Inspection on 17/11/08 for Westleigh Lodge

This inspection was carried out on 17th November 2008.

CSCI found this care home to be providing an Poor 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Westleigh Lodge 26/06/08

Westleigh Lodge 01/11/07

Westleigh Lodge 25/10/06

Westleigh Lodge 15/05/06

Westleigh Lodge 05/12/05

Westleigh Lodge 11/05/05

Westleigh Lodge 04/10/04

Westleigh Lodge 15/04/04

Westleigh Lodge 21/11/03

Westleigh Lodge 27/05/03

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Westleigh Lodge Nel Pan Lane Leigh Lancashire WN7 5JT     The quality rating for this care home is:   zero star poor 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: Judith Stanley     Date: 1 7 1 1 2 0 0 8 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 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 29 Information about the care home Name of care home: Address: Westleigh Lodge Nel Pan Lane Leigh Lancashire WN7 5JT 01942262521 01942674783 westleighlodge@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Southern Cross Healthcare Services Ltd Type of registration: Number of places registered: care home 48 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The home is registered for a maximum of 48 service users, to include: Up to 48 service users in the category of DE(E) (Dementia over 65 years of age); Up to 3 service user in the category of DE (Dementia under 65 years of age) may be accommodated within the overall number of registered places The service should employ a suitably qualified and experienced manager, who is registered with the Commission for Social Care Inspection. Date of last inspection Brief description of the care home Westleigh Lodge is a purpose built three-storey nursing home that offers care for up to forty-eight people of either sex who are suffering with a dementia related illness. The Home is owned by Southern Cross Health Care and is situated on the outskirts of Leigh town centre. The Home is within easy reach of local shops and other amenities and is well served by public transport. There is a car park to the front of the Home and gardens at the rear. Accommodation is provided on the ground and first floor; both Care Homes for Older People Page 4 of 29 Over 65 48 3 Brief description of the care home floors have a communal lounge and dining rooms. All residents have a single room with en suite facilities. Bathrooms and toilets are situated on both floors. There is a passenger lift to all floors; the third floor houses the homes kitchen, laundry and staff room. Residents do not access this area. The current rate of fees at Westleigh Lodge is 325.55 pounds per week. Additional charges are made for hairdressing and chiropody and tuck shop. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: zero star poor 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 unannounced inspection was carried out by two inspectors over an eight hour period on one day. This is the second key inspection at this home since April 2008. We (The Commission) looked at some records the home holds on residents (care plans) and other information the home needs to keep to ensure that it is being run properly, including, medication records, staff rotas, staff training and staff files etc. We also looked around the home and spoke with residents, staff and a visitor. Prior to the inspection the manager was sent an Annual Quality Assurance Assessment (AQAA) to complete. This tells us what the home does well at and in what areas they feel they could develop and improve. Care Homes for Older People Page 6 of 29 Comment cards, asking residents and staff what they thought about the home and the care provided were sent. We have not received any completed surveys. We spoke with one visitor who indicated overall satisfaction of the care his relative received. All residents at Westleigh Lodge have a dementia related illness and have nursing needs. It is difficult for most residents to voice their opinions and views of the service and care provided. 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. Care Homes for Older People Page 8 of 29 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 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A pre admission assessment is carried out to ensure the home and staff can meet the needs of the individual. Evidence: The home has a statement of purpose and a service users guide. This is available to all residents and their relatives. This information tells people about the staffing structure, about the range and services the home offers and the terms and conditions of stay. It is the managers intention to review the guide and to include comments from residents and relatives who have used the service to provide prospective residents and their relatives an insight in to living at the home. We selected four residents care plans to work with during the inspection. We checked to see that all four had a written contract/statement of terms and conditions regardless of how their care was purchased. All four had a contract on file which is Care Homes for Older People Page 11 of 29 Evidence: kept in the administrators office not in the main care plan. All residents are referred and assessed for the Funded Nursing Care contribution and continuing care if they meet the criteria. Before any new resident moves in to the home they are assessed by a senior member of staff. The assessment is carried out to ensure that the home and staff can meet the needs of the individual. The assessment covers: personal care, mental state, mobility and dexterity, diet, sight, hearing and communication, continence, sleep and rest, medication and social interests etc. To ensure the needs of the residents can be fully met, some staff have now completed the Yesterday, Today and Tomorrow dementia training. All staff will eventually complete this training. One member of staff spoken with said the training was very good and she had enjoyed it. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and care needs of the residents are not being met to an acceptable standard. Poor medication practices are placing residents at risk of significant harm. Evidence: We continued working with the same four care plans, however the pharmacist inspector looked at several other residents files. The care plans are divided in to twelve main areas of care covering: maintaining a safe environment, breathing, eating and drinking, elimination (toileting), personal care, body temperature, mobility, expressing sexuality, sleeping and last wishes. These had been completed and had been updated. From further examination it became apparent that the care plans had been signed off as checked but this appears to be a paper exercise rather than ensuring the information is up to date and correct and that staff are able to use them as a working tool. For one resident the care plans states, to be weighed weekly. This had not happened and this resident is having problems with eating and drinking and has lost a considerable amount of weight. Other information in the care plans included: risk assessments for moving and handling, use of bed wedges and crash mats, pressure Care Homes for Older People Page 13 of 29 Evidence: care and nutrition. It was difficult to assess the validity of the risk assessments. For one resident who had been visited by the Speech and Language Team (SALT) on 09/10/08 due to problems with eating and drinking and change of diet, the nutritional risk assessment had not been updated since 30/09/08. The same resident had also been seen by the Tissue Viability Nurse (TVN) and her advice had not been properly actioned. The care plans showed that staff contact outside agencies such as doctors, SALT and TVN but do not always follow what they advise and prescribe in the correct manner. For one residents who require thickened drinks, we asked a member of staff who was giving out the drinks where details of the drink given would be recorded. The member of staff was unaware the drinks needed to be thickened and information documented. The tin of thickening ingredient on the trolley belonged to another resident off another floor. There was none available for the resident. The manager needs to make sure that the health care needs of all the residents are being met at all times and that staff are following instructions given by the outside professionals. On the day of the inspection staff were observed treating residents with dignity and respect. Residents were seen to be clean and well dressed. Due to the severity of the dementia for some residents living at the home, sometimes inappropriate behavior is observed, staff were seen to respond quickly when these situations occur. During the inspection the pharmacist inspector looked at how well medicines were handled to make sure that residents were being given their medicines properly. This was because at the previous inspection medicines had not been handled safely. Medication records belonging to nine residents were looked at together with their medicines. We found that the standard of record keeping was sometimes very poor. Some nurses failed to sign the records and it was not possible to tell if medicines had been given to residents properly. One residents Medicines Administration Record sheet (MARs) had the wrong dose of insulin recorded on it, if the wrong dose of insulin had been given this residents health could have been placed at significant risk. When records of medicines administration are poor or incorrect residents health may be at risk. Some medicines could not be accounted for or tracked because the records about medicines were poor. If medication can not be accounted for residents health could be at risk if medicines are mishandled. Residents were not always given their medicines as prescribed, either because there were no medicines available in the home for them or because nurses failed to follow the prescribers directions properly. Some residents had been given out of date Care Homes for Older People Page 14 of 29 Evidence: medicines or medicines which had not been shaken properly. When medicines are not shaken as directed some of the active ingredient settles at the bottom of the bottle and when a dose is given there may be too much or too little medication in that dose. Nurses failed to follow other health care professionals advice especially when residents had difficulty swallowing or when special dressings were prescribed to promote healing. When professional advice is ignored residents health could be placed at significant risk. The inspection took place on Monday; the previous Friday the supplying pharmacy had written to the home to inform them that some medicines were not available from the suppliers. On the day of inspection no contact had been made with the residents doctors to seek their advice if medicines could not be obtained nor had the home obtained full information form the pharmacy as to when the medicines may be back in stock. There were no systems in palace to ensure that effective communication could take place in order to safeguard the health of residents. No significant improvements had been made in the way medicines were handled and we found that residents health was potentially at risk. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home welcomes visitors at any time and actively supports relatives who still want to be involved in helping offer care to their relatives. Evidence: The home has two activities coordinators who plan and deliver a range of activities. Activities include: trips to the local pub and shopping trips. On the 12 October 2008 some residents went on the East Lancashire Railway. In house activities offer arts and crafts, manicures and pedicures, a beauty therapist visits once and fortnight and one to one chats take place. The home has a small tuck shop where residents can buy sweets, chocolates and drinks. For most residents living at the home it is difficult for them to make choices and decisions about how they wish to spend their day and what clothes they want to wear and what they would like to eat. Where possible staff encourage and support residents to make choices and for others staff have to make what they think is the right choice. Family