Care Home: Brownlow House Residential Care Home

What the care home does well Admissions are not made to the home until a full needs assessment has been undertaken to ensure that people`s needs can be met effectively. There is a high level of satisfaction with the food served in the home, with the cook displaying a strong awareness of people`s preferences and dietary needs. Residents overwhelmingly feel that staff are "very kind," and understand how to help them. Care plans generally ensure that people`s needs are addressed in a person centred way. Clear systems are in place for recording risk assessments, and ensuring that a high standard of healthcare support is provided in a proactive manner. There are appropriate policies on handling abuse and safeguarding adults, and people generally feel safe and well supported by the home. The home has the necessary adaptations to support people to move around safely. Bedrooms are personalised with items of furniture and pictures belonging to the peoplewho live at the home. The rota shows that a consistent staffing level is being maintained in the home, and people spoken to felt that staff had the necessary skills to meet their needs. Staff are supported through training to meet the individual needs of people. The registered manager is appropriately trained and experienced, with a clear understanding of how to deliver good outcomes for people living at home. What the care home could do better: Improvements are needed in the level of detail recorded in manual handling assessments, accurate recording of wounds/ marks on people`s skin, and ensuring that follow up actions are recorded regarding discrepancies in people`s weights, and requests to see medical professionals. A clear policy is needed regarding the escalation of people`s needs where these are no longer appropriate for residential care. A clear format is also needed for the recording of nutritional intake should this be requested by medical professionals in the case of a person with very low body weight, or other risk areas. It remains required that a greater variety of activities be made available to people living at the home, and all residents must be given the option of having lockable storage units within their rooms, and use of a key to their room doors. Consultation must be undertaken with the local fire authority to address the problem of interconnecting fire doors between people`s rooms which may infringe upon their privacy. The lounge temperature must be monitored to ensure the it is a comfortable temperature for people at all times, and staffing levels at mealtimes must be reviewed to ensure that people with high dependency needs, can be supported in an unhurried and dignified manner. Staff should be provided with training in pressure sore care and addressing challenging behaviour, and more rigorous recording and monitoring of accidents, incidents and near misses would further protect people from the risk of harm. All staff must receive regular individual supervision and requirements and recommendations remain in place from the previous inspection with regard to quality assurance systems within the home to ensure that people`s views are taken into account regarding the running of their home. Random inspection report Care homes for older people Name: Address: Brownlow House Residential Care Home 4 Princes Avenue London N10 3LR two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Susan Shamash Date: 1 0 0 9 2 0 1 0 Information about the care home Name of care home: Address: Brownlow House Residential Care Home 4 Princes Avenue London N10 3LR 02088836264 02084444783 brownlow@ventry-care.com www.ventry-care.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Alena Megova Type of registration: Number of places registered: Conditions of registration: Category(ies) : Brownlow Enterprises Limited T/A Ventry Residential Care care home 24 Number of places (if applicable): Under 65 Over 65 0 0 24 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Conditions of registration: 8 3 0 The maximum number of service users who may be accommodated is 24 The Registered Person may provide the following category of service: Care Home only Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category Code OP (24) Dementia - Code DE (8) Mental Disorder, excluding Learning Disability or Dementia - Code MD (3) Date of last inspection Care Homes for Older People Page 2 of 18 Brief description of the care home Brownlow House formerly known as St James Residential Care Home is a care home for 24 older people, some of whom may have dementia. The registered provideris a family-run business that manages other care homes in London. The home is a large converted house on a quiet street off Muswell Hill Broadway and close to local amenities. There are secenteen bedrooms comprising seven double rooms and ten single rooms (the majority of which have en suite toilet facilities). The home is on three floors with bedrooms on each floor. A lift provides access to all parts of the building. There is a large garden at the rear and limited parking at the front of the home. The communal areas are a large dining/lounge area leading into a conservatory that is also used as a quiet room. There is a galley kitchen, and laundry room on the ground floor. The staff room is on the first floor and the managers office is on the ground floor in the reception area. A further office is situated in an outbuilding off the rear garden near the kitchen stores. The stated aims of the home are to encourage and assist the residents to lead a life of their choosing within a caring and supportive environment. The home provides twentyfour hour care and support and access to a range of residential specialist services geared towards meeting individual service users needs. Care Homes for Older People Page 3 of 18 What we found: This unannounced random inspection was undertaken to follow up on actions agreed at three safeguarding strategy meetings which took place prior to this visit. We also looked at other information we had