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Inspection on 24/11/09 for Mayfield Nursing Home

Also see our care home review for Mayfield Nursing Home for more information

This inspection was carried out on 24th November 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There is a very good pre admission assessment process in place, giving the assurance that peoples` needs are satisfactorily identified, in order to determine if they can be provided for at Mayfield. The care planning documentation is good, with the emphasis being that a person centered service is provided. The provision of activities is of a very good standard, helping to give assurance that people are receiving appropriate motivation and stimulation. The provision of meals continues to be varied, nutritional and wholesome. Mealtimes appear to be flexible and relaxed, enabling people to have choices and helping to maintain and promote independence as much as possible. The provision of training is satisfactorily provided and it is evident that training is kept up to date and appropriate. It was observed that good and trusting relationships exist between service users and members of staff. There was a calm and relaxed atmosphere in the home, with a number of people commenting about the homely and family atmosphere. There is a well established staff team, which helps to give the assurance that people are familiar, comfortable and trusting of the people who support and care for them. It was evident that Mayfield is well managed, with service user`s, relatives and members of staff clearly indicating that they have full confidence in the organisation and the running of the home.

What has improved since the last inspection?

The recording of individuals` health care needs has improved, particularly regarding pressure wound care records. Medication storage has improved. This helps to give the assurance that medication procedures are robust. The increased provision of safeguarding adults training also helps to give the assurance that vulnerable people are protected as much as possible from harm or abuse. Overall the provision of training is of a very good standard.

What the care home could do better:

The cookers in the kitchen are small domestic cookers. It is recommended that a more industrial type cooker be installed. Generally the kitchen would benefit from being updated. The installation of a new sink in the treatment room is advisable. The present sink looks quite old,very worn and doesn`t appear to be too hygienic, especially regarding the management of cross infection.

