Inspection on 09/02/09 for Summerdale Care Home

This inspection was carried out on 9th February 2009.

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

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

Other inspections for this house

Summerdale Care Home 21/04/08

Summerdale Care Home 28/11/07

Summerdale Care Home 20/10/06

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Townley Road, 2-3

Orchard House Nursing Home

St Josephs Rest Home

Foxley Lane (121a)

Tudor 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: Summerdale Care Home 73 Butchers Road London E16 1PH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sarah Greaves     Date: 1 2 0 2 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 27 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 27 Information about the care home Name of care home: Address: Summerdale Care Home 73 Butchers Road London E16 1PH 02075402200 02075402201 summerdale.court@fshc.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Four Seasons (No 11) Limited care home 72 Number of places (if applicable): Under 65 Over 65 0 0 72 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: 72 72 0 The Registered Person may provide the following categories of service only: Care home with nursing - Code N 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 Dementia - Code DE Mental disorder, excuding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 72 Date of last inspection Brief description of the care home Summerdale Court is a 72 bedded nursing home in Canning Town that provides care for up to 72 older people. The service is divided into three units. Oak unit provides care for frail older people, Beech unit is for older people with enduring mental health problems, and Ash unit provides care for people who have dementia. Summerdale Court is owned and operated by the Four Seasons Health Care group, one of the largest groups in the UK providing care services to the elderly. The premises are Care Homes for Older People Page 4 of 27 Brief description of the care home purpose built and all bedrooms have en-suite facilities. The units are self-contained, but catering, laundry and parking facilities are shared. The nearest station is the DLR at Royal Victoria. The home is situated in the London Borough of Newham. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection was conducted over three days. We gathered information through speaking to the residents, their visitors (relatives and friends) and the staff. We also gained further information through speaking to visiting professionals and by reading the Annual Quality Assurance Assessment, which is a self-audit document that the Commission requires services to complete. We toured the premises, checked medication storage and records, joined mealtimes and observed recreational activities. Seven care plans were randomly selected and read. We also looked at randomly chosen financial records for residents, health and safety documentation, and staff files (for training, supervision and recruitment). Care Homes for Older People Page 6 of 27 Care Homes for Older People Page 7 of 27 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 27 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 27 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. Prospective residents and their families are provided with suitable information and written assessments prior to moving in for a trial period. Evidence: We read the services Statement of Purpose and Service Users Guide, which were found to be satisfactorily presented. A recommendation had been issued in the previous inspection report for the service to produce accessible versions of this information, (such as an audio tape) which had been achieved. We spoke to the family of a recently admitted resident during this inspection. We noted that the resident and family were about to commence the first statutory review ( a meeting conducted approximately six weeks after admission, to enable an individual and his/her representatives to decide whether the placement should be permanent). The resident, family and social worker from the placing authority all stated that they were pleased with the care; however, the next-of-kin identified that they had not received a copy of Care Homes for Older People Page 10 of 27 Evidence: the Service Users Guide and they were unaware of how to make a complaint. This finding was discussed with the registered manager, who stated that ordinarily a copy was placed in the bedroom of a new resident but she would implement a system to ensure that people are given this document incase of it going missing. We observed during the inspection that there were a number of residents that moved items about due to their cognitive conditions. It was noted at the previous inspection that the service could improve upon the quality of information gathered during the initial assessment for a new resident. We found that the care home had introduced a more comprehensive assessment tool, which enabled staff to pursue a more in-depth assessment of a persons relevant history and their current holistic needs. Standard 6 (a key National Minimum Standard) was not assessed, as the service does not provide an intermediate care service. Care Homes for Older People Page 11 of 27 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. The service has demonstrated visible positive changes in its care planning system, although on-going improvements need to be attained. The residents benefitted through good clinical leadership from the registered manager and the deputy manager, which was demonstrated through the management of medication, pressure sore care and the improving scrutiny of care plans. Evidence: We read a total of seven care plans during the course of this inspection; the care plans were randomly chosen from each unit. A detailed feedback was provided to the registered manager, deputy manager and the regional manager regarding each care plan that we looked at; however, the following points were noted: 1. The quality of the clinical assessments (including tools for calculating individual risks for topics such as nutrition and skin viability) and objectives for care was generally good, although a few inaccuracies were observed. For example, a care plan identified that a resident needed the assistance of two staff for transferring, but the resident handling profile had not been updated and stated that this person could walk with a Care Homes for Older People Page 12 of 27 Evidence: zimmer frame. Another care plan stated that a different resident needed the assistance of two staff to transfer but we observed that this person could now safely walk on their own (which was verified by staff). We found evidence within the monthly unannounced visits reports by the service provider to demonstrate that a sample of the care plans were being checked in suitable detail, but staff nurses were not yet vigilant enough in regard to altering all relevant documents when significant changes occured (for example, weight loss/weight gain that had been recorded on the nutritional assessments might indicate a need to make changes to a skin viability assessment). One of the seven care plans demonstrated that the service was picking up on clinical errors (an entry on the Waterlow chart for prevention of pressure sores was wrong for three months but was picked up by the fourth month via the on-going auditing arrangements). 