Inspection on 13/11/08 for Richmond Lodge Nursing Home

This inspection was carried out on 13th November 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Richmond Lodge Nursing Home 05/12/06

Richmond Lodge Nursing Home 22/03/06

Richmond Lodge Nursing Home 01/09/05

Richmond Lodge Nursing Home 14/03/05

Richmond Lodge Nursing Home 15/11/04

Richmond Lodge Nursing Home 17/03/04

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Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Richmond Lodge Nursing Home Bede Village Goodyers End Bedworth Warwickshire CV12 0PB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Michelle McCarthy     Date: 1 3 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. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 29 Information about the care home Name of care home: Address: Richmond Lodge Nursing Home Bede Village Goodyers End Bedworth Warwickshire CV12 0PB 02476645544 02476389621 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Louise Thompson Type of registration: Number of places registered: Richmond Health Care Limited care home 51 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Richmond Lodge may also care for the named person in the application for variation of registration dated 22 March 2006. Within the 51 places Richmond Lodge may provide care for six service users between the age of 55-64 whose nursing needs require palliative care or complex nursing needs. Date of last inspection Brief description of the care home Richmond Lodge is a purpose built care home, situated at Bede Village in Bedworth. The home is registered to provide care with nursing for older people. A serious fire destroyed part of the building in June 2008. The damaged building was demolished and repair and adaptations were successfully completed by September 2008 to accomodate 26 residents. Work is underway to rebuild the damaged section of the property, but this is not adversely affecting the service provision for people currently Care Homes for Older People Page 4 of 29 Over 65 51 0 Brief description of the care home living in the home. The accommodation is a single storey building, with easy access to all areas of the home for its residents. Residents can also access the garden areas and bowling green in the surrounding Bede Village accommodation. Information about the home is given to prospective residents and their families in the statement of purpose and service user guide. Weekly fees are between £550 and £700 per week, depending on the care needs of the individual. Additional charges are made for hairdressing, chiropody, and personal items. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Before the inspection, we looked at all the information we have about this service, such as information about concerns, complaints or allegations, incidents and previous inspection reports. We do this to see how well the service has performed in the past and how it has improved. We undertook an Annual Service Review of the home on 5th March 2008, which indicated the service was maintaining good quality outcomes for people using the service. There was a serious fire in the home on 29th June 2008. Staff facilitated the safe evacuation of all the residents in the home into temporary accomodation in other care Care Homes for Older People Page 6 of 29 services. About half of the individual bedroom accomodation for residents was destroyed in the fire. The communal areas and other bedrooms were left intact. We undertook random inspections of the service on 8th July and 1st September 2008 to review the work and alterations undertaken to make the remaining accomodation safe and ready to re-admit residents temporarily accomodated elswhere. The outcome of the random inspections are included in the Environment section of this report. We looked at the Annual Quality Assurance Audit, completed and returned to us by the manager within the timescale we required. We visited the home on Thursday 13th November between 10.45am and 5.15pm. 25 people were living in the home on the day of our visit. It was the assessment of the home manager that the majority of people living in the home had medium to high dependency nursing care needs. We used a range of methods to gather evidence about how well the service meets the needs of people who use it. We talked to people who use the service and observed their interaction with staff, where appropriate. We also looked at the environment and facilities provided and checked records such as care plans and risk assessments. We talked to the manager, two nurses, an activities co-ordinator and a member of care staff. We sent surveys to people who use the service. Seven people returned survey forms to us. No comments were included, but the tick box responses to our questions indicated mostly positive experiences of the service. Three people using the service were identified for case tracking. This is a way of inspecting that helps us to look at services from the point of view some of the people who use them. We track peoples care to see whether the service meets their individual needs. At the end of the visit we discussed our preliminary findings with the home manager. What the care home does well: What has improved since the last inspection? Action has been taken to address all the requirements made at our last inspection. Residents are cared for in a way that respects their privacy and dignity. Peoples wishes for end of life care, such as resuscitation, are disussed with them, their relatives and other healthcare professionals and the multi disciplinary agreement is recorded. Records were available to demonstrate that residents are consulted about thier preferences for social activities. The manager has kept staffing levels under review to make sure there are always sufficient staff available to meet the needs of residents. Care Homes for Older People Page 8 of 29 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 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 29 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. People who are considering moving into the home benefit from having their care needs assessed so that they can be sure the home can meet their needs. Evidence: We looked at the case files of three people, admitted since our last key inspection, to assess the pre admission assessment process. The manager said that it was usual practice for a senior member of the nursing staff to visit people who are considering moving into the home to undertake an assessment of their needs and abilities. All three files contained a pre admission assessment of each persons needs and abilities. For example, staff identified that a person had a high risk of developing pressure sores and required a specialist, pressure relieving mattress. Care Homes for Older People Page 11 of 29 Evidence: This means that sufficient information was available so that the home could confirm they could meet each persons needs and develop care plans. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are treated respectfully and are protected from harm by the safe management of medicines. Care plans are available for each of the identified needs of residents and staff recognise and respond to changes in the health and well being of people living in the home. This means that people living in the home can be confident their health and personal care needs will be met. Evidence: We observed that people living in the home looked well cared for and were clean, their hair had been combed and nails were trimmed and clean. They were well presented and wore clothes that were suited to the time of year. It was evident from observation that the personal care needs of people living in the home are met. Each person had a care plan, daily records and monitoring records. Care plans were based on information secured during the pre admission assessment and supplemented by continual assessment following their admission. Care Homes for Older People Page 13 of 29 Evidence: Care plans were available for the identified needs of each person and supplied staff with the information needed to make sure the persons needs were met safely and appropriately. For example, the care plan to support one resident with their personal hygiene included, xxxx is able to choose her own clothing but needs some assistance with dressing. The care file for another resident who developed pressure sores included a care plan for treatment and wound care evaluation records demonstrate improvement and healing. The service uses risk assessments for falls, nutrition and pressure sores, which are reviewed monthly. When the outcome of the assessment identifies an increased risk, action is implemented to minimise the risk. For example, weight monitoring records for one person documented a progressive weight loss. Staff made a referral to the GP and dietician for advice to minimise the risk of poor nutrition. Food supplements were prescribed. Records in residents care files demonstrate that residents are supported to access other health care professionals such as GP, optician, dietician. speech and language therapy and chiropodist. Nursing staff communicate effectively with each other. They are aware of the needs of residents in their care and are observant of changes in their health. For example, one persons records document several requests for the GP to visit to review pain relief. We looked at the systems for management of medicines in the home. A monitored dosage (blister packed) system is used. Medication was safely stored in a locked trolley, which are kept in locked clinical room. Medicine fridges were available with daily recordings of the temperature, which was within recommended limits. Daily room temperature recordings were not maintained, so staff cannot be sure that medicines are stored within recommended limits to maintain their stability. Systems are in place for staff to see prescriptions from the GP before they are submitted to the pharmacy for dispensing. This should make sure that all medication ordered has been correctly prescribed and no new medication has been added by mistake. The facility for storing controlled drugs (CD) was satisfactory and complies with legislation. The contents of the controlled drug cabinets were audited against the controlled drug registers and the quantities were correct. Care Homes for Older People Page 14 of 29 Evidence: We audited the medicines of people involved in case tracking by comparing the quantity in stock against the signatures on the medicine administration records (MAR). The audits indicated that the medicines had been administered correctly. People living in the home were observed to be treated with respect and their dignity maintained; for example, personal care was provided in private and residents were spoken to respectfully. We observed safe practice was when staff assisted people to move using a hoist. During observation of working practice it was evident that staff are knowledgeable about the likes and dislikes of people living in the home and were kind, caring and attentive towards them. Peoples wishes for end of life care, such as resuscitation, are disussed with them, their relatives and other healthcare professionals and the multi disciplinary agreement is recorded. We saw this documented in the care files of two people. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a planned programme of activities led by activities co-ordinators so that people in the home have recreational opportunities. People benefit from a nutritious and varied diet with a good menu choice. Evidence: The service employs two activities co-ordinators, who plan and support the programme of activities in the home. Some of the activities are shared with people living independently in the apartments and bungalows in Richmond Village which means residents can socialise with the wider community. Care files examined documented the life histories of people living in the home and included details of their enduing interests and relationships. This should enable the activity co-ordinators to plan a programme that reflects the interests of the people living in the home. We talked to an activities co-ordiantor and looked at the records maintained, documenting residents participation in activities. Care Homes for Older People Page 16 of 29 Evidence: On the afternoon of our visit we observed residents involved in a game of skittles. A weekly programme of activities is distributed to residents. Several activities are scheduled for each day of the week nd, during the week of our visit, included singalong, film matinee, darts, religious