Inspection on 26/02/09 for The Clitheroe Residential Care Home

This inspection was carried out on 26th February 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Clitheroe Residential Care... 11/09/08

The Clitheroe Residential Care... 28/02/08

The Clitheroe Residential Care... 18/07/07

The Clitheroe Residential Care... 16/05/06

The Clitheroe Residential Care... 09/11/05

The Clitheroe Residential Care... 11/05/05

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Clitheroe Residential Care Home Eshton Terrace Clitheroe Lancashire BB7 1BQ     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: Pat White     Date: 2 6 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 29 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 29 Information about the care home Name of care home: Address: The Clitheroe Residential Care Home Eshton Terrace Clitheroe Lancashire BB7 1BQ 01200428891 01200442166 admin@primecarehomes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Prime Care Homes Ltd Name of registered manager (if applicable) Mrs Lorraine Hayward Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC 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 The maximum number of service users who can be accommodated is: 28 Date of last inspection Brief description of the care home The Clitheroe provides care and accommodation for 28 older people. Prime Care Homes Ltd owns the home. The house is a detached property located in a residential area, near to town centre shops and facilities and close to a bus route. There is a car park and enclosed patio area with garden seating at the front. Accommodation is on 3 floors, linked by a passenger lift. Altogether there are 18 single Care Homes for Older People Page 4 of 29 care home 28 Over 65 28 0 1 1 0 9 2 0 0 8 Brief description of the care home bedrooms (two with an en-suite) and 5 double bedrooms (with privacy screening), a two part lounge, a conservatory and two dining rooms. Various adaptations and equipment (such as handrails and toilet aids) are provided to assist service users with independence and mobility. The home has a Statement of Purpose and Service User Guide providing information about the care provided, the qualifications and experience of the owner and staff and the services residents can expect if they choose to live at the home. A copy of the Service User Guide is issued to all residents and their relatives/representatives on admission. The fees from 1st April 2008 ranged from £346 to £402.64p for care and accommodation. Additional charges are made for such things as hairdressing, papers and private chiropody. Care Homes for Older People Page 5 of 29 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: A key inspection including a site visit to the home was undertaken on the 26th February 2009. This was a main inspection the purpose of which was to determine an overall assessment on the quality of the services provided in the home. This was done through checking the important areas of life in the home that should be checked against the National Minimum Standards For Older People. The progress on the matters that needed improving from the previous key inspection in February 2008 and a random inspection in February 2008 was also checked. This inspection included talking to the residents, touring the premises, observations of life in the home, looking at residents care records and other documents and discussion with the manager and deputy manager. Six residents spoken with gave their views Care Homes for Older People Page 6 of 29 about the home. In addition survey questionnaires from the commission were sent to residents and staff and the district nursing team. Ten residents and eleven staff and 2 district nurses returned completed questionnaires. Some of the views of these people are included in the report. Also used in the inspection was the written information that the home provided to the commission prior to the site visit. This provided information about the residents, staff, the facilities and what improvements had been made in the last 12 months. What the care home does well: What has improved since the last inspection? What they could do better: The care plans could be further improved so that they include sufficient detail on all important matters, such as for continence, agression, and social interests and hobbies. This will help staff provide the right care and support and to meet individuals needs and preferences. Care Homes for Older People Page 8 of 29 The management must ensure that all residents receive a good standard of care, including meeting peoples continence needs and ensuring they are looked after safely. Some aspects of medication could be further improved, and more detailed instructions about how some medicines should be given should be written down to give staff clear guidelines. This should help to prevent mistakes being made. Although we were told that the activities in the home were being reviewd and developed, most residents who gave their views felt that there were only sometimes suitable activities. One said there wasnt much going on and that there should be more to do. Also the staff need to find out the individual interests of all the residents, including those with dementia, so that as many as possible can take part in suitable stimulating activities. The recording of complaints made about the home, and what action is taken, should be improved so that management and other personel have access to accurate information for reference and future use. The odour in some bedrooms should be improved so that these residents live in pleasant surroundings. People should not start work in the home until the full Criminal Records Bureau check has been obtained, including senior members of staff. References should be from former employers or people who can give genuine character references, and not from friends, so that a genuine view is obtained about peoples suitability for employment . This should help ensure that only suitable people are employed in the home. Though the staff training had improved, it could be further improved through attending more outside courses to help keep them up to date, for example in the protection of vulnerable adults from abuse. The overall management and development of the home could be improved by stable and continuity of management offering strong and clear leadership. This should assist in the maintaining and sustaining of improvements and developments in the home. 