Care Home: Barkat

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What the care home does well The people who live at the home generally report that it is a good place to live, that they like the staff that support them, and that they are satisfied with the opportunities available to them. The staff are friendly and helpful. There are some staff who have worked in the home for a long time. The staff team is stable, and people are supported by staff they know, and who are familiar with their needs. The food available is very varied. There is a planned menu, but there is a lot of flexibility about what is eaten. All the people living in the home have single bedrooms. These are all very different, and each person`s bedroom contains the things that are important to them. The staff help people to stay in touch with family and friends. What has improved since the last inspection? Medication management has improved and is more robust. This means people receive their medication as prescribed which help to keep them well. Training has been undertaken by the staff to ensure they have the skills to care for people safely. There has been some further improvements to the environment to ensure the home is comfortable for people to live. People said the staff team are more stable which means they have a better continuity of care. What the care home could do better: There are still some areas in care plans that need further development to include information about past life history to make each care plan more individualised and build on peoples strengths. This will mean the information gathered about each person will record their personal identity how they can be supported to make choices and decisions of how they want to be cared for while living in the home. Activity records need to show how each person has been given the opportunity to continue with a wide range of activities that they would like to attend. This will reflect their choices and opportunity of taking up new activities. The service user guide needs to be accessible to people where English is not their first language. This will ensure people have the information they need about the home to make a decision as whether to live there. Assessments must be undertaken before the person moves into the home and detail how the home can meet their needs. This will ensure people do not move into the home without their needs being assessed. It is recommended that the current manager continues with the format previously used to obtain information about the individual. This will enable the manger to draw up a care plan that is tailored to the persons individual needs. The manager must ensure information is accurate in peoples care files to ensure their needs are being met as per their assessed needs. Risk management plans must be reviewed and tailored to the individual. They must also show the control measures to minimise the risk. This will ensure people are cared for safely. It is recommended the manager includes feedback when meetings take place with both staff and the people living in the home. This will ensure people know their views are being listened to and acted upon. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Barkat 254 Alcester Road Moseley Birmingham West Midlands B13 8EY     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sue Scully     Date: 3 0 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 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 30 Information about the care home Name of care home: Address: Barkat 254 Alcester Road Moseley Birmingham West Midlands B13 8EY 01214490584 01214492726 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Ms Shahnaz Butt,Ms Seemia Butt care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: That the home can accommodate up to three people under 65 years of age for reasons of mental disorder. Date of last inspection Brief description of the care home Barkat House is a large detached property situated on the main Alcester Road in Moseley. It is within easy walking distance of the main shopping area of Moseley where shops, restaurants, public houses and churches can be found and a larger shopping area can be reached by walking to Kings Heath. The home enjoys easy access to public transport routes leading to the city centre and beyond. Barkat House offers accommodation 27 older people in single rooms on the ground and first floor and a number of these rooms have en suite facilities. There is a passenger lift between the ground and first floor. Communal areas are located on the ground floor. There is a Care Homes for Older People Page 4 of 30 Over 65 27 0 Brief description of the care home large lounge to the front of the house, a smaller lounge to the rear. People that smoke use the small lounge. The home has a separate dining room. There are communal toilets and either assisted bathing or a shower facilities based on both floors. The ground floor also houses the kitchen, office, laundry and large storage area. The home has a dedicated garden for the use of service users. The home has a small amount of parking at the front of the building. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate 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 focus of inspections undertaken by the Commission is upon outcomes for the people who use the service and their views of the service provided, meaning they tell us if the home is meeting their needs, if the home is flexible and suits their life style, and if the home enables them to maintain their independence, preferences and choice of how they want to be supported. We also talk to staff and relatives about peoples care and look at care files focusing on outcomes for people. In addition to this, information is looked at during the inspection such as policys and procedures, and the general operation of the home in relation to meeting peoples needs. Before the visit took place we looked at all the information that we had received, or asked for, since the last key inspection. This included notification received from the Care Homes for Older People Page 6 of 30 home. These are reports about things that have happened in the home that they have told us about. Three of the people living in the home were cased tracked. This involves establishing individual experiences of living in the home, this was done by meeting them, observing the care they receive, discussing their care with staff , looking at care files and focusing on outcomes. Care tracking peoples care helps us to understand the experiences of people who use the service. We also ask the manager to provide information to us by way of completing an AQAA (Annual Quality Assurance Assessment) this is where the manger of the service tells us about the organisation and any planned improvements for the future. The home currently charges £332.00 per week for the rooms en suite rooms are likely to be charged for more when the contract is agreed with Social Care and Health. What the care home does well: What has improved since the last inspection? What they could do better: There are still some areas in care plans that need further development to include information about past life history to make each care plan more individualised and build on peoples strengths. This will mean the information gathered about each person will record their personal identity how they can be supported to make choices and decisions of how they want to be cared for while living in the home. Activity records need to show how each person has been given the opportunity to continue with a wide range of activities that they would like to attend. This will reflect their choices and opportunity of taking up new activities. The service user guide needs to be accessible to people where English is not their first language. This will ensure people have the information they need about the home to make a decision as whether to live there. Assessments must be undertaken before the person moves into the home and detail how the home can meet their needs. This will ensure people do not move into the Care Homes for Older People Page 8 of 30 home without their needs being assessed. It is recommended that the current manager continues with the format previously used to obtain information about the individual. This will enable the manger to draw up a care plan that is tailored to the persons individual needs. The manager must ensure information is accurate in peoples care files to ensure their needs are being met as per their assessed needs. Risk management plans must be reviewed and tailored to the individual. They must also show the control measures to minimise the risk. This will ensure people are cared for safely. It is recommended the manager includes feedback when meetings take place with both staff and the people living in the home. This will ensure people know their views are being listened to and acted upon. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service do not always have the information in a format suitable for their needs to enable them to make an informed choice as to whether to use the service. Assessments for people wishing to use the service are lacking in detail to provide a comprehensive plan of care. Evidence: The statement of purpose is in a picture format which gives details about the home, how to complain, and details of the fees that will be payable. Some of the people living in the home are from different cultural backgrounds and English was not their first language. The service user guide would not be suitable for their needs so it would be difficult for them to have all the information required to make an informed choice about whether they wanted to move into the home. Care Homes for Older People Page 11 of 30 Evidence: Before anyone moves into the home the manager completes an assessment of their needs. This means the manager visits the person and gatherers information of what the person is looking for and why they need residential care. We looked at one assessment that had been undertaken recently. The manger had written brief information in a diary. When we looked at the information it was difficult to understand what their needs were and no acknowledgment letter had been sent to the individual confirming the home could meet their needs. Previously the manger of the home had used a format that gave details about a persons history, needs, likes dislikes and other information staff could use to make the decision as to whether the persons needs could be met. It is recommended that the current manager continue to use this format. People wishing to move into the home are able to visit the home prior to moving in. These visits could be for a meal, overnight or a weekend stay. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are treated with respect and dignity. Further development is required in care plans and risk assessments to ensure peoples assessed needs are recorded accurately so staff have the information to meet their needs. Medication records have improved and are being maintained in order to ensure people receive their medication as prescribed to keep them well. Evidence: We looked at three care files for the people living in the home alongside their health care records, daily records, and medication records. The care plans identify the persons needs and what needs to be done to ensure their health and welfare. Each care plan has a different heading such as life history, personal care, skin care, health care, mobility and nutrition. Under each section the staff and the person using the service detail what needs to be done on a daily basis. The information in one care file was good and gave details of how the person would be supported on a daily basis, how they likes things to be done, who they would prefer, Care Homes for Older People Page 13 of 30 Evidence: such as female or male care staff, and what they could do for themselves. Another care file said the person required their hair to be