received about the home since the last inspection, including notifications of incidents that the home had told us about. The inspection took place over one day involving two compliance inspectors, and we were assisted by the acting manager, Damien Heneghan, the responsible individual on behalf of the provider organisation, Liam Heneghan, and the staff team. We had the opportunity to speak with twelve people who live at the home, and four members of staff. We also observed interactions between staff and people living at the home, including during mealtimes and the medication round, and walked around the building and examined a number of records relating to the care provided, and management of the home. Health and Personal Care We observed the morning and early afternoon routines within the home, including breakfast and lunchtime in the lounge area. Whilst the majority of people appeared to be supported appropriately, one particular resident appeared to become distressed when her support with feeding was interrupted at breakfast time. Interuptions appeared to be due to the needs and requests of other residents which the staff member needed to attend to. This indicated that the staffing levels or arrangements made during this meal time may not have been sufficient to meet all residents needs appropriately. However the situation was improved at lunchtime, when additional staff support was provided including support from the cook, and residents appeared to receive the support that they needed with this meal. A requirement is made regarding staff support at mealtimes under Standard 27. The care plans of three people case tracked, were found to be detailed in most areas, identifying how the needs of people would be met. Care plans were being reviewed on a monthly basis, and their format indicated that peoples needs are addressed in line with a person-centred approach. There were indications of peoples choices and preferences recorded in their care plans. People spoken to advised that they had been asked about how they wish to be supported by staff. Staff were observed to interact respectfully and cheerfully with residents, maintaining their privacy as far as possible, and treating them with respect. Three residents were using pressure relieving matresses, and pressure relieving cushions for sitting up in a chair. These were found to be correctly operating during the inspection, and staff spoken to were aware of how to use them. Turning regimes were in place for people with pressure care needs, and these were being completed at regular intervals by staff on duty. The continence needs of people were assessed and recorded as part of their care plans, and staff spoken to were clear about how frequently they needed to assist people with continence needs. Each care plan included a manual handling risk assessment. However although these assessments were lengthy including a range of important information, they did not specify particularly how each person should best be supported with their mobility, e.g. which side should be supported, how to prompt them etc. and a requirement is made Care Homes for Older People Page 4 of 18 accordingly. A new hoist had been provided for one particular resident, and staff advised that they had been provided with training in this from the relevant occupational therapy team. However they advised that this persons needs were now judged to be too high for the service, and were awaiting a transfer for them to a nursing setting. This persons care plan had not been updated to specify how they should be supported using the new hoist. We were also concerned that where there had been new red marks identified on one residents heels, this was not reflected in their daily notes, nor was there a new body chart of this area, although the district nurses had been treating this new problem area. It is of concern that such potential discrepancies in peoples care notes may place them at risk and a requirement is made accordingly. In general other risk assessments ensured appropriate management of risk, explaining how safety issues are addressed whilst promoting peoples independence of movement as far as possible. Nutritional, tissue viability, and falls assessments are in place. People were being weighed regularly,as appropriate, without significant changes in most peoples weight. However in one case where staff had recorded a significant loss in weight within the last month, there was no action recorded as to how this was addressed. Discussion with the head of care indicated that they thought that it was possible that this recording was mistaken due to the use of new weighing equipment, since the previous reading. They advised that the persons family and staff members did not feel that the person looked as though they had lost a significant amount of weight, however they would be consulting with the GP regarding this persons weight as it had become quite low. In discussion it was agreed that this persons weight should be monitored more closely for a while to ascertain the reason for the weight loss, and ensure that no further weight loss occurred. A requirement is made accordingly that there should be clear recording of all actions taken following significant weight changes. Diary notes alongside recording in peoples daily records, indicated that appropriate medical attention and advice is sought including regular contact with the GP, district nurses, opticians, dentists and chiropodists. This was confirmed by people living at the home. However during the inspection one resident advised that they had been waiting to see the GP for a few days for relief of an itchy back, and they had still not seen the GP on the Friday of the inspection. We were concerned that this request had not been recorded in their medical notes, and that no other options appeared to have been offered to this resident for relief of this problem which was clearly troubling them. Following discussion with the manager, we were assured that such support would be offered to this resident, and it was