Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: The White House, Falmouth 128 Dracaena Avenue Falmouth Cornwall TR11 2ER 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: Diana Penrose
Date: 1 2 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 White House, Falmouth 128 Dracaena Avenue Falmouth Cornwall TR11 2ER 01326318318 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Helen Judith Christopher Name of registered manager (if applicable) Mrs Helen Judith Christopher Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home The White House is situated in Falmouth on the main route into the town. The home provides personal care for up to seventeen elderly people. Accommodation is provided on two floors and there are stair-lifts to access the first floor. Residents have their own bedrooms that are fitted with hand washbasins. There are sufficient toilets and assisted bathing facilities are provided. Meals are prepared in the kitchen on the ground floor and served in the lounge diner. Residents can choose to eat in their individual bedrooms if preferred. The home has small parking area to the front and slopping gardens to the rear with patios accessible to residents. Some areas are suitable for wheelchairs. The front access to the home is on a slope and limited parking space is available. There is a flexible visiting policy and residents can see their visitors in private. Information about the home is available in the form of a residents? guide, which can be supplied to enquirers on request. A copy of most recent inspection report is available in the home. Fees range from #305 to #415 per week. Additional charges Care Homes for Older People Page 4 of 29 0 Over 65 17 care home 17 Brief description of the care home are made in respect of private healthcare provision, hairdressing and personal items such as newspapers, confectionary and toiletries. Mrs Christopher became the owner of the home in December 2005. She is responsible for the day-to-day running of the home and employs a team of care assistants and domestic staff. 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: An inspector visited The White House Care Home on 12 March 2009 and spent six and three quarter hours at the home. This was a key inspection and an unannounced visit. The purpose of the inspection was to ensure that peoples needs are properly met, in accordance with good care practices and the laws regulating care homes. The focus was on ensuring that peoples placements in the home result in good outcomes for them. All of the key standards were inspected. On the day of inspection 16 people were living in the home although one was currently in hospital. The methods used to undertake the inspection were to meet with a number of residents, relatives, staff and the registered manager to gain their views on the services offered by the home. Records, policies and procedures were examined and the Care Homes for Older People
Page 6 of 29 inspector toured the building. The registered provider has returned a completed Annual Quality Assurance Assessment, which has informed this inspection. Also CSCI surveys have been returned in respect of 7 residents, 2 staff and 4 professionals, these have also informed this inspection. This report summarises the findings of this inspection. The atmosphere in the home was relaxed and friendly, staff were well mannered and caring towards the people living there. Residents and visitors expressed satisfaction with the care and services provided at the home. What the care home does well: The White House provides a warm, comfortable, homely environment for the people using the service. The home is clean and there are no offensive odours. People are only admitted following a thorough assessment to ensure the home can meet their needs. Prospective residents and their family are invited to visit the home prior to any decisions being made to live there. Peoples healthcare needs are met and specialist healthcare professionals visit the home when required. All of the people spoken with during this inspection said they are satisfied with the care and services provided to them, including arrangements to maintain their privacy. They said their individual preferences are respected and they can choose what they do each day. All of the surveys returned were positive in respect of the care and services. Comments include The care girls are lovely and kind and Mother is given excellent care and support, physically, medically and emotionally. There is a suitable system for medications that ensures peoples safety and staff are trained in the safe handling of medicines. Most of the residents who were interviewed said that they are very satisfied with the food provided to them. They are able to choose to either have their meals served to them in their own rooms, or to dine in the main dining room, which adjoins the lounge. Social activities and events take place and entertainers visit the home. The care staff are responsible for activities and people said they enjoy what is on offer. Those that do not wish to join in said their wishes are respected and staff spend time with them on a one to one basis. There is a menu that spans four weeks and choices are available. Residents said the food is good and they get enough to eat. Fresh fruit and vegetables are included some of the time and drinks and snacks are available at all times. There have been no complaints but there is a system in place that ensures that complaints would be dealt with promptly and records kept. There is a suitable policy for the prevention of abuse and staff have received training in the protection of vulnerable adults and the procedure to be followed. The recruitment process is satisfactory with relevant checks undertaken prior to the employment of staff. 