Inspection on 11/08/08 for Middletown Grange

This inspection was carried out on 11th August 2008.

CSCI found this care home to be providing an Adequate 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.

Other inspections for this house

Middletown Grange 14/08/07

Middletown Grange 26/04/06

Middletown Grange 08/11/05

Middletown Grange 08/06/05

Middletown Grange 26/01/05

Middletown Grange 06/09/04

Middletown Grange 09/12/03

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Middletown Grange Middletown Hailey Witney OX29 9UB Lead Inspector Kate Harrison Unannounced Inspection 11th August 2008 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Middletown Grange DS0000040174.V369256.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Middletown Grange DS0000040174.V369256.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Middletown Grange Address Middletown Hailey Witney OX29 9UB Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01993 700396 01993 775704 middletowngrange@barchester.com www.barchester.com/oulton Barchester Healthcare Homes Ltd Vacant Care Home 56 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0) of places Middletown Grange DS0000040174.V369256.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. From time to time people over the age of 60 may be accommodated. The home may accommodate one service user within the category LD(E). 14th August 2007 Date of last inspection Brief Description of the Service: Middletown Grange care home is situated in a village location approximately 4 miles from the market town of Witney. The home is registered to provide care for up to 56 residents and is owned by Barchester Healthcare Limited. The home provides care for residents with nursing needs, and care and support for people living with dementia. There are two spacious lounges, a conservatory and a separate dining room on the ground floor, with bedrooms on the ground and first floors. The first floor Memory Lane - also has its own lounges and dining room. An extensive building and refurbishment programme was completed in 2007 and included new kitchen and laundry facilities There is a large enclosed front garden, a garden with water feature in the central courtyard, and a garden at the rear primarily for the use of people living in Memory Lane. The home’s current scale of charges range from £575.98 to £1000 per week. Middletown Grange DS0000040174.V369256.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This inspection of the service was an unannounced ‘Key Inspection’. We arrived at the service at 10.00 hours and the inspection lasted for 9 hours. This inspection was a thorough look at how well the service is doing. It took into account detailed information provided by the service through the Annual Quality Assurance Assessment (AQAA) and any information that we received about the home since the last inspection. The service stopped providing intermediate care earlier this year. The general manager is in charge of the home, assisted by the deputy manager, who is a nurse responsible for the quality of care provided. We saw most areas of the home and looked at records and documents relating to the care of the people living at there. We asked the views of the people who live in the home, the staff team and other people seen during the inspection or who responded to questionnaires we sent out, and their views are included in this report. Altogether we received 16 written responses. Because people are not always able to tell us about their experiences, we used a formal way to observe people in this inspection to help us understand. We call this the ‘Short Observational Framework for Inspection’ (SOFI). This involved us observing people living in the home and recording their experiences at regular intervals. This included their state of well being, and how they interacted with staff members, other people who use services, and the environment. We looked at how the service was meeting the standards set by the government and in this report made judgements about the outcomes for people living at the home. On the day of our visit contractors were addressing a flooring problem on an area of the ground floor, so some people who would usually use the ground floor spent most of the day upstairs. From the evidence seen and comments received, we consider that this home would be able to provide a service to meet the individual needs of people from diverse backgrounds, once the planned staff training is completed. Middletown Grange DS0000040174.V369256.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The general manager and the head of care are aware of the key need to improve dementia care training for the staff, and the home has provided dates to show that all the staff team will have the training very soon. The pre-admission assessment documentation about people admitted with dementia needs to be improved, as does the care planning, so that their particular needs are recognised and met. As evidence show that people with dementia find different colours and signage useful in helping them to know where they are, the Memory Lane part of the home needs to be improved so that people with dementia find it a comforting, homely place to live. Middletown Grange DS0000040174.V369256.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Middletown Grange DS0000040174.V369256.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Middletown Grange DS0000040174.V369256.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. The home has stopped providing intermediate care. