Inspection on 03/12/08 for Marjorie Cobby House

This inspection was carried out on 3rd December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Marjorie Cobby House 25/11/09

Marjorie Cobby House 03/01/07

Marjorie Cobby House 07/02/06

Marjorie Cobby House 12/08/05

Marjorie Cobby House 18/02/05

Marjorie Cobby House 16/08/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Marjorie Cobby House St Peters Crescent Selsey West Sussex PO20 0NA     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lesley Webb     Date: 0 3 1 2 2 0 0 8 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. the things that people have said are important to them: They reflect 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 28 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 28 Information about the care home Name of care home: Address: Marjorie Cobby House St Peters Crescent Selsey West Sussex PO20 0NA 01243605334 01243605334 june.lawrence@westsussex.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: West Sussex County Council care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The Commission for Social Care Inspection is notified in writing of the date on which both people are discharged from the home at which time the registration will revert to admissions of people over 50 years of age. The total number of service users accommodated must not exceed 34. Two service users under 50 years of age may be admitted. Date of last inspection Brief description of the care home Marjorie Cobby House is registered to provide care and accommodation for up to 34 people over 50 years of age for short stays or rehabilitation. There are no permanent or long stay residents accommodated at the home. The home is located near to the centre of Selsey, West Sussex and the accommodation is on two floors served by a passenger lift. There is a courtyard garden, which is well maintained. All residents have their own room although none have en-suite facilities and there is a range of communal space including a separate room for residents who smoke. Part of the premises is dedicated for the rehabilitation service and suitable kitchen facilities are Care Homes for Older People Page 4 of 28 Over 65 34 0 0 34 Brief description of the care home provided. Residents are referred by health and social services and therefore are subject to a financial assessment to determine the fee payable by them. Rates therefore vary between 89.90 and 451.00 per week depending on the outcome of the financial assessment. 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 undertook this inspection over one day, with the home being given no prior notice that we would be visiting. During our visit we spoke to people receiving a service, staff and members of the management team. We also case tracked two peoples care. This involves talking to the individual, observing care practices and examining records relating to the care and support they receive. In addition to this we also examined other records, sat and ate lunch with people and observed support given to other people. The home sent us its Annual Quality Assurance Assessment (AQAA) prior to our inspection. The contents of this were assessed and used when forming judgements on the standards of service provided and outcomes for people. Care Homes for Older People Page 6 of 28 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: All Controlled Drugs must be stored in a cupboard which meet the requirements of the Misuse of Drugs (Safe Custody) Regulations 1973. This must happen in order to comply with the law. Complete and acccurate records must be kept of all medicines received into the home and of all medicines given to people. This must happen so as to show that people get their medicines. Written confirmation must be maintained in the home that CRB disclosures have been obtained for all staff, including agency workers as detailed in CSCI CRB policy guidance issued October 2008. This must happen in order that the home can evidence its recruitment practices safeguard people. Risk assessments must be completed for all people where the decision has been made to use bed rails. This must happen to ensure any risks to people are managed safely. Care Homes for Older People Page 8 of 28 Foot rests must be in place on wheelchairs and used by staff unless it is demonstrated through documented risk assessment this is not in the persons best interest. This must happen to ensure people are not exposed to unnecessary risks. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 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. Assessment processes ensure peoples needs are known to staff so that they receive the support they require. People have the opportunity to visit the home before moving in so that they can decide if it will meet their needs. People referred for intermediate care are helped to maximise their independence and return home. Evidence: The home sent us its Annual Quality Assurance Assessment (AQAA) prior to our visit. With regard to admissions it states the admission process for service users is very comprehensive. Because no service user is permanent we need to quickly establish a relationships with the people. We give people time to settle into the home because we understand that they are at a period of change in their life, we monitor and review regularly. We help people come to terms with difficult choices. We have a multidisciplinary approach, working closely with the community rehabilitation team, GP surgery,nursing team and social work team both in the community and hospitals. This Care Homes for Older People Page 11 of 28 Evidence: is a very flexible service and we are able to respond quickly to emergencies. At our visit to the home we talked to the Registered Manager, people using the service and looked at records, all of which evidence the contents of the AQAA as accurate. For example all files that we looked at for people using the service contained health and/or social services assessments detailing peoples needs. The Registered Manager informed us that assessment processes have improved since our last inspection. She explained that the service was receiving inappropriate referrals but by working with locality teams they now understand if we say no it is in the persons best interest, we have to be confident we can meet needs. People at Marjory Cobby House stay for short periods of time for intermediate care (rehabilitation), respite or a period of assessment and recuperation before moving back to their own homes or into a residential home. People that we spoke to confirmed that they and/or their relatives are able to visit the home prior to admission if they wish. Marjory Cobby House has twelve beds dedicated to intermediate care (rehabilitation). Accomodation for intermediate care is situated in a separete area of the building. The accommodation includes two domestic kitchens and two lounges. Specialist equipment to assist with rehabilitation and to promote independence was evidence. Specialist services from relevant professionals, including occupational therapy and physiotherapy are provided. