Care Home: Alton House

What the care home does well The service has a good activities programme, to ensure they can meet all the needs of residents. There is a good selection of meals provided at the home and residents made very positive comments about the menu at the home. Pre-admission assessments are completed before prospective residents move into the home, ensuring that the service will meet their needs and to ensure that they receive a personalised service. Trial visits are offered to all prospective residents, to ensure residents have information on the services and facilities provided at the home. Care planning is very comprehensive and person centered with particular attention given to meeting residents personal preferences and respecting their individuality. All residents could also be assured that at the time of their death, staff would treat them and their family with care, sensitivity and respect. The home has a clear complaints procedure, which includes timescales within which a complaint is to be investigated. The management of the home operate a open door culture welcoming complaints and feedback. What has improved since the last inspection? Eleven requirements were made at this last inspection in relation to the home`s statement of purpose; care plans, making proper provision for the health and welfare of residents; medication practices; a review of the social activities at the home; safeguarding residents; environment; quality assurance; health and safety checks within the home and providing specialist equipment to meet the needs of people who use the service. At this inspection all these requirements have been complied with. What the care home could do better: We have made four requirements at this inspection in relation to ensuring that the home maintains a safe, hazard free environment; to complete follow up checks on residents when they are involved in accidents or incidents at the home, to ensure their are no further health associated risks; to provide a Controlled Drugs cupboard which the meets the Care Home Regulations 2001 and to ensure all Regulation 26 visit reports completed by the registered providers are available at the home at all times for inspection purposes and to evidence that they are taking place. Failure to act on requirements that relate to the care provided for the people living in the home impacts on the welfare and safety of service users and may lead to the Commission taking enforcement action against the registered person. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Alton House 22 Sunrise Avenue Hornchurch Essex RM12 4YS     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: Harbinder Ghir     Date: 2 6 0 5 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: Alton House 22 Sunrise Avenue Hornchurch Essex RM12 4YS 01708451547 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : altonhouse@btconnect.com Mrs Patricia Lilian Barrs,Mr Frank Barrs care home 19 Number of places (if applicable): Under 65 Over 65 19 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who can be accommodated is: 19 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Alton House is a privately owned care home registered to provide care and support to 19 older people. The home is situated in a quiet residential area of Hornchurch with access to local shops and transport links. The home is traditionally styled and in keeping with other properties in the area. It offers a warm, welcoming environment. The property has two separate lounges and 19 single bedrooms, 17 of which have en-suite facilities. As informed by the current registered manager of the home, the ranges of fees charged by the service are from £416 to £460 per week. Care Homes for Older People Page 4 of 28 Brief description of the care home 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: This was an unannounced inspection undertaken by Regulation Inspector Harbinder Ghir. The inspection took place over one day on Tuesday 26th May 2009. The registered manager was available throughout the day of the inspection and feedback was provided to her at the end of the inspection. During the inspection the inspector was able to talk to the residents residing at the home and staff on duty. Their comments have been included in the report . As part of the inspection the inspector toured the home, read records of people who use the service and examined documents in relation to the management of the home. The inspector would like to thank everyone involved in the inspection process. Care Homes for Older People Page 6 of 28 Care Homes for Older People Page 7 of 28 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 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 8 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 9 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. At this inspection we looked at standards 1, 3, 4, 5 and 6. The statement of purpose and service user guide provide comprehensive information on the service, enabling residents to decide whether they would like to move into the home. The service completes comprehensive pre-admission assessments, to ensure they can meet the needs of residents. Trial visits are offered to all prospective residents, to ensure residents have information on the services and facilities provided at the home. The service does not provide intermediate care. Care Homes for Older People Page 10 of 28 Evidence: All residents have a copy of the statement of purpose which is available in their bedrooms. The document is supported by a service user guide and both documents are easy to read and understand. Both documents on request are available in different languages, braille and in audio. Three pre-admission assessments were closely examined. Records showed that comprehensive pre-admission assessments are completed before a prospective resident is admitted to the home. Assessments comprehensively covered the personal, health care and social care needs of residents. Residents mental health needs were identified in detail and care plans were devised accordingly. For Local Authority funded residents, the service had obtained care management assessments from the placing authority and the above pre-admission processes were also followed for any residents admitted for a respite stay at the home. Pre-admission assessment information correlated with the information provided by the local authority. Individuals are supported and encouraged to be involved in the assessment process and information is gathered from a range of sources including other professionals, family and friends. All prospective residents and their relatives and family are given the opportunity to visit the home prior to being admitted. Two newly admitted residents were spoken to as part of the inspection who commented very positively about the care provided at the home. We have no complaints, we like it here. We like the bedroom and the carers are very nice. The know our likes and dislikes and if we need help, its always there said one resident. Another resident spoken to informed I have settled in well and I like it here. We are well satisfied. The bedroom is alright and the girls on at night are very nice. Care Homes for Older People Page 11 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. 