Inspection on 26/02/09 for Peasmarsh Place

This inspection was carried out on 26th February 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Peasmarsh Place 15/03/07

Peasmarsh Place 09/02/06

Peasmarsh Place 06/10/05

Peasmarsh Place 02/02/05

Peasmarsh Place 20/08/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Peasmarsh Place Church Lane Peasmarsh East Sussex TN31 6XE     The quality rating for this care home is:   two star good 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: Deborah Calveley     Date: 2 6 0 2 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 28 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Peasmarsh Place Church Lane Peasmarsh East Sussex TN31 6XE 01797230555 01797230051 clairebradley@peasmarshplace.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Peasmarsh Place (Country Care) Limited Name of registered manager (if applicable) Mrs Claire Angela Bradley Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 24 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Peasmarsh Place is a former shooting lodge set in five acres of grounds. Service users accommodation is provided on two floors and provides 14 single bedrooms and five double bedrooms, all with an ensuite facility. A shaft lift is fitted to provide level access to most areas. All private rooms and communal areas have extensive views across the estate and gardens. Care Homes for Older People Page 4 of 28 care home 24 Over 65 24 0 Brief description of the care home The home ensures that copies of the inspection report are made available upon request and there is always a copy available in the home to refer to. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings For the purpose of this report those living at Peasmarsh Place to as residents. This was a key inspection that included an unannounced visit to the home and follow up contact with residents representatives and visiting health and social care professionals. This unannounced inspection was carried out over 6 hours on the 26 February 2009. There were 16 residents living in the home on the day of which four were case tracked Care Homes for Older People Page 6 of 28 and spoken with. During the tour of the premises four other residents both male and female were also spoken with. The purpose of the inspection was to check that the requirements of previous inspections had been met and inspect all other key standards. A tour of the premises was undertaken and a range of documentation was viewed including the Service Users Guide, Statement of Purpose, care plans, medication records and recruitment files. Two members of care staff and chef were spoken with in addition to discussion with the deputy manager and manager from the sister home. Telephone contact was made with visiting professionals following the visit and their views and comments are incorporated into the report along with the information received verbally during the site visit. An Annual Quality Assurance Assessment was received from the Manager completed in full prior to this key inspection on the 07 January 2009. The fees for the home at this time range from 530 pounds to 710 pounds per week. Additional charges are made for hairdressing, chiropody, newspapers and magazines. What the care home does well: What has improved since the last inspection? 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 set out on page 4. Care Homes for Older People Page 8 of 28 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 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 10 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 provides prospective residents and relatives with a good level of information about the home, its facilities, services and the costs involved. The admission procedures allow for the needs of prospective residents to be assessed by a competent person before admission, however little information is documented thus not evidencing that their needs can be met. Evidence: The statement of Purpose and Service Users Guide were reviewed and were found informative written in clear English and with colourful photographs of the home facilities and gardens. It was confirmed that it would be available in a larger font if required. Copies of these documents are available along with the last inspection report and a copy of the homes terms and conditions of residency in the front entrance area. Care Homes for Older People Page 11 of 28 Evidence: Residents spoken with were clear on the services provided by the home and costs involved. The registration certificate is clearly displayed and was found to be accurate at the time. A review of the care documentation confirmed that pre-admission assessments are completed by the manager and deputy manager. The format of the pre-admission document was seen to be relevant however more information could be recorded, which will inform the inspection process and ensure that the home can meet the identified needs. The prospective residents are seen either in their home or hospital before admission and the manager confirmed that wherever possible the family or representatives are involved. A recommendation of good practice is that the venue and all the people involved in the assessment are documented. The deputy manager was able to verbally demonstrate her knowledge and awareness of the different specialities required in the home and the management team ensures that the carers employed attend relevant courses to deal with the needs of the elderly and also specialised courses for certain diseases. Trial visits to the home can be arranged. The manager confirmed that residents are invited to a trial period to ensure suitability of the home, this is clearly stated in the Statement of Purpose and in the statement of terms and conditions. Since the last key inspection the home now sends out a letter following assessment to confirm that having regard to the assessment they can or cannot meet the identified needs. Intermediate or rehabilitative care is not provided at Peasmarsh Place. 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. