Inspection on 19/11/08 for Preston Towers

This inspection was carried out on 19th November 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 14 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Preston Towers 29/01/08

Preston Towers 22/01/07

Preston Towers 15/06/06

Preston Towers 05/01/06

Preston Towers 16/09/05

Extracts from inspection reports are licensed from CQC, this page was updated on 20/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Preston Towers Preston Road North Shields Tyne & Wear NE29 9JU     The quality rating for this care home is:   zero star poor 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: Suzanne McKean     Date: 1 9 1 1 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. 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 34 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 34 Information about the care home Name of care home: Address: Preston Towers Preston Road North Shields Tyne & Wear NE29 9JU 01912591828 F/P01912591828 noemail Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Moorlands Care Homes (N.E.) Limited Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 48 Number of places (if applicable): Under 65 Over 65 51 0 old age, not falling within any other category physical disability Additional conditions: 0 2 At any time, three service users can be aged 55 years to 64 years category physical disability (PD) added condition s requested. Date of last inspection Brief description of the care home Preston Towers is a large stone built detached building set in its own grounds set back from one of the main roads leading out of North Shields. It has been converted to provide accomodation for older people. The home is located within walking distance of local amenities. To the front of the building there are extensive lawns and garden areas and ample car parking is provided. The home has retained many original features such as mosaic-tiled floors in the hallway and high ceilings with original covings. Preston Towers is registered to provide personal and nursing care for up to fifty-three older people. The home charges fees of £361 per week. As the home Care Homes for Older People Page 4 of 34 Brief description of the care home provides nursing care the free nursing care element of the funding is provided in addition to the costs charged to the resident. The home provides information about the service through the service user guide. A copy of the last inspection report from The Commission for Social Care Inspection is available in the entrance to the home. Care Homes for Older People Page 5 of 34 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: zero star poor 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: Summary - This is an overview of what the inspector found during the inspection. How the inspection was carried out, Before the visit we looked at:- Information we have received since the last visit on 29th January 2008. How the service dealt with any complaints or concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service and their relatives, staff and other visiting professionals. An unannounced visit was made on 30th October 2008 and was completed over seven Care Homes for Older People Page 6 of 34 hours by two inspectors. During the visit we: Talked with people who use the service, relatives, staff the manager and visitors. Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last visit. We told the senior nurse on duty what we found. What the care home does well: What has improved since the last inspection? What they could do better: The home must have an effective manager in place to offer leadership and make sure that there is a clear action plan, which will be followed to make the improvements that are necessary. New residents and those returning to the home who have had a change in their dependency must have an assessment carried out in more detail to identify if the home can meet their needs safely. The care plans must be improved to show detailed assessments, care planning, and evaluation. The records of daily care need to be completed to a better standard, and residents and their representatives must be more involved in the development of their plan of care. There must be proper provision for the health and welfare of service users and there must be suitable arrangements to ensure the home is conducted in a manner which respects the privacy and dignity of the service users. People living the home should be consulted about the programme of activities and the home should provide facilities for recreation and social activities in line with their expectations, preferences and capacities. And residents must be supported to make decisions with respect to the care they are to receive. Care Homes for Older People Page 8 of 34 The way that complaints are managed must be improved to show that they are being fully investigated. Improvements must be made to make sure that staff training and other measures are in place to prevent residents from being harmed or being placed at risk of harm or abuse. The toilets and bathrooms are in need of redecoration and this work must take into account the needs and dependencies of the residents and maximising their opportunities to live independent lifestyles. The registered person must make sure that there are suitable adaptations and facilities as may be required for the residents accommodated in the home. Arrangements must be made to prevent the spread of infection, toxic conditions. There must be an effective recruitment and selection process to make sure that staff employed are fit to work at the care home and that they receive structured induction training. Also the staff must receive statutory and clinical training so that they can meet the needs of the residents. Staff must receive adequate supervision at the necessary frequency. The home must have better systems to monitor the environment, maintenance, and equipment to protect the residents and staff from harm. There must be a comprehensive quality assurance programme to make sure that the home is run in the best interest of the residents, taking into account their views. 