Care Home: Brookwood Manor Ltd

What the care home does well Experienced staff are employed in sufficient numbers to support the people who use the service and thereby ensure the smooth running of the service. There was seen to be an easy rapport between the residents and the staff who encourage them to make as many appropriate choices and decisions about their own lives as it is safely possible for them to so do and who give the residents good support to live in the home as independently as possible. The home provides a wide range of activities and social events, which are planned to meet individual residents needs and to accommodate their interests and requests. These included activities such as manicures, 10 pin bowling, art and craft and gentle exercises. The home employs an activities organiser who works part time. We were also told of a recent cheese and wine party that was attended by relatives. What has improved since the last inspection? Following the requirements we made at the previous random inspection of this home we found improvements in the quality of service offered. At this inspection we were able to see progress on all areas with those developments in matters such as management of the home, a working shaft lift, care planning has developed with more person centred plans that focus on social and emotional needs as well as ensuring health and care needs are met. We also saw improvements in medication management. We also had commented upon catering in our last report and are pleased to see positive developments have taken place. The meal looked very appetising. Some residents needed their food to be pureed and this was presented as separate tastes and colours on the plate. Some residents needed support to eat their meal and this support was given well. Comments from residents included `I enjoyed my lunch`. `The juice is good` and `I feel quite full up, but can always make room for dessert`. Bathing facilities are set to improve to meet the needs of residents. All these improvements are reflected within the detail of this report. What the care home could do better: Detailed feedback was given at the end of the inspection and the management was able to action some matters immediately. An example of swift action was that we were notified the next day that hot water temperatures were now adjusted within safe limits to protect residents from potential harm. The key area for development is around staff training and recruitment. The manager spoke of developing a training plan for the home, and had ensured all staff had received up to date manual handling, but was aware more training was needed for staff in dementia, first aid, safe handling of food and safeguarding from abuse. This will ensure the care and support needs of residents are met. In addition the management of the home needs to ensure robust recruitment checks in line with regulation are made before staff start work with vulnerable people. We made a good practice recommendation in relation to medication: That it is good practice to see staff use a thickening formula for drinks for those residents for whom it is prescribed, however the formula used must be prescribed for those individuals. Key inspection report Care homes for older people Name: Address: Brookwood Manor Ltd Holbrook Hall Park Little Waldingfield Sudbury Suffolk CO10 0TH     The quality rating for this care home is:   two star good 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: Claire Hutton     Date: 0 3 0 3 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 26 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 26 Information about the care home Name of care home: Address: Brookwood Manor Ltd Holbrook Hall Park Little Waldingfield Sudbury Suffolk CO10 0TH 01787248062 01787247525 brookwoodmanor@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Brookwood Manor Ltd care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: Date of last inspection Brief description of the care home Brookwood Manor, Great Waldingfield, is registered to provide care for 28 older people with Dementia. The home is located between Sudbury and Lavenham on the B1071. The Home is a large period building set a distance back from the main road and can be reached by a single-track road. There is sufficient parking for several cars and the homes is surrounded by mature grounds and then open fields. The building has been converted into a care home and has a shaft lift to access the first and second floors. The home consists mainly of single bedrooms with three bedrooms being shared. There are two lounge areas and one dining room. There are ample bathroom and toilet facilities positioned appropriately around the home. On the second floor there is a small laundry. Fees for this home range from £625.00 to £650.00 per week. 3 0 1 1 2 0 0 9 0 Over 65 28 Care Homes for Older People Page 4 of 26 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: two star good 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: This unannounced inspection took place over 7 hours during a weekday. This inspection focused on the core standards relating to older people. During this visit we made made a tour of the building, had in depth discussions with the management of the home, met the residents and spoke individually with many of them, spoke also with the staff on duty and carried out spot checks on a number of the homes records. The comments in this report reflect the findings made by the inspector during that visit and also take account of information gathered over the past months from the homes manager, previous random inspection reports and by way of pre-inspection questionnaires completed by 8 the of the residents. We (CQC) also assessed the outcomes for the people living at the home against the Key Lines of Regulatory Assessment (KLORA). We became aware on 21st October 2009 that this home was in liquidation. We had not Care Homes for Older People Page 5 of 26 been notified by the home of any financial difficulties. On 3rd November 2009 an application was made in the high court and this home moved back into administration. The Insolvency Practitioner for Brookwood Manor is Baker Tilly and they notified us on 9th November 2009 that a management company called Healthcare Management Solutions Limited had been appointed