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Inspection on 02/11/09 for Oak Lodge Nursing Home

Also see our care home review for Oak Lodge Nursing Home for more information

This inspection was carried out on 2nd November 2009.

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

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

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

What the care home does well

Oak Lodge provides a good level of care to people living there resulting in a high level of satisfaction from them and their relatives. Typical comments received included "cannot fault them" and "the standard of attention is very high". A number of relatives spoke about the improvement to the health of their family members since they were admitted to the home.It has a good management structure which includes people with a long experience of the home to provide continuity. It employs staff in the required numbers so that individual attention can be given when needed. Users of the service spoken to were very complimentary about the standard of personal care being provided and included the comment "perfect, couldn`t wish for anything better".The home`s premises are suitable for their purpose and have been maintained to a good standard. Staff took particular pride in the level of cleanliness in the home and this was also reflected in comments received from users of the service which they felt was a particular feature of the home. Meals are being provided to a good standard with choices available so that individual preferences can be met.The home has a full range of policies and procedures to underpin practice and to ensure that the care is provided safely and appropriately.

What has improved since the last inspection?

Since the last inspection the home has addressed the issues surrounding medication which were the main requirements of that inspection. Controlled drugs are being handled correctly, an improved recording of the disposal of drugs has been introduced and procedures are now in place to ensure that medications are being properly stored and distributed. The home has provided extensive fire prevention training for the protection of staff and people living there. The individual monies for users of the service are now individually audited and kept so that a clear audit is maintained. Thehome has significantly improved staff training in moving and handling so that they remain up to date in this area.

What the care home could do better:

The absence of a care plan for one user of the service was explained as not being necessary. Care plans are required for all users of the service to direct staff and to provide a framework for individual care. The home could show that it has made some improvements to the training of staff and that efforts are being made to increase this. However, training is not sufficient in a number of areas and must be increased and planned for so that training needs can be systematically met. Within the context of a pleasant and appropriate premises, not all bedrooms contained a comfortable chair which needs to be provided, or the explanation for its absence recorded, so that people living there can fully utilise this space. The range of activities were generally approved by people living and working in the home although this was not universally so and it would be preferable if more discussions took place so that people could express their views. Any absence of staff references needs to be documented in the files and staff supervision needs to be expanded and recorded so that staff employment and support is fully documented and demonstrated. Fire drills take place regularly but it would be preferable for people attending them to be listed so that their training in this area is better documented. Policies in respect of deprivation of liberty safeguards needs to be acquired so that full information is available in this area.