explained that the GP had been called, however they had not yet visited as this was not an emergency situation. It was suggested that the resident in question might visit the surgery themselves, with staff support if necessary, but they had declined. Again more accurate recording is needed of the actions taken to address such residents medical needs. The records of medicines received, administered and returned to the pharmacist were complete and appeared to be accurate and up to date. We observed staff administering medication to residents as prescribed, and recording these at the time of administration as appropriate. One particular resident had a risk assessment regarding the way in which their medication was administered due to challenging behaviour exhibited. We observed staff supporting them appropriately with their medication during the inspection. Medicines were stored safely and at the appropriate temperature, with no controlled Care Homes for Older People Page 5 of 18 drugs in stock at the time of this inspection. Weekly management checks are carried out to make sure that medication is administered safely to people, and these appear to be effective in ensuring safe practices regarding medication administration within the home. Training has been provided on the safe administration of medicines. Discussion with staff indicated that they were clear about their responsibilities and how to handle medicines safely. Following on from the safeguarding meetings held prior to the inspection, the overall care planning system for the home had been updated to ensure that previous information recorded in each residents care plan can now be retrieved, as previous versions of care plans are kept on file. However it remains required that a policy be put in place to set criteria for escalating the transfer of people whose needs are no longer appropriate for residential care and require a higher level of support, and further improvements are needed in the recording and communication of information about peoples health needs within the home. There is also a need for a nutritional recording format, for use when medical professionals request that a residents nutritional intake be monitored. Daily Life and Social Activities An activities schedule was posted in the homes conservatory including quizzes, exercises, puzzles, movies, reminiscence, discussions and bingo, in addition to a church service within the home. Peoples interests were recorded as part of their care plans, however peoples daily records still did not reflect activities that they had been involved in. Records of activities over the last few weeks included ball games, bingo, puzzles, afternoon movies, hair styling, garden walks, dancing, colouring and library visits. The only outings recorded were for residents able to go out independently or with family support. The manager advised that only four residents had been identified who would wish to go out in the local area, and that there were plans to arrange trips out for these identified people. He also advised that a new communication board was to be introduced for the home including menus, photographs and useful information such as the staff on each shift. Residents spoken to during the inspection advised that they were provided with some activities, however a substantial number of those spoken to felt unenthusiastic about the options available to them, and confirmed that they did not have the opportunity to go out to local shops/cafes with staff support. At the previous inspection the registered provider and manger advised that they were in the process of recruiting an activities coordinator, who would also work across other homes owned by the provider organisation. However during the current visit they noted that they had not been successful in recruiting to this post. We remain concerned about the variety of activities within the home as required at the previous inspection. We observed staff spending time talking with people within the communal areas of the home, and those spoken to were very aware of the importance of one-to-one contact for people. Residents spoken to were very positive about staff support provided, and their friendliness and cheerful manner continue to be particularly appreciated. Relatives were seen visiting the home, although it was not possible to speak to any relatives during this visit. Daily notes, and the visitors book confirmed that people had regular contacts with family, friends and the wider community. Staff and the management advised that residents were consulted regarding the homes menu. The menu showed that options are offered at each meal, and that a varied Care Homes for Older People Page 6 of 18 selection of meals is offered. All residents spoken to were happy with the quality of the food provided. One person advised you get what you ask for and others confirmed that staff would bring an alternative if you were not happy with the menu choices. Discussion with the cook indicated that she is very aware of peoples preferences and makes an effort to accommodate each persons preferred cooking styles. As required at the previous inspection, a greater choice of evening meals were available to residents,and twice weekly deliveries of fresh fruit and vegetables were now being made to the home. Whilst it appeared that the cook was providing individual options to residents, the recording of food served did not always reflect this. It is recommended that more detail be recorded of different options provided to residents within the home, to evidence that the home is responsive to their choices. Complaints and Protection Since the previous inspection safeguarding issues had arisen regarding a small number of individual residents at the home with high dependency needs. The outcomes of these investigations were discussed with the acting manager, who provided evidence that a number of agreed actions had been met including informing relevant family members of the homes complaints procedure, arranging safeguarding training to the staff team, location