Care Home: Beeston Lodge

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What the care home does well The home is clean and benefiting from refurbishments that are presently being undertaken. Residents tell us that the staff are kind and helpful and that they feel safe there. They tell us that the food is good and that they have choices at mealtimes. The staff plan the care and support that each person needs and write a care plan that is discussed with each resident to make sure they are happy with the support and agree to it. Residents tell us they receive their medicines on time and have their health needs met. The records we viewed tell us that the staff team have received training exceeding the minimum standards and are in the process of receiving required refresher training. What has improved since the last inspection? There is a new acting manager in post who has focused on improving the way care is planned and health risks assessed. She has ensured that each resident`s care records are up to date and reflect their current needs and that she has consulted them on their care plans. The staff training has improved and more refresher training has been undertaken to make sure staff skills are up to date. The home is more organised and the acting manager feels she has sufficient time to undertake her role properly, this has also ensured that medicines are now dispensed at the correct time so that people receive them as the prescription requires. What the care home could do better: The acting manager must ensure that there is enough information available to prospective residents to enable them to make an informed decision about coming to the home and this includes providing each person with an up to date complaint procedure. There should be a clear record of what has been reviewed at each care plan review to ensure that information about any changes are not lost within daily records and that any change is properly monitored and followed up. The focus on staff training needs to continue, ensuring that each person receives a minimum of three paid training days each year. Planned refresher training must continue and the acting manager must ensure that any shortfalls identified are suitably addressed through supervision and planned training. The acting manager should contact Skills for Care to ensure that the home has a suitable induction standard that meets the National Common Induction Standards. The acting manager must ensure that each person is suitably assessed for any risk to their safety when accessing the garden pond area. Key inspection report Care homes for older people Name: Address: Beeston Lodge 15-17 Meadow Road Beeston Rylands Nottingham NG9 1JP     The quality rating for this care home is:   one star adequate 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: Mary OLoughlin     Date: 2 9 0 9 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 29 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 29 Information about the care home Name of care home: Address: Beeston Lodge 15-17 Meadow Road Beeston Rylands Nottingham NG9 1JP 01159259014 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Rodenvine Nottingham Limited Name of registered manager (if applicable) Type of registration: Number of places registered: care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is 28 The registered person may provide the following categories 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 - Code OP Physical Disability - Code PD - maximum number of places 3 Date of last inspection Brief description of the care home Beeston Lodge is situated in the Beeston Rylands area in close proximity to Beeston Town and Chilwell. The area is well served by public transport. The home provides care for up to 28 people aged 65 and over that require nursing and residential care. The home is registered to accept up to three people with physical disability. Care Homes for Older People Page 4 of 29 Over 65 28 0 0 3 1 8 0 3 2 0 0 9 Brief description of the care home The Accommodation is over two floors and a passenger lift and staircase access is provided. Peoples bedrooms are sited on both ground and first floor levels, none of the rooms have en-suite facilities. Ramped access is provided to the front garden and there is also an enclosed courtyard garden to the rear of the home. The weekly fee is £366.00 to £404.00 A statement of purpose is available on request. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 Care Quality Commission(CQC) is upon outcomes for the people using the service and their views on the service provided. This process considers the providers capacity to meet regulatory requirement, minimum standards of practice and focuses on aspects of the service that need further development. Prior to our visit an analysis of all the information we have received about the home since our last inspection was undertaken. We looked at what the manager had told us in the Annual Quality Assurance document(AQAA) and the responses we received from our Have Your Say surveys which we sent to residents and staff at the home. Care Homes for Older People Page 6 of 29 The main method of inspection used was called case tracking, which involves looking at the quality of care received by a number of people living at the home.We use evidence from our observations, from speaking to people about their experience of living at the home, talk to staff about their understanding of peoples needs and the training they receive to support them in their role. Nottinghamshire County Council discussed with us their Quality Audit findings following their visit to the home on 10/09/09 and we used this information to inform our inspection. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: The acting manager must ensure that there is enough information available to prospective residents to enable them to make an informed decision about coming to the home and this includes providing each person with an up to date complaint procedure. There should be a clear record of what has been reviewed at each care plan review to ensure that information about any changes are not lost within daily records and that any change is properly monitored and followed up. The focus on staff training needs to continue, ensuring that each person receives a minimum of three paid training days each year. Planned refresher training must continue and the acting manager must ensure that any shortfalls identified are suitably addressed through supervision and planned training. The acting manager should contact Skills for Care to ensure that the home has a suitable induction standard that meets the National Common Induction Standards. The acting manager must ensure that each person is suitably assessed for any risk to Care Homes for Older People Page 8 of 29 their safety when accessing the garden pond area. 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 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive an appropriate assessment of their needs before coming to the home but there is not enough information available for people to make an informed choice about moving in. Intermediate care is not provided. Evidence: Information provided by the acting manager in the Annual Quality Assurance Assessment states We have introduced a statement of purpose and our service users guide available for all service users, giving them an opportunity to make a fully informed choice about whether our home is suitable. Copies of our latest inspection and complaint procedure are accessible for everyone to see on request. All service users are issued with a contract, this indicates the room, fees and terms and conditions. All service users have undergone a full assessment prior to admission. Care Homes for Older People Page 11 of 29 Evidence: We looked at the statement of purpose and found that it gave information about the facilities and services the home provides. A service user guide was not available as a stand alone document and although the statement of purpose contained a complaint procedure the information was out of date relating to the National Care Standards Commission which no longer exists. We examined the records of a recently admitted person and saw that the manager had completed an assessment of the persons needs before arranging admission to the home. The manager told us that the advocates of this person had been involved in the assessment process but this could not be verified from the documents seen as no record of who had been involved was available. The staff we spoke to were able to tell us about the care and support this person required. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their health and personal care planned in accordance with their wishes and receive their medicines as prescribed. Evidence: Our last inspection found that there was not enough consultation with residents about their care plans and infrequent reviews of care were taking place to ensure that staff knew how to support people in accordance with their wishes and manage their health needs safely. Information provided by the acting manager in the Annual Quality Assurance Assessment stated We have now devised an improved format for our care plans that are now reviewed monthly. Any changes to the service users care is highlighted in hand overs to all care staff. At this inspection we examined 4 care plans and each plan showed that staff are now assessing health risks and writing a care plan that addresses any identified risk to make sure that they are supporting residents safely and health issues are addressed Care Homes for Older People Page 13 of 29 Evidence: quickly. We saw that residents are involved in their care plans where possible and sign them to say they have agreed to the content of the plans. We saw that where a resident lacked capacity to make his own decisions about his care the acting manager had ensured he was referred to the appropriate authority and appointed an advocate to act in his best interests. Staff also write a daily record about each person that records health events and changes in condition. This information was not always transferred to the care plans and we could not identify the process of each monthly review to see what had been considered. This could mean that actions may not always be followed through unless the daily records are reviewed at each care plan review. The Have your Say pre inspection questionnaire asked residents,Do you receive the care and support you need, one respondent stated Always and nine respondents stated Usually. We examined the medicine managed for 2 people and found that staff store, record and administer medicines safely. The acting manager has also implemented an information sheet for staff about each medicine that is used on an as required basis to make sure they are fully aware of the reason the medicine is used so that appropriate dispensing takes place. We saw that people now receive their medicines at the times prescribed. The acting manager told us she now regularly checks medicines to ensure staff comply with the policies and procedures for safe practice. Residents spoken with told us that the staff were lovely and treated them well. Care Homes for Older People Page 14 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are activities and events taking place inside and outside of the home and staff recognise the importance of ensuring people receive adequate nutrition and hydration which maintains their health. Evidence: Our last inspection found that these standards were being met with the provision of varied activities and suitable nutrition being provided. Information provided by the acting manager in the AQAA states, service users are encouraged to join in activities and special events, we have two activity coordinators in post to fulfill the service users needs. Service users are taken out in pairs to do shopping, go to church and out for lunch. We spoke to four residents about activities they could take part in and they all confirmed that they had opportunities to go out, do board games and receive visitors as they wish.They said they saw the local minister at the home and also attended church. Information provided by the acting manager in the AQAA relating to the provision of Care Homes for Older People Page 15 of 29 Evidence: meals states We have four weekly menus and service users dietary needs are documented in their care plans. We saw within the care plans of the residents we case tracked that staff assess each persons nutritional needs regularly