Key inspection report Care homes for older people Name: Address: Oak Lodge Nursing Home 514 Bury New Road Prestwich Manchester Lancashire M25 3AN The quality rating for this care home is: 2 star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: John Mullen Date: 0 2 1 1 2 0 0 9 This report is a review of the 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 stars – excellent • 2 stars – good • 1 star – adequate • 0 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. things that people have said are important to them: 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. They reflect the Care Homes for Older People Page 2 of 28 Evidence: This box describes the information we used to come to our judgement 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 Page 3 of 28 Care Homes for Older People manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Internet address www.cqc.org.uk Care Homes for Older People Page 4 of 28 Information about the care home Name of care home: Address: Oak Lodge Nursing Home 514 Bury New Road Prestwich Manchester Lancashire M25 3AN Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration Category(ies): dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: 0 41 Number of places (if applicable): Under 65 Over 65 None Dr Kumar Shamroa Kotegaonkar, Mr S R Latimer Mrs Mavis Birkenshaw Care Home 41 01617980005 01617735572 Date of last inspection: Brief description of the care home: 1 2 1 1 2 0 0 8 Oak Lodge is a care home providing nursing and personal care for older people. It is a redeveloped building with the addition of a purpose built extension. Several of the bedrooms have ensuite facilities. There is nearby access to the motorway network and the home is very close to supermarkets and shops. The main door is at the front of the home and the conservatory allow level access for Care Homes for Older People Page 5 of 28 wheelchair users and people who have problems climbing steps. The home is registered to care for 41 residents and provides accommodation in mainly single bedrooms on the ground and first floors. The bedrooms on the first floor are reached either by stairs or passenger lifts. There is a large lounge area to the side of the home and in front of this is the conservatory. This looks out onto a small garden area. There is also a large dining room and at the far end of this, there are two small, but bright sitting rooms. The toilets and bathrooms have aids to assist people with a disability or mobility problem. The home runs a Rapid Response service, which provides urgent short term nursing care for people who do not necessarily require admission to hospital. The weekly fees at the time of inspection ranged from 424 pounds to 538 pounds, according to care needs. Some people in receipt of Rapid Response or Continuing Care had individual fees in accordance with their health needs assessment. Additional charges were made for private chiropody, hairdressing and newspapers Care Homes for Older People Page 6 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: 2 star good service Our judgement for each outcome: Bar chart – design as agreed for outcome versions but headings on the left column need to be changed to Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration How we did our inspection: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This was a key unannounced inspection of Oak Lodge Care Home which included a visit to the service. All key standards were assessed in addition to an additional standard. The inspection encompassed information received since the last key inspection. In addition it included information provided by the agency through its Annual Quality Care Homes for Older People Page 7 of 28 Assurance Assessment document (AQAA). The AQAA gives an overall picture of the performance of the agency as well as factual information about the service. Interviews took place with the registered manager, the deputy manager, the operations manager and three care workers. Contact was made with the business consultant, the housekeeper and one of the kitchen staff. Four users of the service were case tracked; that is their support was examined in detail including telephone interviews with relatives when they were available. Surveys were also received from three users of the service. During the tour of the premises conversations took place with various people living there plus friends and relatives visiting the home. The premises were inspected and a large amount of documentation examined. Care Homes for Older People Page 8 of 28 What the care home does well: Oak Lodge provides a good level of care to people living there resulting in a high level of satisfaction from them and their relatives. Typical comments received included cannot fault them and the standard of attention is very high. A number of relatives spoke about the improvement to the health of their family members since they were admitted to the home. It has a good management structure which includes people with a long experience of the home to provide continuity. It employs staff in the required numbers so that individual attention can be given when needed. Users of the service spoken to were very complimentary about the standard of personal care being provided and included the comment perfect, couldnt wish for anything better. The homes premises are suitable for their purpose and have been maintained to a good standard. Staff took particular pride in the level of cleanliness in the home and this was also reflected in comments received from users of the service which they felt was a particular feature of the home. Meals are being provided to a good standard with choices available so that individual preferences can be met. The home has a full range of policies and procedures to underpin practice and to ensure that the care is provided safely and appropriately. What has improved since the last inspection? Since the last inspection the home has addressed the issues surrounding medication which were the main requirements of that inspection. Controlled drugs are being handled correctly, an improved recording of the disposal of drugs has been introduced and procedures are now in place to ensure that medications are being properly stored and distributed. The home has provided extensive fire prevention training for the protection of staff and people living there. The individual monies for users of the