Inspection on 16/10/08 for Pennwood Lodge Nursing Home

This inspection was carried out on 16th October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Pennwood Lodge Nursing Home 25/10/06

Pennwood Lodge Nursing Home 12/01/06

Pennwood Lodge Nursing Home 25/05/05

Pennwood Lodge Nursing Home 01/02/05

Pennwood Lodge Nursing Home 04/10/04

Pennwood Lodge Nursing Home 12/05/04

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Pennwood Lodge Nursing Home Wotton Road Kingswood Wotton-under-Edge Gloucestershire GL12 8RA     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: Adam Parker     Date: 1 7 1 0 2 0 0 8 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. the things that people have said are important to them: They reflect 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: Pennwood Lodge Nursing Home Wotton Road Kingswood Wotton-under-Edge Gloucestershire GL12 8RA 01453521522 01453521551 pennwoodlodge@highfield-care.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Southern Cross Care Centres Limited Type of registration: Number of places registered: care home 70 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users who can be accommodated is 70 The registered person may provide the following category of service only: Care home with nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following category: Denentia (Code DE) Date of last inspection Brief description of the care home Pennwood Lodge is a purpose built care home situated within grounds that are shared by a sister home. It is within the village of Kingswood, near Wotton-Under-Edge in the South of the county, approximately midway between Bristol and Gloucester. The twostorey building is split into four separate units. All four units specialise in the care of elderly people with dementia. The Home offers predominantly single accommodation, although there are some shared bedrooms. Most rooms have en-suite facilities. Each unit has its own communal areas consisting of lounge/diner rooms and smaller, quiet Care Homes for Older People Page 4 of 28 Over 65 0 70 Brief description of the care home lounges. There are other seating areas within the units. Each unit is accessed via a keypad system as well as one of the main entrance doors to the home. The first floor units can be reached via a staircase or shaft lift. The central body of the building contains offices, kitchen and conservatory, which overlook the front lawns. An uninterrupted, level pathway is provided to the main entrance of the home leading from the car park, which is located in front of the building. Fee ranges are from 558.00 pounds to 847.27 pounds including the nursing contribution but does not include extras for example chiropody and hairdressing. Copies of the homes Statement of Purpose and Service Users Guide is available in the main reception area. 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 inspection visit was carried out by one inspector over two days in October 2008. The manager of the home was present for the two days of the inspection visit that consisted of a tour of the premises and examination of residents care files. In addition staff recruitment and training was looked at as well as documents relating to the management and safe running of the home. A sample of residents were selected for inspection against a number of outcome areas as a case tracking exercise. Observation was made of the care and supervision of the residents in some communal areas. Survey forms were received from residents relatives, staff working in the home and a General Practitioner (GP). Two residents were spoken to during the inspection visit as well as a visitor. Care Homes for Older People Page 6 of 28 We requested an Annual Quality Assurance Assessment (AQAA) from the home, which was provided. Although this was brief in content, it gave us the information we asked for. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. 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. 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 8 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 9 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 homes admission procedure ensures that all residents are admitted on the basis of a full assessment of their needs, so that they can receive the care that they require. Evidence: Assessment documentation for a number of residents in the four units of the home was looked at and a discussion about admission procedures was held with the manager. In all cases a comprehensive pre-admission assessment had been completed along with a pre-admission draft care plan. Where residents had been admitted from hospital with either physical or mental health needs then information had been obtained from these sources. Documentation had also been obtained from funding authorities in the form of assessments and care plans before the home had carried out their own assessment. This was in line with the procedure described by the manager. The home does not provide intermediate care and so Standard 6 does not apply. Care Homes for Older People Page 10 of 28 Care Homes for Older People Page 11 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. The home works well to meet residents health and personal care needs and uphold their privacy and dignity. Evidence: Care plans examined were detailed and individualised and had been subject to monthly review, there was also evidence of ongoing evaluation. As well as personal care issues,residents had care plans for health care issues and end of life care. There were also specific care plans to deal with wound care that included photographs. A number of residents had been receiving input from mental health professionals although there was no documentation on file relating to the Care Programme Approach (CPA) to check if the residents care plan was in line with this. The home should find out if arrangements are in place under the CPA and if so request a copy of related documents and involvement in any future review meetings. Residents had risk assessments completed for pressure areas,moving and handling,falls and nutrition. In addition a specific nutritional assessment tool was in Care Homes for Older People Page 12 of 28 Evidence: use. Residents were also being weighed on a monthly basis. Records showed that residents had been receiving visits from health care professionals such as GPs and specialist nurses. There