Inspection on 17/11/08 for The Knoll

This inspection was carried out on 17th November 2008.

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

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

Other inspections for this house

The Knoll 31/10/06

The Knoll 14/11/05

The Knoll 13/06/05

The Knoll 11/01/05

The Knoll 09/08/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Knoll 335a Stroud Road Gloucester Glos GL4 0BD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lynne Bennett     Date: 1 8 1 1 2 0 0 8 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. the things that people have said are important to them: They reflect 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 © (2008) 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 Knoll 335a Stroud Road Gloucester Glos GL4 0BD 01452526146 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Alder Meadows Limited care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home The Knoll is a large detached house that was extended in the early seventies to provide the present accommodation. It is located on the main Gloucester to Stroud Road near Tuffley. The Home stands in its own extensive grounds of fifteen acres and has impressive views over the suburbs of the city of Gloucester and towards May Hill in the Forest of Dean. The Home offers care for older people over the age of sixty-five with residential needs. The Homes staff provide personal care and other health care needs are met via the GPs and external health care professionals. It is not registered for dementia care, learning disabilities or service users with nursing needs. The Homes accommodation is on three floors and access to all floors is via a large shaft lift or stairs. Communal areas consist of one very large lounge/dining room on the ground floor and a large lounge on the first floor located at the far end of the building with views over the garden. Several of the rooms can be used as double rooms and each room has a washbasin. Toilet and bathing facilities are located on each floor with assisted bathrooms on all floors. The homes Statement of Purpose and Service User 0 Over 65 34 Care Homes for Older People Page 4 of 30 Brief description of the care home Guide are available in the entrance hall along with the last inspection report for the home. 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection took place in November 2008 and included two visits to the home on the 17th and 18th November. The registered manager was in attendance throughout. The registered manager completed an AQAA (Annual Quality Assurance Assessment) as part of the inspection, providing considerable information about the service and plans for further improvement. An Annual Service Review had taken place in June 2008 and surveys had been received from nine people living in the home, four visitors and relatives and seven members of staff. These contributed towards this inspection. Visitors and relatives also made additional comments during the inspection. Care Homes for Older People Page 6 of 30 Time was spent talking to people living in the home and observing the care they were receiving. The care of three people was case tracked which included talking to them, looking at their care plans and other related documents, examining medication records and visiting their rooms with their permission. Five staff were spoken with and talked about their roles and responsibilities in the home. A range of records were examined which included care plans, staff files, health and safety records and quality assurance systems. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. What the care home does well: What has improved since the last inspection? What they could do better: Care plans should indicate peoples preferences for the gender of care staff providing personal care. Where people choose to have the alternative meal this should be recorded in the same detail as the evening meal. Bodymaps should be used to monitor bruising or injuries to people. The temperature of the medication cabinet should be monitored and recorded. Management should attend Enhanced training in the Safeguarding of Adults. Care Homes for Older People Page 8 of 30 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. A full assessment of peoples wishes and aspirations are completed before the home decides whether or not they can meet their needs. People are provided with a statement of terms and conditions providing them with information about the service they are to receive. Evidence: The admission information for four people who had recently moved into the home were examined. One of these people was also case tracked. Each person had been assessed by the Registered Manager and a comprehensive assessment of their physical, emotional, intellectual and social needs had been completed. For people placed by the local authority there was also evidence that a copy of their assessment of needs and current care plan had been obtained. Each file contained a copy of a note indicating that the home had assessed their Care Homes for Older People Page 11 of 30 Evidence: individual needs and they were able to meet these. Each person also had a statement of terms and conditions or placing authority contract which indicated the room they were to occupy, the fees they were paying and any additional expenses. The Quality Assurance Manager confirmed that these were reviewed whenever changes to fees or other costs changed. There was evidence on admission records that people and/or their next of kin had visited the home prior to admission and that they had been given a copy of the homes brochure including the Statement of Purpose and Service User Guide. The Registered Manager described how needs of people living in the home were monitored and that where there were changes which the home believed they could not meet then people would be referred to placing authorities for a reassessment. One person had moved to accommodation where their needs could be met. Intermediate care was not being provided by the home. This standard was not assessed. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A person centred approach to care planning identifies peoples wishes and aspirations enabling staff to meet their assessed needs. Peoples health and personal care needs are being met helping them to stay well. Their health and wellbeing are promoted by satisfactory arrangements for the handling of medication. Evidence: The three people case tracked, included a person who had recently moved into the home and two people who had been living at the home for some time. Each person had a current assessment of their physical, intellectual, social and emotional needs in place. From these care plans had been developed which clearly identified their wishes and aspirations and provided staff with specific information about how these should be met. Plans had been signed by people living in the home or their next of kin. An audit of care plans, by the Quality Assurance Manager, indicated that six plans were being followed up with next of kin to obtain their signatures. These plans were being reviewed each month with any changes being noted in a summary sheet referring the reader to the amendments in the care plan. Care plans did not indicate peoples Care Homes for Older People Page 13 of 30 Evidence: preferences for the gender of staff providing their personal care. Concerns highlighted at the previous inspection about mobility care plans not giving sufficient information were seen to have been addressed. For instance a plan for one person stated,mobile with zimmer frame, take small steps and need to be reminded to place your left foot on the floor. Staff were observed supporting people to walk with aids around the home and prompting them in a sensitive manner when needed. Daily records were being maintained and overall the quality of recordings were good with some excellent examples providing evidence of support being provided to people throughout their day. These latter entries could be cross referenced with peoples care plans indicating that support was being provided in line with their identified needs. A generic risk assessment was in place for each person identifying significant hazards and outlining how risks had been managed. Falls risk assessments were also in place. It was evident from accident and incident records that falls were being monitored and where necessary prompt action taken to minimise risks of further falls such as referral to the falls clinic, providing specialist equipment or monitoring by staff. Staff were heard reminding one person who liked to be independent of the risks of falling and to seek support from staff when wishing to come down into the lounge. The AQAA stated the home was working closely with health care professionals. Health care records were being maintained which indicated that people had regular access to a range of health care professionals such as Doctors, District Nurses, Chiropody, Opticians, Dentist, Speech and Language Therapist and Physiotherapist. Outcomes of appointments were being recorded and followed up. Specialised equipment had been provided for one person prior to moving into the home to minimise risks of injury due to falling out of bed. One person, according to their care plan, was at risk of developing pressure sores and it indicated that appropriate measures had been taken to prevent tissue breakdown. The Registered Manager said that staff regularly monitored this persons skin. Daily notes confirmed this. Systems for the administration of medication were examined and found to be satisfactory. Safe systems were seen to be in place for the administration and storage of controlled drugs. Staff confirmed that they had completed training both with a local provider and with the Registered Manager. She stated that she also completed assessments of competency with staff during supervision sessions. She was observed arranging to do this during a visit. She also stated she completed medication audits weekly to make sure medication was being administered safely. The temperature of Care Homes for Older People Page 14 of 30 Evidence: the room containing medication was not being monitored although the radiator in the room had been turned off. There was no evidence on peoples care plans that they had consented to have their medication administered by staff. Where people wanted to self medicate this had been indicated on their initial assessment and lockable facilities had been provided in their rooms. No homely remedies were being kept by the home. Staff were observed treating people with respect and dignity. During lunch staff explained what they were going to do before supporting people to move, offer protective clothing or help with their meals. Issues around incontinence were dealt with sensitively. There was no odour in the home during the visits and no obvious signs in communal areas that people may at times be incontinent. People having their hair done during one visit, had this done in private, either in their own room or a quiet lounge on the first floor. Concerns about professional conduct and observations of over familiarity were discussed with the Registered Manager and she said that this would be dealt with through supervision. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the opportunity to participate in social, educational, cultural and recreational activities that reflect their personal expectations. People living at the home are offered a range of freshly produced meals giving them choice about their diet. Evidence: The AQAA stated that as a result of listening to residents menus now incorporate their ideas, and there are increased activities/social opportunities. Comments from a relative indicated that they had been pleased to see people involved and enjoying activities when they visited one weekend. One person said they particularly enjoyed skittles and bean bag throwing and that they liked to play the keyboard in the conservatory regularly. Another person was looking forward to having a manicure and had their hair done the following day. Other people were observed watching the television in the lounge, listening and dancing to music, reading books and socialising with friends in their rooms. Each day activities were recorded on a white board in the hall outside the lounge. Daily notes also made reference to what people had being doing during the day. People Care Homes for Older People Page 16 of 30 Evidence: spoken with said they found this useful and looked forward to the activities provided. People were observed choosing where to spend their time and with whom. One person said they liked to be with people in the lounge each morning but spend time in their room each afternoon. The time people liked to have breakfast and go to