Inspection on 13/10/09 for Marley Court Nursing & Residential Home

This inspection was carried out on 13th October 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Marley Court Nursing &... 06/11/08

Marley Court Nursing &... 15/04/08

Marley Court Nursing &... 16/07/07

Marley Court Nursing &... 27/02/06

Marley Court Nursing &... 12/10/05

Marley Court Nursing &... 17/01/05

Marley Court Nursing &... 17/05/04

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 16/02/2010.

Key inspection report Care homes for older people Name: Address: Marley Court Nursing & Residential Home Bolton Road Heath Charnock Chorley Lancashire PR7 4AZ     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Susan Hargreaves     Date: 1 3 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 29 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 29 Information about the care home Name of care home: Address: Marley Court Nursing & Residential Home Bolton Road Heath Charnock Chorley Lancashire PR7 4AZ 01257226700 01257234407 marleycourtnh@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Marley Court Nursing Home Limited Name of registered manager (if applicable) Mrs Sharon Anne Brennan Type of registration: Number of places registered: care home 49 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 with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 49 Date of last inspection Brief description of the care home Marley Court is a purpose built home, which is registered to provide both personal and nursing care for older people. The accommodation at Marley Court is offered on two floors, the first floor being accessed by stairs or passenger lift. There are a range of single rooms some with en suite facilities and double or companion rooms, some of which also have en suite facilities. There are two lounge/dining rooms, one on each Care Homes for Older People Page 4 of 29 Over 65 49 0 0 6 1 1 2 0 0 8 Brief description of the care home floor and a range of toilet and bathing facilities throughout, there is also a fully equipped laundry. There is a large patio area at the front, furnished with hardwood garden furniture and set around a central fountain. This area, along with the side gardens is fully accessible to residents, regardless of mobility. As Marley Court is situated on the main A6 road from Chorley to Adlington it is well provided by public transport. The current fees charged at Marley Court are £365 to £583 per week. Additional charges are payable for hairdressing, newspapers, chiropody and toiletries. A statement of purpose and service user guide is available to people considering using the service and their relatives on request. 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: 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: A key or main unannounced inspection, which included a visit to the home, was conducted at Marley Court on 13 October 2009. As part of the inspection process we looked at all the information we have received about Marley Court since the last key which took place on 6 November 2008. Information about the last key inspection can be obtained from Marley Court 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. At the time of this visit thirty seven people were living at the home. A tour of the premises took place and we looked at staff files and care records. We also spoke to members of staff on duty and people who use the service. Discussions also took place Care Homes for Older People Page 6 of 29 with manager and regarding issues raised during the inspection. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: A risk assessment must be completed for the safe use of bed rails where these are considered necessary. A care plan must also be in place explaining what members of staff need to do in order to ensure any identified risks are managed safely and bed rails are used correctly. To ensure all wounds are treated correctly records relating to wound care must be up to date and accurate and followed by the nursing staff. Prompt action must be taken to improve the management of medication in order to prevent mistakes being made. A record of all medication received into the home must be kept. Clear written instructions should be in place for staff to follow to ensure medication prescribed when required is given correctly. Handwritten instructions on medication administration records should be signed and witnessed to check that these have been copied correctly. All containers of medication should be dated when they are Care Homes for Older People Page 8 of 29 opened. When a variable dose of medication is prescribed for example one or two tablets the actual amount given should be recorded. The manager must further develop the system for checking medication to ensure medication is managed correctly and any shortfalls are identified and corrected. To ensure all members of staff understand the principles of safeguarding vulnerable adults they must receive appropriate training. To ensure people using the service are protected from the employment of unsuitable staff each applicant must complete a job application form. Two written references including one from the last employer must be obtained before all new members of staff start working at the home. 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 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. A thorough admission procedure ensured the health and personal care needs of people using the service were identified and met. Evidence: A copy of the statement of purpose and service user guide is available to people who are considering using the service and their relatives on request. These supply information about the care and facilities provided at the home. The manager or a senior member of staff visited people who were considering using the service in hospital or their own home before admission. The purpose of this visit is to assess the persons health and personal care needs to ensure they can be met at the home. We looked at the care records of four people using the service. Pre-admission assessments were seen in all four files. These assessments provided important Care Homes for Older People Page 11 of 29 Evidence: information for the development of their care plans. 