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care needs of people are assessed before they move into the home, although the particular needs of people with dementia need to be better documented. EVIDENCE: The home’s statement of purpose says that admission to the home follows a careful assessment of need. We looked at how the home arranges admissions, and saw that the general manager or her deputy goes to see the individual and carries out a pre-admission assessment to make sure that the home can meet their needs. The assessments we saw included information from a care manager and from the discharging hospital about the person’s needs, including medication, and showed that the individual’s physical needs were well documented on the home’s pre-admission form by the general manager or her deputy. Middletown Grange DS0000040174.V369256.R01.S.doc Version 5.2 Page 10 We noted that the pre-admission assessment for people with dementia does not contain sufficient information about their needs, and needs to be more detailed, as the dementia is the main reason for admission. Middletown Grange DS0000040174.V369256.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although the physical health needs of people living in the home are met, the particular needs of people with dementia are not always met, due mainly to a lack of appropriate staff training. The home lacks a vision based on best practice regarding caring for people with dementia. EVIDENCE: The majority of people living in the home who responded to our survey said they ‘always’ received the care, support and medical help they needed. People told us that the staff team treat them with respect, and we observed staff members deal respectfully with people. We discussed care planning with the head of care and saw detailed care plans for three people. The plans for addressing the physical health needs of people in the home were documented, and everyone is registered with a general practitioner. The home has good arrangements for access to healthcare practitioners within the National Health Service, such as the Speech and Language service, dieticians and experts in wound care. Middletown Grange DS0000040174.V369256.R01.S.doc Version 5.2 Page 12 The care plans contained arrangements for activities of daily life, such as moving around, personal hygiene and nutrition, and risk assessments detailing how the risks needed to be minimised. The plans varied, from being personal to impersonal, so that some plans showed how the individual liked to chose what clothes to wear, but did not contain information about other personal preferences, such as for daily showering or bathing. There was no evidence to show that the staff were aware of their responsibilities under the Mental Capacity Act 2005 to make choices, if they needed to, in the best interests of the people living there who lack capacity. The head of care explained that care planning was recognised as an area needing improvement, and this is reflected in the home’s AQAA. The home’s statement of purpose says that the dementia service provided ‘has a person centred focus, highlighting the uniqueness of the individual and aiming to maintain the concepts of personhood and well-being’. The care plans we saw for the people living with dementia did not reflect this focus. The strategies suggested in the care plans to help staff care effectively for the individuals were outdated, and are failing to meet the needs of people in the home with dementia. For example, regarding one individual, the instructions for staff stated ‘needs to be orientated to her environment’, and this approach is not current best practice. We observed instances where individuals became frustrated and upset, others were calling out while other individuals in the corridors said they were lost and continually needed directions. Our observations throughout the day showed that the staff team, although well meaning, were not implementing best practice in dementia care, and this means that the particular needs of people with dementia are not met. We asked some staff members about their dementia care training, and none had received the training, especially the evidenced based training recommended by the dementia organisations. We understand that in the staff team 2 members have received the training, and several have received training in addressing challenging behaviour. The home is registered to care for people with dementia so our expectation is that the particular needs of people with dementia will be met. These issues were discussed with the head of care and the general manager, and following the inspection, swift action was taken to bring forward the planned staff training so that good person-centred care is provided quickly. We saw the arrangements about managing the medication in the home. A local branch of a large pharmacy delivers medication ordered from prescriptions on a monthly basis, and all medication received is recorded. The medication administration records are completed for individuals when their medication is administered, and we noted that these were correct and up to date. We checked the controlled drug register for the medication of one individual and this was accurately recorded. There is a contract in place for the disposal of drugs no longer needed at the home, and these are recorded Middletown Grange DS0000040174.V369256.R01.S.doc Version 5.2 Page 13 appropriately. Staff who manage medication receive update training on medication, and regular audits of the medication are carried out. Middletown Grange DS0000040174.V369256.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The routines of the home usually suit the people living there, and daily life for people with dementia will improve after the planned staff training on the subject takes place. EVIDENCE: The home employs an activities organiser who works 30 hours a week, and the home is seeking to employ another person to help part time. Activities are provided over the weekdays, and include a variety of events for groups in the home and outside, and outings are organised using the home’s minibus. The majority of people who responded to our survey said that there are ‘usually’ activities provided that they can take part in, and people said that the activities organiser knows their wishes about activities, as he has been at the home for a long time. On the day of our visit a group was working on a wall painting and it was evident that the activity was very enjoyable. The home’s gardens provide good areas for people to get fresh air and exercise, and there are