Care Home: Alston House

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What the care home does well Information about the service is readily available. A website has recently been created, enabling interested parties to see what services can be offered via the internet, a new brochure has been developed offering more information to the reader and the service user guide has been updated. This document provides further information regarding facilities available. People currently living in the home are treated with respect and care and support is provided in a relaxed and friendly manner. Recruitment practices ensure that the necessary checks are carried out before a new member of staff commences work in the home. This protects the people living in the home from possible harm. Relevant training has been sourced to ensure that staff are appropriately trained and knowledgeable in the care and support they are to provide. What has improved since the last inspection? A number of improvements have been made since the last key inspection in May this year. Information about the service has improved, this now includes an internet website, brochure, statement of purpose and service user guide. The care plan and risk assessment documentation has been improved, these now include more information, with the risk assessments providing more detail as to what actions to take when a risk has been identified. A personal planning book has been introduced and care workers are currently completing these with those living in the home and with their relatives. These books provide information on individual personal preferences and will assist in the implementation of person centred care. Medication management has improved since our last visit. We were told that particular members of staff are now in charge of certain areas within the medication administration to reduce the chances of errors being made. Regular checks are also carried out to audit the management of medication. The files held for each staff member have been improved making it easier for the reader to access relevant documentation. The downstairs shower room and toilet have both been re tiled and redecorated making them much more user friendly. A number of rooms have been provided with newbedroom furniture, including wardrobes, chest of drawers and bedside cabinets. The fire and heating systems have been updated and new office equipment has been purchased, including new computer, printer and mobile phone. An extra member of staff has been provided between the hours of 4.00pm and 8.00pm to support the activities leader and the care workers. Staff supervision is now provided on a regular basis and team meetings are also being held to enable the acting manager to gather staff views of the service being provided. The acting manager and the provider have also recently held a meeting for people living in the home and their relatives to enable them to share their thoughts on Alston House and the service it provides. A number of training courses have been provided since our last visit and further courses are being arranged for the next twelve months. The management has shown a commitment to ensuring that all staff are appropriately trained and have the knowledge necessary to carry out their roles effectively. What the care home could do better: Although improvements were found within the care plan and risk assessment documentation, a small number of inconsistencies were noted and these need to be addressed. The acting manager needs to make sure that instructions to staff remain the same through out the documentation, for example, if the care plan states test blood sugars twice a day, the risk assessment should say the same. More information still needs to be included in the care plans so that the reader knows exactly what they need to be doing to meet that persons individual care and support needs. A small number of medication blister packs, which hold the tablets to be administered, had been started in the middle of the month, this caused some confusion to the care workers administering the medication. If all the blister packs were organised so that they all started at the beginning of the month the risk of errors being made would be greatly reduced. Some of the woodwork around the home was badly scratched due to being knocked by wheelchairs etc. Attention to these areas would provide people with a much more homely and well maintained place to live. We looked at the rota and found that between 7.00am and 9.00am only two care workers were rotared on shift. We were told that there were other staff around to assistfrom 7.30am onwards should it be required. The management team need to constantly reassess current staffing levels to ensure that there are enough staff on at all times to meet the needs of the people in their care. Quality assurance surveys are not currently used to gather peoples views of the service provided. If these were reintroduced the management team would gain a clearer picture as to what the service does well and what, if anything, it doesn`t do so well and requires addressing. Key inspection report Care homes for older people Name: Address: Alston House 380 Aylestone Road Leicester Leicestershire LE2 8BL 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: Diane Butler Date: 0 3 1 1 2 0 0 9 This report is a review of the 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 stars – excellent • 2 stars – good • 1 star – adequate • 0 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. things that people have said are important to them: 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 They reflect the Care Homes for Older People Page 2 of 30 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. Care Homes for Older People Page 3 of 30 Internet address www.cqc.org.uk Care Homes for Older People Page 4 of 30 Information about the care home Name of care home: Address: Alston House 380 Aylestone Road Leicester Leicestershire