Key inspection report Care homes for older people Name: Address: Mayfield Nursing Home 3 Central Avenue Eccleston Park Prescot Merseyside L34 2QL     The quality rating for this care home is:   two star good 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: Phil McConnell     Date: 2 4 1 1 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 27 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 27 Information about the care home Name of care home: Address: Mayfield Nursing Home 3 Central Avenue Eccleston Park Prescot Merseyside L34 2QL 01514309503 01514311230 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Maywood Care Limited Name of registered manager (if applicable) Mrs Sally Griffiths Type of registration: Number of places registered: care home 31 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 people 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 people who can be accommodated is: 31 Date of last inspection Brief description of the care home Mayfield Nursing Home is a 31 bedded home which provides nursing care to older people (i.e. over 65). It is situated in the Eccleston Park Area of Prescott. This is a quiet residential area, which is close to a main road with good connections to the M57 motorway and the near by town of St Helens. Local shops are a short car journey away. The building is a detached Victorian house, which has been converted so that it is accessible for wheelchair users. Care Homes for Older People Page 4 of 27 Over 65 31 0 2 6 1 1 2 0 0 8 Brief description of the care home Fees charged are currently between £540 to £600 per week, depending on individual needs. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Various information was gathered in order to be able to assess the National Minimum Standards for Care Homes for Older People, including: The Annual Quality Assurance Assessment, this is a document which the registered manager completes every year and it contains information about the service being provided. We use this information, in part to focus on our inspection activity. An unannounced Key Inspection, which was carried out on the 24th of November 2009 by the Care Quality Commission (CQC). The registered manager (Sally Griffiths) was present throughout the inspection visit. There was the opportunity to speak to some of the people who use the service in private, speak to some visitors and discussions also took place with some of the staff team. Peoples files were examined, with all relevant documentation being in place including, initial assessment documentation and care plans. Care Homes for Older People Page 6 of 27 A number of the staff files were examined and they also contained all of the necessary documentation needed for inspection purposes including, recruitment information and evidence of relevant training that has been provided. Throughout the site visit there was the chance to observe the support and care that was being provided to individuals, which was done in a caring, appropriate and professional manner. The organisations policies, procedures and the health and safety documentation were examined and they were found to be up to date and satisfactory. A tour of the premises was carried out and it was found to be clean, safe, hygienic, comfortable and very well decorated throughout. Four requirements and one recommendation were issued by the CSCI following the previous inspection. It was evident at this inspection, that the requirements and recommendation have all been satisfactorily addressed. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: The cookers in the kitchen are small domestic cookers. It is recommended that a more industrial type cooker be installed. Generally the kitchen would benefit from being updated. The installation of a new sink in the treatment room is advisable. The present sink looks quite old,very worn and doesnt appear to be too hygienic, especially regarding the management of cross infection. Care Homes for Older People Page 8 of 27 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 27 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 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is an excellent comprehensive pre admission assessment process in place, giving the assurance that new or prospective service users are appropriately assessed. Evidence: The homes admission policy and procedures were checked and they were observed to be up to date and thorough. Five service users files were examined, including the last person to go and live at Mayfield Nursing Home. The files were very well organised, containing all of the relevant assessment documentation including: admission assessments, nursing assessments, contracts, detailed care plans with informative personal profiles for each person, Social Services assessments, up to date daily record documentation, appropriate risk assessments and medication profiles. The observed nursing assessments, which had been completed by the registered manager were of a very good standard. Care Homes for Older People Page 11 of 27 Evidence: An initial enquiry sheet is completed. They were observed to contain significant, detailed and appropriate information, giving the care and nursing staff relevant information, which would help them to support and care for the new / prospective service user. The homes statement of purpose and the service users guide were both available at the entrance to the home. These documents were also available in large print and Braille. This shows that consideration is given to people who have visual impairment problems. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples care plans are thoroughly detailed, with specific health care needs prominently identified. It is clear that service users assessed needs are appropriately provided for and people are being treated with dignity and respect. Evidence: The home uses the Standex system, which is a very good detailed documentation system that incorporates all aspects of care provision. Some of the items covered in the standex files were, a dependency profile, care and support needs, health record, risk assessments, weight monitoring and medication. The care plans of five people were examined and they were found to be very well maintained, detailed,with appropriate individualised information for each person. There was a photograph of the person on the file, helping with identification, especially in the event of an emergency. Plans also contained individuals past employment history and other important background information. It was evident that peoples plans are person centered and Care Homes for Older People Page 13 of 27 Evidence: are focused on the person and their individual specific needs. Files contained evidence that peoples health care needs are being provided,with records of GP visits, hospital appointments and all other appointments and consultations with health professionals. The feedback received from service users and relatives was positive about individuals health care needs. Some of the written comments were, he has received the best of attention your kindness and the care and consideration you showed did a great deal to ease my mind during his illness and words cant thank them enough for caring and looking after my dad. There