Care Home: Astune Rise

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What the care home does well Astune Rise is well managed and run in the best interests of people who use the service. People who use the service are happy with the care that they receive. Comments made by people who use the service and relatives included, "The home is great, the staff are helpful and friendly and do anything that is asked of them" "I am well looked after the manager is lovely and the care staff are smashing" "We have piece of mind because of Astune Rise" "This is a lovely home with a friendly atmosphere" People can lead their own lifestyle and choose to the things they want to do. People said that the food is very good and can make lots of menu choices. Staff are experienced, well trained and knowledgeable about the people they are caring for. Visitors are made to feel welcome at any time. What has improved since the last inspection? There has been a number of improvements since last inspection of the service. Externally some new windows have been fitted and the front garden landscaped. Communal lounge areas have been redecorated as has the downstairs corridors. Five bedrooms have been redecorated and fitted with new carpet. The home now have a plan of refurbishment that is to take place over the next twelve months. Last inspection highlighted the need for care plans to include more information. The sample of care plans seen at this inspection were very detailed and provided clear guidance to staff about how to help to meet each person`s needs. Improvement was noted in medication systems. Staff now keep a record of unused medication carried over from one month to another and Medication Administration Records have been updated to include a picture of the person to aid identification and prevent errors. The homes complaint and adult protection procedures have been updated and the home have developed a formal quality assurance system. Surveys are now sent out to people who use the service and relatives on a yearly basis to seek their view on the home, service provided, care and staff. The home have developed their induction for new staff to meet with the required standard. Staff have received training in emergency aid. What the care home could do better: The manager should ensure that care plans are updated/evaluated on a monthly basis or more often if needed to advise of changes to care, deteriorations and improvements made to help to ensure the care needs of the person are met. Risk assessments for people who use bed rails should be updated to include all safety checks recommended by the Department of Health to help to prevent injury or harm. The registered manager should complete a management qualification. The manager should do a report, which details the summary of findings of surveys that were sent out to people that use the service and relatives. A certificate should be available within the home to confirm that fire alarms have been serviced to ensure safety. Key inspection report Care homes for older people Name: Address: Astune Rise 114 High Street Eston Middlesbrough TS6 9EJ     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: Katherine Acheson     Date: 0 1 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Astune Rise 114 High Street Eston Middlesbrough TS6 9EJ 01912428600 01912428602 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Popular Care Ltd care home 38 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 38 The registered person may provide the following category of service only: Care Home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following category: Old Age, not falling within any other category, Code OP - maximum number of places 38 Date of last inspection Brief description of the care home Astune Rise is registered to provide personal and nursing care to thirty eight older people. The home is situated on Eston High Street and as such is close to shops, pubs and churches. The home is a two storey building. A passenger lift gives access to the first floor. There are thirty two single rooms and three double rooms. Not all bedrooms meet space requirements of National Minimum Standards. Eighteen bedrooms have ensuite facilities which comprises of a toilet and sink. There are three communal lounge areas and a separate dining room. Care Homes for Older People Page 4 of 27 Over 65 38 0 3 0 0 9 2 0 0 8 Brief description of the care home There is an enclosed garden and patio area for people who use the service and car parking facilities for visitors. The cost of care at the time of the inspection visit ranged from £417.75 to £529.05 a week. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The Quality rating for this service is two star. This means that people who use the service experience good quality outcomes. We have reviewed our practice when making requirements to improve national consistency. Some regulations from previous inspections reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the service are not being put at risk or harm. In future if a requirement is repeated it is likely that enforcement action will be taken. The manager completed and returned an Annual Quality Assurance Assessment, (AQAA). The AQAA is the services self assessment on how they think that they are meeting National Minimum Standards. This information was received before the inspection and was used as part of the inspection process. Care Homes for Older People Page 6 of 27 Before this inspection visit we looked at all of the information that we have received since the last inspection of the service on 30th September 2008. This unannounced key inspection took place on 1st October 2009. The inspection started at 9:30am and finished at 4:05pm The reason for the inspection was to see how good a job the home does in meeting the National Minimum Standards set by the Government for care homes. Numerous records were examined including care records of people living at the home, medication records, risk assessments, complaints and staff records. We looked around parts of the home to make sure that it was clean, safe and comfortable. Requirements and recommendations highlighted at the last inspection were revisited to see if improvements had been made. During the visit we talked with people who use the service, their relatives, the manager and staff. Before the inspection surveys for people that use the service and staff were sent to the home for the manager to distribute accordingly. Surveys sent to people that use the service were asked to comment on care received. Surveys sent to staff were asked to comment on what it was like working at the home and training. We received five surveys from people that use the service and three surveys from staff. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: The manager should ensure that care plans are updated/evaluated on a monthly basis or more often if needed to advise of changes to care, deteriorations and improvements Care Homes for Older People Page 8 of 27 made to help to ensure the care needs of the person are met. Risk assessments for people who use bed rails should be updated to include all safety checks recommended by the Department of Health to help to prevent injury or harm. The registered manager should complete a management qualification. The manager should do a report, which details the summary of findings of surveys that were sent out to people that use the service and relatives. A certificate should be available within the home to confirm that fire alarms have been serviced to ensure safety. 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 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Assessments of people who are to use the service are carried out before they move into the home to ensure all needs can be met. Evidence: The manager said that people who are to use the service are assessed before coming into the home. They firstly receive an assessment from a Social Worker and/or health care professional. This assessment is sent to the home for the manager to look at. Once this assessment has been reviewed the manager then visits the person at home or in hospital to carry out a further assessment. The manager uses these assessments to decide whether the home can meet their needs. If a person is funding their own care an assessment is usually only undertaken by the manager or senior staff working at Astune Rise. People are encouraged to visit the home before they move in. On the day of the Care Homes for Older People Page 11 of 27 Evidence: inspection a person who was looking for a home for their relative came to look round. People who are to use this service are offered a trial period of up to six weeks. At the end of the trial period a review takes place to make sure that the placement is both successful for the person using the service and the home. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service receive good support and are happy with the care that they receive. Care plans are not evaluated as often as they should be and bed rail risk assessments need to include more detail to help to ensure the safety of the person. Evidence: The files of three people that use the service were looked at during the visit. Files looked at contained contained evidence of assessment before they moved into the home, a further detailed assessment of needs, a plan of care and risk assessments. Care plans are records used by care services to show what sort of help each person needs and how staff will provide that care. The sample of care plans seen were very detailed and provided clear guidance to staff about how to help to meet each persons needs. The care plans were written in a sensitive and respectful way that promotes the individuality and preference of each person. One plan of care detailed how a person liked to get up about 7:00am and go to bed between 10:00pm and 11:00pm. The plan detailed how they liked to spend their day. Care Homes for Older People Page 13 of 27 Evidence: Last inspection of the home identified that a risk assessment agreed by a multidisciplinary team needed to be in place for those people who use bed rails. One file looked at during the visit was that of a person who required bed rails to ensure their safety. A risk assessment was in place for this person that detailed the GP, manager of the home and family had been involved in deciding that bed rails were needed. The risk assessment detailed safety checks that needed to be carried out to maintain safety of the person whilst using bed rails but not all as detailed in the Department of Health guidance on safe use of bed rails. The manager at the time of the inspection had a copy of the guidance and said that she would take immediate action to update the risk assessments. Some of the care plans looked at during the visit had not been updated or evaluated on a monthly basis. The manager acknowledged this and said that this was due to a shortage of nurses. The manager demonstrated a commitment into looking/auditing all plans of care to bring them up to date. There is clear evidence of the involvement of GPs, District Nurses and other healthcare professionals such as chiropodists. People living at the home confirmed that if they were feeling unwell, the GP would be called. During the inspection visit the manager and staff were observed to interact well with people that use the service and visitors. Staff approached people in a supportive and respectful way. People spoken to during the visit and surveys received in general were complimentary about life in the home and care received. Comments made included, This is a lovely home and all staff do their best The home is very good. The staff are marvellous. Staff cant do enough for you When people were asked what does the home do well? comments included, Always attentive, like the open house approach. Always