plans to make better use of these areas. Information about activities is recorded in the individual care records, and we noted that some individuals who cannot take part in group activities miss out on activities. One care plan shows that for the month of July one individual’s Middletown Grange DS0000040174.V369256.R01.S.doc Version 5.2 Page 15 sessions were ‘very limited’. The general manager explained that this situation would improve after the recruitment of another person. Relatives are asked by the home to supply life history information to inform how the home cares for the person but we saw little evidence of this in the care planning. We saw some evidence that the provision of activities for people with dementia was linked to their past lives, such as rummage boxes and soft toys, but this needs to be developed and expanded so that it relates to individuals and is meaningful in improving their daily lives at the home. The head of care explained that the planned training for staff on how to care for people with dementia will help the team to understand the needs of the people at the home with dementia, and this will improve their caring practice. Visitors are welcome to the home, and the service user guide states that visitors are welcome to arrange to have meals with their relatives. People we spoke to said that food at the home is very good, and we noted that most people enjoyed lunch on the day of our visit. The service user guide shows that arrangements are in place to deliver post promptly, and we saw that people can have their own phone or can use the home’s facility to keep in touch with friends and family. Middletown Grange DS0000040174.V369256.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People know how to complain if they want to, and the home’s policies, procedures and staff training protect people from harm. EVIDENCE: The home has a complaints policy and procedure, and the procedure is displayed in the home. It is simple and easy to follow, and shows the details of the person in the organisation who is responsible for addressing complaints if they cannot be resolved within the home. Complaints are recorded, and we saw, through the correspondence, that they are responded to within the appropriate timescales. We received information about two complaints during our visit, and we discussed these with the general manager. The organisation had arranged for a senior manager to respond to one complaint, and since our visit has met with the complainant. The general manager had discussed the complaint with the other complainant, but as the issue is not yet resolved she needed to review the issue and respond personally to the complainant. The AQAA information shows that the home has a policy about safeguarding vulnerable people and the general manager explained her awareness of the local safeguarding procedures. All new staff receive information about safeguarding vulnerable people at the time of induction to the home, and most staff members have received additional training. Middletown Grange DS0000040174.V369256.R01.S.doc Version 5.2 Page 17 Middletown Grange DS0000040174.V369256.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People live in a safe comfortable well maintained home, but the Memory Lane area needs to be better organised to meet the needs of people with dementia. EVIDENCE: The home recently underwent an extensive programme of rebuilding and refurbishment, and now provides a very comfortable environment for the people living downstairs. Outside the surroundings are very pleasant, with colourful flower beds and flower baskets, and recently improvements have been made to the rear gardens. People told us that they appreciate the pleasant surroundings. While the downstairs area meets the needs of the people living there very well, the upstairs Memory Lane area where 32 people with dementia live, is not well organised to meet their needs. At present there are few appropriate indicators to help people find their way around the area, such as appropriate signage on communal or private rooms, and there are long stretches of same colour Middletown Grange DS0000040174.V369256.R01.S.doc Version 5.2 Page 19 corridors going different ways. This means that it may be difficult for people to walk around their communal accommodation without feeling disorientated, and our observations showed that this was happening. This was discussed with the deputy manager, who understood that the Memory Lane area needs more work to meet the particular needs of people with dementia, but this work needs to be carried out quickly. People in Memory Lane also need staff members to help them access the garden, as it is downstairs, and the general manager needs to make sure that on most days most people living upstairs can go to the garden if they want to. The AQAA information shows that contracts are in place to make sure that the home’s services are well maintained, and the home’s maintenance manager is responsible for managing routine maintenance and safety issues. People who responded to our survey said that the home is ‘usually’ clean and fresh. The home was clean and mainly odour free on the day of our visit. The laundry service was upgraded last year and most of the staff have received infection control training. Middletown Grange DS0000040174.V369256.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although staffing issues such as recruitment, staffing numbers and health and safety training is well managed, the lack of appropriate dementia care training for staff means that the needs of people living with dementia are not always met. EVIDENCE: We saw the staff rota showing the numbers and skill mix of the staff team on duty over the month. The home uses the organisation’s system to determine the numbers of staff needed, and for the 48 people living in the home on the day of our visit 10 care staff including two registered nurses were on duty. Also on duty were the deputy and general manager, the activities organiser, administrative support, housekeeping and kitchen staff. These numbers also reflect the numbers on duty according to the rota for the remainder of the month. 