was a medication policy in place, clearly informing the staff of the correct procedures to follow in the administration of medication. The medicine administration records (MAR) were examined and they were all correctly maintained with accurate recording. The medicines are securely and appropriately stored in the treatment room. The previous requirements regarding the storage and recording of medication have been satisfactorily addressed. Each persons MAR sheet had a photograph attached, which helps eliminate potential identity mistakes. Only qualified nurses administer medication. There was up to date information available regarding, what medication had been prescribed for, with detailed information available about any possible side affects. The members of staff on duty during the inspection visit were observed demonstrating a caring and respectful approach to service users, and the feedback received from people was that respect and dignity is demonstrated at all times. Care Homes for Older People Page 14 of 27 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. Relevant, appropriate, recreational, leisure activities and interests are provided, demonstrating that people are positively motivated and stimulated. This helps give people a sense of wellbeing and of being valued. Evidence: The activities programme for Mayfield was examined. It was evident that careful consideration is given to ensuring that appropriate, meaningful and stimulating activities are regularly provided. The planned activites and events are advertised and displayed in prominent places throughout the home. A questionnaire is completed for all new service users regarding, life history, past employment, relious beliefs, lifestyle, hobbies, interests and likes and dislikes. It was observed that individual care plans have more in depth information regarding life history. There were detailed up to date records of activities including which service users had attended, with helpful and informative comments from members of staff. Some of the activities available were, Physio chair excercises, Reminiscence sessions, Pat dogs, musical bingo, Wei games golf and bowling, film shows, Saturday social evenings with drinks and snacks, regualr sing alongs and carnival games. Care Homes for Older People Page 15 of 27 Evidence: Other events taking place include, hairdressing , manicure sessions, all birthdays are celebrated with a party. Other regular celebratory events throughout the year include, Easter, Valentines day, Grand National, St Patricks day and it was observed a Victorian day for the Christmas period had been arranged. Peoples interests in local rugby and football are also promoted, with the provision of Sky TV. Major sporting events are also promoted to maintain and create individual interest, in order to provide stimulation. During the inspection it was evident that there was a really happy atmosphere in the home, with people coming and going. In the afternoon a sing-a-long was taking place with service users and staff all singing along and some people were dancing. It was clear that this was a usual event, by the way people were responding. There is an open house policy at Mayfield, with positive comments being, always made welcome lovely atmosphere the manager operates an open door policy, which relatives appreciate and I have always found the staff very friendly and helpful. Staff were observed supporting service users in a calm, relaxed atmosphere, with sensitivity. The menus for meals were examined and they were found to varied and nutritional. The kitchen staff maintain good records of individuals specific dietary needs and it was evident that the cook endeavors to consistently provide nutritional wholesome meals and is fully aware of peoples dietary requirements. At the time of the inspection thirteen service users were needing to have their food liquidised. The liquidised food was shaped into different items, for example, steak and fish. The cook was committted to making all of the meals appealing, presentable and appetising. The comments received about the meals were all commendable. Care Homes for Older People Page 16 of 27 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. There are satisfactory policies and procedures in place at Mayfield regarding complaints and safeguarding issues. Up to date safeguarding training is provided, helping to give the assurance that vulnerable people are protected from harm or abuse. Evidence: Mayfield had a comprehensive complaints policy and procedure in place. Two complaints had been received since the previous inspection visit. However, the complaints had been dealt with appropriately and within the recognised acceptable timescale. Questionnaires and comments cards all indicated that people were aware of the complaints procedure and would have the confidence to complain if needed. In discussion with people using the service and relatives it was apparent that people knew who to raise any concerns or complaints with. There was a thorough policy in place to deal with a suspicion or allegation of abuse. The previous inspection carried out by the Commission for Socail Care Inspection (CSCI) highlighted a shortfall in the provision of specific safeguarding training. This shortfall has been addressed, with all staff receiving appropriate safeguarding training. Training records were examined to confirm this. Some of the staff team were asked about safeguarding / abuse issues and they were able to demonstrate that they had a good understanding of these issues. It was also Care Homes for Older People Page 17 of 27 Evidence: apparent that people would have the confidence to appropriately raise any concerns if there was a suspicion or allegation of abuse being made. This helps to give the assurance that vulnerable people are protected from harm or abuse. Care Homes for Older People Page 18 of 27 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 home is clean, hygienic and well maintained, helping to ensure that people live and work in a safe, comfortable and pleasant environment. Evidence: A full tour of the home was carried out and throughout it was found to be of a very good standard. It was found to be clean and hygienic, with anti bacterial hand gels strategically situated around the home. This is regarded as good practice, helping with the management of cross infection. There was a treatment room where medication is stored, medical records maintained and some medical procedures carried out, for example the changing of dressings. However, it was observed that the sink in this room is need of being replaced. It looks quite old,very worn and doesnt appear to be too hygienic, especially regarding the management of cross infection. Peoples bedrooms were found to be very well decorated and individualised with peoples own personal items. This helps people feel familiar and comfortable with their surroundings. The entrance to Mayfield was observed to be welcoming, with photographs displayed of all of the staff who work at the home, helping service users and visitors to identify Care Homes for Older People Page 19 of 27 Evidence: the staff team and to be able to put names to faces. The lounges are also well decorated and comfortable. The dining rooms