Care Home: Bendigo Nursing Home

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What the care home does well The atmosphere in the home was comfortable, homely and relaxed and staff were seen to be kind and caring towards people living in the home. Residents spoken with said that staff are very good and they liked the meals. There is a wide range of meals offered at each mealtime and special diets are catered for. People moving into the home are able to bring in their personal possessions to personalise their bedrooms and the home has a well maintained and accessible garden to the rear of the property, which is secure and secluded. There is an open-house policy, which welcomes visitors at all reasonable times and complaints are handled well ensuring that residents feel listen to and their views acted upon. The decor in bedrooms and communal areas is good and they are well maintained. Comments from relatives surveys included: `everyone is very helpful and friendly`; `a very friendly atmosphere`. What has improved since the last inspection? Two requirements were made as a result of the last Key Inspection The requirement in respect of activities has been met and a copy of the programme was supplied to the Commission. There is a good programme of activities available to residents. Key information and documents are made available to residents and relatives were reviewed and updated in February 2009 to ensure they are accurate and up to date. The introduction of a pictorial menu has made it easier for residents to choose their preferred meal. What the care home could do better: Shortfalls were identified in respect of care planning, risk assessments and the recording of medication. Residents autonomy would be improved if they were given the opportunity to self medicate and offered keys to their bedroom doors. Communal bathrooms and toilets need to be sufficiently maintained to reduce the risk of cross infection and staff recruitment needs to be more robust to ensure residents are not at risk. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Bendigo Nursing Home 22 Arundel Road Eastbourne East Sussex BN21 2EL     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: Gwyneth Bryant     Date: 2 9 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 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 27 Information about the care home Name of care home: Address: Bendigo Nursing Home 22 Arundel Road Eastbourne East Sussex BN21 2EL 01323642599 01323431080 mariana.philipova@kindcare.co.uk 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) : Kindcare (UK) Ltd care home 25 Number of places (if applicable): Under 65 Over 65 25 0 old age, not falling within any other category physical disability Additional conditions: 0 25 The maximum number of service users to be accommodated is 25 The registered person may provide the following category of service: Care home with nursing (N) to service users of th following gender: Either whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (OP) Physical disability (PD) Date of last inspection Brief description of the care home Bendigo Nursing Home is registered to provide nursing care for up to 25 people whose primary needs are nursing care. Situated in a residential area of Eastbourne it is approximately 20 minutes walk from the town centre with its variety of shops and public transport facilities, with a library, GP surgeries and dental practices accessible. The home is a converted detached property, the kitchen, the staff room and storage facilities are in the basement with a further three floors containing a lounge, residents individual bedrooms, 19 single rooms and three double rooms, assisted bathrooms and toilets. There is a small passenger lift, which has been recently improved and can now be used by wheelchair users and staff. There is a large garden to the rear with an Care Homes for Older People Page 4 of 27 Brief description of the care home access slope at the side of the home for wheelchairs and is used when weather permits. Fees charged as from 1 April 2009 range from £532.80 to £1,000, which includes basic toiletries. Additional charges are made for hairdressing, chiropody, newspapers and outside activities such as visits to the theatre. Intermediate care is not provided Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report those living at Bendigo care home will be referred to as residents. This was an unannounced inspection and took place over seven hours. The purpose of the inspection was to check compliance with key standards and other standards. There were twenty-three people in residence on the day of which one was in hospital. Three residents were spoken individually and an additional four as a group. In addition all aspects of the service were discussed with the Registered Manager and a brief discussion also took place with a Registered nurse. The last key inspection was carried Care Homes for Older People Page 6 of 27 out on 19 June 2007 and an Annual Service Review carried out on 19 June 2008. A number of documents and records were viewed; including personnel files, medication charts and care plans and a tour of the premises was also carried out. Prior to the site visit we asked the Registered Providers to complete an Annual Quality Assurance Assessment (AQAA). The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. This was completed well and provided when we asked for it and the information included in this report as necessary. In light of a detailed response from the Registered Provider a second site visit was carried out by a Local Area Manager on 5 August 2009 which started at 10.45am and ended at 2pm. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Further improvements could be made to the pre-admission process to provide more detailed documentary evidence that The Bendigo can meet the needs of people admitted to the home. Evidence: Four pre admission assessment records were viewed and were a tick box system with some additional comments as to what action staff need to take to meet needs. The lack of detail in the pre admission assessment was identified at the last inspection in 2007. The assessment for the person admitted the day prior to the site visit was brief and did not include direction to staff in meeting needs and was not in line with the Nursing and Midwifery Council guidance. As a care plan had yet to be compiled there was no point of reference for staff in meeting assessed needs. It is important for the home to demonstrate what action it will take to meet assessed needs at the point of admission. The Registered Provider sends a letter to the resident and their relatives to Care Homes for Older People Page 10 of 27 Evidence: confirm the home can meet their needs. The Statement of Purpose and brochure have been reviewed and updated to ensure they are up to date. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care planning systems need to reflect the current needs of people living in the home and improvements need to be made to the risk assessments process and to the recording and administration of medication. Evidence: Four care plans were viewed in detail in conjunction with other documents such as medication administration charts, daily notes and discussion with the Manager and staff. While the care plan format is good, not all parts of the plans had been completed and in parts information was inconsistent with the assessment/dependency scores. Dependency levels and risk assessments are a scoring system but not all plans included information as to the action staff need to take to reduce risks and meet needs. Reviews tended to be just a date and a signature which does not inform the reader whether or not all parts of the plan had been reviewed especially as other documents such as medication charts, indicated that needs had changed. In general healthcare needs were met but these needs had not been consistently identified in the care plans and reviews. There was evidence that two people had eyesight tests and Care Homes for Older People Page 12 of 27 Evidence: that chiropody services had been provided but the information was in documents other than the care plans. It is good practice to ensure that all information relating to a resident be held in the care plan to facilitate the review process and provide a clear audit trail in meeting assessed needs. The lack of additional information in respect of residents social profiles and risk assessments was identified at the inspection carried out in 2007. Some aspects of the care planning were quite confusing and it was difficult to locate some key information. There was also some duplication. For example, one residents care plan indicated that they had recently lost weight and that build up was required. The evidence that staff had been providing this was initially located in the food and fluid chart in the persons bedroom. However, this showed that none had been offered or taken in a five day period. The deputy manager explained that this would be recorded on the medication records, which showed that the build up had been offered and taken regularly. Therefore the food and fluid chart in the bedroom was not an accurate record. The care plan also stated under dexterity offer light exercise. There was no evidence that this was encouraged and so no evidence to say it had been actioned. On the positive side, the care plan did state as an action, to find out whether the resident had any hobbies and interests and another section of the care plan identified that the person liked dominoes. There was evidence that the resident was encouraged to play dominoes with staff regularly. Daily notes were variable with some providing good information as to how the individual spent their day, while others were limited with comments such as had a good day or slept well. In addition daily notes often included information recorded elsewhere such as where notes state medication given. Risk assessments were also based on a scoring and dependency rating but these did not consistently include clear direction to staff in meeting needs and reducing the risks. Discussion with the Registered Manager found that she believed that staff would know how to meet care needs. While this may be true for registered nurses, care staff may not have the same knowledge and training so would need direction. to The daily notes for one person stated that they had consistently refused to take prescribed antibiotics and while this information matched that in the medication records, there was no information to demonstrate the effect of refusing this medication nor what action staff were taking to remedy the situation. Daily notes are a good tool to demonstrate that the home is meeting assessed needs and when well completed reflect staff input and facilitate the review process. Some parts of the plans were inconsistent. For example, one person was assessed as low nutritional risk but later in the plan it stated that they needed to be encouraged to eat. A number of people are on PRN (as required) medication and it is good practice to include any triggers for such medication in care plans, in particular for those residents who cannot easily communicate. Reviews of the plans tended to be just a signature and date rather than the plan reflecting current care needs. For example, one person was prescribed four different medications and although the plan had been signed as reviewed the medication Care Homes for Older People Page 13 of 27 Evidence: administration chart showed this person was now prescribed seven medications. There was no information in the plan to show why they needed this additional medication. Subsequent to the site visit the Registered Manager stated that the explanation for medication changes would be in section marked doctors visits and not on the Medication records. Medication administration charts were viewed and there were a number of shortfalls, with signatures being overwritten or scribbled out and some gaps. Therefore it was not clear whether or not medication was given and where signatures were overwritten with a code letter it indicates that staff are signing the charts prior to administration. Registered Nurses have a professional obligation to ensure medication is handled, recorded and administered in line with their professional guidance and be monitored by the Registered Manager. The home has a controlled drugs cabinet that meets the latest legislation and the controlled drugs register was clear, accurate and up to date. