Inspection on 26/05/10 for Sun Hill

This inspection was carried out on 26th May 2010.

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

The inspector found no outstanding requirements from the previous inspection report, but made 15 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Sun Hill 22/07/10

Sun Hill 17/03/10

Sun Hill 11/03/10

Sun Hill 09/03/10

Sun Hill 13/05/08

Similar services:

Chirnside House

Keer Sands Residential Home

Sunny Bank (P.R.S.) Ltd

Ruskin Lodge

Bushell House

Ashwood Court Unit 1

Clover House

Langrigg House

Extracts from inspection reports are licensed from CQC, this page was updated on 03/09/2010.

Key inspection report Care homes for older people Name: Address: Sun Hill 147 Manchester Road Burnley Lancashire BB11 4HT     The quality rating for this care home is:   zero star poor service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Susan Hargreaves     Date: 2 6 0 5 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Sun Hill 147 Manchester Road Burnley Lancashire BB11 4HT 01282422500 01282434696 sun_hill_residential@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): S.J. Care Homes (Wallasey) Limited Name of registered manager (if applicable) Miss Brenda Ormonde Type of registration: Number of places registered: care home 22 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia learning disability mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The registered person may provide the following categories of service only. Care home only - code PC, to people of the following gender:- Either. Whose primary care needs on admission to the home are within the following categories: - Old age not falling within any other category - Code OP, (maximum number of places: 7) Dementia Code DE Mental disorder, excluding learning disability or dementia - Code MD (maximum number of places: 4) Learning disability - Code LD (maximum number of places 1) The maximum number of people who can be accommodated is: 22 Date of last inspection Care Homes for Older People 1 1 0 3 2 0 1 0 22 1 4 0 Over 65 0 0 0 7 Page 4 of 30 Brief description of the care home Sun Hill provides 24-hour care and accommodation to older people and older people who have a dementia or mental health problem. One person has a learning disability. The home is a large detached house, located on a main road close to Burnley town centre. There are good bus and rail links nearby. There is car parking at the front of the home and an enclosed garden/patio at the back. Car transport with staff escort is provided. There are two lounges and a dining room/lounge on the ground floor. Private single bedrooms and one double (most en-suite) are on the ground, first and second floors. There is a lift to the upstairs bedrooms. The home has an activities programme that includes movement to music, reminiscence, entertainers, dominoes, bingo and outings. The home has a Statement of Purpose and Service User Guide providing information about the care provided, the qualifications and experience of the owners and staff and the services residents can expect if they choose to live at the home. A copy of the Service User Guide and most recent inspection report is issued to all prospective residents and their relatives/representatives to help them make an informed choice whether to move into the home. The current fees at the home are £386.00 to £435.00 covering all aspects of care, food and accommodation. Care Homes for Older People Page 5 of 30 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: zero star poor 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: A key or main unannounced inspection, which included a visit to the home, was conducted at Sun Hill on 26 May 2010. As part of the inspection process we looked at all the information we have received about Sun Hill since the last key which took place on 13 May 2008. This included an Annual Service Review on 22 May 2009. The purpose of this was to assess if the quality of care provided to people living at the home had changed and to make sure the home was being properly managed. We have also carried out three random unannounced inspections in March 2010 following concerns raised about recruitment practices. Information about the last key inspection, the Annual Service Review and the random inspections can be obtained from Sun Hill or www.cqc.org.uk The previous manager completed an annual quality assurance assessment several weeks before this visit to the home. This document is a self-assessment that focuses on how well outcomes are being met for people who use the service. It also gives us Care Homes for Older People Page 6 of 30 some numerical information about the service. Eight completed surveys were returned from people using the service and nine from members of staff. At the time of this visit eighteen people were living at the home. A tour of the premises took place and we looked at staff files and care records. We also spoke to members of staff on duty and people who use the service. Discussions also took place with the homeowner and area manager regarding issues raised during the inspection. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: To ensure peoples health and personal care needs can be met at Sun Hill a detailed assessment of these needs must be carried out before they are admitted to the home. Care plans must accurately identify the health and personal care needs of each person using the service and provide clear directions for staff to follow in order to ensure their individual needs are met. Risk assessments for falls, nutrition and the development of pressure sores must be completed for each person using the service. This will ensure that risks associated with falls, the development of pressure sores and nutrition are effectively managed. To ensure people are cared for in the way they prefer people using the service or their relatives should be involved in care planning. To promote dignity for people using the service they should receive appropriate help and support at mealtimes including suitable protection for their clothing. Medicines must be handled more safely so