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 adequate 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 the management of medication could affect the health and wellbeing of some people. Evidence: We looked at the care plans of four people who use the service. These plans usually identified the health and personal care needs of each person and provided clear directions for staff to follow to ensure their individual needs were met. One care plan advised staff to speak clearly and slowly so the person could fully understand what was being said. Another care plan told staff that the person liked to have the light on at night. Care plans also included information about peoples preferred daily routine. This information helped to ensure that people were being cared for in the way they wanted. However, the wound care records we looked at were not always clear about the dressings to be used and the frequency of dressing changes. One care plan stated that a dry gauze dressing should be used and on two occasions a different one was used. Care Homes for Older People Page 13 of 29 Evidence: One nurse had recorded that a wound was noted and the dressing was done according to the plan when the plan stated that the wound had healed. One wound care plan stated wound management alternate days which we understood to mean dressing changes but on one occasion the records showed that the dressing had not been changed for five days. Risk assessments for falls, nutrition and the development of pressure sores were in place. Guidance for staff to follow about how to manage identified risks was also included in the care plans. Three of the care plans indicted that bed rails were used to prevent the person from falling out of bed. However, risk assessments had not been carried out to ensure these could be used safely. Only one of these care plans contained instructions for staff to follow about the safe use of bed rails and the management of any identified risk with their use. Having a risk assessment and clear guidance in place for staff to follow helps to ensure that bed rails are used safely. A 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 and risk assessments were usually reviewed monthly and with the exception of wound care plans updated when the needs of the person changed. There was some evidence that people using the service and their relatives were involved in care planning and had been asked to sign the care plan to indicate their agreement to the use of bed rails. The manager had written in the AQAA that further improvements could be made by encouraging people using the service and their relatives to become more involved in care planning. There were records of the involvement of GPs and other healthcare professionals including the chiropodist and optician in the care of people who use the service. Medication was stored correctly and administered by qualified nurses.We looked at the records for the management of medication these included a record of unused medication collected for disposal by a licensed waste carrier. However, a record of medication received into the home was not always made. We checked a sample of medication records and stock but found it difficult to account for some medication. This was because medication was not dated on opening and where a variable dose was prescribed for example one or two tablets the actual amount given was not Care Homes for Older People Page 14 of 29 Evidence: recorded. Keeping detailed and accurate records helps to prevent the mishandling of medication. Hand written instructions on the medication administration records were not signed or witnessed by another member of staff to indicate that the instructions had been copied correctly. Some people were prescribed medication such as pain killers to be taken when required. However, there were no written instructions for staff to follow stating if the person was able to tell them when they needed their medication or what signs and symptoms they displayed if they could not. Having clear written instructions for the administration of when required medication ensures people using the service are given their medication when they need it. We checked how controlled drugs were handled, these are medicines that can be misused. A special register was used for record keeping and was seen to have been completed correctly. We looked at the records of how medication was checked by the manager. This was done regularly and involved checking that medication administration records had were completed correctly and the amount of medication in stock against the administration records. The competence of members of staff administering medication was also checked every month. We advised the manager to further develop this process to ensure it is effective in identifying and preventing the shortfalls found at this visit. 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. One person said, The staff are all very nice. A visitor explained that they were satisfied with the care given to their relative. 