majority at the home come under that category. This means they risk not having their health needs fully met. Evidence: Relatives spoken with concerning their loved ones moving to Linden Lodge said that they had made a positive decision to choose the home, after visiting, and looking at other places. Some residents did not recall the circumstances surrounding their move to the home, but others were positive about it. One person said that they chose it because it was local. Care Homes for Older People Page 11 of 29 Evidence: The care file of the most recently admitted person contained an assessment that had been completed prior to their admission, showing what their needs were, enabling the home to be confident that these could be met. Needs assessments covered such areas as mobility, diet, and personal preferences, where known. A Getting to Know You, or Personal History, record was seen in files of residents. Staff advised that these are filled in and returned by relatives, to help give background information, showing topics of interests, as well as subjects to be avoided. For example, it showed one person was not comfortable with references to the war. These assessments are then used as the basis for individual care plans. The home is now registered as a dementia home. However, there are a very small number of people still at the home who do not have a diagnosis of dementia. One person was spoken to who, although they had a number of grumbles about the home, did not wish to leave. The complaints of this person were known of by the manager, and were not at all reflected in any other views by either residents or relatives. People are not admitted to this home for intermediate care. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home benefit from good attention to healthcare and to personal and social needs. Privacy and dignity is generally well respected. Good medication practice is compromised if recording does not clearly demonstrate accurate administering of medicines, and this has the potential to place peoples health at risk. Evidence: A sample of three care files were looked at in detail. These were handwritten, but were clear, and contained relevant information needed for the care of each person, without being too detailed, so that staff needing to familiarise themselves with a persons care needs from the plans could do so relatively quickly. One person spoken with had a keen interest in and knowledge of stately homes. There was no mention of this seen in their care plan, but the manager was able to confirm how the service catered for this, with a regular visitor with a similar interest, and lots of books on the subject. Plans to accompany this person on trips to particular buildings Care Homes for Older People Page 13 of 29 Evidence: had not yet come to fruition. Health needs were recorded in care plans, and examples of how these were met were discussed with staff. One person was at risk from infections, precautions in respect of this were noted, and staff spoken with on this were aware of these. Relatives commented on how well the home managed peoples health, always getting in outside help if needed, and keeping people informed of any health concerns, and of actions to maintain good health. One resident commented that being at the home was like being on holiday. Call bells were in evidence. One, in a downstairs toilet, was tested, and a member of staff arrived within a minute. Throughout, staff were seen to be helping and talking to residents in a friendly, positive manner and upholding their dignity and respect. One area where dignity and privacy was compromised is noted in the environment section, where the fact that the lock on a well-used toilet was broken and not noted for repair. This had the potential to compromise the dignity and well-being of anyone using that toilet, as they could not only not lock themselves in, but could not alert anyone to the fact the toilet was being used. A staff member acknowledged that this toilet lock had been broken for several days, but there was no record of this as a job to be done in the repairs book. There is a separate staff toilet. The possibility that not having separate staff toilets might have resulted in the lock being fixed more promptly was discussed with management. The manager was able to confirm, following the inspection, that the toilet lock had been repaired. Throughout, staff were stimulating, reassuring and supportive to residents in their face-to-face contact with them. The simple act of smiling at people a lot gave lots of reassurance to many. The administration and recording of medication was looked at. Some of the Medication Administration Record Sheets in the medication folder were loose. A member of staff advised that they fell out, because a new ring binder was needed. Medication is stored securely and appropriately. Most medication is dispensed via blistered packaging. Samples of these were looked at, and these showed as being administered and recorded correctly. The controlled medication register was examined. This contained accurate records of Care Homes for Older People Page 14 of 29 Evidence: all controlled medication administered, appropriately signed by two staff. However, a record for one medication for someone who was no longer at the home showed as having one medication one remaining. The manager advised that this medication had been returned to the pharmacy. However, there was no record of this having happened, and no record of a signature from the pharmacist for receipt of this signature. The manager advised that this single, unused medication would have been returned to the pharmacist, but could not account for the fact that this was not recorded, or that there was no receipt from the pharmacist. The manager was able to confirm, following the inspection, that a receipt for the unaccounted for medication had been obtained from the pharmacist and added to the controlled medication register. There were some medications that are not dispensed by blister pack, either because they must be dispensed directly from their packaging, or because they are dispensed infrequently and according to need. These are not stock controlled on a daily basis. The manager advised that they are checked and audited on a random basis. These were checked and in two cases it was found that the amounts remaining did not tally with the records of what had been dispensed. The manager was able to advise, following the inspection, that staff are to be instructed in ensuring that the amounts of these medications are checked when dispensed to ensure accuracy. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Linden lodge benefit from a range of activities and from the individual attentions of staff who consistently engage them in stimulating activity. Relatives are welcome, and the home engages positively with them. Residents enjoy a choice of good nutritious food in a pleasant, relaxing environment. Evidence: There were notices in evidence concerning visits by entertainers, and of other planned activities. Relatives spoke favourably of activities provided by the home. Initiative and commitment was shown by staff in arranging ad hoc activities. These were small scale, a but provided stimulation and enjoyment for individual residents, and often not just for the person undertaking the activity, but also for those in the vicinity. Examples of this were ladies having their nails done, which was causing much merriment, as was an activity with a beach ball seen later. In addition, staff were frequently seen using spare moments to have a brief chat with residents, noticing those who had perhaps been quiet or a little withdrawn. Relatives spoken with were positive concerning activities, saying that the home organised a variety of things for people to do. Care Homes for Older People Page 16 of 29 Evidence: All relatives spoken with said that the home was always welcoming, was good at contacting and informing them of anything relevant. There were frequent visits by relatives throughout the inspection. Relatives had a good rapport with staff, as well as with other residents and each other. Residents were seen exercising choice in where they went and what they did within the home, only being guided and supported by staff if they appeared lost or distressed. There are three dining areas, one on each floor, so that there are no more than twelve people eating together. The midday meal was a relaxed, unhurried time, with suitable time and space for all. One person spoken with later had commented that some staff hurried people at meal times, but there no other evidence of this, from observation or from anyone else. A meal was taken with residents on one floor. This was freshly prepared, tasty and enjoyed by residents. A choice was offered at the table, and consideration was given to current diets, with puddings low in sugar, and a liquidised diet for one person. Assistance was offered to one person, whose ability to eat unassisted fluctuated. Hot and cold drinks were offered at many occasions throughout the day, and staff were aware of residents whose fluid intake caused some concern, and prompted and encouraged here. The kitchen was clean and tidy. The cook advised that the last Environmental Health Inspection, in May 2008, took place at a time of refurbishment, and the requirements made at that time had all been addressed. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has suitable procedures and policies in place to manage complaints. Policies, procedures, and the ethos of the home helps protect the people who live there against abuse. There may be instances where residents express unhappiness with the service, and these are not registering as complaints, and are therefore not fully addressed. Evidence: The complaints log was looked at. The last recorded complaint was in 2005, and the manager was able to explain how this had been responded to and how the service had improved its practice. We have received no complaints about this service since the last inspection. All relatives spoken with said they had no complaints, only compliments, about the service. They all said that they felt the staff and management were approachable and would have no hesitation in discussing any concerns with them. A notice about how to complain was displayed, but was in small print and not very eye-catching. The manager advised that leaflets on this subject, like other leaflets, rapidly disappeared. One resident had spoken of what they felt were shortcomings of the service, such as a shortage of staff, manifesting as staff not having enough time for individual residents. Care Homes for Older People Page 18 of 29 Evidence: No other resident or relative indicated that this was a problem. The manager advised she was aware of the concerns of this person, and attempted to address them by ensuring staff gave additional attention in this direction. These concerns had not been logged as a complaint. Staff spoken with were aware of what to do if abuse of a resident was witnessed, alleged, or suspected. The manager was able to detail how a recent issue of concern, not involving any of the staff of the home, was being dealt with appropriately. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with a comfortable, clean and suitably equipped home that meets their needs. Maintenance is good, although staff and management need to make sure that all problems are promptly reported, to ensure that the well being of residents is not compromised. Evidence: This home, purpose-built seven years ago, is on three floors. There is a shaft lift and a stairs connecting the floors. Each floor has around eleven people living on it, with a lounge and an adjoining dining room on each floor. The ground floor also has a conservatory. Staff and management advised that, although residents eat on their floors, a number of them tend to spend time on different floors, and, in good weather, in the conservatory. There are no quieter, additional lounges for residents wishing to be apart from the main lounge/dining room areas, other than the conservatory or their own bedrooms. No resident or relative spoken with viewed this as a problem. Each floor has a staff room, which also doubles as an area where individual residents can be helped to make toast of hot drinks themselves, as the wish arises. Main meals come from the ground floor kitchen. Care Homes for Older People Page 20 of 29 Evidence: There is a double room on each floor. All bedrooms have en suite (toilet) facilities. All areas are pleasantly furnished, decorated and maintained. Carpets in some areas are worn, but not yet to a hazardous degree. The manager advised that these are soon to be replaced, and received a quote for this work during the inspection. Some chairs in communal areas had brand name waterproof coverings on. Most were of a high quality, less noticeable type. Some were light pink and noticeable. The manager agreed that lounge areas would look more homely if all were of the less noticeable type and advised that these would all be changed over. A ground floor toilet had a broken lock, which compromised the privacy and dignity of anyone using that toilet, as there was no way of locking it, or showing that it was occupied. A staff member advised that it had been broken for a day or two, and was surprised to find out it was not written in the maintenance book, which alerts the maintenance person to jobs that need doing. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home benefit from the attentions of a consistent and well motivated staff team who are familiar with individual needs and how best to meet them. Evidence: During the inspection, there were two care staff on duty on each floor, in addition to management, kitchen and domestic staff. The rota showed that this was the usual compliment, with three care staff on duty at nights. Relatives spoken with were very complimentary about the staff, saying they were nice, approachable and informative. Staff were seen to interact with residents in a warm, friendly way throughout the inspection, and use their initiative to spend time with residents and to check out their well being and to provide re-assurance regularly. Staff were seen throughout to be positive and creative in stimulating and reassuring residents. Staff responded promptly to call bells. At meal time, I observed that one resident may benefit from a plateguard. Very soon after, the staff member advised that she had requested one and that it had been ordered. Care Homes for Older People Page 22 of 29 Evidence: A sample of three staff files, including that of the most recent recruit, were examined. These showed recruitment checks taking place including references and Criminal Records Bureau checks. Staff spoken with described the induction process, which was recorded in files. One Criminal Records Bureau check looked at showed a caution. Management advised that this had been discussed with the person, but there was no record of this discussion on this file, nor could any record be found during the inspection. The manager was able to confirm, after the inspection, that this record had been located, and retrieved, from amongst archived files. Management advised that that the home had had relatively few recruits recently, as staff turnover was very low. Agency staff are not used by the home, with part-time or regular bank staff filling in any shortages caused by absences. There was agency staff being used to provide oneto-one support for one person. This agency staff was funded and employed by the health authority, as a special agreement to continue care for this person at the home. Evidence of staff training was seen, including National Vocational Qualification and dementia care, alongside the mandatory training. Staff spoke positively of training opportunities and of ongoing dementia care training. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a well run home that is run in their best interests, takes account of their wellbeing and safety, and strives to constantly improve. Evidence: The manager holds a nursing qualification and a diploma in dementia studies, in addition to the Registered Managers Award. She has many years experience of the care of older people and is well qualified for her role. She showed a keenness to maintain and improve standards at the home, and to rectify those shortcomings identified during the inspection. Staff, as well as relatives spoken with, said that the management was helpful and supportive. The manager has done extensive training in Dementia Care Mapping, which involves Care Homes for Older People Page 24 of 29 Evidence: closely observing the support and well being of a sample of residents in order to ascertain their well-being and any improvement that can be made. She was able to give an example of how this had highlighted an area of need which was then addressed. Quality assurance questionnaires were seen for 2008, along with the results of the 2007 surveys, an appraisal of those results, and recommendations for the following year. What was not evident was any appraisal of whether those recommendations had been followed through. Replies were very positive, and this tallied with the overwhelmingly positive responses from almost all those spoken with during the inspection. In a discussion about complaints, the manager advised that information leaflets put out rapidly disappeared. A discussion was had about how these could be displayed, without them all being removed by persons unknown. It was suggested that the outer alcove be used as a display area. The manager advised, following the inspection, that there is also a relative contact sheet, where any concerns, and how they are responded to, are logged. An example was given regarding a comment that the food one day was a little cold. This record was not seen during the inspection. The manager advised that residents meetings do not take place. Individual issues are raised at reviews which take place for all those who live at Linden Lodge, whether privately or social services funded. Relatives are invited to these. Relatives spoken with said they were kept informed of any issues concerning their loved ones. The manager advised that the home does not look after any personal monies of residents. The Annual Quality Assurance Assessment returned by the manager indicated that all regular health and safety checks, including hot water, and Legionella, take place. The maintenance book was seen, showing a list of routine maintenance requests and when they were carried out. No health and safety concerns were noted on a tour of the building. A fire risk assessment was seen, along with evidence of regular fire checks. Staff spoken with were aware of fire procedures. Care Homes for Older People Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 10 13 The service must ensure 04/04/2009 that all medications returned to the pharmacy are recorded as such, and that receipts for these are in evidence. This is particularly important for controlled medication. This is necessary so that people using the service can be confident that all unused medications have been disposed of properly. 2 10 13 The service must ensure that the amounts of all as required medications are checked when dispensed, so that any discrepancies are accountable and can be dealt with in a timely manner. This is necessary so that people can be confident that all medication is being dispensed properly at all times. 04/04/2009 Care Homes for Older People Page 27 of 29 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 2 3 9 10 16 Dignity and privacy of residents is compromised if broken toilet locks are not reported and mended promptly. Medication records should be stored securely, so that accurate recording is not compromised. The home should consider logging any individual concerns about the home, or staff, as a complaint, even if that individual has not raised it as such, so that it can clearly be seen that it has been addressed. Where there has been an appraisal of Quality Assurance surveys, and recommendations following on from them, it would be useful for the following years appraisal to analyse how successful or otherwise, the implementation of the recommendations are. 4 33 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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