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care planning systems give clear information so that staff have the information needed to support people. Health care needs are fully met by the home and community health services. Not all medication systems offer sufficient safeguards to people. People are treated with dignity and rights to privacy respected. Evidence: As at previous inspections all residents files that we viewed included a plan of care. These set out their health, personal and social care needs. All people staying at the home for rehabilitation and interim care have regular reviews with the home and social services prior to discharge. A nurse practitioner holds a surgery at the home once a week. A separate, dedicated room has been provided by the home for this. The Registered Manager informed us they have a good working relationship with the local GP who provides this service. She informed us that residents of Selsey retain their own GP and out of area placements become temporary residents and transfer to the local GP whilst staying at the home. Care Homes for Older People Page 13 of 28 Evidence: We spoke to five people receiving a service from the home. All confirmed their satisfaction about the support they receive to maintain good health. The systems for management of medication were examined. On the day of our visit we were informed by senior staff that the home is in the process of changing its systems to a monitored dosage system (MDS) supplied by a different pharmacy. We looked at the records for four people receiving a service and found none to include records of medication when it entered the home. The senior member of staff who was showing us the medication systems looked for these but could not find. She informed us we would have to check with the senior who would be on duty on the afternoon as she is responsible for medication. When this person came on duty she could not find the records, stating, I dont know where gone to, have been transferring paperwork, where they have gone I honestly dont know. Records were in place for the same four people of their medication being administered. Two of these contained gaps where staff had not signed to say their medication had been administered. One persons records we examined show they are administered a Controlled Drug. No record could be found of when this entered the home. Records are in place of it being administered. These do not reflect good practice guidance from the Royal Pharmaceutical society. We were informed by senior staff that Controlled Drugs have not been recorded separately. They informed us, we have been trying to get audit, but the pharmacy say they only have one relief pharmacist. We explained that it is not the pharmacists responsibility to ensure medication is stored and recorded safely but the homes. We were informed that senior staff are responsible for managing, recording and administering medication. A senior member of staff informed us they have received medication training. When asked if competency assessments are undertaken they stated, not to my knowledge. We asked the senior member of staff how they would know what a Controlled Drug is. They stated, they usually come with warning from hospital or if GP he will tell us. We asked the senior to give examples of Controlled Drugs and they stated Morphine. They could give no other examples and informed us they would have to check. They left the room and returned explaining they could not find the information and could not give any further examples of Controlled Drugs. We did see a Controlled Drugs register but this has no recordings entered. We were informed this is going to be introduced as part of the new medication system being introduced to the home. People we spoke to confirmed they are able to administer their own medication Care Homes for Older People Page 14 of 28 Evidence: following assessment. As one person explained, I self medicate, they gauge if you are mentally capable then support you. During our visit staff were observed knocking on bedroom doors and seeking approval before entering. This practice promotes peoples rights to privacy. A telephone is situated in the hall for the use of people receiving a service. It is in an enclosed cubicle to maintain privacy. People receiving a service on the day of our visit expressed satisfaction with support given to promote their personal hygiene care. People were observed having their hair attended to by a professional hair dresser who visits the home each week. One person informed us, its a treat to get my hair cut and set. Care Homes for Older People Page 15 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a lifestyle that respects privacy, dignity and choice, matching peoples expectations and preferences. People are fully supported to maintain their independence. Wholesome and appealing meals are provided, with a range of choices and alternatives that meet peoples needs. Evidence: Evidence finds that people receiving a service are provided with a range of activities that suit their individual needs. Some group activities such as bingo are provided. Individual activities such as manicures and walks are provided. The ethos of Marjory cobby House is to promote Independence. This is reflected in the activities that people are encouraged to participate in. For example people are supported to develop life skills such as making drinks, simple meals and attending to their own personal care. People we spoke to expressed satisfaction with activities. One person explained, Im into my second week now, was in hospital after a hip replacement, I could not move, shop, clean, do anything. They have helped me gain my Independence, its all about quality of life. Now I can get in kitchen to make drink, able to dress self. Staff also demonstrated understanding with regard to promoting independence. As one Care Homes for Older People Page 16 of 28 Evidence: person explained, main thing we do is help people for when leaving, so its about giving confidence that can do things for selves. A