Inspection on 04/03/10 for Lumb Valley Residential Home

This inspection was carried out on 4th March 2010.

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

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

Other inspections for this house

Lumb Valley Residential Home 02/04/09

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 03/06/2010.

Key inspection report Care homes for older people Name: Address: Lumb Valley Residential Home 906/908 Burnley Road East Lumb Rossendale Lancashire BB4 9PQ     The quality rating for this care home is:   zero star poor service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Susan Hargreaves     Date: 0 4 0 3 2 0 1 0 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 33 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 33 Information about the care home Name of care home: Address: Lumb Valley Residential Home 906/908 Burnley Road East Lumb Rossendale Lancashire BB4 9PQ 01706225027 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Waqar Hussain care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care Home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is 15 Date of last inspection Brief description of the care home Lumb Valley, formally a school building, is a residential care home registered to accommodate 15 older people. It is located on the main road in a semi rural area of Lumb in Rossendale. The home is accessible by public transport and is close to some local shops and a post office. Externally there is a small car park, from which a platform lift provides access to the main entrance. There is a patio area is to the front of the home, garden furniture is provided. The home has single and double bedrooms on both the first and second floors. There is a stair lift to provide access between floors. The home has two interlinking lounge areas a separate dining room and a Care Homes for Older People Page 4 of 33 Over 65 15 0 Brief description of the care home sunroom. Staff are available, to provide assistance with personal care and support, in response to individual needs and wishes. Written information about the services provided at Lumb Valley was available on request from the homes office. At the time of this inspection visit, the fees charged were £325.00 per week, there are additional charges for hairdressing. Care Homes for Older People Page 5 of 33 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: zero star poor service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: A key or main unannounced inspection, which included a visit to the home, was conducted at Lumb Valley Residential Home on 4 March 2010. As part of the inspection process we looked at all the information we have received about Lumb Valley Residential Home since the last key which took place on 2 April 2009. Information about the last key inspection and the Annual Service Review can be obtained from Lumb Valley Residential Home or www.cqc.org.uk The manager completed an annual quality assurance assessment several weeks before this visit to the home. This document is a self-assessment that focuses on how well outcomes are being met for people who use the service. It also gives us some numerical information about the service. Four completed surveys were returned from the relatives of people using the service and five from members of staff. Care Homes for Older People Page 6 of 33 A tour of the premises took place and we looked at staff files and care records. We spoke to members of staff on duty and people who use the service. Discussions also took place with the deputy manager and homeowner regarding issues raised during the inspection. Care Homes for Older People Page 7 of 33 What the care home does well: What has improved since the last inspection? What they could do better: Peoples health and personal care needs must be assessed before they are admitted to the home in order to ensure their individual needs can be fully met at Lumb Valley. Care plans must accurately identify the health and personal care needs of each person using the service and provide clear directions for staff to follow in order to ensure their individual needs are met. Risk assessments for falls, nutrition and the development of pressure sores must be completed for each person using the service. This will ensure that risks associated with falls, the development of pressure sores and nutrition are effectively managed. It is important that risk assessments for moving and handling are reviewed every month to ensure the information they contain is up to date. To ensure people are cared for in the way they prefer people using the service or their relatives should be involved in care planning. Medicines must be handled more safely so that peoples health and wellbeing is protected. This includes giving medicines as prescribed by the doctor and keeping accurate records of medicines received into the home, given to people and the disposal of unwanted medication. In addition to this staff should have their competency in giving and recording medicines regularly assessed. This will help make sure medicines are handled safely by suitably skilled staff. It is essential that controlled drugs are stored in a controlled drugs cupboard that meets the requirements of the law. This will help prevent mishandling and misuse. To make sure any complaints are dealt with correctly detailed records of all complaints, the investigation and action taken should be made. Care Homes for Older People Page 8 of 33 To protect people from abuse it is essential that all members of staff know the action they must take if allegations of abuse are made. To protect people using the service from the employment of unsuitable staff recruitment procedures must be thorough. This involves obtaining a completed application form, two written references and criminal records bureau check before any new staff start working at the home. To enable the Commission to decide if the home is being managed properly the homeowner or manager must complete all sections of the AQAA in sufficient detail in order to provide an accurate assessment of the service. The Commission must be notified of any incidents which affect the health and wellbeing of people using the service. This will enable us to monitor these issues to ensure they are being managed correctly. All members of staff who are required to carry out moving and handling procedures must receive training. This will help to promote the health and safety of people using the service and members of staff. The homeowner must visit the home at least once a month and prepare a written report for the manager. This ensures the homeowner is monitoring the day to day running of the home and checks the care needs of people using the service are being met. 