Care Home: Burman House

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What the care home does well The residents all appear smart, clean and tidy. The staff do have a good relationship with the residents and the dedicated staff work hard to ensure the care for each person is met appropriately. The home is very clean and tidy. With only one domestic on duty the care team help with domestic chores to ensure the environment is in good, clean order. The staff team do know the residents well and are aware and do try to deliver person centred care within the limitations of staff numbers on duty. The home encourages and welcomes any visitors to Burnam House and actively involves them in th day to day life of the home. What has improved since the last inspection? Since the last inspection personnel records of all staff in the building are now held in locked drawers within the home and are now available for inspection. The home has introduced a night care co ordinator to ensure a senior staff member is available to support the night staff team throughout their shift. One of the bathrooms has been turned into a large walk in shower room that can be used assisted and unassisted once assessed for any risks. What the care home could do better: Records in the home are spread in different folders and rooms yet all belong to the residents and all efforts should be taken to keep records together for staff to access. Charts for recording the application of creams and lotions need to be with the resident for staff to complete on applying the prescribed medication. Staffing within the home needs to take into consideration the social support required to ensure all care for the person is supported by appropriately recruited staff, allowing laundry staff to concentrate on the laundry and care staff have the time for some one to one or group activities with residents. The meals provided in the home need to offer more choice especially after 4 pm when access to the kitchen is limited and a choice of hot food later in the day is not an option. The home needs to improve the control of the water temperature around the home to ensure the recommended 43 degrees is monitored and maintained in all areas accessed by residents. When an acting manager is put in the position of managing a home over 28 days or more the Commission does need to be informed. Key inspection report Care homes for older people Name: Address: Burman House Burman House Mill Road Terrington St John Wisbech Norfolk PE14 7SF     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: 2 3 0 9 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 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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 27 Information about the care home Name of care home: Address: Burman House Burman House Mill Road Terrington St John Wisbech Norfolk PE14 7SF 01945880464 01945881416 pat.mccallum@norfolk.gov.uk www.norfolk.gov.uk Norfolk County CouncilCommunity Care care home 32 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 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 32 The registered person may provide the following categories of service only: 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 categories: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Burman House is a care home providing care and accommodation for 32 older people. It is owned by Norfolk County Council Social Services Department. The home is located in the village of Terrington St John, which is midway between the market towns of Wisbech and Kings Lynn. Care Homes for Older People Page 4 of 27 Over 65 32 0 Brief description of the care home Burman House is a two-storey building with the accommodation for service users on the ground floor. There are some office areas and staff sleep-in facilities on the first floor. All of the bedrooms are single. Access into the building is unimpeded including access for wheelchair users. The grounds are well kept and there are seating areas outside for service users in warm weather. The cost for this service is available for the local authority. Norfolk County Council, Social Services. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 inspection report has been carried out following a visit to the home over seven and a half hours. Throughout the visit, records were inspected, residents, staff and visitors were spoken to, a meal was taken with residents in the dining room and a tour of the building took place. Information on care plans, medication, health and safety, personnel and complaints were discussed and records were seen. Prior to this visit the Acting Manager had completed and returned to the Commission the Annual Quality Assurance Assessment (AQAA) that gave us some information about the service offered. Some residents had completed surveys that had been sent to the home previously giving their opinion of the service. We also checked information that had been sent to us over the year since the last report was written. No surveys were received from staff or professionals involved with the home. Care Homes for Older People Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: Records in the home are spread in different folders and rooms yet all belong to the residents and all efforts should be taken to keep records together for staff to access. Charts for recording the application of creams and lotions need to be with the resident for staff to complete on applying the prescribed medication. Staffing within the home needs to take into consideration the social support required to ensure all care for the person is supported by appropriately recruited staff, allowing laundry staff to concentrate on the laundry and care staff have the time for some one to one or group activities with residents. The meals provided in the home need to offer more choice especially after 4 pm when access to the kitchen is limited and a choice of hot food later in the day is not an option. The home needs to improve the control of the water temperature around the home to ensure the recommended 43 degrees is monitored and maintained in all areas accessed by residents. When an acting manager is put in the position of managing a home over 28 days or more the Commission does need to be informed. Care Homes for Older People Page 7 of 27 