Inspection on 08/07/09 for Springfield House Residential Care Home

This inspection was carried out on 8th July 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Springfield House Residential... 17/08/09

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Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Springfield House Residential Care Home Springfield House North Hill Cornwall PL157PQ     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: Helen Tworkowski     Date: 0 9 0 7 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 32 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 32 Information about the care home Name of care home: Address: Springfield House Residential Care Home Springfield House North Hill Cornwall PL157PQ 01566782361 01566782169 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Mohammad Jahmeerbacus Type of registration: Number of places registered: Cornish Care Ltd care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 23. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) Dementia aged 65 years or over on admission (Code DE(E)) - maximum of 6 places Mental disorder aged 65 years or over on admission (Code MD(E)) - maximum of 6 places 0 0 0 Over 65 6 6 23 Care Homes for Older People Page 4 of 32 Date of last inspection Brief description of the care home Springfield House is located in the rural village of North Hill, which is between Liskeard, Callington and Launceston. The home is registered to provide care for 23 older people some of whom may have dementia or mental health needs. The home has a large lounge, a conservatory and a dining room. In addition there is a lawned garden to one side of the house, and a smaller enclosed courtyard garden near the dining room. The bedrooms are on the ground and first floor, and there is a stair lift for people who have difficulties climbing stairs to the first floor. Six of the rooms are arranged in pairs, so whilst each pair of rooms shares a small lounge area, they also only have borrowed light. Four of the bedrooms have ensuite toilets. Information about the services provided in the home can be obtained from the home. Up to date information on fees is available in from the home. Items not included in the weekly fee are chiropody, hairdressing, newspapers, and personal toiletries and clothing. Care Homes for Older People Page 5 of 32 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 Key Inspection, which looked at all areas of the service provided at Springfield House. This was the first inspection under the new management of Cornish Care Ltd, and Mr Jahmeerbacus. As part of the inspection process we asked Mr Jahmeerbacus to complete an Annual Quality Assurance Assessment, however no completed document has been received. We sent surveys to all of the people who live at Springfields and to the staff, we received six surveys back from staff, and one from a person who lives at the home. As part of this inspection we spoke with a visiting district nurse and the relative of someone who lives at the home. We visited the home on two occasions, the first time on 8/7/09 between 9.45 a.m. and 5.00 p.m, and the second time on 9/7/09 between 1.30 p.m. and 5.30 p.m. During these visits we looked around the home, we spoke with six of the residents and looked at the care of four individuals. We looked at the Care Homes for Older People Page 6 of 32 records of care, and various documents and also at the medication system. We spent time in the dining room and observed what happened over lunch time. We spoke with four of the staff in the home, and looked at recruitment and training records. We also spoke with the owner/ manager Mr Jahmeerbacus, and looked at records relating to the management of the home. What the care home does well: What has improved since the last inspection? 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 Care Homes for Older People Page 8 of 32 7535. Care Homes for Older People Page 9 of 32 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 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who move to Springfield House can be assured that there needs will be known about, however this will not be in sufficient detail to ensure that they can be consistently met. Evidence: We asked Mr Jahmeerbacus for a copy of the Statement of Purpose and Service User Guide. These are documents that must be available. The Service User Guide gives people who are thinking about moving to the home information about what they can expect, and a copy of any contracts or terms and conditions that would be expected to sign. Mr Jahmeerbacus explained that these documents were not available in the home, however he had copies elsewhere. We looked at pre-admission assessments for a person who have recently moved to the home. We found that there was evidence to show that an assessment had been done, however the information was very limited (18 lines in total). The information did Care Homes for Older People Page 11 of 32 Evidence: provided a clear reason why the person was moving to the home, which included a high risk of falls. But there was no evidence of any assessment in relation to falls. Also there was no evidence that this had been used to develop the care plan. Care Homes for Older People Page 12 of 32 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 at Springfield House feel happy with the standard of care. The information and guidance to staff as to how to provide care or to avoid harm (risk assessments) do not address all the issues they should, lack