washed three times a week with medicated shampoo due to a scalp condition. When we looked at the daily records for this person and found this had not been completed for a period of four weeks. The care plan said the person needed to be weighed monthly again this task had not been undertaken. The manager said that the staff could not weigh the person due to their poor mobility. The review that had taken place said no changes. The manager needs to update the persons care plan because there had clearly been changes in their needs as tasks were not being undertaken. The third care file we looked at shows the person needs encouragement with personal hygiene. The care plan said staff are to offer a bath or shower on Mondays and Thursdays and report if there is a change or the person refuse these. The daily records and personal hygiene records indicated the person had refused a shower or a bath over a period of two months. The review said no change. There had clearly been a change in the persons needs as this task is not being undertaken. The care plans sampled included some details of maintaining the privacy and dignity of the people living in the home however information of how the person is involved in their care could be further developed. Risk assessments for all three care files seen were generic meaning the same for example, all risk assessments referred to going out into the community, mobility, falls, nutrition. Risk assessments must be undertaken if a risk has been identified for an individual and the risk assessment must be about them and detail the control measures in place to minimise the risk. External health care professionals such as the chiropodist, optician , general practitioner, social workers and tissue viability nurses had seen people , but some information recorded was either incorrect or there was no outcome of the visit. For example in one persons health care record it said doctor visited but gave no reason for the visit, or the treatment needed. Another health care record showed that a professional speech and language therapist had visited the person and the staff had written that all meals were to be liquidised and drinks thickened. The manager said the staff member who had written this in the person health care record had made a mistake, because the person had a soft diet. Such a mistake could place the person at serious risk of harm. Daily records were repetitive such as fine no concerns and did not tell us how people were looked after or what they did on a daily basis. Care Homes for Older People Page 14 of 30 Evidence: Medication continued to be administered via a 28 day monitored dosage system and this was very well managed. Only staff that had been appropriately trained administered medication. All medication received into the home was being recorded and there were no gaps on the MAR (medication administration records). The system was very easy to audit and all medication checked was correct. The controlled medication in the home was stored appropriately and the records for administration were as required. The home also has a homely remedy policy for paracetamol which people living in the home can request if required. One persons medication record we looked at showed us the person was prescribed paracetamol, however often requests paracetamol from the staff for pain relief. The manager was advised to contact the general practitioner to review the medication for pain relief for this person as the records indicate that the current treatment is not working because the person had requested paracetamol in addition to the prescribed dosage. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home support people to attend activities but records do not show what most of these activities are. This means peoples life style and choices may not be met. People have regular contact with family and friends which maintains links with the local community. The menus show that balanced and nutritious meals are provided and offer a choice each day with peoples cultural needs being met. Evidence: The plans of care contained details of peoples preferences for activities but there was little evidence to demonstrate how people attended these activities. It was recorded in daily notes that individuals have chosen to stay inside or listen to music. The one persons file we looked at said they liked to listen to Asian music as the person did not speak English. Through observations it was noted the person was listening English to pop music. There is no evidence to demonstrate how the home is being proactive in the planning of activities and utilising all local resources, to engage individuals in meaningful activities in the home or in the community. The manager said I am in the process of developing an activity programme and gathering information about what people would like to do. Each week a key worker completes a record of what activities have taken place. There needs to be more details as entries state took part Care Homes for Older People Page 16 of 30 Evidence: in activities but does not say what the activities were. Visitors were seen to come and go throughout the course of the inspection and were made welcome by staff. One relative who was spoken to and commented I am very happy with the care they have been fantastic. Family and friends are always welcome and from daily records sampled they show us when family visit and when people go out with their relative or on their own. People spoken with were happy with the support they receive and one person said they are brilliant here staff are really kind and do what you ask them to do with out hesitation. Observation made throughout the day showed staff were respectful and asked people what they wanted, waited for responses ensuring they were given choices and made their own decisions. The menus in the home were varied, nutritious and offered choices. Some of the people we spoke with said the food was good but sometimes they did not know what was for