Inspection on 31/03/09 for The Manor House

This inspection was carried out on 31st March 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Manor House 10/09/07

The Manor House 02/02/07

The Manor House 14/12/05

The Manor House 25/11/05

The Manor House 13/09/04

The Manor House 06/04/04

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 Manor House 6 Bawnmore Road Bilton Rugby Warwickshire CV22 7QH     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: Michelle McCarthy     Date: 3 1 0 3 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 Manor House 6 Bawnmore Road Bilton Rugby Warwickshire CV22 7QH 01788814734 01788814734 manorhouse@pinnaclecare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Pinnacle Care Ltd Name of registered manager (if applicable) Ms Caroline Margaret Rose Irvine Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users who can be accommodated is: 26 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: Dementia (DE) 26 Date of last inspection Brief description of the care home The Manor House is a mature building with parts dating back to the 16th Century, and is set in its own grounds, adjacent to the village green, in Bilton, Rugby. The Manor House was converted from a private dwelling into a care home in 1985. The Manor is registered to take 26 older people with dementia. The Manor House has twenty-two single bedrooms, twenty-one of which have en-suite facilities. One of the two double rooms also has en-suite facilities. There are two communal bathrooms and four communal toilets. The home has three large communal lounges with south facing gardens. The accommodation is over two floors reached via two passenger lifts. The Care Homes for Older People Page 4 of 29 care home 26 Over 65 0 26 Brief description of the care home local shops and amenities are a 2-minute walk away. On the day of this inspection visit there was no written information available about the costs of living in this home. 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: Before the inspection, we looked at all the information we have about this service, such as information about concerns, complaints or allegations, incidents and previous inspection reports. We do this to see how well the service has performed in the past and how it has improved. We looked at the Annual Quality Assurance Audit (AQAA) which the manager completed and returned to us before our visit. This is the managers review of the service and gives us information about how the service has progressed in the last 12 months. Care Homes for Older People Page 6 of 29 Nine survey forms were completed and returned to us by people who use the service. Their responses are reflected in the report. We visited the home on Tuesday 31st March 2009 between 11.30am and 6pm. We did not tell the home we were coming on that day. There were 30 people living in the home at the time of our visit. We used a range of methods to gather evidence about how well the service meets the needs of people who use it. We talked to people who use the service and observed their interaction with staff. We looked at the environment and facilities provided and checked records relating to staff recruitment and training and the running of the home. We talked to the manager, the deputy manager and two care staff. Three people using the service were identified for case tracking. This is a way of inspecting that helps us to look at services from the point of view some of the people who use them. We track peoples care to see whether the service meets their individual needs. We looked at their records, such as care plans and risk assessments. At the end of the visit we discussed our preliminary findings with the home manager. What the care home does well: What has improved since the last inspection? The manager developed an improvement plan following the last inspection to address the requirements we made. This has reulted in improved outcomes for people using the service. The homes care planning system has been reviewed since the last inspection. Peoples care files were organised and the information was easily accessible to staff. The service has improved the way it manages peoples medication which should mean people are safeguarding from the risk of harm from medication errors. Care Homes for Older People Page 8 of 29 The homes policies and procedures for responding to allegation or suspicion of abuse have been reviewed and updated so staff have information about how to respond. This should safeguard people using the service from the risk of abuse. The number of staff with a National Vocational Qualification (NVQ) in Care has increased since the last inspection. More than half the care staff employed in the home have the qualification, which means people can be confident they are cared for by competent staff. Systems have been developed to make sure equipment and services in the home are effectively maintained and records were available for inspection. This should promote the safety of people. What they could do better: 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. People who are considering moving into the home benefit from having their care needs assessed so that they can be sure the home can meet their needs. Evidence: We looked at the case files of three people who have moved into the home since our last inspection, to assess the pre admission assessment process. The manager said that it was usual practice for her to visit people who are considering moving into the home to undertake an assessment of their needs and abilities. All three files contained a pre admission assessment of each persons needs and abilities. This means that sufficient information was available so that the home could confirm they could meet each persons needs and develop care plans. Care Homes for Older People Page 11 of 29 Evidence: Prospsective service users are encouraged to visit the home before they move in. We met one prospective resident and their relative who were visiting on the day of our inspection. The prospective resident was encouraged to spend time with other residents and participate in activities while the manager spoke with the persons relative. One person told us, The manager was extremely helpful and supportive in giving me comprehensive information when we brought Mum to the Manor House, initially for a respite stay. 