Inspection on 27/10/09 for Widecombe House

This inspection was carried out on 27th October 2009.

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

Other inspections for this house

Widecombe House 28/11/06

Widecombe House 11/01/06

Widecombe House 22/06/05

Widecombe House 05/01/05

Widecombe House 16/06/04

Widecombe House 09/03/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Key inspection report Care homes for older people Name: Address: Widecombe House Widecombe House Barrington Road Torquay Devon TQ1 2QJ     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: Michelle Finniear     Date: 2 7 1 0 2 0 0 9 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 29 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) 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Widecombe House Widecombe House Barrington Road Torquay Devon TQ1 2QJ 01803298692 01803298692 colin.brandi@virgin.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Eileen Edith Alicia Brandi,Mr Andrew Brandi care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Widecombe House is registered to provide accommodation and care for a maximum of eighteen people in the registration categories of Old Age and Dementia. The Home is situated in a residential area of Torquay and is within walking distance of Wellswood Village, where there are several shops and a bus service to and from the town centre, which is approximately one mile away. Information about the service is available from the Home in a brochure/information pack, which incorporates a Statement of Purpose and Service Users? Guide. Copies of inspection reports are also available from the Home or can be accessed on the CSCI Website. Care Homes for Older People Page 4 of 29 Over 65 18 18 0 0 Brief description of the care home The current fees range from 340 to 460 pounds a week and cover all care and accommodation costs, food and drink, heating and lighting, any laundry done on the premises and any other service the staff provide. Service users are expected to pay from their own personal allowance or private income for personal items such as newspapers, tapes, books and magazines and for professional hairdressing and chiropody. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: To complete this inspection we asked the home to complete an annual quality assurance document or AQAA telling us about how the home is run and what has changed since we last visited; we sent questionnaires to the people who live and work at the home; we looked at all the information we have received about the home since we last visited including the last Annual service review; we made a visit to the home without telling them when we were coming; we spoke to the staff on duty and the managers of the home; we looked at the records kept; we toured all areas of the home looking at cleanliness and how suitable the accommodation is for people; we looked at how the home has managed complaints and concerns and we looked at the care planning systems in use. We also spent a period of two hours sitting in the home;s lounge observing the care being delivered, how well staff communicated with people at the home and how well they engaged with their environment. Care Homes for Older People Page 6 of 29 These methods help us to get a rounded picture of what it is like to live at the home. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: The home should consider current guidance and practice on environmental adaptation to meet the needs of people with dementia. It is recommended, for example, that people should be able to find their way around the home using visual clues only, and without having to rely on their memory. Staff must receive a full Induction. This is to ensure they are clear about their role and the standards and practice of the home. The homeowner must ensure that all of the required records are obtained before a member of staff is able to work at a care home. This is to ensure people are not being cared for by people who may be unsuitable to work with people who may be vulnerable. Care Homes for Older People Page 8 of 29 The owner must ensure that people employed at the care home receive training appropriate to the work they are to perform. The owner must establish and maintain a system for reviewing and improving the quality of the care provided. This is so that the home can assess what is working well and what could be improved and provide clear plans of how to make improvements. Staff must be appropriately supervised. Supervision should make sure that staff are working consistently and to their full potential to support people living at the home. The owner needs to undertake risk assessments for all areas of health and safety at the home. This is to reduce the risks of accidents wherever possible. All hot surfacers should be protected to ensure people cannot come into contact with them and suffer injury. Following the Inspection the owner informed us that they have attended to these areas. 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 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. Information is available about the service to help people decide if it is the right place for them. Evidence: Widecombe House has information available to give to people thinking of moving to the home. This comprises a statement of purpose and a service user guide, which contains information about the services and facilities the home provides. Some of this information needed updating and reviewing to ensure it presented an accurate picture. The statement of purpose also includes a copy of the homes contract or statement of terms and conditions of residency. This gives information about peoples rights and any rules for living in the home, such as what people can expect to receive for the fees paid and the grounds under which people may have to leave the home. We looked at the ways in which the home makes sure they can meet the needs of the Care Homes for Older People Page 11 of 29 Evidence: people wishing to come and live there. Before a decision is made about admission the home owner visits them at their home or previous placement to complete an assessment. This helps to identify the support they need and helps to decide if they will be compatible with people already living at the home. We looked at the file for the last person admitted. This had been unusual as it had been an emergency admission. However within a few days the owner had completed the assessment and provided a care plan identifying the support needed. We spoke to a relative of a person living at the home on the site visit. They confirmed that the owner had visited their relative at their previous home before deciding to offer them a place. They had visited several homes before choosing Widecombe House, which they had chosen as they said it had felt like a real home. The home currently provides care for ladies only but this may be under review. The home does not provide intermediate care. This means they do not provide specialist programmes of rehabilitation with a view to returning the individual to their own home. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health care needs are being met. Some documentation needs updating. Evidence: On the site visit to the home we looked at the ways in which the home assesses, plans and delivers care to people. Each person at the home has a care plan which identifies the care and support they need and how that care is to be delivered. The plans seen were easy to follow and were being reviewed but it was not always easy to see when changes had been made. The plans outlined the care and routines being followed each day for each person. They also identified any health care concerns and risk assessments. Risk assessments help to minimise any risks to people, for example from falling, and of ways in which these can be reduced. The majority of the people at the home suffer from some degree of memory loss, and some people are so frail they are now cared for in bed all the time. Their care included the use of regular pressure area care and relieving equipment as needed. Peoples mental health needs were identified in their plans. Some of this information could Care Homes for Older People Page 13 of 29 Evidence: benefit from expansion for example to include more information on the direct impact on the individual of their impairment, and on how this can be supported, and clear protocols for managing behaviours that may challenge. Evidence was seen of people receiving health care, from district nursing services and medical support. The home owner felt they do not always receive timely support for peoples mental health needs due to the referral systems involved, but have many years experience of caring for people with dementia themselves. People we spoke to or who completed questionnaires for us said that they or their relatives received the care and support they needed. We did not see any evidence on the plans that they had been drawn up with the person themselves or their supporters/advocates but the manager tells us that they work closely with peoples relatives, and maintain good links. Time was spent talking to staff and management at the home about the care they deliver and discussions were held on individual people living there who may present some challenges. Three care plans were looked at in detail and others sampled to gather a perspective on how well they are used in practice. We also discussed ways of ensuring that staff use them to inform their practice. One staff member spoken to had read all of the plans when they started to work at the home, to ensure they had a clear understanding of peoples needs. Daily update recording is written so that a clear record is kept of what has happened to each person. Some information in the care plans needed updating. As an example one risk assessment had last been updated in May 2008, and one persons recorded medical history did not include a serious medical condition for which they were receiving treatment. At the home we looked at the ways the home managed medication for people. The home uses a monitored dosage blister pack system, which is regularly inspected by the supplying pharmacist. Each administration is signed for and medication is only dealt with by senior staff who have received training in care of medication. This is now being delivered by the owner in accordance with a recognised training package. Care Homes for Older People Page 14 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples care may benefit from additional information being gathered on their chosen lifestyle patterns and social histories. Evidence: During the visit to the home we spent time looking at how people spend their lives, and how they are supported to do the things they want to do, despite their illness or impairments. We spent a period of two hours in the homes lounge observing how well people were being supported and how well they were engaged with their environment. This told us that people were mostly involved in what was going on in the lounge and had interactions with each other, as well as with staff. Some people read magazines with intermittent help from staff and some slept for short periods. There was no organised activity arranged during the day, and peoples files seen said mostly that they enjoyed talking to staff or reading. Discussion was held on person centred activity planning for people and of the importance of gaining really clear information and recording to demonstrate how peoples needs are being assessed and met. Some files had information on peoples lifestyle choices and histories but this was not in much depth. Discussion was also held on the use of resources to stimulate peoples memory, and the use of memory boxes and training in Dementia care and activities. Care Homes for Older People Page 15 of 29 Evidence: Communication from experienced staff on duty was clear and supportive of peoples sense of well being. However the observation did highlight some staff on duty would benefit from some additional training and development during their induction training to ensure communication is most effective and supportive. Staff seen were discreet when undertaking personal care tasks with people, and some were offered choices in for example meals and where they sat. People living at the home have very different needs, from some who are very frail to some who exhibit behaviours that are quite challenging. The home has locked doors, so that people cannot leave the home without staff being aware, but visitors told us they were welcomed to visit at any time and keep in contact. The manager told us that he regularly contacts relatives who live at a distance to keep them in contact with the home. On the day of the inspection visit the manager was cooking the lunch which comprised home cooked gammon ham, potatoes and mixed vegetables. Dessert was chocolate pudding or strawberry whip. One person had a sandwich and a nutritional drink as they had not wanted to eat a main meal. Some people need their food liquidised and others needed support with food being cut up. Care Homes for Older People Page 16 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. Some procedures are in place to ensure peoples welfare is protected, however staff needs training in ensuring peoples rights and decision making are supported and