Inspection on 22/01/09 for The Old Library

This inspection was carried out on 22nd January 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Old Library 09/01/08

The Old Library 31/01/07

The Old Library 01/02/06

The Old Library 22/06/05

The Old Library 10/03/05

The Old Library 16/08/04

The Old Library 26/03/04

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Old Library Isaac`s Hill Cleethorpes North East Lincs DN35 8JR     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: Kate Emmerson     Date: 2 2 0 1 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 31 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 31 Information about the care home Name of care home: Address: The Old Library Isaac`s Hill Cleethorpes North East Lincs DN35 8JR 01472601364 01472694111 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Charles William Jackson Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 30 Number of places (if applicable): Under 65 Over 65 30 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 The Old library is a 30-bedded care home registered for older people. The accommodation is set in a Victorian style building, retaining much of its original features. It is set in the seaside town of Cleethorpes, with views of the main thoroughfare to the sea front. There are eighteen single rooms and six shared rooms; one of the shared rooms has en-suite facilities. The home has two lounges and an adjoining dining area; all rooms are decorated and furnished to a good standard. The fees for the home are £377 per week plus a £16 per week third party top up. A top up is a fee paid over and above the contribution paid by the person living in the home and the funding authority. Care Homes for Older People Page 4 of 31 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: This inspection was unannounced and took place over one and a half days in January 2009. To find out how the home was run and if the people who lived there were pleased with the care they got, the inspector spoke staff working in the home at the time of the inspection and people who lived in the home. Some of the records kept in the home was checked. This was to see how the people who lived in the home were being cared for, that staff were safe to work in the home, that they had been trained to do their job safely. We also checked records to make sure that the home and the equipment used was safe and were checked regularly. Care Homes for Older People Page 5 of 31 A tour of the home was conducted to see if it was kept clean and tidy. The home provided a very friendly atmosphere and people who lived in the home and visitors said they were happy with the care provided. A fire officer was conducting a full audit of the home during the inspection. He reported that there were no requirements arising from his visit and that fire safety in the home was well managed. The majority of requirements from the previous inspection had been met. What the care home does well: What has improved since the last inspection? They had looked at care plans in more detail on a regular monthly basis to check that the care plan was still relevant. However they had not always used this information to update the care plans as required. There was improved odour control in the home. The manager clearly showed how the decisions regarding the number of staff on duty in the home were made using the Residential Forum guidance. They provided evidence that staff had received mandatory training. Care Homes for Older People Page 7 of 31 They had improved the way that activities were provided and assessed and recorded individuals interests and expectations. 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 8 of 31 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 9 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provided clear information about the services provided in the home and ensured that peoples needs could be met prior to admission. The home did not provide intermediate care. Evidence: In the surveys received by the Commission people stated that they had received adequate information about the home before they moved in. There was signed evidence in individuals files of agreement to the contract or statement of terms and conditions. These indicated that some people had signed to agree and were paying a third party top up fee. On checking the placing authorities contract this additional fee had not been agreed with them. The manager was advised that the placing authority must be advised of all third party top up fees and the relevant documentation Care Homes for Older People Page 10 of 31 Evidence: completed. The home offered a trial period and people were encouraged to have a short visit to the home for a meal before they decided to stay in the home. A pre admission assessment of peoples needs was completed by one of the management team and this was signed and agreed by the resident. A care plan was then developed to show how peoples needs were to be met. Care Homes for Older People Page 11 of 31 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. There were detailed care plans in place to support the care needs of people living in the home. However these had not always been updated when care needs had changed. This means that staff do not always have up to date information to enable them to meet peoples needs consistently. The staff did not always follow the homes medication procedures which increases the risk of error. The manager had identified this and was monitoring practice. Evidence: Random selections of care plans were examined. The care plans were detailed and focused on the individuals abilities as well as areas in which they required assistance. There was evidence in the plans that individual risk assessment was undertaken: risk assessments for moving and handling, tissue viability, falls, nutrition, bed rails and general issues were in place. Daily diary records were well maintained and detailed. There was evidence that peoples health was monitored and professional advice sought Care Homes for Older People Page 12 of 31 Evidence: for pressure area care and dietary needs. There was evidence that care plans had been discussed with people and the majority had signed to agree them. There were continued improvements in the care plans since the last inspection in that formats had been applied consistently, regular monthly evaluations had been completed and some formal reviews had been held. The manager had also provided detailed information for carers from NHS direct in each care plan where the person had a specific health problem. The manger had developed direct links with the dietitian at the local hospital and referrals were made directly where issues were identified. The people living in the home were very positive about the care they received. comments included staff are very nice, they look after you well, staff are very