of lost property belonging to an indivual and safe storage of these items and a review of a particular residents medication strategy in their care plan. The overall care planning system for the home had been updated to ensure that previous information recorded in each residents care plan can now be retrieved, as previous versions of care plans are kept on file. Although progress had been made there remains further work to do to meet two other outcomes agreed regarding setting criteria for escalating the transfer of people who are no longer residential and require a higher level of support, and further improving ways in which information is communicated within the home and recorded. Clearly recorded complaints and safeguarding adults policies are in place for the home. People living at the home seemed to be aware of the complaints procedure, and indicated that they would feel able to speak up about issues of concern to them should the need arise. Inspection of the homes complaints book indicated that concerns raised continue to be taken seriously, with actions taken to address issues recorded alongside the timescales. Discussion with the management indicated that they were aware of the local authoritys procedures in the event of an allegation or disclosure of abuse. Staff confirmed that they had received training on adult protection, and displayed an understanding of the signs of potential abuse, and how they should respond. However as indicated during the safeguarding meetings prior to the inspection, it is recommended that all members of the staff team be enrolled to take the local authority safeguarding adults training as soon as possible. Environment The building continues to be comfortably furnished, with suitable adaptations to allow people to access all areas in the home safely including a passenger lift to all floors. There are large open plan dining and sitting areas where the majority of residents congregated on the day of the inspection. At the rear of the house is a conservatory, which provides a relatively quiet area for activities, or for people to meet friends or relatives. A number of television screens set to different channels were available in these areas, however it Care Homes for Older People Page 7 of 18 remains recommended that consideration be given to providing larger flat screen televisions in theses areas, for the comfort of people living at the home. There is a large rear garden which is accessible and well presented. The manager advised that he had attempted to interest residents in a gardening group, with the provision of two raised flowerbeds for this purpose, but there had been limited interest from residents. People spoken to advised that they continued to enjoy using the garden in good weather. We did not look into many bedrooms as part of this inspection, but those viewed were personalised with items of furniture, photographs and pictures, and decorated to an adequate standard. Privacy screens were available in shared rooms, although staff advised that most residents chose not to use them. We remained concerned about the presence of open fire doors connecting a number of residents rooms, which appear to compromise peoples privacy. A door signified as a fire exit led into one persons bedroom, with another interconnecting door from this room, opening into a further room (unoccupied at the time). Staff confirmed that it was sometimes expedient to use these links between rooms to navigate around the house more efficiently, however this does not protect the privacy and dignity of residents living in such rooms. It is required that the local fire prevention office be consulted regarding the need for open doors between peoples bedrooms, to ensure that peoples right to privacy is protected as far as possible. As required at the previous inspection, no prescribed topical lotions were seen in peoples rooms. However it was of concern that no bedrooms were being kept locked at the time of the inspection. The manager also advised that no residents had requested lockable storage space in their bedrooms. However it remains required that all residents should be offered the option of having a lockable storage facility within their bedrooms, and be encouraged to use the keys to their rooms where this is possible. The management advised that they had replaced a significant number of bed covers within the home (which appeared to be marked with bleach at the previous inspection) alongside some items of furniture as required at the previous inspection. The home was generally clean and tidy with appropriate measures in place to prevent cross infection, and detailed policies on the prevention of cross infection. Staff confirmed that they had access to disposable gloves and aprons. Liquid soap and paper towels were available throughout the home. During the inspection, a number of carpets were being deep cleaned by a maintenance person, who advised that they visited the home periodically to undertake this task. The home also has a carpet cleaning machine for use at other times. No unpleasant odours were detected around the home during the inspection visit. The home had procurred a new hoist for a particular resident, new seated weighing scales, more walking frames for people living at the home, and a new falt screen television in the conservatory since the previous inspection. New pass codes had also been fitted to the kitchen and laundry doors to ensure the safety of residents. Staff and residents confirmed that any repairs are dealt with quickly to ensure peoples comfort and safety and hot water is available at all times. However one resident complained that the lounge area was frequently draughty first thing in the morning, and we noted that it did appear to be cool at some intervals during the day, particularly for residents who are not moving around. Staff were seen to provide most residents with blankets in this area. It is required that the temperature in the lounge be monitored with Care Homes for Older People Page 8 of 18 appropriate action