what to do if they suspect abuse. Evidence: On the visit to the home we looked at how the home manages complaints and protects the people who live there. Widecombe House has a complaints procedure which details how and to whom concerns should be raised. The complaints procedure is on display in the hallway but this needs updating to reflect the name of the commission. During the last year one complaint was made to the home, which was investigated by the owners. As a result of the investigation some areas were substantiated and the owners after reflection made some changes, including the way in which the care plans are kept. Some staff at the home have received training in safeguarding and protection of potentially vulnerable adults from abuse, however newer staff have not yet received this training. The manager has also received training in the Mental capacity act, however this has not yet been cascaded throughout the staff group. Discussion was held on the need to do so and ensure that plans reflect any decision-making that staff are making on behalf of people living at the home. This helps to ensure peoples rights are respected. Care Homes for Older People Page 17 of 29 Evidence: The home has a whistleblowing policy, and discussion was held on making this easily accessible on the staff noticeboard. Some staff files seen did not contain evidence of a full recruitment process having been followed through. This could potentially put people at risk of being cared for by people who are unsuitable to be working with potentially vulnerable people. Care Homes for Older People Page 18 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Widecombe house provides accommodation which is comfortable and homely. Evidence: On the site visit we toured all areas of the home. All of the areas we saw were clean, warm and comfortable. Widicombe house is a large detached period property situated in a desirable residential area of Torquay. It is close to the facilities at Wellswood Village and is situated in attractive secure gardens which have been landscaped. The accommodation available for people is situated over three floors, with two rooms on the lower ground floor along with kitchen and office areas. On the ground floor are more bedrooms, lounges and a dining room, as well as a specialist bathing facility and laundry. The first floor comprises bedrooms and bathrooms. Arrangements for storage of clinical waste are to the rear of the building. The home has a number of double bedrooms which were being used on the visit for people who are substantially bedbound. The home has hoists, including an overhead hoist in the main adapted bathroom, and stair lifts to access the lower ground and upper floors. This means people can get around the building without having to climb stairs, however would need the support of Care Homes for Older People Page 19 of 29 Evidence: staff to use the chairlift. The bedrooms were comfortably furnished and showed evidence of peoples individuality and belongings. There was little evidence seen throughout the home of particular environmental adaptation to meet the needs of people with dementia, however a relative speaking to said that they liked the fact that the home was like someones living room. Discussion was held on environmental risk assessment, infection control practices within the home, and on the provision of an infection control risk assessment. The home should also ensure that the Fire precautions risk assessment takes into account the fact that several people requiring full assistance in the event of a fire would be situated on floors above the ground floor. The homes laundry was clear and capable of achieving a sluicing cycle which means they can launder items in a way that reduces any risks of cross infection. Staff at the home have access to aprons, gloves and antibacterial washes to help manage any infection risks, some of which were discussed on the visit. Care Homes for Older People Page 20 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing arrangements leave people at risk. Evidence: During the site visit to the home we looked at how the home recruits, trains and supports the staff who work there. We selected a number of staff files at random to reflect people who were working at the home at the time of the inspection. Some of the required paperwork was not available and it was still being chased by the owner. This included references, which should be obtained before people start working at the home. A thorough recruitment process is important as it protects the people living at home who may be vulnerable from being cared for by people who might be unsuitable. There has been a turnover of staff recently at the home. On the morning of the inspection there were three care staff working at the home, with the manager and a cleaner. Of the three care staff, one was a senior, another had worked at the home for three weeks and the third was in their first few days of working in care. No formal induction programme was in place to support the staffis learning. This is important as it helps to ensure that staff are working and delivering care in accordance with the homes of standards and best practice. The home told us that staff are always supervised by both management and the shift leader, who is Care Homes for Older People Page 21 of 29 Evidence: always a senior member of staff. They are taught and continuously monitored for both good practice and safe working procedures. They do not work alone. Some areas of the staff training schedule appeared to have fallen behind, but the home have told us that staff recieve training in first aid and moving and handling shortly after the Inspection. On the day of the visit a number of staff were attending a course in dementia care in a local hotel. It is understood that a number of staff are keen to pursue National vocational qualifications in care. Two staff have recently just finished their NVQ 3. This is a national award recognising the competency of staff in their working role. During the observation we observed how staff worked with clients. Senior staff on duty showed a good level of skill, however some new staff needed direction and support in developing excellent skills in communicating with people with dementia. Staff spoken to in the inspection were committed and interested in the work that they were undertaking and evidence a good deal of affection for the people they were caring for. A relative we spoke to on the site visit told us they had chosen the home for their relative because it had felt like a real home, and other staff and management always seemed to know what they were doing and cared for people with