lunch each day. There are four people living in the home who have their meals brought in to the home in small containers with the words Asian food written on the containers. These meals are the provisions to meet their cultural needs however one person does not eat meat and one person only eats Halal meat. It is recommended that the contents of the food are recorded to ensure they are suitable for the individual. Care Homes for Older People Page 17 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home and their families can be sure that their concerns will be listened to and acted upon. People can not be sure all risks to their health and welfare have been identified and this could place them at risk. Evidence: The complaints and adult protection procedures for the home had been seen at previous inspections and were found to be satisfactory. The adult protection procedure however was not available at this inspection and a copy must be forwarded to the commission. The people living in the home or their representatives received a copy of the complaints procedure in the service user guide. There have been no complaints to us about the home since the last inspection and the manager explained that no complaints have been made directly to the home during the same period. There is an accessible complaints procedure in place at the home including a picture format to help people who may have communication difficulties. This means people have the information they need to raised concerns and how to do this. The comments received indicated that any concerns raised were listened to and acted on. They included: The manager is always ready to listen and give advice on any problems I have. Care Homes for Older People Page 18 of 30 Evidence: Ive had no reason to complain. In general conversation with people living in the home, said if they had any concerns they would tell staff or the manager as they felt their concerns would be dealt with. This means people have the confidences to express their views. The complaints procedures should also be available in other languages to ensure people have the information they need if English is not their first language. The training matrix for the home shows that, apart from new staff who have not had the opportunity to complete adult protection training, all staff had received training in safeguarding people from abuse. The risk assessments completed for people living in the home identify the risks that are not relevant to the individual and fail to identify those risks that are. The risk assessments must tell staff the control measures that are in place to minimise the risks. The manager is aware that the risk assessments contain limited information and need to be reviewed so as to ensure all people living in the home are cared for safely. Care Homes for Older People Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home where the standard of the environment needs constant attention and continues to improve with on going refurbishment. Evidence: A tour of the communal areas of the home was made, and some bedrooms were also seen. Some parts of the home have been decorated. We looked at the equipment used to assist people with bathing and one of the chairs was split which could cause cuts to people using the seat. We advised to take the seat out of use until repair to prevent injury to people using the service. Some improvement in maintaining infection control is required. For example, one of the kitchen cupboards needs to be repaired and some of the toilets seen require resealing around the base. Since the last inspection the service has employed more domestic staff to ensure the environment is kept clean. Bedrooms seen were personal to the individualised and clean. People were clearly comfortable and the ample communal space in the home enabled people to either spend time together or more privately. The home had both a designated smoking area and no smoking area. Every one spoken to said they were happy with their bedrooms and felt staff respected their privacy. Care Homes for Older People Page 20 of 30 Evidence: The laundry was appropriately equipped and was accessible to the people living in the home. The home was generally clean. The AQAA (Annual Quality Assurance Assessment tells us, the service have plans to develop a maintenance programme and to document all maintenance work that had been carried out throughout the year. This will enable us to keep up to date with work required. Care Homes for Older People Page 21 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are safeguarded by the homes recruitment procedures meaning the manager completes all the necessary checks to ensure staff are suitable to work with vulnerable people. People can be sure staff are appropriately trained to care for them safely. Evidence: Staffing levels in the home are appropriate for the needs of the people who use the service and the managers hours are not part of the care rota. This means the management of the home can be undertaken without having to share the time undertaking care tasks. It also means the manager is able to stand in for a care worker if a person needs to go to hospital. The manager told us the staffing levels consist of one senior care, three care staff, one cook and two cleaners during the morning shift, one senior care,two care staff, during the afternoon and two waking night staff. A copy of the rota was taken and when examined confirmed what the manager had told us. This means people living in the home are supported by adequate staffing levels to meet their needs. Staff training records show us that staff receive regular training to support people safely such as first aid, health and safety, medication, food hygiene, manual handling and protection of vulnerable people. This means staff are competent and have the skills required to ensure people are looked after safely. Care Homes for Older People Page 22 of 30 Evidence: The manager told us that only one member of