Inspection on 22/05/09 for Yew Trees

This inspection was carried out on 22nd May 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Yew Trees 05/04/07

Yew Trees 10/01/06

Yew Trees 15/08/05

Yew Trees 22/03/05

Yew Trees 03/07/04

Yew Trees 02/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Yew Trees Off Long Lane Sycamore Avenue Chadderton Oldham Lancs OL9 8BQ     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Steve Chick     Date: 0 4 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Yew Trees Off Long Lane Sycamore Avenue Chadderton Oldham Lancs OL9 8BQ 01616816204 01616816204 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Karen McCarley care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: 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. The maximum number of service users who can be accommodated is: 16. Date of last inspection Brief description of the care home Yew Trees Rest Home is a comfortable residential home registered to provide for 16 older people over two floors. The home is situated within walking distance of convenience stores, take-away restaurants and a video rental shop. The garden area is easily accessible and pleasantly landscaped with raised beds and planted pots. The accommodation consists of 12 single rooms, eight of which have en-suite facilities and Care Homes for Older People Page 4 of 29 Over 65 16 0 Brief description of the care home two double rooms. Bathing and toilet facilities are adapted to meet the needs of the service users. There is a choice of two large lounges and a dining room. The home displays the previous inspection report at the main entrance. The home charges approximately 360.00 pounds per week. 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: The quality rating for this service is one star. This means the people who use this service experience adequate quality outcomes. We (the Care Quality Commission) undertook a key inspection, which included an unannounced visit to the home. This meant that no one at Yew Trees knew that the visit was going to take place. We returned, by appointment, on a second day as the manager was not available at our first visit and the staff on duty did not have access to certain records we needed to see. All the key inspection standards were assessed at the site visit. For the purpose of this inspection two service users were interviewed in private, as were two people who were visiting friends or relatives and two visiting professionals. Additionally discussions took place with the manager and three staff members were interviewed. Care Homes for Older People Page 6 of 29 We also looked at information we have about how the service has managed any complaints, what the service has told us about things that have happened in the service, these are called notifications and any relevant information from other organisations. Before the site visit, we asked for surveys to be sent out to staff, asking what they thought about the care at the home. Six staff returned their surveys to us. Some of the information from these surveys is that included in the report. We also asked the management of the home to fill in a questionnaire, called an Annual Quality Assurance Assessment (AQAA). This is a legal requirement. The AQAA is an opportunity for the management to tell us what they thought they do well, what they need to do better and what they have improved upon. Where appropriate, some of these comments have been included in the report. We undertook a tour of the building and looked at a selection of service user and staff records as well as other documentation, including staff rotas, medication records and the complaints log. Since the previous inspection we have completed an Annual Service Review (ASR). An ASR does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection. The ASR did not make us change our opinion of the service. We have not received any complaints about the service since our last Key Inspection. What the care home does well: What has improved since the last inspection? What they could do better: Several areas were identified where records did not appear to accurately reflect either the care practices or steps routinely taken to ensure a safe physical environment. Whilst these records do not necessarily have an immediately detrimental impact on service users they make it more difficult for the home to demonstrate clearly that the people living in the home are having their needs met consistently, or live in a safe, well maintained environment. The failure to address the requirements made at previous inspection visits in connection with protecting service users from the potential risk caused by the hot surfaces of radiators and hot water pipes demonstrates a flaw in the way the responsible people assess priorities. The potential risks to older people of exposure to hot surfaces should be well known to people working in residential social care and is identified by the Health and Safety Executive as an issue which needs to be thoroughly risk assessed. The legally required processes for vetting of prospective staff members must be completed fully before they commence employment at the home. Care Homes for Older People Page 8 of 29 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 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. Service users needs are assessed before moving to the home to ensure that their needs can be appropriately met. Evidence: The manager told us in the AQAA (Annual Quality Assurance Assessment) that prospective new residents are always assessed by staff from the home, to ensure that their needs can be catered for. We looked at a selection of files relating to service users. All had written evidence of an assessment having been undertaken. One visiting relative who we spoke to, confirmed that staff from Yew Trees came to assess their father before he moved in. Staff who completed surveys for us told us that they had up to date information on Care Homes for Older People Page 11 of 29 Evidence: service users. Staff who we asked, told us that they felt competent and had the skills to meet the needs of the service users who lived at Yew Trees. Yew Trees does not offer intermediate care. 