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. Leisure activities and meals are well managed and enabled people using the service to have an interesting and fulfilling lifestyle. Evidence: A full time member of staff was employed to organise leisure activities and social events at the home. Although this person was not on duty during this visit several people enjoyed playing dominoes in the afternoon. A trip to take some people to Blackpool illuminations was arranged for the evening. A similar trip had taken place the week before. One lady said, We went to Blackpool last week and went to a fish and chip shop in Bispham. People living at the home and members of staff said that leisure activities included arts and crafts, baking, dominoes and board games. When the weather permitted people were taken to the local ice cream parlour or ice cream was bought for people to enjoy when they were sitting outside. One lady said, The activities lady is excellent, theres plenty to do. One care worker explained that the activities co-ordinator also spent time chatting to people individually. Social events to which relatives and friends were invited included quiz night, bingo, cabaret night and afternoon tea every Friday. Special occasions such as birthdays and bonfire night were also celebrated. Care Homes for Older People Page 16 of 29 Evidence: Local clergy regularly visited the home and a Church service with communion was held every two weeks for people who wished to practice their faith in that way. People using the service and members of staff said that visitors were welcomed into the home at anytime and offered refreshments. One visitor said they stayed for tea every day. The daily routine was flexible in order to meet the needs and preferences of people using the service. All the people asked said they could choose when to get up and go to bed. One person said, I ring my bell when I want to get up and go to bed. The meal served at lunchtime looked wholesome and appetising and a choice was offered for both main course and dessert. Lunch was unhurried allowing people time to socialise and enjoy their meal. A care worker was observed patiently feeding one person. Members of staff were also observed offering a person alternatives to the menu. The cook said that the menus had recently been changed because people using the service had asked for a lighter alternative like salad or a jacket potato at lunch time. All the people asked said the meals were good. One person said, The meals are very nice. 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 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 felt confident to express their concerns. Some members of staff had not received the training necessary to ensure they understood the principles of safeguarding vulnerable adults. Evidence: A copy of the complaints procedure was included in the statement of purpose and service user guide and displayed in the home. The relative of a person using the service said they would feel confident to make a complaint should it become necessary.The manager said no complaints had been made since the last key inspection and no complaints have been made directly to the Commission. Policies and procedures for the safeguarding of vulnerable adults were in place. Discussion with two members of staff confirmed that they had received training in safeguarding vulnerable adults. They both said they would report any concerns immediately and knew the procedure they must follow. However, another member of staff who had worked at the home for more than a year was unsure of the procedure and said they had not received training. The manager explained that safeguarding was discussed during formal staff supervision and she was trying to arrange training before the end of the month. Care Homes for Older People Page 18 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. 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. 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. Communal rooms are spacious and suitable for a variety of social activities. The grounds and gardens were well kept and accessible to people using the service. There is a large area with tables and chairs where people can sit when the weather is nice. All the laundry was done at the home. A suitably equipped laundry room ensures clothes are washed promptly and returned to people using the service. Care Homes for Older People Page 19 of 29 Evidence: Gloves and plastic aprons were available throughout the home for members of staff to use in order to protect themselves and people using the service from infection. Care Homes for Older People Page 20 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Training for members of staff was encouraged but a lack of thorough recruitment practices put people using the service at from unsuitable staff. Evidence: The duty rota provided details about the grades and number of staff on duty for each shift. One person using the service explained that when they buzzed for assistance they did not usually have to wait long for staff to come. A visitor said that staff always came when their relative needed help. We looked at the files of five members of staff appointed since the last inspection. Three of these files indicated that all the required information had been obtained before these members of staff had started working at the home. This included two written references and a Criminal Records Bureau check.These checks ensure people who use the service are protected from the employment of unsuitable staff. However, a reference for one these members of staff was from a friend and the manager was advised not to accept references from close friends of the applicant. Only one reference had been obtained for each of the other two employees. One of these was undated making it impossible to determine if this had been obtained before this person had started working at the home. There was no evidence to suggest that one of these employees had completed an application form. Employing people without following thorough procedures could put people using the service at risk from Care Homes for Older People Page 21 of 29 Evidence: unsuitable members of staff. Discussion with the manager and members of staff confirmed that training for all members of staff was encouraged. This included induction training for new employees, moving and handling, basic food hygiene, dementia, health and safety, infection control and