Inspection on 05/02/09 for The Beeches

This inspection was carried out on 5th February 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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Turret Villa Retirement Home

Moor House

Mendip House

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Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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: The Beeches Church Lane Kelloe Durham DH6 4PT     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Andrea Goodall     Date: 0 5 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 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: The Beeches Church Lane Kelloe Durham DH6 4PT 01913773004 01913778361 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Sunny Okukpolor Humphreys Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 31 Number of places (if applicable): Under 65 Over 65 5 31 dementia old age, not falling within any other category Additional conditions: 0 0 The maximum number of users who can be accommodated is - 31 The registered person may provide the following category 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, maximum number of places. 31 Dementia - Code DE (E) over 65 years of age, maximum number of places 5 Date of last inspection Brief description of the care home The Beeches is a care home that is registered to provide residential and nursing care for people over 65 years old. It is has been operating for several years, and was registered to a new Provider in August 2008. The home is located in a quiet area on the outskirts of Kelloe village with easy access Care Homes for Older People Page 4 of 30 Brief description of the care home to a small number of local amenities. The building has been converted and extended for use as a care home and can accommodate up to 31 service users in single rooms, most of which have private en-suites. The home has a range of sitting and dining areas available. There is level access into the home and a passenger lift serves both floors. The home has extensive, well kept gardens that have seating areas. The fees for residential and nursing care places are in line with Durham County Council rates. The home should be contacted for current fee information. 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: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Before the visit we looked at information we have received since the last visit on 22nd July 2008. We looked at how the service dealt with any complaints or concerns since the last visit. We looked at any changes to how the home is run.We asked the Provider for their view of how well they care for people in the annual quality assurance assessment (called an AQAA). We made an unannounced visit to the home on 5th February 2009. During the visit we talked with people who use the service, relatives, staff, the manager and visitors. We spent time with the people who live here and looked at how staff support them. We looked at information about the people who use the service and Care Homes for Older People Page 6 of 30 how well their needs are met. We looked at other records which must be kept by a care service. We checked that staff had the knowledge, skills and training to meet the needs of the people they care for. We looked around parts of the building to make sure it was clean, safe and comfortable. We checked what improvements had been made since the last visit. We told the acting manager what we found. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: If someone has dementia care needs this should be included in their care plan so that all staff know how to support them in the same way. Care plans should be reviewed at least every month. The home should help people to enjoy activities outside the home, for example to spend time in the garden, or walk to the village or go on short trips. The home should provide information for people about choices of menus and activities. It would be better if there were Residents Meetings so that people have the chance to make suggestions and comments about the service. It would be better if a record was kept of informal comments and complaints. All staff should have clear information about where to report suspected abuse. The new Provider should continue with the programme of decoration to ensure that all parts of the home are reasonably decorated and furnished. Care Homes for Older People Page 8 of 30 The toilet that is still without a lock should be fitted with one, and the lock to the bathroom door should be fixed. Door handles should be fitted to the inside of the two communal toilets on the ground floor so that they are easy to close by the people who live here. The Provider should keep looking for an experienced manager who will be able to help the home make the improvements that are planned. Records should show that staff have fire training often enough so that they would know what to do. Other things that would make the home better include:care assessment records should be fully completed, signed and dated; weight records should be completed at least every month; dining arrangement should be reviewed to make sure everyone has the choice of sitting in a dining room if they chose to; the broken assisted bath should be repaired or replaced; dirty light pull cords should be replaced then regularly cleaned; staff training records should be kept up to date; and the Provider should keep a record of the outcome of his visits to the home on at least a monthly basis. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Overall people get good information about the service and their needs are assessed before moving here so they know whether home can meet their needs. Evidence: Since the last inspection in July 2008, the home has been purchased by a new Provider. The homes information pack has been changed to show the details of the new owner, and there is also a new picture brochure about The Beeches. People who come to live here are also provided with good information about the terms and conditions of their residence in a Residents Contract. As recommended, the contract has been reprinted in larger print so it is now easier to read. Most of the people who live here are from the local area and chose the home because they were familiar with it. At the time of this visit there were 21 people living here, i.e. nine people in the nursing unit, eleven people in the residential unit and one person Care Homes for Older People Page 11 of 30 Evidence: staying here for a short break. The needs of prospective residents are assessed by social care and/or health care professionals before they move in so that the home knows whether those needs could be met here. The home also carries out its own assessment of new residents, and this information is used to help plan someones care. Care Homes for Older People Page 12 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are treated with respect but some peoples personal and health care needs are not sufficiently planned to ensure people always receive care in the right way. Evidence: Care plans are records that are used by all care services to show what sort of help each person needs and how staff will provide that care. For example how to help people with their mobility, diet, and personal hygiene. Although care records at The Beeches were sensitively written, the quality and detail of care planning was mixed. Overall the care plans of people receiving the nursing service were detailed and monthly reviews were up to date. However the care plans for people receiving a residential service were not of the same standard. For example there were still no care plans about peoples dementia care needs even when this is their primary need and the reason for them being here. This means there is no guidance for staff about how to support someone with their behaviour and/or memory loss. In this way staff may not be responding in the same consistent way to someones dementia care needs. This Care Homes for Older People Page 13 of 30 Evidence: was reported at the last inspection. Also the care plans in the residential unit had not had a monthly evaluation since October 2008. (In later discussions with the Providers professional adviser it was acknowledged that this is an area that is planned for improvement and she will be providing staff with support and instruction in care planning records.) Health care assessments were also mixed in quality. There have been improvements to moving and assisting plans that now show all the equipment and support people need if they have mobility problems. In the nursing unit there were clear assessments of peoples health care needs on admission and regular reviews. However in the residential some health care assessments, including mental health needs, had not been fully completed when the person moved in, had not been reviewed, and were not signed or dated by the assessor. For some people with nutritional needs there had been no weight records since July 2008. In this way the home would not know if peoples nutritional well being was changing, and whether they needed extra support with this. The home supports people to access community health care services such as GPs, district nursing services, and opticians. It was evident from care records that residents are supported to access relevant health care services as and when they require them. One relative said The staff always keep me informed if she has not been well and needs to see the doctor. Nursing and senior staff are responsible for the administration of medication, and they are provided with suitable training in the safe handling of medicines. There is secure, suitable storage for medication for both floors of the home. The home uses a recognised monitored dosage system, which means that medication is delivered to the home by the pharmacist in easy-to-use blister packs. The records of incoming and administered medication were up to date and in good order. Residents had positive comments about the way they are supported, and feel that they are treated with respect. Overall staff were observed to be helpful and supportive when carrying out care tasks, although some staff are more engaged than others with the people who live here. Relatives were complimentary about the manner in which staff support people. One visitor said, The staff are always nice towards her. Sometimes they dont know Im here, but they pop their head round her door to see if she wants a cup of tea or anything. Another relative said, Staff are lovely. They have a nice attitude and are very helpful. Care Homes for Older People Page 14 of 30 Evidence: But they dont always see what needs to be done, such as making sure she has socks on when shes going out to an appointment. Care Homes for Older People Page 15 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. Residents enjoy a flexible lifestyle but they do not have sufficient opportunities to go out and do not have enough information about choices so their rights to exercise control are not fully promoted. Evidence: For several months last year there was no activities staff to engage people in leisure and social activities. Recently a new activities staff has started to work at the home for 18 hours a week. She has introduced a range of activities for people including bingo, manicures, connect4, singing