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. Service users health, personal and social care needs are predominantly met by the implementation of policies and procedures. Staff practices also serve to promote the dignity of service users. Evidence: We looked at a selection of service users files. Each had a written care plan and there was documentary evidence that each plan was periodically reviewed. There was also written evidence on some files of service user involvement in the care planning process. The amendment and updating of information in the care plan was not always as clear nor as consistent as best practice would dictate. For example records were seen which indicated that for one service user the care of their catheter was not being undertaken when necessary. Discussion with staff and the manager indicated this was an administrative error, in that the appropriate care was given but not recorded. Another example was seen in connection with one service users mobility and their use of walking aids, where different information and advice was given in different parts of his Care Homes for Older People Page 13 of 29 Evidence: file. Again discussion with staff indicated a good understanding of the service users current and up-to-date situation. However, clear and consistent written records are an important part of ensuring that service users always received the correct care to meet their needs. Discussion with staff indicated that the combination of their personal knowledge of each service user, together with the written records and a verbal handover at each shift change, meant that they were confident that they were aware of the current situation of each service user. All staff who returned a survey to us said that up-todate information regarding service users was always available. All staff who returned a survey to us also said that the way in which information between staff was passed about people who use the services work well either always (5) or usually (1). All visitors and service users who we asked, were positive about the care received. One visitor said that they were aware that staff were open to suggestions. Both service users we spoke to were confident they could influence the way in which their care needs were being met. In responding to our survey one member of staff said, the care given to service users is excellent while another said, in response to the question, what does the service do well, the service does well on everything but I think its best aspect is personal care. There was good written evidence that service users have access to the full range of medical services in the community. All staff who we asked were confident that medical support was obtained in a timely manner and that good professional relationships were maintained with doctors, district nurses etc. We talked to two visiting health and social care professionals. They both reported positively on their experience of the competency of staff and that they received a positive friendly welcome when visiting the home. Medication presented as being mainly stored safely, although the recommendation made at the inspection in April 2007 to purchase a small fridge for medication which needed to be kept at a certain temperature, had not been acted upon. We looked at a small number of records relating to the administration of medication. These presented as being predominantly well maintained although there were some omissions, several relating to the same date. The member of staff who had administered the medication on that day reported that the medication had been given. The controlled drug register also contained omissions, including examples where the person who had witnessed the administration had not countersigned. The importance of maintaining medication records rigorously to ensure that staff can demonstrate that the correct dose of the correct medication is given to the correct person at the correct time was understood Care Homes for Older People Page 14 of 29 Evidence: by the staff spoken to. We looked for records to confirm that certain medication had been returned to the pharmacist in January and February of 2009. The manager reported that these were not available as the pharmacist had told her that it was legitimate to destroy records of returned medication after one month. Advice from Care Quality Commission pharmacists is that all medication records need to be kept for three years to remain compliant with the Care Homes Regulations. Observation of staff and service user interactions indicated a positive, friendly and relaxed atmosphere. All visitors, service users and staff who we spoke to, told us the people living at Yew Trees were treated with respect and had their dignity and privacy maintained. 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. An appropriate range of activities is available to service users, and visitors are welcome in the home which enhances service users fulfilment and social stimulation. The provision of food to maintain service users health and well-being is good. Evidence: The manager told us in the AQAA that they encouraged people to be as independent as possible within their capabilities and that people were encouraged to continue to practise the pastimes which they enjoyed before coming to Yew Trees. Service users who we spoke to told us that, out of choice, they tended not to participate in any activities which were provided by the home. Similarly one visitor felt that although there were not many structured activities, that this was not a problem for their relative and they were aware that staff interacted a lot with service users on a one-to-one basis. Staff were able to identify some activities such as occasional entertainers and occasional trips out which were on offer for service users. One service user we spoke to told us that they regularly attended church services. Service users and staff who we asked, confirmed that there was freedom of choice about how people used their time, when they got up and went to bed and whether Care Homes for Older People Page 16 of 29 Evidence: they used the communal areas or spent time in their own bedrooms. One service user identified as one of the best things about the home, the freedom you have, no restrictions, ... people can come and go at any time of the day. All visitors, service users and staff who we asked confirmed that there were no unreasonable restrictions on visiting the home. Visitors described being welcomed to the home by the friendly staff. During this visit to the home one meal was sampled which was pleasantly presented and tasty. An alternative was available and both staff and service users confirmed there was a choice at meal times. One service user, when asked what the best thing about the home was, said that they were well fed and well looked after. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are protected from abuse or exploitation by the homes policies and practices and are confident that any complaints they may have would be dealt with appropriately. Evidence: The manager told us in the AQAA that all service users and families have a copy of the complaints procedure given to them and that residents and families are encouraged to voice their opinions informally or formerly. The written complaints procedure has been found to be appropriate on previous inspection visits and was not specifically looked at on this occasion. No complaints had been recorded in the complaints log and staff who we asked were not aware of any formal complaints having been received. We were not aware of any formal complaints or allegations made since the previous key inspection. Service users and visitors who we spoke to all expressed confidence that any complaint would be listened to and responded to appropriately by staff and management at the home. Staff who returned a survey to us all said that they knew what to do if they became aware of any concerns. A copy of the Oldham adult protection committee procedures were available in the homes office. Staff training records indicated that several staff had received training Care Homes for Older People Page 18 of 29 Evidence: in the protection of vulnerable adults and that training was planned for others. All staff who we asked presented as being aware of the need to maintain vigilance and told us that they understood the whistleblowing policy. All staff visitors and service users who we asked believed that people living at Yew Trees were protected from abuse or exploitation. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is predominantly appropriately maintained to provide a safe and homely environment for service users. However, some aspects of the physical environment present a potential risk to service users. Evidence: The manager told us in the AQAA that the dining room and lounge had been decorated, new dining room furniture had been purchased and the hall, stairs and landings had been decorated and re-carpeted. During this unannounced visit a tour of the building was undertaken. This included communal areas and a selection of service users bedrooms. The building presented as clean and tidy with no unpleasant smells. This was confirmed as being the usual state of the building and service users staff and visitors who were asked. Although looking a little tired in places, the environment provided a homely place to live. Service users who were asked, liked their accommodation. Service users bedrooms gave good evidence that people could personalise their own rooms. Some damage to the floor in a shower room was noted. It was reported by the manager that this had been repaired following the previous inspection visit and that this current damage as a result of the previous job not having been completed properly. The manager reported that the shower room was due to be refurbished. Care Homes for Older People Page 20 of 29 Evidence: Unprotected radiators were still apparent in service users bedrooms in spite of this having been identified as a potential risk at previous inspection visits. Written risk assessments had been produced which should be used to manage and minimise any risk created by the hazards posed by the radiators. These risk assessments did not all appear to specifically address the circumstances of the individual occupying the room which would undermine their effectiveness. The manager was reminded of the predictable nature of accidents caused by prolonged contact with unprotected hot water pipes and hot radiator surfaces and was advised, if further guidance was needed, to access information in connection with this issue produced by the Health and Safety Executive (HSE). 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The numbers and skills mix of staff on duty promotes the independence and wellbeing of service users. Recruitment and vetting procedures are not effectively applied to minimise the risk to service users of inappropriate staff being employed. Evidence: A copy of the staff Rota for the week beginning 17/05/09 was looked at. This confirmed the shift pattern of two carers being on duty between 08:00 and 15:00, and two carers between 15:00 and 22:00. This Rota also indicated that a new staff member was shadowing more experienced staff in a supernumerary capacity as a part of their induction. Staff who completed our survey told us that there were enough staff to meet the individual needs of all the people living at the home either always or (4) or usually (2). The manager told us in the AQAA (completed in February 2009) that of the 13 permanent care workers four had completed the NVQ 2, 2 had nearly finished and four were waiting to sign up for the course. The NVQ (National Vocational Qualification) is a nationally recognised qualification intended to improve the knowledge, skills and competency of care staff. Staff who completed our survey all said that they had taken part in an induction and that they received training which was relevant, helped them to meet the needs of Care Homes for Older People Page 22 of 29 Evidence: service users and kept them up to date. Visiting professionals told us that staff presented as competent. Staff and visiting professionals who we asked, told us that the management of the home encouraged and enabled staff to attend relevant training opportunities. Staff training was identified by one member of staff completing our survey as being something that the service did well. Comments from service users and visitors indicated that staff were experienced as being friendly and competent. Comments included friendly helpful staff (being one of the best things about the home), staff are all pretty decent people, all