Inspection on 02/04/09 for Redlands House

This inspection was carried out on 2nd April 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Redlands House 08/04/08

Redlands House 24/04/07

Redlands House 26/10/06

Redlands House 29/11/05

Redlands House 21/07/05

Redlands House 03/03/05

Redlands House 11/10/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Redlands House 134 Reepham Road Hellesdon Norwich Norfolk NR6 5PB     The quality rating for this care home is:   one star adequate 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: Jane Craig     Date: 0 2 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 03000 616161 (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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Redlands House 134 Reepham Road Hellesdon Norwich Norfolk NR6 5PB 01603427337 Telephone number: Fax number: Email address: Provider web address: Redlands@fireflyuk.net Name of registered provider(s): Mrs Frances Smart,Rhoderick James Robert Smart care home 33 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Thirty-three (33) Older People, not falling within any other category may be accommodated. Date of last inspection Brief description of the care home Redlands House is a care home providing personal care and accommodation for 33 older people. Mr Rhoderick Smart and Mrs Frances Smart are the owners. The home is located on a busy road in Hellesdon on the outskirts of Norwich and is close to all local amenities. Redlands House is a large detached house that has been extended over recent years. There is accommodation on the ground and first floor, providing seven double and nineteen single bedrooms. Some of the rooms have en-suite facilities and there are a number of other toilet facilities throughout the home. There are three Care Homes for Older People Page 4 of 28 Over 65 33 0 Brief description of the care home bathrooms and one shower room. Residents have a choice of lounge and dining areas. The grounds and garden area are well maintained and provide attractive outside facilities for service users in the summer months. Information about the home is available to people enquiring about admission and the latest inspection report is displayed in the home. The fees range from 350 to 485 pounds per week and there are extra charges for hairdressing, newspapers, chiropody, toiletries and escorts for appointments. 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: The last key inspection on this service was completed on 8th April 2008. This key (main) inspection includes information gathered since the last inspection and an unannounced visit to the home. The visit was carried out on 2nd April 2009 by one regulatory inspector. At the time of the visit there were twenty five residents in the home. We met with some of them and asked about their views of Redlands House. We spent time observing daily routines in the home and how staff interacted with residents. Three residents were case tracked. This meant that we looked at their care plans and other records and talked to staff about their care needs. We talked to the manager, the proprietor, staff and visitors. We looked around the home and viewed a number of documents and records. Care Homes for Older People Page 6 of 28 What the care home does well: What has improved since the last inspection? What they could do better: The directions in care plans should be clearer and more detailed so that staff know Care Homes for Older People Page 7 of 28 exactly how the resident wishes to be supported. Hazards to residents health and safety caused, for example, by restricted mobility and the use of bed rails, must be thoroughly assessed and plans must be drawn up to try to minimise the risk. Some areas of the home needed attention to ensure it remained homely and comfortable. There should be a plan, with timescales, for redecoration and for renewal of carpets. In order to fulfil legal responsibilities the manager must be registered with the Care Quality Commission. The systems for monitoring the quality of the service should include methods to enable residents and other people involved in the home to make their views of the service known. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –03000 616161. 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. Staff received sufficient information about new residents to enable them to understand their needs. Evidence: The manager was in the process of revising the service users guide but this was only in draft form at the time of the visit. Residents and their families were being invited to make contributions to the new Information Booklet, which should help to make it more meaningful to people thinking of using the service. Most people who were referred to the home had an assessment by social or health care professionals. The manager also carried out her own assessment to make sure that the service provided at Redlands House would be able to meet the persons needs. These assessments were conducted with the prospective resident or their family, which gave them opportunities to discuss issues that were important to them. Following a previous recommendation, assessment records were dated so that staff Care Homes for Older People Page 10 of 28 Evidence: could be sure the information was current. Staff told us that they received enough information about new residents to help them to understand their needs. Prospective residents and their families were invited to visit the home before making a decision to move in. The manager kept a record of the visits so that any issues that were raised could be addressed before the person moved in. One family member we spoke to said visiting before their relative came in had helped them to get a good feel for the home. 