sessions, reminiscence chats, and making greetings cards. Several people prefer to spend a lot of time in their own bedrooms so the activities staff visits them for one-to one chats. Relatives felt that this is a much needed improvement but are also aware that it will take some time for people to become more engaged in social events. One relative said, Its good that there is an activities co-ordinator now, but its hard work trying to motivate people here. They could do with more music sessions, because they like that. Care Homes for Older People Page 16 of 30 Evidence: Residents commented that they can still follow their own preferred routines in the home, and that this is respected by staff. Some residents described how they like a lie-in and a late breakfast and this is supported. The home is in a very secluded area, surrounded by trees. There are very few amenities in the local village, and residents have had no opportunities to go out since the last inspection (unless with their own relatives.) There is a visiting hairdresser but there is no other contact with the local community. It is better that residents can now make their meal choices on the same day, although they are asked verbally and still do not have any written (or pictorial) information about the menus. The new activities co-ordinator said she is planning to restart Residents Meetings, and it is hoped that this will give residents more opportunities to be more involved in making comments about the service, such as their suggestions about activities and menus. The standard of catering continues to be very good and residents were complimentary about the quality of the meals. The choices for each meal are traditional, nutritious and appetising. There are two dining rooms, one on each floor. There is a significant difference between the standard of these two rooms. The dining room on the ground floor is large enough to comfortably seat about 16 people. It is well decorated, bright, has good views of the garden, and offers a pleasant dining experience. However the dining room on the first floor is still a small, dark room with low ceiling, bare fluorescent strip light and worn decoration. It cannot comfortably seat more than 8 people so is not sufficiently large enough for the number of places on this floor. This may be why several people choose to dine in their own rooms. Care Homes for Older People Page 17 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff do not have sufficient guidance about how to manage complaints or concerns so the protection of residents is not fully promoted. Evidence: All residents (or their relatives) are given a copy of the complaint procedure, which is in the information pack. This has been updated to now show the address of the new Provider. In discussions, residents and visiting relatives said that they felt staff are approachable and that they would feel comfortable about mentioning any concerns or complaints. The homes complaints records show that there have been no formal complaints about this service since the last inspection. The current acting manager indicated that only written complaints are formal complaints. However, in discussions, one relative commented that they have informally commented several times on the state of the carpet in a residents bedroom and that the window will not close fully, but these complaints had not been recorded, or dealt with. In this way the home does not demonstrate that it takes all comments seriously. This may be due to the lack of experienced management in the home over the past few months. The majority of staff have had previous training in protection of vulnerable adults, although newer staff are yet to have this training. At the time of this inspection the Care Homes for Older People Page 18 of 30 Evidence: acting manager was unable to find the homes Safeguarding Adults procedure, so it is not known whether this complies with the Durham County Council procedures. In this way staff are aware of their responsibility to protect the people who live here, but do not have guidelines about how to report any suspected abuse. Care Homes for Older People Page 19 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 is clean, warm and comfortable, and the Provider is making improvements to the accommodation but some areas remain worn so that some residents do not live in a well-maintained environment. Evidence: The home is a Victorian two storey building with a modern new single storey extension to the side. The first floor provides accommodation for people who require nursing care. The ground floor is mainly for people who receive a residential care service. Overall most parts of the home are warm, clean and comfortable. However the quality of decor and furnishings in the home remains rather mixed. The standard of accommodation within the newer extension is good with wide corridors, well lit lounges, well decorated bedrooms and spacious, well equipped bathrooms. One relative said, She has a nice room on the ground floor. We chose it because it is the nicest room with the best view. However the standard of accommodation in the main part of the building is not as good in terms of decor, space and access. Over the past few years these areas of the home have become more worn. One relative described the older part of the home as Care Homes for Older People Page 20 of 30 Evidence: dated. The new Provider was aware of the work that was needed to improve the standard of accommodation when he purchased it, and he has implemented a programme of redecoration. This is being carried out by a relief maintenance staff, who also has to attend to the routine maintenance checks and repairs, so the