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 9 of 34 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 34 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Pre-admission assessments of new residents make sure that the home is prepared for the person moving in. However assessments of people needing to return to the home from hospital are not being carried out to make sure that needs can be met safely. Evidence: The home has an assessment document which is designed to give the staff in the home information a way of recording information about the needs of the people who are considering moving into the home or staying for a short period. Pre-admission assessments were in place for new residents, and they were in enough detail for the home to make sure that they could meet their needs, however they were not very comprehensive in some areas such as the social profile. Where an individual had been admitted to hospital and have had a change in their Care Homes for Older People Page 11 of 34 Evidence: needs there was not always a re-assessment carried out to make sure that they can be cared for safely on their return. Potential residents can visit the home and spend time in the communal areas prior to making the decision to move in but those spoken to on the day had relied on their relatives to make the choice for them. Care Homes for Older People Page 12 of 34 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home can not be confident that they will have their health and personal care needs met in a planned way. Evidence: Each person living in the home has an individual care plan which is developed from the admission assessment and added to throughout their stay. These care plans are to show how the personal and health care needs of the resident are to be met. However these are not completed in sufficient detail to show the staff how this is to be achieved. Care plans are in place around both the physical needs and the social care needs of the people living in the home. Risk assessments are completed for a selection of areas including falls, nutrition and deterioration in skin condition. They were being reviewed but this is inconsistent between the care plans and they were not always completed in enough detail to show the changing health care needs of the residents. Some areas of the care plans were missing information that was needed. An example of this is the moving and handling assessments. They should clearly identify the type of hoist and the specific sling to be used as well as clear direction to the staff on how Care Homes for Older People Page 13 of 34 Evidence: to carry out the procedure. Generally they not person centred. Also social care plans were not completed consistently. Residents are not always being supported to access NHS services and facilities as and when they need to. The care plans showed that the specialist advisors are used for individual people living in the home. However their advice is not always being transfered to the main body of the care plans or being followed closely. The Community Matron visits the home to give advice and support the staff in their clinical decisions, but again the records of this is not clear and on at least one occasion the staff failed to take this advice without clear indication as why they failed to do so. There was an example of a resident being identified as not being comfortable have her personal care needs met by a male carer but was not having that preference met, suggesting that her dignity was being compromised. The care staff were knowledgeable about the day to day needs of the people living in the home and could describe how they had to report any relevant issues to senior staff. A number of the residents are being given adequate care and the staff are able to provide the people living in the home with support for thier day to day activities and personal care. The residents and their representatives are not being supported to take part in the review of their care. Although residents said that they felt well cared for by the staff and an example of this was the staff are nice and they help me alot they were not aware of the contents of their care plans or how the plans were being developed. Residents spoken to were positive about the care they were being given and were complementary about the staff. An example of this was that they thought it was nice living here and that the staff were lovely. Staff were communicating well with the residents on the day and they were engaging them in conversation as they provided care. The residents maintain contact with their families, friends and visitors and can use either their own rooms or the communal areas. The relatives are not always being given good assistance to help them to be as involved in the care as they feel comfortable. One visitor was positive about the way they had been supported in providing care to their relative, however there has been a number of relatives who are not confident about the way the home is being run and feel that this is impacting on the care of their relatives. Records also show that concerns have been raised during resident reviews and it was not clear how this had been dealt with. The home manages the administration of prescribed medication appropriately. There are appropriate systems in place to arrange for the ordering of the residents Care Homes for Older People Page 14 of 34 Evidence: medication and the records were up to date and in good order. The home has a contract for the disposal of the medication which is no longer required and the records of this were in place. Controlled drugs are managed appropriately. Care Homes for Older People Page 15 of 34 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home are not sufficiently supported to live active and fulfilled lives in line with their choices, abilities and previous lifestyles. Evidence: The home has an activities assessment in the care plans but these were not being fully completed, and although there was an individual social activities