Inspection on 01/04/09 for The Worthies

This inspection was carried out on 1st April 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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Worthies 02/04/08

The Worthies 03/05/07

The Worthies 27/06/06

The Worthies 25/11/05

The Worthies 04/05/05

The Worthies 11/01/05

The Worthies 28/06/04

The Worthies 11/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 07/08/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Worthies 79 Park Road Stapleton Bristol BS16 1DT     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: Sandra Jones     Date: 0 2 0 4 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 32 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 32 Information about the care home Name of care home: Address: The Worthies 79 Park Road Stapleton Bristol BS16 1DT 01179390088 01179655881 shenbutt@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Worthies Residential Care Home Ltd care home 24 Number of places (if applicable): Under 65 Over 65 0 24 dementia old age, not falling within any other category Additional conditions: 24 0 The maximum number of service users who can be accommodated is 24 The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) Dementia (Code DE) Date of last inspection Brief description of the care home The Worthies is a care home registered with the Commission for Social Care inspection to accommodate 19 people in the older persons category and 5 older people with dementia. The home is located in Stapleton village situated on a bus route, within quarter of a mile to shops, libraries and health centres. The accommodation is arranged over three floors, with shared space on the ground floor and bedrooms on all floors, accessible to all floors by a passenger lift. There is a courtyard at the rear of the house. However, this area is not enclosed With two exceptions, bedrooms are single. The double bedrooms are en-suite offering privacy with personal care. The fees range Care Homes for Older People Page 4 of 32 Brief description of the care home from #348.00 - #415.00 per week and extra charges are made for chiropody, hairdressing, etc. Currently this information is initially only provided verbally prior on admission. Care Homes for Older People Page 5 of 32 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: The quality rating for this service is one star. This means the people who use this service experience adequate quality outcomes. This key inspection was conducted unannounced over two days in April 2009. The main purpose of the visit was to check on the welfare of the people who use the service, ensure the premises are well maintained and to examine health and safety procedure. During the site visit, the records were examined and feedback sought from individuals, their relatives and staff. Prior to the visit some time was spent examining documentation accumulated since the previous inspection, including the Annual Quality Assurance Assessment (AQAA). This Care Homes for Older People Page 6 of 32 information was used to plan the inspection visit. Six people were case tracked. Case tracking is the method used to assess whether people who use services receive good quality care that meets their individual needs. The inspection included looking at records such as care plans and reviews of the care of people using the service and other related documents. The homes policies and procedures were also used to confirm the findings. The views of the deputy manager, staff and people using the service were gathered through face- to- face discussions. What the care home does well: What has improved since the last inspection? What they could do better: There are seven requirements arising from this inspection and relates to the way the needs of people with dementia are met at the home. The service provider must ensure that the Statement of Purpose informs people about the range of needs that can be met at the home in particular the needs of people with dementia. Pre-admission assessments must show that the needs of people with dementia are assessed to ensure the staff have the skills and the environment can meet the needs identified. The like, dislikes and preferred routines must be included in the care plan. A person centred approach will ensure that the individuals needs are met in an individualised and consistent approach Prescribed medications must form part of the care planning process which must be regularly reviewed. This will ensure that people are not over medicated and are only taking correct medication. The range of activities to be provided must be suitable for the range of needs that the people accommodated have. The service provider must ensure that the environment fulfils the primary aim of the home. Alternative safety measures that are not institutional and respect people must be sought. The service provider must ensure that the staffing levels meet the needs of the people accommodate. This will ensure that staff are available for people to meet the needs of the people accommodated. Care Homes for Older People Page 8 of 32 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 32 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 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Statement of Purpose must enable people to make decisions about moving into the home. The pre-admission assessment processes must ensure that placements are only offered to those people whose needs can be met. Evidence: The Statement of Purpose says that the aim of the home is to provide individualised care to people with dementia and the primary aim is to provide a secure, relaxed and homely environment. While it is stated within the aims of the home that people with dementia are accommodated, the information