progress is quite slow. At the time of this inspection around five bedrooms had been repainted and fully refurbished. Bathrooms in the older part of the home are uninviting and are particularly in need of redecoration and refurbishment. One bathroom on the ground floor has a chair hoist that has been broken for several months, which means two staff have to support people in and out of this bath. One toilet with a sliding door still does not have a lock. One bathroom has a lock which does not fit into the recess. There are still no door handles on the inside of two communal toilets on the ground floor so they are extremely difficult to close and lock. These issues do not support the privacy and dignity of the people who live here. The standard of cleanliness and odour control was generally good throughout the home, although one or two individual bedrooms might benefit from some additional attention. Some light pull cords in toilets and bathrooms have become very grubby. They are difficult to clean in their current state and this could compromise infection control within the home. Care Homes for Older People Page 21 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Overall the home provides suitable, competent staff to meet the number of people who live here. Evidence: At the time of this inspection the staff team included an acting manager (former deputy manager of the residential unit) a deputy manager for the nursing unit, RGNs (Registered General Nurses), senior care and care staff. There are also catering and housekeeping staff, a part time activities staff and a relief maintenance staff. At the time of this visit there were 21 people living here. The daytime staffing levels provided at this home are one RGN, one senior carer and two care assistants. During the night there is one RGN and two care staff. These are satisfactory staffing levels to meet the number and needs of the people who currently live here. There are good relations between staff and residents, and with relatives. Overall the home enjoys a relatively low turnover of staff, which can supports the continuity of care of the people who live here. One relative said, Its always the same staff so they can tell me if shes been off-colour or whether she has any appointments. Care Homes for Older People Page 22 of 30 Evidence: At the time of this visit only one staff, the manager, had left since the last inspection in July 2008. Only one new staff, the activities co-ordinator, has been appointed. The personnel files showed that appropriate checks and clearances had been received before new staff start work here, including police checks. However, in one case, prewritten testimonials had been accepted instead of requested references. This had been an isolated event but there was no record on the staff file to state why references had not been requested. It is very good practice that all care staff now have a care qualification (called NVQ level 2) except one staff who is currently working towards this award. This means that in the near future 100 of staff will have achieved this qualification. It is good practice that both senior staff have achieved the higher award of NVQ level 4. It is also good practice that all except one staff have now completed training in Positive Dementia Care, as recommended at the last inspection. This training should support staff to understand the needs of the small number of people with dementia care needs who live here. The home uses a training agency to provide staff with all mandatory health & safety training. There are individual training records for each member of staff, but these are not fully up to date so do not show all the training that staff have received. At the time of this visit there was no training plan to show what training each member of staff needs, or when they require refresher training. Care Homes for Older People Page 23 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes current lack of a registered manager means that residents have recently received a service that is not well organised. Evidence: Since the last inspection in July 2008 the registered manager has left the home. During the past few months the deputy manager of the residential unit has been the acting manager, until the new Provider can appoint a new manager. During that time the acting manager has been supported by a professional adviser on behalf of the Provider. The deputy manager for the nursing unit who has continued to provide clinical supervision to the nurses who work here. The acting manager returned the annual quality assurance assessment (AQAA) to us before the inspection visit. This was satisfactorily completed and described some of the planned improvements for the home. Care Homes for Older People Page 24 of 30 Evidence: On the day of the visit the acting manager informed us that she was resigning from the home to take up another position elsewhere. Since then the professional adviser for the Provider has kept CSCI informed of the planned interim management arrangements until an experienced, qualified manager can be appointed. The new Provider visits the home frequently, but there is not a record of his visits to the home or any actions as a result of his findings. He has held two meetings with relatives and residents to keep them updated about his plans for improvements to the home. It is intended that there will be more regular meetings with residents and their relatives from now on. The Providers professional adviser has also held meetings with staff, both individually and as a group, so that the areas for improvements to the service can be shared with the staff team. On request the home will support residents