Care Home: Ashcroft Rest Home

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What the care home does well Service users and relatives spoken to generally expressed satisfaction with the home. One service user commented "I like it here." while a relative said "The home is always bright, clean and smells fresh. Food was seen to be of a good standard, and mealtimes were relaxed and unhurried. Care plans and risk assessments were of a good standard, as were pre admission assessment. Effective health and safety controls are in place. Staff were seen to have built up good relations with individual service users. What has improved since the last inspection? There have been improvements to the home since the previous inspection, and the overall number of requirements made has fallen from ten at the last inspection, to three at this inspection. Staff have now undertaken training in adult protection, and the home has suitable policies and procedures in place around this. Improvements have been made to the physical environment, and a new fridge has been purchased. Service users now have access to health care appointments as appropriate. What the care home could do better: There are still some areas that need to be addressed, and a total of three requirements, along with two good practice recommendations have been made as a result of this inspection. The home must ensure that staff undertake all required mandatory training as appropriate, including in first aid and infection control. The home must ensure that medications are administered and recorded appropriately, and that systems are in place around recording service users finances. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ashcroft Rest Home 27-29 Chadwick Road Leytonstone London E11 1NE     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: Robert Cole     Date: 2 0 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 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Ashcroft Rest Home 27-29 Chadwick Road Leytonstone London E11 1NE 02085306072 02085306072 ashcroftres@btconnect.com 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) : Mrs Neva Bernice Gilpin,Ms Hyacinth Valeska Sandilands care home 15 Number of places (if applicable): Under 65 Over 65 0 15 dementia old age, not falling within any other category Additional conditions: 5 0 The Registered Person may provide the following categories 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 (maximum number of places: 15) Dementia - Code DE (maximum number of places: 5) The maximum number of service users who can be accommodated is: 15. Date of last inspection Brief description of the care home Ashcroft Rest Home is a care home providing personal care, support and accommodation to up to 15 older people. The home, which is privately owned and operated, is located in a residential area of Leytonstone in East London. There is easy access to local shops, transport links, and other amenities. The property is two storey with bedrooms situated on both the ground and first floor. There are two double rooms with the remainder for single occupancy. There is a stair lift available on one set of Care Homes for Older People Page 4 of 29 Brief description of the care home stairs with a separate staircase for those who are more mobile. There is a rear garden available and accessible to residents with support of staff. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 inspection took place on the 20/05/09 and was unannounced. The inspection was carried out by two inspectors. The inspection included discussions with service users, staff and the homes manager was present for part of the inspection. The inspection included an examination of records and other documents, along with a tour of the premises. Prior to the site visit, the home completed an Annual Quality Assurance Assessment (AQAA) at the request of the CSCI. Surveys were sent out to service users to gain their feedback on the running of the home, three of these were returned. All of this has contributed to the overall inspection process, and to judgements made within this report. Care Homes for Older People Page 6 of 29 Care Homes for Older People Page 7 of 29 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 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the inspectors judgement that prospective service users are provided with sufficient information about the home to enable them to make an informed choice as to move in or not. This information is provided through written documentation, and the opportunity of visiting the home. Evidence: The home has a Statement of Purpose and Service User Guide in place. Both documents are dated and written in plain English. The Statement sets out the philosophy of care in the home, and states that All service users have the right to maintain maximum independence . . . all service users have the right to their dignity . . . all service users will be shown respect from all those that are involved in their care. The Statement also includes details of the facilities and services provided, and of the organisational structure of the home. Care Homes for Older People Page 10 of 29 Evidence: The service user guide states that CSCI investigate complaints and can be consulted if the process at the home fails to give satisfaction. This is incorrect. The CSCI has now become the Care Quality Commission and this body does not undertake to routinely investigate complaints. However it can be consulted at any time in a complaints process. The service user guide should be amended to reflect this. The home has an admissions procedure in place, this states that service users will be given the chance to visit the home before making any decision as to move in or not. After an initial referral has been made, the homes manager will visit the prospective service user in their own home to carry out an assessment. this will be complemented by an assessment provided by the placing authority. The inspector checked an assessment carried out for a recent admission to the home, and found this to be of a good standard. The assessment was clear and comprehensive, clearly setting out the needs of the service users, for example around mobility, personal care and medication. The inspector was able to speak to a relative of this person, who confirmed that they were indeed able to visit the home prior to moving in. After an initial six week period, a placement review meeting is held. For one service user such a meeting was taking place on the day of inspection, and the inspector