bed were recorded in their care plans, showing a great deal of personal choice and flexibility. One person said that they liked to go out for walks and to the local shops. They occasionally took the bus into town. Day trips had been planned for some when drivers were available. Christmas entertainment had been planned and was displayed on notice boards. This included a meal out at a pub, carol singing by a local guide group and a Christmas raffle. People said they had already enjoyed singing along to Christmas Caroles in the lounge. Communion was being offered to people monthly and a local Church had contacted the home with a view to visiting each week. The home was involved with the local Partnerships for Older People Projects (POPPS) who were in the process of supporting the home to develop an evening once a week at the home, to provide a restuarant/cafe style meal to people living in the home and up to 6 people from the community. A project developing an allottment nearby was also being planned which would provide the home with a source of freshly grown vegetables. Visitors to the home said they were made to feel welcome. People said they were able to use the homes telephone to speak to relatives and some people had telephones in their rooms. The Registered Manager stated that the home was not supporting people with their personal finances. Any additional costs for hairdressing or chiropody were charged to people along with their fees by Head Office. People were observed enjoying a lunch of Braised Steak with fresh vegetables followed by Rice Pudding. On the following day the majority of people had chosen Ham Omelette rather than Pork Casserole which had surprised staff indicating that the new menu was providing people with more personalised choices. Alternatives to the main meal were offered each day and a record was being kept in the kitchen of what people had chosen for their evening meal. There were no records where people had chosen an alternative to the main meal. Fresh fruit was available in the dining room and people were observed being offered drinks and snacks during the day. A sweet trolley was also available for people to buy chocolates, sweets and other snacks. The cook confirmed that there were no special diets for people and that people with diabetes had been offered diabetic cakes and biscuits. Care Homes for Older People Page 17 of 30 Care Homes for Older People Page 18 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems are in place that enable complaints and concerns to be raised by people using the service or on their behalf and that should safeguard people from possible harm or abuse. Evidence: The complaints procedure for the home was displayed in the entrance hall. People spoken with said they would talk through any concerns with staff or the Manager, but that they did not have any. House meetings had been held in April, June and October providing a forum for people to express any concerns. The minutes for these meetings indicated that people had complained about activities and they would like to go out for day trips. They also mentioned that commodes when emptied were not always returned to their rooms. The Registered Manager had brought these issues up at staff meetings following on from house meetings and had recorded the action taken as a result. These issues were also picked up during Regulation 26 visits to the home and audited to check on action taken. A complaints folder contained copies of four complaints received in 2007 and the response to these complaints. Any action taken to address these complaints was recorded. Staff spoken with confirmed they had completed training in safeguarding and abuse. Care Homes for Older People Page 19 of 30 Evidence: They had a good understanding of how to recognise abuse and stated they would report any suspicions to the Registered Manager. They were confident that she would deal with this appropriately. The Registered Manager described the processes she would follow and when she would involve the local Adult Protection Unit and the Police. A copy of the local procedures was available in the office. Contact details were given to her about the Enhanced Training in Safeguarding of Adults which was available through the local team. Some staff had completed training in the management of challenging behaviour. They indicated that they had no concerns about the behaviour of people currently living in the home. Accident and incident records were being kept for incidents and a monitoring form was in place following up any action taken as a result. Bodymaps were in place to be used when people moved into the home. They were not being used to monitor any bruising identified on people in accident and incident records. Care Homes for Older People Page 20 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was warm, safe and comfortable providing well maintained accommodation of a high standard. Specialist adaptations and equipment were provided to people who needed it. Evidence: The Knoll although situated close to the city centre of Gloucester benefits from large well kept grounds which staff say was also home to squirrels and deer. People were observed choosing to sit by windows overlooking the grounds and one person commented on the views from their window. There was a maintenance plan in place for the home to make sure the high standards of cleanliness and decor were maintained. During the visits the home was clean and tidy. Six peoples rooms were inspected and found to be clean, warm and odour free. This was also reflected in communal areas around the home. A new wet room on the top floor was proving to be very beneficial according to staff. All rooms had health and safety checklists which confirmed that monthly checks were being made on water temperatures, window restrictors, fire equipment and door closures. The laundry, although small, was clean and tidy during the visits. Hazardous products were Care Homes for Older People Page 21 of 30 Evidence: stored securely and data sheets were in place. Staff were provided with personal protective equipment. Care Homes for Older People Page 22 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. Peoples needs are met by a competent staff team, who have access to a satisfactory training programme that provides staff with knowledge about the diverse needs of people living at the home. Recruitment and selection