to manage the home. This was a positive inspection. The home had a well-ordered and homely atmosphere where staff and residents were seen to be interacting positively together. The residents looked happy and without exception all said that they were well cared for. Comments such as I am very happy and pleased with this home were made by the residents to the inspector. The requirements and recommendations made at previous inspections have all been actioned; Three requirements and one good practice recommendation were made following this inspection. Care Homes for Older People Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: Detailed feedback was given at the end of the inspection and the management was able to action some matters immediately. An example of swift action was that we were notified the next day that hot water temperatures were now adjusted within safe limits to protect residents from potential harm. The key area for development is around staff training and recruitment. The manager spoke of developing a training plan for the home, and had ensured all staff had received up to date manual handling, but was aware more training was needed for staff in dementia, first aid, safe handling of food and safeguarding from abuse. This will ensure the care and support needs of residents are met. In addition the management of the home needs to ensure robust recruitment checks in line with regulation are made before staff start work with vulnerable people. We made a good practice recommendation in relation to medication: That it is good practice to see staff use a thickening formula for drinks for those residents for whom it Care Homes for Older People Page 7 of 26 is prescribed, however the formula used must be prescribed for those individuals. 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 8 of 26 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 26 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. Information about this service is available and pre admission assessments are set to be completed on any new admissions, thereby ensuring health and social care needs can be met before people move into the home. Evidence: There is information available about this care home in the form of a Service Users Guide and a Statement of Purpose. Information has been updated in terms of activities being offered. We fed back to the persons in charge that information should be available to people about the current situation at the home. Full information about the home being in administration and that a management company had been appointed should be available to interested parties before they decide to place people at the home. No new residents have recently moved into the home and this was because the management company agreed with the regulator not to move new people into the Care Homes for Older People Page 10 of 26 Evidence: home until the shaft lift was in full working order. The shaft lift is now in full working order and we were given a copy of the pre admission assessment that will be completed for prospective residents. The 2 page assessment when completed would allow the service to determine if the care home could meet a persons health and care needs. In addition we were told that information would be obtained from relatives and Social Workers if they were placing people. Care Homes for Older People Page 11 of 26 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. Good, up to date care plans are used on a daily basis. Residents are given every opportunity and encouragement to make as many decisions about their own lives, as is safely possible for them to do. The homes medication storage and administration system is generally robust and gives good protection to the residents. However, some improvements could be made. Evidence: A number of care plans were inspected to track how the care was determined and delivered and to see how the level of support required was ascertained. The previous system of standex was being replaced with a new format of care plan. Staff told us that the change over was time consuming, but they had changed approximately 25 of plans on to the new format. The new care plans are more person centred and individualised. There is a greater emphasis on lifestyle and how the home can meet the individuals social and emotional needs as well as those of health and care. We saw that an assessment of need had been completed upon transfer to the new Care Homes for Older People Page 12 of 26 Evidence: care plan. The pattern of care for specific health needs such as continence care and nutritional care could be evidenced via the various recording charts including a waterlow score, manual handling, and nutritional and weight recording charts which included the management of diabetes. The care records reviewed showed that residents have regular access to a variety of medical professionals and are consulted in the development of the care plan. Survey feedback from 8 residents told us that they did receive the care and support they needed and received the medical care they needed. One resident told us the good thing about Brookwood is The attention you get. If I need something, someone will come and sort it out straight away. All the residents were observed to be wearing smartly laundered clothing and had glasses if needed. Overall the personal hygiene of the residents was very good and supported their dignity. Personal care was seen during this inspection to be being delivered to the residents in a kind and understanding manner by staff who clearly understood their care needs both physical and emotional. Staff were seen to reassuringly intervene when a resident became somewhat anxious, this being done in a manner which promoted their independence and feeling of well-being. Other staff were seen to distract a resident away from a potentially difficult moment - we looked at this persons care plan and saw that this instruction was in the plan for staff to follow to avoid confrontations. We examined the medication management within the home and overall this is satisfactory, but some improvements should be made to protect the residents further. We observed medication being given and saw the process was well managed. Drugs were seen to be dispensed by consulting drug sheet and medication containers, administered