Care Home: Alexander Court Nursing Home

Similar services:

• Snydale Care Home
• Abbey The
• Hawkhills
• Larchfield Manor
• Beeches The - North Yorkshire County Council
• Carentan House
• Ravensworth Lodge

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Alexander Court Nursing Home 2 Lydgate Court Crookes Sheffield South Yorkshire S10 5FJ     The quality rating for this care home is:   two star good 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: Sue Turner     Date: 0 6 0 4 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 28 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 28 Information about the care home Name of care home: Address: Alexander Court Nursing Home 2 Lydgate Court Crookes Sheffield South Yorkshire S10 5FJ 01142682937 01142682945 alexandercourt@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Southern Cross Healthcare Services Ltd Name of registered manager (if applicable) Ms Carole Ann Barker Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 60 The registered person may provide the following category of service only: Care home with nursing - Code N, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Alexander Court is a purpose built home for older people, which provide 60 places for people with personal and nursing care needs. All bedrooms have an en-suite facility. It is in a residential area of Sheffield with good access to public services and amenities for example shops, pubs, and public transport. Care Homes for Older People Page 4 of 28 care home 60 Over 65 60 0 Brief description of the care home It is built on three levels serviced by a lift. The home has single and double rooms and a suitable number of lounges and dining rooms. The home has a car park and lawned areas. A copy of the previous inspection report was on display and available for anyone visiting or using the home. Information about how to raise any issues of concern or make a complaint was on display in the entrance hall. The manager confirmed that the range of monthly fees from 1st April 2009 were 329 pounds to 640 pounds per week. Additional charges included newspapers, hairdressing and private chiropody. Care Homes for Older People Page 5 of 28 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: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This was an unannounced key inspection carried out by Sue Turner, regulation inspector. This site visit took place between the hours of 7.40 am and 3.00 pm. The manager is Carole Barker who was present during the site visit. The operations manager is Tracey Atkins, who was also present for part of the visit. The manager and was given verbal feedback during and at the end of the site visit. Care Homes for Older People Page 6 of 28 Prior to the visit the manager had submitted an Annual Quality Assurance Assessment (AQAA) which detailed what the home was doing well, what had improved since the last inspection and any plans for improving the service in the next twelve months. Information from the AQAA is included in the main body of the report. Questionnaires, regarding the quality of the care and support provided, were sent to people living in the home, their relatives and any professionals involved in peoples care. We received nine from people, five from staff and four from professionals. Comments and feedback from these have been included in this report. On the day of the site visit opportunity was taken to make a partial tour of the premises, inspect a sample of care records, check records relating to the running of the home and check the homes policies and procedures. Time was spent observing and interacting with staff and people. Eight people, three relatives and seven staff were spoken to. The inspector checked all key standards and the standards relating to the requirements outstanding from the homes last key inspection in April 2008. The progress made has been reported on under the relevant standard in this report. We wish to thank the people living in the home, staff, and professionals for their time, friendliness and co-operation throughout the inspection process. What the care home does well: What has improved since the last inspection? What they could do better: The service provided at Alexander Court is of a good standard and everyone involved with the home should be proud of this. To maintain and promote peoples health and welfare, each persons needs in respect of their personal wishes and preferences should be recorded in a care plan. So that staff are aware of peoples current care and support needs, care plans should be thoroughly reviewed and updated. So that independent eating is encouraged, people should be provided with suitable eating aids. So that written information can be clearly read and understood, staff should improve their writing skills. So that peoples health, safety and welfare is not put at risk, the faults identified on the warning notice issued by the gas safety company should be rectified. The fire risk assessment should be updated and reviewed to include any particular precautions that need to be in place for people that have dementia. We acknowledge that the provider and manager continue to evaluate and monitor the service and make any changes necessary to ensure that the home continues to provide the good service that is presently offered. Care Homes for Older People Page 8 of 28 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 28 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 28 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. The home provided sufficient information to inform people about their rights and choices. People were encouraged to visit the home, look around and meet other people staying there. Evidence: The home had a Statement of Purpose (SOP) and Service User Guide (SUG). These were available for people living in the home and anyone who may be considering living in the home. The SOP and SUG were informative and up to date. Before people stayed in the home they were assessed by a social worker. The manager also carried out a pre assessment by visiting people in their own home or hospital. This meant that everyone could be assured that the home could meet the persons needs. People were invited to visit the home, try out the meals and spend time meeting the staff and seeing the services available. Any information collated from the needs assessment would then form the basis for the care plan. Care Homes for Older People