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. People are treated respectfully and their personal care needs are met. Peoples medicines are managed safely. Risks to peoples health are not consistently identified, which does not promote their well being. Evidence: We looked at the care files for three people identified for case tracking. Care plans and daily records were available for each person. Each care file contained details of the strengths and abilities of the person and identified some of their needs. These files were stored in the managers office. A separate document describing the action staff have to take to meet peoples needs was in each persons bedroom, along with daily records. Residents care files were standardised, well organised and documented detailed information about each person. This should mean that staff have good access to information about the needs of people living in the home and the actions they need to Care Homes for Older People Page 13 of 29 Evidence: take to meet those needs. Care plans were available for most of the identified needs of each person and supplied staff with the information needed to make sure the persons needs were met safely and appropriately. For example, the needs assessment for one person identified they required support to maintain their personal care needs. A care plan was developed describing the physical assistance and psychological support the person needed. It was evident from our observations that the personal care needs of people living in the home are met and residents are provided with a good quality of life. During our visit residents looked well were supported to maintain their abilities. People looked cared for; their hair had been combed or dressed and nails were trimmed and clean. People appeared to be well supported by staff to choose clothing appropriate for the time of year which reflected individual cultural, gender and personal preferences. One relative commented, I feel that Mum is very satisfied with the way she is cared for. The service uses a range of risk assessment tools to identify whether people are at risk of falls, poor nutrition and developing pressure sores. However, the outcome of the risk assessments do not always correspond with the experience of the individual, suggesting that staff have a limited understanding of how to use the assessment tools. This means risk to proples health and well being are not always identified so that action can be taken to minimise the risk. For example: Weight monitoring records for one person recorded a weight loss of 3Kg between December 2008 and February 2009. There was no evidence of any action taken to investigate the weight loss, increase the frequency of weight monitoring or any other action to prevent the risk of poor nutrition. The nutritional risk assessment for this person identified a low risk, despite the recent weight loss. This does not promote the well being of this person. Another person developed a pressure sore on their hip and staff made a referral to the district nurses. Records show this pressure sore healed. Entries in the daily records of this person in the days before our visit documented the development of a newly developed pressure sore on the other hip. The pressure sore risk assessment for this person identified a low risk of developing pressure sores, despite two incidents of pressure sore development. A care plan was not available to give staff directions about the action they needed to take to promote healing and prevent deterioration, although we observed the person using a pressure relieving cushion. Care Homes for Older People Page 14 of 29 Evidence: People have their weight monitored and recorded regularly. Peoples records show they are supported to access other health and social care professionals such as GP, optician, chiropodist and district nurses. We looked at the way the home manages peoples medication. Medicines are only administered by staff who have received training in the safe administration of medicines. A small, locked room is dedicated for the storage of medicines. The staff member responsible for medicines administration holds the keys on their shift to prevent unauthorised access to medicines. Suitable medicine storage cabinets are fitted, to comply with legislation and a medicines fridge is available. Medicines are ordered monthly from residents GPs. Staff photocopy and retain written prescriptions from the GP before they are admitted to the pharmacy for dispensing. This should make sure that staff can check that all medication ordered has been correctly prescribed and no new medication has been added by mistake. A monitored dosage (blister packed) system is used and medication is delivered to the home on a monthly basis. We audited the medicines of people involved in case tracking by comparing the quantity in stock against the signatures on the medicine administration records (MAR). These were correct, indicating that medicines had been administered correctly. People living in the home were observed to be treated with respect. For example, personal care was provided in private and residents were spoken to respectfully. 