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 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home will not accept a resident who has not been assessed and found to be suitable for the service offered in this home. Evidence: The acting Manager showed us two recently admitted residents pre assessment paperwork. The details recorded gave a good picture of the needs required. The service also relies on the information fed onto the computer programme system care First by social care professionals to give a bigger picture of the needs assessment. Throughout observation during the day of the inspection and on talking to the residents people appeared to be suitably placed. Some remembered visiting the home prior to admission and one person showed us the copy of the information all about the service provided. The acting manager also talked of the need, on occasion, to have a resident Care Homes for Older People Page 10 of 27 Evidence: reassessed as their needs alter and the care required can no longer be met by the service provided in this home. Consideration is taken carefully of the needs of the rest of the residents and the ability and resources available in the home before a person is admitted. The home does not provide an intermediate care service. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home could improve the recording practices to ensure that details are not forgotten or are repeated. Care plans are in place and personal and health care needs are met. Evidence: Each resident has a care plan that at present is locked inside a cupboard in the main lounge. Two care plans out of the 28 people in the home on the day of the inspection was looked at in detail. The information read gave a picture of the needs of the individuals and on talking to the residents the care provided is what they feel is correct. We could do with more staff as we have to wait for long periods some times. Staff are very good but too busy to give me the time I would like. I am supposed to have a bath weekly but I missed out, they promised to give me one in the afternoon but didnt. On checking records the care plan does state when the baths should happen and the record for baths show this did not happen when inspected for this particular resident. Weights are recorded for each resident regularly and it was noted that a concern with one residents weight created a monitoring of food and the MUST tool had been implemented to ensure the correct nutrition was provided. It was good Care Homes for Older People Page 12 of 27 Evidence: to note that the persons weight did improve and that the monitoring process had been successful. Each resident has their risk assessed and these documents are placed in the residents rooms, inside the wardrobe, to give easy access to any staff member while carrying out the daily care tasks. These documents stand alone from the day to day care plan and need to be held in one care plan file in one place. The home seems to have documentation in so many different areas that the recording and updating can be untimely and perhaps forgotten such as the recording of the application of creams and lotions. Daily records are written in another folder and many have fairly meaningless comments such as up, had breakfast and in the lounge, or dinner eaten no problems. The night care plans are detailed and available but held in another folder separate from the main care plan. The home is very well supported by the local GP practice. The acting manager is aiming to have regular surgeries held within the home and also for a designated District Nurse to be allocated to enable continuity of care within the medical needs of the residents. The home also is supported by the Continence Adviser with a Senior Carer taking the lead in the continence management within the home. The medication is provided by Boots and is stored in a locked designated room within the home. The lunchtime administration process was observed and carried out correctly in a calm and unobtrusive manner during the midday meal. Residents were quietly asked to take their medication, observed swallowing the medication and then recording on the MAR chart. The records were looked at and it was noted that one small error had occurred but all other recordings were correct. The fridge in the medical room is held at the correct temperature and noted at 4 degrees during inspection with a clear daily record held by the officer responsible for medication. A concern of the monitoring and application of creams was discussed due the many gaps on the charts of all of the cream/lotions. The written details on the chart states clearly where and how many times creams should be applied but there was limited recordings to say this had happened. The charts are not held with the creams and so recording does not take place as creams/lotions are applied. It was also noted that the medication cabinet in the bedroom wardrobe (seen) was wide open yet did contain a number of creams that should be stored safely. Throughout the day the staff were noted to be kind, courteous, respectful and discrete. All personal care was carried out in private and task such as hoisting and transfers were carried out calmly and quietly. All residents looked clean, smart and Care Homes for Older People Page 13 of 27 Evidence: tidy and on talking to us stated that they like to look nice and were glad they could have their hair done and their nails cut. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home tries hard to stimulate the residents within the staffing levels and budget available. Relatives are include and encouraged to visit when they wish. The meals are enjoyed by the residents but choice and quality could be improved. Evidence: The residents do appear contented and when spoken to said they do have the occasional trip out and events do happen occasionally. The staff on the day of the inspection were busy with care and laundry tasks and interaction for stimulation was very limited. The home does not have a designated activities person and although activities are written on the display board not many people take part was stated by the acting manager. A jigsaw was partly completed by one resident and the home does have daily newspapers delivered for everyone to use. Any trips that cost, or planned entertainment is paid for by the money gathered through raffles and fund raising events so these are limited. Trips to the garden centre or a ride to the coast does take place in the good weather and residents have commented in their surveys received prior to this inspection, saying the staff are good at arranging trips out, and the staff try their best to entertain us. Care Homes for Older People Page 15 of 27 Evidence: Throughout the day relatives were coming and going. The interaction between staff and visitors made the people feel welcome. Two people spoken to said they are always welcomed and updated on their loved one. Some survey comments stated they are such a good team and we are always happy to visit. The acting manager told us of the involvement of a church service held in the home and one visitor gave us details of the church attended by the resident every Sunday. No matter what time of day we plan to go out our relative is always dressed and ready. The meals provided to the residents are prepared by contractors and not employed directly by the home. On the day of this inspection a meal was taken with the residents. The choice was limited to roast beef or vegetarian sausages. Although residents said they enjoyed the meal and comments received in surveys also say the meals are good some mentioned the lack of fresh vegetables. The whole meal was served on the plate and there was no choice in quantity etc. It appears that the food is vacuum packed style catering and so limits the use of fresh vegetables. The pudding was also prepacked but choice was available and as the sweet was shown to the residents more stimulation and participation in choosing was evident. Residents were sitting up, alert and looking from dish to dish to make a decision. The trolley was pushed from table to table displaying queens pudding, ice cream, jelly, cheese and biscuits, yoghurts and fresh fruit. Throughout the meal residents were encouraged to drink with a wide variety offered of different flavoured cold drinks. After the meal a hot drink was served as was the case at timely intervals throughout the day. Cold drinks were also noted in the lounges for people to help themselves. The home does not have a cook in the building after 4 pm, restricting the possibility of choice later in the day. The tea on the day of this inspection was sandwiches. If a hot meal was required later it would be very limited and would have to be carried out by the care staff who are busy with care/laundry tasks. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints and concerns will be listened to, taken seriously and acted upon. Residents are cared for safely and are protected from abuse. Evidence: The acting manager shared the record book of complaints held in the office and informed us that the home has an open door policy and that concerns are dealt with quickly and efficiently. The recordings see are more of concerns rather than complaints and have been dealt with quickly. No formal complaints have been received in the home or with the commission. 13 out of the 14 surveys from residents received prior to this inspection state they know how to make a complaint. Staff spoken to on the day understand their duty to report any concerns of poor practice that may be abusive. They also have records of training in the protection of vulnerable adults with certificates held within the home. Residents comments about the staff were positive and although the acting manager knows and understands the safeguarding of adults procedures there has not been the need to use this service to date. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and hygienic but some areas need improving such as water temperatures to ensure the home is maintained safely. Evidence: The home is a seventies building that is a little institutionalised in appearance. Most of the bedrooms are small with no en suite facilities and only have shared toilets and bathrooms. The maintenance of the property is carried out thoroughly and records were seen of the dates and tasks recorded of fire, legionella testing and water temperatures. During the checking of these records it was noted the hot taps appeared to be far too hot. The acting manager and the Inspector checked a number of rooms to discover the water to be far too hot to hold your hand underneath and although no thermometer was used it was agreed that the water was above the recommended 43 degrees. This temperature did vary around the building and on checking the baths, one was at a suitable temperature, one was cold and the shower was variable. The home has three bathrooms for 30 people but with one runing cold and not fit for purpose it leaves only two bath/shower rooms. The recommended number is 1 bathroom to 8 people. At present this home does not have a suitable number of workable bathrooms. The gardens were noted to be fairly tidy and there is places for people to sit outside if they wish. Care Homes for Older People Page 18 of 27 Evidence: Bedrooms, although small, are nicely furnished and made homely by the residents own pictures and ornaments. Most bedrooms had a commode for night time use. Residents spoken to are pleased with their rooms and feel safe and comfortable. The communal areas are spacious with plenty of areas to choose from. All the lounges (3) are light, bright and well furnished with homely items around the rooms. The one lounge has a proper fireplace and gives the appearance of a family homes front room. The decor in some areas is looking a little tired and knocked about by wheelchairs and frames but credit is due to the cleaning staff who keep the place fresh and tidy. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels need to be looked at to ensure residents are stimulated and offered purposeful activities. The staff are qualified, recruited and trained to ensure that residents are cared for by capable hands. Evidence: On the day of this inspection the home had the correct number of staff as stated on the rota. There were 3 carers, 1 senior, 1 care co ordinator and 1 domestic. None of the residents appeared rushed and everyone was presented smartly. What was apparent was the lack of stimulation and purposeful activities. Once people were up and in the lounge the staff concentrated on the laundry or record writing with limited time spent in the lounges or in individuals bedrooms. Two comments from residents stated, they really do the best they can but there is just not enough of them. I wish they would come quicker especially when I am on the toilet. During the afternoon it was noted that 2 carers were busy with laundry tasks leaving 1 carer in the 3 lounges with the care co ordinator doing office tasks. With no designated activities person or a designated laundry staff member the residents miss out on the conversations and stimulation that could be worthwhile. On the day of this inspection visit the NVQ assessor was working with a staff member. She told us that the home has worked really hard to get the staff qualifies and that Care Homes for Older People Page 20 of 27 Evidence: another 2 staff members were all but completed. The care co ordinator also told us of her recent achievement of NVQ 3. The recruitment of staff is carried out through guidance with Norfolk County Council human resources department. Procedures are followed and in the home were copies of personnel files including CRBs, two references and forms of identification were seen. Staff spoken to said they are supported well and offered the relevant induction and training to enable them to do their job well. The acting manager gave us good examples of the training in place for staff. The statutory courses are available throughout the year and Norfolk County Council provide dates and venues for these courses to take place. The Senior carer on the day of the inspection felt the home was very supportive and that all the training and development needs were available when required. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is being suitably managed over this temporary management arrangement and systems are in place to ensure quality, safety and support by management is in place for all residents, staff and visitors. Evidence: The home has had an acting manager in post for three months. The person covering the position at present is one of Burman Houses Care Co ordinators who has many years of experience both in home care and residential care. The AQAA had been completed by this person and gave some information about the service. Areas that required clarification were discussed during this visit to give a more detailed picture of the service provided and the way the home plans to develop. Throughout the day staff, relatives and professionals were welcomed and questions dealt with appropriately. The staff told us that the management team is very supportive and they feel able to approach anyone at anytime. Care Homes for Older People Page 22 of 27 Evidence: The home has recently carried out their own quality checks. Surveys had been circulated to all stakeholders and the returned results were shown to us. The Registered Manager should be returning to the home in a months time and the evidence gathered from this survey should be used to move the service forward and improve the quality. In the summer the home had concerns about the management of residents money when some went missing. A thorough audit by Norfolk County Council took place and a more secure system of managing the money is now in place. The whole process was looked at by us and the audit trail of the recent check on finances was noted. The Commission had been notified of this incident and the Commission had talked to the acting manager at the time. Correct action was taken and improvements have been made. Within the staff personnel files supervision notes were seen. The details appeared appropriate and are taking place fairly regularly. It was noted on the staff room notice board future dates planned for a number of staff. The home is about to have a new format to record supervision that will prompt questions and hopefully will make the session more focussed. The health and safety within the home is managed well. Systems are in place to ensure all aspects of the service is as safe as it can be. Staff have the mandetory training such as moving and handling, fire safety, food hygiene, infection control and first aid. Induction procedures are thorough for new staff. The store cupboard for cleaning materials was noted to be locked and safety data sheets (COSHH) for the safety management of all chemicals used in the home are held on file for all staff to access. Accidents and injuries were looked in depth and all recordings were appropriate. The forms are stored in a box file and information on falls are transferred into the residents documentation to check for patterns that are then reviewed monthly with care plan reviews. The one main concern for the safety of the residents has been the water temperature control which is mentioned previously in this report where a requirement has been made. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The recording of the application of creams and lotions must be clear To ensure the administration of all medication is carried out safely and correctly. 01/11/2009 2 9 13 Medicine cabinets within bedrooms and containing medication must be kept locked. To ensure safe keeping of medication is adhered to. 01/11/2009 3 21 23 There should be sufficient working bathrooms to meet the needs of the residents. To ensure all residents have close access to a working bathroom 01/11/2009 4 25 13 The water temperatures in all areas accessed by the residents must be maintained at the recommended temperature. 01/11/2009 Care Homes for Older People Page 25 of 27 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action To ensure residents are safeguarded from water that is too hot. 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 7 It is recommended that records are collated and stored in one file in one place to ensure continuity of recording is up to date and accurate. Is recommended that a designated staff member be employed to ensure the social care needs are met for individual residents needs. The home should ensure that the meals are of quality and that choice is available at all times, including after 4pm. The home needs to look at the way staff are deployed in the home and ensure ensure residents are supported with their social care needs. 2 12 3 4 15 27 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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