LE2 8BL Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration Category(ies): Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: 0 0 0 Over 65 19 19 19 Mrs Margaret Madden Vacant Care home 19 01162915601 01162915611 Date of last inspection: Brief description of the care home: 2 2 0 6 2 0 0 9 Alston House is a care home for older persons, providing accommodation and personal care for up to nineteen residents some of whom have mental health needs, dementia and/or a sensory impairment. It is situated on the Aylestone Road in Leicester, approximately 15 minutes away from the city centre. There are shops within five minutes walking distance from the home and there is a small park nearby. Care Homes for Older People Page 5 of 30 Accommodation is on two floors with the upper floor accessed by lift or stairs. There are three lounges, two dining room areas and a conservatory on the ground floor. It offers both single and shared bedrooms some of which come with ensuite facilities. A large parking area is to the front of the home and there is a wellmaintained secure garden to the rear. Current charges range from £350.00 per week to £400.00 per week. Additional charges are in place for hairdressing, chiropody treatment and transport to appointments. Details of all charges can be found in the Service User Guide, (a document which provides relevant information about the home) which is given to everyone living in or interested in living in the home. A copy of the latest Inspection report is available at the home, or it can be accessed via the CQC website: www.cqc.org.uk. Further information is available from the acting manager. Care Homes for Older People Page 6 of 30 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 How we did our inspection: The quality rating for this service is 2 star. This means the people who use the service experience good outcomes. This key inspection took place over one day in November 2009. We (the Care Quality Commission or CQC) arrived at the home on Tuesday 3rd November at 9.05am and completed the visit at 3.45pm. The inspection was unannounced and this means the service was not aware that we were coming. When undertaking key inspections CQC focuses on the outcomes for people receiving a service. Care Homes for Older People Page 7 of 30 In order to do this we case tracked three people receiving care and support. This means we checked records, spoke with them where possible and spoke to the care workers providing the care and support. Where communication was difficult observation was used to evidence whether care needs were being met. Planning for the site visit included checking the service history of the home and last inspection report and looking through the AQAA document (Annual Quality Assurance Assessment), which was submitted to the CQC prior to the visit. The AQAA document is the main way that providers inform us of how well their service is delivering outcomes for the people using it. We checked all the standards that the CQC has decided are key standards during this inspection. The information below is based only on what we checked in this inspection. We have kept details about individual people out of the report to make sure we respected their confidences. Care Homes for Older People Page 8 of 30 What the care home does well: What has improved since the last inspection? A number of improvements have been made since the last key inspection in May this year. Information about the service has improved, this now includes an internet website, brochure, statement of purpose and service user guide. The care plan and risk assessment documentation has been improved, these now include more information, with the risk assessments providing more detail as to what actions to take when a risk has been identified. A personal planning book has been introduced and care workers are currently completing these with those living in the home and with their relatives. These books provide information on individual personal preferences and will assist in the implementation of person centred care. Medication management has improved since our last visit. We were told that particular members of staff are now in charge of certain areas within the medication administration to reduce the chances of errors being made. Regular checks are also carried out to audit the management of medication. The files held for each staff member have been improved making it easier for the reader to access relevant documentation. The downstairs shower room and toilet have both been re tiled and redecorated making them much more user friendly. A number of rooms have been provided with new Care Homes for Older People Page 9 of 30 bedroom furniture, including wardrobes, chest of drawers and bedside cabinets. The fire and heating systems have been updated and new office equipment has been purchased, including new computer, printer and mobile phone. An extra member of staff has been provided between the hours of 4.00pm and 8.00pm to support the activities leader and the care workers. Staff supervision is now provided on a regular basis and team meetings are also being held to enable the acting manager to gather staff views of the service being provided. The acting manager and the provider have also recently held a meeting for people living in the home and their relatives to enable them to share their thoughts on Alston House and the service it provides. A number of training courses have been provided since our last visit and further courses are being arranged for the next twelve months. The management has shown a commitment to ensuring that all staff are appropriately trained and have the knowledge necessary to carry out their roles effectively. What they could do better: Although improvements were found within the care plan and risk assessment documentation, a small number of inconsistencies were noted and these need to be addressed. The acting manager needs to make sure that instructions to staff