Care Home: Brundall Nursing Home

What the care home does well The home has a warm and welcoming atmosphere that is reflected in the comments from residents families and friends. The staff who work as housekeepers/domestic all interact and work with the carers to offer a seamless service. The environment in the main house is light bright and inviting with an attractive dining room that is comfortable and where meals are enjoyed. The residents comment on the kind and caring staff who are helpful and work hard to try and meet everyones care needs. What has improved since the last inspection? The improvement in the home has been the effort made to improve the activities available with a variety on offer to meet most peoples needs. The home has a more relaxed, happier atmosphere and staff feel the team work much better together now. Some staff who previously worked at the home are no longer employed and this has changed the working relationships in the home. The home has recently recruited a new Manager who has filled a vacant slot to release the Acting Manager back to carry out his designated role. The new Manager is highly qualified and experienced and will hopefully make a difference to this service. What the care home could do better: The home does need to look more at the support and stimulation offered to people who are cared for in their own rooms. Effort, allocated time and records need to be in place to ensure people are not just left with the TV or radio on for stimulation. Charts placed in peoples rooms, such as nutrition intake, should be fully completed and not left for days with nothing recorded. The grounds could be improved with handrails outside to allow people free access to come and go into the garden in the nice weather. The internal areas in the Norfolk Unit should be improved to make it lighter, brighter and environmentally friendly with signs and indicators to assist people to orientate who have memory problems. Key inspection report Care homes for older people Name: Address: Brundall Nursing Home 4 Blofield Road Brundall Norwich Norfolk NR13 5NN     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: Ruth Hannent     Date: 0 5 0 6 2 0 0 9 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) 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. 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: Brundall Nursing Home 4 Blofield Road Brundall Norwich Norfolk NR13 5NN 01603714703 01603716652 brundallnh@schealthcare.co.uk www.southerncrosshealthcare.co.uk Ashbourne (Eton) Limited care home 48 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: 1. The registered person may provide the following category of service only: Care home with Nursing - Code N 2. The maximum number of people who can be accommodated is: 48 To service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP (maximum number of places: 28) Dementia - Code DE (maximum number of places: 20) Date of last inspection Brief description of the care home Brundall is a care home providing residential or nursing care for up to 28 older people and care for up to 20 older people who may have a diagnosis of dementia (a total of 48 service users). The home is situated in the village of Brundall a few miles to the east of Norwich. The home is a large detached building that has been extended. It is Care Homes for Older People Page 4 of 26 Over 65 0 28 20 0 0 3 1 1 2 0 0 8 Brief description of the care home divided into two main wings, Verne House and Norfolk House. The latter caters for service users who have a diagnosis of dementia. The accommodation is located on both ground and first floors. There are single and shared rooms. There are garden and patio areas to the rear of the home. There are local shops, pubs and other amenities within the immediate vicinity of the home. Brundall is one of several homes in Norfolk owned by the proprietors. The range of weekly fees for the home is #347 - #551. Care Homes for Older People Page 5 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 home visit was carried out as an unannounced key inspection six months after the last inspection. The home has not had time to return the AQAA (Annual Quality Assurance Assessment) as this visit was made earlier than originally planned. The report has therefore been written following an 8 hour inspection where staff, relatives, residents and management have assisted with comments. Records were looked at that included care plans, medication records, maintenance/fire records, accidents and complaints. A tour of the building and grounds took place and time was spent observing the care support offered to residents throughout the day. 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: 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 7 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 8 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. The potential residents can be assured that information will be offered to help them choose if the home is suitable. A thorough assessment by a competent person will ensure the home will be able to meet the persons needs prior to admission. Evidence: The pre assessment details have not altered since the last inspection of 6 months ago. The information on assessing the potential resident is carried out prior to accepting the person into the home. The information is placed on the persons file. Many of the residents appeared to be suitably placed and it was noted that one person who had been unsuitable for Brundall had been helped to move onto a different service home very quickly. Two residents shared their experience of moving to the home with us and felt this was a suitable home to care for them. They appeared content and talked happily about the care they are receiving. Care Homes for Older People Page 9 of 26 Evidence: The brochures in the hallway of the home gives a picture of the care offered to any potential resident. Inside the one looked at was an up to date A4 sheet giving the details of the new Manager in post. Care Homes for Older People Page 10 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. The residents have all got a care plan that is detailed and staff are able to offer an appropriate service for their personal care and health care. Medication administration recording could be improved for all creams and lotions to ensure they are administered correctly and safely. Privacy and dignity is nearly always upheld. Evidence: Care plans were seen during this inspection in