7, 8, 9, 10, 11 Residents health and personal care needs are set out in individual care plans. Care plans are detailed, to ensure the needs of residents can be met effectively. There are clear medication policies and procedures. However, the service needs to review its medication practices to ensure the safety of residents. All residents can be assured that, at the time of their death, staff would treat them and their family with care, sensitivity and respect. Evidence: Three care plans were closely examined and case tracked. Care plans were comprehensive, and clearly set out residents health, personal and social care needs. Information covered the comfort and safety of residents, their communication needs, Care Homes for Older People Page 12 of 28 Evidence: their nutritional needs, personal care, mobility and their hobbies and leisure. One care plan identified a residents like of knitting. The resident was spoken to who informed that she has continued knitting since being admitted to the home. Care plans effectively detailed the level of care each resident required and adopted a person approach, focusing on promoting residents independence instead of creating a dependency on care staff. Information in care plans was consistent and reflected the actual needs of residents. Each residents care plan also included information on their daily routines and their likes and dislikes of food. It was evident when speaking to residents at the home that these preferences were noted. One resident informed I like it here and lunch was lovely. I thoroughly enjoyed it. The afters was very nice, they know I dont like rice, so they gave me ice-cream. Its marvellous how they know these things, but they do know. They also know that I dont like tea so they always make me coffee. The documentation/ health records relating to pressure care areas; management of diabetes, falls were examined. The records for these were found to be detailed and were adequately maintained. There was evidence that care plans were being reviewed at least monthly. Risk assessments are routinely undertaken for all residents around nutrition, manual handling, continence, falls and pressure care areas and are reviewed on a regular basis. Monthly weight checks were undertaken for all residents and appropriate action being taken where necessary. Records indicated other health professionals such as the district nurses, optical, dental and chiropody services saw residents. The district nurse who was visiting the home during the inspection was spoken to who said The home is on the ball and they always tell us or ring us if they have any concerns. They are very good here and we are in quite regularly. We have no concerns or issues. They also contact the doctor regularly. The accident and incident book was reviewed. Accidents were recorded in full, however residents did not always receive follow up checks to ensure there were no further health-associated risks. Although some residents did receive these checks the practice was not consistent. This was discussed with the registered manager who acknowledged this. A requirement will be made in relation these findings. Care plans were closely examined, which contained information on the end of life wishes of residents and the contact details of relatives and representatives where appropriate. There were clear and easy to follow policies and procedures for the handling and recording of medicines. There were comprehensive policies and protocols to follow if an Care Homes for Older People Page 13 of 28 Evidence: medication error occurred, information on handling toxic drugs to ensure the safety of staff. An audit was undertaken of the management of medicine within the home and a random sample of Medication Administration Records (MAR) charts were examined. The medication files included the signatures of staff with permission to administer medication. Each residents care plan included information on allergies each resident may have. However, the following issues were highlighted and discussed with the manager of the home. -There were hand written entries on the Mar chart, which were not signed or dated to indicate when the entry was made. Staff must clearly sign and date in the medication details box when making a handwritten entry, to ensure accountability of those making the entries. -The home currently has Controlled Drugs at the premises which are stored in a large home made cupboard in the wall which has a small metal cupboard within it which is bolted to the shelf. It is within this cupboard that they store the Controlled Drugs. Controlled drugs were not stored in a Controlled Drugs Cupboard which must be bolted to the wall. The controlled drugs cupboard must comply with the The Misuse of Drugs Act, 1973 and meet the Care Homes Regulation 2001. A requirement will be made in relation to these findings. 