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although care documentation provides a framework for the delivery of care, it needs to be developed to reflect the changing needs of the residents along with robust systems for risk assessment to ensure individual person centred care is delivered. Evidence: The care documentation pertaining to four residents were reviewed as part of the inspection process. The care plans seen included a good level of information about the abilities and needs of the people who use the service. Residents that have been identified as needing extra support on the whole were appropriately assessed with a plan of action. There were some shortfalls identified that were discussed in full during the inspection and these included ensuring that the residents changing needs are reflected in the care plan e.g the deterioration of eyesight of one resident was not evidenced and risk assessed though it has clearly impacted on her life, another did not fully take in to account his shoulder fracture in respect of his mobility and safety. The home keep daily records detailing information about personal care given to residents, however a little more detail would be beneficial requiring their moods and how they Care Homes for Older People Page 13 of 28 Evidence: spent their day. Staff spoken with confirmed that they received a full report on each resident daily and read the care documentation that is kept in the main office. They felt that their views were taken into account when planning residents care. The district nurses notes are kept in the home which guide staff in the home. Residents are supported to attend a wide range of health care appointments as necessary to meet their needs, this includes opticians, chiropodist and dentists. There are detailed policies and procedures in place for staff to follow in respect of the management of the medications in the home. There is a clinical room, which is where the medication trolley is kept when not in use. This room is also where the medication stocks are kept. This room could be used more effectively for the dressings and other equipment which are at present kept in a corridor. The Medication Administration Charts (MAR) were viewed and no gaps identified. The MAR sheets include the codes use by staff for the non administration of prescribed medicines and staff are to be reminded that the reasons for non administration need to be documented clearly on the reverse of the administration charts. Areas of good practice were discussed and addressed during the inspection, and include reviewing the as required (PRN) medication recording. There are some residents that self-administer their own medication and there is a risk assessment in place to determine any perceived risks associated. All staff that administer medication have received appropriate training. It would benefit all staff and residents if the medications for each resident was listed with the reasons for it being prescribed, the possible side effects and contra indications and the effects on the resident if not taken. This will protect and promote the residents health. Care Homes for Older People Page 14 of 28 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. Social activities and meals continue to be creative and provide daily variation and interest for people living in the home. Residents are able to make a range of choices about their lives as well as maintaining links with friends and relatives. Evidence: The deputy manager takes responsibility for organising activities in the home. The homes documentation states we offer a varied range of activities and events supported by our staff team local groups and volunteers. The in-house library is updated regularly to include large-print books delivered by Rye Public Library. Transport can be arranged to visit the local towns of Rye and Tenterden. Residents spoke of activities that take place and included: scrabble, craft afternoons, music sessions and outings. There was talk of bridge meetings that take place on a daily basis, though cancelled on the day of the inspection. One of the residents still has a car, and continues to enjoy an independent lifestyle. Staff and residents confirmed that the activities in the home have been a great benefit to those living in the home and that celebrations are held regularly for special occasions including birthdays. The residents confirmed that they can attend the Care Homes for Older People Page 15 of 28 Evidence: activities if they want to, and if they prefer to not attend its never been a problem. From talking to the residents it is clear that they are supported and enabled to continue an independent and interesting lifestyle. It was confirmed by staff that the residents are supported and enabled to join local events held in the vicinity and attend the Church Services at a nearby church. All religious preferences are supported. There are no restrictions on visiting times as long as consideration is shown to all the residents. There are communal areas throughout the home that are available to residents and their visitors for private meetings if required. The tour of the home evidenced that many of the residents have individualised their bedroom with items from home and residents and relatives spoken with confirmed that they are encouraged to make it homely, one resident proudly showed her ornament collection and photographs that hold many memories of her life. It was observed during the inspection that the routines at the home are flexible, residents spoken with confirmed that they were consulted about all aspects of their lives. The home has an advocacy policy in place and the information regarding this is available to all residents. The chef was available to talk with and was able to discuss the residents dietary needs and confirmed that he would be able to prepare food for different cultures if required. He confirmed that the menus are changed to suit the seasons and are on a four weekly cycle. The menus are given out a week in advance and residents then choose what they want. The use of a comment section allow residents to comment on the food if they should choose to. It was found that the chef had not attended a food hygiene refresher in the past three years or more, this was booked during the insdpection visit and