Care Home: Brierfield House Care Centre

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What the care home does well By looking at the systems in place we saw the home provides care in a flexible way so that people have choice in their day to day lives. Comments included, " I get up when I want and go to bed when I want, there are few rules", " The staff are always around when you want them, there a good bunch", A relative we spoke with told us " My Auntie is very comfortable here, everyone is kind and she is well cared for, she has been in other homes but she is happier here" We observed staff speaking to and treating people sensitively and with respect, which people we spoke to said they appreciated. We saw the staff members talked freely with people and the communication between staff and people living there was positive. Staff we spoke to demonstrated they had a good understanding of the needs of people living there, including the social and cultural needs of residents so that they are not disadvantaged. Comments included, " I talk to people and treat people as I would expect myself or my own family to be treated", "some residents have been here a while and you really get to know them and their families". What has improved since the last inspection? At the last inspection we were concerned that there was insufficient information in some of the care plans, and that this was affecting the standard of care of certain residents. At this visit we looked at some of these care plans again and found that overall that there had been improvement in the information recorded and that the gaps in information seen last time had been rectified. There had been an improvement in the information on the care plan for people with mental health problems and that there had been ongoing involvement with the mental health team. We looked at a sample of care plans and records to check if medicines were properly reflected in them. We found some good information about how medicines should be safely used and we saw up to date directions about how to use specific medicines either in people`s care plans or kept with the medicines records. The requirements and some recommendations made at the last inspection had been met and the corresponding improvements made. What the care home could do better: At our last visit we noted that staff had received medicines handling training within the last year but formal competency assessments had not been recently carried out, these are recommended to help make sure staff are following the correct procedures and have the necessary skills. We found that staff had been given a competency assessment document but the majority had not completed the assessment and the manager had failed to ensure that the staff were assessed as competent in the administration of medicines. There is an overpowering smell of urine evident on the top floor of the care home and the manager has failed to to the necessary remedial steps to overcome this despite the malodour being brought to her attention on previous occasions. This problem must be addressed in the timescale given. The fabric and decoration of the care home should be assessed and a planned upgrade of the facilities be undertaken with a emphasis on making the accommodation more homely. Key inspection report Care homes for older people Name: Address: Brierfield House Care Centre Hardy Avenue Brierfield Nelson Lancashire BB9 5RN     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: Bernard Tracey     Date: 2 5 0 2 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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: Brierfield House Care Centre Hardy Avenue Brierfield Nelson Lancashire BB9 5RN 01282619313 01282698477 brierfield@ashbourne-homes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ashbourne Homes Ltd Name of registered manager (if applicable) Mrs Ann Suleman Type of registration: Number of places registered: care home 42 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: A maximum of 41 service users who fall into the category of OP (Older People) One named service user who falls into the category of PD. A variation application must be submitted to the CSCI to remove this category when this person no longer resides in the home. The service is registered to provide personal care for a maximum of 42 service users The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Date of last inspection 0 0 1 Over 65 15 26 0 Care Homes for Older People Page 4 of 27 Brief description of the care home Brierfield House is a residential care home registered to provide care and accommodation for 27 older people and 15 older people with dementia. The 27 older people occupy the ground floor and part of the first floor. They have the use of a lounge, a dining area and a conservatory on the ground floor. The residents with dementia related needs reside in a self -contained unit occupying the rest of the first floor. The dementia unit has its own dining area, lounge and separate staircase access to the outside grounds, part of which was adapted for exclusive use of the residents in the unit. A passenger lift provided access between the two floors. The home is purpose built, in its own grounds, on the outskirts of Brierfield. All bedrooms are single and en suite. There were 6 WCs, 3 bathrooms and 2 shower facilities, all with equipment and adaptations to assist people with restricted mobility. Fees were given as GBP448 GBP519:20p per week and cover all aspects of care, accommodation, food and laundry. Hairdressing, chiropody, papers, magazines and some trips are not included in these fees.The home has a Statement of Purpose and Service User Guide that provide residents and relatives with written information about the home, including about staff and the services and facilities. 