40 of the staff have NVQ qualifications and others are working towards them so people can have confidence that they are competent to work with them. The provider is very experienced in the care field with over 40 years experience in management and the delivery of care services. She keeps herself updated and attends courses relevant to her role. Staff and residents spoken with thought highly of her, they said she works alongside the staff, runs the home well and is approachable. Care Homes for Older People Page 8 of 29 There is a quality assurance system in place that allows people to air their views and various audits take place. Relevant service checks take place as required and are up to date. Accidents are reported and there are few. Staff receive relevant statutory training. What has improved since the last inspection? What they could do better: The provider was given very detailed feedback throughout and at the end of this inspection and welcomed the opportunity throughout the inspection to show the work undertaken to meet with her responsibilities under the Care Homes Regulations. She is aware that regulations have been breached and agreed to work hard to put the deficits right. The provider should continue with the previously agreed improvement plan to provide Care Homes for Older People Page 9 of 29 thermostatic control valves to all hot water outlets. Until these are in place she agreed to undertake risk assessments for all residents and their access to hot water outlets. The homes environment should continue to be improved so that people using the service and staff have a more pleasant and safe place to live and work in. The registered provider said that a fire officer is going to visit and discus fire precautions in the home. She agreed to inform the Commission of the outcome of the visit. This needs to take place as soon as possible to avoid fire doors being wedged open. The medicines policy needs to be made available to staff along with the pharmaceutical guidelines for care homes. Controlled drugs must be stored in a cupboard that complies with legislation. Care plans need to be in place for people requiring medicines on an as required basis, they should include how people are to be assessed prior to the administration of the medicine. Protective clothing should be worn at all times whilst staff are preparing and serving food to prevent the risk of infection. 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 10 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 11 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. Residents are only admitted to the home following an assessment of their needs to ensure the home can provide suitable care. Evidence: People using the service said that they and their family were encouraged to visit the home to have a look around before deciding to move in. They told us that the registered provider visited them at home or in hospital and an assessment was undertaken. Assessments were seen in the care files and were detailed. They were also signed by the resident or their representative; indicating their involvement in the process. On admission another assessment form is completed which forms the first care plan. The provider said that the full care plan is developed within 4-6 weeks of admission. Assessment information from the department of adult social care and discharge information from hospital is obtained where appropriate. Care Homes for Older People Page 12 of 29 Care Homes for Older People Page 13 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person using the service has a written care plan that directs staff to ensure that healthcare needs are met. There is an appropriate system for the use of medicines that safeguards the people using the service. Evidence: Each person accommodated has a written care plan that is agreed and signed by them or their representative. Two care files were examined in depth during this inspection. Care plans are reviewed monthly with the staff and the resident; the records show that changes are made when needed. Relevant risk assessments were seen in the care files and they are reviewed monthly or more often if needed. Staff said the care plans are informative and they are involved in the reviews during their staff meetings. Day and night records are maintained. There is a photograph of each person in their file, which assists new members of staff. There are records of visits by doctors and other healthcare professionals. A doctor visited during this inspection and wrote in the care file that good care was being given. Care Homes for Older People Page 14 of 29 Evidence: There is a medicines policy which needs to be made available to staff along with the current pharmaceutical guidelines for care homes. A monitored dose system is in place for medicines. Senior carers are responsible for overseeing the system and care staff that administer medicines receive training in the safe handling of medicines. The pharmacist reviews peoples medication regularly and provides training for staff; there is a record of her visits. The receipt, administration and disposal records are satisfactory. There is suitable storage for medicines requiring refrigeration and the daily records maintained of the fridge temperature are within the normal range. Controlled drugs must be stored in a cupboard that complies with legislation, this was discussed with the registered provider who agreed to address this. For the few people prescribed to have medicines administered, when required, we found that there were no care plans in place about the use of this medicine, or any directions on how to make an assessment if this medicine is required. The registered provider said she would write care plans in respect if these. Peoples privacy was upheld during this inspection. People using the service said they are treated with respect and their privacy is upheld at all times. 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. Staff spend time with people and activities are provided, links with family and friend are encouraged and people are helped to maintain control over their lives and live a life of their preference. Evidence: Care staff provide activities for people using the service as part of their daily work. Several people spoken with said they enjoy the activities on offer and others said their wishes are respected as they do not like to join in. Surveys returned to us from people using the service included these comments I like my own company, papers are delivered to me, I watch TV in my room and the only activities I take part in are the musical afternoons, I join in everything, The ones I enjoy most are music afternoons, aromatherapy, the organist, music and exercise and bingo and Mother is not one to join in and is not jollied to do so. The registered provider said that most people do not want organised activities but they enjoy aromatherapy, manicures, skittles, making cards and one to one chats. Several people talked about the music for life sessions that take place each month. The registered provider said that an organist visits and there are also slide shows sometimes. We saw Easter cards that people are making and some lovely wooden models made by people using the service. One