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 9 of 29 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 29 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. The admission procedures helped prospective residents and relatives to decide whether or not the Clitheroe was a suitable place for them, and whether or not staff could meet their needs. Evidence: Since the previous main inspection 2 years ago there had been an improvement in the homes admission procedures. The records viewed of a resident who had been recently admitted, and talking to the deputy manager, showed that the manager and deputy manger had visited this person in hospital prior to admission and had assessed their needs to find out if the home could meet these needs. Also this resident confirmed that her relatives had visited the Clitheroe, and several other homes in the area, and had advised her that they thought the Clitheroe was the most suitable. Details of her needs had been documented to assist staff to understand these needs and to assist them draw up a care plan. Some of the risks associated with everyday life, including Care Homes for Older People Page 11 of 29 Evidence: falls, had been assessed and written information was available to staff to help them reduce the risks. However information about this persons social and leisure interests had not yet been completed and staff were not sure what activities this person would enjoy or benefit from. Since the previous main inspection senior staff showed a greater awareness of the importance of correctly managing the needs of people whose behaviour becomes more difficult due to deteriorating mental health, and this had resulted in appropriate intervention from the mental health services. Residents spoken with and those who completed the questionnaires from the commission indicated that they thought their needs were met in the home. Care Homes for Older People Page 12 of 29 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. Residents had written care plans assisting staff to understand their care needs but some important information was missing about some aspects of personal care needed, and some care practices could be improved. Residents had access to the health care that they needed and medication was in general managed safely in the home. Evidence: Viewing of records showed that all residents had written care plans based on a care needs assessment. Some parts of the care plans viewed were detailed and contained useful information to help assist staff to look after people. There was also evidence that the assessments and care plans had been reviewed. There were also useful risk assessmets underpinning nutrition, moving and handling and pressure area care. However not all aspects of personal, health and social care needs were in sufficient detail. On one care plan viewed there was insufficient information about the residents epileptic seizures and what staff should do. Also there was no information about what assistance this person needed in the bath or about their leisure interests and former hobbies. Therefore there was no written guidance to staff on what leisure activities Care Homes for Older People Page 13 of 29 Evidence: would be suitable. Another resident did not have a care plan or underpinning risk assessment for challenging behaviour. On 2 care plans viewed there was insufficient information about promoting continence even though this had been a problem for some residents last year (see below). There was evidence from the records viewed, and talking to the senior staff, that people had access to the health care they needed including involvement with the mental health service (see previous section). Records showed that district nurses were involved as appropriate. However there had been recent concerns from the district nurses about the poor continence care of some residents, and that the special sheets used to help people keep dry in bed were inadequate. A resident had developed skin problems because of this. These matters were subsequently addressed by the owner and the deputy manager, and 2 district nurses who completed questionnaires for the commission said that they were satisfied that the care practices had improved and that systems had been put in place to prevent such concerns arising again. The deputy manager informed us of the action that had been taken to monitor and supervise staff to ensure that this would not happen again. Residents spoken with and those who completed the questionnaires were satisfied that they received the care and support they needed and at the time they needed it, though one spoken with said that they sometimes had to wait for attention. Residents also said that they always had the medical care that they needed. However 2 observations at the site visit were brought to the managers/ deputy managers attention which could have adversely affected the safety and the comfort of the residents involved. One resident was seen in a wheelchair at the dining table with her feet and legs unsupported. Another person with dementia was left to eat her meal unattended whilst lying down in bed and could have been in danger of choking. There were some good practices with respect to medication and an outstanding procedure had been developed satisfactorily. Looking at records showed that medication received and leaving the home, and medication administered, was recorded accurately. Controlled drugs were managed and administered safely. However some errors were identified and some areas for improvement. For one resident there was insufficient information about the safe administration of two types of pain killers in relation to each other. Whilst there was no evidence that these pain killers were not being given safely, more written guidance for staff would help to prevent mistakes. There was also insufficent guidance for some medicines that had to be given before food. The manager said that the medicines were being given at the right time but further written guidance would help to ensure these medicines are always given correctly. Care Homes for Older People Page 14 of 29 Evidence: One resident did not have a photograph for identification, and also had not been given one dose of a medicine that should be given once weekly. There was also insufficient guidance to staff about when to administer when required medication that includes what the medication is for and the signs for when this is needed. These details are needed so that residents are given the correct medication when needed. Residents spoken with and those who completed the questionnaires said that staff treated them properly and with respect. One said that the staff were lovely and another said they were kind. A previous matter outlined above regarding continence care, which did not uphold residents dignity, had been addressed. Care Homes for Older People Page 15 of 29 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. Routines were sufficiently flexible to suit peoples needs. There were some suitable activities but these were not offered according to individual interests and capabilities. The food served was sufficiently varied and wholesome and suited peoples tastes and preferences. Evidence: The manager and deputy manager said that the programme of activities had been reviewed and developed. Activities such as