service are now individually audited and kept so that a clear audit is maintained. The Care Homes for Older People Page 9 of 28 home has significantly improved staff training in moving and handling so that they remain up to date in this area. What they could do better: 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 10 of 28 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 11 of 28 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. The home has full information on people accommodated so that their needs can be met as required. Evidence: The AQAA stated there were full care needs assessments in place to provide guidance to staff. An examination of the files of people who live in the home found this to be the case with up to date care needs assessments present in all which provided a clear picture of the requirements of the people concerned. Interviews with care workers found them aware of these needs and of the work required to meet them. Telephone interviews with the relatives of people living in the home confirmed that the home had a good understanding of the people accommodated and a great deal of satisfaction with the manner in which they had been met. Typical comments were cannot fault them and impressed with what they are doing. Care Homes for Older People Page 12 of 28 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. 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. Policies and procedures in relation to health and personal care result in an individualised and appropriate stay for people accommodated. Evidence: An interview with the registered manager revealed that she felt confident that care plans were in place and had been reviewed regularly to confirm their relevance. However, an examination of one of the people case tracked found that there was no care plan in place which detracted from the process. The registered manager and her deputy felt that there was no need for such a plan in this instance as the care was unproblematical. It was pointed out that the care plan is a statutory requirement and must be present in all cases to direct staff. Other files seen found full care plans in place with needs detailed to inform staff. These had been reviewed regularly to confirm that that plans are updated as necessary. Care workers interviewed felt the care plans were of a good standard and informed them appropriately. The last key inspection found no concern in the area of healthcare provision and this was confirmed by the AQAA which showed that healthcare needs were being met as required. An interview with the registered manager revealed no concerns with the access to healthcare provision and confirmed good procedures in meeting the healthcare needs of people accommodated. Their files revealed a full assessment of Care Homes for Older People Page 13 of 28 individual health needs and evidence that these were being met as required. Interviews with relatives, in particular, were complimentary about the manner in which the healthcare needs of their relatives had been met. The last key inspection found significant deficits in the area of medication which caused concern. An interview with the registered manager showed that these matters had been addressed effectively so that procedures meet the required standards. The visit to the home found this to be correct. The Controlled Drugs Register now showed that it is being completed correctly to meet the required practice. Insulin pens are individually named, the home has a new stock book to record drugs returned to the pharmacist and dates when medicines are opened are recorded; all of which were requirements of the last report and have been addressed successfully. An examination of the sheets recording medicines for those people who were case tracked found that they were being correctly completed to, again, reflect good practice. An examination of the service history of this home has revealed no concern about medication practices since the last key inspection which confirmed the evidence of the visit to the home. Surveys of people living in the home and interviews with relatives, staff and friends visiting the home all confirmed a very high opinion of the standard of personal care being provided within this home. Comments received from a person living in the home included perfect and couldnt wish for anything better, from a friend the home is absolutely fantastic, and from a relative carers are so kind. No negative responses were found from any source which confirmed a high opinion of the home from them. Interviews with care workers found them well motivated towards their work with a good understanding of good practice in this field. Observations during the visit to the home found a good, positive relationship between staff and people living there which reflected in the pleasant atmosphere throughout. 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: Care Homes for Older People Page 14 of 28 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. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a pleasant environment for the daily care of people accommodated. Evidence: The registered manager confirmed that there was an activity coordinator for the home twice a week to organise events for people accommodated. The operations manager described her work as brilliant and other care workers said that she made a continual effort in this regard. However, there was one survey from a person living in the home which stated that more entertainment was required and this was agreed by a member of staff interviewed, although it was stated that often people will not participate which reduces the effectiveness of the programme. A number of friends and family members were interviewed during the visit to the home, contacted through surveys or given telephone interviews so that a wide variety of views were canvassed. All were very complimentary about the manner in which they were received in the home and included the comments I am received very well and the carers are so kind. A tour of the premises found a number of visitors during the visit to the home and all were found to be mingling easily and freely within the home. The registered manager stated there was an open visiting policy for the home which was confirmed by contact with other people. Care Homes for Older People Page 15 of 28 Interviews with care workers showed that, in common with other