detail and the residents have not been consulted in this process. Medication is poorly administered and managed, therefore people cannot be confident that they will get the medication to which they are entitled. Evidence: We talked with people who lived at Springfield about the help they receive. They told us that they were happy with the care and support received, and that staff were kind. We asked one person who had recently moved to the home if she had been shown or had had discussed a Care Plan, she told us she had not seen such a document. Care Plans are documents which specify the help people need to meet their assessed needs. Residents should be consulted about their care plans and their agreement to any plan should be recorded. Care Homes for Older People Page 13 of 32 Evidence: We looked at a number of care plans for people who had recently moved to the home, and for those who had lived at Springfield for some time. Mr Jahmeerbacus told us that he was considering changing these documents, and wanted to get staff more involved in contributing and writing these documents, in the future. We consider this to be a very positive change. The documents that are currently being used to guide care provide very limited information, for example for one person it states that in relation to their oral care, that they their own teeth. There is no indication of whether they need any assistance to clean them, or in relation to attending a dentist. For another person their plan indicated that they would need help to change and dress, but their was not indication of what help they would need. When we looked at peoples bedrooms we noted that one person had significant problems with continence, however their was no mention of this difficulty in the care plan, or how it would be managed. We looked at the care and support of one individual who had significant difficulties in relation to dementia. We found that the information in the care plan did not fully reflect their care needs, risks that existed or restrictions that were placed on the choices they made. Because of particular concerns for this person, an immediate requirement was made to review this individuals care. As part of this visit we spoke with a visiting District Nurse, who considered that the home manage the care of people very well. She confirmed that staff called the District Nursing Service when needed, and followed any advice or guidance they were given. We looked at Risk Assessments, and found that these had not always been completed. As has already been noted one person had been specifically admitted to the home because of a high risk of falls. However there was no evidence of a risk assessment or any actions taken to try and avoid falls or lessen the harm of a fall. We looked at the way the medication system works with one of the senior staff. We were told and saw that the home is supplied with medication from two different pharmacists, one whom supplies medication in blister packs prepared by the Pharmacist, the other provides medication in its ordinary packaging. Mr Jahmeerbacus told us that he was in the process of reviewing the way the medication system operates. During the visit we saw that medication to given to people had been prepared in advance, and placed in little pots. Some of the pots had peoples names on others, not. This practice, often known as potting up , is poor because an unnecessary element of risk is introduced. We also noted that at the bottom of the medicine trolley there were 4 pots with tablets in, the senior care worker thought that these might have related to someone who had refused their medication, but could not Care Homes for Older People Page 14 of 32 Evidence: be sure. There must be a proper procedure in place and operation for medication that is declined. We asked one of the staff about what happened if people refused medication. She explained that they went back later and offered it again. However, she also said that on occasions in the past medication had been placed in the individuals food, without their knowledge or any agreement. Where an individual refuses medication and lacks the capacity to make such a decision, then the Mental Capacity Act Guidance must be followed to ensure that the persons best interests are considered. We looked at the system for recording medication, and saw that the sheets are handwritten. We asked where this information came from, and was told that it was from the previous months sheet. This means that if an error is made one month then it will be transcribed to the next month and so on. Where staff handwrite such documents then these should be signed by the individual, and checked and signed by a second person. We also noted that there were no times for giving medication on these sheets. It must be clear at what time medication is given. Some people have been prescribed painkillers, and can be offered one or two tablets, but there was no record of how many tablets were actually given.Where there is a variable dose there must be a record of the amount administered. We also saw that one person was given medication as required. We were told that this medication had not be given for some time; where such medication is prescribed there should be clear guidance for staff as to the circumstances when such medication should be administered. This helps ensure that the person gets their medication when they need it. We asked if people were on occasions give other peoples medication. A staff member confirmed that this some