bingo, dominoes, singalongs, skittles, crafts were apparant. We were informed that there had been a Valentines Day party and that a member of staff had been designated responsible for organising activities. However there was no evidence that peoples individual interests were understood and encouraged, including those with dementia, and not all the care plans included information about peoples personal interests. Peoples religious interests were noted and local ministers sometimes visited the home to give Holy Communion. However most residents who completed the questionnaires said there were only sometimes suitable activities Some links with the local community were maintained through churches, and in Care Homes for Older People Page 16 of 29 Evidence: particular the Salvation Army, and visitors were made welcome in the home at any reasonable time. The district nurses commented that staff in the home were friendly and cooperative, and that the home was comfortable and homely. Residents said that the daily routines were sufficiently flexible and that they could get up and go to bed when they wanted and spend time in their room if they wished. The meals served appeared to suit the residents tastes. All those who were spoken with praised the food served. One said that the food was marvellous and another said it was very good. Most of the nine residents who completed the questionnaires said that they usually liked the food served. The menus seen showed a variety of traditional dishes, and that there was usually a choice of 2 main meals at lunch time and a choice of snack meals at tea time. There was also an option of a cooked breakfast. The cooks talked to the residents each day to find out what they would like. Care Homes for Older People Page 17 of 29 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. Peoples concerns were taken seriously but the policies and procedures had not always ensured a high standard of care for all residents and the record keeping did not help to protect people. Evidence: The home had a complaints procedure that was accessible to people. Those spoken with at the visit to the home said that they had no complaints, and most of those who completed questionniares said that they knew how to make a complaint and who to speak to if they were not happy about anything. The information provided to the commission before the site visit said that 2 complaints had been made in the last 12 months. However the records available in the home for viewing were incomplete and the new manager therefore did not have sufficient information about important matters relating to staff and residents. One complaint, from a General Practitioner, appeared to be about the same concerns of the district nurses, and referred to in a previous section. However the computer records viewed did not detail who the concerns were about, what the concerns were, who and how the concerns had been investigated and how the matters had been resolved. Computer records of another complaint showed that this was about cleanliness of a residents room and a personal hygiene matter. The records seen did not indicate who had investgated these concerns and whether or not the complaints procedure had been followed in terms of time scales and informing the complainant of the outcome of the investigations. Care Homes for Older People Page 18 of 29 Evidence: There had been one incident that had resulted in a carer being reported to the Protection Of Vulnerable Adults register and the management of the home had taken the correct action in this matter. The home had satisfactory policies and procedures to help protect people in the home from abuse and staff had undertaken some in house training in this matter, to raise awareness and further help protect people. However we were informed that this training was ready to be renewed, and staff would benefit from external training to help keep them up to date in these matters. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The premises were homely and comfortable and met the residents expectations. Most areas of the home were clean and fresh but some of the bedrooms had unpleasant odours. Evidence: The inspection site visit included a tour of the premises. This and the information provided to us by the home before the visit showed that some improvements had been made since the last main inspection in February 2007, and that the home was comfortable and homely. The passenger lift had been repaired and some bedrooms had been redecorated and refurnished. Work had been undertaken on the homes boiler and on the hot water system and some double glazed window units had been replaced in accordance with requirements made at the last random inspection in September 2008. Residents bedrooms appeared suitable for their needs and most residents had brought small personal items with them. Residents spoken with were satisfied with their rooms and 2 in particular spoke favourably of their private accommodation. One said that she loved her room. In spite of work being undertaken to regulate the hot water system to ensure safe Care Homes for Older People Page 20 of 29 Evidence: temperatures, hot water outlets tested on the site visit showed that in at least 2 bedrooms the hot water temperatures were too hot. We were informed that regular monitoring of the hot water temperatures took place. However this had not resulted in this fault being identified and rectified. Action was taken immediately to rectify the problem on the day of the site visit. As stated above some double glazed window units had been replaced in the conservatory to improve the appearance and vision. However there was a bedroom window that had still not been replaced and this could affect the residents view from the window and the lighting in the room. Most areas of the home viewed were clean and free from unpleasant odours, but at least two bedrooms were still malodourous making this unpleasant for the residents concerned. This has been an ongoing problem over a number of inspections and further advice should be sought by the home regarding alternative cleaning products. In the questionnaires most of the residents said that the home was always fresh and clean. Care Homes for Older People Page 21 of 29 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. Most staff had the right qualifications and training to help them look after older people, but the staff recruitment procedures could be improved to help prevent unsuitable people from working in the home. Evidence: We were informed by the manager that the staffing levels were sufficient to meet the needs of the residents. Also residents who completed questionnaires, and those who were spoken with, in general felt that staff attended to them when they needed care. Most staff who completed questionnaires said that they thought there was usually enough staff on duty but one said that the shift always ran better with 