Care Home: Bronte Park

What the care home does well The staff are approachable, have a caring attitude and try hard to create a homely atmosphere. There is an ongoing programme of refurbishment and renewal which will make sure people have a safe and comfortable place to live. What has improved since the last inspection? Improvements have been made to the care plans in place and they now provide staff with sufficient information about how people`s personal and health care needs will be met. However, more information about people`s social care needs should be included. What the care home could do better: The admission procedure should be more thorough so that people can be confident that once admitted to the home the staff have the skills and experience necessary to meet their needs. When people are identified as being nutritionally at risk more attention should be given to making sure their weight is recorded at the specified intervals, to monitoring their dietary intake and to making sure that they get the support they need to eat and drink. More attention should also be given to meal service to make sure people are given appropriate support and to make sure that people are able to enjoy their food at the correct temperature. Nursing staff must make sure that policies and procedures are followed at all times when managing medication, so that people living at the home can be confident that their medication is being stored, administered, and disposed of appropriately. People living in the home must be given the opportunity to take part in variety of social and leisure activities that take account of their individual preferences and abilities. This will make sure that people`s individual social, cultural and spiritual needs are met. Staff recruitment and selection procedures must be followed at all times so that people can be confident that their care is provided by staff suitable to work in the caring profession. The domestic hours must be increased to make sure there are sufficient domestic assistants employed to keep the home clean, tidy and free from offensive odours. All the communal bathrooms should be available for use and more attention should be given to maintaining hot water temperatures within the recommended safe limits. Key inspection report Care homes for older people Name: Address: Bronte Park Bridgehouse Lane Haworth Keighley West Yorkshire BD22 8QE     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: Stephen Marsh     Date: 0 4 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: Bronte Park Bridgehouse Lane Haworth Keighley West Yorkshire BD22 8QE 01535643268 01535647468 theheathersbrad@fsmail.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Bronte Regency Healthcare Ltd Name of registered manager (if applicable) Mr Glenn Jones Type of registration: Number of places registered: care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users who can be accommodated is: 28 The registered person may provide the following category of service only: Care home with nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Dementia Code DE Date of last inspection Brief description of the care home Bronte Park is a detached, converted property situated in the village of Haworth and is registered to provide nursing care for older people with dementia. The home is close to local amenities and public transport routes, although there is a long driveway leading up to the home. There is parking to the front of the property. The rear gardens are accessible to the people who live at the home and steps have been taken to make this a secure area. A side entrance provides disabled access into the property. The main Care Homes for Older People Page 4 of 27 Over 65 0 28 2 3 1 0 2 0 0 9 Brief description of the care home house is a listed building with an extension to the rear of the property. The accommodation is on two floors, with access between floors via a new shaft lift. Some of the bedrooms have en suite facilities. There is a lounge and separate dining room on the ground floor as well as a separate smoking room. There are three bathrooms, one shower room and seven toilets in the home. 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 quality rating for this service is one star. This means people that use the service experience adequate quality outcomes. The last key inspection for the service was carried out on the 18 June 2009 and no requirements were made at that time. However, as a result of concerns raised by other healthcare professionals about the standard of care being provided at the home we carried out a random inspection of the service on the 25 October 2009. Four requirements were made at that time relating to care planning, care records, the skill mix within the qualified nursing staff team and the number of domestic hours provided to keep the home clean and free from offensive odours. The purpose of the visit was to assess what progress had been made in meeting the requirements and the impact of any changes in the quality of life experienced by people living at the home.The methods we used during the inspection included looking Care Homes for Older People Page 6 of 27 at records, observing staff at work, talking to people living at the home and visitors, talking to the providers , operations manager and staff and looking around the property. During the course of the visit we were informed by the providers that the home is in the process changing the registration from a nursing home to residential home. As part of this process consultation will take place with people living at the home and/or their relatives to make sure they are suitably placed and their needs can be met in line with their agreed care plan. We have recently improved our practice when making requirements to improve national consistency. Some requirements from previous inspections may have been deleted or carried forward as recommendations, but only when it is considered that people that use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Feedback was given to the registered providers and operations manager at the end of the visit. The current fees for the service range from GBP428:00 to GBP505:00 per week. Additional charges are made for some service such as hairdressing and private chiropody. A full list can be obtained by contacting the home direct. 