Inspection on 18/12/08 for Rowlandson House

This inspection was carried out on 18th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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Moor House

Mendip House

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Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Rowlandson House 1 Rowlandson Terrace Ryhope Road Sunderland SR2 7SU     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: Rachel Martin     Date: 1 8 1 2 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 © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Rowlandson House 1 Rowlandson Terrace Ryhope Road Sunderland SR2 7SU 01915144125 01915144125 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Rowlandson House Limited care home 33 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 33 The registered person may provide the following category of service only: Care Home only - Code PC To service users of the following gender: - Either Whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category - Code OP, maximum number of places: 33 Dementia - Code DE, maximum number of places 10 Date of last inspection Brief description of the care home Rowlandson House is a residential care home. It is registered with CSCI to accomodate up to 33 older people. Up to 10 of these people may have specialist care needs due to dementia. It can not provide nursing care. The home has been taken over by a new owner, Rowlandson House Limited, who registered with CSCI in May 2008. The registered manager is Elizabeth Doreen Milner. The home is close by the junction of Villette Road and Ryhope Road, near the city of Sunderland. It is a victorian terraced property that has been converted for use as a care home. The communal facilities and bedrooms are located over three main floors, accessible by passenger lift and stairs. A Care Homes for Older People Page 4 of 29 Over 65 0 33 10 0 Brief description of the care home small number of bedrooms can only be accessed by stairs, so they can only be used by people who can mange this independantly. Communal facilities on the ground floor include two dining areas and two good sized lounges. There is a small paved parking area at the rear of the property and small garden area to the front. Up to date information about the homes fees and terms and conditions should be sought directly from the homes manager. 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: 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 the first inspection of Rowlandson House since it was taken over by a new owner. Before the inspection we sent the home a self-assessment to complete and return. The manager says she returned this to us on time, but there is no record of this in our systems. The manager has sent us another copy of the completed self assessment, but unfortunately this electronic copy has corrupted and we cannot read it. We also sent some surveys to the home for staff and people who use the service to complete. However, none of these had been returned before this report was written. We completed a site visit on 18th December 2008. The visit was completed by one inspector, who spent 9 hours at the home. During our visit we talked to the manager, staff and some of the people who live at Rowlandson house. We spent time observing Care Homes for Older People Page 6 of 29 what happened in the home, including how staff looked after people and the lunchtime meal. The manager showed us around the home and we looked at a selection of the homes records. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: We found that some care plans and risk assessments were not fully completed or being reviewed as often as they should be. This is important so that staff have comprehensive and up to date information about the care people need. Improvements are needed in the way that the home manages controlled drugs. These are drugs that have special rules to make sure they are stored and used safely. At the time of the inspection the home was not recording the storage and administration of these drugs very well. Rowlandson provides a comfortable and homely place to live, although the property would benefit generally from redecoration and refurbishment. This is important so that people continue to have a pleasant and well maintained place to live. Care Homes for Older People Page 8 of 29 We found that new staff sometimes start work before all of the required checks have been completed. This means that people arent always being fully protected by the homes recruitment practices. At the time of this inspection the homes manual handling equipment inspection was overdue. This is important, because the inspection makes sure that equipment is safe to use. 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 have their needs assessed before moving into Rowlandson house and can visit first to see if they like the home. This helps to make sure that the home can meet peoples needs and is somewhere they want to live. Evidence: We talked to the manager about new admissions to the home and looked at some peoples records. The manager told us that anyone who wants to come and live at Rowlandson House has to have their needs assessed first. This helps the home make sure that they can meet the persons needs. She also told us that people can come to look around the home to help them decide if it is the right place for them. We looked at three peoples assessment records and found that these contained assessments by the homes manager and information that had been gathered from other professionals involved in the persons care. For example, an assessment by social services or information from hospital. The manager was also able to describe to us how she asks Care Homes for Older People Page 11 of 29 Evidence: for re-assessments if peoples needs change and if necessary will support that person to move to a more appropriate service. For example, someone had recently needed to move into a nursing home because Rowlandson House could no longer meet their needs. People had terms and conditions in with their records, although these had been put in place by the homes previous owner. The manager told us that the homes terms and conditions are in the process of being updated to reflect the homes change in ownership. It is important that this happens quickly so that people have valid and up to date terms and conditions. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive the care they need from well meaning staff. However, care records need to be fully completed and kept up to date. Improvements are also needed in the way controlled drugs are managed, so that people are protected by robust recording arrangements. Evidence: The manager told us about the work she had been doing to improve the homes care records, because she recognised that this was something that needed to be improved. This work had included developing a new paperwork system that she had put in place for one person and planned to use throughout the home. We looked at three peoples care records, including the one with the new paperwork. The new paperwork included assessments, risk assessments, care plans and records of the care people had received. There was some good detail about peoples abilities and needs. For example, the dietary care plan told us that the person could eat independently, but needed staff to help cut up their food and to spread butter and marmalade on their toast. It also told us that they couldnt have grapefruit juice because of their medication. However, Care Homes for Older People Page 13 of 29 Evidence: the other records we looked at still needed to be improved. Not all of the relevant risk assessments had been completed. For example, one persons manual handling assessment, falls risk assessment and nutritional assessment were blank. Reviews and evaluations were also not up to date, with one persons records not having been reviewed since September. The National Minimum Standards say that care plans should be reviewed monthly, or more often if someones needs change more frequently. This is important so that staff have clear and up to date information available about the care people need. The older records were also less detailed than the new ones. For example, they told us that someone used two pieces of manual handling equipment, but didnt specify which ones. The records that we looked at showed that people got help from other health professionals when they needed it. During our visit one person went out for a health appointment and another met with family, their advocate and social services to discuss their care needs. The home was monitoring peoples weight regularly and the records we looked at showed that people were either maintaining or gaining weight. Where people needed continence aids their needs had been assessed by the relevant professional and continence products were supplied on a regular basis. We saw care staff providing care and interacting with people throughout our visit. Staff chatted with people and had a nice manner. We heard staff asking people what they wanted and offering choices. Personal care was done in private and people generally looked clean and tidy, although we did notice that one person we talked to needed their glasses cleaning. Comments from people using service included oh, they are alright (the staff), they are nice and this place is okay, its me thats wrong, Id rather be at home. People were generally happy with their care and the staff. We looked at how the home helps people with their medication. They use a monitored dosage system that is supplied on a monthly basis from a local pharmacy. Medication in this system appeared to be managed and administered safely. However, at the time of our visit the home wasnt using a dedicated medications fridge and kept any medications that needed refrigerating in a container in the kitchen fridge. It would be better practice to have a small, secure fridge that is only used to store medication. The manager told us they were waiting for one to be supplied by their pharmacist. Each persons medication administration record (MAR) didnt have their photo on it, although the manager told us that they were in the process of taking peoples photographs so that they could do this. Having photographs on MAR charts is important because it helps staff identify people and reduces the risk of medication being given to the wrong person. We also found that the home needed to improve the way that controlled drugs are recorded and administered. The controlled drugs register (an important legal record) did not accurately reflect the stock of controlled drugs that Care Homes for Older People Page 14 of 29 Evidence: the home had and was not always being updated properly by staff when they gave people their medication. For example, the controlled drugs register said that they had 22 tablets of one persons medication in stock, when they actually had over 100. The manager has informed us that they carried out a full audit of controlled drugs with their pharmacist the next day and that staff have been re-trained to make sure they know how to use the controlled drugs register properly. 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. People have the opportunity to take part in social events and activities. Staff try to keep routines flexible and offer choices. A varied menu of meals and snacks is provided, with different choices available. Evidence: The home is currently trying to recruit an activities coordinator who will help to develop the activities and social stimulation provided at the home. However, the home does use social care trainees from the local colleges, who work in the home helping to do activities. For example, talking to people, doing manicures, quizzes and games or reading to people. Staff told us that there was plenty going on and we saw that activities and trips were planned during the Christmas period. For example, the notice board advertised a trip to a local church carol concert and a party night with a singer/entertainer was taking place that evening. During the day we heard nice Christmas music playing, saw school children visit to sing carols, heard a staff member offer one lady a manicure and saw staff interacting cheerfully with people. We found that peoples care records didnt contain a lot of information about their wishes and preferences regarding social events and leisure activities. For example, what people liked to do or would be interested in taking part in and the support they needed from Care Homes for Older People Page 16 of 29 Evidence: staff to do these things. Activity sheets had been introduced to record the activities that people took part in, but these had not been completed for a long time. Staff told us that they try to keep routines flexible. They told us that breakfast usually takes place between 8am and 10am, so that people can get up when they want. Staff also said that people can stay up late if they want to or go to bed early if they are tired. People we spoke to who live in the home generally agreed with this. During our visit we saw staff offering people choices, such as drinks, snacks, asking what they wanted for meals, if they wanted to attend the carol concert and where they wanted to spend time (for example, in their room or in one of the lounges). We thought that some of the care records we looked at could be improved if more details about peoples preferred routines and preferences were included. For example, peoples preferred times for getting up or going to bed, if they like a bath or shower and when they would prefer to have one. This would help to make staff more aware of people preferences and better able to provide care in the way that people prefer. The manager told us that the home has an open visiting policy, so that people can come and go when they want to. We saw visitors coming and going during our inspection and those we spoke to confirmed this. On the day