affection. Other people told us the home was Clean, friendly and staff were approachable, and that the home Keeps residents safe, clean and warm. Care Homes for Older People Page 22 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Some management systems at the home have not been implemented or reviewed. These could place people at risk. Evidence: The owners of Widecombe House are Mr and Mrs Brandi who have owned the home for over 20 years. Their son works as a manager at the home, but is not registered as the manager with the commission. The family are very experienced in the care of people with Dementia and have previously run other homes locally in addition to Widecombe House. The home does not have a formal quality assurance system in place, and the AQAA or annual quality assurance assessment returned to us was very brief and did not give us all the information we would want about how the home was being run. A quality assurance system should help identify what is working well at the home and what could be improved. Mr Brandi felt that as the home is family run they have close links with families, which provide informal systems for assessing the quality of the service. Care Homes for Older People Page 23 of 29 Evidence: We discussed supervision and appraisal systems for staff, which are currently not being carried out. These should be regular sessions where time is spent individually with staff looking at their performance and any training needed. They should help to ensure that staff are working consistently and to their full potential. The manager told us that they do not deal with or handle money belonging to people living at the home. If expenditure is required outside of areas covered by the fees, such as hairdressing or chiropody, then relatives or financial supporters are billed for the expense. On the site visit we looked at the arrangements the home makes to protect the people living and working at the home from risks to their health and safety. The home has a commercially prepared health and safety policy document and risk assessments in relation to some areas of safe working practices. There was a fire risk assessment, and other information in relation to first aid and food hygiene. Regular portable appliance testing is carried out to help ensure electrical safety. Risk assessments were not in place for all areas seen, for example infection control, and some needed updating, for example the COSHH assessment which was last updated in 2000. Regular servicing is carried out on hoists and the homes chairlifts, and the owner told us the home has been checked for legionella bacteria and Asbestos. When we looked round the building we noticed there were still some radiators that were not covered. These present a risk to people who may come into prolonged contact with very hot surfaces. The owner told us that windows were restricted and hot water regulated throughout the home. Care Homes for Older People Page 24 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 29 19, Schedule 2 The registered persons must 28/01/2007 obtain two written references and carry out a POVA First check before employing staff to work with the residents. And, an Enhanced CRB check must be obtained before staff work unsupervised with residents. The registered persons must 28/02/2007 establish and maintain a system of quality assurance/quality monitoring. Previous timescales 15.3.05, 23.10.05 & 16.04.06. 2 33 24 Care Homes for Older People Page 25 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 29 19 The homeowner must ensure that all of the required records are obtained before a member of staff is able to work at a care home. This is to ensure that people are cared for by staff who are suitable to be working with people who are potentially vulnerable. Not to do so places people at risk. 29/11/2009 2 30 18 The owner must ensure that 29/01/2010 people employed at the care home receive training appropriate to the work they are to perform. This is to make sure that staff have the right skills and updated knowledge to care for people. Care Homes for Older People Page 26 of 29 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 3 30 18 Staff must receive a full Induction. This helps to ensure staff are working and delivering care in accordance with the homes standards and best practice. 30/11/2009 4 33 24 The owner must establish 26/02/2010 and maintain a system for reviewing and improving the quality of the care provided. This is to ensure the home understands what is working well at the home and what can be improved. It should also provide a plan for improving the service. 5 36 18 Staff must be appropriately supervised. This is to ensure they are working to their full poitential to support people and in a consistent fashion. 26/02/2010 6 38 13 The owner needs to undertake risk assessments for all areas of health and safety at the home. This is to ensure any risks to people living and working at the home are managed as far as possible. 29/01/2010 Care Homes for Older People Page 27 of 29 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 1 7 The home owner needs to ensure that the statement of purpose and service user guide are kept up to date. Care plans need to be up to date and should be drawn up in conjunction with the person, their relatives or supporters wherever possible. Some care plans would benefit from information on the direct impact of an impairment on the individual being expanded upon. Peoples care may benefit from additional information being gathered on their chosen lifestyle patterns and social histories. This is so that people can be supported to continue to live their lives in familiar routines wherever possible. The complaints procedure should be updated to ensure it gives people accurate information on agencies to complain to outside of the homes direct line management. The whistleblowing policy should be made easily available within the home. Staff should receive training in prevention of abuse and the Mental Capacity Act. The home should consider current guidance and practice on environmental adaptation to meet the needs of people with dementia. It is recommended for example that people should be able to find their way around the home using visual clues only, and without having to rely on their memory. Risk assessment should be provided for all areas of the environment of the home. All hot surfaces should be protected to ensure people cannot come into contact with them and suffer injury. 3 7 4 12 5 16 6 7 8 18 18 19 9 10 19 38 Care Homes for Older People Page 28 of 29 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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