kind, I like living here, and the staff are very good they do anything for you. A visitor commented that they were very, very happy with the care provided to their relative. Systems had been developed to ensure that dietary intake, continence and care to relieve pressure were recorded and could be monitored. However staff had not consistently completed these records to ensure an accurate record was maintained therefore effective monitoring was compromised. Monthly evaluations were now more detailed although where changes had been identified care plans had not always been updated. For example where it was identified in the evaluation that a person now required assistance of two carers in mobility rather than one the care plan had not been updated. Where the district nurse had given instructions for care to reduce the risk of pressure sores this had not been included in the care plan although the care had been provided. This means that staff do not always have up to date information to enable them to meet peoples needs consistently. Where it had been identified mental health issues affected a persons ability to care for themselves a detailed support plan had been developed. However daily diary records showed that the persons mental health may be be deteriorating. This was described by the manager as a pattern of behavior prior to the persons admission to the home. However these subtle changes had not been identified by the manager or her staff as signs that the persons mental health may be deteriorating again. It was suggested to the manager that they should discuss these changes with the mental health team to ensure early intervention. They were also advised to further develop the care plan detailing the way the person presents as their mental health deteriorates to ensure that timely intervention is sought in future. Care plans were stored in an unlocked cupboard in the lounge. This meant they were accessible to anyone in the home or visiting the home. this does not protect peoples privacy or meet data protection legislation. Care Homes for Older People Page 13 of 31 Evidence: The home had well developed procedures in place for the safe handling of medication, which included self-administration of medication and accredited training for the staff. However one member of staff had been promoted to a senior position with responsibility to administer medication but there was no evidence that accredited training had been completed and competency had been checked. Records of receipt, administration and disposal of medication were maintained. On checking the records there were some discrepancies identified. For example one medication which had been signed as given was still in the medication tray, one medication which should be stored in a refrigerator was stored in the medication trolley and hand transcribed records had not been witnessed and signed to evidence that accuracy of the record had been checked. Some staff thought that other staff did not always follow the homes procedures when handling medication. They cited issues such as administration records not being signed when medications given or medications signed as administered but not given and medications being given at the wrong time. The manager had identified some of the issues through monthly audits and had written to all the staff setting out their roles and responsibilities in this area and she was continuing to monitor the situation. The clarity of the controlled drugs records had improved but had not been signed off when drugs were returned to the pharmacy to complete the audit trail. The home had not obtained written confirmation of the dose required where warfarin was prescribed, this is recommended. The manager stated they were having some difficulty with GPs providing this. Risk assessments were completed for people who wished to self medicate. The induction program covered peoples rights to privacy and dignity. To encourage privacy and dignity to be respected terms of address were indicated on the care plans, a telephone was available for use in private, personal mail was handed directly and unopened to the person to whom it was addressed, unless otherwise agreed and privacy locks had been provided on private accommodation and toilets and bathrooms. Observation of staff during the inspection identified that they were patient and courteous at all times. Care Homes for Older People Page 14 of 31 Care Homes for Older People Page 15 of 31 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 felt they were able to exercise control over their lives. They were provided with a varied activities plan and good quality meals. Evidence: Activities on offer were planned and people were informed of the activities in a newsletter and the plan was displayed in the lounge. Peoples interests and social needs were assessed and care plans had been developed. This included in one case staff bringing wool for one person living in the home to make sure that they could maintain their interests. Newspapers were also provided for people living in the home and they were observed sharing these and discussing the news stories. Activities provided were varied and included entertainers such as singers visiting the home. The home had a social committee to raise funds for activities. In surveys people indicated that there were activities availalbe to them and a relative stated my relative does not always join in but is always asked and encouraged. A residents meeting was usually held every three months although at the time of the inspection this was overdue. The meeting was organised and chaired by a residents Care Homes for Older People Page 16 of 31 Evidence: relative. There was evidence in notes taken that people felt free to express their opinions in this meeting. People living in the home said they could rise and retire when they wished, and a cup of tea and breakfast in bed was available. The people who lived in the home could chose where to sit and had the opportunity to watch the television programs of their choice or listen to music. A visitor commented that the staff had been very supportive with their relatives sleep pattern. The meals were provided on a four-week rotating menu and the menu was written daily on a board in the dining room, this was in direct response to comments in the last report that people did not know what the meal choices were. People living in the home were very positive about the meals provided to them. Comments included the food is very good, food is excellent, food is good and the meals are very good, I look forward to them. One person commented that temperature of the food was sometimes not hot enough and the portion sizes were too big. The manager had also completed a quality monitoring exercise on the meals provided and had received very positive comments. Suggestions had been passed to the kitchen staff and feed back had been