3 staff on duty. Two cooks and a cleaner were employed in the home to help maintain standards with respect to meals and cleanliness. Seven out of 12 permanent members of staff had completed national vocational qualifications in care and 5 others had just started a relevant course. Staff had completed in house training in challenging behaviour and dementia and external training in infection control. Eleven staff completed questionnaires for the commission, and most said that the Induction when they started work, and the ongoing training, was suitable for their needs and prepared them for their work. We were also informed Care Homes for Older People Page 22 of 29 Evidence: by the manager and the district nurses that the district nurses were offering training to staff in skin care and promoting continence. The staff recruitment procedures were not fully in accordance with the Care Homes Regulations and best practice. The new manager had commenced work in the home about 6 weeks before the full criminal records bureau (CRB) check was obtained, and with only the protection of vulnerable adults check. The records of two care staff recruited since the last main inspection were looked at, and for one of these all the procedures had been followed according to the regulations and best practice. However for the other member of staff a full employment history had not been recorded and one reference was from a friend and someone she had looked after for a short while. These practices could potentially mean that unsuitable people were employed in the home. Care Homes for Older People Page 23 of 29 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 home had been through a series of management changes, and a period without manager, leading to uncertainty and instability within the home. Evidence: In the last 2 and a half years the home had been through a series of management changes, so there had not been a period of stable and continuity of management leadership and direction for some time. This could have contributed to the lack of overall development in the home as reflected in some of the recommendations. The previous manager was in post for just over a year and was replaced by the present manager about 2 months ago. She has the qualifications relevant to the manager of a care service and had previous experience as the manager of a domiciliary care agency. At the time of the site visit she was still learning about the systems operating in the home and about the Care Homes Regulations. She had applied to the commission to be the registered manager. The owner supported the home and the staff and visited on a regular basis to monitor the quality of care and facilities in the home. Care Homes for Older People Page 24 of 29 Evidence: The information supplied to the home prior to the visit, which informs the commission of the homes own assessment of the service, was adequately completed but was short of detail in some areas. For example this document did not acknowledge some of the problems that have been outlined above and how they have been addressed. We were told that the home had not undertaken a quality monitoring exercise with the residents and relatives in 2008 so there was no evidence that the home was run in the best interests of the residents. However residents meetings were held about every 2 months and minutes taken of these meetings. Matters such as the meals, activities and the laundry were discussed. The home had policies and procedures to help promote the health and safety of residents and staff. Staff had undertaken some relevant in house training in health and safety, risk assessments and food hygiene. There was evidence that the appliances and installations were tested and maintained appropriately to ensure they worked safely. A recent fire safety inspection had assessed the homes fire precautions as satisfactory. The management notified the commission of accidents and incidents affecting the health and welfare of the residents so these could be monitored. Care Homes for Older People Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 29 19 References must always be 07/11/2008 sought from previous employers and especially from previous employers of a care service if this is an option. If employment references cannot be obtained there should be a full written explanation. To help ensure that suitable people are employed in the home Care Homes for Older People Page 26 of 29 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 8 13 All residents should be cared 31/03/2009 for safely and comfortably including when being transported in wheelchairs and when eating So that residents are kept safe from harm and that there comfort and well being is promoted 2 9 13 Medication must not be 31/03/2009 ommitted without reason, and must always be given as prescribed To ensure the medication is a-effective and residents health is promoted 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 Care plans should contain sufficient information in all aspects of personal, health and social care to assist staff to provide the preferred care wanted and needed by Page 27 of 29 Care Homes for Older People residents, including information about how to manage epileptic seizures and challenging behaviour and information about individuals leisure interests. 2 9 There should be sufficient written information and guidelines for staff about the administration of pain killers that are to be used together, the administration of when required medication and for medication that must be given before food. Leisure activities should be provided to suit individuals specific interests and capabilities including those with dementia. There should be sufficient records kept in the home about complaints made including what and who the complaint is about, who and how the matters have been investigated and the outcome of the investigations The staff should have access to external training on the Protection of Vulnerable Adults. The bedroom window identified should be replaced and the hot water montoring system should be effective leading to appropriate action. All parts of the home should be free of offensive odours. People should not be employed in the home until the full criminal records bureau check has been obtained and references from employers or genuine character references have been obtained. Full employment histories should be recorded. There should be a permanent manager in the home who is registered with the commission, to give clear, and continuity of, leadership and direction. The homes own quality monitoring measures should be implemented and fully used to take into account the residents and relatives views about the home are taken into account. 3 12 4 16 5 6 18 25 7 8 26 29 9 31 10 33 Care Homes for Older People Page 28 of 29 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 29 of 29 - 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!