2. The service had clearly worked upon producing an individualised style of care planning, which explained specific preferences for daily care. It was agreed during the feedback that some care plan objectives for almost identical needs could be condensed into one item, in order to prevent unnecessary repetition. 3. We noted that some care plans provided information in a manner that was more accessible to residents, their supporters and non-clinical readers (such as the care staff).It was recommended that this approach should be universally adopted within the service, as we found that some care workers did not understand specific clinical terms within the care plans. 4. The auditing process needs to identify insensitively worded statements; for example, one care plan stated that a resident just gabbles incoherently. Staff need to demonstrate a greater awareness that the care plans for people with dementia are documents to be shared with relatives and friends. We spoke to a visiting tissue viability nurse, who reported that the service was responding well to incidences of pressure sores; it was stated that staff within the care home were able to use their own initiative and implement appropriate clinical care. We were informed of one concern by this visiting professional, which was in regard to poor communication relating to the results of a wound swab, which occurred a few months prior to this inspection. We discussed this finding with the registered manager and were satisfied that the concern was suitably investigated and responded to. It was also noted within a care plan that a visiting Primary Care Trust nurse had initially observed that a resident required chiropody services; it was agreed that this was the kind of observation that staff within the care home should be picking up on. We checked the recording and storage of medication (including controlled drugs, refrigerated medications and the first aid box) on one of the units. We observed at the last inspection that the service had introduced a rigorous auditing system, which we found to be working well at the time of this visit. It was noted that the unit manager that we checked the medications with was new in post but demonstrated a confident understanding of the medication practices and individual regimes for residents. It was Care Homes for Older People Page 13 of 27 Evidence: noted that the medication administration record for one resident did not specify which ear required ear-drops, and a pair of gloves and two sterile dressings had expired); otherwise there were no issues for improvement. We observed that two residents had decided to keep their prescribed creams/lotions in prominent positions within their bedrooms. The registered manager stated that the residents would not agree to these items being kept in a secure place (which we witnessed); therefore, it has been advised that risk assessments should be put in place to identify and attempt to minimise risks to others. It was also noted that a resident had discarded a medication pot in a communal lounge, which contained a small amount of liquid medication. We found that staff spoke to residents in a manner that promoted their entitlement to dignity and respect. The care plans identified how a resident wished to be addressed and staff were observed to always knock on bedroom doors before entering (this protocol was correctly conducted even if it appeared that the resident was elsewhere). We observed residents and staff together after their evening meal. It was noted that this could be a difficult time for older people with dementia (for example, feeling restless and disorientated). We were pleased to find that staff provided calm and reassuring responses, such as offering distractions with magazines, board games and refreshments, as well as words of comfort. We found that the service was working in partnership with the Primary Care Trust in regard to End of Life care planning, and staff were accessing training. We were not able to track the care of an individual through their final care, hence this standard has not been fully assessed. Care Homes for Older People Page 14 of 27 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. Residents were provided with opportuities for fulfilling activities and their needs to integrate with the local community was promoted. Favourable comments were received regarding the food service, although some issues for improvement have been recorded in this report. Evidence: We found that the care plans identified the interests and hobbies of the residents. Since the last inspection the service had produced individual profiles regarding the social and family background of residents, and these documents were well produced. We met with the two staff employed to arrange activities within the care home; one activities co-ordinator had a more general role and the other person was allocated to the unit for people with dementia. We found that the service had developed good links with three local churches, hence residents had a choice of opportunities to participate in Christian worship. The service liaised with families and relevant persons in the community in the event of residents requiring contact with representatives of other faiths. The activities co-ordinator had commenced a nationally recognised qualification in the provision of social care activities; the registered manager confirmed that this training would be offered to the Care Homes for Older People Page 15 of 27 Evidence: activities provider for the dementia care unit. We found that the service had established a link with the Age Exchange Theatre Trust; it was suggested that this could be