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 lack of consistency in care planning and delivery could compromise residents safety or result in their needs not being met. Evidence: We looked at three sets of care records as part of the case tracking process and others were looked at to check specific issues. As required following the last inspection all residents had a set of care plans. However, the quality of the plans varied. There were some good examples of plans to support residents to meet their personal care needs. They took into account the residents preferences and abilities, which helped them to maintain their independence. These plans were also sufficiently detailed to help staff to provide care to a consistent standard. However, care plans to address other needs were not as clear. For example, one person had three separate care plans to address their nutritional needs. The information was confusing and some directions for staff were contradictory. Plans to support residents who had mental health needs were not specific enough to make sure staff knew what assistance was needed. Care Homes for Older People Page 12 of 28 Evidence: As required at the last inspection care files were reviewed every month but information on the review notes were not always transferred to care plans, which meant that new instructions could be missed. Residents could be involved in reviewing their care if they wished. Each of the care files we saw included health care risk assessments. These had not all been reviewed. The assessments for moving and handling and for use of bedrails were not thorough enough, which could impact on the safety of the residents. The associated risk management plans did not always address the specific risks identified in the assessments. For example, not all plans to reduce the risk of developing pressure sores included equipment to be used. The manager had recently carried out a care plan audit. She had identified, and was addressing, a number of the shortfalls we found during the visit. The management team were also in the process of introducing a new system for care files. The example we saw during the visit included more robust risk assessments and clearer care plans. The new plans also gave staff more scope to include residents in planning and reviewing their care. Residents told us that they were well looked after by staff and one said they always received good attention if they were not well. A family member said their relative was in better health since being at the home. A visiting professional said they had no problems with the service, that staff knew the residents well and could pass on any information they needed. Records showed that residents were referred to other professionals as necessary and the GP visited the home on a weekly basis. There had been improvements in the way medicines were managed and requirements we made at the last inspection had been met. In part this could be attributed to the regular medication audits that were being carried out. The most recent audit had highlighted a serious medication error and the manager had reported it and taken appropriate steps to ensure the safety of the resident and prevent recurrence. Most medicines were stored in a locked room with restricted access. We discussed how this could be made even safer. Following a previous requirement residents had lockable cabinets in their rooms to store prescribed creams and other potentially hazardous substances. Only one resident administered some of their own medicines. The risk assessment and plan included limited checks to ensure the continued safety of the resident. We Care Homes for Older People Page 13 of 28 Evidence: discussed how these could be further developed. There were complete records of medicines received into the home and, following a requirement at the last inspection, the records of disposal were also complete. There were no gaps on the Medication Administration Record (MAR) charts. The correct codes were used to show when medicines had been omitted and there were corresponding notes for carers. Some MAR charts had been handwritten. These were not always an exact copy of the instructions on the medication packages, which could lead to residents not being given the correct dose at the correct time. There was no evidence that the entries were double checked to reduce the risk of transcribing errors. The stocks of medication were controlled appropriately and there was no evidence that residents were running out of medicines. We did a random check on a small sample of medicines. They were accurate, which was an indication that these residents received the correct amount of medication. There were no controlled drugs at the time of the visit but appropriate storage and a recording register were available. Some of the care plans directed staff to maintain residents dignity and how this was to be achieved. One member of staff told us that promoting privacy and dignity was an important issue in the home and during the course of the visit staff were seen to treat people with respect and offer care in a sensitive manner. A resident told us the staff were always polite and friendly. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents were satisfied with the level of activities, the meals and the routines in the home. Evidence: The home had recently employed two activity co-ordinators with the aim of providing recreational activities over seven days. The co-ordinators were working with each resident to find out their interests and suggestions for activities but this process was not complete. They also planned to draw up individual social and recreational plans but these were not in place at the time of the visit. There were a variety of individual and group activities on offer. A few residents had been supported to put together a book of memories. With the help of the activity coordinator one resident had written an article for the local newspaper and was very involved in arranging a party at the home to commemorate a war event. There were regular sessions from outside entertainers including reminiscence and music for health. One resident told us, There are things going on if you want them but you are not pushed if you dont, and a group of residents said they thought there was enough to do. During the course of the day a number of people were engaged in small group activities or one to one conversations with staff. Care Homes for Older People Page 15 of 28 Evidence: The staff told us that all the residents were able to make choices about most aspects of their daily lives. There was also information on care files about residents preferred routines, likes and dislikes. One resident confirmed that she chose when to get up and when to go to bed. Another said, I do as I please, they are not always telling me what to do. A number of residents told us they were happy at the home. One commented, I wouldnt want to leave here now, and another said, I am very happy with the way things are. A family carer commented that the staff, try their hardest to keep people active and included in everything. There was open visiting which helped residents to stay in contact with family and friends. A visitor told us that they always felt welcome at the home. Residents had opportunities to go out into the local community with staff. One person told us, they