of this inspection a group of local school children visited the home to sing carols and there was a trip planned to the local churchs carol concert. One person went out for a hospital appointment and another went out with a family member and their advocate for a meeting. We saw staff offering people choices at meal times and the manager showed us the pictorial menus she is developing to help people decide what they would like to eat. On the day we visited there were two main options for lunch. Liver and onions or pork, both served with gravy, vegetables and mashed potatoes. There was a choice of pudding too. Some people didnt want the main options, so the cook prepared them sandwiches or an omelet instead. We thought the food looked appetising and peoples comments included oh thats okay too (the food), its lovely and very nice that liver, I love liver. Staff told us that there are snacks, such as crisps, biscuits and fruit, available with tea and coffee in the morning and afternoon. Staff also said that they can always get someone something to eat if they are hungry, even during the night. People got plenty to drink during the day, with us seeing drinks being offered in between meals and staff providing plenty of top ups to drinks during meal times. 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 feel that they can raise issues with staff and the manager and that any concerns will be dealt with appropriately. Evidence: People we spoke to said that they could talk to staff if they needed to. Staff told us that they had been trained in abuse and the protection of vulnerable adults and would report any concerns they had to the manager. One staff member commented that the manager was approachable and that the residents always come first with her. People felt that concerns would be handled properly and that small issues were usually put right straight away. There have been no formal complaints or concerns raised directly with CSCI since the new owner took over the home. Care Homes for Older People Page 18 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Rowlandson House provides a comfortable and homely place to live, although the property would benefit generally from redecoration and refurbishment. This is important so that people continue to have a pleasant and well maintained place to live. Evidence: Rowlandson House is a terraced property that has been converted into a care home. The accommodation is arranged over three main floors, which can be accessed using the stairs or a passenger lift. However, some bedrooms are only accessible by stairs and should only be occupied by people who are mobile and can access them independently. Downstairs there is a kitchen and the main communal areas, which include two dining areas and two separate lounges. There is limited outdoor space, with a paved parking area at the rear and a small area at the front. We looked around the building with the manager. The home is decorated in a comfortable and homely style. Staff had made a real effort to decorate the home for Christmas, with lots of cheerful decorations throughout the communal areas. However, we noticed that some parts of the home and some of the furnishings looked a little worn. For example, furniture and carpets looked past their best and there was an unpleasant smell noticeable in some areas. We talked to the manager about this. She told us that the new provider was investing in the home and improving the Care Homes for Older People Page 19 of 29 Evidence: environment. The manager showed us some of the bedrooms that had recently been redecorated and told us that new furniture and carpets had been ordered and would be fitted in January. It is important that this work continues so that people have a pleasant and well maintained place to live. The home appeared clean and tidy and people we spoke to confirmed that this was usually the case. We saw domestic staff cleaning the home during our visit. We also saw care staff washing their hands and using anti-bacterial hand gel during the inspection. Care Homes for Older People Page 20 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. Staff are provided in appropriate numbers and training is being provided to help them do their jobs well. However, new staff sometimes start work before all of the required checks have been completed. This means that people arent always being fully protected by the homes recruitment practices. Evidence: Staff we spoke to told us that they thought staffing levels in the home were appropriate, particularly with the input of the trainees from the local college who help with activities and social stimulation. Staff confirmed that the trainees do not help people with personal care, but help set tables and do social activities like manicures and reading to people. At the time of the inspection there were twenty-four people living at the home and usually two care staff, a senior carer, one or two trainees and the manager on duty in the home during the day. Two carers were on duty at night. The manager confirmed that they are currently recruiting a deputy manager, more senior care staff and an activities coordinator to help improve the staff team. Comments made to us about the staff included oh they are alright, theyre nice (the staff), we have a good staff team at the moment and loyal and here for the right reason, they care. We saw that staff were usually available in the communal areas, providing the supervision and support people needed. Care Homes for Older People Page 21 of 29 Evidence: We checked the recruitment records for three staff who had started work in the home over the last year. These showed that the home had carried out criminal records bureau disclosures (CRBs) and obtained two written references for the new staff. However, the records showed that two of the staff had started work before the manager had received their second references. One persons records didnt show when their CRB disclosure had been completed, so we couldnt tell if it had been completed before they started work. It is important that staff do not start work before the necessary checks and references have been completed or the home may employ unsuitable people. We talked to the manager and she told us that she wanted to improve the training that is provided. She has been working hard to gather information about courses and training providers and had a training matrix on her wall, which helped her to see which staff had completed training and what training was needed. Staff told us that training was being provided and that recent staff training had included managing challenging behaviour, mental health and dementia care. Training records showed us that staff had also completed training in fire safety, food hygiene and manual handling recently. Not all training was up to date, but the manager was aware of this and is taking appropriate action. Care Homes for Older People Page 22 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 