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 33 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 33 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The admissions procedure did not ensure that peoples health and personal care needs were known before they were admitted to the home. Evidence: A copy of the statement of purpose which also includes the service user guide is available to people who are considering using the service and their relatives on request. This supplies information about the care and facilities provided at the home. We looked at the care records of a person who had been admitted to the home recently. There was no evidence to suggest that a senior member of staff from the home had visited and assessed this person before they were admitted to the home. Carrying out a detailed assessment of the health and personal care needs before a person is admitted makes sure their needs can be fully met and Lumb Valley is a suitable place for them to live. Care Homes for Older People Page 11 of 33 Evidence: However, it is stated in the AQAA people were not admitted to the home unless their needs could be met. Care Homes for Older People Page 12 of 33 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service were cared for in a manner which promoted their privacy and dignity. Deficiencies in care planning and the management of medication could affect the health and wellbeing of people using the service. Evidence: We looked at the care plans of four people who use the service. These plans identified some of the health and personal care needs of each person and provided some directions for staff to follow to ensure their individual needs were met. This included details of peoples dietary likes and dislikes and the times they preferred to get up and go to bed. However, the care plans for several people stated that they suffered from diabetes but there were no clear directions for staff to follow about how to manage this condition. We discussed this issue with two members of staff. Only one of them knew what to do if a common complication requiring immediate action occurred. Having detailed care plans in place about healthcare issues helps to promote the health and wellbeing of people using the service. Care Homes for Older People Page 13 of 33 Evidence: Although a risk assessment for moving and handling was in place for each person ones for falls, nutrition and the development of pressure sores were not. Carrying out risk assessments enables the risks of falling, poor nutrition and the development of pressure sores to be identified. Measures can then be put in place to make sure any identified risks are managed correctly to help prevent falls, malnutrition and pressure sores. In addition to this risk assessments were not in place to help ensure the safety of people who were able to go out by themselves. A written report about the care given to each person using the service was written during each shift. This ensured that all staff had up to date information about the condition of each person in order to ensure continuity of their care. Care plans were usually reviewed monthly. However, the risk assessments we saw for moving and handling had not been reviewed since they were carried out. Some documents in the care records including care plans and reviews were not dated on the day were written and some were not signed by the person completing them. Dating and signing all care records ensures that members of staff to know who has completed them and if the information is up to date. There was no evidence to suggest that people using the service or their relatives were involved in care planning. Involving people using the service and their relatives in care planning helps to ensure their individual needs are met in the way they want. There were records of the involvement of GPs and other healthcare professionals including the chiropodist, optician and district nurse in the care of people who use the service. Despite the shortfalls in care planning people using the service and their relatives were generally satisfied with the provided at Lumb Valley. One person said, Were well looked after. The relative of one person commented on the survey that her relative was always clean, well fed, happy and content. Personal care was carried out in the privacy of the persons own room or the bathroom. Members of staff were observed attending to people in a polite and friendly manner. As part of the visit a pharmacist inspector checked how medicines were being handled. We checked medicines records, medicines stock and spoke with three staff and one resident. At the end of the visit we took some photocopies of the records because we Care Homes for Older People Page 14 of 33 Evidence: found some serious shortfalls in the way medicines were being handled that were placing the health and wellbeing of people at unnecessary risk. When we arrived at the home the deputy manager said all the morning medicines had been given out from approximately 8:30am. When we checked the medicines records at 10:30am we found none of them had been signed for that morning and for the previous evening. Our checks showed some of these medicines had been given but we could not confirm this for all. This is poor practice that shows staff were not always checking and signing for medicines correctly. Records of medicines given to people must be signed for immediately after giving them so that an accurate record is made and to make sure they are handled safely. We found the records of medicines received into the home were not always accurate and for a period of seven months no records of medicines returned to the pharmacy were