remain the same through out the documentation, for example, if the care plan states test blood sugars twice a day, the risk assessment should say the same. More information still needs to be included in the care plans so that the reader knows exactly what they need to be doing to meet that persons individual care and support needs. A small number of medication blister packs, which hold the tablets to be administered, had been started in the middle of the month, this caused some confusion to the care workers administering the medication. If all the blister packs were organised so that they all started at the beginning of the month the risk of errors being made would be greatly reduced. Some of the woodwork around the home was badly scratched due to being knocked by wheelchairs etc. Attention to these areas would provide people with a much more homely and well maintained place to live. We looked at the rota and found that between 7.00am and 9.00am only two care workers were rotared on shift. We were told that there were other staff around to assist Care Homes for Older People Page 10 of 30 from 7.30am onwards should it be required. The management team need to constantly reassess current staffing levels to ensure that there are enough staff on at all times to meet the needs of the people in their care. Quality assurance surveys are not currently used to gather peoples views of the service provided. If these were reintroduced the management team would gain a clearer picture as to what the service does well and what, if anything, it doesnt do so well and requires addressing. 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 11 of 30 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 12 of 30 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 the 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’ needs are assessed to ensure that they can be met and information is provided to enable them to make an informed choice as to whether it is the right place for them to live. Evidence: Information is available to anyone interested in moving into Alston House. A brochure and website have been developed and a service user guide, which informs the reader about the services that can be provided, is given to everyone on admission to the home. The service user guide also includes information regarding staff training, the provider’s aims and objectives and details of how to make a complaint should someone be unhappy about something. We were told that anyone interested in moving into the home would have an assessment of need carried out. This involves the acting manager visiting them in their own home, or in hospital if applicable, to ensure that their care and support needs can be met. We looked at the records for the most recent person to move into the home and found that an assessment of need had been completed by their social worker and an Care Homes for Older People Page 13 of 30 assessment of need had been completed by the acting manager. They told us that their family had been able to look around the home before they moved in to make sure that it was a suitable place for them. They told us, My daughter and sons came looking; they said come and have a look at the room. For a second person who was in the home for respite care we found that an assessment of need had been carried out by the acting manager, though this was very basic in content. The acting manager explained that this was because staff had previous knowledge of their care and support needs due to them visiting the home for meals and day care on a fairly regular basis. Intermediate care is not currently provided at Alston House. Care Homes for Older People Page 14 of 30 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. This is what people staying in this care home experience: Judgement: People using the 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’ care and support needs are currently being met. Further work to improve the care plan documentation would ensure that individual preferences are identified and ultimately provided. Evidence: We looked at some care plans and some risk assessments to see if they contained all the information care workers needed to meet the needs of those they were caring for. We could see that improvements had been made to these documents since our last visit in May this year and on the whole, the documents checked included the relevant information to enable the carers to provide the appropriate care and support. There were a small number of inconsistencies within the care plans and risk assessments we looked at and after discussing these with the acting manager we were told that these would be rectified straight the way. For one person the care plan stated that staff must check their blood sugar levels twice a day, the medication records showed that these were being checked three times a day. We were told that this was due to the person not sleeping terribly well and having a tendency to eat things like chocolate at night. On checking their sleeping care plan it stated that they slept well. The catheter care for one person was not included in the risk assessment documentation however a care worker spoken with was aware of the things to look out for and routines to follow. Care Homes for Older People Page 15 of 30 For one person their care plan stated that they had a graded pressure sore, and the risk assessment stated the need for a pressure cushion. This was discussed with the acting manager who explained that the person had not got a cushion due to their constant moving around the home and further notes held showed that the sore had nearly healed, the acting manager explained that it wasnt always possible to gain feed back from the nurse attending the person, but would do so straight the way so that she was fully aware of the current situation. Some of the care plans we saw could have benefited by having more specific details about the individuals personal preferences, however