staff had been recruited since October 2008 when she was appointed.The position was for a cook. We looked at the recruitment records for this person and these showed us that CRB (Criminal Record Bureau Checks) and POVA (Protection of Vulnerable Adults Checks) were completed. Two references had been obtained and previous employment details were included in the interview notes and application form. It was noted a member of staff food and hygiene certificate was out of date. The manager said that a course had been booked for the staff member to undertake this training. A brief induction had taken place that included discussions around the employees hand book, holidays and sickness, peoples diets, fire and polices and procedures. The person was qualified to NVQ level 3 and completed training in protection of vulnerable people. Care Homes for Older People Page 23 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health and Safety of the people who use the service is safeguarded by routine servicing and testing of equipment, but needs to improve in the areas of risk assessments and plans of care to ensure peoples needs are met safely. Evidence: The current manager has been in post since October 2008 and has completed the RMA (Registered Manager Award), completed training in Deprivation of Liberty, holds an NVQ level 4 and has completed an NVQ assessor award. The manager has applied to the Commission for registration and her application is pending. The staff in the home said the manager was approachable and supportive. To ensure the home is run in the best interest of the people who live there improvements in areas such as care plans, risk assessments, activities and daily records need to be undertaken. Care Homes for Older People Page 24 of 30 Evidence: We looked at the records for peoples finances where the owner has taken on the responsibility of ensuring people receive their money on time and what is due to them. The records show us that all transactions are recorded. The balances of accounts when sampled were found to be correct. It is recommended that the owner numbers the receipt to support adequate auditing. Formal supervision has commenced to provide staff with a platform in which their practice can be appraised as well as providing a sense of direction in their work. This will benefit the people who use the service by having staff who are monitored in their practices of delivering care. Staff meetings are taking place where staff discuss issues such as people living in the home and their needs, medication key workers and activities. The manager said no meetings have been held with the people living in the home as yet but the staff and the manager are planning the next meeting in the near future. It is recommend the manger display the agenda for the next meeting so people living in the home have the opportunity to add to the agenda if they wish. It is also recommended that once the meeting has taken place at the next meeting issues raised are discussed to ensure those ideas put forward have been acted upon or a reason given if they have not. Health and safety checks in the home are carried out regularly on equipment that is used in the home, such as hoists, bath chairs, testing of electrical equipment, Gas landlords safety checks, periodic test for water temperatures to prevent scalds and regular testing of the fire system. The manager has not undertaken a Quality Monitoring Audit of the service so peoples views are obtained in order for the home to improve. The manager said I have sent some surveys to the people living in the home and external professional but we are in the early stages of completing this. Care Homes for Older People Page 25 of 30 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 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 3 14 A comprehensive assessment must be completed to identify a person needs before they move into the home. This will ensure the home can meet the person needs. 30/06/2009 2 8 12 Accurate records must be 30/06/2009 completed to ensure the health care people receive is correct and people are not placed at risk by misleading information. This will ensure people health and welfare is maintained at all times. 3 18 13 There must be comprehensive risk assessment in place for any identified risks that include strategies for managing the risk. This will ensure that the people living in the home 30/06/2009 Care Homes for Older People Page 27 of 30 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 are not exposed to any unnecessary risks to their health and wellbeing. 4 19 23 The service must ensure all 30/06/2009 repairs are completed in a timely manner. The items identified during the inspection must be repaired. This will ensure people are not placed at risk of harm from equipment that has a defect. 5 30 18 There must be a full induction to the service that is in line with skills for care when new employees commence employment. This will ensure new recruits are trained in the first six months of employment. 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 31/07/2009 1 1 The manager should consider the format in which the service user guide is available to ensure people with different language have the information to make an informed decision whether to move into the home. Care plans need to detail peoples current needs so staff have the information to meet their needs Care plans and daily records should show how peoples dignity and respect is maintained on a daily basis. 2 3 7 10 Care Homes for Older People Page 28 of 30 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 4 5 12 15 A variety of activities should be available to the people living in the home to ensue they lead a fulfilled life style. It is recommend the containers detail the contents to ensure people are not given the wrong meal. Care Homes for Older People Page 29 of 30 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. 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