Care Home: Beechcroft Nursing Home

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What the care home does well The home is situated in a pleasant residential area of Birkenhead. The exterior is very tidy and well-maintained, with pleasant and well-tended gardens. Inside, everywhere was clean, tidy, well-maintained and nicely decorated when we visited and there were no unpleasant odours. Records showed that equipment is checked and serviced regularly to ensure safety. The manager always goes out to meet and assess anyone who is interested in coming to live at Beechcroft to make sure that their needs can be met. A pre-admission assessment form is filled in and this is available for the staff, to give them information about the needs of a new resident. Each person who lives at the home has a care plan. The care plans we looked at contained detailed assessments of the person`s needs. There were very detailed wound care records for a person who had been admitted to Beechcroft with pressure sores. People identified as being `at risk` are provided with a pressure relieving mattress and fully adjustable bed. The care plans also showed that specialist advice and intervention is sought from healthcare professionals where necessary. We observed that the staff were polite and respectful in their interactions with residents. The people we spoke with were all very happy the way that they are treated at Beechcroft and told us `the staff are all good, very, very helpful`, `staff are absolutely wonderful, caring and friendly` and `the girls are good you can have a laugh with them`. We also looked at some written comments that had been received recently: `We cannot thank you all enough for the way you cared for our dear [relative]. He could not have been looked after any better. You were all kind and considerate all the time, not only to [our relative] but also to us his family. It was such a comfort to know that he was looked after by such caring people.` `We would like to thank you for the way you looked after [our relative] during his stay with you. We were always able to call in without an appointment and always found him comfortable and happy in his own way and always clean.` `Thank you for the kind care and excellent nursing given to [relative] during the three years plus that he was in your care at Beechcroft. You made his life as comfortable as possible, nursed him though the bad times and gave him as good a quality of life as could healthwise be expected.` Two activities organisers are employed and a weekly programme of activities is displayed on noticeboards. Enough qualified and experienced staff are employed to ensure that people`s needs can be met. The manager said that she has flexibility with the rota and can increase staff numbers if needed. The home has robust recruitment policies and procedures. Files for new members of staff showed that the procedures had been followed. More than 50% of the care staff have achieved a national vocational qualification in care. The manager and deputy have both been in post for more than ten years and have continued to show their commitment to the home. The manager is a registered nurse and has an NVQ level 4 in management. The proprietor visits once a fortnight or more often if needed, and the manager told us `he`s great, if we want anything we get it`. The staff team is stable and we observed that staff morale and motivation was very positive. Beechcroft is accredited with the ISO 9000 quality standard. What has improved since the last inspection? No requirements or recommendations were made following our last inspection of the home. Work has continued to upgrade the environment both inside and outside, including new furniture and flooring, and new outdoor areas for residents to enjoy. What the care home could do better: The system for checking medicines needs to be more robust to ensure that there is an accurate record of all medicine items that are being kept in the home, and that unused items are disposed of without delay. Comments made by people who live at the home suggested that there is room for further improvement in the meals and in the way that choice is offered each day. Ensure that new staff do not work with residents until they have received all the training they need to be able to work safely. Key inspection report Care homes for older people Name: Address: Beechcroft Nursing Home 62-64 Bidston Road Oxton Birkenhead Wirral CH43 6UW     The quality rating for this care home is:   three star excellent 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: Wendy Smith     Date: 2 9 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 25 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 25 Information about the care home Name of care home: Address: Beechcroft Nursing Home 62-64 Bidston Road Oxton Birkenhead Wirral CH43 6UW 01516526715 01516526715 admin@flightcare.co.uk www.flightcare.co.uk Flightcare Limited care home 43 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) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: 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 categories: Old age, not falling within any other category. The maximum number of service users who can be accommodated is: 43. Date of last inspection Brief description of the care home Beechcroft Nursing Home is one of a number of care homes owned by Flightcare Limited. The home is a four storey mature building, situated in the Oxton area of Birkenhead. It is registered to provide care for 43 older people. 