Inspection on 08/12/09 for Meadows Sands Care Home

This inspection was carried out on 8th December 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Meadows Sands Care Home 10/06/09

Meadows Sands Care Home 02/08/07

Meadows Sands Care Home 03/08/06

Meadows Sands Care Home 05/04/06

Meadows Sands Care Home 19/12/05

Meadows Sands Care Home 24/08/05

Meadows Sands Care Home 14/12/04

Meadows Sands Care Home 23/08/04

Meadows Sands Care Home 10/03/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2010.

Key inspection report Care homes for older people Name: Address: Meadows Sands Care Home 98 South Parade Skegness Lincs PE25 3HR     The quality rating for this care home is:   zero star poor service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Elisabeth Pinder     Date: 0 8 1 2 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 30 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 30 Information about the care home Name of care home: Address: Meadows Sands Care Home 98 South Parade Skegness Lincs PE25 3HR 01754762712 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: marina@meadowssands.co.uk Accredited Care Limited care home 26 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The home is registered to provide personal care for service users of both sexes whose primary needs fall within the following categories:- Old age, not falling within any other category (OP) (26) Dementia - over 65 years of age (DE[E]) (26) The maximum number of service users to be accommodated is 26. Date of last inspection Brief description of the care home Meadow Sands Care Home is situated on the sea front at the Southern end of Skegness. There are public car parking facilities to the front of the home and three car park spaces to the rear of the home for staff. The home has no garden but seating is available at the front of the building and there is a park across the road. The bedrooms are situated on three floors accessible by stairs or a passenger lift. There are communal lounges and dining facilities on the ground floor. The current weekly fee is £310.00 - £446.00. Additional charges are made for chiropody, hairdressing, newspapers and personal toiletries. Care Homes for Older People Page 4 of 30 Over 65 26 26 0 0 1 0 0 6 2 0 0 9 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: zero star poor service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced visit and it formed part of a key inspection, focusing on key standards which have the potential to affect the health, safety and welfare of people who use the service. Throughout this report the terms we and us refer to the Care Quality Commission (CQC). The inspection was carried out by two inspectors and lasted just over five hours. We took into account previous information held by us including the previous inspection report and the providers action to address the requirements made during the previous visit, their service history and records of any incidents that we have been notified of since our last visit in June 2009. The main method used to carry out the inspection is called case tracking, this includes following the care of a sample of people through their care records and assessing their care. We spoke to people who use the service and saw rooms of those who said we could and to two members of staff, the new manager and administrator. Care Homes for Older People Page 5 of 30 What the care home does well: What has improved since the last inspection? What they could do better: Pre-admission assessments should contain more information to ensure all aspects of care are considered including how people are able to make decisions and choices and the action needed if they are not able. They should be signed by the person carrying out the assessment and should take into account peoples preferences, their legal status and record who provided the information. Care plans must continue to improve to make sure they contain sufficient detail to ensure that peoples needs are met. They should be person centred and clearly record how people are able to make decisions and how their privacy and dignity is to be respected. They should also show that people Care Homes for Older People Page 6 of 30 have been offered the choice to keep and administer their own medicines and record details of any visits to other health care professionals. Activities and leisure opportunities must be provided, these should be varied and suitable to meet the needs, expectations and capabilities of people living at the home. People should be offered a snack meal in the evenings and the interval between this and breakfast the following morning should be no more than 12 hours. Priority must be given to re-siting the toilets near to the dining room to make sure people using wheelchairs can use these facilities without having to go upstairs. Attention must also be made to the internal environment to make sure all areas of the home are reasonably decorated. Both room temperatures and water temperatures must be monitored and regulated where necessary to ensure people live in safe, comfortable surroundings. A robust recruitment procedure must be followed and all new staff must be designated a person who will supervise them throughout their induction. Staff must be appropriately supervised and have the necessary skills to care for people living in the home, this should include 50 of staff having a nationally recognised vocational training in care. Training relating to safeguarding vulnerable adults and dementia must be given to all staff and all staff must have sufficient knowledge about the new laws around decision making to ensure they respond appropriately to peoples decisions. The provider must appoint a manager who must then be supported to apply for registration with the Commission. Systems must be in place to regularly review and monitor the quality of care being provided and monthly reports written by the providers should reflect the outcome for people living at the home. Appropriate provision of activities and leisure interests must be provided. 