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Inspection on 16/03/09 for Rose Lodge Care Home

Also see our care home review for Rose Lodge Care Home for more information

This inspection was carried out on 16th March 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Rose Lodge Care Home provides a clean and warm environment for people to live in. Visitors are made to feel welcome and people coming into the home have the opportunity to discuss their care needs before admission. People generally gave positive comments about their care and felt their health care needs were being met. One person told us `it`s a very nice place` and a relative told us they were `happy with the care so far`. The staff team are trained and supervised and people are protected by the robust recruitment procedures in place.

What has improved since the last inspection?

The previous manager had taken action to address the requirement and recommendation given during the previous inspection. People are now being recruited using safe robust procedures and risk assessments record what the risk is. A programme of re-decoration and refurbishment continues and within the last twelve months improvements included: new carpets, re-upholstering of some furnishings and the purchase of a large television and DVD player.

What the care home could do better:

A service user guide must be written and the acting manager must obtain a copy of the Care Homes Regulations 2001 and the National Minimum Standards for care homes for older people. People planning to come into the home should receive written confirmation that having regard to their assessment the care home is suitable for the purpose of meeting their needs. The Statement of Purpose should include details regarding how people can access our reports. Care plans should contain more information about how people want their care providing, as well as their abilities and include reference to the Mental Capacity Act and the effects it has upon their lives. They should be clear and show that people are given the opportunity to be involved in writing their plan of care and any subsequent reviews. Risk assessments should be written in respect of people using the electric scooter and a resident`s car. Risk assessments in place should be expanded to give staff clear guidance on the action they should take to minimise risk. The recording of medicines given must be completed without gaps in their record sheets. Regard must be given to people`s privacy and dignity whilst they are having their hair cut and set. The provision of activities must be reviewed to provide more regular and appropriateactivities for people. People should be consulted and involved in the planning of menus and a choice should be offered everyday. Records should be kept to evidence this. Records must be kept of any complaints made and the acting manager must obtain a copy of Nottinghamshire County Council safeguarding adults procedure to ensure the correct reporting process is followed should an alert be made. There must be sufficient staff on duty at all times to meet the health and welfare needs of people living at the care home. Staff should be given training to enable them to have knowledge of the Mental Capacity Act and how it influences how they support people. This will help to ensure that people`s rights and choices are protected. There must be a system in place to ensure that records are up to date and contain accurate and sufficient detail in relation to people`s finances. There must be monthly reports available for inspection to show areas of the service are being monitored to ensure the health and welfare of people living there are promoted.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Rose Lodge Care Home 88-90 Musters Road West Bridgford Nottingham NG2 7PS     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: Elisabeth Pinder     Date: 1 6 0 3 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 29 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Rose Lodge Care Home 88-90 Musters Road West Bridgford Nottingham NG2 7PS 01159455575 F/P01159455575 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Old Brompton Court Limited, c/o Mr David Wheatcroft (Shrubs) Limited care home 17 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 17 old age, not falling within any other category Additional conditions: 1 resident shall be aged 55 or over Date of last inspection Brief description of the care home 0 Rose Lodge Care Home is located close to West Bridgford town centre and the main local amenities. The home is registered to provide care care for up to seventeen older people. Communal space includes two lounges and two dining areas. There is a stair lift to the first floor and the home is well maintained throughout in terms of decoration and furnishings. There is an enclosed garden to the rear of the property with seating and shade for communal use. At the time of the inspection the acting manager confirmed that the weekly fees ranged from GBP390 - GBP494, additional charges are made for hairdressing and chiropody. Information about these costs, as well as the day-to-day operation of the home, including a copy of the last inspection report is available from the office. Care Homes for Older People Page 4 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: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced visit and it formed part of a key inspection, focusing on key standards which have the potential to affect the health, safety and welfare of people who use the service. Throughout this report the terms we and us refer to The Commission for Social Care Inspection (CSCI). The visit lasted just over five hours and took into account previous information held by us including the previous inspection report, dated 13/07/2006, their service history and records of any incidents that we had been notified