care homes, the level of disability of people living there has increased over time which limits their ability to act independently. Within this context, interviews with both nursing and care workers showed that peoples wishes were respected to the extent that it did not compromise their safety. All interviews with users of the service and their relatives revealed no concern about the unnecessary restrictions on the independence and choice that is exercised by them. An interview with a member of the kitchen staff and an examination of menus showed that a good and nourishing diet is being served within the home. Choices are available and the home meets individual preferences on a daily basis. One survey received from a user of the service was particularly complimentary about the homes positive response to a request for different puddings. Interviews with people living in the home revealed a positive view of the food on offer with a typical description being good. Observations of a lunch time meal confirmed that it was being served in pleasant surroundings in a quiet and relaxed atmosphere. Care Homes for Older People Page 16 of 28 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. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home protects people living there through full policies and procedures. Evidence: A review of evidence found no complaint that has been sent to us, confirming a satisfaction with the service. The AQAA stated there had been one complaint and an interview with the operations manager confirmed that this had been fully dealt with within the required time schedule. The home has a full complaints procedure to ensure that any complaint will be dealt with thoroughly and correctly. Contact with relatives, friends and people living in the home revealed no complaint about the care being provided. A review of evidence found that there had been one safeguarding matter which had been reported to us but which had been shown to be unfounded. However, the actions taken showed that the home was aware of its responsibilities in this area for the protection of people accommodated. The home uses Bury Councils safeguarding policy which is comprehensive and gives good direction to staff on the actions to be taken if necessary. Training records seen showed there had been six care staff who had had training in this subject within the recent past. An interview with the deputy manager who has responsibilities for training confirmed that she continues to seek further places in this subject but has experienced difficulties in accessing training in this area. Care Homes for Older People Page 17 of 28 Care Homes for Older People Page 18 of 28 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. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The premises are fit for purpose and so provide a good environment for people living there. Evidence: The AQAA stated that the home continues to be refurbished and parts have been reorganised to provide a more pleasant environment for people accommodated. A tour of the premises found this to be the case. The home presented as a homely environment with a good standard of furnishing and decoration for the comfort of people living there. All contact with them and their relatives was positive about the physical environment of the home which they felt was suitable for its purpose. Lounges were pleasant and comfortable and bedrooms presented as of a good standard to fulfill their purpose. One of the bedrooms is lacking a lockable facility but the operations manager confirmed that this matter was in hand. Not all bedrooms contained an easy chair which was explained as personal choice. However, this is not documented in the care plan so that the proof of individual preference is not stated. This needs to be addressed to show that the home addresses this matter based on individual preferences. The registered manager stated that the home employs a housekeeper and four domestic staff to maintain standards. A brief conversation with the housekeeper confirmed that she is confident of maintaining standards and that there were no outstanding problems in this area. A tour of the premises found it hygienic with a good standard of cleanliness to underpin the care practices. People living there and staff commented on the cleanliness of the home as one of its main features and confirmed its good standards in this area. The home has appropriate laundry and cleaning Care Homes for Older People Page 19 of 28 facilities to ensure that these standards are continued. Care Homes for Older People Page 20 of 28 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. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home employs a good standard of staff although training must be improved for the benefit of staff employed there. Evidence: An interview with the registered manager showed that the home was employing sufficient staff to fulfill its purpose. Rotas showed that registered nurses and care workers are on duty in sufficient numbers to provide the level of care required. Interviews with both nurses and care workers found them well motivated in their work with a strong commitment to the care of the people in the home. All contact with users of the service and family members found a high opinion of the staff in Oak Lodge with comments such as “cannot fault them and absolutely delighted. The AQAA stated that the number of qualified staff was below the required level for the care of people accommodated. In fact, training records seen during the visit to the home showed that this in fact was not the case and that more vocational training has been given that initially stated. Interviews with care staff found that all either had or were undertaking the required qualification with the exception of one who was hoping to undertake nurse training next year. A review of evidence has found no concern in the recruitment practices of the home which were confirmed to be of a good standard by the AQAA. A review of recruitment and selection material in staff files found that almost all had full documentation for the protection of users of the service. The exception was in one file where was a lack of a Care Homes for Older People Page 21 of 28 reference due to the difficulty in obtaining one from a previous employer. There was no record of this in the file which should be done so that a full explanation for this