that peoples health and wellbeing is protected. This includes making sure that members of staff responsible for dealing with medication have been properly trained. Keeping a record of all medication received into the home in order to enable accurate checks to be made to make sure people are being given their medication as prescribed by the doctor. Clear written instructions should be in place for staff to follow to ensure medication prescribed when required is given correctly. To ensure people have a varied and well balanced diet of their choice there must Care Homes for Older People Page 8 of 30 always be sufficient stocks of food available at the home. Menus should also be preplanned in consultation with people using the service. It is important that people using the service and their relatives feel confident to make a complaint without worrying that this may be detrimental to their care. Urgent action must be taken to improve the standard of care provided at Sun Hill in order to reduce the risk of harm to people using the service. Action must be taken to ensure the home is clean and odour free so that people live in a comfortable and pleasant environment. So that care workers do not have to cook and clean the home in addition to caring for people using the service a sufficient number of domestic and kitchen staff must be employed at the home. To ensure the home is being run in the best interests of people using the service a formal system must be put in place to obtain their views. The homeowner must visit the home at least once a month and prepare a written report for the person responsible for managing the home. This will ensure the homeowner is monitoring the day to day running of the home and checks the care needs of people using the service are being met. The Commission must be notified of any incidents which affect the health and wellbeing of people using the service. This will enable us to monitor these issues to ensure they are being managed correctly. All members of staff must be given training in fire prevention so that they understand the principles of fire prevention and will know the action they must take in the event of a fire. Fire drills must also take place regularly. 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 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 9 of 30 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 30 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The admissions procedure did not ensure that peoples health and personal care needs were known before they were admitted to the home. Evidence: We looked at the care records of a person who was recently admitted to the home. These records did not include a pre-admission assessment. Carrying out a detailed pre-admission assessment of a persons health and personal care needs is essential in order to ensure their individual needs can be met at the home. The manager told us in the AQAA that people who were considering using the service were offered a service user guide and invited to visit the home on a day of their choice. However, there was no evidence in the care records we looked at to suggest that this person had indeed made such a visit. Care Homes for Older People Page 11 of 30 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Privacy and dignity was not promoted for everyone using the service. Deficiencies in care planning and the management of medication could put people at risk. Evidence: We looked at the care plans of four people using the service. These plans identified some health and personal care needs and provided some directions for staff to follow to ensure their individual needs were met. One of these care plans stated that the person suffered from diabetes but there were no clear directions for staff to follow about how to manage this problem. We discussed this issue with several members of staff. Only one of them knew what to do if a common complication requiring immediate action occurred. Having detailed care plans in place about healthcare issues helps to promote the health and well being of people using the service. One of the care plans only provided information about the help the person needed with personal hygiene, communication and mobility. Having detailed care plans in Care Homes for Older People Page 12 of 30 Evidence: place ensures that people using the service receive the care they need in the way they prefer. This care plan had not been dated on the day it was written or signed by the person who wrote it. Dating and signing all care records ensures that members of staff know who has completed them and if the information is up to date. Risk assessments for falls, nutrition and the development of pressure sores were not in place. Carrying out risk assessments enables the risks of falling, poor nutrition and the development of pressure sores to be identified. Measures can then be put in place to make sure any identified risks are managed correctly in order to help prevent falls, malnutrition and pressure sores. A written report about the care given to each person using the service was completed during each shift. This ensured that all staff had access to up to date information about the condition of each person in order to ensure continuity of their care. Care plans were usually reviewed monthly however, the ones we looked at had not been reviewed since February 2010. When there were any changes to the care needs of the person these were usually recorded in the review section of the records instead of the care plan. Reviewing care plans every month and up dating them when the needs of the person changes ensures members of staff know exactly what they need to do to in order meet the individual needs of each person. There was no evidence to suggest that people using the service or their relatives were involved in care planning. Involving people using the service and their relatives in care planning helps to ensure their individual needs are met in the way they prefer. There were records of the involvement of GPs and other healthcare professionals including the chiropodist and optician in the care of people who use