provided to people living in the home. Care Homes for Older People Page 17 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensured that people were made aware of the complaints procedure and had the opportunity to raise issues. The home had processes in place to protect people from abuse but they had not been fully implemented in respect of referral to appropriate agencies for investigation where an allegation of abuse had been made. However the manager had taken these allegations seriously and had taken action to protect people living in the home. Evidence: The home had a policy and procedure for management of complaints. The manager made sure that people were aware of the complaints procedures by displaying the procedures in the home and in information about the home. Meetings from residents meetings showed that people felt comfortable raising issues. Information provided to the Commission by the home prior to the inspection stated that the home had received three complaints. The records of complaints and associated records such as staff disciplinary records were examined. These showed that five complaints had been investigated by the home. Records of complaints and investigation were maintained. The records of investigations were at best very basic. However it could be determined from complaints records and Care Homes for Older People Page 18 of 31 Evidence: staff disciplinary records and discussions with the manager and staff that the issues raised had been taken seriously by the management and action to safeguard people in the home had been immediately implemented where required. However in three of the four cases the complaints should have been referred to the local authorities safeguarding team for independent investigation as allegations of abuse had been raised. The manager was advised of her duties under these policies and procedures and an outstanding complaint was referred appropriately. There was a lack of clear communication and feedback between the manager and staff when issues were raised, leading to some staff believing that their concerns were not being dealt with in a serious manner. The manager was advised to develop a more formal approach when managing internal complaints so that staff had a clear understanding of the action taken, within the confines of data protection and confidentiality, in response to their concerns. Three complaints had been received by the Commission which were referred for investigation by the safeguarding team due to allegations of abuse being raised. The investigations were still ongoing at the time of writing the report. The staff had access to a copy of the multi agency safe guarding adults policy and procedures; the home had also developed their own detailed safeguarding policy, which linked in with this document. There were policies on restraint, dealing with aggression, whistle blowing and managing finances in place. All the staff had accessed safeguarding adult training with the Local Authority. The manager stated that training was also given to new staff within induction training and refresher training was provided annually. Care Homes for Older People Page 19 of 31 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 clean, tidy and well maintained and provides a very comfortable environment for people living in the home. Evidence: The home is located in a very central area, close all the local amenities and the sea front. The home has three floors that are accessed via stairs or passenger lift. The general condition of the furnishings and decoration was of a good standard; redecoration and refurbishment was ongoing. New bedding, towels and curtains had been provided in bedrooms, some bedrooms had been redecorated and new carpets had been laid in the hall, stairs and landings. All areas seen as part of this inspection were clean and tidy. Odour control in the home had significantly improved at this inspection. A letter provided by the proprietor indicated that the water system in the home was a pressurised system and hot water was not stored, minimising the risk of Legionella. The hot water temperatures in bathrooms were within acceptable limits on the day of Care Homes for Older People Page 20 of 31 Evidence: inspection. Policies and procedures were in place for control of infection; this was covered in the induction-training program for new staff. Staff confirmed that they had adequate supplies of protective clothing. There was evidence in staff files that staff had completed training in infection control. Care Homes for Older People Page 21 of 31 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. Trained staff were provided in sufficient numbers to meet peoples care needs. The recruitment procedures had improved and were adequate for the protection of people living in the home. Evidence: The home was registered for thirty residents and at the time of the inspection there were seventeen people accommodated. The manager provided evidence that the dependency of the people living in the home was used to calculate staffing levels in the home using guidelines set out by the Residential Forum. She was able to evidence that she checked the calculations monthly to ensure that the staffing levels were adequate to meet the needs of the people living in the home. There was evidence from staff training records and staff discussions that the home had an active training program, which included mandatory and service specific training such as moving and handling, fire safety, dementia awareness and arthritis awareness. In surveys staff said training has been very varied and interesting. The home was committed to staff receiving NVQ training and of 18 care staff employed 10 had achieved at least NVQ 2 and the remainder were completing this qualification. Care Homes for Older People Page 22 of 31 Evidence: Two staff were completing NVQ 3. New staff completed skills for care induction training workbooks. The records show new staff initially spend three days with the deputy manager and then have three supernumerary days on the shift. Care must be taken when promoting staff to senior positions that they have received training in all areas of their role such as medication before they have responsibility for these tasks. Adequate checks were completed prior to employment of staff. POVA (Protection of Vulnerable Adults) 1st checks had been completed in all cases prior to employment but it is recommended that, other than in extreme circumstances, staff are not employed prior to the receipt of a full CRB (Criminal Records Bureau) check. People living in the home gave very positive comments about the staff which included Staff work as a team and are very nice to you, staff are very nice and look after you well and staff are very kind. Care Homes for Older People Page 23 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. An experienced but unregistered manager