Care Home: Acacia Lodge

Similar services:

• Henry Nihill House
• Birchwood
• The Infirmary
• Orchard House Nursing Home
• St Josephs Rest Home
• Red Court Nursing Home
• Spinney (The)
• Queen Elizabeth House

What the care home does well The home provides a very comfortable, attractive and homely environment for residents to live in. There are good procedures for assessing peoples needs before admitting them and good care plans are prepared for meeting their needs. The people who live in the home are afforded plenty of choice about how they like to spend their time in the home, including a variety of stimulating activities and meals. The home encourages people to express their views about the service by having a comments box and consulting them at regular meetings. The standard of cleanliness and decoration is very good and the home is well maintained to protect the health and safety of residents, staff and visitors. There are thorough staff recruitment procedures in place to protect the wellbeing of residents and the staff are well trained and knowledgeable about meeting residents needs. What has improved since the last inspection? The residents or their representatives sign their care plans as evidence that they have been consulted regarding how they prefer their care to be provided. Fire alarms in the home are tested every week. What the care home could do better: We have made two requirements and a recommendation in this report regarding medication. The home needs to take more care when recording when medication is administered or omitted. There should be copies of signatures of staff who are authorised to administer medicines and the amount of medication delivered to the home must be recorded. These measures are necessary to protect the health and safety of residents and to allow for accurate audits of medication stock. We have also required the home to ensure that mop buckets are not left in residents bathrooms which is poor hygiene practice. We have recommended that condiments be provided which residents can choose to enhance their meals if they wish. Key inspection report Care homes for older people Name: Address: Acacia Lodge Acacia Lodge 37-39 Torrington Park Finchley London N12 9TB     The quality rating for this care home is:   two star good 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: Thomas McKervey     Date: 3 0 0 7 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 27 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 27 Information about the care home Name of care home: Address: Acacia Lodge Acacia Lodge 37-39 Torrington Park Finchley London N12 9TB 02084451244 02083437459 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Janet Wairimu Bethuel,Mr Michael David Pringsheim Name of registered manager (if applicable) Type of registration: Number of places registered: care home 32 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 32 The registered person may provide the following category/ies of service only: Care home only - Code PC to service users of either gender Either whose primary care needs on admission to the home are within the following categories: Dementia - Code D (maximum number of places 28) Old age, not falling within any other category - Code OP (maximum num ber of places 4) Date of last inspection Brief description of the care home Acacia Lodge is a care home registered to provide care for a maximum of thirty two older people. It is owned by Mr Michael David Pringsheim and Mrs Janet Wairimu Care Homes for Older People Page 4 of 27 Over 65 0 4 28 0 Brief description of the care home Bethuel. The home was first registered in 1971. The homes stated aim is to stimulate and help maximise each residents physical, emotional and social capacity, so that they remain mentally and physically active, subject to any personal limitations, which will always be respected. The home is a detached three storey house with fourteen single bedrooms and nine shared bedrooms located across the three floors of the building. On the ground floor, there is a kitchen, laundry room, toilets, bathrooms, large lounge, dining room and bedrooms. On the first floor there is an office, small lounge, toilets, bathrooms and bedrooms.On the second floor there are toilets, bathrooms and bedrooms. A shaft lift is available from the ground to the first floor and a stair lift is provided from the first floor to the second floor. There is a small parking area at the front of the building and a large garden at the rear with wheelchair access. The home is located in a quiet residential area of North Finchley close to shops, restaurants and transport links located along the High Road. The fees of the home range from £402.00 to £775 per week. These fees are subject to current discussions with the local authority and depend on the needs of the individual and private funding arrangements. The provider must make information available about the service, including inspection reports, to service users and other stakeholders. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection took place on 30th of July 2009 and was completed in seven hours. The previous registered manager had left the home and there was a new person in charge, referred to as the acting manager in this report. The acting manager and the administrator fully cooperated in the inspection process, as did the proprietor who was present for most of the inspection. Prior to the inspection we received the homes Annual Quality Assurance Assessment, (AQAA). This document is a self assessment by the manager which describes what the home believes it does well and what areas need improvement. It also gives us numerical information about who lives and who works in the home. In addition, we sent out questionairres to residents and staff to ask them about their views. We received eight responses from residents and four from staff. We have made reference to the AQAA and the surveys in the appropriate sections of this report. We interviewed five residents and four staff, a local authority care manager and a district nurse during the inspection. Statutory records were examined. These included Care Homes for Older People Page 6 of 27 six residents case