Inspection on 16/03/09 for St Teresa`s Nursing Home

This inspection was carried out on 16th March 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

St Teresa`s Nursing Home 21/03/07

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: St Teresa`s Nursing Home St Teresa`s Nursing Home Corston Bath Bath & N E Somerset BA2 9AE     The quality rating for this care home is:   three star excellent 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: Andrew Pollard     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 28 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 28 Information about the care home Name of care home: Address: St Teresa`s Nursing Home St Teresa`s Nursing Home Corston Bath Bath & N E Somerset BA2 9AE 01225873614 01225872157 st.teresas@cedarcarehomes.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Barkers Chemicals Ltd care home 43 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 43. The registered person may provide the following category of service only: Care home with nursing- Code N to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category- Code OP Date of last inspection Brief description of the care home St. Teresas is registered as a care home to provide nursing care for up to 44 older people. The home is a converted older property partially extended and set in wellmaintained gardens with a pleasant location. The Home is situated within 3 miles of the centre of Bath.The fees at St Theresas Nursing Home range from £508.00 to £700.00. weekly reviewed annually. The fee does not include provision for items such Care Homes for Older People Page 4 of 28 Over 65 43 0 Brief description of the care home as hairdressing, chiropody, dental, ophthalmic, or audiology services. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent 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 inspection conducted as part of the annual inspection process. The inspection lasted one day. Prior to the visit the inspector spent some time examining documentation accumulated since the previous inspection, including the AQAA, notified incidences in the home, Regulation 37s and the unannounced reports conducted by the Registered Providers Regulation 26s. The inspector distributed questionnaires to residents at the inspection and five were returned. Information from these has been collated and is detailed throughout the report. The manager provided outcomes from their own surveys. The inspector spent time throughout the inspection in discussions with residents, Care Homes for Older People Page 6 of 28 relatives, the manager and members of staff. A number of records and files relating to the day to day running and management of the home were examined. The inspector toured the premises accompanied by the manager. Feedback was given to the manager on the outcome of the inspection. 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 7535. Care Homes for Older People Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents or their families have all relevant information to determine if the home is suitable for their needs. Prospective residents needs are assessed prior to admission to ensure that their needs can be met. Trial visits give prospective residents an opportunity to assess the nature of the home. Evidence: When an initial enquiry is made a booking enquiry form is completed and prospective residents are invited to visit the home. During the visit staff use a viewing information checklist ensuring that relevant information is given in order to assist prospective residents to make a decision about the home. Information provided includes the homes statement of purpose, service user guide and brochures about Cedar Care and St Teresas. All residents and relatives stated in their surveys that they and their Care Homes for Older People Page 10 of 28 Evidence: families had received information about the home prior to admission. People spoken to felt their admission was well managed. The pre-admission assessments were fully completed and informative. The manager or a senior nurse meet with prospective residents prior to admission. The prospective resident, family and carers are involved in the assessment and all information is used to determine the suitability of the placement. Where possible the manager obtains assessments and care plans from other professionals for example, social workers and hospital staff. The information gathered pre admission provides evidence of the residents wishes and state of health. A detailed assessment of the residents care needs including pressure risk, nutritional and continence assessment, and risk assessments regarding handling and falls are established over the initial few days and regularly reviewed. This information forms the basis of the Care Plan. The prospective resident and relatives are given forms to complete prior to admission detailing life history and personal preferences and choices. Information included what residents preferred to eat and drink, where they wish to eat their meals, what time liked to go to bed and get up and if they preferred baths or showers. A large majority of residents responding to the in house survey said their choices regarding sleeping and waking were respected and the majority confirmed they felt in control of their daily lives. Prospective residents are encouraged to visit the home either for the day or perhaps for lunch dependent on their wishes. A months trial period on both sides is usually undertaken to ensure that everyone is happy with the arrangements and to ensure that the placement is suitable. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans demonstrate that the homes encourages residents to maintain independence, autonomy and choice. Residents are consulted about their health and personal care needs and their views and wishes taken into account. Residents state they are treated with dignity and respect. Evidence: From the pre-admission assessments the manager and the registered nurses are able to develop a set of care plans based on identified needs. During the first months trial period the plans are reviewed and amended as required. A named Registered Nurse (RN) and key worker work with individual residents and or their family to develop and maintain the care plan. The home is working toward a fully person centred approach that reflect peoples wishes and desires and improve their quality of life. It is intended to have a more narrative approach in the first person be used to improve the personalisation in the care plan. Each resident and their families are told about residents consultation and family review meetings. This allows people an opportunity to discuss and evaluate care plans and raise issues or concerns they Care Homes for Older People Page 12 of 28 Evidence: may have. There were clear directions in relation to each residents personal and social needs, such as communication, mobility, cognition, interests, hobbies and contact with family. Health care plans included pressure area risk assessments, moving and handling guidelines, wound care, nutritional profiles and risk assessments for falling risk. All information had been regularly reviewed. The manager is the tissue viability nurse in the home and has completed additional qualifications to enhance his practice and knowledge. It was recommended that where a resident has multiple pressure areas that a care plans is prepared for each. It was also recommended that in future diagrams and descriptions would be used in care plans rather than the taking of photographs unless there is a clinical reason for doing so. The manager intends to implement these recommendations. The GP conducts a weekly visit to the home and will visit on request. All residents stated in their surveys that they receive good medical support. Health Care needs were clearly detailed in the care files. Records of the GP visits and those from other professionals are recorded in care files including, chiropodists, opticians and dentists. Residents and relatives spoken to and surveyed said their care needs were well met. All the residents spoken with said, they were Satisfied with the overall level of care being provided. They spoke highly of the staff saying they were, Friendly and caring. A relative said, My mother is very contented with the service she receives and I think they do a good job. Staff were seen to respect the residents privacy and dignity. They were seen to knock on doors and heard to be courteous and friendly. Residents and visitors spoken with confirmed that they were treated with respect. Policies and procedures for receiving, storing, administering and disposing of medications are in place and meet with current legislation. The controlled drug records were up to date and in order. The pharmacist who supplies the medication carries out monitoring visits. We discussed the design of the disposal bin, which is left open whilst being filled, and the manager is to ask the suppliers to provide a more secure bin. A GP conducts a medication review for all residents regularly. The home also keeps an accurate stock check of medicines given on an as required basis. Fridge temperatures are recorded daily. Care Homes for Older People Page 13 of 28 Evidence: The suction equipment requires a ridged catheter to be available as well as a flexible small lumen catheter. Nurses have attend training at Dorothy house in palliative care including, symptom control, pain management and care of a syringe driver. The manager seeks to establish residents wishes concerning palliative care by developing end of life care plans. The plans are completed with residents and their families and significant others. The resident and a member of staff sign plans. The information gathered should help ensure that residents choices are respected. There are plans to further enhance the quality of these documents by undertaking training in the gold standard approach and using the linked documentation. In due course these plans will be tied to aspects of the Mental Capacity Act where relevant. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A range of social and recreational activities is arranged that seek to enhance the quality of life for the residents, which is both enjoyable, stimulating and meets individual preferences and expectations. Residents are able to maintain close contact with families and friends. Residents families are informed of issues related to their relatives and to take part in activities running in the home. The food is of a high standard and provides choice and a balanced diet for residents. Evidence: The relatives and staff develop a basic life history of residents and it was suggested that this could be further developed into thumbnail biographies noting fuller details and significant events of their lives. Residents complete forms detailing personal preferences, likes and dislikes and preferred daily routines. Some of this information is placed in staff working zones as a quick reference guide. For example specifying when residents like to get up and whether they like to have breakfast in their rooms or in the dining room. Care Homes for Older People Page 15 of 28 Evidence: Residents daily routines are flexible within the home, they can go out when they wish and participate in activities. There are written records of activates and resident participation. Survey outcomes indicated that there are activities people can take part in if they choose. The home has a full time activities co-ordinator who is responsible for developing an activities and outings programme. A monthly newsletter is printed for residents and relatives containing upcoming social events and general house news. The home has two Lounge Assistants who work six days a week supervising residents either in groups or on a one to one basis. The assistants organise such things as daily games, quizzes and reminiscence therapy, manicures and walks around the grounds. Trips and outings take place on a