sheet they were not being written in enough detail to show what the resident had been involved in. There are some activities for the service users to take part in but not enough and not in sufficient variety to give residents choice. The activities programme was displayed on the wall in the foyer but residents and staff were not aware of what was planned and it was not clear how they would find out what was available. The records of activities in some of the files stop in August 2008. There are few ways for residents and relatives the have the opportunity to discuss their views and hear news about the home. The residents are supported to continue their religious practises and there are opportunities for residents to participate in services which are appropriate to their particular faith and beliefs. Service users Care Homes for Older People Page 16 of 34 Evidence: confirmed that they are free to join in social activities if they wish and that they are not made to join in activities if they do not want to. The meal time was well organised and staff were sensitive when assisting the residents with their meals. The residents were observed enjoying their meal which looked appetising and well presented. The catering staff are now receiving training for them to undertake the role. The home has a tea trolley which travels around the home in the morning and in the afternoon, this not well presented. There is only mugs or feeding cups available, restricting residents choice and no saucers. There were only very plain biscuits and these were being served without saucers or plates resulting in residents being unable to put them down and were balancing them on the side of chairs or on their knees. Care Homes for Older People Page 17 of 34 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are adequate policies and procedures in place, however they are not being followed to make sure that complaints are dealt with effectively. Lack of consistent training around adult protection and reporting of safeguarding incidents do not make sure that residents are safeguarded from harm. Evidence: The complaints procedure is made available to residents and relatives through the service user guide. The system for the management of complaints was not clear and the records were not in enough detail to determine what the outcome of the complaint was and the level of satisfaction of the complainant or if any action had taken place to address the outcome of the investigation. The Commission for Social Care Inspection have information that residents have expressed concerns in the past which have not always been formally investigated. We have asked the registered provider to investigate a complaint through the company complaints procedure, however this has not been completed within the timescale and is as yet unresolved. There is a protection of vulnerable adults policy and staff were aware that any events effecting the welfare of the residents must be looked at with reference to the safeguarding guidance and CSCI need to be informed. There is a whistle-blowing policy Care Homes for Older People Page 18 of 34 Evidence: which is made known to the staff very early in their employment through the induction process. Some staff have been given safeguarding training, although sessions were available it is difficult to determine if all of the staff have received this training as the records are not clear. Care Homes for Older People Page 19 of 34 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home offers accommodation which is generally clean but is not well maintained and decorated and it does not have the design features to help people of this client group and to promote their dignity, comfort and welfare. Evidence: The building is sited in a mainly residential area in North Shields with good access to the facilities of the town. The home overlooks large lawned areas at the front of the home. The garden areas are appropriately maintained and there is good access into the gardens for those people who have mobility difficulties or have use of walking aids or wheelchairs. The home is generally clean and tidy and free from unpleasant odours. However the poor standards of decoration in some areas of the home give it a shabby look. There are two lounges and a dining room on the ground floor, these have been redecorated and some new furniture provided. The dinning tables and chairs have been replaced and the room is bright, light and a pleasant place for residents to have their meals. There is a lounge area on the first floor with a glass roof which is not regularly used as lack of shading results it in being hot in the summer and cold in the winter. The ground and first floor corridor carpets have been replaced and now looks tidy, the Care Homes for Older People Page 20 of 34 Evidence: stairwell carpet to the rear of the building was being replaced on the day of the visit. The bedrooms are of different shapes and sizes and vary in the standard of the decoration. There remains seventeen bedrooms that still need to have the carpet replaced and a number need furniture replaced where it is damaged. This was an outstanding requirement at the last inspection carried out 29th January 2008 and the timescale for the work to be completed was 1st September 2008. Residents had been supported to personalise their bedrooms and most had brought in small items and pieces of furniture to make them more comfortable and reflect their previous lifestyles and taste. Residents were asked how they felt about their rooms and all were happy with the level of cleanliness. There are poor records in place to ensure that Health and Safety issues are being managed and to show that that there are processes in place that safeguard the people living there. The records of safety checks were not in sufficient detail and there was no record of electrical tests on of small appliances in the home. The toilets and bathrooms need redecoration upgrading, and the flooring to many of these are loose from the wall making it impossible for them to be cleaned satisfactorily. A number