further developed (for example, an art or drama project). In addition to regular entertainments and activities (such as musical performers, baking, mobile library, karaoke, art and crafts, and a visiting dog for pet therapy), improvements had been made since the last inspection. We observed that a very good effort had been made to locate nostalgic reminiscence items for the lounges, and the service had acquired the shared use of a minibus (jointly owned with a nearby Four Seasons care home). Residents and staff were looking forward to the annual Shrove Tuesday pancake race; events were publicised in a newsletter produced by the activities team. We suggested that the weekly activities schedule should acknowledge that nursing and care staff promote activities at the weekend; this ammendment was made during the course of the inspection. The activities co-ordinator was planning to further develop the existing service, such as the proposed introduction of gardening/plant care for residents and a befriending scheme with the local community. We observed the activities worker and care staff with residents on the dementia unit. We were shown a letter from a relative of a resident, who was very pleased with the way staff interacted with residents during activities sessions. It was noted that staff demonstrated a clear knowledge of the individual likes and wishes of residents; for example, a few of the residents enjoyed hearing religious readings, which reflected their known interests and commitments prior to moving into the care home. We have recognised the benefits that this activity could produce and have suggested that this specific one-to-one activity (which was observed to occur within the communal lounge) should be structured and delivered in a manner which acknowledged that other residents might not wish to overhear the readings. The service offered flexible visiting hours for families and friends. Residents and relatives meetings have been held. It was noted that the majority of the residents would not be in a position to manage their own finances, due to physical and cognitive frailty. However, we did meet a resident that stated they went out shopping with staff for clothes; staff supported the residents individual choices. Evidence was also gathered through checking a random sample of residents financial records, which demonstrated that people used their personal allowances in accordance to their own wishes and needs. Information was provided to residents and their supporters regarding local advocacy services. We looked at the menu programme; it was noted that it had been devised in consultation with a National Health Service dietician.The service offered menus to meet cultural and health-orientated needs, such as Nigerian and Carribean diets, and options for people that needed diets to address their diabetes, weight loss and/or cholestral levels. There were examples of individualised practice, such as cooked breakfasts and favourite cereals upon request. We have noted some areas for improvement, such as staff training regarding food service. We observed that staff did Care Homes for Older People Page 16 of 27 Evidence: not always understand what food they were offering to residents and we observed a care worker dispensing biscuits directly from the packet, rather than decanting to available serving equipment. We would also advise that the service expands upon its current night-time menu; the chef stated that it comprised of cereals, toast and jam, which appeared limited if a resident was hungry at night-time because they had not eaten well during the day. It was also noted that the current menu plan did not evidence that the service offered home-baked items (such as cakes, scones and cookies) a few times a week, although the chef confirmed that this occured. Care Homes for Older People Page 17 of 27 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. Suitable training, policies and systems were in place to listen to and protect residents. Evidence: We read the services complaints procedure, which was found to be satisfactorily presented. As previously identified in this report, the service has recognised the need to double-check that all new residents and relatives have received their service user guide (containing the complaints procedure). The complaints investigations conducted by the registered manager appeared to be thorough and open. It was noted that an issue raised by a visiting Primary Care Trust nurse had not been logged as a complaint. It has been acknowledged that the service reasonably classified the issue as a clinical incident; however, it is advised that any future issues of this nature raised by visiting professionals should be recorded within the complaints file. The service produced an appropriately written Adult Protection procedures, and staff had received training. We noted that disciplinary actions were taken when the service deemed that staff had not complied with company policies for good practice. Care Homes for Older People Page 18 of 27 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 service demonstrated that it was actively improving the quality of the premises; however, a more rigorous approach is needed in regard to safety issues. Evidence: The care home occupies a purpose-built premises and has a garden area. We noted that work had been conducted in order to improve the quality of the environment, and further redecoration and refurbishment was planned. At the last inspection we spoke to the registered manager regarding the need to promote a more homely atmosphere; we were pleased to observe that the service was clearly progressing towards this. Some of the bathrooms had benefitted from the addition of homely touches and the hairdressing room had also been re-decorated. We toured the premises with the registered manager and noted some areas for improvement. We found razor blades in an unlocked cabinet in a communal bathroom on the unit for people with mental health problems, and a bathroom that was stated to not be in use was unlocked. We noted that a sofa with foam falling out was still in a communal lounge and a piece of wood with evident nails sticking out was on top of a piano. The registered manager stated that some of the residents tampered with equipment and furniture, due to their mental health and dementia care needs. We observed this statement to be correct, hence the need for staff to be constantly vigilant in order to promote a safe environment. We noted that some of the bedrooms for people with dementia had suitable