Inspection on 22/01/09 for Uplands

This inspection was carried out on 22nd January 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Uplands 02/02/07

Uplands 21/11/05

Uplands 04/07/05

Uplands 02/12/04

Similar services:

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Claremont House

Oak Ridge

Sun Court Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Uplands 27-31 Cobham Road Westcliff On Sea Essex SS0 8EG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Vicky Dutton     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. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Uplands 27-31 Cobham Road Westcliff On Sea Essex SS0 8EG 01702352752 02088630955 uplands1@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Wendy Fisher Type of registration: Number of places registered: Uplands (UK) Limited care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: A maximum of twelve persons who have a Physical Disability and who are over the age of thirty-five years and under the age of sixty-five may be accommodated at the home. Nursing and personal care to be provided for up to twenty-seven older people. Date of last inspection Brief description of the care home Uplands provides accommodation for up to twenty-seven people who require nursing care. The property is situated in a quiet residential area of Westcliff on Sea within close proximity of the local town and sea front. The accommodation provided includes thirteen single bedrooms and seven shared bedrooms on two floors, which are accessed by a passenger shaft lift. The majority of bedrooms have ensuite facilities. Service users have access to two lounge areas; a large atrium on the ground floor and a small well maintained garden area. At the time of this inspection a major refurbishmant programme was underway which will alter the above information. The Care Homes for Older People Page 4 of 27 0 12 Over 65 27 0 Brief description of the care home range of fees charged for a place at the home as advised in the Service Users Guide is £576.00 - £675.00 per week, depending on funding arrangements. There are additional charges for hairdressing, newspapers, chiropody and other personal requirements. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was an unannounced key site visit. The previous site visit to the home took place on 2nd February 2007. An annual service review took place 26th February 2008. At this visit we (CSCI) considered how well the home meets the needs of the people living there, how staff and management work to provide good outcomes for people, and how people are helped to have a lifestyle that is acceptable to them. The level of compliance with requirements made at the previous inspection was assessed. The site visit took place over a period of seven hours. A partial tour of the premises Care Homes for Older People Page 6 of 27 was undertaken. Care records, staff records, medication records and other documentation was selected and various elements of these looked at to see how well these aspects of care and running the home are managed. Time was spent talking to, observing and interacting with people living at the home, and talking to staff. We also spoke to three visitors during the site visit. The homes Annual Quality Assurance Assessment (AQAA) was sent in to us. The AQAA was received by the due date, was fully completed, and outlined how management feel they are performing against the National Minimum Standards, and how they can evidence this. Before the site visit a selection of surveys with addressed return envelopes had been sent to the home for distribution to residents, relatives, involved professionals and staff. We received responses from four people living at Uplands, seven relatives, two visiting professionals and four staff. The views expressed at the site visit and in survey responses have been incorporated into this report. We were assisted at the site visit by a registered general nurse, who is providing management cover in the absence of the registered manager, the Group Operations Director and other members of the staff team. Feedback on findings was provided throughout the inspection. The opportunity for discussion or clarification was given. We would like to thank the staff team, residents, relatives and visiting professionals for their help throughout the inspection process. What the care home does well: What has improved since the last inspection? 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 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 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that their needs will be assessed before they move into the home to make sure that it will be suitable for them. Evidence: When people are considering moving into Uplands they are not given a copy of the homes Service Users Guide which would provide them with good information about the service. This was raised at the previous inspection. A copy of the Companys glossy brochure is given to people. This has an insert about Uplands. This may not provide people with sufficient information, and did not provide information about cost. The senior person on duty said that verbal information is given, and that people are encouraged to visit the home to see what it is like. On surveys three people felt that they had received sufficient information about the home and one did not. Previous inspections had identified that the manager at Uplands always carries out Care Homes for Older People Page 10 of 27 Evidence: thorough pre-admission assessment and would not admit anyone to the home whose needs could not be met. At this visit we looked at the file of a person who had recently moved in. We saw that a detailed assessment identifying nursing and general care needs had been clearly identified. One relative said, From the moment my [relative] was assessed - in hospital - by [the manager] who administers Uplands, they were at pains to put my family and I at ease, and assured us they would be willing to accept [relative] and care for them. Intermediate care is not provided at Uplands, but the home has previously provided care to people on a Stepdown basis. This is a service for people leaving hospital who may require some additional recuperation or rehabilitation time. Due to the refurbishment of