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 7 of 30 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 8 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know about the service before they move in but the assessment procedure is not satisfactory and people cannot be sure their needs will be met. Evidence: We looked at the records of one person who had been admitted into the home since our last visit. The assessment form had been signed by the head of care but the manager told us she visited the person in another care home and had gathered the information prior to the admission. The assessment form has improved and contained a lot of information about the persons needs and preferences such as personal care, physical condition, mental health, social activities and religious preferences. However, it did not tell us whether the person was able to make decisions about how they wished to be treated or include any end of life wishes, or who gave the information. A letter was on file confirming that after the assessment the home could meet the persons needs. Care Homes for Older People Page 9 of 30 Evidence: Both staff spoken to had been employed since the admission but told us they are regularly given information about the needs of people they support and care for and surveys returned to us from staff prior to our visit confirmed this. Two surveys were received prior to our visit from people living at the home, one person felt they had received enough information about the home to help them decide if it was the right place for them, one did not know. Both told us they had been given a contract/terms and conditions of residency. However, of the four people whose care we followed, only two had been given terms and conditions. People told us its alright here and very good digs. One person said she had no idea how much she was paying to live here and had not been given a contract. Information about the service is written in the Statement of Purpose and Service User Guide and since our last visit these have been amended and given to everyone living at the home. They tell people how to access our reports but do not include any views from people living at the home. The service does not cater for people with intermediate care needs. Care Homes for Older People Page 10 of 30 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. Not all care plans contain sufficient detail about how people wish to be cared for which may put them at risk. Evidence: We continued to case track three further people and looked at their care records. We noted that these have improved since our last visit, however, there are still significant shortfalls in the recording. For example, one persons admission details read that a soft diet is needed, however, there was no care plan to support this. Another records that the person does not wish to have contact with family and states does not require advocacy at this time. However, it is unclear what arrangements have been offered. Care records did not record appointments to see other health care professionals or give detail about how peoples privacy and dignity are to be met apart from staff are reminded to preserve this at all times. They did not tell staff how people wish to be treated at their time of death or whether people have been given the choice of a male or female carer. We spoke to one person who was able to describe the way staff helped with his personal care which corresponded with his care plan. He also told us that staff protected his dignity and privacy. He had no negative comments regarding Care Homes for Older People Page 11 of 30 Evidence: the services provided by the home and told us he had been given a front door key to let himself in and out of the home. Care plans had been signed by the person to show that they were in agreement with them but did not show that people had the opportunity to be involved in any subsequent reviews/evaluations. Reviews had been written by staff and mainly read no need for changing care plan. One persons records detailed that urgent exercises had been given by their doctor to relieve shoulder pain, however, nothing was written to show that these were being carried out. Some risk assessments were in place for things like mobility and going out alone and files contained a dementia assessment. The manager told us that these had been inherited from the previous manager and they did not determine peoples level of capacity to make decisions and were inconsistent, for example, one stated the person does not have capacity but another record in their file stated no lack of capacity. Staff spoken to about this did not have a clear understanding of the new laws around decision making, although, one person had only just commenced her employment in the home and was in the process of completing induction training. We looked at the medication records for the four people whose care was being followed and these were up to date and clearly showed when people had been given their medicines. Consent forms signed by people to record that staff could give them their medicines were on files but these did not show if people had been given the choice to keep their own medicines. We were told that only one person selfadministers an inhaler and a risk assessment had been written to show that they were able and understood the importance of keeping this safe and taking it when necessary. We were told that four staff currently administer medication and they had received training and records were available to show this. The manager told us she has commenced a monthly audit of medication records and plans to include staff competencies in the new year. We saw one member of staff dispensing medication and this was done in a safe way. Records contained photographs to make sure that staff could match medication records to the individual person. The pharmacy had visited on 4th September 2009 and had agreed to write a homely remedies policy for the service, however, the manager said she had not received this yet but would look into it. Two surveys received prior to our visit from