of since our last visit. Before we made our visit the manager had returned the Annual Quality Assurance Assessment (AQAA). This gave us information about their own assessment of how well they are meeting standards and their plans to improve aspects of the service. Care Homes for Older People Page 5 of 29 The main method used to carry out the inspection is called case tracking, this includes following the care of a sample of people through their care records and assessing their care. We spoke to people who use the service and saw rooms of those who said we could and to two members of staff, (one being the acting manager), one visitor and a district nurse. Before our visit questionnaires had been sent to 4 people using the service and to 4 staff. Three questionnaires were returned from the people living at the home and these will be mentioned throughout this report. What the care home does well: What has improved since the last inspection? What they could do better: A service user guide must be written and the acting manager must obtain a copy of the Care Homes Regulations 2001 and the National Minimum Standards for care homes for older people. People planning to come into the home should receive written confirmation that having regard to their assessment the care home is suitable for the purpose of meeting their needs. The Statement of Purpose should include details regarding how people can access our reports. Care plans should contain more information about how people want their care providing, as well as their abilities and include reference to the Mental Capacity Act and the effects it has upon their lives. They should be clear and show that people are given the opportunity to be involved in writing their plan of care and any subsequent reviews. Risk assessments should be written in respect of people using the electric scooter and a residents car. Risk assessments in place should be expanded to give staff clear guidance on the action they should take to minimise risk. The recording of medicines given must be completed without gaps in their record sheets. Regard must be given to peoples privacy and dignity whilst they are having their hair cut and set. The provision of activities must be reviewed to provide more regular and appropriate Care Homes for Older People Page 7 of 29 activities for people. People should be consulted and involved in the planning of menus and a choice should be offered everyday. Records should be kept to evidence this. Records must be kept of any complaints made and the acting manager must obtain a copy of Nottinghamshire County Council safeguarding adults procedure to ensure the correct reporting process is followed should an alert be made. There must be sufficient staff on duty at all times to meet the health and welfare needs of people living at the care home. Staff should be given training to enable them to have knowledge of the Mental Capacity Act and how it influences how they support people. This will help to ensure that peoples rights and choices are protected. There must be a system in place to ensure that records are up to date and contain accurate and sufficient detail in relation to peoples finances. There must be monthly reports available for inspection to show areas of the service are being monitored to ensure the health and welfare of people living there are promoted. 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 –0870 240 7535. Care Homes for Older People Page 8 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 9 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. The admission procedure includes an initial assessment, which helps to make sure that the home can meet the needs of people admitted. Evidence: A review of all information available prior to the visit and the content of peoples care records, showed that people are not admitted before an assessment of their needs has been completed. One person told us she had been to look around the home but the majority of arrangements had been carried out by her son. A member of staff told us that she had accompanied the previous manager and visited a person at their home to discuss their care needs and confirmed that staff are always given information about forthcoming admissions. Records of two people who had recently been admitted were looked at and these showed information had been gathered prior to admission, although this was mainly in the form of a tick box and did not give specific details of the care required to meet needs. Letters confirming that after their assessment the Care Homes for Older People Page 10 of 29 Evidence: home could/could not meet their needs had not been sent to people and the provider who was visiting agreed to action this. One relative spoken to told us he had some information at home but had not read it yet so was unsure of the contents. Terms and conditions/contracts of residency were held on both records looked at. Information about the service is written in the Statement of Purpose and we were told that a brochure is given to people on initial enquiry. The Statement of Purpose was last reviewed in September 2008, since then the registered manager has left the home and an acting manager is now in place and this document must be updated to show these changes. The Service User Guide could not be located and the acting manager was unaware of this document but agreed to take action to produce one. The service does not cater for people with intermediate care needs. Care Homes for Older People Page 11 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal care and health care needs are being met by staff who understand their needs and deliver care in a respectful manner. However, some care plans do not record enough detail to show that individual needs and preferences are always fully met. Satisfactory medication procedures are followed for the administration and storage