deficit is given. All files had full police checks to confirm the suitability of staff for their role. The last inspection highlighted the lack of training in moving and handling and fire safety which was potentially hazardous to people in the home. An examination of training documents during the visit to the service found these deficits had been rectified with training in both subjects having been given extensively for the improvement of staff knowledge. However, other training records seen showed there were a number of deficits in the mandatory training of staff which must be rectified for the benefit of staff and users of the service. An interview with the deputy manager whose has particular responsibility for training showed that she has been making extensive efforts to improve this situation but has had difficulty in accessing training in a number of areas. Care staff interviewed were generally positive about the training but confirmed that they were still awaiting training in certain subjects. Care Homes for Older People Page 22 of 28 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. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is being well managed resulting in a safe and flexible service. Evidence: The AQAA confirmed that there has been no change in the position of the registered manager since the last inspection which confirmed continuity in this post. She is a registered nurse and has worked in the home since 1989 so that she has a good understanding of the residential needs of people living there. An interview with the registered manager found her very committed to the care of people living in the home and this was confirmed by interviews with other staff. An examination of the registered managers file showed that she continues to undertake training to update her knowledge. All comments from people living in the home and their relatives were complimentary about the manner in which the home was being managed. The AQAA stated that there were full quality assurance methods in place to gauge opinions from interested parties. The operations manager could give evidence of this with audits of users of the service and questionnaires to general practitioners and relatives. The results of these audits were very positive about the work of the home. The operations manager could give examples of how these audits have been used to improve practice in the home which was confirmed by a survey received from a person living there. The home has full external monitoring of its practice through Care Homes for Older People Page 23 of 28 management visits and examples seen of these showed that they were well completed to a good standard. One deficit noted during the inspection is that the home does not have policies and procedures in respect of the deprivation of liberty safeguards. A tour of the premises found no person subject to these but it is important that the home has full policies in this area to guide staff if such an eventuality arises. The last key inspection found that the home was not following best practice in its management of the monies of people living there in that they were being pooled and not individually audited. This matter has now been rectified. Of the four case tracked people, one manages his own finances but the records of the other three confirmed that there are individual accounts which are being correctly maintained so that a full audit is available. An interview with the operations manager showed that this is now standard procedure to confirm good practice. The operations manager produced an audit of staff supervision which showed that most care staff had received three or four sessions during the current year which is slightly below the required standard. An interview with the deputy manager revealed that there had been some confusion within the home about the definition of supervision and whether more sessions were in fact being provided. A discussion around the standard confirmed that practical supervision is being provided but not recorded and, therefore, is not being counted as relevant although if documented, it could be. Interviews with care workers confirmed that they felt well supported in the home and that they could call upon help from the managers easily and effectively. A tour of the premises found them to be a safe environment for the accommodation of people living there. The home maintains a full audit of safety checks and a review of these showed that there are regular and comprehensive checks on all utilities and other facilities for the safety of people living there. As noted earlier, extensive fire safety training has been given to staff to improve knowledge in this area. The fire book was generally well kept except it did not detail staff attendance at fire drills which is important so that the home can show that they have received instruction on this. Otherwise, the evidence seen showed that Oak Lodge is a safe environment for those living and working there. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes 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 Care Homes for Older People Page 25 of 28 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 All people accommodated must have a care plan. So that their needs are known and can be acted upon by staff. 14/12/2009 2. 30 18 A full training plan is required. So that all staff have access to the courses they require. 01/01/2010 Recommendations These recommendations are taken from the best practice described in the National Care Homes for Older People Page 26 of 28 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. 12 The home should further canvass the opinions of people living there about the activities on offer to see whether it is fully meeting their wishes. Where a comfortable chair is not provided in bedrooms due to personal choice this should be recorded in the care plans 2. 19 3. 4. 29 33 Staff files should document all attempts to obtain references so that the evidence for this can be clearly seen. The home should acquire policies in the area of Deprivation of Liberty legislation so that they will be fully informed if such a situation arises. 5. 6. 36 38 All supervision of staff should be recorded to evidence the full support given to them. Staff attending fire drills should be listed so that evidence of their experience is available. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!