the service. Personal care was carried out in the privacy of the persons own room or the bathroom. However, we witnessed poor practice at lunch time when one persons clothes were unprotected and they had spilled a large amount of food on their clothes. This persons dignity was not promoted and action must be taken to address this issue. We arrived at the home after the morning medicine round had been completed. However, at 11:55am we observed a member of staff signing the medication administration records to indicate that people had taken their medication. The member of staff explained that it was the beginning of a new medicines cycle and the medication administration records were not delivered until after she had given out the Care Homes for Older People Page 13 of 30 Evidence: medication. We were also told that one person had refused to take their medication but the medication administration record for this person had been signed to indicate they had taken their medication. This is poor practice as an accurate record of the medication administered should have been made immediately after each person had taken their medication to help prevent mistakes. We looked at records for the management of medication and found that a record of medication received into the home had not always been made. We checked a sample of medication records and stock but found it difficult to account for some medication. This was because the amount of medication left over from the previous month had not always been recorded accurately on the new medication administration record. We also found several times that the amount of medication in stock and the amount of medication taken by the person, as indicated on the medication administration record, did not add up correctly. Poor record keeping can lead to serious mistakes that can affect the health and well being of people using the service. A number of people were prescribed pain killers to be taken when required. However, there were no written instructions for staff to follow stating if the person was able to tell them when they needed pain killers or what signs and symptoms they displayed if they could not. Having clear written instructions for the administration of when required medication ensures people using the service are given their medication when they need it. Where a variable dose of medication was prescribed the actual dose given was not always recorded. We checked how controlled drugs were handled, these are medicines that can be misused. A special register was used for record keeping and was seen to have been completed correctly. There was no evidence to suggest that the home owner or a senior manager checked the management of medication including staff competence. Regular auditing of medication identifies mistakes and areas for improvement and helps to ensure that people using the service receive their medication correctly. We discussed medication training with senior members of staff and were told they had not received any formal training but had been shown what to do by the previous manager. Medication administered by staff who have not been properly trained greatly increases the risk of mistakes being made that can seriously affect the health and wellbeing of people using the service. This issue was discussed with the homeowner who was asked to take immediate action to resolve the problem. Care Homes for Older People Page 14 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Leisure activities are well managed but due to limited food stocks people lacked the opportunity to choose their meals. Evidence: Discussion with the activities organiser confirmed that a variety of activities were organised in the home. These included. crafts, board games, movement to music, gardening, reading the local newspaper, flower arranging, watching DVDs, needlework, reminiscence and jigsaws. People were taken out individually to the shops, garden centre and local parks. The activities organiser also told us that she worked at the weekend if special events such as an outside entertainer or birthday celebrations were planned. Members of staff said that visitors were welcomed into the home at anytime. They also told us that the daily routine was flexible and people could choose when to get up and go to bed. On the day of this visit a senior care worker was responsible for cooking the meals. The main course served at lunchtime consisted of home made beef burgers and Care Homes for Older People Page 15 of 30 Evidence: mashed potato. Vegetables were not offered. There were no pre-planned menus and when we asked what was for tea the carer said she wasnt sure and would have to look in the freezer. We were told that people were unable to have breakfast cereals on the day of this visit because they had run out. We checked the food stocks and found these to be very low. Having sufficient stocks of food ensures that people can have a well balanced diet of their choice. The home owner was informed and asked to action to address this problem. Care Homes for Older People Page 16 of 30 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Some people may not feel confident to express their concerns. Management procedures and care practice does not always protect people from abuse. Evidence: According the the AQAA a copy of the complaints procedure is displayed in each bedroom. The AQAA also states that no complaints have been made during the last year. The nine members of staff who completed the survey indicated that they knew what to do if a person using the service or their relatives expressed any concerns to them. Surveys completed by people using the service stated that they knew who to speak to if they were unhappy about anything. However, one visitor said they didnt feel that they could complain because it might be detrimental to their relative. The AQAA told us that members of staff had received training in safeguarding vulnerable adults. We discussed this issue with three members of staff. They all said they would report any concerns immediately and knew the procedure they must follow. However, information we received earlier in