medication, such as Lactulose, people were given medication from other peoples supply. Medication belongs to the individual and must only ever be used for that person. When we looked around the home we found that there were tubs of various creams. Some of the tubs had the names ripped off, one was broken; there was no record of any administration of these creams. Creams and lotions are as much a part of a persons medication as tablets. There administration must be recorded, a sheet may be kept in the individuals room if this is most appropriate. We asked to see the controlled drugs system, and was shown a filing cabinet that contained drugs that did not appear to be controlled. We were told that these drugs are transfered in and out of the drugs trolley each day. This system of management of controlled drugs is not appropriate. The home must have a controlled drugs cabinet that meets the guidelines in the legislation. We looked at the record of administration of these controlled drugs, and found that they had not been signed for on the Care Homes for Older People Page 15 of 32 Evidence: previous day. During a tour of the building we noted that a number of bedroom, toilet, and bathroom doors had vision panels in them. Such panels do not enhance the dignity of people in the home, and should be covered. We also noted that all bedroom doors had locks. We were told that one person had a key, but other people asked a member of staff if they wanted to go to their room. We were concerned that this practice would mean that people did not have access to their rooms, however when we spoke to some of the residents they said that this was not a problem, and that staff were always available. Care Homes for Older People Page 16 of 32 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 at Springfields are provided with a good standard of meals that they enjoy, however the mealtimes can be rushed and lack any sense of occasion. People have the opportunity to make choices about their daily lives including when to get up and go to bed. Evidence: We spoke to a number of people at Springfields about rules, and was told that there arent any. We were told that people could get up and go to bed when they chose, at a time that suits them. We looked at the daily records to see if people were offered the opportunity to participate in activities. There was very little recorded to show that people were offered activities, however when we spoke to staff they confirmed that they did take people out for walks and into the small enclosed garden. On the day of the visit, an entertainer was visiting the home. We were also told of a range of activities in the home. We asked some of the people at Springfields what they thought about the food, they Care Homes for Older People Page 17 of 32 Evidence: said that it was good, one person described it as marvelous. We were told that there is no choice on the menu, but that people could ask for something different if they wished. We sat with a group of people whilst they ate their lunch. People clearly enjoyed the food, but the dining experience was not very pleasant. There are two areas of the dining room, we found that the one adjacent to the kitchen area was very noisy and it was difficult to hold a conversation because of this. The tables were not properly laid, there were no condiments. We observed one person being helped to eat by staff. The person was fed with kindness, but with great speed such that there was no gap between the main course and pudding. The same spoon was used for both courses. The person was only offered a drink at the end of the meal. We also observed that a member of staff put clothes protector on someone who appeared not to need it, we asked the individual about this. She said that she didnt know why she was wearing it, a member of staff had just put it on her without asking. People need to be offered the opportunity to enjoy their food, in pleasant surroundings, where they do not feel rushed. Care Homes for Older People Page 18 of 32 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. The people who live and work at Springfield House can feel confident that any concerns or issues they raise will be dealt with appropriately. Evidence: We spoke to some of the people who live at Springfields and asked them if they felt confident in raising any concerns, and we were told that they were confident. The home has received two complaints, both of which were appropriately investigated and responded to by Mr Jahmeerbacus. Staff we spoke felt able to approach Mr Jahmeerbacus with any concerns or issues that they might have. Staff responding to the survey said that they knew what to do if someone has concern about the home. We looked at staff training in relation to Safeguarding or Adult Protection, Mr Jahmeerbacus told us that no one had received this training since he had taken over, but that he was aware of the need for all staff to have training in this area, and that this would be arranged. Care Homes for Older People Page 19 of 32 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. The home is generally well decorated and comfortable, however one of the bedrooms was of a very poor standard. Vision panels in the doors of bedrooms, shower rooms and toilets mean that peoples privacy may not be respected. There is a lack of basic facilities such as soap, hot water, and towels; these basic measures would help avoid the spread of an infection. Evidence: We looked around the whole of the home as part of this