needs to be more specific about the way the range of needs will be met by the staff. The manager must update the Statement of Purpose to inform people about the way the needs of people with dementia are going to be met. Care Homes for Older People Page 11 of 32 Evidence: Since the last inspection the Service User Guide was reviewed and a symbolised format with pictures and words is now available. This format ensures that the people for whom its intended can understand it. The care records of the two most recent people moving into the home were examined , both individuals are over 65 years with a diagnosis of dementia. Social workers needs assessments and pre-admission checklists were in place confirming that before an admission individuals needs are assessed. However, pre-admission checklists do not incorporate the way the needs for people with dementia are assessed. . The manager must ensure that the dementia needs of people moving into the home are assessed to ensure the staff have the skills to meet the range of needs. Care Homes for Older People Page 12 of 32 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. Health and personal care is based on the needs of the people at the home. Care plans are not seen as crucial and information gathered during the assessments are put into the care plan Evidence: Care files contain pen portraits of the person and include their preferences, daily routines, health and social care needs. Care plans are formulated from the information gathered during the admission process, these are then monitored monthly by the staff and formally reviewed by the manager with the person, keyworker and where appropriate their relative present. It is evident from the review minutes that social and health care professional input is sought, feedback from the person on the level of satisfaction is requested and their changing needs are monitored. The care plans identify all areas of need which includes financial arrangements and contact with family and friends. While the actions needed are listed, the information is not detailed for all areas of assessed need. Action plans must be specific and must Care Homes for Older People Page 13 of 32 Evidence: include the individuals likes, dislikes and preferred routines, this method will ensure that people can direct staff to consistently deliver their care in a individualised way. Feedback was sought from staff about the care planning process and it was stated that senior staff compile care plans and care assistants input into the care plans. We were told that staff are encouraged to read care plans, there is an expectation that staff record their observations of the person and outcome of visits. People at the home were consulted about they way staff meet their needs, they said that the staff know the actions they must take to meet their needs. There are eleven people with a diagnosis of dementia and a further three people with short term memory. While care plans list the need in terms of their mental health, the actions to be taken must be more specific about the individuals dementia care needs. The manager seeks input from the district nurse for individuals with pressure areas and staff attend appropriate training to ensure that staff are able to identify the triggers of deterioration and take appropriate action. Visits from the continence adviser are arranged to ensure the correct aids are used for people with continence problems. GPs visits are requested as necessary by the staff and the nature of the visit and outcome is recorded. Medical visits that include dental, optician and district nurse visits are also recorded and confirm that the people at the home have access to local NHS facilities. Water low risk assessments are conducted to assess the individuals potential to develop pressure areas and where high levels are scored, an action plans to reduce the risk is devised. Risk assessments are in place for activities that may involve an element of risk, including manual handling risk assessments for people with mobility needs. The risk associated with the activity and the actions to be taken to reduce the level of risk are included. They are monitored monthly by the staff to ensure the actions remain appropriate to the level of risk. Manual Handling risk assessments are completed for each person and described are the tasks, techniques, number of staff and equipment to be used. The privacy and dignity policy is included in the Statement of Purpose and confirms that the staff will respect the rights of the people living in the home. Examples on the way that privacy and dignity is respected are detailed which include health checks will be conducted in the persons bedroom. Staff on duty were asked about respecting the Care Homes for Older People Page 14 of 32 Evidence: Rights of the people at the home. It was stated that permission is sought from the person before tasks are undertaken. For people that may refuse, members of staff will explain the tasks before seeking permission. Knocking on doors and waiting for an invitation to enter was another example given about the privacy is respected at the home. Medication profiles are in place for each individual that has prescribed medications. The purpose of the medications and their side effects are included in the profiles, ensuring safehandling of medications. Medication administration policy includes procedures for the safe administration of medications, with the policy on homely remedies, when required medications and risk assessments promoting safe medication systems are included.. Medications at the home are administered through a monitored dosage system and members of staff sign the records once the medication has been administered and use codes to explain the reasons