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People in the home have the opportunity to experience a lifestyle that matches their expectations, choice and preferences in respect of leisure activities and meals. Evidence: There is a range of activities provided for both the mornings and afternoons but the programme also sets out times for meals, snacks and naps which suggests a level of inflexibility. Subsequent to the site visit, the manager explained that times in the programme are written just as a guide. On the day it was sunny and five residents chose to have an activity in the garden rather than the planned bingo session which demonstrates the programme is flexible. Discussion took place with these individuals and all were happy in the home and it was evident that they had a good relationship with the carer who was providing the activity. The activity sheets in care plans had not been consistently completed so it was difficult to evaluate how many residents regularly joined in group activities and this needs to be rectified. There is an open house policy for visitors and comments in the feedback provided by the home indicated that relatives are always made welcome. The Registered Manager confirmed that 4-5 of the male residents regularly visit the local pub and two ladies had visited tea rooms but had not done so in the last three Care Homes for Older People Page 15 of 27 Evidence: months. Some residents have also been taken on visits to local tea rooms as part of the activity programme. In addition to the activities, visitors from local churches come to talk to residents and to provide church services on a regular basis. Those people who were able to communicate said they enjoyed the activities and meals. Care plans did not include food and fluid intake charts but the Registered Manager explained these were in the individuals bedrooms. These were viewed and found to have good details of food and fluid intake. There is a wide range of menu options, including a cooked breakfast and information in one care plan confirmed this is provided for the individual. The menu is pictorial so it is easy for all residents to make a preferred choice. Where required residents have been refereed to a dietician and the Registered Manager confirmed that the chef is given details of those people who need high calorie foods and adds cream and butter as required. There was a bowl of fruit in the lounge and food charts indicated that people are given fruit with cream if necessary. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a complaints procedure with evidence that those living in the home feel that their views are listened to and acted upon but service users are not protected because not all staff are trained in identifying and reporting safeguarding concerns. Evidence: The AQAA demonstrated that the home has policies and procedures on both complaints and safeguarding adults. The complaints log was viewed and showed that only one complaint had been received in the home since the last inspection. The one complaint was recorded, found to be unsubstantiated and included actions taken and outcomes. On the day the staff training matrix showed that of the 15 care staff only seven had received training in Safeguarding Adults and this needs to be addressed. It is important to ensure all staff have a good understanding of what constitutes abuse and how to report any concerns in line with the latest legislation. Following the site visit the Registered Provider told us that 9 staff have now been trained in Safeguarding Adults. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Most parts of the home are maintained providing a homely and comfortable environment for people living in the home; improvements need to be made in respect of on-going maintenance of toilets and bathrooms cleanliness to ensure all areas of the home are pleasing and safe Evidence: A tour of the premises was carried out and a random selection of rooms inspected and it was evident that individual bedrooms and communal areas have been well maintained. Bedrooms were light and airy and were nicely decorated and furnished with good quality furniture and furnishings. Residents are encouraged to bring in personal possessions to personalise their rooms and many have done so with photographs and ornaments. The absence of offensive odours indicates that incontinence is well managed and that there is a good cleaning programme for bedrooms. Although communal areas and bedrooms were in very good order, communal bathrooms and toilets were not so well maintained. There is a lack of storage space for equipment such as hoists, wheelchairs and zimmer frames and the communal bathrooms are used for this purpose. The impact of using bathroom as storage space is that it impinges on staff caring time as they need to move the equipment before the baths can be used. The home was assessed by an Occupational Therapist in March 2009 to ensure the home has the appropriate aids and adaptations. Care Homes for Older People Page 18 of 27 Evidence: As a result of this consultation, the home has purchased a television loop system, which has been installed in the communal area. Residents should be offered a key to their bedroom and the choice recorded in their care plans to demonstrate the home has offered this option. There were a number of shortfalls that pose a risk of cross infection such as no lids on waste bins, clinical waste bags left unsealed, bare wood exposed on floors/window sills and tiles missing. These need to be addressed to reduce the risk of cross infection for staff, visitors and residents. Generally communal bathrooms and toilets needed a thorough clean and maintenance or refurbishment to ensure these areas are as good as the lounges and bedrooms. The shortfalls in the communal toilets and bathrooms was identified at the inspection carried out in 2007 and that they are used as for storing equipment. Following the site visit the registered manager confirmed that all shortfalls identified during the inspection had been addressed including the provision of pedal bins for clinical waste and locks fitted to sluice room doors. In addition communal bathrooms and toilets have been repainted. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient staff with the skills and competency to meet the needs of people living in the home but recruitment practises need to be more robust to ensure that people using the service are protected. Evidence: The Registered Manager confirmed that there is one Registered nurse on duty for each shift in addition to four care staff during the mornings, three in the afternoons and one at night. Staff were working unhurriedly and were seen to have time to chat to residents which indicates that there is sufficient staff on duty to meet needs. Of the eleven care staff one has achieved National Vocational Qualification in care at level 2 and a further seven are working towards this qualification, therefore the home is on target to exceed the minimum of 50 of care staff with this qualification. The Registered nurse spoken with had a good understanding of residents needs and how to meet them. She was confident that the Manager listens to her and provides additional training when requested. Staff induction is basic and consists of a tick box system that does not allow an evaluation of staff understanding of the homes policies and procedures and of the needs of people living in the home. In addition some had been signed off as being carried out in one day. Although all care staff are provided with a staff handbook it is important to give them time to become familiar with the homes routines and expected Care Homes for Older People Page 20 of 27 Evidence: practices. Recruitment records for the last three staff to be employed were viewed and it was found that two had started work prior to a POVA first check being received. This practice puts people living in the Bendigo at risk and needs to be addressed. All three staff had completed an application form and two references prior to employment. The staff training matrix provided on the day showed that the three staff who write the care plans have received training in care planning. The service has a good staff training programme which includes training in areas such as moving and handling, safeguarding adults, infection control, nutrition, first aid, dementia care and dealing with challenging behaviour. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements need to be made to all aspects of management to ensure all aspects of the welfare, safety and health of people living in the home are protected and promoted. Evidence: The Registered Manager has the a relevant care and management qualification and has the experience and knowledge to effectively manage the home. She was able to outline plans for the purchase of new televisions, bed bathing facilities and a new call bell system. The Registered nurse spoken with confirmed that she is comfortable with the Manager and feels supported by her. There is a quality monitoring system in place which includes residents questionnaires. The Registered Manager provided copies of these and it was evident that people living in home are happy with the care they receive and this was echoed in the comments from relatives of residents. Comments from relatives surveys included: It is always pleasant smelling; the staff are always friendly and courteous; I feel confident that Care Homes for Older People Page 22 of 27 Evidence: my aunt receives good care and consideration; the care given to (name) is excellent; just wanted to say a big Thank you for the care you gave to (name) when she was with you. The shortfalls identified during the site visit indicate that the Registered Manager needs to carry out more robust auditing especially ensuring all recruitment processes are completed prior to staff working in the home to ensure residents are not at risk. The home does not handle any residents monies, all additional items are added to the monthly invoice and receipts provided as required. During the tour of the premises it was found that cleaning fluids and air fresheners were accessible in bathrooms, toilets and unlocked sluice rooms and this is not in line with the legislation in respect of the storage of hazardous substances. All chemicals and cleaning fluids need to be locked away as outlined in the homes policies and procedures to reduce the risk of accidental ingestion/spillage and reduce the risk of harm to residents. Information in the AQAA indicated that all safety checks on electrical and gas appliances and systems is regularly serviced in addition to all policies and procedures being reviewed annually. Accident records were viewed and found to be maintained in line with the legislation and the Registered Manager said she also collates these records as part of the annual audit to identify if any particular resident is at risk. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 That all service users have a 29/07/2009 plan of care that accurately reflects current care needs and are regularly reviewed. To ensure all staff are directed in meeting care needs. 2 9 13 That medication records are clear, accurate and up to date. To ensure it is clear whether or not medication has been administered and by whom. 29/06/2009 3 18 13 That all staff be trained in safeguarding adults. To ensure they are on what action to take in the event of an allegation. 29/07/2009 4 19 23 That an action plan be submitted in respect of providing adequate storage facilities for equipment. 20/08/2009 Care Homes for Older People Page 25 of 27 To ensure communal bathrooms are easily accessible at all times. 5 19 23 That an action plan, with timescales, is submitted for the refurbishment of communal bathrooms and toilets. To ensure all parts of the home are pleasing and safe. 6 24 12 That service users are offered a key to their bedroom. To enable service users to maintain privacy. 7 26 13 That good practice is maintained in respect of ensuring all wastebins have lids including clinical waste bags. To reduce the risk of cross infection. 8 38 13 That all cleaning products and chemicals are stored safely in a locked area when not in use. To reduce the risk of accidental ingestion and the risk of harm to service users. 29/06/2009 29/06/2009 29/09/2009 29/09/2009 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 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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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