the year about recruitment practices resulted in three random inspections and a warning letter issued to the manager. Several allegations relating to poor care practice have also been made since the last random inspection. These are currently being investigated by social services. Care Homes for Older People Page 17 of 30 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 was generally well maintained but the environment in some areas was not conducive to the wellbeing of people using the service. Evidence: We were told by care workers that the cleaner had been off sick for several weeks and they were now responsible for cleaning the home. We were also told that the vacuum cleaner was broken and care workers were observed using a long handled brush to clean the carpets. This meant that carpets in most areas of the home were not being cleaned properly. Moreover, some areas of the home smelt of urine. An unpleasant odour and dirty carpets does not promote the health and wellbeing of people using the service. People using the service were encouraged to bring personal items for their bedrooms to make them more homely. These included, ornaments, photographs and pictures for the walls. The grounds and gardens were well kept and accessible to people using the service if they wished to sit outside when the weather was nice. All the laundry was done at the home. A suitably equipped laundry room ensures clothes are washed promptly and returned to people using the service. Care Homes for Older People Page 18 of 30 Evidence: Gloves and plastic aprons were available throughout the home for members of staff to use in order to protect themselves and people using the service from infection. Care Homes for Older People Page 19 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Recruitment procedures were through but a lack of ancillary staff affected the quality of the service provided. Evidence: The duty rota provided details about the grades and number of staff on duty for each shift. Members of staff told us there had not been a weekend cleaner for months and the weekday cleaner was probably going to be absent for some time. We were also told that only one cook was employed and when she was having her days off care staff were required to prepare all the meals. We looked at the files of three members of staff appointed since the last random inspection. These files indicated that all the required information had been obtained before these members of staff had started working at the home. This included two written references and a Criminal Records Bureau check. These checks ensure that people who use the service are protected from the employment of unsuitable staff. Discussion with the area manager and the information provided by staff who completed the survey confirmed that induction training for new employees was in place. However, this consisted of a basic check list and the area manager was advised to further develop induction training in order to ensure this met the Skills for Care standard. In addition to this care workers had received training in dementia, moving Care Homes for Older People Page 20 of 30 Evidence: and handling and basic food hygiene. According to the AQAA most of the care workers had National Vocational Qualifications at NVQ level 2. Care Homes for Older People Page 21 of 30 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management arrangements do not ensure the health and safety of people using the service is promoted. Evidence: The manager left several weeks ago and the area manager is currently responsible for managing the home. Although the area manager spends sometime at the home every week a number of staff expressed their concerns about the management arrangements in the absence of a full time manager. On the day of this visit we found that none of the staff on duty had the authority to address the issues we identified which affected the health and wellbeing of people living at the home. It is the responsibility of the home owner and area manager to ensure that medication is managed correctly, care plans contain the required information, privacy and dignity is promoted, the home is clean and adequate food stocks are available. According to our records the Commission has not been informed about things that have happened at the home since the last key inspection of May 2008. These are Care Homes for Older People Page 22 of 30 Evidence: called notifications and are a legal requirement. They also enable the Commission to monitor any issues in order to make sure they are being managed correctly. The homeowner told us that they had obtained the nationally accredited Investors in People Award. However there was no evidence to suggest that the views of people using the service or their relatives had been sought in the last year by either anonymous satisfaction questionnaires or at meetings. Obtaining the views of people using the service and their relatives ensures that the home is being run in their best interests and people are being cared for in the way they prefer. Although the homeowner visited the home regularly he did not complete a written report every month. The purpose of these visits is to supervise the management of the home and ensure it is being run in the best interests of people using the service. A written report provides the person responsible for managing the home with details of any action that they need to take in order to ensure people using the service are being cared for in the way they prefer. Several people using the service had a small amount of money kept at the home to pay for hairdressing, chiropody and other personal needs. To ensure this was managed safely records of all transactions were kept. We checked three of these during the visit and found the records to be up to date. According to the AQAA Policies and procedures for safe working practices were in place. These help to make sure the home is a safe place to live and work. Although records confirmed that fire extinguishers, fire alarms and emergency lighting had been serviced in April fire alarms and emergency lighting were not routinely