Inspection on 27/04/10 for Wall Hill

This inspection was carried out on 27th April 2010.

CQC 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Wall Hill 18/02/10

Wall Hill 22/10/09

Wall Hill 15/06/09

Wall Hill 26/07/07

Wall Hill 14/08/06

Wall Hill 24/10/05

Wall Hill 12/07/05

Wall Hill 23/11/04

Wall Hill 12/07/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 17/07/2010.

Key inspection report Care homes for older people Name: Address: Wall Hill Broad Street Leek Staffordshire ST13 5QA     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Jane Capron     Date: 2 7 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 31 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: Wall Hill Broad Street Leek Staffordshire ST13 5QA 01538399807 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Wall Hill Care Home Limited Name of registered manager (if applicable) Mrs Susan Jane Briand Type of registration: Number of places registered: care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 34 The registered person may provide the following category of service only: Care Home only Code PC To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP - maximum number of places 34 Dementia Code DE, maximum number of places 7 Date of last inspection Brief description of the care home Wall Hill is registered to provide care and accommodation for 31 older people, 9 of whom may have needs associated with a physical disability, 9 of whom may have mental health needs and 4 whom may have dementia. The home is located close to the centre of the historic market town of Leek in the Staffordshire Moorlands. There is Care Homes for Older People Page 4 of 31 Over 65 0 34 7 0 1 5 0 6 2 0 0 9 Brief description of the care home a wide range of community facilities, including shops, restaurants, pubs and other leisure amenities in the town. There is good access to local bus services. The home also has its own minibus which is a well used and popular facility. The home is a twostorey building that has undergone considerable refurbishment to meet the needs of people who use the service. A passenger lift allows easy access to the first floor. Of the 29 single bedrooms available, 26 have en-suite toilet facilities. There is one shared bedroom available. The environment is well maintained and decorated throughout. Attractive communal sitting areas are provided at Wall Hill, with large and small lounge areas with comfortable seating and a large and attractive dining room that opens onto the rear grounds and patio area. People interested in accommodation at Wall Hill are advised to contact the home direct to obtain information about current fees and availability. Care Homes for Older People Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection and the service did not know we were visiting. The inspection took place over a 12 hour period and was completed by the Link inspector and a pharmacy inspector. Information that contributed to this inspection included the Annual Quality Assurance Assessment. This is self assessment document completed by the service that gives us information about the service as well as some numerical information. We also looked at information we have about any complaints and safeguarding ans well as notifications. These are legal requirements that the service sends us to tell us about incidents that occur at the service. We also had ten surveys from people that live at the service and six from staff that work there. During the inspection we spoke to some of the people that live there, the deputy manager and several staff. Care Homes for Older People Page 6 of 31 Since the last key inspection we have made two random inspections. Following the last key inspection we made a random inspection to inspect the medication arrangements. A further random inspection was made to check whether the service had met the requirements made at the previous random inspection. Care Homes for Older People Page 7 of 31 What the care home does well: What has improved since the last inspection? What they could do better: We made some requirements as a result of this inspection. Records must be kept of peoples weight. This will make sure that if there is any significant loss/ gain it is identified and acted upon. The service also needs to put in place a more robust system for safeguarding peoples money. The services medication arrangements still need some attention to ensure that there is a robust system in place that can ensure that people are receiving their medication as prescribed. In the light of ongoing concerns we are considering whether further action should be taken. Care Homes for Older People Page 8 of 31 We also recommend that the service further develop its care plans in a more person centred format and put in place more systems for reviewing and monitoring the standard of the service. We also feel that staff should be more aware of the Mental Capacity Act including information about the Deprivation of Liberty provisions. 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 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 31 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People considering living at the service are provided with information about the service to help them decide if it can meet their needs. An assessment of peoples needs is completed to make sure that the service can provide people with the care and support they need. Evidence: The services Annual Quality Assurance Assessment states that it provides people with information about the service giving them a clear view of what the service offers. It also states that each person is assessed before admission to ensure the service can meet their needs. People tell us that they had enough information about the service to decide if they wanted to live there. They also tell us that they had the chance to visit the service before making up their mind to live there. Care Homes for Older People Page 11 of 31 Evidence: Our examination of a sample of three files confirms that the service completes an assessment of peoples needs before offering them a place. The assessment includes information about peoples health and personal care including mobility and medication issues, any spiritual needs as well as their social interests. Care Homes for Older People Page 12 of 31 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the service are having their health and personal care needs met but people that require weighing must receive this. Everyone living at the service has a plan of care but these should be more individualised and where people have needs relating to dementia this should be fully identified. The system of medication is not adequately robust to confirm that people are always receiving their medication. Evidence: The AQAA states that the service promotes peoples health and that people access all health care services. They also say that peoples weight and nutrition is monitored. The AQAA also states that staff are trained in medication and that there are policies in place for its administration. People tell us they are happy with the care they receive. Of the 10 surveys we received all expect one tell us that they always receive the medical care they need. Nine people also tell us that they always or usually receive the care they need. We observed staff supporting people and saw this done in a sensitive manner. When Care Homes for Older People Page 13 of 31 Evidence: we spoke to staff they had an overall understanding of peoples needs. Staff could also tell us how they support people to have their dignity and privacy promoted. Staff also tell us that they have received training in dementia care. At the last key inspection we identified a need for some improvement in the care planning process. We examined three files and saw that each person had a personal profile that provided information about peoples needs including health and personal care needs. We have seen some improvement but feel that care plans still need to be more person centred to reflect the individual care needs of each person including how they wish tasks to be completed. We also feel that when people have dementia care needs specific information should available that shows the effects of the condition and information about peoples lives thereby giving staff information about how to respond to people as individuals. People tell us that they see the doctor when they were ill and that they receive nail and oral care. Records confirm that people have eye checks, see the chiropodist and have the opportunity to attend the dentist. We saw that the service provides support for people that may be at risk of pressure sores including suitable seating and mattresses. We also saw evidence that people check peoples skin and involve the District Nurse if they identify any redness. The service tells us that it monitors peoples weight but of the three records we checked there were gaps in two of them. People are having their personal care needs met. We saw that people are well groomed. People are dressed suitably including appropriate footwear. Peoples hair and nail care is attended to. People tells us that staff deal with their needs sensitively and that staff are available when they need them. Comments include: Staff look after me, Staff there when you need them, Looks after us well, and I see the doctor, the staff give me my medication and they give me the help I need. The pharmacy inspector looked at the services arrangements for the receipt, storage and administration of medication. Since the last key inspection two visits have been made due to concerns with the medication arrangements. One this inspection we found that concerns still remained over the arrangements. We found that the Care Homes for Older People Page 14 of 31 Evidence: medication record were still poor and were not robust enough to demonstrate that people using the service were receiving their medicines as prescribed. The home was only on day two of the medication cycle so the administration records for the previous two medication cycles were examined as part of the audit trail. We found that the recording of the receipt of medicines coming into the home was not as good as the recording seen at the previous inspection. We found occasions where no quantity had been recorded even though there was evidence that medicines had been received. . We found quantities had been inaccurately recorded for example we found that the administration record showed that 7 tablets of a calcium supplement had been received but we found that 28 had in fact arrived in the home. We found that the quantity being carried forward did not always represent the quantity of medicines found in the home. We also found that the home was not always recording the quantity administered for medicines that had been prescribed with a variable dose. We found a number gaps in the administration record and therefore the home could not demonstrate whether the medicine concerned had or had not been administered. We found that one of the inhalers prescribed for this person had not been administered as prescribed. This particular inhaler had an indicator for the user to see how many doses were left before it ran out. The inhaler would have had 124 doses upon opening and the MAR chart showed that since opening a quantity of 118 doses had been administered. We would have expected therefore that the indicator on the inhaler would be showing that there was 6 doses available for the users. We found that the indicator was showing that there was 112 doses still available indicating that only 12 doses had actually been administered. We also found that this particular inhaler had expired in November 2008. We found that the information about medicines in the care plans still needed to be improved. In particular the information about the management of when required medicines still needed to be improved. We also found that a number of people were still continuing to hold and administer some of their medicines. We found that the home had implemented written risk assessments for each of the people involved in this activity. We found however that there was still no formal monitoring programme in place to ensure that the people were administering the medication as prescribed by the doctor. We found some Controlled Drugs that required storage in the Controlled Drugs cabinet were not being stored in the Controlled Drugs cabinet. Instead we found that they were being stored with the rest of the excess medication located in the managers office. We again found that the care staff were failing to fully complete the required sections in the Controlled Drugs register. We found that the receipt of the Controlled Drugs found in the office had not been recorded on the day of receipt in the Controlled Care Homes for Older People Page 15 of 31 Evidence: Drugs register. We found that the home had continued to monitor the maximum and minimum temperatures of the fridge on a daily basis. On the whole the fridge had been maintained within the required range since the last inspection. However on seven occasions during March and April 2010 the maximum temperature had been recorded above 8 degrees Celsius. In the light on the continued concerns over the medication arrangements we intend to have a management review to consider whether we, the commission, will take further action. Care Homes for Older People Page 16 of 31 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that live at the service can enjoy a lifestyle that meets their