of medicines but there are gaps in the recording which puts people at risk. Evidence: We continued to case track a further person and looked at three care plans and risk assessments. Needs were identified in care plans but the action staff needed to take to meet the needs were unclear, for example, one persons care plan read short term memory loss, needs prompting to do some tasks. Another read staff to run the bath and check the water temperature. Not all records included peoples wishes regarding death, or recorded whether people wished to practise their religion or whether they had made a living will. None of the records looked at made reference to the Mental Capacity Act and the acting manager told us she was unaware of this legislation. Care Homes for Older People Page 12 of 29 Evidence: Records did not show that, where able, people had been given the opportunity to be involved in writing their plan of care or any subsequent reviews, however, people told us they felt their care needs were being met and felt staff respected their privacy and dignity. Daily records were written and the majority recorded fine, ate well. No records were being kept of visiting professionals to show people are able to access other healthcare services, however, the acting manager showed us a form she had written which will be used to record this information. Three surveys from people living at the home were received prior to the visit, two felt they always received the right care and support, one usually. No specific comments were made. A visiting nurse told us someone visits the home twice a day and feels it is an organised service, no one looks unkempt and staff always seek appropriate advice. During our visit the hairdresser was visiting and some people were having their hair set, however, this was being carried out in the dining room which is a public area and this was discussed with the acting manager who agreed to look into providing an alternative room for this. During the previous inspection a recommendation was made regarding risk assessments recording what the risk is and those seen during the visit had been written in relation to falls, scalding and for one person leaving the building. However, they had not been written for one person using an electric scooter or going out in another residents car and the acting manager agreed to address this. Information taken from the AQAA told us that policies and procedures concerning the receipt, storage, administration and disposal of medications were available. During our visit the acting manager was observed given people their medicines during lunch and did so in a safe way. Records looked at showed some gaps in the administration record sheets and the acting manager agreed to address this issue. We were told that the service does not have a visiting pharmacist to undertake inspections but the acting manager agreed to contact their dispensing chemist for advice. Care Homes for Older People Page 13 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to choose how they spend their time and maintain contact with family and friends. However, activities are limited and do not always take into account peoples individuality or social preferences. Meals provided are well balanced and take into account personal preferences and special dietary requirements but people do not always have a choice of main course. Evidence: Information taken from the AQAA told us that the service recognises they could improve on the provision of activities. During our visit some people told us they were able to spend their time as they liked and felt their rights and independence were always respected. Other people told us there is nothing to do and I just sit here all day and because I cannot hear very well people dont spend time talking to me. During our visit no activities were taking place, although records looked at showed that people had taken part in exercises, TV and music, nail care, bingo and dominoes. The service does not employ a designated activity co-ordinator, this role is undertaken by one of the carers whilst on duty as the second member of care staff. We were told that resident meetings do not take place and the acting manager was unable to provide evidence that people were consulted about activities. A visitor told us they were Care Homes for Older People Page 14 of 29 Evidence: always made to feel welcome and confirmed there were no restrictions on the times they could visit. Three surveys from people living at the home were received prior to our visit and these told us that 2 people felt activities were always available that they could take part in and a comment written on the other read mother has only been at Rose Lodge for ten weeks during the winter so activities have been virtually nonexistent up to yet. During our visit people were observed having their lunch in one of the two dining areas and were chatting to each other and staff whilst they ate. The menu for the day read Toad in the hole or fish fingers and fruit crumble or ice cream, however, the main menu served was sausage and onion, mashed potato and peas, rice pudding or yogurt. People told us they did not have a choice but they usually liked the food. The cook was on annual leave and the food was being cooked by one of the care staff who told us people are usually offered a choice but they had run out of fish fingers, this was discussed with the acting manager who agreed to keep records of choices offered and of what people have. Care Homes for Older People Page 15 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are not being sufficiently protected due to inadequate safeguarding procedures. People are confident that their complaints and concerns will be listened to and taken seriously but not all staff have received training in these subjects to help them protect the people they support. Evidence: Information