Inspection on 12/03/10 for The Haven

This inspection was carried out on 12th March 2010.

CQC found this care home to be providing an Poor 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Haven 21/06/10

The Haven 11/06/10

The Haven 01/03/10

The Haven 14/09/09

The Haven 26/11/08

The Haven 04/06/08

The Haven 19/06/07

The Haven 21/11/06

The Haven 29/08/06

The Haven 19/09/05

The Haven 10/12/04

The Haven 27/05/04

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Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2010.

Key inspection report Care homes for older people Name: Address: The Haven 6 - 10 North Terrace Seaham Durham SR7 7EU     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: Steve Tuck     Date: 2 3 0 3 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: The Haven 6 - 10 North Terrace Seaham Durham SR7 7EU 01915816305 01915130377 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Haven Hommes 2003 Ltd Name of registered manager (if applicable) Manager Post Vacant Type of registration: Number of places registered: care home 43 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 43 The registered person may provide the following category of service: 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, maximum number of places: 36 Dementia - Code DE, maximum number of places: 7 Date of last inspection Brief description of the care home The Haven is a registered care home providing personal care and accommodation for up to 43 older persons. The home is not registered to provide nursing care however community nursing services visit people who have these needs. The home is owned by Haven Hommes 2003 Ltd which is a private limited company. Care Homes for Older People Page 4 of 30 Over 65 0 36 7 0 Brief description of the care home The Haven is a two storey building located on the main street in Seaham, close to local amenities. Peoples bedrooms are provided on both floors and there is a lift so that people can get access to the upstairs easily. The lounge and dining areas are on the ground floor along with other areas such as the kitchen laundry. There is a patio and garden area located to the rear of the property. It costs £412 per week to live at this home (given in november 2009). The costs of newspapers, hairdressing, private chiropody and toiletries are not included in the fees. Fees may vary depending on peoples circumstances, further details can be found in the homes Service User Guide or through Durham County Council . 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: How we did our inspection Before the visit we looked at: Information we have received since the last Key Inspection in September 2009. This included, Notifications, these are where the home manager/owner must tell us about things which have happed at the home. Information about the home that has been given to us by other agencies or organisations such as the local council Durham County Council and Primary Care Trust. Information from members of the public who have visited the home. Care Homes for Older People Page 6 of 30 How the service dealt with any complaints and concerns. Any changes to how the home is run. Following a Random Inspection on 25/11/09 the owners were issued with a legal notice to improve the way that medication is stored and administered. A follow up inspection was carried out on 01/03/10 which found that the requirements of the legal notice had not been met. Further enforcement action is being taken. The Visit Four unannounced visits were made on 12th, 15th, 17th and 23rd March 2010. During the visit we: Talked with the people who use the service, the staff, the manager and visitors to the home. Observed life in the home. Looked at information about the people who use the service and how their needs are to be met. Looked at other records which must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around parts of the building to make sure it was clean safe and comfortable. We told the acting manager what we had 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. 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: The homes owners have been issued with warning letters and a legal notice. Further enforcement action is being taken by the Care Quality Commission to improve the services at this home. The administration of medication in the home must be safe and have accurate records so that people who live there get the treatment they need and are not placed at risk of harm by errors, staff incompetence or neglect. There must be improvements made to the building to make sure that the people who live and work there are safe in the event of a fire, and the home is hygienic and comfortable. People who live at the home and their representatives must have a way of making a complaint about the service when they are unhappy about the homes performance or have a dispute or grievance; and records must be kept which show what has been done to satisfy these complaints. People must not be employed at the home until they have sufficient background checks carried out which demonstrate that they are legally able to work at the home and are suitable to work with vulnerable people. There should be a Service User Guide that can be used by the people who live at the home or wish to move there. This is so that people have important information about the home, their rights as residents and how they can complain. The homes initial assessment should continue to be improved so that the needs of people who are moving there are known, agreed and understood information makes sure that peoples needs can be met at the home and should help to plan the ways in which staff are to support them. Only people whose needs can be met by the home should be admitted. The homes capacity to meet the assessed needs