Care Homes for Older People Page 16 of 29 Evidence: person was making a jigsaw puzzle and another was knitting during this inspection. There are records of the activities undertaken by each person in their care file. Interaction between residents and staff was very good during this inspection. People said they could get up and go to bed when they wished, and can make decisions how they spend their time. Everyone was suitably dressed in clean clothes. The bedrooms were homely and personalised with peoples belongings and furniture. They said there are suitable arrangements are in place for them to receive family and friends and visitors were seen throughout the day. Visitors were relaxed and spoke openly to staff and the manager. People can meet with their visitors in their bedroom or in the dining room or lounge. A four week menu was seen with pictures included, there is a choice of two meals at lunchtime and several choices at tea time. The menu for the day was displayed on a board in the dining room. The meal was beef casserole with potatoes and vegetables or ham with mashed potatoes and vegetables. The sweet was Angel Delight. The cooking of the meal was seen and included some fresh vegetables. Staff said that fresh fruit is provided and a bowl of oranges was seen in the kitchen. The provider said that a cook was employed for a short time but it did not work well so a member of the care team cooks each day. An additional care assistant is on duty from 8.00 to 13.00 so that that the person cooking does not have to leave the kitchen to attend to residents care needs. It was noted that the person cooking the main meal came from caring duties. They must wear protective clothing in the kitchen at all times to stop cross infection and maintain good practice. A tabard was worn but only when dishing up, the provider said that she is going to provide chefs jackets for staff in the kitchen. There was water and fruit juice available in the lounge and bedrooms for people all day. Meals are served in the dining/lounge areas or individual bedrooms if residents prefer. The dining tables have tablecloths and special cutlery is supplied for those who need it. The kitchen has been refurbished and is a great improvement. There is a shed situated in the back of the garden that holds a freezer and tins of food. A risk assessment has been completed for the storage of food here and for protection against vermin. Everyone spoken with said the food is good and they enjoy what they have. Survey comments include I enjoy the meals and I have enough, The meals are always different and I enjoy them all and I love the food. 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. There are suitable policies and processes in place for complaints and adult protection to ensure that people using the service are safeguarded. Evidence: There is a suitable complaints policy in the home and a method for recording complaints, the action taken and the outcome. Residents and relatives said they could approach the staff or manager if there was a problem. There have been no complaints to the home or the Commission. Thank you letters and cards are kept The home has an adult protection policy and staff said they were aware of this, and confirmed that they have received training in this area. The registered provider has attended the Adult Social Care alerters training and has a copy of the local authority procedures. The registered provider has updated the contact details for the Commission in the policies as advised at the last inspection. There have been no abuse issues at the home since the last inspection. Care Homes for Older People Page 18 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is evidence of ongoing financial investment in the home and there have been further improvements since the last inspection making the home a safer and more pleasant place to live in. Evidence: The home is warm, comfortable and homely. It is well ventilated and there is domestic style lighting. The registered provider has made further improvements including the refurbishment of the kitchen and a downstairs toilet, further re-decoration and cleaning to ensure that offensive odours are eliminated. The broken bidet in an upstairs bathroom has been removed and the provider talked of the plans she has for the improvement of the two bathrooms and the shower room. These were to include the installation of a Parker bath. Grab rails and raised toilet seats are provided in toilets and there are stair lifts to access upstairs. People have their own bedrooms; the double is not shared at the moment. Some of the downstairs bedrooms have doors leading to the garden; the windows in these rooms have restrictors fitted and alarms on the doors. The hot water has not been fully addressed since the last inspection and is reported under the management section of this report.
Care Homes for Older People Page 19 of 29 Evidence: The home was reasonably clean but there were a few cobwebs in the top corners of some rooms. The laundry facilities are two washers and one drier; the provider said she is hoping to replace these with industrial machines. The home deals with all laundry and all staff undertake this. People said that on the whole the system works well, issues have been raised at residents meetings and are being addressed by the provider. Suitable hand washing facilities are provided; alcohol gel is not in use. Protective clothing is supplied. Care Homes for Older People Page 20 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 suitable staffing levels for the number of residents and evidence that staff hold NVQ qualifications. Recruitment procedures are satisfactory to help safeguard the people using the service and staff receive regular training to ensure they have the knowledge and skills to care for residents. Evidence: The registered provider said that two new staff are in the process of being employed they are having training whist awaiting CRB checks and suitable references. There are generally two care staff on duty at all times, with three in the mornings to cover cooking the main meal. At night there is one awake and one sleeping. This seems to be sufficient for the people accommodated. Care staff take turns to cook the meals and there are separate cleaning staff and a maintenance man. The registered provider said there has been new care staff employed since the last inspection. Three personnel files were inspected. The files provided evidence of application forms, 2 references, POVA checks and evidence of interviews. A photograph of each member of staff needs to be on file and the provider said she has these in hand. One file held a copy of a CRB check but the other two were not there, the provider said she would ensure these are put in the files. There is an equal opportunities policy. One survey comment was The manager did my CRB and my references and work history was looked into before I started work.