inspection. The majority of the bedrooms were in good order. Rooms that had recently been refurbished provided a good standard of accommodation. Some of the refurbished bedrooms had en suite facilities. A number of the bedrooms that had not been refurbished had vision panels in the door. One of the staff told us that some people found that the light from these panels kept them awake. People who live in a care home have a right to privacy and such panels mean that anyone passing in the corridor could see into the room. We saw that some of the bedrooms had been created by the subdivision of a large room with a bay window, to create two small bedrooms, and a lounge in the bay. The effect of this was that the bedrooms only had borrowed light. We also noted that one of these lounges was being used to store hoists that are not in use. This is not appropriate. Care Homes for Older People Page 20 of 32 Evidence: We noted that many of the bedrooms did not have low surface temperature radiators or radiator covers. Lying against a hot radiator can cause a serious burn. No risk assessments were available to show that appropriate action had been taken to protect individuals from injury. One of the bedrooms we saw stood out as being of a very low standard. The flooring in the corridor was damaged and dangerous. This was repaired before the end of the inspection. The room smelt of urine, and had not been recently cleaned. There were urine stains on the wallpaper and on the window ledge, indicating that an attempt had been made to clear up the urine some days before, but it had been left and had dried. Building works had been started in the room, and this meant that there were significant areas of the room that were unplastered. Wall paper in some areas was ripped, and old. The curtains in the room were falling off the rail, the only chair was stained. One of the radiators was falling off the wall. We noted that the person who occupies the room has a significant degree of dementia and had caused some of the damage to the room. However everyone, whatever their disability must be provided with accommodation that is clean, comfortable and suited to their needs. We also saw that one of the shower rooms and toilets had not only vision panels in the door, but there were no locks. All bathrooms must have suitable door locks, that can be over-ridden in an emergency. We also noted that some of the bath and wash hand basins did not have tap heads. We were told that this was because some individuals flood the rooms. This meant that it was not possible to wash your hands properly after using the toilet. In one toilet, there was no wash hand basin at all. A member of staff told us that a person would have to return to their room to wash their hands. We also noted that in some of the toilets and bathrooms there was no soap. Where there was liquid soap it was in recycled containers for another product (fabreze), and it was not obvious that it was liquid soap in the bottle. In most bathrooms there were no towels, and there were no paper towels. We noted during this inspection that one of the staff was wearing disposable gloves, we were told that this was they were helping people to go to the toilet. However we saw them walking around the home wearing these gloves in the lounge. Gloves should only be worn where needed (ie for handling soiled or infectious substances) and when finished with they must be disposed of safely. One of the comments made by a visiting District Nurse was that there was no proper hand washing facilities, and no place to dispose of clinical waste. We also looked at the laundry facilities. We asked staff if they had any special bags or facilities to deal with soiled laundry. We were told that soiled linen was sluiced in an open sink, before washing. Consideration must be given to improving the management of laundry to avoid the spread of infections. Care Homes for Older People Page 21 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at Springfield House are supported by competent and caring staff. Evidence: We asked the residents that we spoke with whether they considered there were enough staff, and they confirmed that there usually was. One person commented that sometimes they seemed a little short as staff had to rush . We also received feedback from staff surveys, four of the five staff thought that there were always enough staff whilst the fifth person thought that there was usually enough staff. The people who live at Springfield House told us that they generally liked the staff. One person described the staff as lovely maids, another person said that she liked some staff, but not others. People also told us that staff treated them with respect. Mr Jahmeerbacus told us that he had not recruited any new staff since he had taken over, however one person had come into post at the time the home changed hands. We discussed with Mr Jahmeerbacus the need to ensure that all staff, including those recruited through an agency, have appropriate checks. This must include two written references (not testimonials), a Protection of Vulnerable Adults list check and a Criminal Records Bureau check. These checks must be completed on all staff, including those from abroad. Care Homes for Older People Page 22 of 32 Evidence: All five of the staff responding to the survey said that they had been given training that was relevant to their role, and that helped them to understand and to meet the individual needs of people. We were shown an induction form for a member