fire awareness. In addition to this most of the care workers had National Vocational Qualifications at level 2 or 3 in health and social care. Care Homes for Older People Page 22 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. The views of people using the service are considered when decisions about the care and facilities provided at the home are made. Evidence: The manager is an a qualified nurse and manager with experience of caring for older people. She keeps up to date with current practice by attending relevant seminars, reading care journals and using the internet. Two members of staff were interviewed during this visit and both said the manager was approachable and supportive. One of them said, You can talk to her, you enjoy coming to work. However, it is the managers responsibility to ensure that effective management systems are put in place so that medication is managed correctly and recruitment procedures are thorough. The manager explained that to improve the quality of the end of life care for people using the service they were committed to implementing a recent initiative called the Gold Standard Framework. This involved further training for members of staff in order to increase their knowledge and understanding of the physical and emotional needs of Care Homes for Older People Page 23 of 29 Evidence: people approaching the end of their life. The manager also expressed her intention to arrange training for all staff about the recent deprivation of liberty safeguards legislation. This will help to ensure the rights of people using the service who are unable to make decisions for themselves are protected. Discussion with the manager confirmed that she 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. The people using the service and their relatives were asked to give their views about the home by completing anonymous satisfaction questionnaires every year in October or November. Meetings with people using the service were held regularly to enable them to discuss any aspect of their life at the home. At the meeting held in July activities were discussed and as a result some activities are organised in the evenings and at the weekend. Several people using the service had a small amount of money kept at the home to pay for hairdressing, chiropody and other personal needs. To ensure this was managed safely records of all transactions were kept. We checked two of these during the visit and found the records to be up to date and accurate. 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. Fire alarms and emergency lighting were tested weekly. We looked at the records of routine servicing of equipment. These included up to date electrical installation and gas safety certificates and evidence that the testing of small electrical appliances was carried out annually. Care Homes for Older People Page 24 of 29 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 9 24 There should be an effective system in place to check medicines and staff competence. This will help to make sure people who live in the home are kept safe. 02/01/2009 2 9 24(1) There should be an effective system in place to check medicines and staff competence to help make sure people who live in the home are kept safe. 28/09/2008 Care Homes for Older People Page 25 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 7 15 A care plan for the safe use 27/11/2009 of bed rails must be put in place for each person where they are used. This will make sure that members of staff have clear directions to follow so that bed rails are used safely and any risks effectively managed. Where it is considered necessary to use bed rails a risk must be carried before they are used. This will ensure they used appropriately and safely for people using the service. 27/11/2009 2 7 13 3 8 12 Wound care plans must be 27/11/2009 clear and kept up to date. This will ensure that nursing staff have up to date and accurate information about the care and treatment of all wounds. Care Homes for Older People Page 26 of 29 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 4 9 24 There should be an effective system in place to check medicines and staff competence. This will help to make sure people who live at the home are kept safe. 31/12/2009 5 9 13 A record of all medication 27/11/2009 received into the home must be kept. This will enable medicines to audited to make sure they are being given correctly. All members of staff must have training in safeguarding vulnerable adults. This will help to protect people using the service from abuse. 31/12/2009 6 18 13 7 29 29 An application form must be completed and two written references obtained before members of staff start working at the home. This protects people using the service from the employment of unsuitable staff and volunteers. 13/11/2009 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 9 All containers of medication should be dated when they are opened. This will ensure medication is managed correctly and enable accurate checks to be made. When a variable dose of medication is prescribed the actual amount given should be recorded on the medication administration record. Hand written instructions on the medication administration records should be signed and witnessed. This ensures that instructions have been copied correctly. Clear written instructions should be in place for staff to follow to ensure medication prescribed when required is given correctly. To ensure references are objective they should not be requested from close friends of the applicant. The manager should ensure that effective systems are put in place to ensure that medication is managed correctly and recruitment procedures are thorough. 2 3 29 31 Care Homes for Older People Page 28 of 29 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 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. 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!