Inspection on 12/05/09 for New Victoria Nursing Home

This inspection was carried out on 12th May 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

New Victoria Nursing Home 26/11/08

New Victoria Nursing Home 11/06/07

Extracts from inspection reports are licensed from CQC, this page was updated on 20/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: New Victoria Nursing Home 137 / 139 Hornby Road Blackpool Lancashire FY1 4JG     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Pauline Caulfield     Date: 1 2 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 32 Information about the care home Name of care home: Address: New Victoria Nursing Home 137 / 139 Hornby Road Blackpool Lancashire FY1 4JG 01253621043 01253292342 newvictoria@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Regency Healthcare Ltd care home 30 Number of places (if applicable): Under 65 Over 65 30 old age, not falling within any other category Additional conditions: 0 The registered person may provide the following category of service only: Care home with Nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 30 Date of last inspection Brief description of the care home The New Victoria Care Home is situated in a residential area of Blackpool, with good access to shops and amenities including a regular bus service. The home is purpose built and provides care and accommodation for up to thirty people. Residents are cared for with a wide range of needs, from residential care to nursing. The home is set on three levels. There are lounges, dining areas and bedrooms on all three floors. All bedrooms are single rooms. There is a Statement of Purpose/Service User Guide, which is given to all prospective residents. This written information explains the care service that is offered, who the owners and staff are, and what the resident can expect if he or she decides to live at Care Homes for Older People Page 4 of 32 2 6 1 1 2 0 0 8 Brief description of the care home the home. Information received on 08/06/09 showed that the fees for care at the home are from two hundred and ninety two pounds and twenty five pence to four hundred and fifty five pounds and twenty one pence per week, with added expenses for hairdressing, chiropody and newspapers. Care Homes for Older People Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was an unannounced visit undertaken as part of the inspection process which commenced at 9am for eight and a half hours. Before the visit the home completed an annual quality assurance assessment (AQAA). this is a document that provides CQC with written information and an assessment about the quality of the services the home provides. The registered person is asked to provide us with this information each year. The inspection involved case tracking three residents as a means of assessing the care provided in the home. Case tracking means the inspector looks closely at a small group Care Homes for Older People Page 6 of 32 of people living in the home. We talk to them about the home if they are willing to and are able to talk to us. If they cannot talk to us we watch how staff care for, talk to and involve them in activities. We look at any information about their care and support and look around the home, particularly at rooms the case tracked residents use. We also spend time talking to other people in the home. We also talked to some staff and looked at administrative records in the home. Comment cards were received from four residents, two relatives and four members of staff. We have put this report together from watching the care provided, from comments received from residents, relatives and staff and written information we saw before or during the inspection. The last key inspection on this service was completed on 11th June 2007. What the care home does well: What has improved since the last inspection? What they could do better: Care records need improving so that they are up to date and accurate, record any restrictions to residents rights and look at the residents views on any issues. Some medication should to be stored very securely, and treated as a controlled drug. Care Homes for Older People Page 8 of 32 Activities need developing so that residents have interesting and stimulating things to do in the home and local community. Prospective staff need to have a full working history so that staff are aware of their past work experience and can identify any gaps in employment. Staff need training on how to involve residents in decisions and recording information. The fly screen at the outside kitchen door needs mending to make sure no insects can come through it. The requirements made by the fire service and the electrical check need completing to make sure the home is safe. Information to show that the building work has been completed safely should be sent to us so that we know it has been completed satisfactorarily. The owners need to visit the home monthly and speak to residents and staff and look around the home to check that everything is alright in the home. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out 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 32 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 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents have their needs assessed before moving into the home to ensure that the home can meet their needs. Evidence: We case tracked three residents. Each had a care needs assessment in place. This helps staff to find out important information about each residents specific care needs and know how they can meet these. Resident who spoke to us or who returned comment cards said they and their families had been given information about the home before they moved into New Victoria and staff from the home spoke to them before admission about what care they needed. Care Homes for Older People Page 11 of 32 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. Most residents care plans are up to date but areas of record keeping and ensuring residents rights are not unnecessarily restricted need attention. Resident must be involved in care decisions and supported to make choices and have control over their life. Evidence: We case tracked three residents. Care plans had been updated and some residents case tracked had detailed care plans and risk assessments. These are an improvement on previous care plans. Risks assessments were in place for most residents case tracked so any risks are reduced and managed appropriately. These included Nutritional, waterlow, falls and moving and handling and use of bed rails. One residents risk assessments had not been dated but it was clear these were recently completed. Care Homes for Older People Page 12 of 32 Evidence: Most care plans included a brief life history. There were also had individual daily records in place. Some care plans were detailed and described any issues or concerns and any profession visits such as GP, but some did not have the required information in. One resident had a detailed care plan but risk assessments and the resident profile/life history was not completed. We had concerns about some daily records which suggest that decisions about some residents care has been decided without involvement of the resident. The home holds cigarettes for some residents. There is no information about whether the residents have agreed to this or that this has been discussed. Other information suggested that one resident had restrictions placed on her about who she could spend time with in the home. There was no evidence of discussion with the residents involved or on how these decisions may affect the residents and whether they want these restrictions to apply. Decisions affecting residents cannot be taken without discussion and agreement with residents. Staff need to consider issues about capability to consent. Those involved need to look at whether the resident has the capacity to make each decision. Even if a resident has some confusion they may be able to decide what they want and make some decisions. If the resident has not the capability to make a decision about a particular situation then a best interests pathways must be followed. This is particularly important if the residents rights may be restricted. Staff may benefit from training on the mental capacity act and Deprivation of liberty safeguards to make them more aware of how best to protect the interests of people in their care. The daily records for one resident show that she is wander-some and distressed at times. However records are limited and there is no information about the duration of or specific information about how the resident shows her distress. There is no record of whether the resident wanders about contentedly sometimes or is distressed when wandering. There are also no guidelines for managing the residents behaviour or strategies to reduce the residents wandering and distress. A strategy for managing this residents distress and wandering should be in place so that all staff have clear and detailed instructions for managing this behaviour. This needs attention quickly so that staff complete detailed reports and have the information so that they are aware of how to support this resident effectively. Daily records state that one resident had been prescribed a particular medication but no reason why this had been prescribed was given. The following day the daily records state that another medication has been prescribed, no reason given. This made it appear as if both drugs had been prescribed. On checking the medication administration record (MAR) it was clear that only one medication had been prescribed but there was still no information on why the medication was prescribed. Where staff are recording a change in medication or new medication the reason for this medication Care Homes for Older People Page 13 of 32 Evidence: should be stated. Accident records were seen. None of the residents case tracked had been involved in any accident and no-one in the home had frequent falls or accidents, but the manager was aware of the need to audit to see if any lessons could be learnt or accidents reduced. One resident had a fall once every few weeks but this resident although unsteady, wanted to remain independent. Steps were in place to ensure that too many falls did not occur. Medication administration was satisfactory in most areas with clear entering of medication and disposal of medication, appropriate signing and storage of medication. Controlled medication is appropriately stored, administered and signed for but the home is not treating temazepam as a controlled drug and it would be good practice to do so. Safe custody guidelines mean that temazepam must be stored in controlled cabinet, which staff are not doing. Residents have access to appropriate health services. There are regular GP visits and District nurses visit residential residents as needed. Staff called paramedics for one resident during the inspection as the resident was found in an unresponsive condition. The resident later improved and remained at home. Blood pressure and weight are taken monthly and charts are in place and up to date. Action is taken if weights change without clear cause. All care plans would benefit from end of life information as this was not in place for any resident case tracked and may affect the care given before and after death. Staff advise residents of the health risks involved in smoking and the risks of passive