sat in for part of this meeting. In addition to the service user, the homes manager and deputy manager also attended, along with the service users social worker and relative. All service users are provided with a written contract/;statement of terms and conditions. Contracts have been signed by the homes manager and the service user (or their representative where appropriate). Contracts include details of fees payable, what these fees cover and what is extra, along with terms and conditions of residency within the home. The home does not provide intermediate care. Care Homes for Older People Page 11 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the inspectors judgement that the home is generally meeting the health and personal care needs of service users, although some improvements need to be made with regard to the management of medications. Evidence: Individual care plans are in place for all service users. These are of a good standard, clear and comprehensive, setting out how the home is able to meet the needs of service users. Plans provide detailed information about what support is required, for instance X is usually able to feed herself, but when her hands are causing pain she will need some support. Care plans cover needs around medication, mobility and diet preferences, and are subject to regular review. Care plans indicated that service users privacy and dignity is maintained, for instance around personal care plans made clear that service users should be encouraged to manage this themselves as much as possible. For example one plan stated X needs support to get dressed, but is able to choose their own clothes to wear. Care Homes for Older People Page 12 of 29 Evidence: Risk assessments are in place for all service users, and as with care plans, these too are of a satisfactory standard. Assessments identify risks, and include strategies to manage and reduce those risks. Assessments seen included falls, mobility and infection control. We inspected the arrangements for the safekeeping and administration of medication. The home has a medication trolley, in the office, which they have secured to the wall with a chain. They also have a locked cupboard, which is bolted to the wall, where they keep stocks of medication. We discovered however, that night time medication was being stored in the kitchen in a cupboard where it shared space with foodstuffs. When we noticed the cupboard it was unlocked, although it does have a padlock. We were told by a staff member that she had unlocked the cupboard to get out some biscuits. The cupboard is above where the kettle boils. The temperature in the kitchen is very variable and it is not a suitable place to store medication. The manager stated that the storage arrangement is to allow night staff to have access to the medication without needing to get into the office, which is locked at night.We advised the manager that the storage of medications in the kitchen was not acceptable. The manager moved the medication into the trolley during the course of the inspection and undertook to advise the night staff that from that night onwards, there would be no storage of medication in the kitchen. Staff will have access to the key to the office. We were told that medication coming into the home is recorded on the Medication Administration Record (MAR) chart. We balanced various medications for the service users we were case-tracking. Most of these balanced accurately with stocks held. However one service user had been prescribed one or two tablets per administration. It was therefore impossible to audit or balance this medication. We asked the manager to ensure that a way is devised (different colour pens perhaps) to indicate whether one tablet or two has been given at an administration. Another medication, which was for the respite resident, could not be made to balance. The manager stated that this was because only part of the medication coming into the home had been recorded on the MAR chart. She said that this was because she put the rest of the medication away in the aforementioned cupboard thinking it would not be needed. We explained to the manager that recording medication coming into the home means all medication, wherever it is stored. She said she now understood this. There was evidence to suggest that the home is meeting the health care needs of service users. Records of medical appointments are maintained, and these indicated that service users have access to health care professionals as appropriate, including dentists, chiropodists and opticians. Care Homes for Older People Page 13 of 29 Evidence: It was noted that several yellow sacks full of used continence products were left in the homes driveway. The manager said they were left there every Wednesday morning for collection. To help maintain the dignity of service users, and to help prevent the risk of infection, it is recommended that used continence products are left in a bin until they are collected. Care Homes for Older People Page 14 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the inspectors judgement that service users are supported to live valued lives. Activities are provided, and food was of a good standard. Evidence: Visitors are welcome to the home at any reasonable time, and service users can see visitors in private if they so wish. On the day of inspection the inspector spoke with a relative of one of the service users, who expressed satisfaction with the home, and said that she was always made welcome. Service users are given their own mail to open, and where appropriate staff will support service users with reading mail. Service users have access to a telephone. The home makes various arrangements to meet the social and leisure needs of service users. Some attend day services, and on the day of inspection one service user went out for lunch with their brother. Mobility London visit the home, where they provide various activities, including gentle exercises. Professional entertainers are occasionally booked, usually singing acts. The home arranges occasional day trips, for instance to see the Christmas Lights in Londons Westend. Service users are able to visit local Care Homes for Older People Page 15 of 29 Evidence: shops and other amenities such as hairdressers. In house the home provides various activities, including quizzes and BBQs. Service users have access to television, music, newspapers and magazines. In order to help meet needs around equality and diversity issues, the home provides talking books. Representatives