32 people were living in the Memory Lane area and of the care staff members on duty, five carers and one registered nurse were caring for them. We received information about concerns regarding numbers of staff on duty, and these were discussed with the general manager. The general manager explained the current issues, including difficulties about turnover of staff and some team working difficulties and felt that the numbers of staff on each shift is appropriate. Our observations indicate that the staff numbers may be appropriate, but staff members need training in how to care appropriately for people with dementia. Middletown Grange DS0000040174.V369256.R01.S.doc Version 5.2 Page 21 The home is registered to care for people with dementia, but appropriate training for staff in dementia care has not been provided. This is evident in the care plans, in the results of our observations of people living with dementia, and in the home’s training matrix. The deputy manager is trained to provide the dementia staff training and the general manager has had training in managing people with dementia; however most of the staff team have not received the training although it is planned. The home’s statement of purpose states that the staff team’s aim is to provide the highest possible standard of care, but due to the lack of appropriate staff training on dementia care, the home is not meeting its aim regarding people with dementia. Following our visit a senior manager from the organisation confirmed that urgent staff training was being organised, so that the staff team would be trained in an evidenced based training programme about caring effectively for people with dementia. All new staff members attend corporate induction, which is completed within six weeks of starting work, and all the staff have personal development plans. The home’s deputy manager provides much of the staff training, and training on health and safety issues is generally well managed. The majority of the staff team who responded to our survey said that they ‘always’ have the right support, experience and knowledge to meet the different needs of people at the home. The nurses we spoke to said that they were supported to keep up to date with issues such as managing medication and pressure wounds. The AQAA information shows that of the 34 care staff members who are not nurses, 28 hold the National Vocational Qualification Level 2 in Care, and this means that the home is meeting the national minimum standard for the numbers of staff with the qualification. We saw three staff files to check the home’s recruitment procedure, and were satisfied that all the necessary information about people working in the home was available. The general manager explained that at times there is a need at short notice to have ancillary staff through an agency, and we discussed the need to have appropriate information available about people who come to work at the home, even for very short periods. Middletown Grange DS0000040174.V369256.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements are needed to make sure that the home meets its stated aim of meeting the needs of people with dementia. EVIDENCE: The general manager has been in charge of the home since January 2008 and although she is in the process of registering with the Commission, she is not the registered manager, so Standard 31 has not been assessed. The quality assurance system at the home includes monthly audits on topics such as cleaning, and a senior manager from the organisation carries out monthly unannounced visits to audit the quality of care. People living at the home are formally consulted on their views of the home annually, and the next survey is being arranged for September 2008. Middletown Grange DS0000040174.V369256.R01.S.doc Version 5.2 Page 23 The AQAA information shows that the home has policies and procedures about the management of the valuables, money and financial affairs of the people living at the home. Relatives or representatives manage relatives’ personal money, and individuals are invoiced for additional expenditure such as chiropody, escorting duties or hairdressing. The home’s health and safety policy statement is displayed in the home, and a named staff member is responsible for health and safety and a health and safety committee meets regularly. There is a fire risk assessment for the home, and evacuation equipment is available. As discussed in the Staffing section above, the home is not meeting its stated aim regarding the quality of the dementia care service provided. Although there are senior staff members with knowledge and experience of dementia at the home, in practice there is no clear philosophy, strategy or leadership regarding the outcomes for people with dementia. The organisation has given a commitment to implement the dementia staff training programme quickly, and a requirement is made in this report to improve the daily experience for people with dementia at Middletown Grange. Middletown Grange DS0000040174.V369256.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score N/A X 3 X 3 X X 3 Middletown Grange DS0000040174.V369256.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 OP19 OP30 Regulation 4 Requirement That the home takes action to meet its statement of purpose regarding the quality of care for people with dementia. The home must make sure that it meets the needs of people with dementia, by taking into account their particular needs at assessment and care planning, by ongoing staff training, and by making changes so that the environment in Memory Lane is more suitable for their needs. Timescale for action 30/09/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Middletown Grange DS0000040174.V369256.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Middletown Grange DS0000040174.V369256.R01.S.doc Version 5.2 Page 27 - 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. 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