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: 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. Care Homes for Older People Page 8 of 27 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. The home is at times admitting people without carrying out a thorough pre-admission assessment and therefore it is difficult for them to evidence that staff have the skills and experience to meet their needs. Evidence: The home has produced a service user guide which provides people with the information they need to be able to decide if the home can meet their needs. At the current time the information is only available in English but the operations manager confirmed that it would be made available in different languages and formats on request. The operations manager is aware that as the home is changing the category of people it is registered to care for the service user guide will need amending to reflect this change in circumstances. The operations manager confirmed that the needs of all people considering moving into the home are assessed before admission and they are visited either in their own Care Homes for Older People Page 11 of 27 Evidence: home or temporary place of residence. We looked at the pre-admission assessment report available for one person recently admitted to the home. Although the manager had visited the person in hospital the staff had difficulty finding the assessment as it had not been put on their file. When eventually found the assessment information recorded was very basic . This matter was discussed with the operations manager who confirmed that in future the preadmission assessments reports would be more detailed so that the home can clearly evidence that they can meet peoples needs. The operations manager confirmed that people are invited to visit the home before admission to see at first hand the facilities provided, meet the staff and other people living there and stay for a meal if they wish to do so. People are also able to move in to the home on a trial period if they are still undecided. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care and support is not always provided in a way that respects peoples right to privacy and dignity. Care records do not always provide up to date information, which means that some people might not receive the level of support and care they require to meet their health, personal and social care needs Evidence: We looked at three peoples care plans. Overall, the care plans are satisfactory and have information about how peoples personal and health care needs will be met. However, there was very little information about peoples social care needs. There are risk assessments in place to identify when people are at risk for example of developing pressure sores, of falling or of malnutrition. For the most part the care plans are reviewed every month. However more attention should be given to making sure that reviews are done properly. For example, one Care Homes for Older People Page 13 of 27 Evidence: person had a care plan for eating and drinking which stated they should have their weight recorded every month. The review of the care plan which was done in January 2010 did not identify that that persons weight had not been recorded since November 2009 despite the fact that the person is identified as being nutritionally at risk. The care plans for two people who are identified as being nutritionally at risk said they should be encouraged by staff at meal times to eat their meals. Our observations at lunch time showed this was not happening. There were no food charts in place for these people therefore there was no effective way of monitoring what they were eating and when. This was discussed. There is a communal toilet and wash room on the ground floor near the dining room. Staff use the wash room area to help people with their personal care needs. During the visit the lock on the wash room was broken and we saw people walking into the wash room while people were being helped with their personal care. This does not respect peoples privacy and dignity and was discussed during the visit. The owners said the lock would be repaired immediately, however this should have been identified and dealt with by the home. Following the inspection report we received written confirmation from the operations manager that this room would no longer be used to provide personal care. We reviewed the medication system in place and found a number of discrepancies on the Medication Administration Record (MAR) sheets whereby the qualified nursing staff had either failed to sign the sheet when medication had been given, or had signed the sheet when medication was actually still in the blister pack. We also found three entries in the controlled drugs register which were unclear but indicated that some medication was still being held by the home even though the nurse in charge felt that it had been disposed of some time ago. In an attempt to clarify the matter a second nurse recently made responsible for the medication system was contacted at home. However, although she confirmed that she had disposed of some controlled drugs the day before the inspection she had failed to record this in the register. This is unsafe practice and therefore we asked the operations manager to carry out an internal investigation into the concerns raised and to let us know the outcome. Following the inspection we received a copy of the investigation report, which showed that a thorough investigation had been carried out and although there had been failures in the system the medication had been disposed of appropriately. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are some activities for people to take part in but a more person centred approach to social care is needed to make sure everyone living in the home gets the support they need to make the most of their abilities and follow their personal interests. Evidence: The home does not have an activities organiser. Care staff are responsible for meeting peoples social care needs. In addition to providing direct care they now have to do the laundry and therefore have less time to spend with people supporting them in group or individual activities. There was very little personal information about people in the care records we looked at. Without information about peoples past lives, interests and hobbies it is difficult to see how staff can provide person centred social care. There were no social care plans in the records we looked at. During the visit we observed the meal service at lunch time. Staff helped people to the dining room where the meal service started at 11.50 am. The food was brought from the kitchen to the dining room on a trolley, but this was not a hot trolley therefore the Care Homes for Older People Page 15 of 27 Evidence: food was not being kept warm during the meal service. Staff put plastic aprons on some people before they started to serve lunch, they did not ask people if they wanted an apron and did not speak to people while putting the aprons on. There was no choice of main course, one person was given sandwiches when they said they didnt want the meal. The meal shown on the orientation board in the dining room was not the meal served. When asked staff said the meal shown on the orientation board was yesterdays lunch. The tables were set with table cloths and cutlery before people sat down. There were no condiments on the table but they were provided when someone asked. The food was plated by staff and handed out to people, staff did not speak to people when serving the food. Staff made no attempt to encourage or help people to eat even when they seemed to be having difficulty. One person was trying to drink from a beaker but was holding it the wrong way around so that the spout where the fluid comes out was away from her mouth. Two care staff approached the table on two different occasions but neither noticed this and offered to help. Staff left the dining on several occasions leaving people without any supervision. Overall the mealtime was not well organised and there was no system in place to monitor peoples dietary intake. 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. There are suitable systems in place to make sure that complaints are dealt with appropriately and people are protected from any form of abuse Evidence: There is a clear complaints procedure in place and people spoken with said that they would have no problem at all in approaching staff if they had any concerns about the standard of care being provided. Adult protection (safeguarding) policies and procedures are in place and the area manager told us that all staff have received training in the recognition and reporting of allegations of abuse. The operations manager also confirmed that the home operates a zero tolerance approach when dealing with complaints and safeguarding issues. We have received one anonymous complaint about the home since the random inspection visit in October 2009, which we have referred to the Bradford Social Services Safeguarding Team. Staff said they are aware of the homes policy on whistle blowing and knew what to do if they suspected that people were being abused or working practices at the home were not in the best interest of the people living there. 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. The home is comfortable but more attention needs to be given to making sure is it well maintained and suitably equipped to meet peoples needs. Evidence: Overall the home was clean and free of unpleasant odours. There were slight odours in two bedrooms, the home told us they are dealing with this. The communal rooms are on the ground floor, the home also has a designated smoking room. The smell of tobacco smoke does not permeate to other parts of the home but the room itself is not well ventilated, it was warm and smoky. The floor in the smoking room is in need of attention, the paint is badly scuffed. The home only had one communal bathroom in use when we visited, this is located on the ground floor. The bathroom on the first floor is not available for use because the bath seat is broken. The owners told us they are looking at the possibility of creating a wet room shower on the ground floor. The temperature of the hot water in the bathroom that is in use was 47 degrees C, the recommended temperature is 43 degrees C plus or minus 2 degrees. This is to reduce the risk of scalding. This was discussed with the owner and he said he would deal with it immediately. Peoples bedrooms are suitably equipped and some people have lots of personal Care Homes for Older People Page 18 of 27 Evidence: belongings in their rooms. The home is in the process of replacing all the beds, eight new profiling beds have been provided. When we looked around we saw that some of the bedding and towels were looking the worse for wear and needed to be replaced. The owners told us new bedding and towels had been purchased, they said they would make sure the old stock was taken out of use. The laundry is located in the basement. There are two washing machines but only one was working when we visited. This is a domestic washing machine and does not have a sluice cycle which means that staff have to manually sluice soiled clothing before it can be washed. The washing machine which was out of order is a commercial machine with a sluice cycle, however, staff told us it had been out of order for several months. One of the two tumble dryers was also out of order. This was discussed. 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. Staff recruitment and selection policies and procedures are not always being followed and therefore there is a chance that the home might employ people that are not suitable to work in the caring profession. Evidence: The home has a thorough staff recruitment and selection procedure, which includes obtaining at least two written references and a Criminal Record Bureau (CRB) before new staff start work unsupervised. However, we looked at the employment files for four recently appointed staff and found in some instances the procedure had not been as thorough as it should have been. For example in one instance no references or CRB could be found for a qualified nurse working as bank staff even though the operations manager confirmed that she had worked for the company for some time. We advised that this nurse should not be offered any more work at the home until all recruitment checks had been carried out and the recruitment file put in order. In a second instance a recently appointed qualified nurse had been employed without management having received a satisfactory CRB. The operations manager contacted this member of staff at home and was informed by her that she had received her copy of the CRB on the 6 January 2010. However, it was obvious that management was unaware of this and had allowed her to work unsupervised regardless of the fact that they had not received a Care Homes for Older People Page 20 of 27 Evidence: satisfactory CRB check. The home