0 Over 65 43 Care Homes for Older People Page 4 of 25 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: three star excellent 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 three stars. This means that the people who use this service experience excellent quality outcomes. We (the Care Quality Commission) visited Beechcroft unannounced on 29 October 2009 as part of this inspection. During the visit we spoke with residents and staff. We walked round the building to see all the communal areas and some of the bedrooms. We checked records kept at the home and spent time talking with the manager. We also looked at any information that we had received about Beechcroft since our last inspection there. Before the visit, the manager was asked to complete a questionnaire to give us up to date information about the service. Care Homes for Older People Page 5 of 25 What the care home does well: The home is situated in a pleasant residential area of Birkenhead. The exterior is very tidy and well-maintained, with pleasant and well-tended gardens. Inside, everywhere was clean, tidy, well-maintained and nicely decorated when we visited and there were no unpleasant odours. Records showed that equipment is checked and serviced regularly to ensure safety. The manager always goes out to meet and assess anyone who is interested in coming to live at Beechcroft to make sure that their needs can be met. A pre-admission assessment form is filled in and this is available for the staff, to give them information about the needs of a new resident. Each person who lives at the home has a care plan. The care plans we looked at contained detailed assessments of the persons needs. There were very detailed wound care records for a person who had been admitted to Beechcroft with pressure sores. People identified as being at risk are provided with a pressure relieving mattress and fully adjustable bed. The care plans also showed that specialist advice and intervention is sought from healthcare professionals where necessary. We observed that the staff were polite and respectful in their interactions with residents. The people we spoke with were all very happy the way that they are treated at Beechcroft and told us the staff are all good, very, very helpful, staff are absolutely wonderful, caring and friendly and the girls are good you can have a laugh with them. We also looked at some written comments that had been received recently: We cannot thank you all enough for the way you cared for our dear [relative]. He could not have been looked after any better. You were all kind and considerate all the time, not only to [our relative] but also to us his family. It was such a comfort to know that he was looked after by such caring people. We would like to thank you for the way you looked after [our relative] during his stay with you. We were always able to call in without an appointment and always found him comfortable and happy in his own way and always clean. Thank you for the kind care and excellent nursing given to [relative] during the three years plus that he was in your care at Beechcroft. You made his life as comfortable as possible, nursed him though the bad times and gave him as good a quality of life as could healthwise be expected. Two activities organisers are employed and a weekly programme of activities is displayed on noticeboards. Enough qualified and experienced staff are employed to ensure that peoples needs can be met. The manager said that she has flexibility with the rota and can increase staff numbers if needed. The home has robust recruitment policies and procedures. Files for new members of staff showed that the procedures had been followed. More than 50 of the care staff have achieved a national vocational qualification in care. The manager and deputy have both been in post for more than ten years and have Care Homes for Older People Page 6 of 25 continued to show their commitment to the home. The manager is a registered nurse and has an NVQ level 4 in management. The proprietor visits once a fortnight or more often if needed, and the manager told us hes great, if we want anything we get it. The staff team is stable and we observed that staff morale and motivation was very positive. Beechcroft is accredited with the ISO 9000 quality standard. 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 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 7 of 25 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 8 of 25 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. Peoples needs are assessed before they move to Beechcroft to make sure that this will be the right home for them. Evidence: Beechcroft is registered to provide care for up to 43 older people. There are 40 bedrooms, three of which can be shared by two people if this is their wish. On the day we visited there were 40 people living at the home; most of them require nursing care but a small number require personal care. The manager told us that she always goes out to meet and assess anyone who is interested in coming to live at Beechcroft. Occasionally, if the manager is away, the deputy will do the assessment. A pre-admission assessment form is filled in and this is available for the staff, to give them information about the needs of the new resident. We saw pre-admission assessment forms in the care plans and they had been Care Homes for Older People Page 9 of 25 Evidence: completed to a good standard. There was also information provided by social services and by hospital staff. The manager said that most people come into Beechcroft directly from hospital but some come from their own home or from another care home. Care Homes for Older People Page 10 of 25 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. The health and personal care needs of the people living at the home are met. Evidence: Each person who lives at the home has a care plan. We looked at a sample of four care plans during our visit. All of the care plans we looked at contained very detailed assessments of the persons needs and the assessments were updated each month to reflect any changes. The instructions for staff about how peoples needs should be met were not always personalised to reflect the specific needs of the individual and had not always been kept up to date as peoples needs had changed. For example, one person we met during our visit was very frail and being looked after in bed, however her plan for bowel management stated encourage adequate mobility where possible. The daily reports were generally meaningful, but the monthly reviews did not give much information to show that the nurse had spent time considering whether any changes were needed to the care. There were very detailed wound care records for a person who had been admitted to Beechcroft with pressure sores. People identified as being at risk were provided with Care Homes for Older People Page 11 of 25 Evidence: a pressure relieving mattress and fully adjustable bed. There were records of repositioning and of food and fluid intake. The care plans also showed that specialist advice and intervention is sought from healthcare professionals where necessary. We looked at the arrangements for storage, administration