and weigh people monthly. There were also records for those at nutritional risk that recorded what they had to eat each day so that staff could monitor any changes and refer people to the Doctor as problems arose. One care plan described how staff should support the person to eat as they had swallowing problems which made them at risk of choking.We saw staff supporting the person to eat safely and in keeping with the specialist advice. The Have Your Say pre inspection questionnaires asked residents Do you like the meals provided, one respondent stated Always, eight respondents stated Usually and one respondent Sometimes. We spoke to residents during the inspection who made the following comments, I have plenty to eat and choices of meals,They ask me each day what I would like at mealtimes I can have a full English breakfast or a bacon sandwich if thats what I want. Care Homes for Older People Page 16 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaint procedure is not widely available for the residents within the home to ensure they know what to do if they have concerns. The staff team are trained to recognise and respond to abuse but are not trained to deal with physical or verbal aggression. Evidence: Information provided by the registered manager in the Annual Quality Assurance Assessment states Our complaints procedure is visible in the reception for all to read and access if needed.The complaints procedure is discussed with the families at meetings and our door is always open if they are unhappy with anything within the home. We like to address any issues quickly to prevent distress on the service user and their families. All staff have a Protection of Vulnerable Adults training. Training has been commenced in relation to the Mental Capacity Act. We looked at the complaint information within the statement of purpose and saw that it contains out of date information about the Commission. The acting manager said that residents were not issued with a copy of the complaints procedure. The Have your Say pre inspection questionnaire asked residentsIs there someone you can speak to informally if you are not happy, all ten respondents stated Yes. The survey also asked service users Do you know how to make a complaint, three Care Homes for Older People Page 17 of 29 Evidence: respondents stated Yes and seven respondents stated No. The Nottinghamshire County Council quality audit was completed on 10/09/09 and found that no staff had received training in challenging behaviour which does not ensure that staff will know how to deal with physical or verbal aggression appropriately. The Commission has received one complaint about the service since our last inspection about restricting a persons liberty. This concern was referred for investigation through the safeguarding of adults procedures. We saw that the provider had undertaken a thorough investigation into the concerns and had demonstrated good practice by ensuring that the resident had been referred to a Mental Capacity assessor to ensure that any decisions taken about the person where in his best interest. The complaint was not upheld. Training records indicated that the acting manager has commenced staff training in safeguarding adults, the records indicated that over 50 of the staff have now completed this training and the acting manager said that more dates are planned for the remainder of the staff team to ensure that any allegation or suspicion of abuse is recognised and dealt with appropriately to safeguard residents. We spoke to four residents who told us they felt safe, comments made were, I can look after myself, I do what I like The staff are very kind. Care Homes for Older People Page 18 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is warm, clean and in the process of being improved for the comfort and needs of the people living there. Evidence: Information provided by the acting manager in the Annual Quality Assurance Assessment states We have a maintenance book which all staff can use to identify areas of maintenance needed. Our handy man maintains our garden area. Domestic staff ensure the home is clean and tidy. Service user rooms are decorated and re carpeted when required. Recent training has been performed in relation to infection control. Policies and procedures are in place to ensure service users are safe in a well maintained home. The Have your Say pre inspection questionnaire asked residents Is the home fresh and clean, two respondents stated Always and eight respondents stated usually. We asked 2 residents if they were satisfied with the standard of cleanliness in the home both stated yes. We observed communal areas and bathroom areas, lots of work was in progress, replacing floor coverings with new carpets and laminate flooring. The planned maintenance and renewal of the building was underway as the acting manager Care Homes for Older People Page 19 of 29 Evidence: confirmed within the improvement plan she sent to us and she told us that the required bathroom upgrades are also part of this work. Care Homes for Older People Page 20 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience 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 supported by a trained staff team in sufficient numbers to meet their needs. Evidence: Since our last inspection the staff team have been provided with more training to ensure their practice is up to date. Training has taken place for how to move and handle people safely, first aid, basic food hygiene, safeguarding adults and the Mental Capacity Act. The training records indicated that most staff have either completed these refresher training courses or are booked on them in the near future. We were told that staff only receive 2 paid training days each year which does not meet the National Minimum Standards. We looked at one staff file and confirmed from the documents that a robust recruitment procedure is being followed in practice which ensures that people are not employed before appropriate checks are made to ensure they are suitable to work with vulnerable people. The Nottinghamshire County Council quality audit reported that two staff files for trained nurses had been checked during the audit on 10/09/09 and also found to be Care Homes for Older