has increased the domestic staff hours since our last visit in October 2009. They have domestic staff on duty everyday during the week and on alternate weekends. However, to achieve this they have reduced the hours in the laundry. The laundry assistant has been moved to domestic duties. This means care staff are now responsible for doing the laundry. It wasnt clear who is now responsible for doing the ironing. Some staff said the laundry assistant does 45 minutes ironing when she is working, others said the night staff do it. This is not an appropriate long term solution and was discussed during the visit. All new staff receive induction training in line with the Skills for Care Common Induction Standards. These are nationally agreed induction standards designed to help new staff get the skills and knowledge they need to care for people. Following induction there is an expectation that staff will study for a National Vocational Qualification (NVQ) at level two or three above depending on the post they hold. Staff training records are held in their individual personnel files. We have therefore asked the operations manager to provide us with a training matrix and a training programme for 2010 so that we can clearly see the training and development opportunities made available to staff both on an individual and team basis. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered providers are commited to improving the lines of communication and accountability both within the home and external management, which should make sure the home is run effectively and in the best interest of people living there. Evidence: The manager left the home on the 23 December 2009 and at the current time the operations manager is providing management cover, supported by the manager from another home owned by the same provider. The providers have also enlisted the assistance of an external consultant who will initially look at all the policies and procedures in place and support the operations manager in moving the service forward. During the course of the visit we had lengthy discussions with the registered provider regarding their future plans for the service and found that they had a positive attitude to the inspection process and showed a willingness to work with us to maintain and improve standards at the home. Care Homes for Older People Page 22 of 27 Evidence: The operations manager confirmed that all staff have one to one supervision meetings with their line manager on a regular basis and this evidenced by the supervision records we looked at on individual files. Supervision meetings support staff to plan their personal and professional development and give them the opportunity to discuss any areas of concern in a confidential setting. There are some recognised quality assurance monitoring systems in place although they need to be developed further so that concerns highlighted in the body of the report are identified sooner and not brought to the attention of the provider through the inspection process. The operations manager confirmed that an important part of the quality assurance process is sending out survey questionnaires to people living at the home, their relatives and other healthcare professionals on an annual basis to assess how well the home is meeting stated aims and objectives. We have asked her to forward us the results of the next survey so that we can be sure that any concerns raised by people are dealt with appropriately. At the last key inspection we found that where the home helps people to manage their personal finances, accurate records are kept of all transactions and all monies are securely stored. Regular audits are carried out by the homes management, to make sure everything is in order. Information provided by management shows that all equipment in use at the home the passenger and hoists are serviced in line with the manufacturers guidelines, which means that people can be sure they are in good working order. 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 9 13 Nursing staff must make sure that policies and procedures are followed at all times when managing medication. So that people living at the home can be confident that their medication is being stored, administered, and disposed of appropriately. 12/03/2010 2 12 16 People living in the home must be given the opportunity to take part in variety of social and leisure activities that take account of their individual preferences and abilities. To make sure that peoples individual social, cultural and spiritual needs are met. 23/04/2010 3 29 18 Staff recruitment and selection procedures must be followed at al times. So that people can be 19/03/2010 Care Homes for Older People Page 25 of 27 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 confident that they are being cared for by staff that are suitable to work in the caring profession. 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 3 The admission procedure should be more thorough so that people can be confident that once admitted to the home the staff have the skills and experience necessary to meet their needs. When people are identified as being nutritionally at risk more attention should be given to making sure their weight is recorded at the specified intervals, to monitoring their dietary intake and to making sure that they get the support they need to eat and drink. More attention should be given to promoting peoples dignity, for example by asking people if they want to wear aprons or tabbards at meal times. More attention should be given to meal service to make sure people are given appropriate support and to make sure that people are able to enjoy their food at the correct temperature. All the communal bathrooms should be available for use and more attention should be given to maintaining hot water temperatures within the recommended safe limits. More attention should be given to making sure that equipment is maintained in working order and when equipment breaks down it should be repaired or replaced without undue delay. There should be enough staff employed for domestic and laundry duties to make sure that these roles can be carried out effectively. This will help to make sure that it is not necessary for care staff to be taken away from caring duties to attend to carry out housekeeping duties. 2 8 3 10 4 15 5 19 6 26 7 27 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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