informative. Appear to give my mum lots of attention, always have time to talk to her and treat her with dignity and compassion. The home has a lovely atmosphere, staff are relaxed and happy. This creates a homely and friendly ambiance The manager said that it is the responsibility of nurses working at the home to give out medication. She said that those people who are able are encouraged and Care Homes for Older People Page 14 of 27 Evidence: supported to manage their own medication. At the time of the visit there was nobody expressing a wish to manage their own medication. Medication systems were looked at during the visit and found to be good. The manager said that a community pharmacist has been appointed by the Primary Care Trust. She said that the community pharmacist visits the home to review the prescribed medication of people that use the service and then discusses any possible changes with the persons GP. People who are over 75 receive an annual health check a nurse who covers six GP practices visits. Last inspection of the service highlighted that medication being carried over from one month to the next should be documented on Medication Administration Records (MAR). Examination of MAR currently in use identified that staff were documenting the amount of medication being carried over from one month to the next. MAR had been updated to include a photograph of the person to enable identification make sure that the right person gets the right medication. The Manager said that nurses working at the home have received recent medication training to update their knowledge and skills. Care Homes for Older People Page 15 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that use the service lead fulfilling lifestyles through exercising choice and control over how they spend their day. Food provided is enjoyed by people that use the service. Evidence: At the time of the inspection visit the home were advertising to recruit an activity coordinator to work sixteen hours a week. Up until an activity co-ordinator is appointed care staff working at the home are responsible for planning activities. Time permitting the home tries to plan activities four times a week. Once a month a Motivation Company visit the home to provide quizzes and reminiscence sessions. The cost of the visit from the Motivation Company is shared between those taking part. Other activities include bingo, cards, dominoes and watching old films. On occasions people go out to the local shops with staff and entertainers come to the home to sing to people. In July some people attended a Party in the park event at the local pub. The manager said that she is in the process of planning a Christmas shopping trip. One person spoken to during the inspection said, My pal comes everyday to take me out for a pint. Care Homes for Older People Page 16 of 27 Evidence: The manager said that representatives visit from the local Church of England and Roman Catholic churches on a weekly basis. She said that once a month there is a service and hymns. Relatives said that they are made to feel welcome at any time, and there was a steady stream of visitors during this inspection. Visitors described the home as Lovely , Welcoming and homely. One person spoken to during the visit said, I get a great big welcome and there is always a cup of tea. They make me a sandwich when I am hungry, The lunchtime of people that use the service was observed. The lunch time menu of the day was was gammon or sausages with mash potato, broccoli, mixed vegetables and gravy. The meal time of people that use the service was relaxed with people enjoying the food that was provided. Tables were appropriately set and people were offered a cold drink and a cup of tea with their meal. The homes last visit from Environmental Health in accordance with the Tees Valley Food Hygiene Award Scheme, awarded them with four stars (out of five) for good standards of hygiene. People spoken to during the inspection and surveys received spoke highly of the food provided comments made included, The food is lovely an there is always plenty of it and, I had sausages for my lunch today they were really tasty. Care Homes for Older People Page 17 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are confident that their complaints would be listened to, taken seriously and acted upon. Staff working at the home receive adult protection training which will help to ensure the safety of people living at the home. Evidence: The home has a complaints procedure, which informs people of how and who to make a complaint to, including timescales for action. There have been three complaints in the last twelve months. People spoken to during the inspection said that the manager and staff were approachable and that they felt that they could raise any concern that they may have. The homes complaint procedure is also displayed on the back of bedroom doors. The home has an adult protection procedure, which advises staff of action to follow if abuse is suspected. The manager said that all staff working at the home have regular adult protection training. People living at the home said that they felt safe. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of the environment is good providing people that live there with an attractive, homely and comfortable place to live. Evidence: Astune Rise is registered to provide both personal and nursing care. The home is situated on Eston High Street and as such is close to shops, churches and pubs. The home is a two storey building. There are thirty two single bedrooms and three double bedrooms, however at the time of the inspection all bedrooms were being used for single occupancy. Eighteen of the bedrooms have ensuite facilities, which comprise of a hand wash basin and toilet. There is a passenger lift to the first floor of the home. There is a pleasant garden/patio area for people to use, this is well established with trees, plants and shrubs. During the inspection the Inspector walked around the home with the manager. Externally many improvements have been made to the home. A number of windows have been replaced, the front garden has been landscaped and new fencing has been put up. Internally lounge areas have been redecorated as has the ground floor corridor. The manager said that in a few weeks time new carpet is to be fitted to the ground floor lounges and corridor areas. Five bedrooms have been redecorated and Care Homes for Older People Page 19 of 27 Evidence: had new carpets. Appropriate laundry facilities were in place. The standard of cleanliness around all of the home was very good. It is clear that housekeeping staff work extremely hard to keep the home clean, tidy and odour free. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides suitable, competent, well trained staff to ensure that people who use the service are protected and their needs are met. Evidence: At the time of the inspection there were twenty four people using the service, ten people receiving nursing care and fourteen people receiving personal care. Duty rotas looked at during the visit informed that there were four care staff on duty during the morning and afternoon and three care staff on duty on an evening and night. In addition to Care staff on duty there is a nurse on duty day and night. The manager of the home works full time over five days. The manager said that four out of five of the days should be supernumerary, however due to a shortage in nurses she has not been getting as much supernumerary time as she should be. Fourteen out of nineteen care staff at the home have achieved a minimum qualification of NVQ level 2 in Care or equivalent. Five staff have just enrolled to do an NVQ level 3. Records were examined to confirm that the home follows good recruitment procedures. Three files of newly recruited staff were looked at during the visit. Files looked at contained evidence that references and Criminal Record Bureau Checks that had been obtained prior to commencement of employment. Care Homes for Older People Page 21 of 27 Evidence: The manager said that since last inspection the homes induction for new starters has been developed to meet with standards as set by Skills for Care. Records were available within files examined to confirm that staff have commenced induction, however not completed. The manager said that inductions have been taking a little longer than twelve weeks because of a shortage in nursing staff. Staff receive regular training certificates were on file to confirm that staff had received training in emergency aid, moving and handling, fire, health and safety, stoma care and dementia awareness. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and run in the interest of people that use the service. The health safety and welfare of people that use the service is promoted. Evidence: The manager is a Registered General Nurse who has many years of experience of working in a nursing and residential care environment. At the time of the last inspection the manager was working towards achieving an NVQ level 4 in Management, however due to personal and work commitments was unable to complete. The manager is to recommence the training in November 2009. People spoken to during the inspection spoke highly of the manager, one person said, The boss is great you can talk to her about anything another said, The manager and staff are lovely nothing is too much trouble. The manager said that since last inspection the home have developed a quality assurance monitoring system. She said that surveys were sent out to people that use the service and relatives in April 2009 to seek their views on the service provided by Care Homes for Older People Page 23 of 27 Evidence: the home, care and staff. Records were available to confirm that this was the case. The manager said that she has been unable to do a report of the summary of findings due to decreased supernumerary time. She said that she is to do the summary in the next few weeks. The home looks after small amounts of money belonging to some people that use the service. Appropriate records of transactions are kept. A sample of health and safety records were examined and in general found to be in order. Records were available to confirm that the homes gas boilers and fire extinguishers had been serviced in the last twelve months. At the time of the inspection the manager could not find the certificate to confirm that fire alarms had been serviced, however assured the Inspector that fire alarms had been serviced a few months prior to the inspection. The manager said that the home have a contract with a company to do regular fire training. She said that the company visit four times a year to ensure that they catch all staff. She said that the company also do unannounced visits in which they do fire drills with staff. On average weekly tests of the fire alarm system are carried out. Water temperatures are taken and recorded on a weekly basis to ensure that they are within safe limits. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 7 Care plans should be updated/evaluated on a monthly basis or more often if needed to advise of changes to care, deteriorations and improvements made to help to ensure the care needs of the person are met. Risk assessments for people who use bed rails should be updated to include all safety checks recommended by the Department of Health to help to prevent injury or harm. The registered manager should complete a management qualification. The manager should do a report, which details the summary of findings of surveys that were sent out to people that use the service and relatives. A certificate should be available within the home to confirm that fire alarms have been serviced to ensure safety. 2 8 3 4 31 33 5 38 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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