taken from the AQAA tells us that a clear complaints procedure is available and is regularly reviewed and updated. This was available in the reception areas of the home and people told us they feel able to raise issues with staff and felt these would be taken seriously. Three surveys received from people living at the home all identified that they know how to make a complaint. The AQAA also told us that within the last twelve months one complaint had been made and one referral had been made to Nottinghamshire County Council Safeguarding team. However, the acting manager told us she did not have any knowledge of these and could not find any records to show what action had been taken or the Nottinghamshire County Council safeguarding adults procedure. Training records looked at verified that not all staff had undertaken training relating to adult abuse and although staff spoken to had knowledge of the types of abuse they did not know the correct reporting process. The acting manager told us that a course was booked for the 2nd April 2009. Care Homes for Older People Page 16 of 29 Care Homes for Older People Page 17 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 live in a well-maintained, clean, comfortable and homely environment Evidence: We took a partial tour of the home which included looking at the bedrooms of the people whose care was being followed and some communal areas. Communal areas were bright and nicely decorated and bedrooms had been personalised with photographs and ornaments. There were no unpleasant odours in the home. People told us they liked their rooms and felt very safe in the home. Information taken from the AQAA told us that carpets are regularly renewed and furniture re-upholstered. Fresh flowers are arranged in the home weekly and these were evident during our visit. Improvements within the last twelve months have also included; a large television and DVD player, new curtains and bedspreads in every room and new towels and flannels. The acting manager is supported by the handyperson who is available when needed and one domestic staff working from 07:00 13:00 Monday to Friday. During our visit the Environmental Health Officer was also carrying out an inspection and a number of recommendations were made to which the acting manager agreed to ensure were addressed. Hot water temperatures throughout the home were being monitored regularly and Care Homes for Older People Page 18 of 29 Evidence: protective covers have been fitted to radiators. Various pieces of equipment were in use during the visit including raised toilet seats and grab rails and staff spoken to told us they felt they worked in a safe environment and had access to protective clothing when needed. Care Homes for Older People Page 19 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by the homes robust recruitment procedures, but staffing levels do not always reflect care needs. Staff are adequately trained. Evidence: On the day of the visit 15 people were living at the home. Duty rotas looked at for the past two weeks showed that there were two care staff from 08:00 - 22:00 and one carer from 22:00 - 08:00 with another carer sleeping on the premises and available throughout the night if needed. In addition to this the acting manager works 08:00 16:00 Monday - Friday and a housekeeper works from 07:00 - 13:00. Carers complete all laundry tasks. During part of our visit an unannounced visit was also made by the Environmental Health Officer and staff were very busy. Staff told us they felt extra staff should have been called in to assist them and when this was discussed with the acting manager we were told that there isnt anyone, she would normally cover. However, she did confirm that she is currently recruiting one additional carer. Three surveys received prior to our visit from people living at the home told us that one person felt staff were always available, and two usually, no specific comments were written. A mixed response was received from people during our visit, one person told us they often has to wait to go upstairs to their room until staff have time, another person told us staff didnt have enough time to spend with her, and another person told us that they were quite independent but people needing help often have to wait Care Homes for Older People Page 20 of 29 Evidence: until somebody is available. A relative told us they visit everyday and there is always staff on hand. Observation of care practises during the visit showed staff to respond to people when needed and in an appropriate manner. The records of two staff recently employed were looked at and these showed that essential checks such as written references and C.R.B. (Criminal Records Bureau) checks had been carried out. Their training records were looked at and showed training undertaken as a basic induction of the home, fire training, health and safety, moving and handling, first - aid and challenging behaviour. The acting manager told us her medication training had consisted of a talk by the chemist and she was unaware of the Mental Capacity Act but confirmed she would take action to address this. Information received told us that most care staff have achieved a nationally recognised vocational award, level II and one carer is commencing level III. The acting manager told us she is hoping to commence level IV shortly. Care Homes for Older People Page 21 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This service is being satisfactorily managed, however, limited systems are in place to ensure that peoples views are listened to and there is a lack of up to date accurate records in some instances to show how aspects of the service are monitored. Evidence: Prior to our visit we had been correctly informed that the registered manager had left the home and an acting manager had been appointed for an initial three month probationary period. People