Page 11 of 28 Evidence: Nine people were asked Did you receive enough information about this home before you moved in so you could decide if it was the right place for you. All nine people said Yes. People commented, I came to look around with my family. Yes but information is not the same as being here. My family visited the home and were very impressed by the home and the staff. Care Homes for Older People Page 12 of 28 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. Further work was necessary to ensure that each person had a care plan that reflected their individual care and support needs and personal preferences. Medication procedures protected peoples health and welfare. The health and personal care needs of people were met in a way that maintained their privacy and dignity. Evidence: Each person that lived in the home had an individualised plan of care. These were checked for five people. Care plans contained information about peoples health and personal needs. Staff had attempted to write care plans in a person centred way. There was information about what the person themself felt their needs were and how they would prefer these needs to be met. When we checked this information against what people told us, it did not correspond. One example was a person that said they didnt like having a bath and never had. Their relative said that staff struggled to encourage them into the bath and the person only occasionally bathed. Their care plan said that they wanted the staff to help them get bathed each week, which was clearly not the persons personal wishes and preferences. The manager said that staff had Care Homes for Older People Page 13 of 28 Evidence: undertaken training in person centred care, however this was not reflected in the way care plans were completed. Care plans had been updated, however updates were brief and not always relavent. This made it difficult to establish peoples present care needs and requirements. Staff completed daily records at the end of each shift. Those seen related to the care plans. We spoke to some relatives that had been involved in care planning and others who had chosen not to be involved. Care plans seen contained details of all health care contacts, appointments and treatments, and the home supported access to these to ensure health was maintained. Access to dentists, chiropodists and opticians was available. Individual risk assessments were seen in peoples care plans. People seen looked well cared for, were dressed appropriately and had received a good standard of personal care and support. Nine people were asked Do you receive the care and medical support you need. Seven people said always and two said usually. People said, Staff are good and help me if I need it. I would rather be at home but this is OK. Staff are wonderful. Relatives said, Mum says everyone is so kind and theyre always there. Medical support has been given very promptly. Staff deal with problems as soon as they begin. Four health professionals were asked Are peoples health care needs met by the service. Two said always and two said usually. Nurses administered medications. Medicines were securely stored in locked trolleys. Staff signed the Medication Administration Records (MAR) sheets at the time of administration. Controlled Drugs (CD) were kept securely stored. Staff recorded CDs in a CD register. This was checked and found correct. During the site visit we observed that people were cared for in a friendly way. Staff were skillful in ensuring that people maintained their privacy and dignity when receiving personal care. Four health professionals were asked Does the service respect individuals privacy and dignity. Two said always and two said usually. Care Homes for Older People Page 14 of 28 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. Peoples recreational interests and needs were met. People were receiving a balanced diet in pleasant surroundings. Evidence: People said they were able to get up and go to bed when they chose, and were seen to walk freely around the home, if able. One relative spoken to said they were able to visit at any time and were made to feel very welcome. Staff took time to make sure friends and family were made to feel comfortable whilst visiting their loved one. Some people said they preferred to stay in their room at certain times of the day and that the staff respected their decision. There were two activities co ordinators working in total 30 hours per week between Monday and Friday. Activities available to people were advertised around the home, which included, board games, quizzes, arts and crafts and movement to music. People said that entertainers also visited the home each month. Two people said they enjoyed going out and had recently attended the local Palm Sunday celebration. One relative said their parent had recently been taken for a stroll in their wheelchair which they had enjoyed immensely. Nine people were asked Are there activities arranged by the home that you can take part in. Three people said always, four said usually and Care Homes for Older People Page 15 of 28 Evidence: two said sometimes. Relatives said, They try hard to include my husband although he is really unable to take part, but it gives him some stimulus. There arent enough activities for the more able, for example, potting plants and gardening and days out. Mum knows she can join in many activities but she prefers to spend her time more quietly. People spoke very fondly about both activity co ordinators. They said that their social life had improved greatly since they had started working in the home. We observed breakfast and lunch being served in the dining rooms. Choices were available and staff were aware of peoples meal preferences. At breakfast people had a choice of cereals, grapefruit or porridge followed by bread or toast with preserves. People said that cooked breakfasts were available if requested. At lunchtime the dining room tables were set nicely with tablecloths, cutlery and matching crockery. Condiments were on the tables and a choice of hot or cold drinks was available. The dining rooms were quite small and had a pleasant relaxed ambiance. Staff said there were a number of people that needed assistance to eat. We saw that staff sat with people and supported and encouraged them. One person was trying to eat independently. They were struggling to place the food on their fork. Staff helped by feeding