notice board at the entrance to the home displays information about forthcoming events. All people that we spoke to confirmed their satisfaction with meals provided. Comments include, each meal is a picture e.g sandwiches arranged in appetising way, wholesome, good quality and staff present them so nicely, there are always clean plates, what better evidence is there than that. We sat and ate lunch with people. The dining room is light, with small table settings. The atmosphere between people receiving a service and staff was sociable. We chose roast lamb, roast potatoes, carrots and sprouts. For desert we chose jelly and cream. The meal was very tasty and well presented. The people we sat with all expressed their satisfaction with their meal. Other people in the dining room were observed to have different meals and staff were seen to assist some people discreetly, offering encouragement to eat but not forcing. During the day staff were observed seeking residents preferences with regard to meals, including offering choices other than those on the menu. We spoke to the cook on duty who demonstrated knowledge and understanding of the dietary needs of people at the home. We were shown dietary information that the cook uses that includes peoples preferences and special requirements. The Registered Manager informed us that the provision of meals has improved since our last visit. They explained that choices have expanded, products are sourced locally and meal options are changed to meet the needs of people at the home. Care Homes for Older People Page 17 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. People feel confident to raise concerns, that these will be taken seriously and responded to. Safeguarding procedures ensure people are protected from harm. Evidence: The majority of people that we spoke to confirmed they would feel confident to raise concerns. Comments made include, would approach whoever in charge and say some thing. I did at the beginning, wrote a thing and it was sorted and would tell someone, they would sort, never a problem. The home has received two complaints in the last twelve months. Records confirm these have been acted upon appropriately. There is a clear complaints procedure that is displayed at the entrance of the home for anyone to access. A copy of West Sussex Multi Agency guidelines was seen on display in the Registered Managers office along with information about safeguarding displayed at the entrance to the home. Staff that we spoke to demonstrated understanding of protection and what their role is in reporting suspected abuse. Care Homes for Older People Page 18 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The building is clean and well maintained, providing people with a comfortable and safe place to stay. Bedrooms are well equipped and meet peoples needs. Equipment is provided that promotes good infection control. Evidence: The property is situated in a residential area of Selsey. There are parking facilities to the front of the home. It is close to shops and other amenities. Accommodation for intermediate care (rehabilitation) is situated on the first floor and is accessible via a passenger lift. As at previous inspection the service provides a very well maintained and comfortable environment, that includes specialist equipment and adaptations needed to meet individuals needs. This includes hoists, variable height beds and ceiling tracking hoist in one bedroom. There are four lounges and kitchens located throughout the building. Each decorated differently. People are not restricted in using any of these facilities. Since our last inspection a wet room has been installed. The Registered Manager informed us that this replaced a Parker Bath that people were not comfortable using. Care Homes for Older People Page 19 of 28 Evidence: The mechanical sluice has also been moved away from a bedroom to a separate dedicated room specifically for this equipment. On the day of our visit all communal areas and bedrooms were seen. All areas were observed to be clean and well maintained. The Registered Manager informed us House-keepers are employed and are on duty seven days a week. Hand washing signage, liquid soap and paper towels were seen to be in place in communal toilets. These promote good infection control. Care Homes for Older People Page 20 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are met by the numbers and skill mix of staff. People are not protected in full by some recruitment recording practices. Evidence: The Registered Manager informed us that staffing levels vary to meet the needs of people receiving a service. She stated, we top up, have flexible staffing levels depending on people receiving service. Have additional funding for this, use casual and agency staff. We use the same agency staff for consistency. Separate kitchen and house-keeping staff are also employed. People that we spoke to expressed satisfaction with staff working at the home. For example one person said,staff very cheerful, i came yesterday, all seem very nice and another staff come on duty with a smile and it stays there, nothing is too much trouble for them. they deal with a mixture of people but always treat each of us with respect. We were shown documentation that details three members of the management team holding the Registered Managers Award, one member of the management team who is social work qualified (not including the Registered Manager) and seven permanent care staff with a National Vocational Qualification (NVQ) at level 2. Two other staff are Care Homes for Older People Page 21 of 28 Evidence: working towards this qualification at level two and three others are working towards achieving level 3. We examined the recruitment records of the two newest members of staff to commence work at the home to assess if practices safeguard people who receive a service. One contained evidence that a Criminal Records Bureau (CRB) disclosure was obtained prior to commencing work and one did not. We discussed this with the Registered Manager who explained recruitment processes are centralised by the authorities Human Resource department and that they send confirmation of the required checks having been undertaken. The Registered Manager checked her emails to see if the missing information had been received but could not find it. We discussed with the Registered Manager the use of agency staff and recruitment records. She confirmed no records are maintained in the home that confirm the agency has ensured the appropriate checks have been undertaken including a CRB disclosure. She