managed by an appropriate person, who tries to put the needs of the people living in the home first. Maintenance systems and safety checks help to keep the home safe, although the homes manual handling equipment inspection is overdue. Evidence: The manager of the home is registered with CSCI and is experienced at managing a care home. Comments made to us about the manager during this inspection included I really cant fault her, shes been there through and through for us many times, approachable and supportive, talks us through everything and the residents always come first with her. Since the last inspection the home has been taken over by a different owner. The new owner was registered with CSCI in May 2008. The manager told us that the new owner listens to her and is investing in the home. For example, they are now recruiting a deputy manager, painting and decorating upstairs bedrooms and arranging for new carpets and furniture to be delivered in January. The manager and staff told us that they feel the home is going in the right direction. Care Homes for Older People Page 23 of 29 Evidence: The home has in place appropriate systems to help people manage small amounts of personal money. We saw that peoples money is stored securely. We check a selection of records and found these to be accurate and up to date, although some were written in pencil. It would be good practice to always use pen so that records can not be altered. We discussed how the manager makes sure that people are happy with their care and that the home is providing a good service. Staff now receive regular supervision sessions to make sure they are working well. We saw records of some of these sessions and the staff we talked to confirmed that they take place. The manager told us that she carries out spot checks on records, bedrooms and medication to make sure things are being done properly. There are also staff and residents meetings and the new owner and manager try to spend time with people, talking about their care to make sure that people are happy. The manager told us that she thinks it is very important to spend time on the floor observing what staff are doing and making sure people are happy. Staff told us that the manager is fair, but will tackle any problems and makes sure that staff are doing things properly. The home appears to have suitable systems in place to manage health and safety. The manager told us about the regular health and safety checks she does to make sure the home is a safe place to live and work. Records of these checks were available and showed us that they take place. We looked at the homes accident records, which showed that staff were reporting and recording accidents appropriately. Few accidents occurred in the homes communal areas, suggesting that people get the staff supervision they need in these areas. Most accidents occurred while people were unsupervised in their own rooms. Staff were aware of the importance of staff always being around to support people and make sure they were safe. We looked at a selection of maintenance records. These showed that the majority of maintenance tests and services were up to date. For example, the nurse call system had been serviced in November and the lift had been serviced in July. Regular safety checks were being carried out to make sure the fire alarm was working and that hot water was at a safe temperature. However, the required six monthly safety inspection of the homes lifting equipment was over due. This is important because it makes sure that lifting equipment is safe to use and is required by health and safety legislation. We also noticed that the homes fire risk assessment appeared quite brief and was not dated. It had been put in place by the homes previous owner and was only one page long. Care Homes for Older People Page 24 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 25 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 7 15 Care plans and records must 28/02/2009 be fully completed, kept up to date with monthly reviews (more often if changes in need require this) and should provide detailed information about peoples care needs, abilities and preferences. Staff need access to comprehensive and up to date information about peoples needs. If care plans and assessments are incomplete and have not been regularly reviewed staff may not have the information they need to meet the persons needs. 2 9 13 The home must maintain up 31/01/2009 to date and accurate records of all controlled drugs. The home is not meeting its legal obligations if accurate records are not kept in a controlled drugs register. Care Homes for Older People Page 26 of 29 3 29 19 Staff must not start work 31/01/2009 until the home has obtained two written references and a CRB disclosure (or in exceptional circumstances a PoVA First check). Unless the required checks are completed before new staff start work the home is not adequately protecting people from potentially unsuitable staff. 4 38 23 The homes lifting and 31/01/2009 handling equipment should be inspected by a competent person on a six monthly basis to ensure that it is in safe working order. Health and safety legislation (Lifting Operations Lifting Equipment Regulations) requires that six monthly safety inspections are carried out on lifting equipment. Unless equipment is inspected by an appropriate person it may not be in a safe condition to use. 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 2 2 9 The homes terms and conditions should be updated to reflect the change of ownership. Each persons MAR charts should include a photograph of the person. This will help staff who administer medication to recognise people and reduces the risk of medication being given to the wrong person. Care Homes for Older People Page 27 of 29 3 4 9 12 Medication that needs to be refrigerated should be kept in a secure refrigerator that is only used to store medication. Care plans and records should contain more information about the social events and activities that people are interested in and the support they need from staff to achieve these things. Care plans and records should include more detail about peoples prefered routines. For example, preferred times for getting up and going to bed, if they prefer a shower or bath and when/how often they would like this to happen. The home should be generally refurbished and improved, to provide people with up to date facilities, furnishings and more pleasant surroundings. Records should be written in pen rather than pencil. This means that records can not be rubbed out and changed inappropriately. The current fire risk assessment should be reviewed to ensure that it covers all of the necessary areas and is up to date. It should also be clearly dated and regularly reviewed. 5 14 6 19 7 37 8 38 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 © (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. 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