told us the acting manager was supportive and available, one person said they had confidence in the new manager and felt they are now getting the training needed. No one raised any concerns. Information provided in the AQAA had been completed by the previous manager and did not tell us how the health and safety of people is promoted, apart from telling us that two people had undertaken training in the prevention and control of infection. The acting manager told us she was unaware of the Department of Health Essential Steps used to assess infection control but confirmed that she had undertaken training in June 2008. Care Homes for Older People Page 22 of 29 Evidence: Discussion and records showed that there are some systems in place to monitor the quality of the service being provided. This includes seeking the views of relatives through questionnaires, the last being undertaken in June 2008 and one comment read I have been very pleased with the care and attention shown to my mother. A discussion was held with the acting manager regarding sending questionnaires to people living in the home, staff, GPs, district nurses and any other people who use the service and she agreed to look into this. Information provided in the AQAA told us that there are a range of policies and procedures in place and the majority of these had been reviewed and most were dated August 2008. We were also told of equipment maintenance and service dates. Financial records of the people case tracked were looked at and two of these were inaccurate, one was two pounds short and the other one pound over, the acting manager agreed to look into this and ensure future records are up to date and accurate. The acting manager did not have a copy of The Care Home Regulations 2001 or the National Minimum Standards and although the provider visits the home regularly no monthly reports about his visits had been completed, which are required by law. Care Homes for Older People Page 23 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 24 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 1 1 5 A written guide must be 30/04/2009 produced (referred to in the Regulations as the service users guide) which will include all the information required by law as listed in Regulation 5 of The Care Homes Regulations 2001. To ensure people have the right information about the service. People planning to come into 30/04/2009 the home should receive written confirmation that having regard to their assessment the care home is suitable for the purpose of meeting their needs. To ensure people are confident the service can meet their needs and are clear about the service that has been agreed. 2 3 14 Care Homes for Older People Page 25 of 29 3 7 15 A system must be in place 30/04/2009 to ensure that after consultation with the person or a representative of theirs, revise the plan of care and notify the person of any such revision. To ensure that information is available for staff to refer to about indiviudual needs and how they are to be met and show people are given the opportunity to be involved in their plan of care. The recording of medicines given must be completed without gaps in their record sheets. To ensure people receive their medicines safely. 30/04/2009 4 9 13 5 12 16 The provision of activities 30/04/2009 must be reviewed to provide more regular and appropriate activities for people. To will ensure as far as possible that they are able to lead fulfilling lives, which meets their needs and wishes. 6 18 13 Policies and procedures 30/04/2009 must be available which include the reporting process for any safeguarding referrals. Care Homes for Older People Page 26 of 29 To ensure any safeguarding alerts are effectively followed up and people are protected from harm. 7 27 18 There must be sufficient staff on duty at all times to meet the health and welfare needs of people living at the care home. To ensure people are confident their needs will be met. 8 31 26 The provider must carry out monthly visits and a written report must be available for inspection to show areas of the service are being monitored. To ensure the health and welfare of people living there are promoted. 9 37 17 There must be a system in 20/04/2009 place to ensure that records are up to date and contain accurate and sufficient detail in relation to peoples finances. To ensure people are safeguarded by the financial procedures of the home. 30/04/2009 30/04/2009 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 Risk assessments should be written in respect of people using the electric scooter and a residents car. Risk Page 27 of 29 Care Homes for Older People assessments in place should be expanded to give staff clear guidance on the action they should take to minimise risk. 2 7 It is recommended that care plans include reference to the Mental Capacity Act and the effects it has upon peoples lives. It is strongly recommended that care plans contain more information about how people want their care providing, as well as their abilities. To enable staff to provide the right level of care and support. The home should be conducted in a manner which respects the privacy of people living there. To ensure that peoples privacy is maintained at all times. People should be consulted and involved in the planning of menus and a choice should be offered everyday. Records should be kept to evidence this. Records must be kept of any complaints made. To ensure people are confident their complaints will be taken seriously and acted upon. Staff should be given training to enable them to have knowledge of the Mental Capacity Act and how it influences how they support people. To ensure that peoples rights and choices are protected. 3 7 4 10 5 15 6 16 7 30 Care Homes for Older People Page 28 of 29 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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