them. We believe that the person would have managed to feed themself if they had been provided with a plate guard. The cook said that there were plate guards available. People said If I dont like it I tell them. Theres always a choice. The food isnt bad. The meals are very good. Relatives said, The meals always look and smell good. Mum has put on weight whilst shes been here and is looking better for it. Care Homes for Older People Page 16 of 28 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. Complaints were dealt with effectively. The policies and practices for referring adult safeguarding concerns was adequate. This assisted in keeping people safe. Evidence: People and their families had been provided with a copy of the homes complaints procedure, which was also on display in the entrance hall. This detailed who to speak to at the home or, if preferred, external to the home to make a complaint, should they wish to do so. The complaints procedure directed people to the manager to deal with any complaints. If the manager was unable to resolve complaints then people were directed to the provider of the service. The home kept a record of complaints, this detailed any action that had been taken and the outcome of the complaint. Since the last inspection the home had received six complaints. All six had been resolved and the service had taken any necessary action in order to prevent a reoccurrence. Nine people were asked Do you know how to make a complaint. Eight people said yes and one said no. People commented, I would go to the manager. I am not one to complain and fear that I may upset someone by doing so. Health professionals said, Any issues I raise are dealt with appropriately. In the incident with the person I visit, the staff have responded to concerns as best they can. Care Homes for Older People Page 17 of 28 Evidence: Since the last inspection there had been three referrals to the adult safe guarding team. All have been resolved. When adult safe guarding concerns were reported, the manager had taken appropriate action to ensure that people were kept safe. The manager said that staff had completed training in adult safe guarding and this training was updated on a regular basis. Staff spoken to were aware of their role and responsibilities in dealing with any alleged safeguarding incidents. The home had copies of, and were working with the revised South Yorkshire protocols for adult safeguarding. People spoken to said they felt safe living in the home. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was maintained to a good standard. In the main procedures for the control of infection were in place which promoted peoples health and welfare. Evidence: The AQAA stated, We provide a well maintained, safe and comfortable environment. The atmosphere is homely and both service users and relatives are encouraged to treat the home as their own. Service users are encouraged to personalise their rooms. The rooms are kept clean and warm and have en-suite facilities which are cleaned daily.There are areas in the home for service users to enjoy private visits with relatives and friends.A nurse call system is in operation throughout the home.We have an ongoing maintenance and refurbishment programme.Specialist equipment is provided throughout the home ie:- raised toilet seats, grab rails We saw that the home was clean and tidy. Lounge and dining areas were domestically furnished. Bedrooms were personalized. Whilst observing lunch we saw that some placemats were stained and marked and needed food debris cleaning from them. We also saw that peoples wheelchairs were unclean and unhygienic. Since the last inspection refurbishment of the home had continued. Some carpets and furniture had been replaced and some bedrooms had been redecorated. The home smelt fresh and clean. Controls of infection procedures were in place. Staff were observed using protective aprons and gloves. The homes laundry was sited away from Care Homes for Older People Page 19 of 28 Evidence: food preparation areas. Staff had undertaken training in infection control. Relatives said, I think the home is lovely and clean. Staff deal with any smells or accidents quickly as they occur. One person said, I would very much like a larger room. My room is very small and cramped. It cannot accommodate more than one visitor comfortably. Care Homes for Older People Page 20 of 28 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. Staffing numbers were appropriate to meet the assessed needs of people. Recruitment information obtained for staff was sufficient to adequately protect the welfare of people. Staff had completed training. Evidence: Staff interviewed said that they enjoyed working at the home and got a lot of job satisfaction. On the day of the site visit staffing numbers were adequate. The manager said that there were some staff vacancies and she was working hard to recruit people. Occupancy at the home was reduced which meant that staffing numbers had been adjusted accordingly. Nine people were asked, Are the staff available when you need them. Two people said always and seven said usually. Relatives said, Staff are always there and mum has a bell to use by her at all times. Generally Alexander Court is now well managed and the staff are friendly and professional, but usually work under pressure as they are understaffed.The residents are usually clean and well fed but care isnt just about that, it would be nice to sit and chat but they dont have enough time. Staff said, I never feel there are enough carers to take immediate care of people. Carers are always so busy and it distresses me to see some people having to wait for a carer to take them to the toilet. Care Homes for Older People Page 21 of 28 Evidence: There are enough staff unless someone phones in sick and then we try hard to cover the gap. The manager had undertaken a review of staff training and had identified the shortfalls. Mandatory training had been booked and further training in specialized topics for example dementia was being delivered. Four health professionals were asked Do the staff have the right skills and experience to support peoples social and health care needs. All four said usually. Five staff were asked Did your induction cover everything you needed to know to do the job when you started. Two said very well, two said mostly and one said partly. Staff were able to talk about the various training courses