kept. We found several medicines in the current stock trolley that were not listed on the current records so there was a risk they might not be used properly. Poor record keeping can lead to serious mistakes that can affect the health and wellbeing of people who live in the home. There was no clear system of medicines stock control so it was not always possible to check whether medicines were being given to people correctly. We found the specially dispensed system, provided by the pharmacy, to help give medicines in a more organised way was usually used correctly. However, we found medicines in packets and bottles could not be easily accounted for because they were not carried forward at the beginning of each new medicines cycle. We found eye drops were poorly handled because they were not dated upon opening so we could not be sure they were still in date, this is important because they go off after 28 days. We looked at the times medicines were given to people. Staff said medicines were normally given at mealtimes but we found some people were taking medicines that should have been given at least half to one hour before food. Giving medicines at the wrong time can stop them working properly. Care staff that handled medicines had all received some certificated training but we saw no arrangements for the assessment of staff competence. Of particular concern was the poor record keeping we had seen over the previous two days that showed some staff were not following the correct procedures for safely giving medicines. Formal audits (checks on the medicines) were not being carried out so mistakes were not being found and so improvements were not being made. Staff training, competency assessments and regular auditing help make sure medicines are handled safely by suitably skilled staff. Care Homes for Older People Page 15 of 33 Evidence: We looked at a sample of care plans and records to check if medicines were properly reflected in them. We looked at how two people were supported to look after some of their own medicines. No formal risk assessments had been carried out and their care plans contained very little information about how they were to be supported. Having good paperwork and procedures for supporting people to look after their own medicines helps them retain some of their independence in a safe way. We checked how controlled drugs (medicines that can be misused) were handled. There was no suitable cupboard to store them in so we saw several controlled drugs being kept unlawfully with all the other medicines. No special register was used so records of controlled drugs receipt, administration and disposal were not properly witnessed. Staff were unaware of the requirements of the law and were unaware they were handling controlled drugs at the time of our visit. Having secure storage and witnessed records help prevent the misuse and mishandling of controlled drugs. Care Homes for Older People Page 16 of 33 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. Peoples choices were respected but the range of leisure activities provided did not meet the needs of some people. Meals were wholesome and appetising and people enjoyed them. Evidence: Discussion with people using the service and members of staff confirmed that some activities were organised in the home. These included bingo, dominoes, arts and crafts, manicures, listening to music and sing-a-longs. On the afternoon of this visit several people were seen to be enjoying a game of bingo. One member of staff told us that in the mornings people liked to read or watch television. Another member of staff told us that people were also encouraged to follow their own interests for example one person liked knitting. However, one person told us there wasnt much to do. The relative of a person living at the home commented on the survey that the home could improve by providing more activities. People using the service and members of staff said that visitors were welcomed into the home at anytime and offered refreshments. The daily routine was flexible in order to meet the needs and preferences of people Care Homes for Older People Page 17 of 33 Evidence: using the service. All the people asked said they could choose when to get up and go to bed. One care worker said, Its their home so its their choice when to get up and go to bed. The meal served at lunch time was shepherds pie or meat and onion pie and fresh vegetables. Dessert was a choice of lemon curd tart, jelly and fruit, yogurt or fresh fruit. The cook told us that she had been informed of peoples individual likes and dislikes and that alternatives to the menu were also readily available. Lunch time was unhurried allowing people time to chat and enjoy their meal. All the people asked said the meals were good. Care Homes for Older People Page 18 of 33 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service and their relatives know how to make a complaint. The lack of knowledge of safeguarding procedures by some staff could put people at risk of abuse. Evidence: A copy of the complaints procedure was included in the statement of purpose and displayed in each bedroom. Surveys completed by relatives of people using the service stated that they knew how to make a formal complaint. Members of staff also indicated on the survey that they knew what to do if a person using the service or their relatives expressed any concerns to them. Although the homeowner had recently investigated a complaint a record of the investigation and any action taken was not available. Keeping detailed records of complaints indicates they are taken seriously and appropriate action to resolve the problem has been taken. We looked at the policies and procedures for safeguarding vulnerable adults. Although a chart explaining the action staff must take if allegations of abuse were made the homeowner was advised to amend the written procedure with the same information. This issue was discussed with three members of staff. They all said that they had received training in safeguarding vulnerable adults. Two of these staff said they would report any concerns to the manager or a senior member of staff. However, the manager was on leave and the senior person on duty