in an efficient friendly manner and then signed for. The medication administration records showed no gaps. At the end of the drug round the person did not secure the trolley to the wall. When this was brought to their attention it was rectified immediately. There are plans to revise the current storage place for medication and remove this from the dining room. The medication fridge was locked. We looked at controlled drugs and found these to be appropriately recorded and accounted for. However to avoid staff touching tablets when counting the controlled drugs for the register, a pill counter should be purchased. Finally, when we observed lunch we saw a staff member ensure that a resident did get their fluids thicken with a prescribed thickener to avoid chocking. However the prescribed formula used was not prescribed for them and was dated August 2009. This was brought to the attention of the management and they agreed to look into this straight away. Care Homes for Older People Page 13 of 26 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. The diverse social and activity needs of the residents are well supported and enjoyed by all. The residents receive a healthy diet of freshly prepared good quality food, which is provided with good variety according to individual needs and preferences. Evidence: The home provides a wide range of activities and social events, which are planned to meet individual residents needs and to accommodate their interests and requests. Information about these activity programmes is advertised on the homes wall and individual activity planning was recorded on the residents care plans. These included activities such as manicures, 10 pin bowling, art and craft and gentle exercises. The home employs an activities organiser who works part time. We were also told of a recent cheese and wine party that was attended by relatives. During our visit we observed all staff being attentive and interactive with residents. There were plenty of activities planned and happening. We saw very good one to one interaction with staff and residents. Mellow music was playing, one person was playing connect 4, another reading a newspaper. Spring has been brought into the home with Care Homes for Older People Page 14 of 26 Evidence: a vase of daffodils and a bowl of snow drops. That evening people were going to be watching the England football match with a promise of beer and popcorn. In the lounge there were tables with drinks freely available and also a tea and coffee round was frequently seen throughout the day. We observed the main meal of the day in the dining room. Residents came into the dining room and chose where to sit. The chef brought in a large hot trolley and individuals were offered a choice of cooked meal. The choice was either pork chop or braised steak with herb potatoes, carrots, peas and gravy. The choice was given to each residents and their decision was respected. The meal looked very appetising. Some residents needed their food to be pureed and this was presented as separate tastes and colours on the plate. Some residents needed support to eat their meal and this support was given well. Comments from residents included I enjoyed my lunch. The juice is good and I feel quite full up, but can always make room for dessert. The pudding was chocolate pudding with chocolate sauce or egg pudding. Both of which the residents said was good. The atmosphere at lunch was relaxed and unhurried. 18 people ate in the dining room and a small number of people chose to eat in their room. Care Homes for Older People Page 15 of 26 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. Brookwood listens to concerns and takes matters seriously, however protection could be more robust with staff training in safeguarding from abuse. Evidence: Brookwood has a complaints procedure in place and is given as part of the Service Users Guide. We looked at the homes log of complaints and evidence shows that complaints are listened too, recorded, investigated and resolved. We believe the service is learning form issues raised as there were no repeat matters. We discussed safeguarding with the management. The home has the latest policy available. They are also aware of the Suffolk Social services website to update knowledge and access services if required. There have been no individual safeguarding matters reported through safeguarding, though Suffolk Social Services have been monitoring and supporting the service under safeguarding due to the home going into administration. In relation to safeguarding people from abuse training, staff have some awareness as this is covered as part of the NVQ training. Staff spoken with have a good understanding of complaints and safeguarding and know about whistle blowing. However, the management are aware of this gap in staff development and agreed to all staff receiving safeguarding training. Care Homes for Older People Page 16 of 26 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. Brookwood Manor provides a comfortable clean environment. Bathing facilities are set to improve to meet the needs of residents. Evidence: We toured most of the home and found it to be warm comfortable and clean. The shaft lift had been repaired and we saw it in full working order. We met the cleaner who was cleaning a bathroom. We saw the maintenance man who was testing nurse call alarms and hot water temperatures. We spoke to the management about working bathrooms and were given a reassurance that there were 3 working bathrooms. One on each floor. The fourth bathroom was not in full working order and the management were looking for replacement parts for the bath seat. In addition there is a plan in place (including finance) to refurbish the downstairs bathroom, however as a matter of maintenance the lime scale should be removed from the bottom of the bath and the seal around the bath made good to ensure a safer, cleaner bathing experience in the mean time. Toward the latter part of the day we looked at the records made that day on hot water temperatures. It identified 2 areas of concern. Several wash hand basins in bedrooms were without hot water and a bathroom recorded a temperature of 61 degrees centigrade. However upon investigation that bathroom could not be identified. Care Homes for Older People Page 17 