therefore a requirement has not been made. If the menu does not tempt the residents alternatives are available for every meal. Four of the residents spoken with stated that the food served was nearly always good, another said it wasnt always to their taste but chooses the alternative. The food on the day was attractively presented and enjoyed by the residents. It was noted that some residents had chosen the alternative. The kitchen is a good size with the original old tables, which are kept very clean. It was discussed that some of the electrical equipment is in need of repair or replacement and some cooking equipment should be replaced. This is something that Care Homes for Older People Page 16 of 28 Evidence: the deputy manager has already identified. There is an additional bulters room, which is used by staff to serve breakfasts and supper meals that also houses the dishwasher and further storage areas. The flooring in this room needs to be replaced to ensure it is sealed and impermeable to prevent cross infection. The dining room is large and airy with plenty of natural light and has lovely views of the gardens. The furniture and decoration is pleasant and attractive all tables are set with napkins and flowers. The dining arrangements was seen as quite isolating as each of the residents has their own table in the dining room and there is no chatting or noise. However this is the residents own choice and in the past suggestions to introduce background music has not been successful. At Christmas there is just one long table and all residents join in the festivities. There is a big gong ritual that alerts residents of lunch time and sherry is served in the drawing room prior to the main meal and this gives the residents an opportunity to meet and catch up. Care Homes for Older People Page 17 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. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a formal complaints system with evidence that residents feel that their views are listened to and acted upon. Staff receive training to protect residents from abuse. Evidence: The complaint policy and procedure is clear and uncomplicated and a copy of this is readily available in the home and the Service Users Guide A system of recording complaints was demonstrated to the inspector during her visit to the home The home has received four complaints since the last inspection and they were responded to within the stated timescales Residents spoken with confirmed that they were confident that any complaints or concerns that they had would be listened to and responded to effectively The home has relevant guidelines on the protection of vulnerable adults and staff have received appropriate training The management team has a clear understanding of adult protection guidelines and are aware of how to initiate an investigation if required There have been no safeguarding referrals since the last key inspection 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. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a comfortable clean and safe environment for those living in the home and visiting. Residents are enabled and encouraged to personalise their room and rooms are homely and reflect the residents personalities and interests. Evidence: Peasmarsh Place is a former shooting lodge set in ten acres of grounds. Residents proudly said This is where Charles Liddells niece, Alice was first told some of the stories by Lewis Carroll, which were later published as Alices Adventures in Wonderland. it is a stone building with shuttered windows, all kept in good condition. Residents accommodation is provided on two floors A shaft lift is fitted to provide level access to most areas The tour of the home confirmed that the home is well maintained and bedrooms are attractive with some being very personalised and all bedrooms have an en suite facility The home have a choice of various communal areas which are attractive and allow for different uses ensuring residents have choice of how they spend their time Residents were visited in their room with their permission and evidenced that many of them have chosen to bring items of furniture and ornaments with them The deputy manager conducted a tour of the communal areas of the home there is a lounge a boudoir second lounge which is used for activities and the dining room All of the Care Homes for Older People Page 19 of 28 Evidence: communal areas are attractively decorated and furnished to a high standard The home has large gardens which include a rose garden and lake and residents spoke of going out for walks and another who spoke positively about caring for the roses. There are no communal bathrooms in the home as each bedroom has a complete en suite There are bath chairs available and each resident has their own chair cover Polices and procedures for infection control are in place and are updated regularly The home was clean and free from offensive odours on the day of the inspection Good practice by staff was observed during the day and there were gloves and aprons freely available in the home Sluice and laundry areas were found clean and safe The home provides a good laundry service 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. 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. Robust recruitment procedures are in place to protect residents and staff training ensures staff are aware of their roles and are able to provide the support and care the residents needs. Evidence: There were sixteen residents living in the home on the day of the inspection. The staffing rota was viewed and the staffing levels were seen to be sufficient to meet the needs of the residents at this time it was confirmed by the manager that there is flexibility of the staffing levels and they are adjusted according to the changing needs of the residents. Care staff spoken with said that the levels of staff on duty were in the main sufficient to give the care required, but also said they struggled at certain times of the day this was discussed and will be reviewed and discussed with the staff at the next staff meeting. A roster is held giving names and designations of staff on duty. A selection of staff