both the nursing and residential side of this home. Clear information is recorded on the personal, health and medication requirements but limited information about the social care needs. The residents spoken to and the observations seen show a care service offered correctly and focused on the persons own needs. I feel so much safer here was one comment the staff are good and I am happy to wait for carers to help me in the mornings, was another comment. The information in the care plan is worded in a more personal manner with Care Homes for Older People Page 11 of 26 Evidence: the staff member writing as if the person was saying the details, such as, I like to have a lie in every morning;. Rather than Mrs X. likes to lie in every morning. Details are in place for all personal and health care. The information of all care needs are a little mixed up and difficult to find as the files are not divided for easy reading. On searching the information for risk assessments as part of the care plan for the residents the details were eventually found and the content of the information was very informative and gave clear instructions. Health care needs appear to be met. Information in the care notes and a doctor spoken to during his visit from the Julian Hospital told us that the staff are able to support the resident correctly. The need for other professionals is often gathered from outside resources. The Speech Therapist had visited recently and the Continence Advisor visits the residents who have continence concerns. Details of the visits had been recorded in the care plan notes. A MUST assessment sheet was noted in many care plans and had been completed correctly. Unfortunately the follow up to these assessments with the monitoring of food intake had not been completed fully and one chart looked at in detail had many gaps throughout the weeks, of what nutrition had or had not been given. Medication recording is not accurate as creams and lotions have not been recorded on the MAR (medication administration record) if the Senior had not administered the creams. This was discussed in full with the Senior and Manager. The Southern Cross company do have cream/lotion recording charts for recording application but they were not in use at Brundall House on this inspection visit. The Manager acted quickly and spoke to the Operations Manager with a promise that these charts would be placed in the individual rooms straight away. The Boots blister pack system seems in order for all tablet medication held in the locked trolley in the locked office. The medication fridge held some medication and we noted that the eye drops dated on opening were clearly written on the package and the fridge showed a suitable temperature on this day (5 degrees). No record book of fridge temperatures could be found to see if recordings were being taken and the Senior in that group could not find the book. We were told recordings do take place but evidence was not available. Throughout the day it was pleasant to notice that staff interact well and that residents are treated respectfully and with dignity. One staff member was noted to be inappropriately helping someone with food by standing up whilst assisting with feeding and also not talking to the person while helping with the meal, but all other transactions were carried out courteously. Care Homes for Older People Page 12 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 activities have improved and more stimulation is taking place but more effort on this support being evidenced for the person in their own bedrooms needs to be considered. Relatives do visit as and when they wish. People are encouraged to take control over their lives. The meals are wholesome and offered in pleasant surroundings. Evidence: The Activities Organiser has planned events displayed on the notice boards throughout the home. During the walk around we noticed that many residents had something in front of them to occupy them. Staff were noted to be in and out of the lounge on many occasions to ensure everyone was occupied. The Norfolk Unit is a little less stimulating with limited items around and the area appearing darker than the Verne Unit lounge. It was noticed that sensory items were on display such as beaded lights and a wedding dress on a manikin. At the top end of the lounge was a light style aquarium and the television was on at the other end of the lounge. On talking to some Care Homes for Older People Page 13 of 26 Evidence: residents it was apparent how much a recent trip out had been enjoyed and they hoped another was planned shortly. I had a great time and saw a number of dogs which I love. The photographs on display around the home show lots of activities that have been enjoyed. Unfortunately the people in their bedrooms do not appear to have the same opportunity to stimulation. One resident was in her room and appeared distressed. The sheets to record interaction in the room showed no details of what support this person is given throughout the day other than the personal/health care tasks. There was no information written about time offered for one to one, hand therapy, reading from the paper or the pat dog etc. The television was on but the tail board of the bed hid the screen and could not be seen. We spent time in this persons room and no staff member came to see this person in the hour we were there. The management informed us that the lifestory books to give a picture of the past life of the resident have been completed or partly completed by the Activities Organiser. Although these were not seen during this visit it would have been useful to see how these could have reflected the social care support in the main care plans. Relatives and friends are encouraged to visit the home and the new Manager is about to hold a relatives meeting to try and involve more families within the home. One relative stated I am always welcomed when I visit. The quality surveys carried out in April 09 show 100 of surveys completed show the home as welcoming and refreshments are offered whenever the family/friends visit. The mealtime was observed in the front dining room in Verne. The room is light, bright and the tables were laid with white tablecloths and matching napkins. The staff served the meal of fish and chips in attractive cloth aprons and appropriately asked each person if their meal was OK and if they required any help. The choice of drinks was from the pre meal sherry to wine or fruit juice. The