preferences including having the chance to take part in a range of activities. People are supported to make choices about how they live their lives. People are provided with a choice of nutritious food. Evidence: The AQAA states that people that live at the service make choices in relation to their daily lives including social activities, meals, relationships and religious services. The service also states that visitors can visit when they wish and join in with social activities. We observed a very lively atmosphere within the service. During the day people could take part in a session of movement to music and a church service. We also saw that a visitor brings in their dog everyday and that once a week a pet therapy dog comes in. Everyone we spoke to really enjoyed these visits. The service also provides people with the chance to take part in making crafts and playing board games. Every month there is an outside entertainer visiting. People we spoke to and the responses to our surveys confirms that activities are available. People also tells us that the service has its own transport and there are bus trips every week. We did feel that the service Care Homes for Older People Page 17 of 31 Evidence: could consider whether there are any more activities for people with needs relating to dementia care. Several people go out of the service including going out with relatives and friends, going independently into Leek, going to a luncheon club and to a day centre. One person is a member of the Womens Institute and is taken to meetings by friends. Another person tells us that they go into Leek to have their hair done. During the day a number of visitors came and we saw that there are no visiting restrictions in place. People enjoy flexible routines. People tell us that they get up and go to bed when they wish. We also saw that people can spend time in their bedroom or in any of the lounges. People are also offered a choice of meals. Bedrooms we saw confirm that people can bring in their own possessions. People in their surveys overwhelmingly tells us that they like the meals. Comments include: Good meals, Food - quite nice and Always a choice of meals. We saw that the service provides a welcoming place to eat meals. Tables are covered with clothes and each table is decorated with a floral arrangement. People including those with special diets are offered a choice at all meals but we did advise that the choice could be sometimes be more varied. We observed plenty of staff available to assist people that needed help with eating. Care Homes for Older People Page 18 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience 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 the service have access to a complaints procedure that listens to them and acts on what they say. Staffs knowledge of safeguarding increases peoples protection but staff should have more knowledge of the Mental Capacity Act. Evidence: The AQAA states that the service has a complaints procedure in place and keeps a record of any complaints. The service also states that procedures are in place to protect people from abuse. The service maintains a record of complaints that identifies the areas of concern and the actions taken. There has been one complaint in the last 12 months. A copy of the procedures is available to people. People we spoke to tell us that they would tell the person in charge if they have any concerns and they are confident that staff will address any issues. Our surveys confirm that the overwhelming majority of people know how to make a complaint. When we asked people what they thought the service did well one person commented listen to your problems. The service has a procedure for safeguarding people that live at the service. Since our last visit the service has obtained a copy of the Inter agency Safeguarding Procedures. The staff are trained in safeguarding issues and the staff we spoke to could tell us of signs of potential abuse. People were less sure about the agreed referral process but a subsequent discussion with the provider confirms that this information has now been Care Homes for Older People Page 19 of 31 Evidence: made available to staff. Our discussions with senior staff did not provide evidence that staff are fully aware of the Deprivation of Liberty provisions of the Mental Capacity Act. This is an area that should be fully understood by staff to ensure that people always have their human rights promoted. The service is promoting peoples rights. People are registered to vote and two people tells us that they have already completed a postal vote. Care Homes for Older People Page 20 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service provides good communal and private accommodation for the people that live there. The service is kept clean and hygienic. Evidence: The AQAA states that the it has an ongoing programme of maintenance and monitoring of the condition of furnishings and decoration. Observation shows that people are provided with good accommodation. There are three/ four lounges and the entrance area giving people a choice of where to sit. Communal rooms are well decorated and provide suitable seating. The service has 33 bedrooms of which all except three have en suite facilities. One room is for shared occupancy and the service tells us that it provides privacy screening. Observation of a sample of bedrooms shows that they provide people with good private accommodation. Rooms provide suitable storage facilities and provide seating. Bedrooms are lockable. People can bring in their own possessions and personalise their rooms. The service has started to implement signage to aid people to orientate themselves. We did feel that further progress could be made to help people recognise their own bedrooms. The provider told us that he will address this. We also raised with the service that some of the vacant/ engaged notices of toilets were not working. The service appeared clean and hygienic. The service has a dedicated housekeeping Care Homes for Older People Page 21 of 31 Evidence: staff group. Cleaning schedules are in place. We observed that protective equipment was available. Care Homes for Older People Page 22 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels are suitable to meet the needs of the people that live there. The services recruitment process is protecting people. Evidence: The AQAA states that they provide staffing levels to safeguard the welfare of residents and that staff have pre employment checks before they start work. The service provides at least three care staff on duty throughout the day. People tell us that staff are available and that they respond to the nurse call. During the inspection we saw that staff spend time with people. One staff