recruitment files were viewed and demonstrate that a robust recruitment process has been introduced to protect residents and contained all the relevant information required. There was evidence of health questionnaires, Criminal Record Bureau checks, two references, a resume of previous employment and work permits where necessary. All the paperwork is kept within a locked room. Care Homes for Older People Page 21 of 28 Evidence: Each staff member has a personal development file and four were reviewed along with their recruitment file. The records evidenced a wide range of training had been provided for staff on a variety of subjects such as health and safety, adult protection, fire safety,, first aid, food hygiene, infection control, medication and moving and handling. There is evidence that some staff have received training and guidance in dealing with death and dying. The AQAA stated that six members of care staff have attained a National Vocational Qualification (NVQ). There is an induction programme in place and has been introduced for all staff. Files seen confirmed this. New staff are required to complete an initial induction programme and undertake mandatory training including fire and health and safety This leads into foundation training, in preparation of NVQ training The induction and foundation training is in line with the Skills for Care guidance 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. 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 overall management of this home is good with effective systems in place to protect residents Evidence: The manager has been in post for nearly six years.She has worked within the care profession for more than ten years, as a carer and deputy manager before undertaking a managers role. Both the manager and deputy manager have completed the NVQ level four and the RMA Registered Managers Award. She has the necessary experience and knowledge to manage the home. During the inspection visit there was no doubt that the manager had a good working relationship with everyone in the home and everyone spoken to said that she was approachable, fair and responded to issues raised quickly. There are systems in place to monitor the quality in the home and include the use of questionnaires. It was confirmed that these are audited reported on and responded to. Care Homes for Older People Page 23 of 28 Evidence: It was recommended that the use of questionnaires is expanded to staff and visiting professionals. There are resident relative meetings and staff meetings, which are minuted and kept. There are regular staff meetings that are recorded and areas for improvement discussed. The home does manage small personal monies for a number of their residents. Residents monies are held as per the homes policies and procedures. It was confirmed that there are robust systems used to provide an audit trail of how transactions are managed on behalf of residents. Staff supervision is in place for all staff and are kept within the training and recruitment files. Staff spoken with confirmed that receive regular supervision. Peasmarsh place looked well maintained and systems are in place to report any problems to the maintenance person that need attention. Certificates relating to Health and Safety in the home were reviewed and found on the whole to be full. Full records of hot water checking are kept there are measures in place to prevent Legionnaires disease and the health and safety policy is up to date. Environmental risk assessments are fully recorded. the fire risk assessments are in place and there is evidence of regular fire drills, equipment testing and fire training. during the tour of the building it was noted that due to redecoration some fire extinguishers were not reattached to the wall, the deputy manager said this would be done immediately and a fire exit door was to be appropriately signposted. There is portable oxygen in use within the home and the signs are affixed to the door of the clinical room and residents bedroom, but they are small and not immediately recognisable. The oxygen bottles need to be in appropriate carriers. The accident book was viewed along with the actions taken to prevent a re occurrence. It was discussed that expert advice be sought regarding those residents that have recurrent falls. The first aid boxes were in need of replenishing especially the first aid box for the kitchen. The kitchen first aid box would benefit from including a burns treatment and an eye wash for immediate first aid. Good practice was observed throughout the inspection in respect of promoting the safety and well being of the residents. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 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 That the registered person ensures that the changing needs of the service users are reflected in the individual care plans. To ensure the health and safety of the service users. 09/05/2009 2 8 12 That the registered person ensures that the changing needs of the service users are appropriately risk assessed and this will include the service users private space. To promote and protect the service users safety. 09/05/2009 3 26 13 That the Registered Person 09/05/2009 ensures that all flooring in the kitchen/butlers room are sealed and impermeable. To reduce the risk of cross infection. 4 38 13 That the Registered Person 09/05/2009 ensures that all first aid boxes are stocked and ready Page 26 of 28 Care Homes for Older People for use. That all oxygen bottles are attached to the wall. That all oxygen bottles are in the appropriate holders. To promote the safety of the service users. 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 3 that the pre-admission assessments contain a good amount of information to ensure that the home has the equipment, staff and knowledge to meet the needs of the prospective service user. That the venue and people who are involved in the pre admission assessment are recorded on the document. Care Homes for Older People Page 27 of 28 Helpline: 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 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. 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!