of the Baptist Church and the Seventh Day Adventist Church visit the home, to help meet service users spiritual needs. We were in the home when lunch and tea were served. Mid morning a cup of tea was served and after lunch in the afternoon more tea and biscuits. Lunch looked and smelled appetizing. It was served in a pleasant way, on a clean tablecloth with places laid. There were condiments on table, although on examination of one salt and pepper, they were rather sticky. The residents appeared to really enjoy their first course. The pace was leisurely and the atmosphere was quiet and peaceful. Residents ate slowly in an unhurried way and a number cleaned their plates. Pudding served after lunch was appreciated in a similar way. Staff were supportive in an unobtrusive and tactful way. People were in no rush to leave the table and our impression was that they had enjoyed the whole experience. Before we left the home, around 5pm soup was served, again at the table with some nice bread. Residents were eating it with enthusiasm, and it looked good. We viewed menu plans and records of food temperature probes, we checked the contents of the refrigerator and freezer. A new fridge has been purchased since the previous inspection. We formed the view that meals are a strength of this home and that a varied and nutritious diet is provided. Care Homes for Older People Page 16 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the judgement of the inspector that the home has taken reasonable steps to help protect service users from the risk of abuse. Appropriate polices and procedures are in place, and staff undertake training around adult protection issues. Evidence: The home has a complaints procedure in place, this was on display in the home. All service users are given their own copy of this procedure included in the Service Users Guide. Surveys completed for the CQC by service users indicated that they knew whom they could complain to if they so wished. The home also has a complaints log, although the manager informed the inspector that no complaints have been received in the past year. The home has a copy of the local authorities adult protection procedure, and also its own policy on safeguarding adults. This was checked by the inspector, and seen to be in line with current legislation. Since the previous inspection, the inspector was pleased to note that most staff working in the home have now undertaken training in adult protection issues, the manager informed the inspector that the others are all scheduled to undertake such training in the near future. Staff spoken to demonstrated a good understanding of their roles and responsibilities with regard to adult protection issues. Care Homes for Older People Page 17 of 29 Evidence: There was evidence that the home seeks to promote the legal rights of service users. For example, service users are on the electoral register, and are able to vote in elections. Service users are registered with appropriate health professionals. Care Homes for Older People Page 18 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the judgement of the inspector that the home is suitable to meet its stated purpose with regard to its physical environment. The home was generally well maintained, and service users have access to adequate private and communal space. Evidence: We undertook a tour of the environment of the home and garden, including a vacant bedroom. The maintenance and decor of the home is good, and corridors and hallways are kept clear of obstacles. There are sufficient toilets and bathrooms to meet the needs of residents. They were clean and free of odours. They had impermeable floors and adaptations to support mobility. Bedrooms are personalised and comfortable. There is an armchair placed by a telephone, on the ground floor, which is for the use of the residents. The lounge on the ground floor, where the residents sit for most of the day is pleasant, but unfortunately has almost no natural light, as there is a conservatory built behind it. The dining area is pleasant with two large tables for residents to sit at to have their meals. There is a side door to the garden. The other other way to access it is through the conservatory and there is a side gate to the house. The kitchen is adequate but the office space is rather cramped. Care Homes for Older People Page 19 of 29 Evidence: There is a garden to the rear of the property. There are three trees in the garden. The maintenance man told us that he thought one of them had become unstable as it leans and creeks in the wind. We strongly advised the manager to have a proper safety assessment made of this tree by a specialist. We also advised that the house would get more light if she reduced the height of all three trees. The home has taken steps to help prevent the spread of infection. Protective clothing is provided to staff, hand washing facilities are situated around the home, and the laundry facilities are of a scale appropriate to the size of the home. Care Homes for Older People Page 20 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the inspectors judgement that the home is staffed in sufficient numbers to meet the needs of service users, and that staff generally have a good understanding of their roles and responsibilities. However, it is required that staff undertake all necessary statutory training, including on infection control and first aid. Evidence: We inspected the records of three staff members including the new deputy manager the home has recruited. We also observed the staff at work. We felt that they interacted very positively with residents. The deputy manager demonstrated good personal skills. We noted that recruitment practice is generally safe and robust with an application form, identity check, health questionnaire and Criminal Records Bureau disclosure (CRB) and equal opportunities monitoring form. We noted that one staff member had one professional reference and one from a friend. We advised the manager that generally references should be from employers. We also suggested that the reference request states the dates when the applicant has claimed to work for the employer, so that these can be confirmed. We inspected the records for staff training. These depend on certificates in the files of Care Homes for Older People Page 21 of 29 Evidence: staff and there is a training matrix which records who has done what training. We were concerned that the person who is responsible for First Aid has in fact not been trained yet. We were also concerned