of staff who had been recruited by the previous owner. Mr Jahmeerbacus said that they would be applying for some of the staff to complete National Vocational Qualifications. Mr Jahmeerbacus also said that he would be carrying out some of the training in relation to particular care issues, for example dementia, as he was qualified and competent to do this. Care Homes for Older People Page 23 of 32 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. Springfield is generally well managed and staff have confidence in Mr Jahmeerbacus. Risk Assessments must be completed to ensure that all significant and avoidable risks are managed. Evidence: Mr Jahmeerbacus has been registered in the last 6 months and found fit to run Springfield House. Mr Jahmeerbacus has a mental health nursing qualification, and has previous experience of owning and running a care home. We spoke with staff about the change of ownership of Springfield House. Staff spoke very positively about the new owner, they felt confident about raising issues. The District Nurse commented that staff morale had improved with the change of owners. We asked Mr Jahmeerbacus about a quality assurance system, and were told that none is in place as yet. Mr Jahmeerbacus is aware of the need to develop such a system. Care Homes for Older People Page 24 of 32 Evidence: We asked Mr Jahmeerbacus to show us risk assessments of the environment, however he was unable to locate these during the visit. We did however look at the Fire Risk Assessment, we were told that the Fire Officer was happy with this document, however it was not complete and was not signed or dated. Risk assessments must be carried out in relation to all significant risks, this must include the risk of fire, legionella, scalds,burns, trips/falls, and injury from hazardous substances. Care Homes for Older People Page 25 of 32 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 26 of 32 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 1 7 12 The Registered Provider must 01/10/2009 ensure that a proper assessment is made of a named individuals needs, and ensure any decisions in relation to the Mental Capacity Act are appropriately made. The care plan and risk assessments must be reviewed. No one may be arbitrarily restricted from leaving the home. This requirement was issued at the time of the inspection to be met by 9/8/09. 2 24 23 The bedroom occupied by ** 01/10/2009 must be decorated, cleaned and furnished to a suitable to standard. Everyone, whatever their disability must be provided with clean and comfortable accommodation. This requirement was issued on 9/7/09 to be met by 20/7/09. Care Homes for Older People Page 27 of 32 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 3 14 A comprehensive assessment must be made and recorded for anyone planning to move to the home. Good information about a persons needs will help ensure that a plan of care is accurate. 01/10/2009 2 7 15 Care Plans must provide a detailed account of how needs are to be met. Individuals must be consulted about their care. Clear care plans help ensure that needs are not missed. 01/10/2009 3 8 13 Risk Assessments must be completed in relation to all significant risks, including falls. People should not be exposed to unnecessary harm. 01/10/2009 4 9 13 The practices of covert medication must cease, unless there has been specific agreement under the Mental Capacity Act. People in care homes have the right to take or refuse their medication. 01/10/2009 5 9 13 There must be a safe system 01/10/2009 in place for the managment Care Homes for Older People Page 28 of 32 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 of all medication in the home. The practice of potting up must cease. Medication must only be given to the person for whom it is prescribed. Controlled drugs must be properly stored, recorded and administered. There must be accurate records of administration of medication. Poor managment of medication can lead to people not recieving the correct medication. 6 15 16 Meal times must be 01/11/2009 reviewed so that everyone has the opportunity to eat at a pace that suites them. Eating is an important part of life and can be a pleasant social occasion. 7 24 13 Potential injury from hot radiators must be risk assessed, and appropriate action taken. Hot radiators can cause serve injury if a person falls and lies against such a surface. 01/10/2009 Care Homes for Older People Page 29 of 32 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 8 24 12 Vision panels in bedroom and bathroom doors must be obscured. Suitable locks must be provided on all bathroom and toilet doors. Peoples privacy and dignity must be respected. 01/10/2009 9 26 16 Appropriate actions must be taken to avoid the spread of infection. This must include proper hand washing facilities. Staff must be appropriately trained in relation to the control of infection. Infections can be easily spread by failing to wash hands properly, and this could has serious consequences for an frail elderly person. 01/10/2009 10 38 13 Risk assessments must be 01/11/2009 carried out and implemented in relation to all significant risks. People need to be safe and not exposed to unnecessary harm. Care Homes for Older People Page 30 of 32 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 17 All staff should have training in relation to Safeguarding. Care Homes for Older People Page 31 of 32 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. 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