for not administering the medication. Records of administration show that a number of people accommodated have when required sedatives and tranquilizers prescribed. It is evident from the documentation that these medications are not regularly used by the home. However, it is clear that medication reviews do not occur following their admission to the home. While the manager returned medications that had not be used for significant periods of time, medication must be reviewed to ensure people have correct medications. A record of medications no longer required is maintained and the pharmacist signature confirms receipt of the medication for disposal. Care Homes for Older People Page 15 of 32 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People at the home must have greater opportunity to maintain their chosen lifestyle and specialists activities programme for people with dementia must follow current trends. Evidence: The service provider said that a full time activities coordinator is to be employed to provide daily activities. At present members of staff are delegated the responsibility to provide daily in-house activities which mainly occur in the afternoon and evening. Records of activities show that people living at the home participate in daily activities which include board games, quizzes and bingo. Entertainers visit the home monthly to provide Karaoke and Sing along, these occasion are marked by a buffet tea and drinks. While it is acknowledge that activities take place, the way staff engage with people that prefer not to mix with others and with people that have dementia is not made clear. It was difficult to establish that the activities provided is within current practice for people with dementia. The manager must ensure that people at the home participate in a range of meaningful activities that support their needs and chosen Care Homes for Older People Page 16 of 32 Evidence: lifestyles. Members of staff were consulted about the way that staff engage with people at the home. A member of staff on duty explained the way in-house activities are arranged, we were told that activities are generally arranged after lunch and in the evenings. Music and Movement, Hoopla, arts and crafts and 1:1s take place. Although 1:1s can be difficult. People at the home were consulted about their lifestyle. Two people said that they are able to leave the home without support from the staff and stated that the in-house activities are geared for people with dementia. The arrangements for visiting are clearly stated within the Statement of Purpose and reinforce that visitors to the home are welcome. A relative visiting the home was consulted about the standards of care observed during their visits. The visitor said that the same standards of care are observed irrespective of the time and confirmed that visitors are welcome at the home. It was further stated that their relatives bedroom can be used for additional privacy. People at the home confirmed that visitors to the home are welcome and they can see their visitors in bedrooms for additional privacy. The four week rolling menu establishes that the people living at the home have a continental style breakfast, with a choice of cooked lunch and lighter tea. Members of staff will ask the person before each mealtime to make a choice from the deflection offered. The range of fresh, tinned and frozen foods held together with the records of food provided show that people have a varied diet. The staff told us that menus are devised by the manager, there is a choice of meals at each mealtime with alternatives for people that dislike both choices. People at the home said that the food was good, we were also told that the home caters for the individuals cultural needs. West Indian food is prepared at least three times per week for one person. Care Homes for Older People Page 17 of 32 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. People that live in this home and their relatives can be assured that any concerns or complaints they have, will be listened to and acted upon and are safeguarded from abuse. Evidence: The Complaints procedure is included in the Statement of Purpose and on display in the home and bedrooms. The procedures in bedrooms are in formats that can be understood by the people for whom its intended. As part of the homes Quality Assurance system, feedback is sought from relatives about the home. The manager then analysis the information and where appropriate develops an action plan of improvements to raise standards. There were no complaints made at the home since the last inspection. People at the home home were consulted about the complaints procedure and who they would approach with complaints. People said that they would approach staff or the service provide. One person said that soon after their admission, they made many trivial complaints which was more to do with getting used to the home. The member of staff on duty was asked the way people at the home are empowered to raise concerns. The member of staff said that the complaints procedure would be followed but any complaints would be passed to senior staff. Care Homes for Older People Page 18 of 32 Evidence: There were three safeguarding adults referrals since the last inspection. One referral was made by a health care professional, the other was made by the service provider and the third was from a member of the public. Safeguarding Adults meetings were convened for the three referrals and two of these referrals have now concluded. In terms of the referrals that were concluded the service provider has taken action to ensure that the staff can work in partnership with other professionals and to ensure no further recurrence. The third incident relates to alleged abuse, the