that there are shifts which have no trained first aider. The home should ensure that there is a trained first aider on every shift. We noted also that one of the staff who administers medication has not had his training updated since 2004. The homes own policy is that training in core areas, like manual handling, health and safety and infection control is updated every year. However training in these areas, has not been renewed within two years and most of the staff had some deficiencies in core areas. The manager must bring the training up to date. There was a staffing rota on display, this accurately reflected the actual staffing situation on the day of inspection. The rota made clear who was in charge of the home at any given time. The home provides 24-hour support, including waking night staff and an emergency on-call procedure. The AQAA supplied by the home indicated that over 50 of care staff working at the home have achieved an NVQ Level 2 in Care or equivalent qualification. Care Homes for Older People Page 22 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the judgement of the inspector that the home has appropriate systems in place around managing quality assurance and health and safety, although tighter controls must be implemented around managing service users monies. Evidence: We inspected supervision records and noted that one worker who started in January has only had one supervision and this was an observation of her carrying out a task, rather than a one to one formal supervision session. Another worker had been supervised twice since starting work in January. We would remind the manager that staff must receive formal supervision six times per year. The home keeps comprehensive records of safety checks and maintenance by themselves and outside contractors. The stairlift had been serviced in January 2009. The Fire Brigade had checked the fire extinguishers in February 2009. The fire alarm had been inspected by an outside contractor in February 2008 and is due for Care Homes for Older People Page 23 of 29 Evidence: rechecking. The home makes weekly checks. Fire evacuation drills had been held by the home in March 2008 and February 2009. The manager was reminded that these drills should take place every three months. The nurse call system had been checked in 2008 and the emergency lighting in March 2009. The electrical installation for the home had been checked in May 2009 and the gas in May 2008. An environmental health inspection had been undertaken in March 2009 with no recommendations. Portable appliances had been tested in March 2009. The fire evacuation route at the home is through a porch door and the front door. The porch door is unlocked but the front door is controlled by a key pad. The practice so far has not been for Visitors to the home to be given the code. This means that they are dependent on staff to get the door open for them, whilst staff are also trying to evacuate residents. We suggested to the manager that she give all visitors the code to pass through the front door as soon as they arrive in the building. An alternative would be a fire alarm which releases the lock on the front door as soon as it is activated. The doors in the home have fire closers on them. As mentioned, the home must ensure that staff undertake all appropriate health and safety training. The homes manager has many years experience of working in care, and has managed the home for the past twenty years. They are a registered nurse, and have completed the Registered Managers Award. They are supported in the running of the home by a deputy manager. The home has a system of questionnaires it issues to service users and relatives to gain their feedback on the running of the home. Completed questionnaires seen by the inspector contained generally positive feedback. Care plan reviews also contribute to the quality assurance process within the home. The home manages the personal finances for only one service user. Relatives manage the finances for all the others. The manager explained to the inspector what the process was for managing the one service users finances. The manager themselves takes money from one of the service users bank accounts into which their benefits are paid. The manager will buy any shopping needed for the service user, and take their contribution towards their fees from this money. Any money left over is then put into a second (savings) bank account that the service user has. However, upto date records of all these financial transactions have not been made. For example, the last recorded withdrawal from the first account dates from the 31/10/08. The manager informed the inspector that they have since then made further withdrawals, and spent money on behalf of this service user, but none of this has been recorded anywhere, and no receipts were available to view on any purchases bought on behalf of the service user. Care Homes for Older People Page 24 of 29 Evidence: In order to help ensure that service users monies are always spent by the home as appropriate, clear and comprehensive records must be maintained of all financial transactions involving service users monies. Care Homes for Older People Page 25 of 29 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 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The registered person must ensure that all medications in the home are stored, administered and recorded as appropriate. To help ensure service users are administered medications as appropriate. 30/06/2009 2 35 13 The registered person must ensure that systems are in place for recording all financial transactions involving service users money. To help ensure that any money spent by the home on behalf of service users is spent appropriately. 30/06/2009 3 38 18 The registered person must ensure that staff undertake all required mandatory training as required, including in first aid and infection control. 31/10/2009 Care Homes for Older People Page 27 of 29 To help ensure staff are able to meet the needs of service users. 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 8 It is recommended that all used continence products are stored in a secure bin until they are collected by the local authority, to help prevent the spread of infection, and to maintain the dignity of service users. It is recommended that the registered person takes steps to ensure that the trees in the rear garden do not pose any threat or risk to the home or its service users and staff. 2 19 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!