were airy, nicely decorated, with the tables being laid with clean fresh table clothes and napkins. The laundry was very well organised, with adequate machinery to cater for the needs of the people living at Mayfield. The feedback received was very positive about the cleanliness, comfort and decor of the home. For example, the home is really well decorated well maintained the whole place has been redecorated in the last twelve months and the home has been done top to bottom. The kitchen was observed to be clean, hygienic and with stainless steel worktops. However, the cookers in the kitchen are small domestic cookers. It is recommended that a more industrial type cooker be installed. This would be assessed to be more safer than the present situation. There was appropriate specialist equipment observed around the home, such as lifting hoists, walking frames and wheelchairs, thereby helping to ensure that individual needs are catered for, whilst independence is promoted. The home employs a maintenance man, who carries out any minor repairs, in order to ensure that the home is safely maintained. It was mentioned that he has changed the lighting in all of the corridors. The dark lighting in the corridors was mentioned in the previous inspection report. This helps to demonstrate that the provider listens and takes appropriate action to improve the safety and standards within the home. The outside grounds are maintained to an excellent standard. Care Homes for Older People Page 20 of 27 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. There is a robust recruitment process in place, helping to give the assurance that only suitable people are employed to nurse, care and support vulnerable people. Evidence: Mayfield was observed to be satisfactorily staffed, with qualified nurses and care staff. It was evident that a number of the staff team have worked at Mayfield for some time. This gives an assurance of continuity and familiarity for the people using the service. Four of the staff files were examined including the most recent person to be employed at the home. The files were very well organised, with all of the necessary recruitment documentation being in place including, application forms, two written references for each person (previous requirement) and in some cases there were three references, Criminal Record Bureau (CRB) checks,contracts of employment and records of induction periods. This helps to demonstrate that only suitable people are employed to support and care for vulnerable people. Some of the feedback received regarding the staff team was, I have always found the staff to be very friendly the girls are great and my mum is very happy and content, she gets looked after really well. There was available evidence to show that all members of staff have received Care Homes for Older People Page 21 of 27 Evidence: appropriate, relevant and satisfactory training. Some of the training provided included, Dementia awareness, infection control, safeguarding adults, first aid, moving and handling, the management of challenging behavior and food hygiene. 100 of the staff team have acquired the National Vocational Qualification (NVQ) at level two, with a number of people in the process of obtaining the NVQ at level three. The training provision is assessed to be very good and people using the service are supported and cared for by a well trained and skilled staff team. Some of the comments from the staff were, The training is really good we have refresher courses and I did the Elder Abuse training. Overall with the feedback received and in observation, it was apparent that the dedication and commitment of the staff team is of a very good standard. Care Homes for Older People Page 22 of 27 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 home is well managed and organised, ensuring as much as possible that service users are safe and receive a good quality service. Evidence: The Registered manager for Mayfield (Sally Griffiths) has many years of experience in nursing and social care. She has been a Registered General Nurse (RGN) for more than twenty years and is registered with the Care Quality Commission (CQC). She has been been in post at Mayfield for eighteen months and from the feedback received it appears that during this time she has made some positive changes. The manager has continued to obtain up to date training and has recently attended, Safeguarding of Adults training, Mental Capacity Act 2005 and The Deprivation Of Liberty Safeguard training. She said, I will be delivering this training to the staff team. She is presently in the process of completing the Registered Managers Award. This demonstrates that she continues to develop, by receiving up to date training and is aware of relevant legislation, in order to maintain the protection of people and the Care Homes for Older People Page 23 of 27 Evidence: quality of care within the home. Some of the comments regarding the manager from relatives were, The matron is very helpful and friendly She is one of the reasons why we chose Mayfield for my mum things have improved so much in the past twelve months, mainly because of the matron and comments from some of the staff, she will go out of her way to help and the matron is very nice and approachable. There were procedures in place, regarding service users finances, with appropriate and adequate records being maintained. This helps to ensure that peoples finances are safeguarded. There was documented evidence to show that regular staff supervisions take place and minutes of recent staff meetings were also observed. This helps to demonstrate that staff are valued and what they say is taken seriously. The health and safety policy and procedures were examined and they were found to be up to date. The previous requirements and recommendations issued by the CSCI have all been satisfactorily addressed. This is another indication that the provider is committed to addressing and improving the quality of care, if any issues arise. All of the homes health and safety inspection certificates were also observed including, electricity, gas, fire extinguishers, portable appliances (PAT), water system, emergency lighting, hoists and the passenger lift inspection certificate. The inspection certificates were all up to date and correct. Also observed were, mattress pressure tests, weekly fire tests, fire drill action plan and monthly health and safety check lists. There was sufficient evidence to demonstrate that the health and safety of service users and staff is promoted as much as possible, to help ensure that people live and work in a safe and healthy environment. Care Homes for Older People Page 24 of 27 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 27 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 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 19 19 The sink in the nurses treatment room looks unhygienic. Its replacement would improve the standard of this room. The present cooker is too small. A more modern and larger cooker would be more appropriate for the needs of the people living at Mayfield. Care Homes for Older People Page 26 of 27 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). 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