was evidence of one resident who had diabetes having blood samples being taken as part of their monitoring. Medication was stored securely with a medication trolley in each unit in addition to further storage in a central medication room. Although there was a record of storage temperatures for the refrigerator in the medication room there was no indication that storage temperatures had been monitored in the unit. Medication containers had been dated on opening as an indication of the expiry date. Medication administration records (MAR) had no gaps in recording and appropriate codes had been used where medication had not been given. Examination of MAR in all units showed that there had been variable practise in relation to the signing,dating and checking of handwritten directions. Some directions and changes had been signed and dated although there was no evidence that they had been checked by another member of staff for accuracy. Medication risk assessments were in place although in Sycamore unit these had been heavily decorated with images. This practice should be reviewed in the interests of keeping records in good order as the images bear no relation to the content of the risk assessments. Protocols were in place to guide staff in the administration of medication prescribed on an as required basis. A Survey form received from a GP indicated that medication was appropriately managed in the home. Medication audits are carried out by the manager with the most recent achieving a high percentage score. Residents confirmed that staff knocked on doors before entering and were polite to them. It was noted that care plans promoted the treatment of the resident with respect. Care Homes for Older People Page 13 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. The home takes an active role in encouraging residents contact with family, friends and parts of the local community. This in conjunction with a varied activities programme provides a good degree of social contact. In addition residents receive a choice of varied and nutritious meals. Evidence: The home employs three activities organisers. Activities are planned and provided for residents on a unit basis with visits to units twice a week. Residents had social profiles completed on admission and some had activities care plans. Examples of group activities provided in the home are crafts,quizzes, music and movement and visits from a pat a dog. Residents had been involved in choosing colours for several mosaics that were being made. The activities organiser described the importance of providing one to one activities for residents with dementia, these included hand massage, hand therapy and walks out of the home. During the inspection visit the activities organiser was observed talking with residents on an individual basis about their choice of activity. Activities outside of the home are also organised with visits made to singing for the brain sessions organised by the Alzheimers Society in Wotton-under-Edge. Trips out had been made on a canal boat organised by a local Care Homes for Older People Page 14 of 28 Evidence: charity. The home has three volunteers to help with outings and it was reported that they had received criminal records checks. A relative of a resident praised the activities organiser and the activities provided in the home. The activities coordinator had completed a training course in activities organised by a local care home support group. The Church of England holds a service in the home once a month and the home has some information on local contacts with other Christian denominations should these be needed by residents. However despite the perseverance of the activities organiser there had been some problems in arranging visits by a Roman Catholic Priest. One resident followed the Christian Spiritualist faith and it was reported that activities organisers read extracts from the Bible to her. A Christmas party was being organised and a number of entertainers had been booked to visit the home in the weeks leading up to Christmas. There is a policy of open visiting in the home, athough generally due to residents care needs visitors are asked not to visit before 10:30 in the morning.Meetings are held with residents and relatives, and a weekly surgery is held where relatives can consult the manager about the care of residents. A notice about the weekly surgeries was displayed in the entrance of the home. One relative commented I can stay as long as I like. and mentioned how she had been given cups of tea while visiting. A relatives communication record was in use in the home to provide two-way communication regarding any issues about the care of individual residents. Evidence was seen of service users bringing their own personal possessions into the home including items of furniture. The home has information on advocacy services for residents. The home had introduced a new menu planning system called the Nutmeg. This is designed to provide a balanced diet for residents as well as a choice. One resident who had been identified as following a largely vegetarian diet on admission had a detailed care plan for eating and drinking. However this did not include information on vegetarian dietary preferences. This was discussed with the registered manager and the care plan was updated before the end of the inspection visit. A separate record of the dietary intake of this resident had not been kept. This needs to be done where any special diets are provided for residents. The service of lunch was observed in Willow Unit. Staff were attentive to residents needs and responded appropriately to any questions from residents about the meal. The atmosphere was relaxed. One resident had been given a drink of orange squash. She stated her dislike of this and asked for a cup of tea which was quickly provided. It was noted that meals served to individual rooms were covered to keep them warm. Tables were attractively laid with drinks and condiments available. Due to the memory difficulties of residents in this unit choices are checked immediately before meals are served and this practice was observed Care Homes for Older People Page 15 of 28 Evidence: during lunch in Willow Unit. One resident described the meals provided as Very Good. The arrangements for food preparation in the home had been inspected by the environmental health department of the local authority with four stars awarded out of a possible five for the standards of food preparation and cleanliness. On a survey form a relative of a resident commented The food is excellent. Another stated Meals always look very appetising. 