people living at the home told us they always received the right care and support including the medical support and during our visit people told us they felt well looked after. Two surveys received from staff told us they feel they have enough support, experience & knowledge to meet the different needs of people who live at the home. Including needs relating to disability, Care Homes for Older People Page 12 of 30 Evidence: gender, age, race and ethnicity, sexual orientation and faith. Care Homes for Older People Page 13 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The limited range of social and cultural opportunities does not ensure that peoples needs are met. Evidence: The home has no activity organiser in post and no system to develop or provide social activities. During our visit we did not see any activities taking place and people told us that activities only take place very infrequently, we play bowls on one day one week and bingo on odd days and there is not a great deal of activities, I have to find things to occupy myself and staff are just starting to try and sort this out We looked at care records for the four people whose care we were following and all contained a document called this is your life, which read they are put together to enable us to have a better insight and understanding of the history of people who live at the care home. It covered topics such as, religious beliefs, place of birth, details of parents and their occupation, education and sport, career and people worked with. It also covered favourite things and read likes to spend most of his time in his room enjoying his own company, will spend time in a lounge area, however declined to take part in social activities. Care Homes for Older People Page 14 of 30 Evidence: Two surveys received from people living at the home indicated activities are always or usually arranged that they can take part in. One care plan detailed that the person read the newspaper or magazine, goes out with her son and daughter-in-law at the weekend and joins in activities in the home. However, we looked at records of recent activities and these showed that very little activity was offered, records mainly read, listening to music, word puzzle relaxed in the lounge, sing along enjoyed looking through the window alphabet game and carpet snakes and ladders. We were told that the previous activity co-ordinator has been working for about a month as the homes cook. She has no catering experience and the manager said she is currently organising a course which will include an update in basic food hygiene. Care records gave some nutritional information about peoples likes and dislikes and during our visit we saw lunch being served. People gave a mixed response about the meal, some people said they liked it, whilst others said it was dull and had no taste. About the meals in general people told us the food here is alright, the quantity is ok but the quality is not always good and some meals are better than others. Prior to our visit information from two surveys told us that people always or usually like the meals, however, a comment read meal times need to be changed as a long time to go from tea. During our visit other comments were made about the timing of food and the provision of snacks and these were discussed with the manager who told us she would address this immediately. Care Homes for Older People Page 15 of 30 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 robust safeguarding procedures in place, however, if these are not followed this may hinder investigations. Evidence: The complaints policy and the local authority safeguarding adult guidelines were available and people living in the home have a copy of the complaints policy in their service user guide. People told us they didnt have any complaints but would speak with the manager if they did. Records show some staff have received training in safeguarding adults and staff spoken to had a good understanding of abuse and said they would immediately report any concerns to the manager. However, the manager was unclear of the correct procedure to report any allegations of abuse and made a general comment of I would tell everybody including the police. Care Homes for Older People Page 16 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Overall the home is clean and has a homely environment. Evidence: We looked at the lounge, dining room and four bedrooms and these were clean and tidy and people told us they were comfortable and they liked their rooms. They told us they were able to arrange them to their liking with personal items and those we saw showed this. Since our last visit in June 2009 four bedrooms have been refurbished. However, no action has been taken to re-site the toilets near to the dining room as identified in correspondence from the providers and people using wheelchairs still need to be taken upstairs to use the toilet to enable enough space for manoeuvre. During our visit the manager was unable to produce any risk assessments relating to the environment. However, we have been advised after the inspection that this was done on 30th June 2009. There were no unpleasant odours in the home, however, we saw a number of areas needing attention, for example, ground floor corridor walls had damaged and worn paintwork. The dining room carpet was stained and one person told us they had purchased a fan heater as their room was cold. Although a risk assessment for this was not seen during the visit and the manager told us that there wasnt one, we have since been advised that one was carried out in September 2009. The manager told us she had purchased room thermometers and is currently monitoring the temperatures of bedrooms to make sure people are warm enough. We Care Homes for Older People Page 17 of 30 Evidence: also saw that water temperatures were not always reaching the required minimum temperature to ensure safety and the manager said she would take action to address this. We also saw one person sitting in a wheelchair on the first floor corridor under a hair dryer