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. People living in the home are supported to maintain their independence and enduring interests which enhances their quality of life. Mealtimes are celebrated as a social occasion and residents benefit from a varied and nutritious choice of food. Evidence: The home has an ethos of building on peoples strengths and abilities. This is reflected in the case files of each person where a life history, interests, important relationships and personal preferences are recorded to assist staff in providing person centred care. The home does not have a planned programme of activities but staff support people living in the home to participate in activities and plan how to spend their time on a day to day basis, depending on their preferences for that day. One person told us, There are always activities but I dont always want to join in with them. Staff spoken to were familiar with the preferences of residents and the type of activities that might engage and stimulate each individual. On the day of our visit, a group of residents participated in a craft session making Easter bonnets. Care Homes for Older People Page 16 of 29 Evidence: There is a strong feeling of community and sense of belonging. Groups of residents interacted with staff and each other and were aware of each others needs and preferences. It was evident that friendships had developed between residents. The home has an open visiting policy. People are encouraged to maintain links with their family, friends and local community. Staff support residents to shopping trips and weekly pub lunches. At 12.30 pm staff invited residents to have their meal in the pleasant surroundings of the dining room but some chose to remain in the lounge area or their own rooms. Tables were beautifully set with linen tablecloths and slip cloths which lent a restaurant type experience to the social occasion of people coming together to enjoy their meal. 22 people attended the dining room for lunch. Residents were offered a starter of grapefruit and orange, followed by a choice from chicken casserole, liver and bacon, cheese and potato pie or vegetarian sausage accompanied by a choice of seasonal vegetables. Dessert was a choice of peach crumble or jam tart and custard. Staff offered each resident a choice of meal at the table; those people who found it difficult to choose were assisted by staff who brought the meal to them as a visual prompt. We observed one resident telling staff I dont fancy a big meal, so staff requested a sandwich from the kitchen for them. The meal was served from a heated trolley from the kitchen and was beautifully presented, nutritious and tasty. Discreet and sensitive assistance was given to residents who needed help eating their meal. Food was plentiful and seconds were offered. When residents had been served, staff took their choice of meal and ate with the residents. Residents made positive comments about the food they were offered; they told us, The food is very good, Lunches are usually tasty. The evening meals are stodgy and not tempting and I like most of the meals. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home can be confident that their concerns will be listened to and acted upon. There are systems in place to respond to suspicion or allegations of abuse to make sure people living in the home are protected from harm. Evidence: The complaints procedure has been updated since the last inspection and is accessible to people living in the home and their families. A copy of the procedure is clearly displayed in the homes reception area. A comments book has been made available in the reception area and the manager records a response to entries in this book. The manager operates an open door policy and we observed that relatives and residents felt at ease coming in to the office to talk to her. We looked at the record of complaints and concerns maintained in the home documenting the action taken by the home regarding each issue raised. Evidence was available to confirm that concerns raised verbally are taken as seriously as more formal, written complaints. One relative told us, The staff have always been receptive to any concerns or problems regarding Mum and have always done their best to resolve them. Care Homes for Older People Page 18 of 29 Evidence: The service has recorded three complaints since our last inspection, raising concerns about misplaced belongings of one resident, the temperature of a persons bedroom and the cleanliness of a residents bedroom. Evidence was available to confirm that the issues had been resolved. There has been no information shared with us since the last inspection that raised concerns about this service. We looked at the homes policy for responding to suspicion or allegations of abuse. The policy has been reviewed since the last inspection to give staff clear direction about how to respond to suspicion, allegations or incidences of abuse. Records show that staff have received training in recognising and responding to signs of abuse. It was evident through discussion with the manager that she is fully aware of her responsibilities in responding to allegations of abuse and discussed with us the procedure for referring allegations for investigation under local Adult Safeguarding Procedures. 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 home is generally well maintained providing a safe, homely and clean place for people to live in and enjoy. Evidence: The home has two large lounge areas leading into one another; both these areas were pleasant and clean with a variety of seating to suit all residents. A homely feel is achieved in the large communal lounge by placing chairs and furniture in a way that encourages people to interact. There is also a large area between the second lounge and dining room; this has an attractive fireplace, suitable seating and some dining tables. The dining room large and bright and very welcoming; it has a restaurant like feel to it. Residents were observed to potter around the home quite freely have the opportunity to socialise with other residents or to be on their own, as to their preference. We looked at the bedrooms of the people involved in case tracking. Rooms were comfortable, well decorated and had good quality furniture and co-ordinating soft Care Homes for Older People Page 20 of 29 Evidence: furnishings. People had taken the opportunity to personalise their space with some of their own belongings so their personal accommodation looked as though it belonged to the person. The home was clean, bright and tidy and no unpleasant odours were noticed. The decor and furnishings in some parts of the home are dated and would benefit from refurbishment; one resident commented, badly needs paint and carpets. Information in the AQQA tells us that new furniture has been provided in both lounges downstairs and some bedroom chairs to match bedrooms, new garden furniture has been purchased and a new bathroom has been fitted in the annexe of the home. Staff have liaised with families and residents about the choice of decoration, fabrics and colours. Systems are in place for the management of dirty laundry. Protective clothing such as plastic gloves and aprons were available and arrangements are in place for the disposal of waste. 