manager took immediate action and is working in collaboration with the multidisciplinary team to improve standards. Care Homes for Older People Page 19 of 32 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. People live in an adequately maintained and homely environment, safety measures in place must be more dignified. Evidence: The Worthies is located in Stapleton Village close to bus routes and fairly close to shops and library. The accommodation is arranged over three floors, accessed by a passenger lift, with bedrooms on all floors and shared space on the ground floor. While the property is maintained to an adequate standard and reflects the age group of the people in the home, the window frames on the outside are in need of repair. The service provider explained that to replace these windows, buildings consent is necessary and has been sought. During the tour of the premises it was noted that there are measures in place to prevent people from leaving the home and accessing the first floor without staff support. While these measures may be appropriate to prevent falls, they are not dignified and may be seen as institutional. The service provider must assess the suitability of alternative measures that are more dignified while keeping people safe. Shared facilities comprise of three lounges sited at the front of the property and a Care Homes for Older People Page 20 of 32 Evidence: dining room to the rear of the home. The homes Service User Guide, risk assessment and complaints procedure is available in each bedroom. Bedrooms contain a combination of the homes furniture and personal belongings and are furnished and equipped to meet the needs of the individual. Privacy is promoted through lockable doors with additional lockable space in bedrooms. Residents consulted were positive about their bedrooms and one person said that with staff support they keep their bedroom tidy. There are toilets on each floor and a bathroom on the second and third floor. Equipment and aids are provided to assist less mobile individuals with moving around the home. There is level access into the home and the passenger lift ensures that individuals can access bedrooms on the first and second level. The laundry room is sited away from the kitchen. The floor covering and walls are impermeable making surface readily cleanable. There is an industrial and small domestic washing machines with specific programmes for sluicing and two tumble dryers. Care Homes for Older People Page 21 of 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing levels must at all times meet the needs of the people accommodate. The recruitment process ensure staff are suitable to work with vulnerable adults and are experienced to meet their needs Evidence: It was evident on the day of the inspection that the staffing levels in place did not meet the needs of the people living at the home. As from the day of the inspection, the manager increased the staffing levels to meet the needs of people with dementia. Four staff are now rostered to work until 5:00 pm, three staff will be on duty from 7:45:00 with the fourth person starting at 8:00 am. From 5:00-9:00 there will be three staff on duty, with two staff awake at night, ancillary staff for cleaning and catering are also employed at the home. Management presence is provided by the service provider and the deputy and both are supernumerary, senior support works are rostered on every shift and their responsibility is to run the shift. Since the last inspection the manager has focused on training that will increase the staffs skills to meet the changing needs of the people at the home. Staff at the home have attended refresher Manual handling and Safeguarding Adults training; dementia Care Homes for Older People Page 22 of 32 Evidence: and Mental Health care. Some staff have also attended specific training such as tissue viability, eating and drinking courses. Vocational qualification is encouraged at the home and currently eight staff have NVQ level 2 and seven have NVQ level 3 or equivalent. A recently employed member of staff gave feedback about the recruitment process followed at the home. We were told that before the interview an application form was completed, two written references were sought and Criminal Records Bureau (CRB) checks were obtained before a start date was given. This robust recruitment process ensures that staff suitable to work with vulnerable adults are employed. An induction programme was provided and it was stated that senior staff were shadowed for the first four weeks of employment. Statutory training that includes Safeguarding Adults, Manual Handling, First Aid and fire training was provided. The role of the care assistants and reading care plans was incorporated into the homes induction programme. Care Homes for Older People Page 23 of 32 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 views of the people who live at the home is important and are included in the decision making process of the home. People at the home live in a safe environment. Evidence: We asked the manger about the direction the home needed to take to ensure people received good quality care. The manager said that there has been an increase in staff meetings and at these forums attention was drawn to the expectations of reporting poor practice observed. Since the last inspection an emphasis has been placed on staff training, supervision and re-assessment of needs to ensure that the needs of the people at the home can be met. People at the home were asked to make comments about the leadership of the home. People said the staff knew how to meet their needs and staff were available when needed. Staff said that the service provider has emphasized that she is approachable and systems