of people that they are considering admitting to the home should be considered before they move there. The home is not suitable for those people who have advanced dementia or complicated care needs. Where people with dementia are to be accommodated at the home, then care planning arrangements should be in place which will effectively describe how their support is to take place and follow current best practice. All the people who use the service should have a written care plan which fully details the actions which staff must take to ensure that all aspects of their health, personal Care Homes for Older People Page 8 of 30 and social care needs are met and follows current best practice. And that these are used to co-ordinate and review their care. There should be strategies in place which help to identify when people who have dementia type illness are experiencing pain and these are recorded in their care plan. There should be meaningful activities in place, which follow current best practice to support the lifestyle needs of people who have with dementia type illness. Measures taken to control odours should be improved so that the home is a more hygienic and pleasant place for people to live. There should be an up to date record of training that all staff have achieved so that this can be monitored by the manager and plans made to meet training priorities including core and specialist skills. Staff should have the skills and knowledge to support people who have dementia type illness. The quality of care at the home should be reviewed where the people who live there and their relatives are asked their views about the service they receive. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements are being made so that the needs of people who are to be admitted to the home are known about and agreed before they move in so that the manager can tell if the home is suitable for them. But there is no information about what the home has to offer people who are or wish to live there which makes it difficult for them to understand what to expect and what their rights are. Evidence: There is no information that would help people who live at the home or who are considering moving there which explains what the home can offer them, what it is like to live there, how they can complain, the terms of the homes contract and a copy of the latest Inspection Report. This information is intended to empower and support people and their families so they know what to expect and who to turn to if they are not satisfied with the service they receive. No one has moved to the home since the last inspection in September 2009 however Care Homes for Older People Page 11 of 30 Evidence: an Inspection in November 2009 showed that only brief information about what peoples needs were when they first moved to the home was available. Since then the present acting manager, who was appointed in November 2009, and the local council have made sure that everyone at the home now has an up to date assessment of their needs which can be now used by the home to plan and co-ordinate their care. Some people have moved to the home then developed more complicated needs. The acting manager is aware that she can not admit people or provide services for people who they do not have the facilities or skills to support as the home is not suitable for everyone. For example, the home is registered to provide services for people who have dementia type illness. However they are unable to support people who have needs which are severe or complex. This is because the layout and facilities in the home and the way that care is provided has not been designed for people who need high levels of support. The home does not provide short term care to help people to recover from illness or injury before returning home because they do not have the facilities or skills that are needed to help people regain their independence. 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The way that medication is stored and administered at the home is poor and does not make sure that people receive the treatment they have been prescribed and places them at risk. Each person has a plan of care, which should set out in detail their preferences and how their assessed needs will be met; But these do not fully describe the measures which staff are to use therefore making it difficult for them to consistently meet peoples needs. Evidence: All people who live at the home have a plan of care which gives a basic description of how their needs are to be met. At a previous inspection in November 2009 Inspectors found that adequate care plans were not in place and there were no care plans which properly described how staff were to support people and meet their needs. As a result steps were taken to force the owners to make sure that the home improved. At this inspection we found that the present acting manager has put basic care plans in place which cover the priority areas where people need support. Staff have a variety of knowledge and experience of caring for people living at the Care Homes for Older People Page 13 of 30 Evidence: home and could adequately describe peoples main needs, preferences and histories. But staff have little experience of using care plans to consistently provide fully coordinated care. All of the staff interviewed could describe peoples basic needs, preferences and histories however staff were not aware of current best practice and how this should improve peoples lifestyles. The home provides care to people who have become frail and may also have dementia type illness. Care planning arrangements for these people do not yet reflect current best practice. For example care plans do not specify how people who have an altered sense of time or reality are to be supported or what