conversations throughout the meal were fun and the plates were nearly all cleared. The one person helped with the meal in the bedroom did have a record chart of what and how much had been eaten/drunk. This chart had not been filled in for a number of days over the past month and was a poor record. Care Homes for Older People Page 14 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. The home does deal with complaints appropriately and residents are protected from abuse. Evidence: The home has a comprehensive complaints procedure that staff are aware of and they sign a document to say they have read the procedure. (seen) How anyone can complain is written in the homes brochures and is also on display around the home. The new Manager talked to us of complaints being handled quickly and thoroughly. Although he has not taken a complaint within his short time at the home he assured us that action would be taken as written in the companys procedures. The records of complaints seen by us are held in a file in the Managers office. The Commission has not received any complaints directly but a notification of a complaint had been sent by the acting Manager in April of this year. The outcome of this complaint was not clear but the acting Manager said it had been resolved. The home has a whistle blowing policy and staff all sign a form to say they have read and understand this policy. The staff are all CRB and POVA checked before they commence employment.Two of the latest recuited documents were seen. One staff member spoken to on the day of this inspection was able to give a clear picture of how she would report on any possible concerns to her line manager. Care Homes for Older People Page 15 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. This home has improved in some areas but would benefit from decoration that would help residents with memory problems orientate around the building and gardens that are safe and suitable for people to sit in. The rooms are homely and clean. Some infection control practices could be improved. Evidence: Throughout the tour of the building certain areas of the home appear in good condition. The Verne Unit has nice bright communal rooms that lead to a conservatory that is air conditioned in the summer and heated in the winter. There are more recliner chairs available for comfortable seating and plenty of small tables for drinks, newspapers etc. The Norfolk Unit is in need of improvement. Some areas are dark and the decoration is poor. The corridors and doors are all painted the same creamy colour and there is little or no signs to direct people to the correct rooms. The Environmental Health Officer visited the main kitchen in November 2008 with requirements to fit fly screens and replace some wall tiles were made. The fly screens are nearly all replaced and were seen during this visit (1 still to do) and the replacement wall tiles are planned, according to the new Manager, shortly. The home has the fire extinguishers serviced regular and these were last completed in February 2009. The fire doors are kept securely locked and are only opened by a key Care Homes for Older People Page 16 of 26 Evidence: pad. They are all released if the fire alarm rings. A comment in the fire book talked of a problem with the fire alarm system a few months ago that would be sorted at some time causing us some concern so the Manager was asked to set off the fire alarm while we were in the building. All staff met at the call point, rather slowly, and all areas where a fire alarm is placed did ring. The home has a new Maintenance Officer who understands the need to complete records comprehensively and timely. This did not happen previously but has now been rectified. The garden at the back of the home was being used on the day of this visit by a resident who was enjoying the sun and was doing a word search. Some areas are not so suitable to sit in and are untidy and not safe to walk down due to there being no hand rails and a number of slopes to manage. The weather has been much better of late yet people are not getting outside and this needs to be encouraged. The Operations Manager informed us that an extensive refurbishment programme for this home has been planned and will take place over the next two years. The different bedrooms around the home appeared clean and personalised. One person has a brandy glass and a nip ready for bedtime. The covers and curtains belong to this person and the room was full of pictures and ornaments. Another room was noted to be shared by a married couple who have their beds pushed together for night times and on the walls are pictures made by this person from jigsaw puzzles. Specialist beds for assisting with the care of residents are in place for those who require them. The home also have hoists in all areas to assist with safe transfers. On the day of this visit a hoist sling was found hanging in the sluice room where the dirty linen had been placed. This was pointed out on the previous inspection as poor infection control. The sling was moved immediately and staff need to be made aware of good hygiene practices. The domestic staff at this home again need to be praised for the cleanliness of all the rooms. No unpleasant odours were detected and it was good to see the interaction of the cleaning staff and the kitchen staff with all the residents. Care Homes for Older People Page 17 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home does have suitably trained staff who are recruited correctly to ensure residents are cared for by safe, competent and suitable staff in numbers that can meet their needs. Evidence: On the day of this visit and by looking at the rotas that are now on display outside the Managers office there appears to be enough staff on duty to offer the care required. The Verne unit where 23 residents live have 4 carers and 1 nurse to support them and on the Norfolk unit where 15 residents were living there were 2 carers and 1 senior carer. The domestic staff, kitchen staff and activities organiser support the home with plenty of interaction and a sense of working together to ensure the residents receive appropriate support for their needs. Two recently recruited staff members personnel files were looked at. The details found included an application, job description, two references, POVA and CRB clearance, forms of identification and a signed document to show the person had read the companies policies. Also in the files were