managed the home. The manager regularly monitored the quality of care in the home and processes were continuing to improve. Staff were not regularly supervised and there were tensions within the staff team. Health and safety was well managed. Evidence: The current manager Ann Jarrett had been in post since February 2008. She had previously worked as the deputy manager for a year and had a long career in the care industry and had been the deputy manager for four years in her previous employment. Mrs Jarrett had completed a wide range of training relevant to her role including NVQ 4 in care and the Registered Managers award. Care Homes for Older People Page 24 of 31 Evidence: She was supported in her role by the deputy manager Helen Line. Helen had previously been been the manager of the Old library. The manager had not made an application to be registered with the Commission at the time of the inspection and she was advised to complete this process as soon as possible. A system of monitoring the quality of the care provided had been maintained. There was evidence of involvement in the process from people who lived in the home in surveys and meeting records. Recent questionnaires had focused on the meals provided and the results of these had been fed back to the kitchen and menus were being redeveloped to include suggestions from the surveys. Action plans had been developed and results of surveys and action plans were displayed. Where issues were raised in residents meetings these had previously taken some time to resolve. At the last inspection the manager was advised to develop action plans following meetings to make sure that people were assured that issues would be addressed in a timely manner. This had been completed and these were displayed on the notice board. People living in the home and visitors spoke highly of the care provided at the home. Comments included I am very happy here, staff are very good, they do anything for you, the food is excellent and that the main thing and I am very, very happy with the care. Processes in the home such as management of medication, health and safety systems and accidents were audited regularly to ensure systems were maintained. There was evidence from staff files, complaints records and discussions with staff that there were tensions within the staff group. Staff did not feel supported and did not feel that their complaints were taken seriously. There was a lack of effective communication between management and the staff group. There was little evidence that staff received regular supervision or had access to regular meetings. In discussions with people who lived in the home these tensions had gone unnoticed. Provision of staff supervision is an outstanding requirement and will need to be implemented as soon as possible to ensure the quality of the care is not compromised. The manager was advised to access training in staff supervision. At previous inspections there were very clear records maintained by the administrator where the home was assisting people with their finances and receipts were held for transactions. This area was not assessed at this inspection. Care Homes for Older People Page 25 of 31 Evidence: Detailed fire and environmental risk assessments were in place and individual risk assessments were held in care plans. The Fire Officer completed a full audit of the premises during the inspection and stated that all areas were satisfactory. He stated that the fire risk assessment completed by the management was one of the best he had seen. Maintenance records showed that equipment in the home was regularly safety checked and serviced. There was evidence of regular staff training and induction training, staff training records evidenced that staff had received adequate mandatory training in areas such as moving and handling. Accident records were maintained and monthly log was completed to enable the manager to study the prevalence of accidents in the home. The majority of staff had received training in first aid. Care Homes for Older People Page 26 of 31 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 36 18(2) The registered person must make sure that staff receive regular supervision. This is to make sure that policies and procedures are consistently implemented and continued staff development. 01/05/2008 Care Homes for Older People Page 27 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 17 Care plans must be kept securely. To protect peoples privacy and meet data protection legislation. 30/04/2009 2 8 15 The care plans must be updated as needs change. To ensure that staff have all the information required to meet peoples needs consistently and safely. 30/03/2009 3 9 13 Medication must stored in 30/04/2009 the refriderator where this is indicated in the prescrition instructions. To ensure the medication is stored at the appropriate temperature to prevent deterioration of the medication. 4 9 18 Training must be provided to 30/04/2009 staff prior to them administering medication. Care Homes for Older People Page 28 of 31 To ensure the safe handling of medicaion and to minimise the risk of errors. 5 9 13 Accurate medication records must be maintained To provide an audit trail whilst medicion is in the home and to minimise the risk of errors. 6 16 17 Records of the investigation of complaints must be maintained. To evidence that complaints have been fully investigated. 7 17 22 Where allegations of abuse have been made a referral under safeguarding procedures must be completed. To ensure that appropriate investigations are undertaken and people are fully protected. 8 36 18 The registered person must make sure that staff receive regular supervision. This is to make sure that policies and procedures are consistently implemented and continued staff development. 30/06/2009 30/04/2009 30/04/2009 30/04/2009 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 29 of 31 1 2 Where people are not funding their own placement the placing authority should be advised of all third party top up fees and the relevant documentation completed. Where people have fluctuating mental health problems details of how they present when their condition begins to deteriorate should be recorded in their care plans. This is to ensure early recognition of any deterioration so that intervention and support can be provided. The manager should apply to the Commission to be the registered manager. To reduce the staff tensions in the home the management must put systems in place to ensure effective communication in the home between management and staff this must include regular meetings. The manager should access supervison training to assist her in implementing effedctive supervison processes. 2 8 3 4 31 32 5 36 Care Homes for Older People Page 30 of 31 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 31 of 31 - 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!