did not know the action that must be taken if allegations of abuse were reported to her. Being aware of the correct Care Homes for Older People Page 19 of 33 Evidence: procedures to follow when allegations are made helps to ensure that people using the service are protected from abuse. Care Homes for Older People Page 20 of 33 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. The premises are well maintained and provide a comfortable and homely environment for people who use the service. Evidence: A tour of the premises confirmed that the home was clean, tidy and generally well maintained. This provided a homely and comfortable environment for people using the service. In the last year communal areas have been redecorated and new carpets fitted. Some of the bedrooms have also been redecorated. Work to further improve the premises is ongoing including new curtains and furniture for some bedrooms. People using the service were encouraged to bring personal items for their bedrooms to make them more homely. These included, ornaments, photographs and pictures for the walls. The grounds and gardens were well kept and accessible to people using the service if they wished to sit outside when the weather permitted. All the laundry was done at the home. A suitable equipped laundry room ensures clothes are washed promptly and returned to people using the service. Gloves and plastic aprons were available throughout the home for members of staff to Care Homes for Older People Page 21 of 33 Evidence: use in order to protect themselves and people using the service from infection. Care Homes for Older People Page 22 of 33 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. Members of staff are encouraged to acquire the skills and knowledge necessary in order to meet the needs of people using the service. Recruitment procedures were not thorough. Evidence: The duty rota provided details about the grades and number of staff on duty for each shift. The members of staff who completed the survey indicated that there was usually enough staff on duty to meet the needs of people using the service. One member of staff wrote on the survey, All carers work well together and have a good working relationship. We looked at the files of two members of staff appointed since the last inspection. One of these files indicated that the required information had been obtained before this member of staff had started working at the home. This included a Criminal Records Bureau check and two written references. However, the references were written to whom it may concern suggesting that they were testimonials. The homeowner was advised to ensure that all references were confidential. The other file we looked at did not contain any evidence that a thorough recruitment procedure had taken place. The homeowner explained that this member of staff had been recruited as part of an apprenticeship scheme run by a local college and recruitment checks had been completed by them. He also said that the manager had interviewed this person but Care Homes for Older People Page 23 of 33 Evidence: there was no record of this in the file. Having thorough recruitment procedures helps to ensure people who use the service are protected from the employment of unsuitable staff. Discussion with the homeowner and members of staff confirmed that training for all members of staff was encouraged. This included induction training for new employees. Care workers were also encouraged to obtain National Vocational Qualifications at level 2 or 3 in health and social care. Care Homes for Older People Page 24 of 33 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The views of people using the service are considered when decisions about activities and facilities provided at the home are made. Management arrangements do not ensure the health and safety of people using the service are promoted. Evidence: At the time of this inspection the manager was on leave and the deputy manager was responsible for the day to day management of the home. According to our records the Commission has not been informed about things that have happened at the home these are called notifications and are a legal requirement. This issue was discussed with the deputy manager who was unaware of this requirement. It is also the responsibility of the homeowner and manager to ensure that care plans contain all the required information and medication is managed safely. This helps to promote the health and wellbeing of people using the service and ensures their individual needs are met. Care Homes for Older People Page 25 of 33 Evidence: Although the AQAA had been completed a few weeks before this inspection the information it contained was very limited and several sections were not completed. These included what we could do better and statistical information about complaints. Discussion with the homeowner confirmed that he was committed to running the home in the best interests of the people living there and had achieved the nationally accredited Investors in People Award. He said that a meeting with people using the service had taken place in December last year but minutes had not been taken. We were told that at this meeting activities were discussed and as a result a trip to Blackpool had been arranged for April. The homeowner said he visited the home every Friday and chatted informally with people using the service. Although the homeowner visited the home regularly he did not complete a written report every month. The purpose of these visits is to supervise and support the manager and ensure the home is being run in the best interests of people using the service. A written report provides the manager with details of any action that she needs to take in order to improve the care provided. According to the AQAA policies and procedures for safe working practices were in place. These help to make sure the home is a safe place to live and work. However, one member of staff told us they had not received training in moving and handling but was required to help with these procedures. Not having training in moving and handling could put people using the service and members of staff at risk of injury from the use of incorrect moving