smoking whilst supporting the individuals right to smoke. There is a small lounge where residents are able to smoke. Residents said staff were kind and caring, polite and friendly. Residents spoken to were satisfied with the care they received. The family of one resident was concerned that sometimes their relative was not as clean and tidy as they would like. However we noticed staff were assisting residents to change clothing they may have spilled on on several occasions during the day. Relatives who completed comment cards said they were kept up to date about any important issues. Residents said staff listen and act on what they say. The relative of one person living in the home said, Staff keep us up to date about my relatives health. Care Homes for Older People Page 14 of 32 Evidence: Residents said they receive the care and support they need. One resident said, I get a routine which I like and I am always cared for and fed well. Another resident commented, Most of the carers are good but sometimes they are busy and patients dont get taken to the toilet quickly enough. Relatives who completed comment cards said the home usually meets the needs of people living in the home and supports them to live the life they choose. One relative said, The care they give my mum is good. Relatives said that staff usually had the right skills and experience to look after people properly. A resident said, The home is pretty efficient in what it does. Care Homes for Older People Page 15 of 32 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Meals are nutritious, routines are flexible and residents visitors are welcomed into the home but social and leisure activities need improving. Evidence: Routines in the home are flexible and residents spoken to said that they can choose when they get up and go to bed and whether they want to join in activities. The manager said that several residents stay up until midnight or later. Several residents said although there are some activities offered, these are limited and there are not as many as they would like. One resident requested a new TV in the lounge adding, Most people just sit all day and watch TV. The manager said staff said they are looking at how best to develop a variety of different and stimulating activities. This is an important area to develop as leisure and social activities enable residents to interact with each other and to spend time together and pass time in a pleasant manner. Friends and relatives of residents can visit at any time so that relationships are maintained and developed and there are several quiet areas in the home that can be used when friends and relatives visit. Care Homes for Older People Page 16 of 32 Evidence: Meals are of good quality and residents said they are good. One resident said, The food is lovely here. Another resident said, I am very satisfied with the food Although current residents are Christian or have no religious persuasion, staff would endeavour to meet the needs of people from any other religion. Residents who want to can see the ministers of their choice. Care Homes for Older People Page 17 of 32 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are usually handled well but some areas of the safeguarding procedure are not always followed. Evidence: According to the annual quality assurance assessment (AQAA), discussion with the manager and from surveys it is clear that residents and relatives know how to make a complaint and the home has responded appropriately if they have made a complaint. Complaints are recorded and acted upon. There has been one complaint sent to the owners of the home regarding a lack of hot water at certain times of the day. The owners have responded by ordering an additional boiler so that water will remain hot throughout the day. The manager advised that a complaint was received by social services about care in the home but this was investigated and was not upheld. Residents and relatives said they knew how to make a complaint and that these were usually acted upon. Staff have received safeguarding adults training on induction and on National Vocational training (NVQ) and have some understanding of the action to be taken if they are alerted to a safeguarding issue. However there was evidence that a resident had expressed concern over an incident. The residents daily record did not make it clear when this had occured or what action, if any was taken when this was reported. Appropriate action to inform other professions was not taken regarding this incident Care Homes for Older People Page 18 of 32 Evidence: and needs to be followed up. Care Homes for Older People Page 19 of 32 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. The environment in the home is comfortable, clean and tidy but some requirements from the fire service and from the recent electrical inspection need attention within the agreed timescales to provide residents with a safe place to live. Evidence: We toured the home and found the environment comfortable,clean and tidy. The owners have almost completed some alterations in the home. The manager will send the Care quality Commission (CQC) information to show the changes have been completed safely. The manager has changed the use in some areas of the home, providing an additional first floor lounge. This has reduced the furniture and occupancy in the ground floor lounge and made it feel more comfortable and spacious. Residents spoken to in the first floor lounge were pleased with the pleasant cosy lounge. Those in the ground floor lounge felt there was more room to manoeuvre around the room and this was better. Residents are encouraged to personalise their bedrooms so that they have familiar things around them. Aids