Care Homes for Older People Page 21 of 29 Evidence: 40 of care staff are qualified to at least NVQ level 2 in care and three are working towards the qualification. The registered provider said that staff receive an induction to the home and completed checklists were seen. We also saw a partially completed programme recently introduced that is in line with the skills for care standards. Certificates of training were seen in staff files and each person has a training record sheet. We could not see who had or had not attended training easily as the details are held separately in each file. It is recommended that the registered provider compile a training matrix to help her see who needs to attend training and when. It was evident that all staff are up to date with fire and moving and handling training as the attendance records were seen. Staff were very positive about the training they have received both in house and externally. The staff meeting minutes show that the provider talks to staff about current issues. She said that she is going to cascade information about Deprivation of Liberties at the next meeting. Care Homes for Older People Page 22 of 29 Management and administration
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered provider is competent in running the home however health and safety issues raised at previous inspections have not been fully addressed to safeguard people using the service. Systems are in place to monitor and improve the service for residents and staff. Evidence: The registered provider has over 40 years experience in management and delivery of care services. The provider works hands on with the staff and knows the people using the service well and how to care for them. She is competent in running the home and has invested in the home to improve the service for the people that live there. She said she keeps up to date on current issues by using the internet and reading relevant magazines, she also attends courses when appropriate. Staff said the provider runs the home well and in the best interest of the people living there. People spoken with said she is kind and considerate and leads the staff well.
Care Homes for Older People Page 23 of 29 Evidence: Visitors to the home said the home is run well and they have no complaints. There is an annual development plan for the home and an annual quality assurance survey takes place, this is distributed to residents, relatives, staff and external stakeholders. The last survey was in December 2008 and completed forms were seen, the provider has not yet produced a report from these results. The forms seen were positive about the home and the services provided. Staff and residents meetings take place and the minutes were seen, they show that issues are discussed and addressed. Several audits were seen and include meetings, maintenance, medicines accidents and health and safety. There are few accidents. The registered provider said she is going to take one policy at a time and discuss it at staff meetings she will then talk with staff individually during supervision to ensure they have understood. She said staff will sign to confirm they have read and understood the policy. The registered provider completed her Annual Quality Assurance Assessment (AQAA) in detail and returned it to the Commission. The provider does not manage personal finances for the people using the service. Residents, family members and relatives deal with finances and fees. Statutory training takes place and attendance is recorded. All staff have attended first aid training since the last inspection as well as fire and moving and handling training. The registered provider discussed the arrangements for the maintenance of fire training, precautions, equipment, gas and electrical equipment and appropriate documentation was in place to evidence servicing and maintenance. We observed that wooden door wedges, chairs and a towel were used to wedge doors open. This practice is very dangerous and should cease. The provider has not purchased the door guards as stated in the last report. She said she has undertaken a fire risk assessment online and has requested that a fire officer visit the home to discuss the fire precautions, there was no written evidence to support this but she must address the issue urgently. A requirement has been set in this report. She told us that Legionella testing has recently been carried out and work needs to be done to the water tank. This work was explained by her and a diagram drawn to show the defects in the tank. The work is to be carried out in April 2009. She said she is also attending training in May for Legionella monitoring. She told us that the hot water system has not been fully addressed as the work on the water tank has to be undertaken first. She said she has had discussions with an engineer about the fitting of thermostatic valves and this is the next job to be done. It
Care Homes for Older People Page 24 of 29 Evidence: is disappointing that risk assessments have not been carried out or hot water signage put in place. The registered provider said that only one person takes a bath and she is always assisted by staff. The registered provider compiled a risk assessment during this inspection for this person. There is an electric shower and the provider said this is controlled. A requirement has been set in this report. The registered provider has agreed to address breaches in legislation forthwith, she is aware that if this is not done enforcement action maybe taken. Care Homes for Older People Page 25 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 26 of 29 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 9 13 Arrangements must be made to ensure that controlled drugs are stored in a cupboard that complies with current regulations This will comply with the law and ensure controlled drugs are safely stored. 31/07/2009 2 38 13 Water outlets accessed by people using the service must be thermostatically controlled or appropriately risk assessed with hot water signage in place. This will make sure that people are safe from the risk of injury from hot water. 31/07/2009 3 38 23 Advice must be sought from the fire authority regarding the fire precautions in the home and any necessary action taken. This will ensure that residents staff and visitors are safe 31/07/2009 Care Homes for Older People Page 27 of 29 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 15 Protective clothing should be worn at all times whilst staff are preparing and serving food to prevent the risk of infection A training matrix should be compiled so that the provider can see easily who needs to attend statutory training, this will also provide better evidence for inspections 2 30 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!