and handling techniques. Only six members of staff had an up to date first aid certificate. The provider was advised to ensure that at least one of them was on duty on each shift. This will ensure that appropriate action is taken in the event of an accident or medical emergency. Fire alarms were tested weekly and emergency lighting every six months. Members of staff said that fire drills took place regularly. Gas safety and electrical installation certificates were not available. However, the provider confirmed by telephone that arrangements had been made for these to be obtained at the beginning of April. The testing of small electrical appliances was also due and arrangements for this to be carried out in March were in place. Care Homes for Older People Page 26 of 33 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 3 Regulation 14 People who are admitted to the home must have there needs assessed to ensure they can be met. 31/05/2009 2 7 Regulation 15 Care plans must be 31/05/2009 developed for all residents with health, social and welfare needs set out in an individual plan of care so that staff are able to deliver support and monitor the well being of residents. Regulation 26 The home owners must visit 31/05/2009 the home at least once a month and prepare a written report to ensure the day to day running of the home is being monitored and the care of the residents are being met. 3 31 Care Homes for Older People Page 27 of 33 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 3 14 People must have their health and personal care needs assessed before they are admitted to Lumb Valley. This will ensure their needs can be met at the home. 02/04/2010 2 7 15 Care plans must accurately identify and address all the health and personal care needs of each person using the service. This will ensure that all care workers know what they need to do in order to meet the needs of each person using the service. 30/04/2010 3 8 13 Risk assessments for falls, 30/04/2010 nutrition and the development of pressure sores must be completed for each person using the service. Care Homes for Older People Page 28 of 33 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action This will ensure that risks are identified and effectively managed. 4 9 13 Controlled drugs must be stored in a controlled drugs cupboard that meets the requirements of the law. This will help prevent mishandling and misuse. 30/03/2010 5 9 13 Staff should have their 30/04/2010 competency in giving and recording medicines regularly assessed. This will help make sure medicines are handled safely by suitably skillled staff. Records of medicines received into the home, given to people and disposed of must be clear, accurate and complete. This is important so that all medicines can be fully accounted for. 30/04/2010 6 9 13 7 9 13 Medicines must be given to people as prescribed. This is important because receiving medicines at the wrong time, wrong dose or not at all can seriously affect a persons health and wellbeing. 30/04/2010 Care Homes for Older People Page 29 of 33 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 8 18 13 All members of staff must know the correct action to take if allegations of abuse are made. This will ensure any allegations are taken seriously in order to protect people using the service from abuse. An application form must be completed and two written references and criminal records bureau check obtained before members of staff start working at the home. This protects people using the service from the employment of unsuitable staff and volunteers. 30/04/2010 9 29 19 30/04/2010 10 31 26 The homeowner must visit 14/05/2010 the home at least once a month and prepare a written report for the manager. This will ensure the day to day running of the home is being monitored and the care needs of people using the service are being met. 11 31 28 When asked to do so by the Commission the home owner or manager must complete all sections of the AQAA in sufficient detail to 18/03/2011 Care Homes for Older People Page 30 of 33 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 provide an accurate assessment of the service. This will enable the Commission to determine if the service is being managed properly and in the best interests of people using the service. 12 38 13 Members of staff who are involved in using moving and handling procedures must receive training. This will help to ensure only approved moving and handling procedures are used in order to promote the health and safety of people using the service and members of staff 13 38 37 The homeowner and 30/04/2010 manager must ensure that the Commission is notified of all occurrences listed under regulation 37 of the Care Homes Regulations 2001 This will enable the Commission to monitor any issues in order to ensure that they are being managed correctly. 28/05/2010 Care Homes for Older People Page 31 of 33 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 Risk assessments for moving and handling should be reviewed monthly to ensure the information they contain is up to date. All care records should be signed and dated by the person completing them. This will ensure that all members of staff will know who has complete the records and if the information is up to date. People using the service or their relatives should be involved in care planning. This will ensure that people are cared for in the way they prefer. 2 9 Care plans and supporting paperwork should have detailed information about how to support people to safely manage their own medicines. A suitable controlled drugs register should be used to make witnessed records to help prevent mishandling and misuse. 3 12 An increased range of leisure activities should be offered to enable more people using the service to have a fulfilling lifestyle. It is strongly recommended that detailed records of all complaints, the investigation and action taken are made. This will ensure that complaints are taken seriously and appropriate action is taken. 4 16 Care Homes for Older People Page 32 of 33 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 33 of 33 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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