sat for some time with one person that was feeling unwell. People that responded to our surveys say that that staff are always or usually available when they need them. All the staff that answered our surveys say that they feel that there are enough staff on duty to meet peoples needs. The services AQAA tells us that 17 of the 19 care staff are qualified and that all staff complete induction training when they start work. Talking to staff confirms that they receive additional training including in health and safety issues, medication, dementia and safeguarding. We observed positive relationships between staff and the people that live there. We Care Homes for Older People Page 23 of 31 Evidence: saw staff talking to people in a respectful manner. People tells us that staff always or usually listen to them and act on what they say. We received positive comments from people including: The management and staff could not in my opinion be bettered, Staff very nice, Staff there when you need them and Staff- quite discreet. Staff files confirm that the service undertakes pre-employment checks. Files contain references and police checks. Care Homes for Older People Page 24 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The managers of the service have the required experience and qualifications to effectively lead the service. The systems for reviewing and monitoring the service should be developed so that the service is able to fully promote the welfare of the people that live there. The arrangements for looking after peoples money should be reviewed to improve peoples protection. Evidence: The AQAA tells us that Registered Manager/ provider has lengthy care experience and has obtained the necessary qualifications. It also states that it has procedures in place to safeguard people in respect of their finances and their welfare. The manager was not present on this inspection and the service was being managed by the deputy. The deputy also has lengthy experience in care and has achieved NVQ 4 and a management award. The service provided us with an AQAA when we asked for it. It gave us information Care Homes for Older People Page 25 of 31 Evidence: about the service but we feel it could have provided more information about areas it could develop. The service has some quality assurance systems in place including surveying the people that live there and other relevant people. We feel that the service could develop its system for reviewing and monitoring the service to include a range of audits. Had these been in place the service would have identified the issues we have for identified for improvement. For example had regular audits been undertaken into the medication system and on the weighing records the service would have noticed errors and could have taken action to address them. The service keeps a record of peoples expenditure that is backed up with receipts. However we were told that the service is holding peoples personal money in the services business account. This system does not fully safeguard people. The service is providing staff with training to promote peoples health, safety and welfare. This includes training in such areas as infection control, moving and handling, fire and food safety. Checks are being completed on fire equipment including the fire alarm and the emergency lighting. The services AQAA also confirms that its equipment such as lifts and hoists are serviced. Care Homes for Older People Page 26 of 31 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 9 13 The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. Regulation 13(2). The registered person shall make arrangements for the recording handling safekeeping safe administration and disposal of medicines received into the care home. 22/01/2010 2 9 18 To ensure that staff are suitably qualified, experienced and competent to safely administer medication before they administer medication to people who use the service. regulation 18(1)(a). The registered person shall ensure thats at all times suitably qualified competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users 22/01/2010 3 9 13 The service must ensure that 22/01/2010 medication is stored securely at the correct temperature Page 27 of 31 Care Homes for Older People 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 recommended by the manufacturer. Regulation 13(2). The registered person shall make arrangements for the recording handling safekeeping safe administration and disposal of medicines received into the care home. 4 9 13 Appropriate information 22/01/2010 relating to medication must be kept for example in risk assessments and care plans to ensure that staff know how to use and monitor all medication including when required as directed and self administered medication so that all medication is administered safely correctly and as intended by the prescriber to meet individual health needs. Regulation 13(2). The registered person shall make arrangements for the recording handling safekeeping safe administration and disposal of medicines received into the care home. Care Homes for Older People Page 28 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 8 12 Where people require regular weighing this must be completed. This will ensure that if significant weight changes occur they are identified and acted upon. 01/05/2010 2 35 20 Where the service is looking after peoples money this must be kept separately from the account used to run the business. This will improve the safe keeping of peoples money. 11/06/2010 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 7 Person centred care plans should be further developed and include specific individualised information. This should also ensure that that peoples needs relating to their mental health needs are identified. This will ensure that care plans provide staff with the information to provide care in the Page 29 of 31 Care Homes for Older People 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 way that meets their needs and in the way they wish it. 2 18 Staff should be aware of the Mental Capacity Act including the Deprivation of Liberty provisions. This will help to promote peoples human rights and that no one is subject to restrictions that are not put in place appropriately and are in peoples best interests. To further develop the systems in place to review and monitor the service including for example medication and care practices. This will ensure that the service can be confident that that the care provided to people reaches the required standard at all times. 3 33 Care Homes for Older People Page 30 of 31 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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. 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