input is a vital source of information to assist staff to understand more about the residents they are offering care to. Care Homes for Older People Page 16 of 29 Evidence: Visitors are welcome at any time, there are no restrictions as to when people can visit. Some visit at lunch time and help feed their relatives as is their choice. The menus are corporate menus planned by head office. These are supposed to offer a well balanced and nutritious diet. The menus are sent to the home along with the recipes and quantities of ingredients required for each meal. Breakfast is served on a flexible basis to allow residents to get up when they are ready. Residents were offered a range of hot and cold dishes including porridge, cereals, toast and preserves or spaghetti on toast with a choice of tea or coffee. Lunch is the main meal of the day and consisted of braised steak, creamed potatoes, garden peas and carrots or sausage and chipped potatoes with gravy, followed by a dessert of semolina or trifle. There is a dining room on each floor and it is good that residents have the choice to dine in their own rooms. However, this can make it difficult for staff to assist some residents and make sure they eat their meal whilst it is hot. We noticed that one resident had been given two whole sausages and chipped potatoes with gravy. This resident was struggling to eat her meal. We assisted by cutting the sausage up and gave the resident her cutlery. The residents hands were covered in gravy. It may be beneficial to review the menus to include more finger food for this home, as other homes in the Southern Cross group cater for a different clientele. It was observed that staff were sitting in the dining assisting those residents who need help with their meals. A lighter afternoon tea was served. It was observed that chipped potatoes were offered for the second time that day. Hot and cold drinks and snacks were served during the day and suppers are available before residents retire. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a procedure in place for the reporting and outcomes of any complaints or concerns made by residents or relatives. Evidence: The home has a complaints procedure in place. There are only a few residents living at the home who would have the capacity to make a written or verbal complaint. Residents rely on their relatives acting on their behalf. The information provided on the AQAA indicates that their had been five complaints made to the previous manager of the home and all five had been dealt with and were substantiated. There has been no complaints brought to the attention of the new manager and none had been forwarded to the CSCI. Staff had received training in the protection of vulnerable adults and a copy of the local councils adult procedure is available for staff to refer to if needed. Staff training is updated as required. The home has made two safeguarding referrals under the previous manager and one safeguarding adult investigation has been carried out. There has been no incidents reported since the new manager came in to post. Serious concerns were raised regarding poor medication practices with residents health and welfare being compromised. Staff were aware that medicines were out of stock and were neglectful of their duties in obtaining medicines or contacting the residents Care Homes for Older People Page 18 of 29 Evidence: doctors for advice. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of decor within the home is satisfactory providing residents with a homely and clean place to live; Evidence: In the main Westleigh Lodge is maintained to a good standard internally and externally. The home has lounges and dining rooms on both floors. The communal areas were clean and comfortable and the manager informed us that some new furniture had been purchased to replace some of the existing furniture. It was noted that the carpet leading from the corridor in to the downstairs lounge was fraying. This requires attention as it could become a trip hazard. One of the lounges on the ground floor has a bar fitted and is utilised as a pub for residents to sit and enjoy a drink. Several bedrooms were looked at on both floors. Rooms were clean and comfortable and had been personalised with residents own belongings and mementos brought with them from home. The home has a salon on the first floor for residents to have their hair done and enjoy a range of beauty treatments. The home has safe and secure established gardens with a decking area and Care Homes for Older People Page 20 of 29 Evidence: appropriate garden. At the last inspection in June 2008 it was discussed that there was an odour problem on entering the home. At this inspection there was still a slight odour, however it had improved. The new manager has put in to place a rigorous cleaning schedule and has ordered the correct cleaning product to ensure that the home will be odour free throughout. Policies and procedures were in place with regard to infection control. Staff were provided with protective clothing for different tasks. Liquid soap and paper towels were provided. The laundry is on the top floor of the home. Residents do not have access to this area. The laundry was well organised and all equipment was in working order. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents were cared for by staff that had been safely and properly recruited following all the necessary checks. Evidence: On the day of the visit staffing levels were satisfactory to meet the need of the residents. Some consideration should be given to meal times as staff cannot be in all areas where residents are dining, therefore are unable to assist some residents. Since the new manager has been in post staff sickness levels have reduced and the home has not needed to use agency staff. The manager had amended staff allocation and rotas had been changed so that staff now work on a specific floor to ensure continuity of care for the residents. Staff training is progressing well with nearly 50 of care staff having achieved a National Vocational Qualification (NVQ) level 2 in care. Other staff have now signed up to start their NVQ. Other training is ongoing and some staff have completed the dementia training Yesterday, Today and Tomorrow (YTT). One of the staff who had done YYT said how much she enjoyed the course and how relevant it was to her work. The manager is working through all the staff training to ensure that all staff are up to date with mandatory training such as moving and handling, food hygiene, protection of Care Homes for Older People Page 22 of 29 Evidence: vulnerable adult and fire awareness, (fire awareness booked for 20 November 2008). All new staff undertakes a full induction programme on commencing work at the home. The files of two members of staff were looked at. These showed all the necessary recruitment checks had been undertaken. Both contained: a written application form, two references. POVA fist check and Criminal Records Bureau (CRB) check and other forms of identification and details of any training. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality assurance systems were in place but improvements are needed to ensure the performance of the home and the well being of residents is regularly monitored. Evidence: The manager has been in post for a relatively short time. She has moved from another Southern Cross home and is therefore aware of how the company operates. The manager has over ten years experience as a registered general nurse and is in the receipt of the Registered Managers Award NVQ level 4. The manager has not yet submitted an application for registration with the CSCI. We appreciate that the manager has only been in post for five weeks and has inherited some problems. It is important that the manager acquaints herself with all the residents and with their care records. During the inspection the manager confirmed she did not yet know all the residents. There are clear lines of accountability which staff and relatives and some residents are Care Homes for Older People Page 24 of 29 Evidence: aware of. During the inspection, it was observed that residents and staff had no hesitation in approaching the manager if they had anything they wished to discuss. The manager now has her own office which allows residents, staff and relatives to speak with her if in private if required. Internal and external quality assurance systems are in place. Staff, resident and relatives meetings take place, these are minuted. The operations manager from Southern Cross visits the home on a regular basis to audit records and speak with residents and staff. A written report is then produced of the findings. The home has a monthly newsletter to that keep people informed of whats going on in the home and other current events. The manager must ensure that the care plans and medication audits are up to date and correct. Some residents have handed over small amounts of money to the manager for safekeeping. It is the company policy that the home has an aggregate personal allowance account. It has previously been confirmed by head office this account will pay interest to the residents and automatically apportion interest to their account. Policies and procedures had been developed, some had been recently reviewed, however some such as management of residents money, valuables and financial affairs had not been reviewed since March 2005 and several including record keeping, pressure relief and food safety and nutrition had not been looked at since 2006. All policies and procedures should be regularly checked and updated if required. The accident reports were available for inspection. All accidents, incidents and injuries were appropriately recorded and the CSCI informed as necessary. With the pre inspection materials (AQAA), the manager provided a list of maintenance and associated records. The following checks included: portable electric equipment, lift, hoists, gas appliances, emergency lighting etc. The premises electrical circuits (checked every five years) should have been in July 2008, the manager must check this has been completed and is up to date and valid. Care Homes for Older People Page 25 of 29 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(2) All records about medicines must be clear and accurate and show clearly that medicines have been given properly and can all be accounted for 27/06/2008 2 9 13(2) All medicines must be stored 27/06/2008 safely and securely to make sure that they are not mishandled. They must also be stored at the correct temperatures to ensure they work properly. All medicines must be given 27/06/2008 as prescribed and an adequate supply of medication must be available to ensure that this is possible You must ensure that all staff 08/08/2008 are competent to carry out their role with specific regard to medication to ensure the health and welfare of the residents. You must ensure a system 08/08/2008 for maintaining the quality of the services provided and in the manner in which the services are to be provided. 3 9 13(2) 4 30 18 (1)(a) 5 31 24 (1) Care Homes for Older People Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Prepare a written plan as to how the residents needs in respect of his health and welfare are to be met. To ensure that staff have relevant information and the care plan is a working tool. 15/12/2008 2 9 13 All records about medicines 15/12/2008 must be clear and accurate and show clearly that medicines have been given properly and can all be accounted for to make sure that medication is not mishandled and residents health is not placed at risk 3 9 13 All medicines must be given as prescribed and an adequate supply of medication must be available to ensure that this 15/12/2008 Care Homes for Older People Page 27 of 29 is possible to make sure that residents health is not placed at risk. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 15 It may be beneficial to review the menus to ensure a wide variety of finger foods is available. Care Homes for Older People Page 28 of 29 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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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