the premises no stepdown placements were being offered at the time of this inspection. Care Homes for Older People Page 11 of 27 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. People living at Uplands can expect to receive a good level of care and support to meet their individual needs. Evidence: Comments from people about the care provided at Uplands were positive such as, Care is superb, cannot be faulted, and, Excellent care with a very personal touch. People spoken with and observed during the day looked well cared for. On surveys received from four people living at the home three felt that they always received the care and support that they needed and one person felt that they usually did. A visiting professional said that staff, Consider individuals psychosocial, emotional and physical health. Relatives felt that they were kept up to date with peoples needs and said, There is frequent discussion of care and treatment, Whenever I have needed information about my [relatives] condition [the manager] or a member of staff has taken the time to explain in laymans language the problem, the effect and the treatment. Also whenever I have been aware of discomfort in my [relative] and sought help the staff have quickly responded and seen to their needs, We know from day to Care Homes for Older People Page 12 of 27 Evidence: day all that is happening and about to happen as far as possible. The care is absolutely wonderful with the present staff. and, We are phoned immediately there is a change. To see how well peoples care is planned for and arranged so that staff are aware of peoples needs, and meet them in an individual way we looked three care files. Assessments were in place dating from the time of peoples admission relating to areas such as Physical Health, Social and Leisure, and behavioural assessment. These were not always fully completed. For example Needs, preferences and Residents Choices with sections relating to Religious, cultural, and occupational, and Physical and mental wellbeing sections blank. Care plans however were well constructed and would enable staff to offer appropriate care and support to people. The home also benefits from having a very stable staff group who have mostly worked at the home for a number of years and know the residents very well. We saw that individual care plans and assessments are reviewed monthly. Every six months a detailed care plan review is undertaken. Some peoples care files did not have a photograph of them which would aid identification. People were happy with the healthcare support they receive at Uplands. On surveys three people felt that they always received the medical support they needed and one that they usually did. One person felt that they Would not be here today were it not for the superb medical care of staff here. Care records showed that care needs relating to falls, pressure area care, continence and nutrition were well assessed, with appropriate care plans being put in place. however we saw that nutritional records were not always fully completed, with what people ate for tea not recorded. Records showed that people access other professionals to meet their needs such as chiropodists, general practitioners and opticians. A physiotherapist visits each week to provide exercise and treatment for people. An involved professional felt that what the home did well was, clinical care, seeking and taking advice, getting other professionals involved. People living at Uplands are generally unable to manage their own medications. We looked at medication systems and records to see how this aspect of peoples care is managed. As Uplands is registered to provide nursing care only Registered General Nurses administer medication. We saw that in general practices and record keeping that keep people safe are maintained. However some practice issues were highlighted to the person in charge. To aid identification and reduce the risk of error photographs should be provided on medication records. Where medication is handwritten onto medication administration records this should be countersigned by another member of staff to verify details and again reduce the risk of error. During the day staff treated people respectfully, and upheld their privacy and dignity when personal care tasks were being carried out. A visiting professional said that what Care Homes for Older People Page 13 of 27 Evidence: the home did well was, Respecting individuals rights and privacy. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have some opportunities for a fulfilling lifestyle and are always able to welcome visitors. Evidence: Since the previous inspection an activities person has been employed to provide people with greater opportunities for occupation and stimulation. They work each weekday from 10.00 to 16.00. Training records showed us that they had undertaken training, Beans, Bingo and Beyond, to help equip them for their role. During the day the activities person was observed undertaking different activities with individual residents to suit their needs. Activities included physical activity such as throwing/catching a ball, board games and pampering. Each Tuesday there is Tuesday Club where entertainment and activity is provided by two outside entertainers. One person told us about the clubs and activity that they took part in outside of the home. We saw that activity equipment is available and that records are kept of peoples likes/dislikes and activities undertaken. These showed us that everyone living at Uplands is offered opportunities for occupation on a regular basis. People spoken with seemed happy with the current arrangements. One said, [Activities person] is very good and tries different things that we might enjoy. The AQAA completed this year Care Homes for Older People Page 15 of 27 Evidence: said that it was hoped to expand the range of activities offered over the next twelve months. People are able to visit at any time. During the inspection we saw that people are always made very welcome. One person told us that The staff feel like my family, and I can always have dinner with my [relative] if I want to. People are free to follow their own routines, and we saw that many rooms were personalised to reflect residents individual preferences. One