checked by staff at the home. Moreover there was no evidence to suggest that fire drills were held regularly. Only one of the care workers on duty at the time of this visit had received fire prevention training. The senior carer on duty who would be expected to manage the situation in the event of a fire had not been given this training. We looked at the records of routine servicing of equipment. These included an up to date electrical installation certificate and evidence that the testing of small electrical appliances was carried out annually. However, a gas safety certificate was not available and the homeowner was advised obtain one as soon as possible. Care Homes for Older People Page 23 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 3 14 People must have their health and personal care needs assessed before they are admitted to Sun Hill. This will ensure their needs can be met at the home. 25/06/2010 2 7 15 Care plans must accurately identify and address all the health and personal care needs of each person using the service. This will ensure that all care workers know what they need to do in order to meet the needs of each person using the service. 16/07/2010 3 8 13 Risk assessments for falls, 16/07/2010 nutrition and the development of pressure sores must be completed for each person using the service. Care Homes for Older People Page 25 of 30 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 This will ensure that risks are identified and effectively managed, 4 9 18 Members of staff responsible 16/07/2010 for the management of medication must be given formal training. This will ensure medication is managed safely. 5 9 24 There should be an effective system in place to check medicines and staff competence. This will help to make sure people who live at the home are kept safe. Records of medication received into the home and given to people must be clear, accurate and complete. This will enable medicines to audited to make sure they are being given correctly. 7 10 12 People using the service should receive appropriate help and support at mealtimes including suitable protection for their clothing. This will promote diginity for people using the service. 18/06/2010 16/07/2010 6 9 13 16/07/2010 Care Homes for Older People Page 26 of 30 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 18 13 The home owner must take effective action to improve care practice. This will ensure that people using the service are protected from abuse. 30/06/2010 9 26 16 The unpleasant odour in several areas of the home must be addressed. This Will ensure people people using the service have a homely and pleasant place to live. 30/06/2010 10 27 17 A sufficient number of domestic and kitchen staff must be employed at the home. This will ensure that care workers do not have to cook and clean the home in addition to caring for people using the service. 16/07/2010 11 31 26 The homeowner must visit 16/07/2010 the home at least once a month and prepare a written report for the person managing the home. This will ensure the day to day running of the home is being monitored and the care needs of people using the service are being met. Care Homes for Older People Page 27 of 30 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 12 33 24 A system must be put in 30/07/2010 place to obtain the views of people using the service and their relatives. This will ensure that the home is being run in the best interests of people using the service. 13 38 23 Fire drills must be held regularly. This will ensure that all members of staff will know the action they must take in the event of a fire. 16/07/2010 14 38 18 All members of staff must be 30/07/2010 given training in fire prevention. This will ensure members of staff understand the principles of fire prevention. 15 38 37 The homeowner must 30/06/2010 ensure thay the Commission is notified of all occurrences listed under regulation 37 of the Care Homes Regulations 2001. This will enable the Commission to mionitor any issues in order to ensure that they are being managed correctly. Care Homes for Older People Page 28 of 30 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 All care records should be signed and dated by the person completing them. This will ensure that all members of staff will know who has completed the records and if the information is up to date. People using the service or their relatives should be involved in care planning. This will ensure that people are cared for in the way they prefer. Care plans should be reviewed monthly in order to ensure the information they contain is up to date. 2 9 Clear written instructions should be in place for staff to follow to ensure medication prescribed when required is given correctly. When a variable dose of medication is prescribed the actual amount given should be recorded on the medication administration record. This will ensure medication is managed correctly and enable accurate checks to be made. 3 15 It is strongly recommended that menus are pre-planned and offer variety and choice. The views of people using the service should also be considered when menus are planned. This will ensure that people can have a varied and nutritious diet of their choice. People using the service and their relatives should be reassured that their concerns and complaints will be taken seriously, investigated and appropriate action taken. This will help to ensure that people feel confident to make a complaint without fear of recrimination. A vacuum cleaner should be made available in order to ensure carpets are cleaned properly. Induction training should be further developed in order to ensure this meets the Skills for Care standard. Fire alarms and emergency lighting should be tested regularly by staff at the home to ensure they are in full working order. A record of these checks should be kept. A gas safety certificate should be obtained as soon as possible. This will help to protect people using the service by ensuring that the gas pipework is sound. 4 16 5 6 7 26 30 38 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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