Inspection on 07/08/09 for Porte Rouge

This inspection was carried out on 7th August 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Porte Rouge 30/09/08

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Key inspection report Care homes for older people Name: Address: Porte Rouge Vicarage Road Torpoint Cornwall PL11 2BW     The quality rating for this care home is:   one star adequate 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: Mandy Norton     Date: 0 7 0 8 2 0 0 9 This is a review of 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 2 1 0 stars - excellent stars - good star - adequate 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. 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. Care Homes for Older People Page 2 of 28 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 manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Porte Rouge Vicarage Road Torpoint Cornwall PL11 2BW 01752814469 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Torcare Limited care home 33 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 who can be accommodated is 33. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old Age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Porte Rouge is sited in an Victorian style building and is currently undergoing modernisation and refurbishment. It sits in large mature gardens and is near the centre of Torpoint, Cornwall where local ammenities and public transport can be accessed. Accommodation is provided on 2 floors, with communal space, 2 lounges, a conservatory and a dining room, on the ground floor and a small lounge of the first floor. Access between both floors is via the stairs or the shaft lift. The home is being developed to provide accommodation for up to 28 older people who require personal Care Homes for Older People Page 4 of 28 Over 65 33 0 3 0 0 9 2 0 0 8 Brief description of the care home care and support. The work to modernise and develop the home started when the curent providers, Torcare Ltd. took over the home in 2008. 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: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced Key Inspection took place from 10.40 am until 3.40pm on 7th August 2009. It was conducted with the provider and the person in charge on the day of the inspection. A tour of the home was carried out and residents and staff were observed and spoken to informally during this time. A variety of records were seen during the course of the day. Other evidence gathered since the previous inspection such as notifications received from the home (e.g. regarding any incidents which occurred) and completed surveys from both care staff (2) and residents (3) was also used to help form the judgements made in the report. This key inspection was bought forward from September 2009 mainly as a result of health, safety and welfare concerns, during extensive building and refurbishment work, raised by Cornwall Department of Adult Care and Support (DACS) Learning Disability Care Homes for Older People Page 6 of 28 service. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: A risk assessment should be carried out on anybody wishing to self medicate in order to establish their suitability to do it safely. The risk assessment should then be reviewed regularly. Using the details of peoples current needs and previous hobbies and interests that are documented in the care plans staff would be able to look after people with a more person centred approach. The manager should ensure that the complaints procedure is easily accessible to all Service Users, that is at a level where people can see it and be provided in an alternative format if required. The senior staff should ensure that they are always familiar with the local safeguarding Care Homes for Older People Page 8 of 28 referral procedures (although we were told that senior staff call on the provider or general manager, one of whom is always available, if an incident has occurred and needs to be reported) and information about the procedure is up to date and available to all staff at all times to ensure that any incidences that are bought to their attention are appropriately dealt with. An appropriate manager should be appointed who has experience in care of the elderly and is able to move the home forward once the building and renovations are complete and the home has registered for the categories of care they wish to provide a service for. The registered provider should ensure the ongoing health and safety of the current residents by ongoing review of the risk assessments, clear instructions about where in the home people are allowed to go and ensure that the doors in rooms where building work is ongoing are always locked when there is nobody working in them. The registered provider should ensure that the water (from sinks, baths and showers) in rooms that are not occupied should be run at least weekly to reduce the risk of Legionella and records maintained to evidence that this has been done. The registered provider should ensure that staff are aware of the principles of infection control and do not leave bars of soap in communal shower or bath rooms in case other residents might use it and increase the risk of cross infection. 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 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 current needs assessment in use means that peoples diverse needs are identified and planned for before they move to the home. Evidence: The person in charge said that people are always assessed prior to moving into the home to ensure their needs can be met. There were not many people moving into Porte Rouge or being referred to the home at the time of the inspection due to the ongoing building work and refurbishment and reassessment of the category of clients the home is going to provide care and support for in the future. The pre admission form will be modified to ensure the relevant information is gained before people move in once the category of care the service provides has been decided upon. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The practice regarding the planning and delivery of care means that people can be sure that their health and personal care needs will generally be met. Evidence: The 2 care plans seen were updated daily and reviewed monthly or as required. The care staff complete daily records about a persons welfare and detail what care has been provided. The care plans examined generally set out peoples needs and contained information about visits made by or to health care professionals such as GPs, district nurses and opticians. Individual risk assessments seen for both older people and for people with learning disabilities (done with input form the learning disability service) were up to date and relevant to peoples current needs and took into account the potential issues with the ongoing building work. Information about peoples current needs and previous hobbies and lifestyles was detailed in the care plans, this information should always be used to inform a person centred care approach. The provider said that a person has been employed (on a sessional basis with the company to work across all 3 Torcare homes) to give some advice on care planning and recording to assist staff. Care Homes for Older People Page 12 of 28 Evidence: People looked well cared for, were dressed in appropriate clothing and were engaged in a variety of activities during the inspection. The person in charge said that people are encouraged to maintain their Independence with personal tasks but staff are available to help and provide encouragement where necessary. All 3 completed Service User surveys indicated that they always get the care and support they need. A tour of the home showed that equipment to help skin stay in a good condition and for prevention of pressure sores is available as necessary and meets peoples current needs. People are weighed regularly if possible, if this is not possible then staff are aware of what people are eating and how their clothes fit them. Significant weight loss is reported to the persons GP and appropriate action taken. The home uses a blister pack system for administration of medicines. They are stored in a locked trolley in a locked room. The person in charge described the system used to administer the medicines. The records of administration were clear and a photograph of each resident is kept with the record to aid identification. The procedure for receipt, storage and disposal of unwanted medicines was explained and is in accordance with laid down legislation. Records seen show that 9 of the 14 care staff have had medication training. At least one person was noted as self medicating. All the medicines were written down so staff were aware of what was been taken. There was no risk assessment in place to ensure that the person is fully able to maintain self medicating. The person in charge said that risk assessment would now be carried out. Staff were heard and observed interacting with people appropriately and providing support in a discreet manner. Staff were knocking on doors before entering. People make choices about what they want to wear each day. Care plans did have preferred names of people detailed in them and staff were heard calling people by these preferred names. 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. A range of activities within the home and the local community mean that people have some opportunities to participate in stimulating and motivating activities. Meals and mealtimes are not rushed and staff are available to help make them an enjoyable occasion for people. Evidence: People are encouraged to exercise choice in how they spend their time and activities are offered individually or in groups regularly throughout the week. No activity plan displayed in the home currently but a weekly planner is being introduced into the care plan where activities that people have taken part in can be recorded and it can also be documented when people decide not to take part in an activity offered. This can then be monitored individually. The person in charge explained that each Thursday they have a trainer to do exercises which is very popular with all of the residents, they also have one staff member who does some activities with people twice a week. Two of the completed Service User surveys indicated that there are always fun things to take part in if they want to and one that there usually are. Visitors are welcomed at anytime and residents were seen coming an going freely during the inspection. The local community is involved with a number of residents and provides transport for Care Homes for Older People Page 14 of 28 Evidence: them to attend local clubs in some cases. There is a mature garden to the side of the house which is accessible to the residents, one person was playing ball with a staff member during the inspection. The best access to the garden is through the conservatory which is to be closed during hot periods as it gets too hot and people who use it may be at risk as a consequence. Residents can also access the garden by using the front door from where there is level access to it. Areas where building work is impacting on outside space is well marked as being out of bounds. The care plans need to have more information about peoples hobbies and interests, this will help in planning individulaised care and support. Individual rooms seen show that people are able to bring some personal possessions with them when they move in. Most people have their meals in the dining room and the mealtime seen showed that there were enough staff available to help people as required throughout the meal. There is a 4 weekly menu rota, people are asked what they would like for their meal and there is always a choice. Drinks and snacks are available 24 hours a day. The person in charge said that the menu had recently been reviewed with residents being asked for their input and as a result there are always things on offer that the current residents like. The conversations with the residents about what they would like to eat have not previously been recorded but the last one was and they will continue to be recorded in the future. All 3 completed Service User surveys indicated that they always like the meals at the home. Care Homes for Older People Page 15 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Formal complaints and safeguarding policies and procedures are in place and are available to staff at all times. Care staff undertake safeguarding training. This means that people who live at the home are adequately safeguarded. Evidence: The complaints procedure was seen displayed in the home, it was not clear if it was available in alternative formats if required. It is comprehensive and gives options about who to contact and timescales for responses to be made. There have been a number of concerns raised to the Commission from the Department of Adult Care and Support (DACS) about the service provided to residents with a learning disability at Porte Rouge following their reviews of those residents (the provider took over the home with the current residents with a learning disability already resident). The concerns were around the lack of appropriate care and support provided to the residents with a learning disability and health and safety concerns due to the ongoing building work and refurbishment of the home. As a result the DACS are working with the provider to find more suitable accommodation for the residents with a learning disability as she has also recognised her staff group are not trained sufficiently in the care and support of people with learning disabilities. This is to be a planned process to reduce the disruption to the residents in question. The Commission have bought forward the unannounced key inspection, due in September 2009, to August 2009 as a result of these concerns to assess if the National Minimum Care Homes for Older People Page 16 of 28 Evidence: Standards for Older People are being met. Two requirements were made as a result of the inspection around future categories of care to be