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. At this inspection we looked at standards 12, 13, 14, 15. There is a varied programme of activities available and residents are given the opportunity to take part in a variety of activities, which meet their recreational needs. There is a wide choice of meals in the home, to ensure they meet the needs and choices of all residents. Visiting times are flexible and people are made to feel welcome in the home, so that residents are able to maintain contact with their family and friends as they wish. Evidence: There is a four weekly menu, which is explained to residents verbally by the cook or the care staff to enable them make their meal choice. The menu included a variety of fresh fruits and vegetables and a choice of two meals at lunchtime and snacks throughout the day. On speaking to the cook, she was able to demonstrate her knowledge of those residents requiring special diets, for example diabetic and pureed diets. She also explained that they were in the process of changing the menu due to Care Homes for Older People Page 15 of 28 Evidence: the hotter season, as residents were preferring colder dishes and the menu would again be changed in the winter. Residents spoken to spoke very positively of the meals provided at the home. The inspector joined residents for lunch and the menu for the day was chicken Chaucer or turkey and dessert was rice pudding or ice cream. Lunch was observed being served which looked and smelt appetising. There were condiments placed on each table and attention was given to dressing the tables with table clothes and table decorations. Residents were offered a choice of drinks. Very positive comments were received about the lunch being served, which included Its nice, The meat is very soft, its very tasty, Very nice. Further comments included I have no complaints and I like it here. What we dont like, we dont eat but the meals here are ok. There is plenty of food choice here. We have what we want. I am well satisfied. I have got nothing to moan about. Staff take the lead on organising in house activities for residents and these take place during the mornings at the preference of residents. During the inspection a member of staff was seen sitting with residents and doing a quiz with them. All residents were offered a choice on whether they would like to participate or not and some residents chose not to. Residents were seen to be enjoying the quiz and actively participated. A record was kept for each resident to evidence their involvement in activities and also recorded whether they enjoyed the activities. On speaking to some residents they commented on how they would like to go out more if transport was provided. A resident informed They do invite us to join in with whatever is going on. But if I had the choice I would like to go out more, provided there was transport. Another resident when asked whether they would like to go out, informed I would love to go out, if they provided transport. Me and my husband are very outdoor people, we always have been. This was discussed with the registered manager of the home who informed that they have in the past arranged trips out, but residents at the last minute have refused to go. However, the home has had a couple of new residents admitted who expressed their like for going out. It is recommended that the home reviews it out door community participation with residents to ensure all residents are given a choice of going out into the community. 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. At this inspection we looked at standards 16 and 18 People who use the service can be assured their views are listened to and acted on. The service records all complaints and concerns to ensure any dissatisfactions with the service regardless of source are actioned. All staff have received up to date training in Safeguarding Adults, which ensures the protection of residents. Evidence: People who use the service are supplied with a complaints procedure, which is clear, concise and easy to follow and was displayed around the home. The procedure is also included in the homes statement of purpose and service user guide which is given to all residents upon admission. A copy of the statement of purpose is also stored in each residents bedroom which was observed during the inspection. A complaints logbook is kept by the home, which was viewed. The home records all concerns and niggles that residents may have and also records how the management resolved them. Since that last inspection no formal complaints have been received by the home and the Care Quality Commission have also not received any complaints about the home. It was evident from speaking to residents, that they were very satisfied with the care received at the home and made very positive comments about Care Homes for Older People Page 17 of 28 Evidence: the care staff and general care at the home. On speaking to residents they informed that they were aware of how to make a complaint and felt comfortable in talking to the staff and the manager of the home. All staff had attended Safeguarding Adults training which is also covered in the induction programme. The service has Safeguarding Adults procedures and protocols in place and include guidance on how to report incidents of abuse. The service has obtained Safeguarding Adult procedures devised by The London Borough of Havering, which is the host authority for the service. Since the last inspection the home has employed a deputy manager to support the registered manager who have both undertaken recent training in safeguarding adults. Since the requirements made at the last inspection the service has also promptly notified the Care Quality Commission by a Regulation 37 notification of any incidents that have taken place at the home, complying with the Care Homes Regulations 2001. 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. At this inspection we looked at standards 19, 20, 21. 22, 23, 24, 25 and 26. Residents live in a comfortable environment. However, further environmental health and safety checks and a re-decoration programme would improve the internal environment of the home. Evidence: At the last inspection a re-decoration programme had been implemented. New wooden radiator covers had been provided throughout the home. During the inspection it was observed that dining room chairs had been replaced and some chairs had arms on them to provide support to less able residents. The internal decor of the home would greatly benefit from new carpets and new paint throughout the home, as the home looks tired. A residents en-suite bathroom had also not been finished as one wall required painting. A number of toiletries belonging to a resident who had recently passed away were found in the 1st floor communal bathroom. One residents bedroom also has loose wiring which presented a serious trip hazard. It is a requirement that the registered persons ensures that all parts of the home are maintained and are made safe and residents toiletries are not kept in communal areas to reduce the risk of communal use and cross infection. Care Homes for Older People Page 19 of 28 Evidence: The service is registered to accommodate nineteen residents. All bedrooms were viewed and residents had also personalised their rooms with pictures, photographs, personal furnishings and belongings. All rooms were lockable and can be overridden by staff in an emergency. The home has also recently admitted a married couple and has given them a double bedroom and has also turned a spare bedroom into a private lounge for them, to enable them to have some time together in private. The kitchen was clean and was equipped with suitable cooking appliances and kitchen equipment. There was a wide range of vegetables and meats. Food was correctly labelled with the date of opening, and fridge and freezer temperatures had been taken consistently. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. At this inspection we looked at standards 27, 28, 29, 30 Recruitment practices are robust and ensure residents are in safe hands at all times. Comprehensive staff training is provided to all care staff, to ensure they are equipped with the skills and are competent to do their jobs. The service has a good skill mix of staff, ensuring adequate numbers of staff are on duty to meet the needs of residents. Evidence: Two staff files were closely examined which were of newly recruited members of staff. Staff files were all in good order. References and Criminals Records Bureau checks had been obtained for both members of staff. The service has made a commitment to staff training that is focused on delivering improved outcomes for people who use the service. Staff spoken to during the inspection spoke very positively about the support and the amount of training they have received. Care Homes for Older People Page 21 of 28 Evidence: The staff rota included all the members of staff on duty and was an accurate reflection of the members of staff on duty, ensuring the protection of residents. There are always two members of staff on duty during the day and two waking staff on duty at night. Residents spoke very positively about the staff team. The staff are wonderful here, they are really good. They get anything for you. They do their best said one resident. Another resident informed The staff are not bad at all, they are very good. The staff do my nails and I am well satisfied. We have got nothing to moan about. The carers are very nice and they have got all our likes and dislikes. Family can come and visit us anytime. If we need help it us always there. 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. At this inspection we looked at standards 31, 33, 35, 36, 38. Residents benefit from an experienced manager who recognises their needs and adequately manages the home. The systems for service user consultation ensure the home is run in the best interests of residents. Residents financial interests are safeguarded. Staff are supervised at least six times year to ensure they are equipped with the skills and knowledge to meet the needs of people who use the service. The welfare of staff and residents is promoted by the homes policies and procedures. Care Homes for Older People Page 23 of 28 Evidence: The registered manager has the necessary experience and skills to run the home. It was evident from speaking to residents and staff that they feel supported and well looked after. The evidence from this inspection also reflects that the service has improved its service delivery and has complied with all the requirements made at the last inspection. Quality assurance surveys are in the process of being given out and are completed annually. Surveys for relatives, care managers and other professionals were seen which are in the process of being given out to complete. Surveys included open-ended questions on all aspects of the care provided at the home. The latest supervision records were viewed for all staff. A supervision programme is in place and staff files evidenced that staff members are supervised formally on a regular basis (at least six times a year). This ensures that staff are provided with the skills, training and knowledge to perform the tasks required by their employment role. Staff spoken to also informed Management provide a good quality service here. We are supervised regularly and we get loads of training. We have had training in palliative care which we are doing at the moment and have done training in medication and dementia. The home works to clear health and safety policy. Health and Safety records were inspected. All documentation was in order and appropriately completed. Certificates viewed included certificates verifying up to date portable appliance testing, electrical installation, gas safety, employers liability insurance and records of fire drills and fire alarm testing. Water temperatures are taken throughout the outlets in the home on a regular basis. Regulation 26 reports could not be inspected at this inspection as they were not available at the home. We were informed that the registered provider had taken them home with her and was currently on leave. Therefore a requirement will made at this inspection to ensure Regulation 26 visit reports are available at all times for inspection purposes and to evidence that they are being completed on a monthly basis. Care Homes for Older People Page 24 of 28 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 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 8 12 The registered persons must 31/07/2009 ensure that residents receive follow up checks to ensure there are no further health-associated risks. . 2 9 13 The Registered Persons 31/08/2009 must ensure that staff must clearly sign and date in the medication details box when making a handwritten entry, to ensure accountability of those making the entries and provide a Controlled Drugs Cupboard that complies with the The Misuse of Drugs Act, 1973 and meet the Care Homes Regulation 2001. . 3 19 12 The Registered Persons 30/07/2009 must ensure that all parts of the home are maintained and are made safe and residents toiletries are not Page 26 of 28 Care Homes for Older People kept in communal areas to reduce the risk of communal use and cross infection. . 4 31 26 The Registered Persons 30/07/2009 must ensure that Regulation 26 visit reports are available at all times for inspection purposes and to evidence that they are being completed on a monthly basis. . 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 13 It is recommended that the home reviews it out door community participation with residents to ensure all residents are given a choice of going out into the community. 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. 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