personal planning books have been developed since our last visit and once these are completed, will provide further information to ensure that care workers are aware of each person’s preferences in daily living. Staff who deal with peoples medication have been given training and when we checked the records that need to be kept, we found them to be up to date and accurate. Opened eye drops and sealed insulin are appropriately stored in a separate medication fridge and records for controlled medication were appropriate and accurate. We checked the blister packs which hold each persons medication and saw that not all were consistent with some being started in the middle of the month. We recommended that the acting manager contact the local pharmacy to try to remedy this to provide less opportunity for mistakes to be made when dispensing the medication. People told us that they were being well cared for and the care workers treated them well. They told us: I was against coming when I first came, but all the people are nice, Ive got my own room, I get my meals and they [the staff] talk and laugh and joke. A relative visiting whilst we were there told us: The staff are very nice, they know his needs and have addressed issues when his health has changed. They dont force him to do something if he doesnt want to do it. Care Homes for Older People Page 16 of 30 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. This is what people staying in this care home experience: Judgement: People using the service good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People enjoy a varied diet, which meets their current needs. Evidence: We were told that choices were offered on a daily basis. Whether it be what time to get up or go to bed, what to eat for lunch and where and whether to join in activities provided or whether to go out alone. One care worker explained, People can get up when they want, we start helping people up at about 7:00am, if they don’t want to get up we leave them until they are ready. One person living at the home explained, You can go out when you want, I just tell them where Im going and its fine. An activities leader is employed for two hours, two days a week. A structured activities programme is in place and when the activities leader is not working the care staff provide the activities. On the day of our visit people participated in music and movement and a manicure and hand care service was provided. A choice of menu is offered at each mealtime and special diets such as diabetic and soft diets are catered for. Care Homes for Older People Page 17 of 30 We were told that the food served in the home was good and the meal seen during our visit was hot, nutritious looking and well presented. One person told us, The foods nice, you get it on a smallish plate, but it’s filled. Hot and cold drinks and snacks are provided throughout the day. Visitors are encouraged to visit and are welcome at any time, one relative told us, They are all very nice, they make you a cup of tea and make you feel welcome. Care Homes for Older People Page 18 of 30 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. This is what people staying in this care home experience: Judgement: People using the 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 feel safe and staffs understanding of safeguarding procedures protected them from harm. Evidence: We were told that people are informed of how to make a complaint, or share a concern, when they move into Alston House and a copy of the complaints procedure is included in the service user guide, which is given to everyone on admission. A copy is also displayed in the reception area. People knew who to go to if they werent happy about something and they told us they felt safe. They told us: Id speak to one of the staff. I am satisfied and I know hes safe I feel safe here, at home I was on edge, but I like it here. The acting manager told us that she had not received any complaints since she took up post in July this year. All care workers have received information on the safeguarding of adults and a workbook is provided to each one of them to work through to ensure that they have the knowledge to identify any act of abuse or neglect. Care Homes for Older People Page 19 of 30 A number of places have been booked for care workers to attend safeguarding training in the new year and further training in this area is currently being sourced. A care worker spoken with showed us that she was aware of actions to take if she thought an incident of abuse had taken place and the acting manager is aware of her responsibilities within the safeguarding of adults. It was recommended that the acting manager looked into accessing safeguarding alerter and referrer training. We were told that they were due to meet the training coordinator for Leicester City Social Services to discuss what further training was available. Care Homes for Older People Page 20 of 30 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. This is what people staying in this care home experience: Judgement: People using the 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 are provided with a comfortable place to live, which would be further enhanced should the scratched wood work be attended to. Evidence: Accommodation at Alston House is provided on two floors with access to the first floor via stairs or lift. Communal areas include a large open plan lounge and dining area at the front of the home with a further smaller lounge available and a third lounge area and conservatory to the rear of the home. Decoration and furnishings within the communal areas were good, though a hole was noted in the dining room wall. We were told that this was to do with the pipe work behind the wall and this was being dealt with. The downstairs shower room has been refurbished with new tiling on the walls and floor and the downstairs toilet has also been refurbished. We were invited to look at one persons