taken where necessary to ensure a comfortable ambient temperature for all. Staffing Inspection of the rota indicated that there were three care staff (including a senior carer) working with 18 residents during the day, alongside a cook and a domestic worker. This was the case on the day of the inspection, and staff advised that this was generally sufficient to meet peoples needs effectively. However we were concerned about whether sufficient staff were available to support people with their breakfast in an unhurried manner. When full the home can take up to 24 residents, and we were concerned that the problems around meal times might be exacerbated at such times. The manager advised that at above 22 residents, he could increase staffing, but not at current levels. A requirement is made that staffing provision should be reviewed at mealtimes to ensure that all peoples needs are met with dignity. Residents spoke positively about the staff, indicating that they had the necessary skills to meet their needs. One person said you cant ask for better referring to the carers. Training records showed that staff had been on a range of courses relating to the needs of people who live at the home. These included training on dementia, depression and other mental health issues, the Mental Capacity Act and person centred care as well as mandatory training in first aid, food hygiene, safeguarding adults, health and safety, infection control and fire safety. However in view of some of the challenges that staff in the home have been facing recently it is also required that all staff be provided with training in pressure sore care and addressing challenging behaviour. A high proportion of staff had undertaken or were undertaking National Vocational Qualification level 2 or above in care, or equivalent. A training matrix was available for the staff team in order to prioritise training for individual staff members. Three staff files were inspected, and these were found to contain all the required information relating to staff recruitment including application forms, two written references, enhanced CRB disclosures, induction and training records, and supervision notes. No unexplained gaps were found in the employment history of recently recruited staff, and identity documents had been checked and health checks had been carried out to ensure that staff could safely meet the needs of residents. We were able to attend the afternoon staff handover meeting, and observed important information being passed from one team to the next, showing that staff had a clear awareness of each residents needs. Management and Administration The registered manager was on maternity leave at the time of the inspection, and the acting manager advised that she was due to return to work in December 2010. It was of concern that no recorded staff supervision had been in place in her absence, nor had an annual quality assurance audits (including feedback from all relevant stakeholders), been undertaken since the previous inspection. The acting manager advised that they had been looking to appoint a deputy manager to provide support to the home, but had been unsuccessful to date in finding an appropriate person. Care Homes for Older People Page 9 of 18 There had also been substantially fewer residents and staff meetings since the managers absence, although there had been meetings of both staff and residents shortly prior to this inspection visit. It remains recommended that these meetings be further developed to encourage staff/residents to be more proactive in raising issues, and considering solutions, and that a clear list of actions be drawn up as a result of each meeting. A progress report should be delivered at the next meeting, to confirm that these have been taken seriously. The home does not hold money for people who live at the home. The home invoices their families or the relevant social service department for any expenditure made on their behalf. A system is in place to ensure receipts are obtained for any expenditure. We were concerned to learn that no indivdual staff supervision sessions had taken place since the Registered Manager went on maternity leave in December 2009. This was confirmed by staff and management, and a requirement is made accordingly that all staff receive individual supervision at least six times annually, and that these address relevant issues relating to their performance and development. Health and safety documentation was not inspected during this visit, other than accident and incident records. Whilst there were records of significant accidents and incidents, these did not include records of near misses, although some of these were alluded to in peoples daily notes. A requirement is made accordingly. A comprehensive set of policies and procedures are in place for people living at the home however there is a need for a nutritional recording format, where medical professionals request that nutritional intake be monitored, and there is a need for a policy regarding how the home will manage the care of people whose needs escalate to nursing care, until they can be suitably placed. Requirements are made accordingly under Standard 8. What the care home does well: Admissions are not made to the home until a full needs assessment has been undertaken to ensure that peoples needs can be met effectively. There is a high level of satisfaction with the food served in the home, with the cook displaying a strong awareness of peoples preferences and dietary needs. Residents overwhelmingly feel that staff are very kind, and understand how to help them. Care plans generally ensure that peoples needs are addressed in a person centred way. Clear systems are in place for recording risk assessments, and ensuring that a high standard of healthcare support is provided in a proactive manner. There are appropriate policies on handling abuse and safeguarding adults, and people generally feel safe and well supported by the home. The home has the necessary adaptations to support people to move around safely. Bedrooms are personalised with items of furniture and pictures belonging to the people Care Homes for Older People Page 10 of 18 who live at the home. The rota shows that a consistent staffing level is being maintained in the home, and people spoken to felt that staff had the necessary skills to meet their needs. Staff are supported through training to meet the individual needs of people. The registered manager is appropriately trained and experienced, with a clear understanding of how to deliver good outcomes for people living at home. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 11 of 18 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 12 of 18 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, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 13 The registered persons must 17/12/2010 ensure that more specific detail be recorded in manual handling care plans, specifying precisely how a person should be supported with their mobility, to ensure the resident and staff members safety. . 2 8 13 The registered persons must 29/10/2010 ensure that a clear format is in place for recording nutritional intake should this be requested by medical professionals, to ensure that their nutritional needs are met effectively. . 3 8 15 The registered persons must 19/11/2010 ensure that a policy is in place to set criteria for escalating the transfer of people whose needs are no longer appropriate for residential care and require a higher level of support, to Page 13 of 18 Care Homes for Older People Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 ensure that their needs are met appropriately in the interim period. . 4 8 12 The registered persons must 29/10/2010 ensure that improvements are made in the recording of wounds/marks on peoples skin in the form of body charts, and that these are clearly recording in peoples daily notes. There is a need for improved recording of any significant changes in peoples weights, alongside action taken to address these concerns, and all contact with the GP, including requests for visits, advice etc. All support offered or provided by care staff to address peoples medical needs must also be recorded to ensure that people receive the appropriate support for their needs. . 5 12 16 The registered persons must 26/11/2010 ensure that records evidence that people living at the home are provided with a greater range of activities within the home , including regular opportunities to go out of the home and use local facilities, according to their preferences. Care Homes for Older People Page 14 of 18 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 . 6 19 23 The registered persons must 29/10/2010 ensure that the lounge temperature is monitored, with appropriate action to reduce draughts, for the comfort of people living at the home. . 7 19 23 The registered persons must 17/12/2010 ensure that the local fire prevention office are consulted regarding the need for open doors between peoples bedrooms, to ensure that peoples right to privacy is protected as far as possible. . 8 19 23 The registered persons must 26/11/2010 ensure that all people living at the home have the option of a lockable storage facility within their bedrooms, and are encouraged to use the keys to their rooms where this is possible. . 9 27 18 The registered persons must 29/10/2010 ensure that staffing levels and procedures around mealtimes are reviewed, to ensure that people requiring a high level of assistance can be supported in an unhurried manner according to their needs. Page 15 of 18 Care Homes for Older People Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 . 10 30 18 The registered persons must 31/12/2010 ensure that staff are provided with training in pressure sore care and in dealing with challenging behaviour, to increase their confidence and competence in supporting people in these areas. . 11 33 24 The registered persons must 31/12/2010 ensure that an analysis is undertaken of feedback received in quality assurance surveys, and that quality assurance systems are further developed to include all areas of the homes performance, to ensure continuous improvements to the services provided by the home. . 12 36 18 The registered persons must 12/11/2010 ensure that all staff members are provided with individual staff supervision at least six times annually, to ensure that staff are appropriately supported and work in line with best practice. . 13 38 13 The registered persons must 29/10/2010 ensure that there are no Page 16 of 18 Care Homes for Older People Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 gaps in the recording of accidents, incidents and near misses, so that appropriate action can be taken to address issues or trends as these emerge, and thus protect peoples safety. . 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 15 It is recommended that more detailed records be maintained of alternative meals served to people living at the home, to evidence that their preferences are respected, and ensure that their nutritional needs are met. It is recommended that larger flat screen televisions be provided in the lounge areas, for the comfort of people living at the home. It is recommended that all staff undertake the local authority safeguarding adults training when possible, for the further protection of people living in the home. It is recommended that staff and resident meetings be further developed to encourage greater participation, and that a list of actions be drawn up as a result of each meeting, with an update on progress at the next meeting, to confirm that these have been taken seriously. It is recommended that fire drills should be undertaken at varied times within the home, and that a key be provided for the order of testing fire call points, to ensure the safety of people living and working at the home. 2 19 3 30 4 33 5 38 Care Homes for Older People Page 17 of 18 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial 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. 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