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. There are sufficient numbers of competent staff on duty to meet the needs of people living in the home. People using the service can be sure staff are properly checked before they start work. Evidence: There were 23 people accommodated in the home on the day of our visit. The manager told us that three care staff are on duty between 7.30am and 9.30pm and two care staff are on duty overnight between 9.30pm and 7.30am. This does not include the managers full time hours, which means she is available to supervise and assist care staff. There is a member of catering staff in the kitchen between 8am and 2pm each day to prepare breakfast and the main midday meal. Kitchen staff prepare the evening meal but it is heated and served by care staff. The home has one person undertaking cleaning duties between 11am and 4pm during the week; there are no cleaning staff on duty at the weekends. Care staff undertake laundry duties. The home does not employ administrative staff but has support from the Care Homes for Older People Page 22 of 29 Evidence: organisations Head Office for training, payroll and wages and recruitment. The home does not use agency staff to cover holidays or unplanned absence such as sickness but relies on permanent staff working overtime. This means that people living in the home have some continuity and are cared for by staff that are familiar with their needs. It was evident from the general appearance of people living in the home and observation of working practices that there are sufficient staff on duty to meet their personal care needs. We observed staff spending time with residents during our inspection visit with lots of friendly discussion about their daily lives. We observed that staff were knowledgeable about peoples needs and abilities and offered appropriate support while encouraging people to retain their independence. Comments included in the survey forms returned to us included; The staff seem to always have time for the residents and their families. Staff availability depends on how urgent my needs are at the time. Carers wonderful. Need more staff. Lots of TLC from carers, wonderful people, always under pressure. Six of the 10 care staff employed in the home have a National Vocational Qualification in Care (NVQ) at level 2, which should mean that people living in the home are cared for by competent staff. The personnel files of two recently recruited staff were examined and both contained evidence that Criminal Record Bureau (CRB) had been applied for, satisfactory Protection of Vulnerable Adult (PoVA First) checks were obtained and satisfactory references received before new staff members started working in the home. These robust recruitment practices should safeguard people living in the home from the possibility of abuse. Staff training records demonstrate that staff receive mandatory training including abuse awareness, fire safety, food hygiene, manual handling and medication. Care Homes for Older People Page 23 of 29 Care Homes for Older People Page 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is competently managed and is run in the best interests of residents. Evidence: An effective management structure is in place. The registered manager has been in post since February 2007 and new deputy manager has been appointed since the last inspection. The manager is qualified to NVQ level 3 in Care and has completed the Registered Managers Award (NVQ Level 4). She is experienced in the care of older people and dementia care. The managers hours are supernumerary to allow her sufficient time to discharge her responsibilities effectively. An on call system is in operation to respond to critical incidents out of hours. The manager provides effective leadership and direction and staff told us she was Care Homes for Older People Page 25 of 29 Evidence: approachable, supportive and listens to them. The manager sent us an improvement plan following our last inspection, detailing the actions to be taken to make improvements in the home. We saw evidence that the plan is reviewed against the objectives set. The manager distributed surveys to residents and relatives in September 2008, seeking their opinion of the service they receive. The results of the survey were collated, analysed and incorporated into the homes action plan for improvement. The service does not hold residents personal monies or valuables for safe keeping so standard 35 is not applicable and was not assessed. Residents are invoiced for additional costs such as hairdressing or chiropody. Records relating to the running of the home were maintained, organised and are easily accessible in the managers office. Systems for maintaining residents care files have been reviewed since the last inspection and staff can easily access the information they need about the people they are caring for. The home has effective systems for maintaining equipment and services to the home to promote the safety of people in the home. A sample of service and maintenance records were examined and found to be up to date; for example, hoists (for lifting people) were serviced in October 2008, portable electrical appliances were tested in December 2008, the fixed electrical installation in the home was checked in 2007 and the fire alarm is tested weekly. Incidents and accidents that happen in the home are recorded and were available for examination. Care Homes for Older People Page 26 of 29 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 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 12 Arrangements must be made to make sure that risks to the health and welfare of people using the service are identified and action must be taken to minimise any identified risks. This includes the risk of developing pressure sores, poor nutrition and falls. This is to promote the health and welfare of people living in the home. 31/05/2009 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 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!