and when staff were asked about this we were told that this is the only place this can be done. Two surveys received prior to our visit from people living at the home told us the home is always fresh and clean. Two surveys received from staff told read the home could do with better bathing facilities and a walk in shower and the home needs to be decorated which they have started to do and is looking well. The Environmental Health Officer last visited on the 5th November 2009 and gave the service a three star rating. The manager told us there are two outstanding issues, regarding cleaning filters and ducting but these are currently being addressed. Care Homes for Older People Page 18 of 30 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. The recruitment procedures are not sufficiently robust to minimise the risk to people living at the home. Evidence: On the day of our visit sixteen people were living in the home, one of whom was in hospital. We looked at staff rotas for the previous week and these showed that three carers were on duty from 7am until 9pm and two carers throughout the night. People living at the home told us they felt there was enough staff on duty and there was always someone around when needed. We were told that there are no current staff vacancies and agency staff are no longer used. Any shortfalls in staff are met by existing staff. Both surveys received prior to our visit from people living at the home told us that staff were always available when needed and both felt staff listen and act on what they say. Staff surveys indicated that they felt there are usually enough of them on duty to meet peoples needs and during our visit we saw staff respond to peoples requests for help and support. We looked at training records and these showed that only 28 of care staff have undertaken a national vocational qualification to enable them to increase their knowledge and obtain the skills needed to care for people living in the home. Since our visit in June training has been completed in medication, First-Aid, infection control, manual handling, safeguarding of vulnerable adults and the Mental Capacity Act and Care Homes for Older People Page 19 of 30 Evidence: Deprivation of Liberty. We spoke to two members of staff who had not been working in the home for very long. Both told us they had been given copies of the General Social Care Council code of conduct booklet and had commenced induction training, however, their records did not show who was supervising or mentoring them. Neither had an understanding of the Mental Capacity Act or the Deprivation of Liberty Act and the manager told us that they had commenced employment after staff had completed training on this subject but would be included in this training when possible. Both staff told us they had completed relevant application forms and provided references and had the necessary criminal record bureau checks (CRB). One file did not give dates of any previous employment which made it difficult to confirm an accurate employment history. Another file showed that references given were not from the persons previous employer and there was no proof of identification on file. The manager said this person had been asked to bring it these documents and agreed to look into this. Care Homes for Older People Page 20 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This service is not being managed well enough to ensure its smooth running or the safety of people. Robust systems are not always followed to make sure peoples money is kept safe. Evidence: Since the last inspection a new manager has been appointed and she commenced employment in July 2009. She told us that she had previous management experience in caring for elderly people and is currently gathering relevant documents to send to us with her application for registration. The manager told us that the home had been visited by the Local Authority contract and monitoring department in September of this year and support was being given to her to develop person centred care plans and training was to be arranged regarding dementia. During our visit people told us the manager was approachable and supportive and no one raised any concerns about the management of the home. Care Homes for Older People Page 21 of 30 Evidence: Resident and relative meeting were held in October and records showed that nine people and four relatives attended. Topics covered housekeeping tasks, choice of food, menus and forthcoming parties. We looked at two staff files and found that they had not received supervision from the manager since commencing employment in July and October 2009 and the manager told us she has not had any formal supervision from the providers since she started working in the home in July. She told us a management meeting had been held where Lincolnshire County Council quality framework system was discussed but she has not had any opportunity to discuss her development or concerns about the home. No staff meetings have been held since the manager came into post. The manager told us she had recently sent quality assurance questionnaires to people and their relatives and to date only four have been returned. These were looked at and generally gave positive comments about the service, such as, its nice, good food, it feels like home most of the time and its home from home. Questionnaires had not been sent to GPs (general practitioners), district nurses or social workers and the manager said she would action this. Records showed that one of the providers had visited the home once a month to monitor and evaluate how the home is running and reports were available of their findings. However, these did not reflect the outcome for people living in the home. The finances of four people whose care we were following were looked at and we saw that the legal status had not established for all of them. We checked the financial records for one person and these corresponded with the money held in the home. However. the current practice for two people is for the administrator to act on their behalf, sometimes moving money from one account to another without always obtaining witnesses or second signatures. Care Homes for Older People Page 22 of 30 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 1 4 A service user guide must be 31/08/2009 given to each person and must inform them how to access our most recent inspection report. They must also be given terms and conditions/contracts of residency. To ensure people have the right information about the service. This requirement has been met in part, a further timescale is given for compliance. 