Care Home: Cathedral View

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Cathedral View Archdeacon Street Gloucester GL1 2QX Two star good service The quality rating for this care home is: 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lynne Bennett Date: 2 0 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. They reflect the things that people have said are important to them: 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 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) 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 Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Cathedral View Archdeacon Street Gloucester GL1 2QX 01452303248 01452505073 debbie.ewers@gloucestershire.gov.uk 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) : Gloucestershire County Council care home 9 Number of places (if applicable): Under 65 Over 65 9 1 9 0 learning disability physical disability Additional conditions: Date of last inspection 1 2 1 2 2 0 0 7 A bit about the care home Cathedral View is a ninebed unit, which provides planned and emergency respite care for adults with learning disability. The facility is owned and operated by Gloucestershire Social Services and would accept referrals countywide. The premises are situated close to Gloucester Cathedral and are within walking distance of the docks and town centre. The accommodation has equipment and adaptations to meet the needs of people with mobility difficulties and can provide accommodation to one person who uses a wheelchair. The home provides single wellfurnished rooms on both upper and ground floors and people have the use of a lift. There is also a separate lounge, a dining room and recreation area. There is a large laundry room. There is plenty of quiet space within various parts of the building for people to have time alone or with visitors. The home encourages people to continue to attend day centres as part of their normal daily routine. The Statement of Purpose and Service User Guide are kept in the main office and new people using the service are provided with a Welcome Pack. 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home This inspection took place in January 2009 and included a visit to the home on 20th January. The manager was present throughout. Four people staying at the home were met and three members of staff were spoken with. The registered manager completed an AQAA (Annual Quality Assurance Assessment) as part of the inspection, providing considerable information about the service and plans for further improvement. We (The Commission for Social Care Inspection) looked at a range of records including peoples care plans, staff files, health and safety records and quality assurance systems. We met three people using the service, and asked staff about those peoples needs. We also looked at the care plans, medical records and daily notes for these three people. This is called case tracking. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. What the care home does well The service provides spacious accommodation which is pleasantly decorated and fitted out with good fixtures and fittings. Equipment and adaptations are provided for people who have a physical disability. A person centred approach to care planning is in place involving people using the service in identifying their wishes and dreams. Staff have access to a good training programme helping them to develop the knowledge and skills to support people using the service. What has got better from the last inspection The home has been decorated and new fixtures and fittings provided. People are able to attend guest meetings to talk about their concerns or the service they would like to receive. What the care home could do better When new staff are employed, the manager must make sure that satisfactory records are in place before they start work. When the registered manager is away from the home for more than 28 days we must be informed, and also told about the arrangements for the management of the home whilst they are away. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Lynne Bennett Colston 33 Bristol BS1 4UA 0117 930 7110 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 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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 . People have access to a range of information enabling them to make a decision about whether they wish to use the service. An assessment of the persons wishes and needs are taken into consideration and any changes are monitored to make sure that peoples needs can be met. Evidence: The home has a Statement of Purpose and Service User Guide which were reviewed in January 2009. A copy of this document was held in the office of the home. People being referred to the service were being given a Welcome Pack providing them with information about the service they will receive. The respite service provides care to around 54 people living in Gloucestershire. Up to 9 people may stay at any one time. During the visit to the service there were five people staying, one person left the morning of the visit. The records for two new people were examined, one person had used the service and the other was having visits. Checklists were being kept which evidenced whether a full assessment of need and care plan had been received from the placing authority. There were copies of these for both people. The checklist also indicated whether people had been given the Welcome Pack and had completed visits. One person had tea visits and an overnight stay was being arranged. Parents or carers were also encouraged to visit the home. New people using the service were also being given an induction during their first stay in the home. The manager confirmed that emergency placements had been received and that they receive the necessary information from placing authorities within 48 hours. Peoples changing needs were being monitored and where necessary the service was withdrawn when it was felt that their needs could no longer be met by the service. Evidence: Each person case tracked had a statement of terms and conditions in place detailing the fees they would pay for their stays at the home. People were being allocated stays at the home for the financial year and they book their preferences with the home. Some people liked to stay in the same room and staff said that wherever possible this was being arranged. Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 . People are being involved in developing their care plans that reflect their aspirations and needs. Risks are being mostly identified and managed safeguarding people from possible harm. Evidence: The care of three people staying at the home was case tracked which included reading their care plans and other related documents, meeting them and talking to staff about their needs and the support they provided to people. Each person had a person centred plan which was developed from their assessment of need. These were being regularly reviewed every 6 months and annually with other people involved in their care such as relatives/carers and day care key workers. Plans provided a holistic analysis of peoples physical, intellectual, emotional and social needs. With a summary of their personal information a list of what works well and what does not work well were noted, as well as what is important to ... and who is important to ... Key workers said they arranged reviews and prepared written reports with people for these. Copies were kept on their files. Changes to care plans were identified in a checklist and evidenced by new copies of these on their files. Staff said that they keep in regular contact with relatives so that any changes to needs can be identified. Some people had signed their care plans. Where necessary people had communication profiles in place providing guidance for staff how they should interpret verbal and non verbal behaviour. Use of Makaton sign language and photographs were promoted for some. Staff were observed using sign language with a person staying at the home. Some records were being produced in a format using pictures and photographs, such as minutes of guest meetings and Evidence: feedback forms. Daily notes were used to reflect how people were supported to make choices during their stay and provided with help to meet their identified needs. Monitoring forms were in place to complement care plans and risk assessments. Information about advocacy was available in the home. There were some restrictions in place such as keeping the front door locked, locking the kitchen door and offices when staff were not around. The rationale for doing this was clearly detailed in care plans and risk assessments and the practice followed when people who were considered to be at risk were staying in the home. The home will need to consider these practices in light of the forthcoming Deprivation of Liberty Safeguards (DOLS). Where listening devices or bed sides were in use protocols were in place providing the reasons for their use. The service was completing a Work Activity Inventory for each person identifying hazards from which risk assessments were developed. These were in place for a range of hazards and mostly related to care plans. Discussions took place with the manager and staff about a risk identified which was not highlighted in a care plan in respect of concerns that a person might scald themselves. It was felt that health and safety checks which were in place minimised these risks. For another person their care plan identified that due to Ataxia they may be at risk from stumbling or tripping but no risk assessment was in place for this. A missing persons procedure was in place and a profile had been developed for each person. Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 . Opportunities to participate in social, educational, cultural and recreational activities are available to people staying for respite. People are offered a varied and balanced diet appropriate to their needs, promoting their health and wellbeing. Evidence: Wherever possible people were being supported to continue with their lifestyles and commitments whilst staying for respite. The AQAA indicated, Our service encourages and enables participation in normal patterns of daily life. Each person had a schedule of their activities in place and transport was provided so that they could access day care and colleges. If people needed to stay at the home during the day then staff support was available. A member of staff said that they were reviewing support for day time activities at the home during the week if needed and when day centres and colleges were closed. People were observed being supported to go to day centres during the visits. Peoples care plans identified their religious preferences and support would be provided if needed to ensure that these needs were met. At weekends people were supported to explore the city centre, to go shopping or the cinema. Staff said that some people liked to stay in the home where they could access an activity room with a computer, snooker table and interactive games. One person liked to play the drums and had the use of the annexe in which to do this. The home Evidence: did not have access to a vehicle at the time of the visit but staff said they could use taxis or walk to most facilities in the city centre. Staff said that people could help around the home if they liked. One person staying during the visit enjoyed laying tables and other people like to get involved in cooking. Comments from people using the service included, I like the home the way it is and I use the washing machine and staff let me do what I want. The home had a public telephone which people could use but most were bringing mobile phones to keep in contact with family and friends. Visits from families and friends were encouraged and relatives said they were made