relative said that the home was good at, Allowing the residents to have their personal belongings around them. We saw that information on advocacy services was available so that people can know where to go for independent support or advice. On surveys opinions about food at the home were varied. Two people said that they always enjoyed the meals, one that they usually did and one that they sometimes did. People spoken with during the inspection said that the food was fine, enjoyable, and Good. We viewed menus and saw that a good range of foods are offered. Although a specific second choice of lunchtime meal is not identified on the menu, it was identified that alternatives are always available. A three weekly rotating menu is used. The group operations director said that these were reviewed every six months, and seasonally in consultation with residents. Lunch on the day of the visit looked appetising. Where people needed assistance, this was done sensitively. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Uplands are kept safe through good procedures and practice. Evidence: We saw that there was a complaints procedure on display to advise people of how they could raise concerns or make a complaint. This needed some amendment to advise people that they can voice any concerns through the Local Authority, and to make clearer our (CSCI) role in relation to complaints. On surveys everyone said that they knew how to make a complaint. People said, In the unlikely event of a complaint being warranted I would raise my concern with [the manager] in the first instance. I have every confidence that they and their team would put right any wrong doing or practice, Always possible to speak to the manager, and, Listens and will follow through any concerns I may have. We looked at the homes complaints records and saw that two concerns had been recorded since the previous inspection. Both had been properly managed and resolved. No issues have been raised with us about the service since the previous inspection. Training records showed us that staff have received training in safeguarding adults. Guidance recently produced by the local authority could not be found, but there were clear procedures in place to advise staff of referring any concerns to the local safeguarding team. Staff spoken with had a good knowledge of safeguarding, and spoke about the importance of whistleblowing. Care Homes for Older People Page 17 of 27 Care Homes for Older People Page 18 of 27 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 a home that is homely, and currently being refurbished to provide better standards and facilities. Evidence: Uplands is currently undergoing a major refurbishment programme. A large extension is being built to the rear of the property. The work will then move inside, and in small phases, upgrade all areas of the home. The work will make all rooms for single accommodation with en suite facilities. Residents and relatives have been involved in the refurbishment plan and offered the choice to move elsewhere during the process if they wished. Numbers being accommodated are being kept at a reduced level during the refurbishment to allow for the flexible use of accommodation available. On the day of the site visit 17 people were living at the home. Residents have also been involved in choosing colour palettes for when the bedrooms are refurbished. As a result of the extension Uplands has lost the limited outdoor space that it had. the Group Operations Director said that following refurbishment terrace areas to the front and side of the building would be available for people as outside space. In spite of the works that are clearly needed, Uplands provides a homely environment for people. A visiting professional said. Once the physical environment is improved it should make it easier to provide privacy for discussion and personal issues and a more appealing environment. Care Homes for Older People Page 19 of 27 Evidence: A tour of the premises showed that the home is kept clean and odour free. On surveys people felt that the home was always or usually clean and fresh. Although the building work is currently outside, an extra domestic is provided on shift to ensure that the home is kept as dust free and clean as possible during works. Adequate laundry facilities are currently sited in a temporary place until the new laundry area within the new extension is completed. Training records and discussion showed, and staff confirmed that training in infection control has been undertaken. Some staff have also undertaken training in MRSA, a specific infection. The manager is a trainer in infection control, and is enthusiastic about the subject. However, as pointed out to the Group Operations Director, posters on display in the hallway, and bathrooms advising of germs and infection control may detract from trying to create a homely environment. Care Homes for Older People Page 20 of 27 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. People are cared for by skilled staff. Evidence: We received positive feedback about staff. Residents said that staff were kind and caring. One person said, I cannot really say what I think about the manager and staff here, because their heads would get so swollen, they would not get out the door! A relative said that the staff were Second to none. Staffing at the home is very stable. The AQAA indicated that no staff had left during the previous 12 months. This provides good consistency for people using the service. Staff spoken with thought that teamwork was very good at Uplands. As the home is registered to provide nursing care many people accommodated have a high level of needs and dependency. Rotas showed that with seventeen people being accommodated, staffing levels are being maintained at a Registered Nurse and three care staff in the morning, and a registered nurse and two care staff during the afternoon, evening and at night. The manager is currently on long term sick, but their hours are normally supernumerary. The person in charge said that the Company are flexible about staffing levels, and that if the need arises, additional staff can be deployed. Ancillary staff are provided for kitchen, housekeeping, maintenance and administration. A volunteer works in the