registered and recruitment of a suitable manager. The provider said that they have regular contact with a number of relatives and feels they would be able to approach them with any concerns that would then be dealt with quickly. Records show that all care staff have attended safeguarding training (in house) in 2008 and 2009. They also have information about safeguarding when doing National Vocational Qualification (NVQ) training and during their induction training. The provider is aware of Deprivation Of Liberty Safeguards (DOLS) under the Mental Capacity Act of 2005 (see www.cqc.org.uk for more information on the Act) and best interests meetings that may be required at times and knows who to refer these matters to. The Commission received one concern in March 2009 which resulted in a safeguarding referral that was dealt with by the provider and DACS. There are currently 2 ongoing safeguarding issues bought by the DACS Learning Disability Service and the provider that are being dealt with alongside the planned discharge of the people with a Learning Disability. The provider has been co-operative throughout the recent safeguarding episodes. We were told that the manager and senior staff at Porte Rouge are familiar with the current local safeguarding referral procedures. The provider and general manager said that if an incident occurs one of them is always available and the staff call them before taking any action to ensure consistency. Care Homes for Older People Page 17 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Ongoing refurbishment, redecoration and maintenance means that people will have a comfortable, homely and safe environment in which to live. Evidence: The home is close to public transport, local shops and facilities of Torpoint. It is a large Victorian building that has been adapted for use as a care home over the years. The current provider bought the home approximately 14 months ago and it is now undergoing major internal building and refurbishment work. From the date of the inspection the provider anticipates the work will take at least another 3 months. When the 2 residents who are due to move have done so the provider said she will close half of the building to allow for the work to continue safely. On the day of the inspection 9 people were resident at the home. A tour of the home showed that peoples rooms are personalised with furniture and momentos they bought in with them. Communal space consists of a lounge, dining room and conservatory on the ground floor and a small lounge on the first floor. The conservatory is being monitored in its use as it becomes very hot in hot weather and despite the use of fans and the door being kept open it still remains hot. It will be closed fro use during these times. People access the first floor via a stair-lift (not currently in use) and a shaft lift.The large Care Homes for Older People Page 18 of 28 Evidence: garden is well maintained and accessible to residents. Car parking is available at the front of the house. At the request of the DACS Learning Disability team (via CQC) the local fire officer was asked to carry out a visit to Porte Rouge as they had concerns about the fire safety measures in place during the ongoing building work. He said the current risk assessment and procedures in place were satisfactory. As a result of the Learning Disability Services ongoing concerns the current manager has ensured that details of parts of the building that are not in use due to the building work and a current list of residents names and the risk assessment are clearly on display in the entrance foyer. She has also asked all of the current residents their understanding of what to do if a fire alarm goes off. Their responses and advice given is clearly documented and the staff are happy that people know what to do in the event of a fire. There are currently enough assisted bathrooms, shower rooms and toilets for the people who currently live at the home and many rooms have en-suite facilities. None of the toilets, bathrooms and showers had signs on the door to say what they were, the person in charge said that when the building work is complete signs will be put in place. The provider was advised to run water in empty rooms at least weekly to reduce risks of Legionella. She said the maintenance man would be able to carry this task out. On the day of the inspection the home was clean, tidy and hygienic. Domestic and laundry staff are employed to support the care staff in maintenance of the environment and control of infection. Policies and procedures around infection control were not examined but we were told that they are up to date and available to staff at all times. The provider said that in house training on the importance of infection control is routinely offered to staff. Care Homes for Older People Page 19 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. The staffing levels and skill mix are satisfactory meaning peoples general needs are being met. The recruitment procedure means that people who live at the home are being looked after by appropriate staff and their welfare is not at risk. Evidence: On the day of the inspection there were appropriate staff numbers and skills mix on duty to provide the required care and support for the 9 people currently resident at Porte Rouge. Staff were seen engaged with residents in a number of ways during the inspection. All 3 completed Service User surveys indicated that there are always staff available when they need them. The 2 completed staff surveys indicated that there are always enough staff to meets the individual needs of the residents. The manager and care staff are supported to provide care for people by administrative, catering, domestic, laundry and maintenance staff. There are a variety of training opportunities provided including first aid, moving and handling and food hygiene. Upcoming training dates were seen displayed on the staff notice board. Torcare has a training officer who provides all of the statutory and other relevant ongoing training. Information provided by the training officer showed that 9 of the 14 care staff have achieved at least an National Vocational Qualification (NVQ) Care Homes for Older People Page 20 of 28 Evidence: level 2 in care with 6 of those having a level 3 also. Induction training was not discussed during this inspection although the 2 completed staff surveys indicated that their induction covered everything they needed to know to do the job when they started very well. It was not clear if these were new staff or staff who had been at the home for a long time. Staff files we looked at (3) all had completed application forms, 2 written references, CRB/POVA clearances, statements of terms and conditions of employment and job descriptions. Care Homes for Older People Page 21 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The systems and procedures in place are designed to meet the needs of the service as they strive to continually improve the service the home offers to the people that live there. The attitude to health and