to feel welcome. Daily notes evidenced choices given to people about times for going to bed, what to eat and where to spend their time. Staff acknowledged that people would choose when to go to bed and at weekends people particularly enjoyed staying up late. People were being given a key to their room if they wished to lock their bedroom door during their stay. The home had a menu which was set up to run over a four week period. People staying at the service had discussed meals at guest meetings which were held every month. Alternatives to the main meal were being offered and recorded. A mixture of freshly produced food and frozen food was being cooked. The service no longer had a cook to prepare meals which staff were now preparing. They had received training in food hygiene. Fresh fruit and vegetables were provided. People staying at the home occasionally helped with the shopping in a local supermarket. Where people have particular dietary needs such as wheat and diary free this was being catered for. Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 . Peoples health and personal care needs are being met helping them to stay well. Their health and wellbeing are promoted by satisfactory arrangements for the handling of medication and training of staff in specialised techniques. Evidence: The way in which people wish to be supported with their personal and health care needs were identified in their care plans. Each person had a list of their likes and dislikes and a care plan for Intimate Care. This plan identified whether people had a preference about the gender of staff providing their personal care. In those plans examined people said that they did not mind. The manager said that she was not aware of any one who had indicated that they wished to be supported by male staff but if they did they would arrange for a male carer to provide this. People continued to receive support from health care professionals they have when at home and these details were recorded in their care plans. The service has close contact with Community Learning Disability Teams and other health care professionals. Systems for the administration of medication were examined and found to be satisfactory. Each person brings their medication with them from home which the service had requested was supplied in packaging dispensed from the pharmacy. Staff confirmed that in most cases this happens and they either refuse medication if not sent in this way or request confirmation from the Doctor about instructions for administration (for medication prescribed give as necessary). Stock was being counted upon admittance and a further check done upon leaving the service. Medication records were completed by hand and systems were in place for checks to be completed by a second member of staff. Medication errors were being identified and the appropriate procedures taken to investigate these and report them to us. A fridge Evidence: had been provided to items needing to be stored under 8 degrees centigrade. The temperature of this was being recorded on the handover record. The temperature of the medication cabinet needs to be monitored to make sure that drugs were being stored at below 25 degrees centigrade. A signature list was in place for all staff administering medication. Staff confirmed they had completed training in the safe handling of medication. Certificates were kept on their files. Staff had received training in the administration of Buccal Midazolam. Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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 service has an accessible complaints procedure which enables concerns to be raised by people using the service or on their behalf. Systems are in place which should safeguard people from possible abuse. Evidence: The home had a complaints procedure in place which was also available in a format appropriate to peoples needs being produced in picture and symbol. The AQAA stated, Service users can, if they wish, make a complaint by speaking to their key worker, the manager or any other member of staff they choose. A complaints file was in place which confirmed that no complaints had been received by the home. Various compliments had been recorded such as staff have patience and take things at .... pace. The guest meetings were also giving people the opportunity to voice any concerns they may have. Staff confirmed that they had attended training in the alerters guide with the local adult protection team and could also access electronic learning in the safeguarding of adults. Those staff spoken with had a good understanding of abuse and their responsibilities in identifying and responding to suspected abuse. They had confidence that the management team would challenge poor practice and in the whistle blowing procedure. Staff had also attended training in the Mental Capacity Act and the manager confirmed completion of training in DOLS. Staff had just attended training in PROACT which was a positive approach to management of challenging behaviour. An audit had just been completed by a trainer to assess their risk and behaviour management plans. Plans were being developed for people who presented the service with challenges. Staff confirmed that physical intervention was not used and that techniques for diversion and distraction were effective. People bring money with them for their stay and some require support to manage this. Evidence: Systems were in place to manage this and records were in place with evidence of regular checks by staff during each day. Safes were provided n bedrooms for people who wished to manage their own finances. 