their personal timescales actually are. Care plans which place the person at the centre of a network of support for their needs and lifestyle requirements are yet to be put in place. This can be particularly important for people who become increasingly reliant on staff as their level of needs increases. This home provides support for people who have dementia type illness. Because of this, some people who live at the home can not express when they are experiencing pain or discomfort. Ways of working which help staff to decide if someone is experiencing pain, for example by monitoring expressions, responses or mood changes were not seen to be taking place at this home and there were no records in peoples care plans which showed how this was to take place. The manager agreed that improving the quality of care and care planning was one of the objectives for this service. At an inspection in November 2009, the way that medication at this home is stored and administered was found to be inaccurate, placing people who live at this home at risk. A Legal Notice was issued because medication was not handled appropriately. A further inspection of how the home manages peoples medication took place on 1st March 2010, however the Requirements of the Legal Notice were not met at this inspection. This is being dealt with under Enforcement Procedures. 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. Some people who live at the home are encouraged and supported by the staff to lead fulfilling lives. But this could be improved if staff had a better way of supporting the lifestyle needs of people who are more needy or have a dementia type illness. Evidence: The manager and staff help people who live in the home to stay in contact with family members and friends where this is possible. Some people are able to get around the home and some use the local community on their own. The manager talked about what they do both inside and out of the home. For example visiting their local club and shop. Everyone spoken to said that they liked living at the home. For some of the people who are unable or do not wish to leave the building there are some activities which take place. Although these had only recently been started so people did not comment about them. Although staff are available, there is no one whose role it is to organise, encourage, motivate or co-ordinate how people may wish to spend their time. Staffing rotas indicate that all staff do have time to spend with people living at the home, however daytime opportunities for people remain limited. There are routines at the home but it is not clear if the people who live there prefer Care Homes for Older People Page 15 of 30 Evidence: these such as regular mealtimes and regular tea / coffee breaks. Although the home is registered to provide for people who have dementia type illnesses, there is not a programme of activities, specifically designed to support, interest and help to structure the lives of people who have a variety of memory loss in place. Presently there are people living at the home who have these needs. Staff at the home like to encourage relatives or friends to visit regularly and people living there said that they like it when people visit and make them feel welcome. Some people who live at the home have brought small items with them making their rooms homely and reflective of their previous lifestyles, religious beliefs or cultural backgrounds. People living at the home are encouraged to make choices about their diet. Most said that they like the meals at the home and that they are asked what they would like to eat. Staff were seen asking people about their choice of meal and size of portion to make sure that people got what they wanted. Staff are available during meals to offer support and assistance where needed. The cook has a good knowledge of the meals which people living at the home prefer. She understands the benefit of using fresh ingredients to help people to remain healthy. Menus were available which confirmed that a range of meals are provided which give people a balanced diet. People are also able to choose any meal if they do not like the main choices. There were three different meals cooked on the day of this inspection. 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. The home has failed to safeguard residents health and welfare which has put them at risk and people living at the home and their families do not have a way that they can make a complaint if they are unhappy, have a grievance or dispute; which prevents them from having control over their lives; Evidence: There is no complaints procedure which people can use if they are not happy with the service receive from this home. There are no leaflets or posters around the home which tell people how to complain. A complaints procedure should inform people about who they should make a complaint to and how much time that a complaint will take to look at, but a this home, these are not in place. There is no record kept at the home of all complaints, which includes details of any investigation and the outcome. There is evidence that a complaint has been made within the past two months, and although there are two statements which were taken from staff, there is no record of the complaint nor is there any indication about how or indeed if it was resolved. There has been one instance where concerns were raised which found that several residents at the home were not receiving the treatment they had been prescribed. This led to a series of safeguarding measures, including oversight of all treatments by the local council and primary care trust, to make sure that prescribed treatment did take place and that people remained safe. Support from other agencies remains in Care Homes for Older People