to safely store a limited amount of personal monies. Residents have access to their individual monies whenever they require. A small sample of monies and records showed that these are kept in good order. The staff receive certificated training in all health and safety matters, such as moving & assisting and infection control. As reported at the last inspection, the records of inhouse fire instruction for staff do not show that this training occurs at the right intervals i.e. not less than 6 monthly for day staff, not less than 3 monthly for night staff and two instructions in the first month for new staff. At this time some staff have completed questionnaires about the location of fire equipment in the home, but this does not demonstrate that staff know what to do in the event of a fire. The maintenance staff is responsible for carrying out routine health & safety checks around the building. For example hot water temperatures should be checked regularly by maintenance staff and adjusted to a safe temperature wherever necessary. However staff could not find any records of these checks during this visit. The maintenance staff has been on sick leave for some time so a relief maintenance staff is employed here. At the time of this visit the water temperature to one bath was well over 50 degrees which is scaldingly hot. Staff do keep a bath temperature record when supporting someone to have a bath. However these showed temperatures such as 34-36 degrees centigrade which is extremely cold for full body immersion. Care Homes for Older People Page 25 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 26 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 7 15 Care plans must include details of peoples dementia care needs where this is applicable. This is to guide staff in how to support people with their significant needs in a consistent, planned way and that any changes in need are identified. 01/04/2009 2 19 23 The new Provider must continue with the programme of decoration to ensure that all parts of the home are reasonably decorated and furnished. This is to ensure that all residents live in equally satisfactory standards of accommodation that values and promotes their dignity. Records of in-house fire instruction must be in place to show that night staff receive this instruction at 01/07/2009 3 38 18 27/03/2009 Care Homes for Older People Page 27 of 30 intervals of 3 months and all staff who work during the day receive this instruction at least 6 monthly. This is to ensure that all staff know what to do in the event of a fire. 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 8 The post-admission assessments of peoples care needs should be fully completed, dated and signed, and regularly reviewed. Each persons weight should be recorded on at least a monthly basis so that the home can check their nutritional well being. The home should make sure that people have opportunities to go out into the local community, and to places of interest. There should be Residents Meetings so that people have the chance to be involved in making suggestions and comments about the service. The home should provide information, in a suitable format, about choices of menus and activities, so that residents can make informed decisions. Consideration should be given to how the home can provide equal standards of dining accommodation for people who live on the first floor. There should be sufficient space and/or arrangements for all residents to dine in the dining rooms should they choose to. It would be better if a record was kept of informal comments and complaints, and included any action taken. It would also be better if the complaints procedure included the telephone number of the new Provider to make it easier for residents and relatives to contact him. There should be a copy of the homes Safeguarding Adults protocols in the office for reference at all times. All staff should have clear information if they have to report suspected abuse. All new staff should have training in this Page 28 of 30 2 8 3 13 4 14 5 14 6 15 7 16 8 18 Care Homes for Older People area as soon as possible after starting work here. 9 10 21 21 It would be better if the broken assisted bath was repaired or replaced. The toilet without a lock should be fitted with one, and the lock to the bathroom door should be fixed. Door handles should be fitted to the inside of the two communal toilets on the ground floor so that they are easy to close by the people who live here. Dirty light pull cords should be replaced and be included on the cleaning schedule. Requested references should always be sought as part of the recruitment and selection processes. Individual training records should be kept up to date to demonstrate what training each staff has attended. It would be better if there was a training plan to show the future training needs of staff so that this can be arranged and planned in advance. The Provider should continue to seek to recruit an experienced, qualified manager who will be able to support the planned improvements of this service. The Provider should keep a record of the outcome of his visits to the home on at least a monthly basis to demonstrate his findings and any actions required (as set out in regulation 26 of the Care Homes Regulations 2001). Records of hot water temperatures should be available for inspection and should demonstrate that the hot water checks are carried out to all baths on a weekly basis and show any adjustments that have to be made to attain a safe water temperature.. 11 12 13 26 29 30 14 31 15 33 16 38 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. 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