of 26 Evidence: Therefore we took all bath water temperatures and found one had a recording of 48.4 degrees centigrade. The management agreed to place a notice not to use this bath. They then confirmed that this was brought within a safe temperature of 43 degree centigrade range the next morning when a plumber called. A plumber was also called to look at the remainder of the wash hand basins in the bedrooms without hot water. Care Homes for Older People Page 18 of 26 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. Experienced staff are employed in sufficient numbers to support the people who use the service and thereby ensure the smooth running of the service. Additional training and robust recruitment practice will ensure the quality of care is maintained at all times. Evidence: The staff were observed to be working very well together as a team in a proactive rather than a reactive manner. They were enthusiastic about their work and clearly had very good relationships with the residents several of whom had also been living in the home for many years. The staff demonstrated a good understanding of the particular needs of the residents and thereby could deliver effective person centred care. The comments made by the residents both written and verbal evidenced that they felt that there was always sufficient staff to meet their care needs. The manager spoke of developing a training plan for the home, and had ensured all staff had received up to date manual handling, but was aware more training was needed for staff in dementia, first aid, safe handling of food and safeguarding from abuse. The management confirmed that all Team Leaders had NVQ 3 and that all care staff either had achieved or were doing NVQ 2. The recruitment records of recently appointed members of staff evidenced that new Care Homes for Older People Page 19 of 26 Evidence: staff had not commenced duties until CRB checks had been made. The correct procedures and checks had been carried out for one new member of staff, but one staff member had not provided a full employment history, with reasons why they ceased work with vulnerable people therefore the management need to ensure they are meeting all Care Homes Regulations 2001 schedule 2 to ensure they are fully protecting residents. Care Homes for Older People Page 20 of 26 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. Residents and their relatives can be assured a competent and experienced management team leads the home. The management and administration of the home is based on openness and respect. An effective quality assurance system is in place to ensure peoples views are obtained and incorporated into the running of the home. Evidence: Brookwood has a newly appointed manager and she has experience of working with older people. The new manager is planning to do a combined award of NVQ 4 and Leadership Award. Staff and residents spoken with confirmed that the manager is supportive and approachable. The home has clear health and safety policies of which staff had a good awareness. Spot checks made of these records during this inspection including fire testing, water temperature logs and risk assessments evidenced that the records are well maintained Care Homes for Older People Page 21 of 26 Evidence: and that routine checking is carried out. We did discuss with the manager the need to have consistent reporting of matters and anomalies that occur so that these can be rectified immediately. We saw that the Fire risk assessment had just been completed. This document highlighted action points to be taken and we would like to know about the developments and improvements with regard fire prevention as part of the AQAA (Annual Quality Assurance Assessment ). We have not included any comments from the previous AQAA as this was completed by the previous manager and does not reflect the current thinking and developments within the home. This AQAA was not satisfactorily completed and did not give us the detail we would have liked to further inform judgements and we look forward to receiving the next AQAA completed by the current management. Records are kept securely and staff are aware of the requirements of the data Protection Act. The good maintenance of these records promotes the safety for the residents. The home has a current Liability Insurance Certificate and the Registration Certificate was on display. Regulation 26 visits are now happening and the manger has support of an area manager who is visiting and offering support and knowledge. The report completed in February 2010 shows that the management company have a good understanding of monitoring quality. Issues found are relevant with action points against them to develop the service. The management spoke of surveying people who use the service in the coming weeks to also monitor quality outcomes for people. The management have held open surgerys for relatives to visit and meet on a one to one basis with the manger if they would like. Recently a Cheese and wine evening was held at Brookwood to update families on changes and developments within the home. We asked about the management of residents monies. We were told this is now on a computer system to add security of accounting and accountability. Care Homes for Older People Page 22 of 26 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 23 of 26 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 18 13 staff require training in safeguarding residents from abuse. This will further protect residents and staff. 01/06/2010 2 29 19 Robust recruitment checks 03/05/2010 in line with regulation must be made before staff start work with vulnerable people. This will ensure only suitable people are employed and residents are protected. 3 30 18 Staff must receive training in dementia, first aid, safe handling of food and safeguarding from abuse. This will ensure the care and support needs of residents are met. 01/06/2010 Care Homes for Older People Page 24 of 26 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 9 It is good practice to see staff use a thickening formula for drinks for those residents for whom it is prescribed, however the formula used must be prescribed for those individuals. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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