noted records of supervision that had been held regularly since their employment had started. The home has a training matrix that was given to us to look at in detail. The home is behind in some of the training needs and especially noted was the need for updating Care Homes for Older People Page 18 of 26 Evidence: on moving and handling with only 10 of the staff currently up to date in this subject. The home also has the unit that caters for people who have dementia but some training, such as Yesterday, Today and Tomorrow and Challenging Behaviour only have 5 of the staff trained. The home management talked of the concentrated effort that is taking place to ensure the training is brought up to date. The staff spoken to stated they felt supported with training and on the day of this inspection a number of staff were in another part of the building attending a training session for the afternoon. Care Homes for Older People Page 19 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. The new Manager should be suitable to carry out his role responsibly and fully and ensure the home is run in the best interests of the residents. The home has procedures that safeguard the residents money. Staff are now appropriately supervised to ensure they are carry out their job correctly. The health, safety and welfare of residents is promoted and protected but could be improved in some training. Evidence: At the beginning of May the home recruited a new Manager. The home being overseen by the Acting Manager until this person was recruited. The new person has many qualifications in management and teaching and is a qualified nurse. The Acting manager has made many improvements to the home over the last six months and will be assisting the new Manager in his induction into Brundall House to give a seamless Care Homes for Older People Page 20 of 26 Evidence: transition from one person to another with, hopefully, little disruption to the home. In April of this year the home has carried out a quality review and sent out surveys, that have been returned, from various professionals and family members. The information was collated and a document produced with graphs and statistics to show the outcomes of the survey and how this will help to develop and improve the quality of the service in the future. On discussing this with the new Manager it was evident he is keen to continue to develop and improve the service and will be carrying out quality reviews on a regular basis. The home has a robust system for assisting residents with their personal spending money. The procedure is carried out in all of the Southern Cross homes and is checked and audited by the Administration Manager. The details were looked at thoroughly six months ago and the Administrator told us that nothing has changed and there were no concerns. Every resident has the interest from the bank placed in their account every month and details are kept for each person. The Commission has not been notified of any problems regarding residents money. Residents spoken to are happy for the home to help them with their money. The finances were not counted or receipts checked on this occasion. Records of staff supervision were seen on two files during this visit. The staff spoken to said they can talk to Seniors or the management at any time and regular sit down and have one to one meetings. Since the last inspection the staff tell us that the support and direction has improved, helping staff focus and work as a team. This was certainly noted by us in the atmosphere within the home during this 8 hour visit. As mentioned previously in the report, training in health and safety areas such as moving and handling are not up to date with only 10 of staff trained. On looking at these records some staff have not been updated since February 2006. Other health and safety training was much more up to date with areas such as Infection Control showing 73 and Food Hygiene 68 of staff trained. The laundry staff member showed us the COSHH safety data sheets and was aware of what to do in the event of an accident. This laundry room was clean and tidy. No items were on the floor and there were no odours detected. The accident records were seen and appeared in order. One care plan was looked at of someone who had fallen and this was reflected in the care plan and the accident form. The rooms seen showed the windows had safe restrictors and the water hand tested in three bedrooms appeared to run at a suitable temperature. The home does have hot water control valves. The new maintenance officer has started to complete records of servicing of Care Homes for Older People Page 21 of 26 Evidence: equipment in the home where at the last inspection records were not in place. 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 19 23 The gardens should be made 01/08/2009 safe and suitable for the residents to come and go as they wish. To ensure that when using the garden all risks are assessed and where possible eliminated. 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 recommended that charts are placed in the residents bedrooms for staff to complete on administering creams during personal care support. The recording of the medication fridge temperature should be available so completion is carried out daily. The recording of interaction for the social support of people who are in their rooms should be part of the daily recording notes to ensure each person has some social time spent with them. The person in bed should have allocated time for social/stimulation and it should be recorded in the daily charts held in their room. 2 3 9 12 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 4 15 Staff should complete all charts correctly if it is part of the required care for the individual, such as how much the person has eaten at mealtimes. The records for maintenance must be kept up to date and comments and action taken written clearly. The staff would benefit from a notice placed in the sluice rooms to ensure that nothing is stored in these rooms and that good infection control procedures are followed. The home does need to ensure that updated training is carried out in a timely manner. The home should ensure that safe working practices are taking place by training in these areas being up to date. 5 6 19 26 7 8 30 37 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. 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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