files, maintenance records, accident reports, complaints log, and fire records. We found these documents were well maintained and easy to read. We visited all areas of the home including bedrooms, bathrooms, lounges, the kitchen, garden and all communal areas. We interviewed staff on a range of topics associated with their work and looked at their records, including supervision records, evidence of CRB disclosures, references and training. The inspector extends thanks and appreciation to the acting manager and her staff for their hospitality and assistance during this inspection. Care Homes for Older People Page 7 of 27 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 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 8 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who wish to use this service can be confident that they are welcome to visit the home prior to admission and their needs will be assessed to ensure the home can meet their needs. Evidence: At the time of this inspection there were twenty nine residents and four vacancies. The home expected to admit a new person very soon. We were informed that this persons relatives had visited the home to assess its suitability. FIve of the current residents are privately funding their care. We sampled two of these residents case files and noted that they contained signed contracts which detailed the fees and what they covered. We also looked at three case files of people who were funded by the local authority and saw evidence that care managers visit the home to carry out annual reviews of the care. Relatives were invited to these meetings. The care managers reports indicated that they were satisfied that the home continued to meet the residents Care Homes for Older People Page 10 of 27 Evidence: needs. We met a care manager during the inspection. She said she had been to the home several times and always found that the service provided to residents was very good. This was also confirmed by comments made to the inspector in surveys and during the inspection. The case files contained comprehensive assessments carried out by the manager. The areas assessed included physical and mental health, communication, personal care, ethnicity and spirituality. There was also a short life history which helps to identify the residents interests and lifestyle. The AQAA states; We give relatives and prospective service users a chance to visit the Home and assess the service we provide and are encouraged to move in on a trial basis to ensure the Home is suitable for their needs. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be confident that their healthcare needs are being met and they are treated with dignity and respect. More care needs to be taken in the administration of medication to protect the wellbeing of residents. Evidence: We looked at five care plans in detail. These had been reviewed monthly and they had been signed by either the residents or their relatives as evidence that they were aware of and agreed to, what was written about them. The care plans recorded a wide range of the assessed needs; for example, mobility, continence, cognition and nutrition. There were also comprehensive risk assessments regarding falls and self neglect and smoking was identified as a serious risk in two case files we saw. There was advice and guidance for staff about how to minimise these risks. The care plans provided clear guidance for staff to ensure that care was provided in the individual residents preferred manner. We saw good records of health care appointments.These included chiropody, dental and opticians appointments. The G.P visits the home weekly and the district nurse comes daily to administer insulin and apply required dressings etc. We spoke to the Care Homes for Older People Page 12 of 27 Evidence: nurse who stated that in her opinion, the quality of care provided by the home was very good. At the time of the inspection no residents had pressure ulcers. The district nurse was treating two residents who had leg ulcers which she said were responding well. In the AQAA, the manager states; We have a procedure for combating dehydration, especially during the hot weather, jugs of fresh water are provided in each room and changed daily. All the people we saw were clean, appropriately dressed and appeared well cared for. The acting manager showed us a new form which key workers complete to record weekly care updates. We examined the standards relating to medication. We found one error in the administration of medicines records,(MAR) whereby a tablet was still in the blister pack, although ir was recorded as having been given. There was no explanation given for this. We also noted that in some instances, the amount of medication supplied by the pharmacy was not recorded. This is necessary for the purpose of auditing. Copies of the signatures of staff who are authorised to administer medication were not available. We have made requirements for these issues to be addressed. The medicines that were returned to the pharmacy for disposal were recorded, as were the temperatures of the fridge and medication room. These were satisfactory. Staff records indicated that those responsible for administering medication had been provided with the required training. We saw details in residents files about their wishes in relation to end of life care. We discussed this issue with the acting manager and recommended that the home enrolls on the PCTs Gold Standard Framework programme. This involves having enhanced care plans for end of life care. The acting manager expressed interest in pursuing this. Residents told us that staff were very attentive and caring and treated them with respect. They said the staff supported them in their personal care with dignity and they always knocked their bedroom door before entering. Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be confident of having a range of stimulating activities to choose from to enhance their lifestyles. They can be assured that their meals are of a good quality with plenty of choice and their personal, cultural and social preferences will be respected. Evidence: The home has an activities coordinator who works three days a week. The varied programme included exercise sessions, outings, manicures, music sessions, birthday celebrations, cheese & wine parties, bingo and art and crafts sessions. Residents who were interviewed were satisfied with the activities provided, although some preferred to do their own thing, such as reading, listening to their radio or watching television in their room. We saw records of each activity that a resident took part in. We noted that in the case of one person who had dementia, their preferred activity was to listen to classical music in their room which relaxed them and prevented restlessness. One person told us they enjoyed going out regularly to the pub where they meet up with friends. This resident showed us their room where they had several newspapers. They also had many personal items that they had brought in themselves. Another resident said they liked playing the piano and singing for the other residents. Residents told us that there was no compulsion to join in any group activities. Care Homes for Older People Page 14 of 27 Evidence: The visitors book showed that relatives and freinds are free to visit without restriction. The manager stated in the AQAA; Once a month we have a religious service and service users take this opportunity to join in and have holy communion if they wish to do so. We welcome relatives, friends and service users comments and do our best to implement viable suggestions as soon as we can. Residents told us that they were very happpy with the meals provided and there was always plenty to eat. We visited the kitchen and were satisfied that food was stored safely and appropriate temperature records were being kept. The home was awarded five stars by the Barnet Enviornmental Health officer for food hygiene. The chefs have worked in the home for many years and knew individual residents preferences for food, including ethnic dishes such as curries, risotto and stir fry dishes. The chef on duty showed us records of special diets for dabetics and pureed meals for residents who have swallowing difficulties. The menu was examined, which was varied and nutritious. We joined the residents for lunch. There was choice of two main meals and desserts. The food was well cooked, hot and attractively presented. The dining room was pleasantly decorated and there was a relaxed and cheerful atmosphere. We noted that staff had to support some residents to eat who could not manage by themselves. The staff sat beside the residents while assisting them, engaged them in conversation and took plenty of time. We suggested to the acting manager and proprietor that meals could be further enhanced by having salt and pepper and other condiments on the table for residents to use if they wish. Care Homes for Older People Page 15 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their representatives can be confident that any concerns or complaints will be taken seriously and that their wellbeing is safeguarded by staff being trained in the prevention of abuse. Evidence: The AQAA states; We listen to complaints and take them seriously. We look upon them as a way of improving our services further. We ensure that all complaints are dealt with promptly and effectively. Service users and their families are confident that their complaint will be listened to, taken seriously and acted upon. The complaints records were examined. The last recorded complaint was in January 2008 which had been promptly responded to. It was evident that there is a low level of complaints about the home which was reflected in our disussions with residents. One resident had been assessed by health and social service staff. This related to their mental capacity, as a result of which deprivation of liberty was approved relating to their access to cigarettes. These are retained by staff and given at appropriate periods in accordance with their care plan and the risk assessments. The surveys that residents returned to us showed that people knew how to complain and that they were confident that these would be taken seriously and addressed. We saw in staff records that they had been trained in the detection and reporting of abuse. In our discussions with individual staff, we were satisfied that they were knowlegeable and were aware of their responsibilities to safeguard residents from abuse. Care Homes for Older People Page 16 of 27 Evidence: We noted that there are forms available in the entrance hallway for people to make comments and suggestions about the service. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be confident that they live in a clean, well maintained and homely environment. They are able to bring their own personal possessions with them to personalise their rooms. Evidence: We visited all areas of the home, including several bedrooms. Bedrooms had been personalised by residents with their own pictures and ornaments which they had brought with them to the home. The overall appearance was of a homely and attractive environment and the home was clean and smelled fresh with no offensive odours. There was a good standard of decoration throughout and we noted during the inspection that painters were at work on the ground floor. The bathrooms and toilets were equipped with adaptations to assist people who have mobility problems. We noted that there were no disposable hand towels in toilets but we were informed that dispensers were on order. No safety hazards were seen. The kitchen and laundry were well equipped and tidy. The home has specialist equipment, including wheelchairs, assisted baths and hoists. Ramps were located near the front doors and the reception for easy access. We were concerned to find a bucket and mop in the bath in a residents bedroom. The acting manager apologised for this, but we are making a requirement to address this issue. The gardens were also accessible via a ramp and were attractive and well maintained. Care Homes for Older People Page 18 of 27 Evidence: There was a good selection of furniture in the garden. The home employs a person to maintain and carry out minor repairs. We were satisfied that that there was hot water in bedrooms which was at an appropriate temperature and there were restrictors on bedroom windows for residents safety. The communal areas were bright, spacious and comfortably furnished. We saw flowers on the dining tables which are removed and replaced after meals. According to the AQAA; The Home is well equipped and provides a comfortable and safe environment for our serice users to live. safety inspections are carried out regularly to ensure that portable appliances, hoists, boilers, gas installations and electrical installations are up to standard. Our staff are highly trained in moving and Handling and the use of hoists and other equipment. Fire safety drills and mock evacuations are on going and health and safety is maintained and observed by all staff. We were able to confirm this statement during this inspection. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents can be confident that there are always sufficient numbers of staff available to support them. The staff are well trained and there are thorough recruitment procedures in place to protect residents best interests. Evidence: We looked at the staff rotas which showed that there are usually five carers in the morning, four in the afternoon and evenings and three carers on waking night shift. This level of staffing was enhanced by catering, cleaning and laundry staff. The acting manager normally works office hours and is supported by an administrator. The staff we spoke to said they felt the staffing levels were sufficient to meet residents needs. The residents said that staff were always available and prompt if they needed to call them for asistance. We observed that staff continually smiled and engaged in conversation with the residents, whatever task they were performing. Staff informed us that there is a commmunication book and handover system for passing on important information about the residents. We looked at the recruitment records of four of the newest staff. These showed that they had an induction to the home when they first started and that proper recruitment procedures, including obtaining satisfactory CRB disclosures and references had been followed. Staff training records showed that staff had been appropriately trained in health & safety, moving & handling, care of residents with dementia, fire training, food hygiene Care Homes for Older People Page 20 of 27 Evidence: and adult protection. We were informed by the acting manager that four staff have NVQ Level 2 and five are currently doing Level 3. The staff told us they work well as a team and they enjoy high morale. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their representatives can be confident that the home is well managed and run in their best interests. There are satisfactory arrangements in place to ensure the safety and welfare of residents, staff and visitors. Evidence: The manager who was registered for this home left recently and at the time of this inspection a new person had been appointed and was in the post about four weeks. Although the AQAA that was sent to us had been completed by the previous manager, the new manager was aware of, and familiar with its contents. The acting manager had previous extensive experience in the care sector and had managed a domiciliary service. She informed us that she had completed her NVQ at level 4 and was currently doing a further management course. She also expressed interest in training on dementia mapping which would be a valuable addition to her skills in caring for this client group. The proprietor, who was present during the inspection, stated that it was the companys policy to appoint managers on three months probation, following which Care Homes for Older People Page 22 of 27 Evidence: they are expected to apply to the Commission for registration if found to be satisfactory. The residents and staff we interviewed all expressed confidence in the acting managers ability and told us that she sets high standards. We found that the atmosphere in the home was friendly and relaxed. The acting manager is well supported by an administrator, and together, they were very adept at providing all the documents, policies and procedures the inspector required to complete the inspection. The acting manager does not have a nominated deputy but the proprietor told us that she covers when the manager is on leave. All the residents and staff, a care manager and the district nurse, told us they were very satisfied with the way the home was managed and with the care provided. We were shown minutes of staff and residents meetings which confirmed that they have a say in how the home is run. Weekly health & safety checks of the home were documented. Safety inspections had been carried out on the portable appliances, gas installations, lift and hoists. A fire risk assessment of the home had been carried out and fire alarm tests were done weekly. Fire drills had been carried out and fire training had been documented. This ensures that all who live in, work in or visit the home are kept safe. The home has a current certificate of insurance. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The quantity of medication 31/08/2009 supplied by the pharmacy must be entered on the MAR sheets. To ensure there is proper auditing of medication 2 9 13 Staff who administer 31/08/2009 medication must ensure that they complete MAR sheets accurately. To protect the health and safety of residents. 3 26 16 Mop buckets must be safely stored in an appropriate place when not being used. To ensure good hygiene 18/08/2009 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 9 The home should make available for inspection, copies of Page 25 of 27 Care Homes for Older People Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations signatures of staff who are authorised to administer medicines. 2 3 11 15 The home should consider enrolling on the Gold Standard Framework programme to enhance end of life care. The home should provide condiments at mealtimes for residents who wish to enhance the flavour of their food. Care Homes for Older People Page 26 of 27 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. Care Homes for Older People Page 27 of 27 - 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!