room, they informed us that they were able to choose their room and were able to bring in their own belongings, they told us: You can bring in your own things, I was able to bring my own stuff, my china cabinet is coming soon. We found that some door frames were badly scratched due to the use of wheelchairs. Attention to these would greatly enhance the presentation of the accommodation provided. Care Homes for Older People Page 21 of 30 A secure garden is available to the rear of the home for people to use. Care Homes for Older People Page 22 of 30 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. This is what people staying in this care home experience: Judgement: People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are appropriately trained and competent to do their jobs. Evidence: People told us that there were currently enough staff on to meet their needs, they told us: There’s always some one available, I have a bell, I pull it and they come straight up. We looked at the staff rota which showed that on the whole there were only 2 care workers on duty between 7.00 am and when the acting manager comes on duty at 9.00am. This means that when those who need assistance from two care workers are being helped, no one is available should anyone else need assistance. We discussed this with the acting manager who told us that the cook arrived at the home at 7.30am and was available to assist in the dining room/lounge should it be needed and that she arrived at the home at 8.00am and was also available. An extra member of staff has recently been employed between the hours of 4.00pm and 8.00pm to assist the afternoon staff. We looked at the files of the two most recent members of staff to be employed to make sure that the necessary checks had been carried out. Both included a POVA (Protection of Vulnerable Adults) check. These are completed to make sure that the person is suitable to work with older people. References had also obtained. Care Homes for Older People Page 23 of 30 One of the new care workers explained to us that they had received both an in house induction and a formal induction which she is currently working through with the assistance of the acting manager. A number of training courses have been provided since our last key inspection in May this year. These include, Fire awareness, food hygiene, moving and handling, first aid, deprivation of liberty, Medication training, mental capacity act, dementia awareness and effective communication training. We were told that further training including safeguarding, medication and catheter care were being sourced. Care Homes for Older People Page 24 of 30 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. This is what people staying in this care home experience: Judgement: People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are appropriately supervised. Evidence: The current acting manager has been in post since July 2009. She has a number of years experience working as a senior care worker and has completed her NVQ (National Vocational Qualification) level 3. She is due to commence her Registered Managers Award qualification and has completed a number of training courses to assist her to carry out the role of acting manager effectively. This includes, Safeguarding training, Deprivation of Liberty training and mental capacity act training. The acting manager has recommenced staff meetings and staff supervisions and a meeting was recently held for both those living at the home and their relatives to enable them to have their say about the service currently being provided. One care worker explained, I recently had supervision and everything I said is now up and running. We were told that money is no longer kept on behalf of those living at the home, but instead purchases are made on their behalf and then an invoice is produced at the end of each month. This safeguards them from any possible financial irregularities. Fire safety training and health and safety training is provided to all care workers on Care Homes for Older People Page 25 of 30 commencement of their employment to ensure the safety of those they support. Records seen during our visit were on the whole up to date and the acting manager assured us that any inconsistencies within the daily recording would be addressed immediately. Care Homes for Older People Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes No X 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 27 of 30 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 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 3 Ensure that assessments carried out on prospective users of the service are as comprehensive as possible. The service must assure it self that it has all the relevant information before making a decision as to whether it can meet their needs. Ensure that care plans include all the relevant information regarding the care and support being provided and are consistent with other documents held. Ensure that the information included in the risk assessment documentation is consistent with other documents held and include all risks associated with the care and support being provided. Consult with the local pharmacy with regards to the current system for medication blister packs to provide more consistency and reduce the possibility of mistakes when administering medication. Ensure that all the areas of the home are well maintained and appropriately decorated. Ensure that at all times sufficient numbers of staff are on duty to meet the needs of those they are supporting. Recommence the use of surveys as part of the quality monitoring system that is in place in order to get the views Page 28 of 30 2 7 3 8 4 9 5 6 7 19 27 33 Care Homes for Older People of those living at the home, their relatives and other stakeholders in the community. Care Homes for Older People Page 29 of 30 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. 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