and adaptations are in place to help residents get about more easily and to be as safe and as independent as they can be. Specialist aids for pressure care and mobility aids seen as touring the building. Care Homes for Older People Page 20 of 32 Evidence: The fly screen at the external kitchen door had large rips in it reducing its effectiveness. This needs attention quickly to meet food safety hygiene regulations. The recent electrical inspection highlighted areas that need attention to meet regulations and ensure the safety of people in the home. These requirements need carrying out in the required timescales. The fire service has made requirements on their recent inspection of the premises to ensure fire safety in the home. These include; improvement of the fire alarm system, safe entrance/exit to the doors if a fire occurs and regular staff fire training. These requirements must be carried out by the dates stated by the fire service. Care Homes for Older People Page 21 of 32 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. Most areas of recruitment and selection are well managed and there are sufficient numbers of well trained staff in the home. Evidence: A lot of the staff have worked in the home for several years and there is only a small staff turnover. This ensures that staff are familiar with residents and their care needs and residents know the people caring for them. We chatted to several staff before and during the inspection as well as through the staff surveys. Most staff were satisfied with and enjoyed working in the home and felt well supported. Others felt less so and felt unsupported with some members of the senior team. Some staff felt that staff confidentiality could be compromised by some senior staff and were reluctant to discuss personal information with some senior staff. Others felt that they could talk to senior staff and concerns were acted upon quickly and discretely. A small number of staff felt staff morale and team work needed attention. Most staff felt staff morale was good and staff worked well as a team. One member of staff said, I enjoy coming into work here. Some staff expressed concern over stocks of disposable gloves and liquid soap sometimes running out. They said that on occasion only very large gloves were in stock which were unsuitable for some staff as they were difficult to keep on for staff Care Homes for Older People Page 22 of 32 Evidence: with smaller hands and could affect care and hygiene. Other staff were satisfied with the provision of disposable stock and said they always had enough gloves, care aids and equipment. Sufficient stock was in place during the inspection and the manager said that orders were placed weekly and there was always stock in. Staff rotas showed sufficient staff on duty doing the inspection. Residents, and most staff felt that there were sufficient numbers of staff on duty most of the time to provide good care and support to residents. The records of three members of staff were checked. All applicants had an application form with work history although one member of staff had only the year of changes of employment, rather than the month and year and one only had a work history from August 2005, despite having worked for many years. A complete working history from first to present job exploring any gaps is required so that the manager has full details of applicants previous jobs, duties and the length of time they remained in these jobs. All staff files checked had written references in place. There was also health information in place and all staff had PoVA checks and were awaiting CRB checks. The manager said that all staff had received an induction. Induction checklists were in place for domestic staff but the induction for the care staff was not in place although the manager showed us a blank copy of the induction used. The manager said that the member of staff was holding her own induction and had possibly lost it. We advised the manager that a copy needs to be kept in the home so that it is always available to check or add information to and cant then be mislaid by the member of staff. Over eighty percent of care staff have completed National vocational qualifications (NVQ). This exceeds the requirement that fifty percent of staff complete this training. NVQs are national awards in care that enable staff to gain up to date skills and knowledge about current care practice. All care staff in the home who have not completed NVQ training, have recently enrolled on NVQ courses and are working towards National vocational qualifications (NVQ). Staff are also involved in literacy and numeracy courses and communication courses. Staff involved in these courses said they have been useful to them. Staff spoken to or who completed comment cards said they received regular training on moving and handling and other mandatory training. Some staff were satisfied with the training offered but others wanted more training on different aspects of care. There were some issues on this inspection about enabling residents to make decisions and control their lives. Staff may benefit from training on the mental capacity act and Deprivation of liberty safeguards to make them more aware of how best to protect the interests of people in their care. Care Homes for Older People Page 23 of 32 Evidence: Formal supervision is carried out. Staff supervision allows the member of staff and manager or other nominated person to meet regularly and look at the member of staffs care practice and the care practice in the home, and any improvements that can be made. They also look at future plans in the home, training and the individuals career developments. One member of staff said that she had regular