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 last key inspection on this service was completed on the 15th July. We also undertook a random visit to the service on the 15th October 2009 to follow up the progress the manager was making with the requirements made at the inspection in July. We (the Care Quality Commission) undertook this key inspection, which included an unannounced visit to the home. The staff at the home did not know the visit was going to take place. This visit was just one part of the inspection. We also looked at other information we had about the home. The manager was asked to fill in a questionnaire, called an Annual Quality Assurance Assessment (AQAA), telling us what they thought they did well, what they need to do better and what they have improved upon. Where appropriate, these comments have been included in the report. Other information we Care Homes for Older People Page 6 of 27 had received since our last major inspection at the home was also reviewed. We spent five hours at the home over one day. During this time, we looked at care and medicine records to ensure that health and care needs were met and also studied how information was given to people before they decided to move into the home. A tour of the building was undertaken and time was spent looking at records regarding safety in the home. We spoke to eight people living there as well as the manager and four staff members An Expert by Experience was also used at this inspection. This is a person who, because of their shared vision of using services and ways of communicating, visit a service with us to help us get a picture of what it is like to live in and use a service. The expert stayed with us for part of the day and spoke to the people living here to get their views about what it was like. We have included some of the things residents told the expert in the body of this report. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: At our last visit we noted that staff had received medicines handling training within the last year but formal competency assessments had not been recently carried out, these are recommended to help make sure staff are following the correct procedures and have the necessary skills. We found that staff had been given a competency assessment document but the majority had not completed the assessment and the manager had failed to ensure that the staff were assessed as competent in the administration of medicines. There is an overpowering smell of urine evident on the top floor of the care home and the manager has failed to to the necessary remedial steps to overcome this despite the malodour being brought to her attention on previous occasions. This problem must be Care Homes for Older People Page 8 of 27 addressed in the timescale given. The fabric and decoration of the care home should be assessed and a planned upgrade of the facilities be undertaken with a emphasis on making the accommodation more homely. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed before they are admitted to the home and this gives an assurance to everybody, that a person is only admitted if the home can meet their needs. Evidence: Admissions are not made to the home until a full needs assessment has been undertaken. Care files contain relevant paperwork, including social work assessments and reports from health care professionals prior to a person choosing to stay at the home. The manager also carries out an assessment, which includes a visit to see the person in his or her own home or while in hospital. These measures ensure that admissions to the home only take place if the service is confident staff have the skills and ability and qualifications to meet the assessed needs of the prospective resident. The Statement of Purpose and the Service User guide requires updating to reflect the Care Homes for Older People Page 11 of 27 Evidence: changes in management. Standard 6 does not apply. The home does not provide Intermediate Care. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans and care practices ensure that the residents needs are met in a safe, caring and dignified way. Evidence: Care plans were examined, two of which related to residents who had lived at the home for a relatively short time. Each resident in the home had a detailed, up to date and individual plan of care, covering all personal, health and social care needs. Any areas of risk for the resident were highlighted, along with the planned action to reduce that risk. Care plans demonstrated that residents personal choices and preferences had been taken into account by staff. We spent time talking with care staff who were working in the home, they were able to demonstrate knowledge, skill and a caring manner in carrying out their specific tasks. They were also supported by the District Nurses from the local surgery who support and advice for the residents living in the home. Care Homes for Older People Page 13 of 27 Evidence: All care plans had been regularly reviewed by staff on a monthly basis. Evidence of resident or relative involvement was seen on two of the care plans, one of which had recently been reviewed with relatives. The care plans of the two residents who had moved in recently had been signed or agreed with them or their representative. Care plans clearly recorded GP, District Nurse,and care management involvement. Residents spoken with said these health professionals were contacted when necessary. One resident described the care as extremely goodand other residents spoken with were satisfied with the overall care provided at the home. . Healthcare arrangements were also good. Residents had good access to their local doctors, dentist and optician and some were also under the care of a district nurse. A resident told us that the The carers really look after us Personal care was provided privately in bedrooms or bathrooms, and door locks or engaged signs were used. Residents wore their own clothes and were dressed appropriately for the weather and their activity. A relative spoken with during our visit stated My Auntie is very comfortable here, everyone is kind and she is well cared for, she has been in other homes but she is happier here As part of a random visit in October a pharmacist inspector looked at how medicines were being handled because some shortfalls had been found at the last key inspection. We found good