of the toilets and baths in the rooms are badly sited and lack appropriate aids to independence. The redevelopment of these areas would give the opportunity to provide a more suitable facility and to promote the Independence of the residents. The shower room on the top floor was dirty with damaged tiles and a broken drain. It was not draining correctly and there was a very foul odour making it unsuitable for it to be used. This was taken out of service on the day and maintenance staff from the home were attempting to repair it. The lift was out of order and had been broken for a number of weeks. The staff are trained in control of infection procedures and were using these practises throughout the day to minimise the risk of cross infection. There are three sluice rooms and two of these have disinfectors which were operating on the day. However the poor standards of maintenance particularly in the bathrooms make the risk of cross infection greater. The homes arrangements for laundering are satisfactory and there is a sluicing facility on the washing machine. Care Homes for Older People Page 21 of 34 Care Homes for Older People Page 22 of 34 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 poor 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 stable staff team who are committed but unsupported by the leadership resulting in people being placed at risk of harm. Evidence: The home maintains minimum staffing levels, and on the day of the visit there was, two qualified nurses and six care staff one of which is a senior carer. There was one domestic, one cook a catering assistant, and the tea lady, who is employed to carry out specific tasks. On the day of the visit there was a carer who is employed at the other home in the company which is acceptable practice to give a way of covering shifts. The staff rotas were generally being covered to maintain the numbers. However this is being achieved because of the commitment of the staff who are covering extra shifts either when staff are on holiday or sick or in the event of short notice sickness. There are also times when all types of staff are unable to, or discouraged from taking holidays because there is insufficient flexibility in the staffing rotas. This results in them having long gaps between holidays and increases the strain on individuals creating a greater potential for sickness. The nurses and care staff are given some opportunities to attend training courses, Care Homes for Older People Page 23 of 34 Evidence: however these are not always undertaken as staff are not always available to cover their absence. It is difficult to determine if the staff are given the necessary training to make sure that they are able to carry out their roles safely including moving and assisting, fire, control of infection, first aid and food hygiene, as the records of the training are poor. Staff records are kept of recruitment and selection. A sample of these were examined and found to contain the necessary information including a Criminal records check and two references as well as checks regarding their qualifications. However, on one record there were gaps in the record of previous work experience which had not been followed up. And on another, a serious issue was not explored in sufficient detail with the candidate or a risk assessment completed to determine the suitability of the candidate. The induction of staff is in line with current good practice guidance, however there is no evidence that staff who are employed in the other home have received any induction to work in Preston Towers. Some training has been given to staff around some clinical areas such as infection control, medication training and stroke management. There was a requirement made at the last inspection for staff to have adequate statutory and clinical training so that they could meet the needs of the residents. This has not been met as there has been a recent incident when a resident failed to get adequate care because nursing staff did not have the clinical skill required. Care Homes for Older People Page 24 of 34 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is lacking consistent management and leadership resulting in it not being maintained in line with good health and safety practises and in the best interest of the residents. Evidence: At the time of the inspection visit there was no manager in post although there is a deputy who was away from the home and therefore not present. There is a lack of leadership in the home to ensure that the home is run in the best interest of the people living there. Staff said that they felt unsupported and relatives also said that they felt that the staff were hard working but were not being given enough resources or guidance. There is no comprehensive, consistently used quality assurance system in place, which would be used to identify any necessary improvements. Residents and relatives are not being asked their views on the service provided and although surveys have been Care Homes for Older People Page 25 of 34 Evidence: carried out by the company there has been no analysis of the information received and action plan put in place. The records of the staff meetings do not show that these are being carried out regularly and the last record found in the home of a staff meeting was on 17th March 2008. Staff have met with the registered provider on an individual basis but it is not clear if this is supervision or appraisals. The supervision of staff is not being carried out and although there is a programme in place it has not commenced. Although the previous manager was in regular contact with the owner the requirement for him to undertake formal visits to the home to under Regulation 26 of the Care Homes Regulations 2001 is not being met. The last record of such a visit was dated 28th March 2008. The home has a system to assist residents in managing their personal finances/allowances. The individuals money is kept separately and the records are maintained. There are receipts kept for any purchases made on behalf of the residents and there are systems in place to make sure that people in the home are provided with money for them to have the items they need. Health and Safety records are poor and there was evidence that practise was poor, particularly around the environment and fire prevention issues. The records for fire prevention, checks and services were adequate, however staff training was not being carried out and the necessary intervals. Care Homes for Older People Page 26 of 34 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 7 15 The care plans must be improved to show detailed assessments, care planning, evaluation, and the records of daily care being provided. 