Page 17 of 30 Evidence: place at the time of writing so that people can continue to live at the home without their needs being neglected. Care Homes for Older People Page 18 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. Improvements are taking place to the building to make parts of it legally safe and decoration to make it a more comfortable place for people to live. But this could be improved if the works was completed more quickly, to a better standard of finish and with more effective odour control. Evidence: There is a routine of cleaning which helps to keep the home suitable for use and pleasant for residents and visitors. However odour control had not been successful in some rooms making it unpleasant for people living there. There has been some refurbishment work carried out in the home which has helped to bring conditions where people presently live (the ground floor) up to a minimal usable, safe and legal standard. The home has been inspected by the Fire and Rescue Authority who have required the homes owners to carry out improvements to the fire protection arrangements for the entire home. At present there are no residents able to live on all of the first floor and one of the ground floor bedrooms because the fire protection is not sufficient. However the remaining of the ground floor of the home is able to be used safely. While work is taking place to comply with the Fire and Rescue Authority legal notice, Care Homes for Older People Page 19 of 30 Evidence: other refurbishment is taking place to bring the first floor rooms back into use. However there is a considerable amount of remedial work still to do before these rooms can be occupied and the standard of finish of the refurbished rooms is poor with lack of attention to detail. For example the windows in two bedrooms did not fit properly in their frames and were draughty; in several other rooms the windows are misted so people can not see out of them. As well as this, two rooms that had been redecorated were done so with only basic paintwork, and this had been applied untidily around fittings and with a poor standard of finish. The home is inspected by the the local authority to make sure that a safe and healthy environment is promoted for the people who live and work there. An inspection had recently taken place and action to meet these legal requirements was started but not yet complete. The laundry is organised and equipped with modern machinery so that people can be confident that their clothing and personal linen is hygienically cleaned within a reasonable space of time and there are facilities in place of the disposal of clinical and other waste. Care Homes for Older People Page 20 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough staff at the home to support the people who live there. But some staff have not had their background checks carried out before they have started work to make sure that they are suitable to work with vulnerable people. Evidence: Examination of the rota and information from the acting manager confirms that there has been sufficient staff working at the home to support the needs of the twelve people who are currently living there. The acting manager confirmed that staff now have regular supervision where their performance and the work they do with residents is discussed and this was confirmed by care workers. The acting manager has started to improve training at the home. Since her appointment she has compiled a list of the training that each worker has achieved although this has yet not been developed into a full training programme for the home. Whilst some staff do hold a National Vocational Qualifications (NVQ) in level 2, some staff who are employed at the home do not have evidence that they have undertaken the basic training that they would need to begin their work in care. The acting manager has therefore taken steps to make sure that all staff get at least this amount of training in the next three months and is planning to further develop a full training Care Homes for Older People Page 21 of 30 Evidence: training programme for all staff. Although the home is registered to provide personal care for people with dementia type illness there has been no successful specific training which would have helped to put a specialised framework of support in place for people who require complex strategies to support them. Some of the care staff at the home said that they were unsure about how they should care for someone who has dementia care needs. The backgrounds of some workers at the home had not been checked to see if they are legally able and suitable to work with vulnerable people. Examination of employment records showed that three staff including the manager and senior manager did not have background checks carried out before starting work at the home. In addition while staff have been recruited from abroad, there were no records available for one person that demonstrates that they are legally able to work at the home. The manager and senior manager both confirmed that they would make sure this information was kept at the home in future. Care Homes for Older People Page 22 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. The overall management approach at the home lacks clear vision and fails to consistently deliver good quality personal care to meet the needs of the people who live there. Evidence: Although the present acting manager has worked at the home since November 2009, for the past three years there has been not been a manager who has been assessed by the Care Quality Commission as having the qualities, experience and knowledge to be the Registered Manager of the home. The owners, The Haven Hommes Limited, have been slow to respond to requests to improve the home and to give guidance