stated, the agency have to be approved by West Sussex, i trust the agency, they have pulled staff in past when visas expired. I think their standards are too high to compromise their reputation by not undertaking required recruitment checks. We explained that written confirmation must be maintained in the home from the agency that details the appropriate recruitment checks have been undertaken including CRB disclosures. This information is needed in order to offer protection to people who receive a service. As at previous inspections staff receive induction training from West Sussex County Council. Staff spoken with during our visit confirmed they have received mandatory health and safety training. We found it difficult to assess the numbers of staff who have received training in other areas such as diabetes, falls prevention and nutrition as currently staff training records are maintained separately with no combined record such as a training matrix in place. We discussed this with the Registered Manager who agreed this would help monitor that sufficient numbers of staff have received training to meet the needs of people who receive a service. Care Homes for Older People Page 22 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. The manager is experienced and competent to run the home. Quality monitoring systems are in place. Safeguards are in place to protect the interests of people. Not all health and safety practices ensure the health, safety and welfare of people are promoted. Evidence: People that we spoke to, including staff all spoke highly of the Registered Manager and her approach to running the home. Comments include, the manager always tries to accommodate. The Registered Manager is a qualified social worker with many years experience in the care field. She has a professional management qualification. Information supplied to us in the homes Annual Quality Assurance Assessment (AQAA) with regard to quality assurance states service user questionnaire provides responses Care Homes for Older People Page 23 of 28 Evidence: for the service user to comment on staffing. Staff meetings and supervision reflect how we monitor practice, communicate with staff and encourage them all to contribute to the development of the home and service opportunities. There are monitoring systems within the home. We discussed these with the Registered Manager in relation to medication practices and recruitment (discussed earlier in this report) as evidence found at this inspection indicates these need to be improved to offer further safeguards to people receiving a service. She agreed with our findings. Finances are handled by people who use the service or their advocates. The home will hold small amounts of money for people if they wish. During our visit we observed three people being assisted by staff to move around the home in wheelchairs. Two did not have footrests in place. One did but these had not been placed to the front of the chair for use. One of the people we saw being assisted had dressings to their legs. The feet of two people we observed were seen hanging with no equipment for them to place their feet on. We discussed this practice with three care staff. They said they had been shown how to use equipment. One stated, I mentioned to girls that foot rests should not be taken off, dont know who takes off, it can be dangerous for people, especially if skin fragile as might catch and tear. We asked a member of the management team if risk assessments have been completed that demonstrate the practice of not using footrests is in a persons best interests and they stated, probably not. We looked at the care records for three wheelchair users. None included information about the use of wheelchairs or footrests. The Registered Manager agreed the practice of removing footrests is not safe. The care records for two people that we looked at state they use bed rails at night. The Registered Manager confirmed risk assessments have not been completed for these. We directed the Registered Manager to the Department of Healths guidance regarding bed rails and risk assessments, instructing these must be implemented to ensure risks to people are managed safely. Information supplied to us in the homes Annual Quality Assurance Assessment (AQAA) with regard to health and safety confirm that the appropriate checks have been undertaken for servicing of equipment. Information was not included with regards to a five year electrical wiring certificate. At our visit the Registered Manager confirmed this information was not in the home. She agreed to look into this to ensure wiring is safe. Care Homes for Older People Page 24 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 25 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 9 13 In line with Regulation 13(2) 03/01/2009 complete and acccurate records must be kept of all medicines received into the home and of all medicines given to people. This must happen so as to show that people get their medicines. 2 9 13 In line with Regulation 13 (2) all Controlled Drugs must be stored in a cupboard which meet the requirements of the Misuse of Drugs (Safe Custody) Regulations 1973. This must happen in order to comply with the law. 03/03/2009 3 29 19 In line with Regulation 19 (1) written confirmation must be maintained in the home that CRB disclosures have been obtained for all staff, including agency workers as detailed in CSCI 03/01/2009 Care Homes for Older People Page 26 of 28 CRB policy guidance issued October 2008. This must happen in order that the home can evidence its recruitment practices safeguard people. 4 38 13 In line with Regulation 13(4) 03/01/2009 foot rests must be in place on wheelchairs and used by staff unless it is demonstrated through documented risk assessment this is not in the persons best interest. This must happen to ensure people are not exposed to unnecessary risks. 5 38 13 In line with Regulation 13(4) 03/01/2009 risk assessments must be completed for all people where the decision has been made to use bed rails. This must happen to ensure any risks to people are managed safely. 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 9 In order to readily detect any losses of Controlled Drugs it is strongly recommended that the receipt, administration and disposal of ALL Controlled Drugs, including Temazepam, is recorded in the Controlled Drugs register, which is a bound book with numbered pages. Care Homes for Older People Page 27 of 28 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 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!