services and chatterbox club. Several residents were unable to participate in group activities because of their physical frailty; activities staff spend one to one sessions with these people. The home supports the people living there to have visitors at any time. We spoke to several residents who said their visitors were always made welcome. We observed the midday meal service in the homes restaurant. Tables were attractively set with co-ordinating tablecloths, slip cloths and small floral arrangements. Nine residents attended the restaurant and three more sat at a dining table in the lounge area. The main meal of the day is served at 12.30pm and a choice is available. On the day of our visit residents chose from chicken soup followed by braised chicken in red wine sauce or mixed bean hot pot with a selection of seasonal vegetables. The dessert choice was osborne pudding and custard or mik pudding. Meals were plated by the homes chef and served by care staff. They were beautifully presented and looked tasty and nutritious. Staff were available to offer timely and sensitive assistance to residents. We observed seven staff available to serve meals and assist people. Evening meals usually offer a hot meal along with a selection of sandwiches and soup. For example, the hot meal available on the evening of ou visit was sausage and chips. Care Homes for Older People Page 17 of 29 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. People living in the home can be confident that their concerns will be listened to and acted upon. There are systems in place to respond to suspicion or allegations of abuse to make sure people living in the home are protected from harm. Evidence: The home has a formal complaints policy which is accessible to people living in the home and their families. One resident told us they would tell their family if they had any concerns so they could sort it out with the manager. We looked at the record of complaints and concerns maintained in the home documenting the action taken by the home regarding each issue raised. Evidence was available to confirm that concerns raised verbally are taken as seriously as more formal, written complaints. The service has recorded three complaints in the last 12 months concerning care practices. Evidence was available that the manager and provider makes a timely and objective response to concerns raised and the outcome is recorded. The home has an adult protection policy to give staff direction in how to respond to Care Homes for Older People Page 18 of 29 Evidence: suspicion, allegations or incidences of abuse. Staff have received abuse awareness training and the manager is aware of her role and responsibilities in safeguarding residents. The manager has made appropriate referrals to social services in response to allegations or suspicion of abuse and has worked co-operatively with other agencies during investigations. Care Homes for Older People Page 19 of 29 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. People are provided with clean, attractive, well-furnished and comfortable surroundings to live in and enjoy. Evidence: There was a serious electrical fire in the home on 29th June 2008. Staff facilitated the safe evacuation of all the residents in the home into temporary accomodation in other care services. About half of the individual bedroom accomodation for residents was destroyed in the fire. The communal areas and other bedrooms were left intact. We undertook random inspections of the service on 8th July and 1st September 2008, following building and repair to establish new accomodation, to review the work and alterations undertaken to make the remaining accomodation safe and ready to readmit residents temporarily accomodated elswhere. On 8th July we looked at 13 ensuite bedrooms in two corridors leading off the reception area. One assisted bathroom was available for the shared use of the residents accommodated in the rooms identified and a store room was converted into a sluice room. A temporary commercial laundry was to be installed in a portakabin in Care Homes for Older People Page 20 of 29 Evidence: the car park adjacent to the home. The rooms identified were not affected by fire damage but they were deep cleaned to remove any residue of dust or smell of smoke. Doors at the end of both corridors housing residents bedrooms would be sealed to restrict access to the damaged part of the building and the door from the dining area would be locked to restrict access to the central garden and duck pond area so that residents could not access the damaged or demolished parts of the building from the garden. The kitchen, reception area, communal lounge and dining area had not been damaged by the fire but were included in the deep cleaning schedule to minimise dust and smells. There was sufficient specialist equipment such as beds, hoists and specialist mattresses for people to use. A locked medicines room was created in one of the corridors with equipment to comply with the safe storage of medication. We agreed that satisfactory arrangements were in place for the re-admission of residents into the rooms identified, from 31st July 2008. We visited the home again on 1st September to examine the environment and discuss the opening and use of a further 12 bedrooms. In one corridor, seven single rooms and one double room were ready for occupation. These had up dated en-suites, with a walk-in shower, toilet and hand wash basin. In another corridor three rooms previously used as offices were converted into bedrooms with newly fitted enuite shower rooms. We agreed that the service could accomodate a total of 26 people. We made no requirements during our random inspections. During this visit we observed other changes and adaptations to the environment were complete, as follows: The Village Shop has been moved to part of the reception/coffee area. What was the Village Shop has been converted into a new hairdressing salon. An office has been converted into a bedroom with fully fitted en-suite. Care Homes for Older People Page 21 of 29 Evidence: The Library has been converted into the managers office and meeting rooms. During this visit we observed that work is ongoing to rebuild the part of the home that was damaged beyond repair in the fire and demolished. There was