regular basis recently visiting the Pump rooms and a glass blowing studio. Special events are arranged during the year and residents and visitors are invited to attend. Garden parties and village events integrate the residents into the local community. The home has organised regular shows provided by visiting entertainers and musicians. Clergy of several Christian denominations visit the home. Monthly services and communion is available to residents. There are currently no residents with other faith backgrounds but the home would seek to meet any cultural or religious practice choices of new residents. The organisation has policies and a commitment toward valuing and understanding diversity and challenging any form of discrimination. Two visitors were spoken with and both said that they found the home to be welcoming and the staff Cheerful and very helpful and had attended events at the home. Residents meetings are organised every three months. The residents are informed a week in advance and asked if there is anything they would like to add to the agenda. Minutes of the meeting evidenced that concerns and issues that were raised were transferred into an action plan to be resolved. The surveys and discussions indicated that the home supports people to live the life they choose and comments included, I enjoy the friendly and fun atmosphere and Good events, helpful and friendly staff. The menu has varied meal options and choice is available at each sitting. The menus Care Homes for Older People Page 16 of 28 Evidence: are reviewed to reflect seasonal trends and availability of produce. Fresh produced is used and bowls of fruit are placed around the lounges for residents. Parties are arranged for birthdays and special occasions. Surveys confirmed that residents were satisfied with the meals provided and how they were presented. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are policies in place to ensure that complaints by residents or their families are taken seriously and acted upon. There are good arrangements in place for staff training and awareness related to safeguarding of adults. There are robust and comprehensive policies in place to protect residents investigate complaints or manage any allegations of abuse. Evidence: The complaints policy and procedure is detailed and contains all the required information and a copy of the procedure is in the service user guide and on display in the hallway. Any concerns raised by residents and visitors are dealt with immediately and if needed written confirmation of the outcome sent to the complainant.The home recently carried out an internal investigation into a adult protection matter at the direction of Social Services which was well managed and resolved to the satisfaction of the complainant. Residents stated in discussions and in the surveys that they knew who to talk if they were not happy and how to make a complaint and that the home responded appropriately when concerns were raised. There are procedures and guidance information on the protection of vulnerable adults from abuse including the Local Authority No Secrets document. The staff induction includes training about protection, whistle blowing, management of challenging Care Homes for Older People Page 18 of 28 Evidence: behaviour and respect and dignity. Records are made that show that staff have received adult protection training by the Local Authority and follow up training by the manager. A number of staff are undertaking the National Vocational Qualification in care award, and a component of the award addresses issues around the topic of the protection of vulnerable adults from abuse. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is a clean, well-equipped home with a good standard of accommodation suitable for older residents. The communal areas are homely and residents are encouraged to personalise their rooms. The standard of cleanliness is high. The grounds are attractive and used to benefit of residents. Evidence: The home is comfortable, well decorated and furnished. It provides a safe, peaceful environment to the benefit of residents. There are very attractive gardens to the rear and patio areas to sit and enjoy fine weather. Major building works are underway to provide more bedrooms and following its completion significant upgrading work is planned for the main house. Residents and relatives have been consulted and kept informed about the plans. The bedrooms and communal rooms and facilities are suitable and well presented for their purpose and meet the residents needs. All the rooms visited during the Care Homes for Older People Page 20 of 28 Evidence: inspection were appropriately equipped to meet the needs of the residents. Some had brought in small items of furniture and other personal items. One resident said, I like my room and have a lovely view. Others spoken with said that The house is clean and warm and maintenance issues are dealt with promptly. The home provides specialist equipment when necessary including pressure relieving equipment, adjustable beds. Individual assessment and provision of mobility and other aids are carried out for any specialist needs. There are handrails and bars, which assist residents to move around the home independently. There is lift access to each floor. The standard of cleanliness in the home is high. A recent Environmental Health check found everything to be in order and awarded the kitchen 4 stars. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The recruitment procedures and records are well managed and in good order to protect residents.The home is well staffed with appropriately trained and experienced staff.Staffing Levels are in accord with residents needs. Evidence: The manager told the inspector that the home ensures staffing levels are indicative of the needs and levels of care required by the residents. The managers hours are supernumerary although he is named nurse for two residents. The domestic, catering, admin and laundry staffing levels are satisfactory. Full time maintenance and activities staff are also employed. All residents and relatives surveys agreed that staff were generally available when they needed them and listened and acted upon what the residents say. One resident said, I am fortunate to be so well cared for. All residents surveyed stated that staff listened to them and acted on what they said. In discussion several residents expressed very positive views about staff and the care they receive. Previous concerns that some staff members whose first language was not English and had limited communication skills now appear to be resolved, no residents or visitors spoken to or surveyed raised this as an issue. Where required staff are funded to attend English language classes. Mandatory training can be provided in Polish if need Care Homes for Older People Page 22 of 28 Evidence: be, various documentation including policies and procedures are given to staff in their own language and dictionaries and phrase books are given to all staff on induction. The new induction training based on the Skills for Care programme is very comprehensive and practically orientated. New staff receive regular formal supervision with the manager and are shadowed on shifts by a senior member of staff until both parties feel confident in their competencies, skills and knowledge. Staff spoken to said that they were enjoying working at the home and had good training. In house training uses a selection of learning aids such as using videos with associated questionnaires in relevant topics. The organisation is an NVQ provider and continues to support their staff with their training. Staff records confirmed that training was up to date and that future courses had been arranged. The employment policies include and equal opportunities policy and monitoring system. The inspector viewed the personnel records for several staff members including new recruits. Staff files seen showed that employment practice and records were in good order. Criminal Records Bureau (CRB) disclosures are carried out prior to recruitment. Registered Nurse (RN) PINs are validated annually. Staff turnover rates are very low. It was evident from interactions witnessed between staff and residents during this inspection that staff worked hard to develop caring and respectful relationships with people living at St Teresas. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is well supported provides clear leadership throughout the home. The home is well managed and run taking into account the views and wishes of the residents. There are good arrangements in place to maintain and service equipment and facilities in the home and protect the health and safety of residents and staff. The staff supervision and appraisal arrangements are good. Evidence: Mr Joseph is the Registered Manager. He is a Registered General Nurse and is well experienced in the management role. He has worked hard with the support of the registered provider and staff group to enhance the quality of life for residents. Residents have regular contact with the manager. A resident stated, He is very caring. Another resident said, How they found him to be approachable. Care Homes for Older People Page 24 of 28 Evidence: Regular staff and management meetings are held, enabling staff to have input and receive feedback concerning the running of the home. Regular resident, relative forums are held and play a role in shaping the provision of care and services in the home. From discussions and observation the management and staff team are a stable and committed to providing quality care. Comments received from surveys included, The home is very well run and I am happy here. The supervision of staff has been established and is at present 2 monthly by department and in cascade, records are kept and contain details of training requests. Appraisals and performance reviews are undertaken and staff development plans written. The policy and procedure for holding residents personal money was not examined on this occasion at the last inspection it was stated that, Good accounting methods are adopted which account for all transactions documented and receipts for sundries were available to see. Health and safety records showed that relevant inspections and maintenance has been carried out at the required intervals for the fire alarm, fire fighting equipment, gas and electrical services, hoists and lift. Regular H&S audits of environment and equipment are carried out. Generic risk assessments are reviewed and updated for resident and staff areas. The home has a system of training staff in Moving and Handling. The home carries out quality assurance surveys of residents and relatives to assess the satisfaction with the service that the home provides. The results from the last surveys were very positive and enabled the home to identify strengths and weaknesses to create a development plan for improvements. The results of the Commissions surveying and discussions with residents and relatives during the visit were overwhelmingly positive with all aspects of care, food, activities and the quality of staff being praised. Comments included, They help people maintain a full life with excellent food, good entertainment and lovely surroundings and It is an excellent home and most welcoming. All residents who responded to the survey indicated that the home always met their needs. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 19 23 (4) Arrangements must be made 27/04/2007 to ensure that the building complies with the requirements of the local fire authority. CSCI must be notified of the outcomes. Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 7 11 Consider developing specific personalised night care plans written by the night staff with the residents. expand and enhance the quality of the end of life care plans by adopting the Gold Standard guidelines and documentation Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!