take us out on little trips, All the residents we asked said they liked the meals. They were described as, excellent and marvellous. One resident said, we get a choice of two meals every day, and another said, the food here is always lovely. The four week rotating menu showed that residents were offered a good variety of nutritionally balanced meals. There were fresh vegetables and fruit. Residents were offered hot drinks and snacks throughout the day and could help themselves to cold drinks at any time. The lunchtime meal on the day of the visit looked appetising. The staff worked hard to make the mealtime a pleasant and relaxed occasion. The manager had created smaller dining areas within the lounges, which seemed to be very popular. Tables were attractively laid with full place settings and vegetables were served in tureens on the table. Residents could help themselves if they wished or staff consulted them about portion size. Staff were attentive when help was needed and in most cases it was provided discreetly and sensitively. 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. Residents could be confident that their concerns would be listened to and acted upon. Procedures and training were in place to help to ensure that people were safeguarded from abuse. Evidence: There was a clear complaints procedure on display in various areas of the home and residents had copies in their rooms. The procedure was available in various languages and a large print copy was in the entrance hall. Those residents we asked said they could speak to the staff or to relatives if they were unhappy about anything but all said they had no complaints at the time. One resident said, I have complete confidence in the staff. There had been one complaint since the last inspection. There was no record of the complaint, which had been received by telephone, but there was a copy of the correspondence to the complainant which showed the issue had been investigated and resolved. There had been three allegations of abuse in the last year. In the absence of the manager there had been an initial delay in referring these to the safeguarding team. This had been investigated and systems put into place to ensure this did not happen again. The three allegations were thoroughly investigated and found to be unsubstantiated. Care Homes for Older People Page 17 of 28 Evidence: The manager had just finished putting together a safeguarding information pack for staff, which meant they had easy access to information and guidance about what to do if they suspected poor practice or abuse. There was a clear procedure to follow and contact numbers were listed. All staff had received safeguarding training in the past year, from an external training provider. The staff we spoke with said they were confident that they would be able to recognise any signs of potential abuse and knew who to report it to inside and outside the organisation. The manager was clear about her role in safeguarding and the role of the local safeguarding team. A few staff had received training to help them to understand the implications of the Mental Capacity Act 2005 with regard to residents at the home. 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. Residents live in a comfortable and homely environment. Evidence: Overall, the home was well maintained and there were systems in place for reporting and dealing with minor faults. Safety measures such as radiator guards were in place. The annual development plan included some improvements to the environment but during a tour of the building we identified other areas in need of attention. These were discussed with the manager. For example, some of seals on the double glazed windows had failed, which caused the windows to be permanently misted. A corridor carpet was in urgent need of replacement and the laundry needed attention. There had been some changes to the communal spaces, which gave residents more choice of where to sit. The manager had created some smaller dining areas within lounges. She said this helped to encourage a more relaxed atmosphere at mealtimes. There was a new quiet area for residents with a small library, which one resident told us was very useful. Lounges had a range of seating and were decorated with pictures and ornaments. One family member said, It is a homely place and all the visitors I have spoken to like it. The activity co-ordinators used an area of the main lounge for their work space. The manager said that residents had been consulted about this and did not mind. This Care Homes for Older People Page 19 of 28 Evidence: lounge was also used for moving equipment, which, although it did not present a hazard, was unsightly and intrusive. Following a recommendation at the last inspection the two downstairs bathrooms had been refurbished. There were grab rails and other aids to assist people to remain independent. Murals had also been painted in both bathrooms, which brightened them and prevented them from looking clinical. Some bedrooms had been redecorated and had new furniture. Most residents had personalised their bedrooms to make them more familiar and homely. Shared rooms had privacy screening. The residents we spoke to said they were satisfied with their rooms. One said, My room is very nice, cosy and all I need. On the day of the visit the home was clean and tidy. There was an unpleasant odour in one area of the home, which the manager was addressing. Only personal clothing was laundered on the premises and the laundry was adequately equipped for this. However, the laundry walls and flooring were in need of urgent attention in order to ensure they were easier to keep clean, which reduces the risk spread of infection. A number of staff had attended infection control training and more was planned later in the year. A member of staff told us that there were hand washing facilities throughout the home and the staff wore gloves and aprons as part of the infection control procedure for the home. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were sufficient staff, with appropriate training and recruitment practices provided safeguards. Evidence: The duty rosters showed that the home was staffed to its target levels at all times. The manager told us that there were always enough staff on duty to meet the needs of the current residents and that she had the flexibility to increase staffing levels should the situation change. The staff we spoke with agreed that there were sufficient numbers. A visitor said there were always staff around and they had never seen a resident distressed because they had to wait for staff. The manager had audited all the staff files and introduced a recruitment checklist to ensure that the recruitment procedure had been followed. We looked at the files of two recently appointed staff. They were tidy and well organised. All pre-employment checks had been carried out and, as required following the last inspection, the files included all the necessary documents and information. New staff had an initial introduction and orientation to the home then went on to do a more extensive induction programme. This covered the common induction standards recommended by the national training organisation. The programme had only recently been introduced and it was planned that it would be delivered through a mix of self Care Homes for Older People Page 21 of 28 Evidence: study and discussion with a mentor. There was a written assessment of competency to ensure that the member of staff had the basic skills to help them understand and meet the needs of the residents. The opportunities for training had improved since the last inspection. There was a training plan for the year to ensure that all staff received refresher training in the safe working practice topics. The central training record showed that this would be achieved within the next few months. A number of staff had attended other courses relevant to the needs of the residents. For example, dementia awareness, care planning and client care, which included an element of experiential learning. The development plan showed that the management team were continuing to source funding to expand the range of training available to staff. Over 50 of care staff were qualified to National Vocational Qualification (NVQ) level 2 in health and social care. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems were being put into place to improve the organisation and management of the home, which will benefit residents and staff. Evidence: The current manager had been at the home for over a year but at the time of the visit the Commission had not received a completed application for registration. The manager has many years experience working with older people and has worked at Redlands for a number of these. She has an NVQ level 4 in care and is due to start the recommended management course later this month. There were some systems to monitor the quality of the service. A number of internal audits had been carried out and action plans had been put into place. Only a few policies and procedures had been reviewed despite a recommendation following the last inspection. Residents meetings had just restarted and the minutes of the last meeting showed that residents were consulted about any changes and could put forward suggestions for improvement. A relatives meeting was due the week after the Care Homes for Older People Page 23 of 28 Evidence: visit. There was a book on display in the entrance hall where visitors could make comments about the home and a suggestions box. The manager told us these were not used often. The annual satisfaction surveys were overdue, which meant residents had not had a formal opportunity to make their views known. The manager and area manager had made a number of improvements to the service and the requirements made after the last inspection had been met. The management team discussed some of the plans for further improvements, especially in the area of care planning. Residents, who were able to, managed their own finances but most had support from their family or appointee. Small amounts of money were held for safekeeping for a number of residents. There were clear records to show all transactions made on behalf of the residents. However, receipts were not always obtained to evidence these. We looked at a small sample of records and found that they corresponded with the money held in the safe. All staff had received fire safety training. The manager carried out regular fire drills and the records showed that staff responded well. Fire alarms were tested regularly and other fire safety equipment had been serviced. The fire risk assessment was due for review. There were certificates to show that most installations and equipment in the home were regularly serviced. There were none available for the premises electrical circuits or gas appliances but we were told these were up to date. 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 8 13 Potential risks to residents 30/06/2009 health and safety must be assessed and appropriate plans must be drawn up to minimise the risks. The assessments and plans must be kept under review. In order to protect residents health and safety. 2 31 9 The manager must submit an application for registration with the Commission. In order to fulfil the requirements of the Care Standards Act 2000. 29/05/2009 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 Care plans should be sufficiently detailed to ensure that all staff provide a consistent standard of care in a way that Care Homes for Older People Page 26 of 28 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 matches the wishes and preferences of the resident. 2 3 4 9 12 16 Handwritten entries on MAR charts should be double signed to show that they have been checked and are correct. Residents should have individual care plans to assist them to meet their social and recreational needs. To assist with auditing, the manager should keep full records of complaints, investigations and actions taken to resolve them. Alternative arrangements should be made for storing moving and handling equipment to ensure that lounges remain homely and comfortable. There should be a plan for redecoration and renewal which includes realistic timescales. In order to minimise the risk of harbouring infection the area of exposed pipework in the laundry should be boxed in and the walls and floor should be easily cleanable. Policies and procedures should be kept under review to ensure that staff have access to current guidance. In order to safeguard residents and keep accurate records, receipts should be obtained for any money spent on their behalf. Records should be available to evidence that appliances and equipment are serviced and maintained in accordance with health and safety legislation and the manufacturers recommendations. 5 19 6 7 19 26 8 9 35 35 10 38 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or 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) 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. 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