and support to the acting manager. Enforcement action is now being taken by the Care Quality Commission to improve services at this home. The acting manager does not have a way of consulting with residents and their families about how the home is to be improved or which uses their comments to improve the quality of the service they receive. Care Homes for Older People Page 23 of 30 Evidence: Staff at the home help some people who live there to manage their money. Records are kept of peoples day to day finances and where staff have supported them to make purchases. The home has been subject to inspections by the Fire and Rescue Authority and local authority environmental health officers who have both issued legal notices that the home needs to be improved so that it is safe for people to live and work there. Presently the owners have agreed that the first floor of the home and one bedroom can not be used until fire safety in these areas has been improved. Care Homes for Older People Page 24 of 30 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 9 13(2) Put in place effective arrangements for the recording, safekeeping and safe administration of all medicines received into the care home. Put in place effective arrangements to ensure that medication records at the home are accurately maintained at all times Put in place effective arrangements at the home to ensure that any omissions or variations in the administration of prescribed medication and the reasons for these are clearly, legibly and promptly recorded. Put in place effective arrangements in the home to ensure that all medication is administered as prescribed. Put in place effective arrangements in the home to ensure that all medication is stored at the correct temperature at all times. Put in place effective arrangements to ensure that an accurate record is kept of all medication received into the home 18/01/2010 Care Homes for Older People Page 25 of 30 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 THIS LEGAL REQUIREMENT IS OUTSTANDING FROM 18/01/10. FURTHER ACTION IS BEING TAKEN. 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 16 22 People who live at the home and their relatives must have a way of making a complaint about the service that they / their relative receives, if they are unhappy, have a grievance or dispute. There must be a written complaints procedure and a record kept of all complaints including what was done to resolve them. This is to make sure that residents and their families know how to complain and what they expect to happen and a record is kept of the actions the home has taken. Refurbishment of all areas on the first floor which are to be used by residents must be completed. 30/04/2010 2 19 23 14/07/2010 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 This is to make sure that the home is well maintained, comfortable and suitable for the people who live there. 3 29 19 Full background checks must 30/04/2010 be carried out before staff start working at the home. This is to make sure that staff are legally able and suitable to work with vulnerable people. 4 38 23 All areas that are to be used 23/06/2010 in the home must comply with legal notices and other requirements issued by the Fire and Rescue Authority and Durham County Council. This is to make sure that the home is a safe place for people to live and work. 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 1 There should be a Service User Guide that can be used by the people who live at the home or wish to move there. This is so that people have important information about the home, their rights as residents and how they can complain. The homes initial assessment should continue to be improved so that the needs of people who are moving there are known, agreed and understood and should help to plan the ways in which staff are to support them. 2 3 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 3 4 The person responsible for the home should make sure that they have the capacity to meet the assessed needs (including specialist needs) by applying current best practice and relevant guidance. There should be strategies in place which help to identify when people who have dementia type illness are experiencing pain and these should be recorded in their care plan. All the people who use the service, should have a written care plan which fully details the actions which staff must take to ensure that all aspects of their health, personal and social care needs are met and follows current best practice. Where people with dementia type illness are accommodated at the home, their care plans should describe in detail how these needs are to be met and how their support is to follow current best practice. There should be a range of meaningful activities taking place at the home which help to support people with dementia type illness and follow current best practice. The condition of the building, rooms and facilities should continue to be improved. This is so that people living at the home have a comfortable place to live and valued lifestyle. Measures taken to control odours should be improved so that the home is a more hygienic and pleasant place for people to live. The planned staff training programme should be completed and carried out. Staff should be trained so that they have the skills and knowledge to support people who have dementia type illness. The planned training programme which gives staff core skills should be completed. The quality of care at the home should be regularly reviewed; and the people who live there and their relatives are asked their views about the service they receive. 4 7 5 7 6 7 7 12 8 19 9 26 10 11 28 30 12 13 30 33 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. 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