no evidence of any disruption to the lives of people currently accomodated at the home. The reception area is inviting and attractive. The home is decorated and furnished to a high standard with good quality furniture, giving a hotel - like feel to the environment. Chairs and furniture are grouped socially in the large, open plan communal area comprising the lounge and restaurant area, creating cosy areas and giving residents the opportunity to interact with each other. We looked at several bedrooms, including the people we case tracked. Rooms were furnished and decorated to a high standard creating an environment where residents can feel comfortable. It was evident that people are encouraged to personalise their rooms with their own items such as photographs or soft furnishings. Residents told us that their rooms were cleaned frequently. Care Homes for Older People Page 22 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient competent staff on duty to meet the needs of people living in the home. Residents are safeguarded by robust recruitment procedures. Evidence: We discussed staffing matters with the registered manager during our random inspection on 1st September. With the reduced number of residetns accomodated, it was agreed that between 8am and 8pm there would still be two registered nurses on duty. One nurse allocated to clinical administration work, while the other was in charge of the social and health care needs of the people living there. The manager told us the current staff complement for the home. Two registered nurses and between five and eight care staff are on duty between 8am and 8pm. One registered nurse and three or four care staff are on duty between 8pm and 8am. The manager is supernumerary and there are sufficient laundry, catering, cleaning, maintenance and administrative staff to ensure that care staff do not spend undue lengths of time undertaking non-caring tasks. We looked at the duty rota between 3rd November and 3rd November 2008, which confirmed the staff complement described above is achieved. Care Homes for Older People Page 23 of 29 Evidence: It was evident from the appearance of people living in the home and information recorded in their case files that there are sufficient staff on duty to meet the health and personal care needs of people living in the home. We talked to eleven residents about their experience of living in the home. Thye all made positive comments about staff including, They do everything I need, Everyone is friendly and nothing is too much trouble and Theyve worked really hard to get back to normal after the fire. Im so glad to be back here, I feel at home. We spoke to two nurses, who told us staff numbers are increased at present which is making working here very pleasant and means that there are enough people to meet peoples needs. 71.5 of care staff employed in the home have a National Vocational Qualification in Care (NVQ) at level 2 or above which, at 19 exceeds the National Minimum Standard for 50 of staff to be qualified. This means people living in the home can be certain they are cared for by competent staff. We looked at the personnel files of three recently recruited staff. Each file contained evidence that satisfactory pre-employment checks such as Criminal Record Bureau (CRB), Protection of Vulnerable Adult (PoVA), and references were obtained before staff started working in the home. These robust recruitment procedures should safeguard people living in the home. Staff training records demonstrate that staff complete an induction programme and receive mandatory training in fire safety, abuse awareness, infection control and moving and handling. Staff have access to other training resources that reflect the needs of the client group, such as dementia care, equality and diversity and end of life care. Training of staff did not take place during July and August due to the fire, which resulted in staff working in other homes, and then working together to ensure that the bedrooms and surrounding areas were useable and suitable for people to move back into. Care Homes for Older People Page 24 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is competently managed and is run in the best interests of residents. People can be confident their health and safety are promoted. Evidence: The manager has been in post for three years. She is a registered nurse and an experienced health care professional and manager. The manager and provider developed a strategic approach to renovating and rebuilding the home to facilitate the readmission of residents. This minimised the disruption to peoples lives. It is commendable that staff remained calm and professional to facilitate the safe evacuation of all the people living in the home at the time of the fire. Systems are in place to keep working practices under review and consider the opinion Care Homes for Older People Page 25 of 29 Evidence: of people using the service. The results of a customer satisfaction survey undertaken in October 2007 were analysed and an action plan was developed to respond to issues raised. This was published in the homes service user guide. Information in the AQAA completed by the manager tells us there are effective systems for maintaining equipment and services to the home to promote the safety of people in the home. A sample of service and maintenance records were examined and found to be up to date. For example, certificates were available to confirm that hoists are serviced six monthly, the Fire Officer confirmed the safety of the home in October 2008 and a certificate was available to confirm the fixed electrical installation in the home was satisfactory. A record of accidents is maintained and reviewed by the manager. Care Homes for Older People Page 26 of 29 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 27 of 29 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 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 9 Records of daily room temperature recordings should be maintained to make sure that medicines are stored within recommended limits to maintain their stability. Care Homes for Older People Page 28 of 29 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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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