that ensure consistency are in place. These systems include supervision, Care Homes for Older People Page 24 of 32 Evidence: staff meetings and handovers when shift changes occur. The home operates a Quality Assurance system which uses questionnaires to seek feedback from people about the care home. Questionnaires are used for people living at the home and their relatives and information received through the questionnaires are acted upon. The manager formulates an action plan to ensure that from feedback received the delivery of care improves. Facilities for the safekeeping of cash and valuables exist at the home and records examined supported the cash held in safekeeping. Receipts in place further evidenced the purchased made on behalf of the people at the home. Fees charged at the home range from £378.00- £400.00 per week. Fire risk assessments are completed to assess the potential of an outbreak of fire in the home to then develop action plans that reduce the level of risk. Additional information is required about measures in place to maintain a safe environment, risk assessments action plans must include the fire safety practices and fire checks conducted. The manager ensures that the home complies associated Health and Safety legislation. Lifting equipment, gas boilers and portable electrical equipment is checked annually by contractors to ensure the people and staff are safe Care Homes for Older People Page 25 of 32 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 1 6 The Statement of Purpose must be reviewed to ensure that all gaps in information are included as outlined in Older Persons NMS 1. (Previously Required 03/05/07). 30/06/2008 2 7 15 (2) (b) Care plans must be kept under review. Care plans must be adapted with individuals changing needs. Care plans must be more person centred. Individuals likes and dislikes must be integrated into the care action plans. 30/06/2008 3 7 12 (3) 30/06/2008 4 7 13 (4) (b) Risk assessments must be 30/05/2008 completed for a) individuals that at times exhibit aggressive and violent behaviours b) for restrictions imposed on cigarettes. Individual medication profiles 30/06/2008 must be devised which include a) the purpose of medications administered b) protocols for when required medications c) compatibility Page 26 of 32 5 9 13 (2) Care Homes for Older People with homely remedies. 6 12 16(2)(m) Consult service users about their social interests and make arrangements to enable them to engage in local, social and community activities. (Previously Required 03/05/07). 02/06/2008 7 18 13 (6) a) Policies and procedures must instruct staff on safeguarding adults from abuse. 30/05/2008 8 29 Schedule 2.1 The registered person shall 02/06/2008 Regulation 19 not employ a person to work at the care home unless he has obtained in respect of the person the information and documents specified in paragraph 1-9 of Schedule 2 (Each member of staff must have a Criminal record bureau check completed through the home. This includes older staff members). (Previously Required 03/05/07). (The service provider must ensure that the authenticity of the reference can be validated). 9 30 18(1)(c) (I) Sch 2.5 All staff must have training in 02/10/2008 working with older persons with mental health needs and dementia (Previously Required 03/05/07). Care Homes for Older People Page 27 of 32 10 35 Regulation 17 Clear accurate records and Sch 2.4 receipts must be kept of possessions handed over for safekeeping. (Previously Required 03/05/07). 30/04/2008 11 38 23 (4A) Fire risk assessments must be reviewed to ensure that appropriate steps are taken to prevent the outbreak of fire. 30/04/2008 Care Homes for Older People Page 28 of 32 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 1 27 18 The staffing level must be appropriate to the needs of the people at the home The service provider must ensure that the staffing levels met the needs of the people accommodate 22/05/2009 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 1 6 The manager must ensure that the Statement of Purpose in kept under review. The manager must ensure that the Statement of Purpose describes the way the range of needs are to be met. Specifically the way the needs of people with dementia are to be met. 30/09/2009 2 3 14 The manager must ensure that before any admission, the needs of people wishing to live at the home are assessed. Pre-admission assessments must show that the needs of people with dementia are 30/06/2009 Care Homes for Older People Page 29 of 32 assessed to ensure the staff have the skills to meet the needs identified. 3 7 12 People at the home must have a say about the way their care is delivered. The like, dislikes and preferred routines must be included in the care plan. A person centered approach will ensure that the individuals needs is met in an individualised and consistent approach 4 9 13 members of staff must monitor the condition of the person and prompt a review of medication. The manager must ensure that prescribed medications are regularly reviewed. 5 12 16 The manager must consult with people about the activities to be provided The range of activities to be provided must be suitable for the range of needs that the people accommodated have. 6 19 23 The premises must be suitable to meet the intended purpose of the home. The service provider must ensure that the environment fulfills the primary aim of the home. Safety measures in place must be more dignified. 31/07/2009 19/06/2009 01/06/2009 31/07/2009 Care Homes for Older People Page 30 of 32 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 31 of 32 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 32 of 32 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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