and recording of medicines. We saw that medicines delivered to the home are checked in on the medication administration record (MAR) sheets and any handwritten entries are signed by two nurses. There were no gaps in the administration records and no items left in the blister packs that should have been given. This suggests that people always get what has been prescribed for them. Controlled drugs were stored and recorded appropriately. In a storage cupboard there was a large quantity of paracetamol that was not recorded anywhere; some residents had three boxes. A stock balance should be kept of all medicines in the home and carried over on the MAR sheet each month. There were also some partly used boxes of antibiotics with labels removed that should not have been retained at the home. The manager let us know that these had been disposed of immediately after our visit. We observed that the staff were polite and respectful in their interactions with residents. The people we spoke with were all very happy the way that they are treated at Beechcroft and told us the staff are all good, very, very helpful, staff are absolutely wonderful, caring and friendly and the girls are good you can have a laugh with them. People were appropriately dressed and look well-groomed. A hairdresser visits the home each week. We also looked at some written comments that had been received recently: We cannot thank you all enough for the way you cared for our dear [relative]. He could not have been looked after any better. You were all kind and considerate all the time, not only to [our relative] but also to us his family. It was such a comfort to know that he was looked after by such caring people. We would like to thank you for the way you looked after [our relative] during his stay with you. We were always able to call in without an appointment and always found him comfortable and happy in his own way and always clean. Thank you for the kind care and excellent nursing given to [relative] during the three years plus that he was in your care at Beechcroft. You made his life as comfortable as possible, nursed him though the bad times and gave him as good a quality of life as could healthwise be expected. Care Homes for Older People Page 12 of 25 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 living at Beechcroft are able to choose how they spend their time and regular social activities are provided Evidence: The people we spoke with said that they can choose the time that they get up in the morning and go to bed at night, and what they do during the day. Two activities organisers are employed and a weekly programme of activities is displayed on noticeboards. On the week we visited this included a quiz, a trip out, bingo, karaoke and a visit by a PAT dog. The trip around the Wirral had been on Tuesday and ended with an ice cream at Parkgate. People we spoke with had really enjoyed this. During the afternoon the lounge was full with people joining in bingo. There is also a smaller lounge area where one person was sitting, and another person was in the dining room with visitors. A number of other people had stayed in their bedrooms and one person had some visitors in her room. One of the people we spoke with in his room said that he had lived at Beechcroft for a few weeks. He is independent for personal care, but his family felt he was unsafe living alone. He said that the staff are always polite and courteous. He has a daily newspaper delivered and is free to go out in garden for a smoke Care Homes for Older People Page 13 of 25 Evidence: because smoking is not permitted in the building. We received mixed comments regarding the meals. One person said the food is great, there is not generally a choice but I eat anything another said you can never please everybody, I find it OK and a third person said The food isnt great, its sometimes good. They tell you you can get a choice but you dont always get it but you can have bacon and egg for breakfast. He said that he didnt like the cottage pie today but hadnt been asked beforehand what he would like. A menu board in the dining room shows the meal of the day and there was also a list of a number of alternatives that can be provided. We saw evidence to show that a small number of people had received an alternative, but there did not appear to be a system whereby people are asked each day whether they wish to have the meal on the menu or whether they would prefer an alternative. Care Homes for Older People Page 14 of 25 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 living at the home are protected from abuse. Evidence: There is a company complaints procedure that informs people how to make a complaint and how their complaint will be dealt with. This is displayed in the entrance area. The manager told us that no complaints have been recorded in the last year. The complaints procedure needs to be updated to include up to date details of how to contact CQC, and it would also be helpful if the complaints procedure gave the names of the home manager and the owner and how to contact them. All except the most recently employed staff have attended training about abuse and updates of this training are due to take place this month. There is a whistleblowing policy that advises staff what they should do if the suspect abuse, and staff are told about this as part of their induction training. Care Homes for Older People Page 15 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Beechcroft provides a most clean, pleasant and well-maintained environment for people to live and work in. Evidence: The home is situated in a pleasant residential area of Birkenhead. The exterior is very tidy and well-maintained. There are pleasant and well-tended gardens with a vegetable plot and a greenhouse. A maintenance person is employed three days a week (or more if needed) and a gardener one day a week. Inside, everywhere was clean, tidy, well-maintained and nicely decorated when we visited and there were no unpleasant odours. Some of the furniture is old, but is in good safe condition and is gradually being replaced. The furnishings throughout the home are domestic in style to provide a homely environment. There are two housekeeping staff and a laundry assistant on duty every day. Equipment is provided to meet the needs of the people living at the home and this