home each day from 10.00 to 14.00 and assists with drinks and general socialising. During the inspection there appeared to be sufficient staff available to meet peoples needs. Care Homes for Older People Page 21 of 27 Evidence: However on surveys people felt that staff were usually or sometimes available to them. Comments made under what the home could do better were, Perhaps more staff, More time on hand feeding, Just time to sit and talk. These comments suggest that staffing levels need to be kept under review. The AQAA said that nine people need two or more people to assist with their care, the building is irregular with lots of nooks and crannies. Therefore during the afternoon/evening when only an RGN and two care staff are on duty, with no ancillary staff around, people may not find staffing adequate to meet their needs. Four staff surveys were returned, of these only one felt that there were always sufficient staff on duty. So that people receive care from a well trained workforce it is recommended that at least 50 of a homes care staff achieve a National Vocational Qualification (NVQ) in care at level two or above. At Uplands from training information and discussion it was ascertained that out of nine care workers, eight have achieved an NVQ in care, five of these at level three. This is a good achievement. We looked at the files of two members of staff who had been most recently recruited to ensure that recruitment procedures protect people living in the home. Good records were in place to show that appropriate checks such as taking up references, checking identification and employment history and carrying out Criminal Records Bureau (CRB) checks had taken place. People are therefore protected by good practice. On surveys staff said that their induction had covered everything that they needed. On the files of the two most recent staff to join the home one, of a Registered General Nurse, had an induction checklist in place. The other for a care assistant, had no induction in place. The administrator said that this had been done but not recorded. The group operations director confirmed that the member of staff will be undertaking Skills for Care foundation training, and signing up for NVQ level 2. Relatives felt that staff had good skills and said, The staff are at various training levels and attending classes at the appropriate college etc, and Younger less experienced staff are trained alongside more experienced staff so that the standard is upheld. they are all so nice. Staff spoken with and on surveys felt that training offered was good. Training records showed that staff access good levels of basic training, with a range of other different skills, knowledge and training courses identified across the staff team. It was identified that a number of staff have also just completed a twelve week distance learning course in dementia care. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe and well managed home. Evidence: Uplands benefits from having a skilled, and very experienced manager in post. Residents, relatives and staff all spoke highly of them, and of the positive role model they present. Unfortunately the manager is on long term sick leave. The Company have been good at keeping us informed of their progress, and of management arrangements at Uplands in their absence. There are opportunities for people to express their views about the home. Although no formal residents meetings are held, the AQAA said that this was something being considered. In the meantime it was said that informal meetings are held. Staff and management meetings are held. Regular monthly visits are undertaken by the group operations director to ensure that standards are being maintained. These visits include talking to people who use the service. Six monthly surveys are undertaken with Care Homes for Older People Page 23 of 27 Evidence: residents, relatives and other stakeholders. This exercise was last undertaken in September 2008. We saw that the responses received were positive about the service. Quality audits are also undertaken that look at a specific area of the service each month, for example care plans, to ensure that good standards are being maintained. The AQAA was completed by the manager. It was well completed and gave us all the information that we had asked for. We looked at records of peoples monies that are held by the home to see that this is done in a safe way that protects peoples interests. We saw that good records are maintained. Monies held balanced against the records, and receipts were in place for all transactions. No major health and safety issues were noted at this inspection. Some potentially hazardous areas such as sluices and a treatment room were however noted to be accessible. Although the home is not specifically registered for dementia, some residents are clearly mentally frail. Staff therefore need to consider this as the home is refurbished to ensure that storage, signage and lighting is suitable and safe for the resident group. Fire records showed that regular drills take place and that all equipment is regularly checked. A fire risk assessment is in place, although this is now due for review. The fire service last visited the home in March last year and found standards to be satisfactory. Last years environmental health visit rated the home as a four star - excellent service in terms of food and kitchen hygiene. Staff training in core areas such as health and safety, moving and handling and food hygiene is ongoing. From training records viewed staff are being kept up to date in these areas to ensure that their practice is current and safe. Care Homes for Older People Page 24 of 27 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 5 The registered person must 10/03/2007 ensure that all persons living at the home are provided with a service users guide, which includes all of the information as described in Care Homes Regulation 5. Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 27 Staffing levels should be kept under review to ensure that staffing is sufficient to provide for peoples holistic needs. This especially so during the afternoon/evening period. Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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