improvements in the recording and general organisation of medicines that helped make sure the records of medicines received, given to people and disposed of were accurate and complete. The progress seen has been maintained. However the recommended competence assessments have not been completed to a satisfactory standard and therefore the provider and the Commission cannot be satisfied that all staff with responsibility for medicine administration are competent in carrying out this role. We looked at a sample of care plans and records to check if medicines were properly reflected in them. We found some good information about how medicines should be safely used and we saw up to date directions about how to use specific medicines either in peoples care plans or kept with the medicines records. People that were taking when required medicines for anxiety usually had good care plans in place and we saw some detailed information about how peoples painkillers and creams should be used. Care Homes for Older People Page 14 of 27 Evidence: Personal care was provided privately in bedrooms or bathrooms, and door locks or engaged signs were used. Residents wore their own clothes and were dressed appropriately for the weather and their activity. A relative spoken with during our visit stated My Auntie is very comfortable here, everyone is kind and she is well cared for, she has been in other homes but she is happier here Care Homes for Older People Page 15 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities and meals provide daily variation and interest for people living in the home. Evidence: We spoke to some of the people living at the home and staff about what the routines are. They told us they are flexible so people can choose how they want to spend their time. This includes no restrictions on what time people get up and go to bed, whether they choose to stay in their rooms or use the communal facilities. We saw people using various parts of the home throughout the inspection. Some people choose to stay in their rooms where they have included TV and audio equipment of their choice as well as furnishings which make it homely. The home has developed an activity programme which includes a variety of themes including entertainment, trips out either as a group or individually, pamper days, manicure, board games etc. People we spoke to said they had enjoyed a trip to the Illuminations, others said they like to go out with staff shopping sometimes. Staff told us they are given the time and the resources to provide activities which they said was usually enjoyed by everyone although they respect peoples rights if they choose not to join in. Care Homes for Older People Page 16 of 27 Evidence: We spoke to people about meals in the home. They told us they enjoyed all the meals and the staff know if they dont like something. We spoke to the cook who was preparing lunch. They told us they use fresh ingredients wherever possible and they are provided with information about peoples individual nutritional needs when they are admitted, so they can identify any specific nutritional need if necessary. The Expert by Experience enjoyed lunch with the residents on the ground floor. She reported, Tables were set properly and the meal served quietly, with the staff being attentive to residents needing help. One young member of staff brought a chair to the side of a lady who was struggling and proceeded to feed her in a pleasant unobtrusive fashion. There was a vegetarian option to Cottage pie followed by sponge pudding. A diabetic at my table was offered banana or a sugar free bun for dessert. Tea was served at the beginning of the meal then fruit juice between courses Care Homes for Older People Page 17 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are handled well and taken seriously ensuring people feel listened to. Staff have access to safeguarding protocols to protect people. Evidence: We looked at the homes complaints procedure. It is made available to people using the service so they know how to raise any concerns or complaints. Surveys we received told us people know how to make a complaint. People we spoke to said, if I am not happy about something I tell the staff and it usually gets sorted out. We spoke to the manager about how people are protected and they showed us records of staff training in this area. Staff we spoke to said they have received training in protecting people and this is also used as part of the staff induction programme so the manager is satisfied all staff have the information they need to act on any suspicion of abuse. There have been no safeguarding referrals since the previous inspection. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The systems in place do not ensure that residents live in an environment kept free from offensive odours Evidence: The home is generally well furnished and decorated although some areas remain in need of decoration and replacement carpets: the manager told us this is part of the refurbishment programme and it is improving all the time. People we spoke to told us, I like my room its cosy and I have what I want in it, I like to use my room as I please, its got everything I need. There are two communal lounges with one incorporating the dining area. We saw there are suitable walking aids and adaptations including wheelchairs and hoists so that people with limited mobility are assisted. Our Expert by Experience reported There is a lack of stimulating items throughout the home, for instance pictures on the walls are mainly of big single flowers, not thought provoking landscapes or portraits. No photographs of past activities e.g. parties or outings. Only three magazines in a rack, there are many more than this in most Doctors surgeries, no daily paper, staff said that residents can order their own if they wish. Just two books out on a small table. 