includes two stand-aids and two sling hoists. Some bedroom doors are fitted with door-guards, which means that people can have their bedroom door open, but the door will close automatically if the fire alarm is activated. There is a sluice on each floor. Infection control policies and procedures are in place and staff receive training about infection control as part of their induction programme. Care Homes for Older People Page 16 of 25 Evidence: Care Homes for Older People Page 17 of 25 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 employs enough qualified and experienced staff to ensure that peoples needs are met. Evidence: There are two nurses on duty during the day, with eight care staff in a morning, seven in an afternoon and six in an evening. Accommodation is on four floors and staff work in two teams, each covering two floors. At night there is a nurse and four cares, or two nurses and 3 carers. The manager said that she has flexibility with the rota and can increase staff numbers if needed to make sure that peoples needs are met. One of the carers stays till 10pm if needed and some come in at 7am or 7.30 am to cover busy times. At the time we visited the home was fully staffed and agency workers were not being used. The home has robust recruitment policies and procedures. Prospective staff are required to complete an application form prior to interview. Two references are taken and checks are made with the Criminal Records Bureau and Protection of Vulnerable Adults list. Gaps in employment history are checked and evidence of training and qualifications are required to be produced. We looked at files for new members of staff and these showed that the procedures had been followed. More than 50 of the care staff have achieved a national vocational qualification in Care Homes for Older People Page 18 of 25 Evidence: care. Staff training is provided by a company trainer and dates were booked in November 2009 for all staff to have updates of their mandatory training which ensures that they know how to work safely. Staff had fire training in May 2009 from an external trainer. The deputy manager does induction training with new staff, however we found that two new members of staff did not have any record of induction training. The deputy manager is not a qualified moving and handling trainer so other arrangements need to be made to ensure that new staff are aware of safe moving and handling requirements before they work unsupervised with residents. Care Homes for Older People Page 19 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a stable and effective management team who ensure that the home is run in the best interests of the people who live there. Evidence: The manager and deputy have both been in post for more than ten years and have continued to show their commitment to the home. The manager is a registered nurse and has an NVQ level 4 in management. The proprietor visits once a fortnight or more often if needed, and the manager told us hes great, if we want anything we get it. Administration is dealt with from head office where there are a team of five clerical staff. The managers office is by the main entrance so she is available for visitors to speak with. One person who complete a satisfaction survey commented that senior staff are always helpful and considerate. The staff team is stable and we observed that staff morale and motivation was very positive. Care Homes for Older People Page 20 of 25 Evidence: Beechcroft is accredited with the ISO 9000 quality standard. There is a monthly company internal audit that is carried out by a manager from one of the other homes in the group. We considered that this audit needs to be more in-depth in terms of medicines, care plans and staff training records because some shortfalls had not been identified. A customer satisfaction survey was last done in June 2009 with mainly positive responses. Any negative comments were followed up, for example with changes to the menu. We saw records of regular meetings for residents and their relatives. The manager meets with the staff every day and there are also staff meetings alternate months that are well attended. This gives people opportunities to express their views. The homes staff do not deal with the financial affairs of any residents but people can keep small amounts of personal spending money in safekeeping. Detailed individual records are kept. The records are all signed by the manager and we suggested that, for the protection of the manager, these should be checked and countersigned periodically by another person. In the questionnaire that was completed before our visit, the manager provided dates when all plant and equipment had been tested and serviced and these were all up to date. A weekly fire alarm test and monthly emergency lighting test are recorded. All staff attended fire training May 2009. The fire risk assessment for the building was updated in May 2009. Monthly fire drills are held so that staff know what to do if the fire alarm goes off. We recommend that a list of the names of staff attending the fire drill so that manager can if anyone has not attended a recent fire drill. The last fire officer visit was in 2007 and the manager said that there are no issues outstanding. An environmental health officer visited in February 2009 and identified one minor issue, which has been addressed. Care Homes for Older People Page 21 of 25 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 22 of 25 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 Any unused medicines should be disposed of. To ensure that medicines are used only for the person they were prescribed for and there is no misuse. 07/11/2009 2 9 13 There must be a record of all 27/11/2009 medicines that are being kept at the home. To ensure that all medicines received are fully accounted for and there is no misuse. 3 30 18 Ensure that all new staff have received a full induction training programme before they work with residents. So that they know how to work safely. 27/11/2009 Care Homes for Older People Page 23 of 25 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 Care Homes for Older People Page 24 of 25 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. Care Homes for Older People Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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