People Page 21 of 29 Evidence: compliant with the standards required. They found that not all induction records were to a recognised standard that reflected National Common Induction Standards. We looked at the induction records for one person and saw that it set down learning outcomes that ensured new staff knew what they needed to know to undertake their work safely and it also leads to further professional development by preparing them for entry onto the appropriate Health and Social Care National Vocational training course. The staff training matrix indicates that over 50 of the staff team are trained to level 2 National Vocational training which exceeds the minimum standard. The Have your Say pre inspection questionnaire asked residents Are staff available when you need them, nine respondents stated Usually and one respondent stated Always. We asked four residents if staff were available when they needed them and all four said yes. We observed an organised home during our inspection where people were being supported in a timely way and receiving their medicines on time which is improved since our last inspection. Care Homes for Older People Page 22 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The acting manager is working hard to improve the service through consultation with residents and their advocates. Evidence: Information provided by the acting manager in the Annual Quality Assurance Assessment states It has been a difficult time for all staff this year within the home as the home did not have a manager in place for a period of time over the summer. I commenced my management role in July 2009 and I am starting to gain trust and a good rapport with staff, service users and their families. I have prioritised the running of the home in the best interest of the service user. Policies and procedures are in place to ensure good practice and protection of the service user and staff. The manager is not yet registered with the Commission but she told us that her probationary period is now completed and she will apply to register. Care Homes for Older People Page 23 of 29 Evidence: I spoke to two residents about the new manager and both felt she was kind and helpful to them, they knew her name and commented that she was very approachable. The Have your Say pre inspection questionnaire asked staff What do you think the home does well, comments included The staff are very loyal and caring people, we have training and opportunities to go on courses and Carers give 100 to the residents needs. the support we receive for courses including National Vocational Qualifications. The carers work as a team. The acting manager has worked hard improving the service. She has had a meeting with relatives to ask for their views on the service and surveys have been sent out to residents and their families. She told us that she intends to provide people with feedback on their participation to show what changes are being made as a result of their comments on the service. Our last inspection found suitable secure facilities for people who wanted to keep their spending money at the home and records showed that suitable safeguards were in place to protect people from any financial abuse. The residents case tracked on this occasion told us that they had advocates who managed their personal money for them. The records of fire tests and maintenance were checked and found to be suitably maintained. The acting manager told us that they had received a visit from the Fire Officers a week ago and they were said to be happy with the fire protection arrangements in place. We saw a water feature within the enclosed garden area with a small pond. The acting manager has completed a risk assessment for this but more needs to be done in terms of assessing each resident for their safety when unsupervised in this area. Care Homes for Older People Page 24 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 2 5 You must provide an up to date service user guide. To ensure people have the information they need to make an informed choice about moving into the home. 30/12/2009 2 16 22 You must provide all service users with a copy of the complaint procedure. To ensure that people are informed of what to do if they have concerns. 02/11/2009 3 18 13 You must ensure that staff are trained to deal with physical and verbal aggression by service users. To ensure that physical and verbal aggression is dealt with appropriately. 01/01/2010 4 30 18 You must provide a minimum of 3 paid training days each year for the staff. 01/01/2010 Care Homes for Older People Page 26 of 29 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 To ensure that all mandatory refresher training is undertaken to provide staff with suitable skills to undertake their role safely. 5 38 13 You must assess the risk to each person who can access the garden pond. To ensure that unnecessary risks to their health and safety are as far as possible eliminated. 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 30/10/2009 1 3 Confirm in writing to all prospective residents or their advocates that following your assessment the home is able to meet the persons needs. Make sure you record who has been consulted in the preadmission assessment and initial care plan to reflect that they are happy with the content of the plan. Remove out of date records from each care file and ensure that undated documents are removed. Record what has been considered at each care plan review to ensure that all daily changes have been recorded and appropriate actions taken to manage any health risks or changes in condition. Review the information within the complaint procedure for the referring of complaints to the Care Quality Commission. Continue to ensure that all staff complete the arranged refresher training. 2 3 3 4 8 8 5 6 16 30 Care Homes for Older People Page 27 of 29 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 7 8 30 30 Contact Skills for Care and review your induction standards in line with National Common Induction Standards. Access Dementia training for staff. Care Homes for Older People Page 28 of 29 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 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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