01/08/2008 2 19 16, 23 The home must undertake a 01/09/2008 refurbishment programme Including: The treatment room must be made fit for purpose. Bedroom furniture Bedroom carpets Outstanding from 15.06.06. The toilets and bathrooms must have remedial work undertaken and then redecorated. This must be carried out taking into account the needs and dependencies of the people living in the home and maximising their opportunities to living an independent lifestyle. 01/09/2008 3 21 23 4 30 18 All staff must receive 01/07/2008 adequate statutory and clinical training sot that they can meet the needs of the residents. There must be a 01/08/2008 Page 27 of 34 5 33 23 & 24 Care Homes for Older People comprehensive quality assurance programmes to ensure that the home is run in the best interest of the residents, taking account of their views. Outstanding from 15.06.06. 6 36 18 Staff must receive adequate 01/07/2008 supervision at the necessary frequency. Outstanding from 15.06.06. Care Homes for Older People Page 28 of 34 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 3 14 The registered person must make sure that new residents and those who have had a change in their dependency, have an assessment carried out in sufficient detail to identify if the home can meet their needs safely. The residents must be confident that if they are being offered a place or retiring to the home that their needs will be met. 31/12/2008 2 7 15 Residents and their representatives must be involved in the development of their plan of care. The residents should be involved in the plan of care and the review so that they can be confident that their needs will be met. 01/04/2009 Care Homes for Older People Page 29 of 34 3 8 12 The registered provider 02/02/2009 must make proper provision for the health and welfare of service users. This will make sure that the residents will recive the care they need and will not gome to harm because of an act or ommision of an act. 4 10 12 The registered person must 02/02/2009 make suitable arrangements to ensure the home is conducted in a manner which respects the privacy and dignity of the service users. The residents must have thier dignity maintained particularly with regard to choosing the gender of the people assisting them with personal intervention. 5 12 16 The registered person must consult service users about the programme of activities and provide facilities for recreation and social activities in line with residents expectations, preferences and capacities. The residents should be given the opportunity to live active and fulfilled lives. 01/06/2009 6 14 12 The registered provider must so far as practicable enable service users to make decisions with respect to the care the are to receive and their health and welfare. 01/06/2009 Care Homes for Older People Page 30 of 34 The residents should be given the opportunity to make choices about how they live their lives. 7 16 22 The registered person must ensure that any complaint made under the complaints procedure is fully investigated. The residents and their representatives must be confident that their complaints and concerns are being dealt with effectively. 8 18 13 The registered person must 06/04/2009 make arrangements by training staff or by other measures to prevent residents from being harmed or being placed at risk of harm or abuse. The staff must be trained to have the skills to minimise the risk to residents from harm. 9 22 23 The registered person must make sure that there are suitable adaptations and facilities as may be required for the residents accomodated in the home. The residents should live in a well decorated and equipped home which is comfortable and safe. 01/06/2009 02/02/2009 Care Homes for Older People Page 31 of 34 10 26 13 The registered person must make arrangements to prevent infection, toxic conditions and the speak of infection at the care home. The residents should live in a well decorated and equipped home which is comfortable and safe. 01/06/2009 11 29 19 The registered provider must have in place a recruitment and selection process which ensure that staff employed are fit to work at the care home. The staff must be employed only if they are suitable to work in the home and are not going to present a risk to the residents. 04/05/2009 12 30 18 The registered provider must ensure that all staff working in the home receive structured induction training. The staff must be able to care for the residents safely. 02/02/2009 13 31 12 The registered provider must ensure that the care home is conducted so as to promote and made proper provision for the health and welfare of the service users. The residents must be able to be confident that they will be safe and well cared for. 02/02/2009 14 38 23 The registered provider must have in place systems to monitor the environment, 01/04/2009 Care Homes for Older People Page 32 of 34 equipment and processes to protect the residents and staff from harm. The residents must be able to be confident that they will be safe and well cared for. 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 15 The way that the morning and afternoon beverages and snacks are served should be reviewed to make sure that they are nutritious and well presented to support residents to maintain good nutritional intake. Care Homes for Older People Page 33 of 34 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). 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