safety shown by the providers, care and ancillary staff during the ongoing building and renovation work has improved meaning that people live in a generally safe environment. Evidence: The registered manager is the current training officer for the company and was registered when the home was taken over approximately 14 months ago. The registration was done quickly as the current registered persons were no longer able to carry on the home. The home was therefore taken over with the residents who were living there at the time. The provider has recognised that her staff group do not have the skills to meet the needs of the people with moderate learning disabilities and has said that once those people move to alternative accommodation (which is being Care Homes for Older People Page 22 of 28 Evidence: arranged by the DACS Learning Disability team) she will then register the home for older people who require personal care and support only. She told us that she anticipates being able to do this within 3 months of this key inspection. As part of this process she is going to recruit a new manager who is dedicated to the role and will be able to meet the needs of the anticipated client group. Torcare conduct regular quality assurance surveys using satisfaction surveys. The results of these surveys are analysed and evidence that action is taken to improve the service is made available. The provider said that questionnaires have been sent to both residents and their relatives recently, with a poor response being received. Torcare has a Care Standards Committee (made up of interested parties including relatives of Service Users) that meet at least 4 times a year. They always look at the last CQC inspection report and discuss it, making recommendations about what could be improved and what is good practice. The reports of theses meetings are always sent to CQC. The homes policies and procedures are up to date and available to staff at all times. They will be reviewed once the re registration has taken place to ensure they are appropriate. We saw the written records kept of all financial transactions on behalf of the residents, they included income and outgoings and receipts. The administrator said they do not handle peoples personal allowances themselves but invoice whoever is paying bills on their behalf. Secure facilities are available for storage of money and any valuables if necessary. The home is currently undergoing extensive building and renovation work as a result of this some residents have had to move rooms and areas of the home that they have been used to using have become out of bounds. These issues led the DACS Learning Disability team to have a number of concerns about peoples ongoing safety and welfare. They raised these concerns withe the provider and CQC. The DACS Health and Safety officer made a visit to the home with the Learning Disability Service Improvement Officer (who has been working with the provider and staff on providing more appropriate support for the residents who have a learning disability) to assess the situation. He found that some doors where building work was ongoing that should have been locked were not and warning notices were not suitable to advise people where they could and could not go safely within the building. He provided a report which DACS shared with the provider. She agreed that there were some areas where the builders and staff were not maintaining good health and safety practices. Relevant risk assessments have now been carried out (and are being constantly reviewed) and the builders and staff have tightened up their approach to the ongoing health and safety of the residents. The provider said that they have learnt a lot from the Care Homes for Older People Page 23 of 28 Evidence: experience and feel that the risk to the residents has now reduced. She said once the 2 remaining residents with learning disability have moved out then half the home will be closed to allow the builders to continue and further reduce the risk to residents. Records seen show that staff have attended statutory training on fire safety, first aid, food hygiene (where applicable) and moving and handling. The provider was advised that the water should be run, at least weekly, in rooms that are currently not occupied. During a tour of the home a bar of soap was seen in one of the shower rooms. The person in charge was reminded that bars of soap in communal areas may increase the risk of the spread of infection as more than one person may use it. The bar of soap was removed before the end of the inspection and the person in charge said she would remind staff about taking peoples toiletries back to their room with them once they have finished in the shower or bathroom. 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 31 9 An appropriate manager must be appointed. The current manager was registered when the home was taken over and is not working in the capacity of registered manager as she is the training officer for Torcare. 09/11/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 More detailed care plans about peoples current needs and previous hobbies and interests would help staff to look after people with a more person centred approach. A risk assessment should be carried out on anybody wishing to self medicate in order to establish their suitability to do it safely. The risk assessment should then be reviewed regularly. More detailed information about peoples hobbies and interests and life history should be recorded in the individual care plans to ensure individulaised care and support (person centred care) can be delivered. Page 26 of 28 2 9 3 12 Care Homes for Older People 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 4 16 The manager should ensure that the complaints procedure is easily accessible to all Service Users and is provided in an alternative format if required. Although either the provider or general manager are always available, senior staff should ensure that they are always familiar with the local safeguarding referral procedures and information about the procedure is up to date and available to all staff at all times. The registered provider should ensure that staff are aware of the principles of infection control and do not leave bars of soap in communal shower or bath rooms in case other residents might use it and increase the risk of cross infection. The registered provider should ensure that the water (from sinks, baths and showers) in rooms that are not occupied should be run at least weekly to reduce the risk of Legionella and records maintained to evidence that this has been done. The registered provider should ensure the ongoing health and safety of the current residents by ongoing review of the risk assessment, clear instructions about where in the home people are allowed to go and ensure that the doors in rooms where building work is ongoing are always locked when there is nobody working in them. 5 18 6 38 7 38 8 38 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). 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