100 Best Loved Poems and The World of Defoe. There were others in a small low book case up a corner, not easily Care Homes for Older People Page 19 of 27 Evidence: accessible. I think any brightly coloured books of maybe flowers, birds or animals would interest the residents whose eye sight is probably poor. Large print books may also be appreciated. No evidence of past Arts and Crafts is displayed for residents to be proud of. There was one very simple wooden jigsaw with 4 pieces to put into slots. Flowers on the dining tables were pretty but artificial. I saw only two plants on the Dementia unit, one small leafy plant and a sad stringy cactus. No spring flowers, so there had been no bulb planting in the Autumn and no one had thought to bring in a bunch of daffodils even though they were expecting important visitors. There is a rear garden area which is private and not overlooked. People we spoke to said they like to use the garden in good weather. There was a very strong smell of urine on the first floor accommodation. This has been previously reported by us and was also observed in the Companys own report in January of this year. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The procedures for recruiting staff are good, ensuring the safety and protection of people. People are supported by well trained and effective staff so their needs can be met. Evidence: We spoke to the manager about how staff are deployed for the benefit of people using the service. We looked at the staffing rota which showed there are sufficient numbers of staff on duty at any one time so the needs of people living there can be met. In addition the manager takes care to ensure the skills of the staff team are mixed in order to provide consistent levels of support and for the staff team to develop further. Staff we spoke said they thought the manager supported them well, and listened to them. Comments included, We work really well together as a team, we bounce ideas of each other, and I think our ideas are listened to. We looked at the homes training records and found there is a full range of training for staff, including mandatory training in moving and handling, first aid, health and safety and safeguarding people. In addition all staff either have a national care qualification or are currently undertaking training in a qualification. Staff spoken to said they are encouraged to attend training for their personal development. We looked at three staff files. They showed us staff are recruited safely using Care Homes for Older People Page 21 of 27 Evidence: procedures which take into account, qualifications and experience, their suitability for the role, references, Protection of Vulnerable Adults (POVA), Criminal Record Bureau (CRB), in order to make sure people are protected. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of the home does not ensure that the safety and protection of people living there is maintained. Evidence: We saw the home has undergone a review of the systems it has in place since the previous inspection to ensure it meets with the requirements of the Care Homes Regulations 2001. However the manager has not fully accomplished the competency assessments of staff in relation to the administration of medication. We reported our concerns at our last visit and expressed the need to ensure that staff giving medicines were competent so that service users were not put at risk. We saw the manager has developed a thorough supervision programme for the staff team. The records we looked at showed the staff are supervised regularly and their personal and professional development is identified and this is monitored and followed through so that there is evidence of the support they are receiving. Comments included, supervision is taken seriously and we talk about how I can develop in my Care Homes for Older People Page 23 of 27 Evidence: job, we are really encourage to go further and take courses whenever they come up. The manager has put in systems which help staff to contribute to the recording of care needs in records which are easy to follow. In addition the manager has implemented risk assessments to meet the requirements of the Mental Capacity Act 2005, whereby a Deprivation of Liberty Safeguarding (DOLS), is carried out for people living there. If it is identified a person is being deprived of their liberty in order to meet their care needs and in their best interests a referral is made to Social Services for this to be recorded, monitored and reviewed. The manager has undertaken training in this area so that they are suitably qualified to carry out this assessment. We looked at how the home gains the views of people using the service and found there are records of staff and resident meetings so that people have the opportunity to contribute to the development of the service. People are also given questionnaires about how the home is run and to offer any comments they may choose for the development of the service. We saw there is a clear line of management responsibility and staff communicated well with the manager. By looking at records we saw regular tests and servicing of essential equipment including lifting equipment, gas and fire were up to date. The manager has not ensured that the environment is essentially odour free and hygienic and examination of previous reports, including the companys own quality report, indicate that the odour problem has been evident for a long while. It is the managers responsibility to ensure that the environment remains odour free and that timely interventions are in place to ensure that any remedial action is taken to eliminate these odours. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 26 12 The premises must be kept free from offensive odours. Residents can live in a hygienic and odour free environment 30/04/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 1 The Statement of Purpose and the Service User Guide needs updating to reflect the changes that have been made. This is to ensure that people who use the service have accurate and up to date information. All staff should have regular formal competency assessments in handling medicines to help make sure they have the necessary skills 2 9 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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