2 3 14 Pre-admission assessments 28/07/2009 must contain sufficient information about the person to enable staff to understand and meet their needs. To ensure peoples needs are identified and can be met at the care home. This requirement has been met in part, a further timescale is given for compliance. 3 7 15 Care plans must contain sufficient information about how people want their care providing, as well as their abilities. They must include 28/07/2009 Care Homes for Older People Page 23 of 30 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 all areas of need and inform staff of the action needed to meet needs. They must be reviewed and updated regularly. To enable staff to provide the right level of care and support. This requirement has been met in part, a further timescale is given for compliance. 4 18 13 All staff must know what to do should they receive an allegation of abuse. To ensure people are protected from harm. This requirement has been met in part, a further timescale is given for compliance. 5 30 18 Staff must receive a 31/08/2009 structured induction programme and be appropriately supervised and supported during their induction training. To ensure staff have the necessary skills to care for people living at the care home. This requirement has been met in part, a further timescale is given for compliance. 28/07/2009 Care Homes for Older People Page 24 of 30 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 6 30 18 Staff must have the necessary skills and knowledge relevant to the work they perform. To ensure staff are able to care for people living at the home. This requirement has been met in part, a further timescale is given for compliance. 31/08/2009 7 33 24 Systems must be in place to 31/08/2009 regularly review and monitor the quality of care being provided. To ensure this service is run in the best interests of people living there. This requirement has been met in part, a further timescale is given for compliance. Care Homes for Older People Page 25 of 30 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 1 4 People must be given terms and conditions/contracts of residency. To ensure people have the right information about the service. 26/02/2010 2 3 14 Pre-admission assessments must contain sufficient information about the person to enable staff to understand and meet their needs. To ensure peoples needs are identified and can be met at the care home. 26/02/2010 3 7 15 Care plans must contain sufficient information about how people want their care providing, as well as their abilities. They must include all areas of need and inform staff of the action needed to meet needs. 26/02/2010 Care Homes for Older People Page 26 of 30 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 To enable staff to provide the right level of care and support. 4 12 16 Appropriate activities and leisure opportunities must be provided. To meet individual needs 5 18 13 All staff must know what to do should they receive an allegation of abuse. To ensure people are protected from harm. 6 19 23 The physical layout of the 26/02/2010 home must meet the needs of people living there and all areas must be reasonably decorated. To ensure people live in a well maintained, safe environment which meets their needs and their privacy and dignity is maintained at all times. 7 29 19 A robust recruitment 29/01/2010 procedure must be followed. To ensure people are protected. 8 30 18 Staff must have the necessary skills and knowledge relevant to the work they perform. 26/02/2010 26/02/2010 26/02/2010 Care Homes for Older People Page 27 of 30 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 To ensure staff are able to care for people living at the home. 9 30 18 Staff must be appropriately supervised and supported during their induction training. To ensure people are protected whilst staff learn the necessary skills to care for people. 10 31 8 The provider must appoint a manager who must register with the Commission To ensure the home is managed by a person who is fit to be in charge. 11 33 24 Systems must be in place to 26/02/2010 regularly review and monitor the quality of care being provided. To ensure the service is run in the best interests of people living there. 12 35 20 There must be robust systems in place for managing peoples finances. To ensure peoples money is safe. 29/01/2010 29/01/2010 26/02/2010 Care Homes for Older People Page 28 of 30 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 1 Information given to people about the service should tell them how they will be helped to make decisions about how they wish to be treated. Written records should be kept of all visits to health care professionals. Records should clearly tell staff about how peoples privacy and dignity needs are to be met. Records should clearly tell staff how people wish to be treated at their time of death. A snack meal should be offered in the evenings and the interval between this and breakfast the following morning should be no more than 12 hours. Both room temperatures and water temperatures must be monitored and regulated where necessary to ensure people live in safe, comfortable surroundings. There should be a minimum ratio of 50 trained members of care staff (NVQ level 2 or equivalent) Monthly reports written by the providers should reflect the outcome for people living at the home. 2 3 4 5 8 10 11 15 6 25 7 8 28 37 Care Homes for Older People Page 29 of 30 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. 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