very nice and treat you with respect and, staff are very good. All staff who completed a survey told us that pre-employment checks were undertaken. A small selection of files relating to the recruitment and vetting of staff was looked at. Examples were seen where the requirement to obtain certain information in connection with prospective staff before they start work was not applied as thoroughly as is necessary to demonstrate that all reasonable steps have been taken to ensure inappropriate staff are not allowed contact with service users within the home. These examples included written references not being received and POVA 1st checks not having been obtained before the person starts work. POVA 1st is a system to check the applicant against a list of people who are prohibited from working with vulnerable adults, pending the arrival of the full CRB (Criminal Records Bureau) disclosure being received. The manager told us that if there was a gap between employment starting and all necessary checks being received, the staff member would be undergoing induction and under close supervision of a senior member of staff. The care homes regulations do not allow for this level of flexibility. 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. The manager is competent to run the home, but does not consistently and thoroughly use quality audit systems or implement the health and safety procedures, for the benefit of service users and staff. Evidence: The manager has been found to be suitably qualified and competent on previous inspection visits and her qualifications were not checked on this occasion. The manager told us in the AQAA that they continued to undertake training to improve the running of the home. There were parts of the AQAA which were not completed in a way which gave detailed information about how the service met the national minimum standards. The manager had not prioritised the requirement to ensure that all radiators were covered to prevent accidental burning, which was initially made in 2006 and repeated at the previous inspection visit in April 2007. Although written risk assessments in connection with uncovered radiators were seen, they did not address in sufficient Care Homes for Older People Page 24 of 29 Evidence: detail the risk to the specific individual occupying the room. There was documentary evidence that service users and other people with an interest in the service had been asked their views on the quality of the service offered by way of questionnaires completed around March 2009. The manager told us that she had looked through the questionnaires although the information had not been collated, nor was a report available regarding what action, if any, was to be taken as a consequence of the information received. We looked at a small sample of records relating to money held by the home on behalf of service users. These presented as being appropriately maintained with receipts being kept for money spent on behalf of service users. Some records showed a small negative balance indicating that the manager was subsidising some service users until relatives or the local authority topped up their spending money. The manager told us that whilst this was not a preferred model, she would not want to see any individual missing out whilst waiting for more of their money being brought to Yew Trees. Staff who we asked, confirmed that they were provided with personal protective equipment such as disposable gloves and aprons. There was documentary evidence that staff received training in connection with health and safety issues and that health and safety was also raised for discussion at staff meetings. A small selection of records relating to routine maintenance, testing and repair of equipment and fittings at the home was looked at. Some of these records were not maintained as thoroughly as necessary. For example, the weekly test of the fire alarm was only recorded as having been done once in each of the three preceding months and the maintenance book implied that no maintenance had been completed in the preceding five weeks. The manager reported that in both these examples more had been done than recorded. 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 25 13(4) The registered person must 01/07/2007 ensure that all radiators are covered to prevent accidental burning. (Previous timescale 01/08/06 not achieved) 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 26 13 The registered person must ensure that the written risk assessments in connection with unprotected radiators and hot water pipework, particularly in service users bedrooms, fully address the relevant circumstances of the service user who is occupying the room. This is to ensure that as far as is reasonably possible steps are taken to minimise the risk of injury service users. 25/08/2009 2 29 19 The manager must ensure that all the necessary pre employment checks including appropriate references and Criminal Record Bureau checks are obtained before any person starts work at the home. This is to minimise the risk of the service users being 24/07/2009 Care Homes for Older People Page 27 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 exposed to staff who are not suitable to work with vulnerable 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 1 7 The registered person should ensure that all aspects of the recording systems used to note the care given and needed by individual service users are maintained thoroughly and accurately. This is to minimise the risk that care may be inadvertently delivered inappropriately. A refrigerator should be purchased to ensure that if any service user living in the home was prescribed medication which needed to be maintained at a certain temperature, that medication would remain safe and effective. The registered person should instigate a system of auditing the medication administration records, including the controlled drug record to ensure that staff can demonstrate that the correct dose of the correct medication is given to the correct person at the correct time. The manager should ensure that records which demonstrate that the minimally required checks on the fire detection and alarm systems are thoroughly maintained. 2 9 3 9 4 38 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!