supervision and appraisal. Care Homes for Older People Page 24 of 32 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 manager provides guidance and to staff. She deals with any issues or concerns quickly and supports residents, staff and visitors. Evidence: Marion Gourlay who is a registered nurse has been the registered manager for several years. She has completed the registered managers award as well as having a diploma in management. She ensures that she updates her skills and knowledge so that she is familiar with any developments in care practice. Most staff said they felt well supported by the manager and felt that she was firm but fair. One member of staff said, New Victoria is a good home to work in. The manager is fair with staff, residents are treated well and eat well in a safe environment. Although there were a number of issues of concern during the inspection, it was positive to notice that the manager began acting on them immediately she was aware of them. Care Homes for Older People Page 25 of 32 Evidence: Most staff spoken to or who returned the comment cards felt well supported by senior staff and said that they were always helpful. There were some staff who did not feel well supported by two different senior staff. One member of staff commented that support depended on which senior staff were on. The manager said that there are regular regulation 26 visits but the reports are not kept in the home. However when we received these they were minutes of meetings rather than regulation 26 visits. Regulation 26 visits are where the owner makes an unannounced visit at least monthly and talks to residents and staff, checks paperwork and tours the home. The owner must then provide a report about the visit and send a copy to the home and make available a copy to CQC if requested. Systems are in place for quality assurance. The home has recently been reassessed for and has again met the standards for investors in people which is a national quality assurance award. There are regular staff meetings and issues discussed affect care practice. There are staff meetings held approximately every two months. This gives the manager the opportunity to impart any information staff need and for staff to discuss any issues, concerns or ideas about the home. Staff training on moving and handling is in place. There are regular health and safety checks in place. The fire risk assessment has been checked by the fire service recently and areas to be improved have been highlighted. Some staff need training in fire safety training and some areas of the fire alarm system and exits to the home need attention. regular fire checks and training are provided by an external company. The manager should develop a homes risk assessment covering activities and areas of the home. There are regular fire alarm and emergency light checks and records kept. The recent electrical inspection showed that some areas of electrical work need attention within an agreed timescale to ensure that it is safe. The manager does not hold any money for residents. If there is no relative to hold the money for residents or they need some items, money is taken from petty cash and a receipt obtained. Head office or the residents family is informed of the cost and reimburses the home later. Care Homes for Older People Page 26 of 32 Care Homes for Older People Page 27 of 32 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 28 of 32 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Care records need to be completed, accurate and up to date. so that information is available to staff to assist with planning care. 01/07/2009 2 7 15 Staff must fully involve 01/07/2009 residents in decisions about their care needs, particularly where restrictions of their rights may be involved. so that decisions are not made without careful consideration and involvement of all concerned. 3 18 13 Possible safeguarding issues should be dealt with quickly and appropriately So that residents are kept safe. 01/07/2009 4 19 23 The requirements made by the fire service and the electrical check need completing. 01/07/2009 Care Homes for Older People Page 29 of 32 to make sure the home is safe. 5 19 23 The fly screen at the outside 01/07/2009 kitchen door needs mending. to make sure no insects can come through it. 6 37 26 Regulation 26 visits must be carried out by the owners monthly and a report completed so that all involved are aware of how the home is running 01/07/2009 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 7 All care plans would benefit from end of life information as this will give staff information about the care needing to be given at the end of a residents life. Daily records should be detailed and informative so that all staff have clear information about each residents health and behaviour. Temazepam medication needs to be stored appropriately and it is good practice to treat it as a controlled drug, so that medication is kept safe. The reason for medication being prescribed and administered to a resident should be recorded particularly, when medication is given as necessary. More activities should be developed so that residents have an interesting and stimulating choice of social and leisure options. Information to show that the building work has been carried out safely and meets all appropriate standards should be sent to us so that we know the building is safe. Page 30 of 32 2 7 3 9 4 9 5 12 6 19 Care Homes for Older People 7 38 Some staff need training in fire safety training to ensure that they are familiar with the procedure in case of fire. Care Homes for Older People Page 31 of 32 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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