pictures Care Homes for Older People Page 19 of 27 Evidence: on the door, to assist people to find their rooms and/or provide reassurance. A noticeboard on one of the units did not promote a homely environment; we were advised that this would be rectified. Appropriate arrangements were in place for the cleaning of the premises and there were no offensive odours, apart from isolated areas that were brought to our attention by the registered manager as the service was addressing matters. Care Homes for Older People Page 20 of 27 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. Residents are provided with safely recruited and suitably trained staff. Evidence: We observed staff (nurses and care workers) on each unit and looked at the staffing rotas. It was noted that some residents presented with complex and/or challenging needs due to their illnesses, and staff worked diligently with a cheerful manner when assisting residents with their physical and social care needs. The registered manager was aware of her responsibility to continually monitor the dependency needs of the residents, in order to establish if more staff are required. The service provided care staff with National Vocational Qualification (NVQ) training; there were no issues of concern regarding staff access and attainment of this qualification. We checked four randomly selected staff files; it was noted that the services recruitment practices complied with the stipulations of the National Minimum Standards for Care Homes for Older Adults. We found that staff were provided with mandatory training. Since the last inspection there has been a focused approach upon dementia care training, which has produced noticeable improvements to practices on the designated unit for people with dementia and the ground floor nursing unit for people with physical frailties (as some of these residents also have dementia or some degree of memory loss). Care Homes for Older People Page 21 of 27 Care Homes for Older People Page 22 of 27 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. Residents benefitted from a well managed service, which took account of their views. Evidence: The registered manager is a registered nurse with a recognised management qualification, and substantial experience in the management and care of people within a care home with nursing beds. The registered manager was supported by a full-time deputy manager. The previous inspection report identified eight requirements and a significant number (seventeen) recommendations for good practice. We noted that the service had carefully considered the findings from the last inspection and taken appropriate measures to improve the quality of care. For example, the registered manager had now acquired train the trainer status for dementia care and three members of staff had achieved dementia care mapping qualifications (a recognised form of auditing the quality of care for individuals with dementia). Positive developments have been observed across the seven outcome areas, although there remains specific issues for further improvement. The standard of clinical care was Care Homes for Older People Page 23 of 27 Evidence: found to be good, hence the service should now be able to successfully focus upon specific objectives (for example, continued environmental improvements, food service and care planning). We read a sample of the monthly unannounced person-in-charge visits, conducted by the service provider. It was noted that these documents now adopted a more rigorous style and suitably identified areas for improvement at the care home. As previously stated in this report, there were systems for seeking the views of the people that use the service and their representatives, such as residents and relatives meetings and a newsletter from the activities team. We observed some good practices during the inspection; for example, some residents demonstrated that they were used to knocking on the registered managers door if they had an issue to discuss and we met the relative of a resident, who had come in for a routine discussion regarding the residents care plan (the relative signed their agreement with the care plan on behalf of the resident, athough we found that some residents signed their own care plans). We checked four randomly chosen financial records for residents. The care homes administrator demonstrated the system for recording and auditing finances, which appeared to be straight-forward and transparent. We noted that residents were supported to spend their personal allowances on items for their comfort and entertainment (in accordance to their own wishes), and appropriate receipts were maintained. The administrator confirmed that the service provider undertook their own checks on these records. We looked at the supervision records for three members of staff. It was acknowledged that one person did not have the expected number of supervisions, although the registered manager confirmed that other informal measures were taken. We discussed the supervision of another employee with the registered manager and the deputy manager, who did not feel that the supervisors view of the individual properly reflected the (good) standard of their work. These findings have identified the need for the registered manager to more closely audit the supervision records. We checked the following health and safety records, which were found to be satisfactory: fire equipment checks, portable appliances testing, landlords gas safety, electrical installations inspection by a competent person, hot and cold water temperatures, safety of washing machines/dryers checks, and maintenance of the lifts. Care Homes for Older People Page 24 of 27 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 27 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 7 New care plans should be written in a manner that avoids unneccessary clinical terminolgy, in order to promote a working document which is as accessible as possible to residents, their supporters and relevant persons without clinical training. Risk assessments should be developed for any residents that do not permit staff to store prescribed creams/lotions in a safe place within their bedrooms. Hospitality food training regarding presentation and delivery of food and beverages would be beneficial. More rigorous monitoring of the supervision sshould be applied. 2 9 3 4 15 36 Care Homes for Older People Page 26 of 27 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 27 of 27 - 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!