procedures which are in place should protect people from possible harm. Evidence: There were four staff on duty for the morning shift ending at 2.00 pm and three staff covering the afternoon/evening shift until 8.00 pm when two waking night staff were on duty. Staff spoken with said that staffing ratios were manageable. At the time of the Annual Service Review in June 2008 there were concerns about staffing levels. Agency staff were being used on occasion. The registered manager confirmed that there were no vacancies at the time of the inspection. The home was employing a cook, a housekeeper and a person to do the laundry. Relatives commented on caring and dedicated staff. The Registered Manager confirmed that over half of the staff team had a NVQ in Health and Social Care and the rest of the team were either completing or registered to do their awards. New staff confirmed that they had completed an induction programme. Copies of this were kept on their files along with certificates confirming they had completed the programme. The certificate stated it was equivalent to Skills for Care Care Homes for Older People Page 23 of 30 Evidence: Induction Standards. Staff files for five members of staff who had started working in the home between June and November this year were inspected. Four were satisfactory confirming that staff had not been appointed before two written references, a satisfactory Criminal Records Bureau check and full employment history had been obtained. There was evidence that the Registered Manager had requested additional information to ensure there was a full employment history and any gaps were explored. For one person the organisation had struggled to obtain both written references. Telephone references had been obtained and a checklist had been completed indicating the information obtained. There did not appear to be evidence of reason for leaving former positions in care (although this person was not working on the care team). There was evidence that proof of identity and a photograph had been obtained. The AQAA had indicated that the Registered Manager had struggled with staff turnover to ensure that staff were getting access to mandatory training. Records evidenced that by the time of this inspection she had managed to make sure that all staff were having access to mandatory training and refresher training courses where needed. Staff confirmed that they had also attended challenging behaviour, abuse, dementia and nutrition training. Further training had been scheduled including continence awareness and further nutrition and well being courses. Copies of certificates were kept on staff files and a training matrix kept. Training needs were being identified as part of staff appraisals held annually. Care Homes for Older People Page 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a well run home. Effective quality assurance systems are in place involving people who live there. Satisfactory health and safety systems are in place providing a safe environment. Evidence: The Registered Manager has considerable experience in this field. She has the Registered Managers Award and will be completing a NVQ Level 4 in Health and Social Care. Her continuing professional development has included training in dementia, fire safety and nutrition (advanced) and conflict management. She had also completed training in the Mental Capacity Act. A Deputy Manager had recently been appointed to support her with the management of the home. A robust quality assurance system was in place which involved people living in the home. They were being interviewed as part of the Regulation 26 visits to the home by the Responsible Individual and also completed surveys annually. A quality assurance Care Homes for Older People Page 25 of 30 Evidence: audit had been produced looking at all aspects of the service provided and an action plan drawn up. There was evidence of regular monitoring of this document to ensure compliance with the actions identified. A summary of these processes was being produced at six monthly intervals. Accident and injury records were being kept in the office and also on a cabinet in the hallway. At the time of the inspection neither were locked away. This was immediately done when pointed out. All other records were stored securely. Good systems were seen to be in place to monitor health and safety within the home. As mentioned each room had a monthly checklist monitoring health and safety. Records were eing kept confirming regular monitoring of fire systems and equipment, servicing of hoists and lifts, portable appliance testing and water temperatures. A current fire risk assessment and environmental risk assessments had been completed. The kitchen had been awarded 5 stars after a recent Environmental Health Inspection and good procedures were observed to be in place. Care Homes for Older People Page 26 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 27 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 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 2 7 9 The gender of staff providing personal care to people should be identified in their care plans. The temperature of the medication room should be recorded on a daily basis. Peoples consent to have medication administered by staff should be recorded. 3 10 Professional relationships between staff and people living in the home should be promoted at all times, this includes not being over familiar with people. Where people have eaten an alternative meal to the main one this should be recorded in the same way that evening meals are being recorded. Management should attend the Enhanced Protection of Adults training with local adult protection team. Bodymaps should be used to monitor bruises to people as a result of accidents or incidents, or unexplained. Copies of Birth certificates should not be taken. Records can indicate that these documents have been seen. Copies of CRB certificates should be kept securely but separately from staff files. 4 15 5 6 7 8 18 18 29 29 Care Homes for Older People Page 28 of 30 9 37 Accident and injury records should be stored securely at all times. 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. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) 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 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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