that they had attended which included, Moving and Handling, Food Hygiene, First Aid and Fire. We believe that staff would benefit from completing further training in person centred care planning. A high number of care staff had completed the NVQ Level 2 in care and others had commenced the training. The number of staff trained exceeded the required minimum of 50 per cent of the staff team trained to NVQ Level 2 in Care. Three records of employment were checked. These included the required references, certificates of training, health checks and evidence of Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) check. Two peoples application forms did not detail their previous employment. This meant that it was not possible to establish if there were gaps in their employment or if the references supplied were from the persons last employer. This was issued as a requirement at the last inspection and is carried through into this report , with a short timescale for action to be taken. Care Homes for Older People Page 22 of 28 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. The home had a management structure, that people and staff were aware of. In the main peoples health and safety was promoted. Evidence: The manager is a qualified nurse and had many years experience of caring for older people. She had completed the Registered Managers Award (RMA). She was committed to ensuring that people living in the home were consistently well cared for, safe and happy. Staff said that they found the manager easy to talk to and they could go to her at any time to discuss issues or concerns. They said they also met with the manager formally for one to one supervision. Staff said, I certainly feel I have the support of a very good manager. We have 2 monthly supervisions but with so many changes in managers our yearly appraisals have been affected. The home was visited on a regular basis by the operations manager. She was nominated to carry out Regulation 26 visits. Following her visits a report was Care Homes for Older People Page 23 of 28 Evidence: completed which highlighted any action that needed to be taken to improve the service. Staff said she was available for them to speak to should they wish to. Relatives said they were asked their opinions of the home and the service provided. They said they received questionnaires from the manager which they completed and returned. The manager said that a report that detailed the findings and told people what actions would be taken, following their comments was provided. We saw a copy of this in the entrance hall. Staff, resident and relatives meetings were arranged and minutes from these were seen. The home handles money on behalf of some people. This was checked for three people. Account sheets were kept, receipts were seen for all transactions and monies kept balanced with what was recorded on the account sheet. Whilst looking at peoples care plans, risk assessments and records, we saw that some information was very difficult to read. Staffs written skills were poor, which made information unreadable. We spoke to the manager about this as we believe staff would be put off reading information if it was poorly written. Fire records evidenced that fire alarm checks took place. However these were done by the handyman and when he was on holiday they were not carried out. We talked to the manager about nominating another person to carry out the fire system checks when the handyman was not working.Staff said that they had received fire training and fire drills. A fire risk assessment had been completed. As the home cared for people with dementia the risk assessment should have highlighted what particular precautions were in place to keep people with dementia safe. We asked to see the gas safety certificate. A warning notice had been served on the 9th March 09 requiring action to be taken, within 14 days about two faults. One fault had been rectified but the other was still outstanding. The manager said that she was in the process of acquiring a quote for this work be completed. This meant that there was no valid gas safety certificate. The manager confirmed that although there was no electrical certificate for periodic inspection, this had been completed. The operations manager arranged for this to be supplied within the next 48 hours. Care Homes for Older People Page 24 of 28 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 1719 There must be a thorough 07/04/2008 recruitment procedure, based on ensuring the protection of people. Therefore: References must be obtained from previous employers. Staff files must contain full and accurate dates of previous employment. Files must evidence that gaps in employment history have been explored. Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Each persons needs in respect of their personal wishes and preferences must be recorded in a care plan. To maintain and promote peoples health and welfare. 13/04/2009 2 7 15 Care plans must be thoroughly reviewed and updated. So that staff are aware of peoples current care and support needs. 13/04/2009 3 15 16 People must be provided with suitable aids and adaptations. So that independent eating is encouraged. 13/04/2009 4 37 17 All records must be clearly readable. So that they can be clearly read and understood. 13/04/2009 Care Homes for Older People Page 26 of 28 5 38 13 The faults identified on the 13/04/2009 warning notice issued by the gas safety company must be completed. To ensure peoples health, safety and welfare. 6 38 13 The fire risk assessment 04/05/2009 must highlight any particular precautions that need to be in place for people that have dementia. So that people are kept safe. 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 3 4 5 6 7 15 26 30 38 38 Care plans should be written in a person centred way. Independent eating should be supported and encouraged for as long as possible. Placemats on the dining room tables and peoples wheelchairs should be thoroughly cleaned. Staff would benefit from receiving further training in person centred care. There should be a person nominated to carry out the fire system checks when the handyman is not working. There should be a certificate on site that confirms that the Electrical Periodic Inspection has been completed. Care Homes for Older People Page 27 of 28 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 28 of 28 - 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!