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. 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. Information is available if any resident or their representative should wish to make a complaint and the homes approach to training staff should ensure that residents are protected from abuse and their legal rights are upheld. Evidence: The home has a register for recording complaints, nine had been documented since November 2007. The responses to these were looked at. In one case the response to the complaint had led to improvements to the environment for one resident. With another complaint, two members of staff had complained and both had received appropriate responses to their concerns. The procedure for complaints is that on receipt, a letter is sent and following an investigation a response is given within 28 days. The complaints procedure was displayed in each unit. Out of six survey forms received from relatives, five indicated that they knew how to make a complaint. In relation to residents legal rights, the home has information on the Mental Capacity Act 2005. Training has been provided for staff and the home had approached an independent Mental Capacity Advocate regarding one resident.The homes AQAA document stated that Mental capacity Act training was planned for all staff. The home has a policy for protecting residents from abuse as well as a whistle blowing policy. This policy is given to all staff when they start work in the home and is also on display in the staff room.Two staff were spoken to and were aware of the Whistle Care Homes for Older People Page 17 of 28 Evidence: blowing Policy with one stating that they would make use of the policy if the need arose. Training in protecting residents from abuse has been given to the majority of staff. A further group of staff had attended the Alerters training provided by the local authority adult protection unit. In addition training is also provided in dealing with challenging behaviour. Information from the Gloucestershire County Council in the form of their Alerters Guide was displayed in each unit. Where an incident of alleged abuse was reported in June 2008, the home took appropriate action and contacted relevant authorities. 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. Despite the small amount of secure outside space available, residents have the benefit of a safe and generally clean environment suitable for their needs. However infection control procedures in the laundry must be improved. Evidence: A tour of the premises was undertaken. All areas of the home inspected were found to be clean, well maintained and decorated and smelt fresh throughout. On a survey form one relative stated The cleanliness of the home is outstanding. Another commented that the home Provides a clean,comfortable living environment for clients. Some work had been done to adapt the environment of the home for the needs or residents with dementia. This included the painting of doors to individual rooms in bold colours which was in contrast to doors to other rooms. Some further work on this was planned for Hawthorn unit. In addition pictorial signs were in use on doors to toilets and bathrooms. In Sycamore unit a number of doors had scratched paintwork. the manager was aware of this and remedial work was planned. On survey forms some relatives had commented on the lack of a secure open air area for residents. There are two enclosed courtyards in the home and the activities coordinator described how use had been made of these in the good weather. The homes Annual Quality Assurance Care Homes for Older People Page 19 of 28 Evidence: Assessment (AQAA) document stated that the courtyards had been made more accessible to residents.The possibility of an enclosed area at the front of the home had been explored but was not apparently possible due to lease arrangements. The home has a large laundry with a system providing an entrance for dirty laundry items and a separate exit for clean laundry items. However on examination there were a number of practices in place that were not in line with good infection control procedures. Although the walls and floor were readily cleanable, the presence of a number of floor mats was not in the interests of providing a cleanable floor surface. In addition it was noted that there were two sinks in the laundry. A smaller sink had been provided for hand washing and access to this had been obstructed by shelving. The larger sink contained some items of crockery suggesting that staff may have been consuming food and drink in the laundry. Both sinks were in need of a good clean. A refrigerator was also found in the laundry and on examination this contained items of food and drink. The storage and consumption of food and drink in the laundry is not in the interests of good infection control procedures. This was further demonstrated by a poster displayed on the laundry wall stating this. The floor mats were removed before the end of the inspection visit and some work had started on allowing access to the hand washing sink. It was also later reported that the refrigerator had been removed. However checks must be made to ensure that correct infection control procedures are being observed in the laundry. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are provided with training relevant to residents needs and generally robust recruitment practices are in place to protect residents. However in order that residents are cared for by a trained staff group some improvement is needed in the number of staff with an NVQ. Evidence: On Sycamore unit staffing was organised so that there was one registered nurse on duty all day with a senior care assistant and two care assistants. On Willow there was one registered nurse in the day with four care staff in the morning and three in the afternoon. Laburnum unit has a registered nurse in the morning with four care staff and in the afternoon the unit shares a registered nurse with Hawthorns which has a registered nurse in the morning with three carers and two carers in the afternoon. At night there are a total of eight care staff on duty in the home, this normally includes two registered nurses,sometimes three. On two survey forms received from residents there were comments about staff shortages with one stating. On occasions there seems to be a shortage of staff. We received two anonymous concerns about staff shortages in the home one in August 2007 and the other in July 2008. Both of these concerns were passed to the registered provider to look at. They responded to us that Investigations show that, on the whole, the home was sufficiently staffed on days. In relation to nights they stated that absences caused by staff sickness were covered Care Homes for Older People Page 21 of 28 Evidence: by staff redeployment or the use of agency staff. The numbers of care staff trained to NVQ was below 50 although it was reported that a further five staff were due to complete the training. Records for three recently recruited members of staff were examined. For two staff all the required information and documentation had been obtained. However for one member of staff only one written reference had been obtained before the person had been employed although other checks had been made. The induction training provided to inexperienced staff was looked at. The document in use was not in line with current standards and it was confirmed on the second day of the inspection visit that an old induction booklet had been used instead of the current one. Staff had received training in a number of areas relevant to the needs of the residents in the home. These included dementia awareness, challenging behaviour and a falls workshop. A number of staff had also completed the Yesterday,Today and Tomorrow dementia training. On a survey form received from a member of staff, they commented about the training that they had Regular training sessions and updates relevant to my role. Comments from relatives of residents about staff were positive such as The carers are very kind to the residents. and The staff are friendly. one resident spoken to during the inspection visit said The staff are very helpful. 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 home is well managed with a variety of quality assurance audits in operation and safety checks to ensure that the home is run in the best interests of residents. Evidence: The manager has previous experience of managing care homes for people with dementia and is a registered general nurse. At the time of the inspection visit she was not registered with the Commission as the manager of the home. Quality audits had been carried out in the home every month, those looked at were very thorough and produced an action plan where issues had been found that needed attention. A home managers audit or an audit by a representative of the registered provider takes place on alternate months. Other audits take place concentrating on such areas as accidents and medication. Unannounced visits by a representative of the registered provider had also taken place and a short report had been produced and copied to the manager. In addition satisfaction surveys are sent out to relatives and Care Homes for Older People Page 23 of 28 Evidence: residents and relatives meetings are held. The home has a bank account for holding residents money. Documentation relating to this was examined and found to be in order although a valuable item belonging to one resident was being held with no record kept. Staff had completed training in safe working practices in fire safety,food hygiene,moving and handling,health and safety,infection control and the control of hazardous substances.The home uses a traffic light system as a way of ensuring that staff do not miss any training or training updates. A number of staff had also completed first aid training. Checks had been made on gas appliances, the electrical wiring and portable electrical appliances. However it was noted that the refrigerator in the laundry had not been part of any appliance check. Servicing had also been carried out on hoisting equipment. A comprehensive environmental checking system was in place that included checks on window restrictors, hot water temperatures and wheelchairs. A Fire risk assessment had been completed by an outside consultant, this had raised some areas to be actioned and it was reported by the manager that some of these had been completed. Following an inspection by the local authority into the measures to prevent risks from legionella, work had been carried out by a specialist consultant. The kitchen had received an inspection from the local authority and had achieved a four star rating. 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 26 13 The laundry must be 30/01/2009 maintained in such a way that correct infection control procedures are observed in relation to hand washing facilities,floor surfaces, cleanliness of sinks,eating and drinking and the storage of food. In order to prevent cross infection in the care home. 2 29 19 Before a person starts work in the home, all the information and documents specified in Schedule 2 of the Care Homes Regulations 2001 must be obtained. This is so that residents are recruited through robust recruitment procedures. 31/01/2009 3 35 17 Where valuables are held on behalf of residents a record must be made as specified in Schedule 4. 31/01/2009 Care Homes for Older People Page 26 of 28 This is so that there is an accurate record of any valuable items held in safekeeping for residents. 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 The home should check if arrangements are in place under the Care Programme Approach for any residents and if so obtain a copy of related documents and request involvement in any future review meetings. All handritten directions and entries on medication administration records should be signed and dated by the staff member making the entry and checked and signed by a second staff member. Temperature checks should be made on medication trolleys in units in order to check that residents medication is being stored at the correct temperature. Review the practice of decorating medication risk assessments in Sycamore unit. Where a special diet is provided for any resident then a record must be kept to check dietary intake. More staff should undertake NVQ training. The home should check that all induction training provided to new inexperienced staff is in line with the Common Induction Standards. 2 9 3 9 4 5 6 7 9 15 28 30 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!