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 . People live in a home that is safe,clean and well maintained which recognises their diverse needs creating an environment that matches their personal requirements. Specialist equipment is provided to those people who need it. Evidence: Considerable work had been done around the home to improve the standard of accommodation provided. Communal areas had been redecorated and new fixtures and fittings provided. People were observed enjoying the different areas around the home including the lounge and foyer. People have access to a private room with sink and have secure facilities for storing personal property. Each room was provided with its own television. One room on the ground floor had an en suite bathroom with overhead tracking. A hospital bed had been provided and a pressure relieving mattress had been obtained for one person when needed. A wet room on the ground floor was out of use due to tiles being replaced on the wall. Arrangements had been made for one person to have a shower at their day centre. The annexe was providing space for training and meetings for staff. People staying at the home also had access to this space if they wanted. There were plans to extend the communal areas providing additional space for the dining area and lounge. A local day centre uses rooms on the first floor during the week. Consideration should be given about security of the upstairs bedrooms. People using the day care rooms accessed these by stairs which lead to the first floor bedrooms. A lift provided access to these rooms without affecting the bedrooms. The laundry had been relocated to a large room. Personal protective equipment was available and communal toilets were provided with paper towels and liquid soap. Hazardous products were stored securely and COSHH data sheets were in place. 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 . Peoples needs are met by a competent staff team, who have access to a comprehensive training programme that provides staff with the opportunity to gain knowledge about the diverse needs of people living at the home. Improvements need to be made to recruitment and selection processes to make sure people are safeguarded from possible harm. Evidence: At the time of the visit the home had three 20 hour vacancies for care staff. The rota confirmed that staffing levels were being maintained with two care staff working each shift, three over the weekend, one person sleeping in and a waking member of staff. Although the home was able to use agency staff they were keeping this to a minimum by using bank staff. The manager confirmed that when agency staff were used they tried to use the same staff to ensure consistency of approach. The AQAA indicated that nearly 90 of care staff had a NVQ Award in Health and Social Care. New staff confirmed that they had completed a corporate induction and also had access to Learning Disability Qualifications. Gloucestershire County Council was providing an induction which was equivalent to Skills for Care induction standards. The manager confirmed new staff shadow existing staff before working shifts. Recruitment and selection of staff was administered by a central Human Resources department and records provided for interviews. Three files were examined. One person had just been appointed but had not started work and two others had been appointed since the last inspection. None of the files had copies of application forms and so it was not possible to ascertain whether a full employment history was being provided. One person had supplied a Curriculum Vitae but this had gaps in employment history which did not appear to have been questioned. All were appointed after a Criminal Records Bureau check had been returned and two references received. References for one person had been obtained from Team Leaders at previous care Evidence: homes to their personal addresses. This is not good practice. As a result there was no reference from their recent or former employers in care. Another person had previously worked for the County Council and verbal references had been obtained. Written references must also be provided. There was no evidence on two files that proof of identity had been obtained and on the other evidence from only one source. The home had access to a robust training programme and were monitoring the training needs of the staff team through supervision, annual appraisals and by updating the homes training matrix. Staff confirmed they had just completed a weeks training including refresher courses in mandatory training and PROACT. Training specific to the needs of people using the service such as epilepsy and autism could be accessed by staff. There was evidence that staff were having frequent supervision and an annual appraisal. New staff had 6/12/18 and 26 week probationary supervisions. All were recorded and copies kept on file. Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 . Overall people benefit from a well run home although improvements in some systems would make sure people are safeguarded from possible abuse and any concerns they may have are acted upon. A quality assurance programme is in place which includes feedback from people using the service. Health and safety systems should protect people from possible harm. Evidence: The registered manager was absent during the visit having been seconded to another service since November 2008. We had not been informed of her absence as required under Regulation 38. The acting manager said she thought we had been informed. The manager who was the deputy manager for the home had been promoted in the absence of the registered manager. Concerns about recruitment and selection records were discussed with her and she said that she would rectify the shortfalls. We needed to send a reminder to the registered manager to return the AQAA which was submitted after the required date. Gloucestershire County Council has a system in place for monitoring quality within the service and the Business and Work Plan for 2006/2007 were available for inspection. The home was having monthly Regulation 26 visits and a report was being produced, copies of which were read. One such visit took place during the inspection. People using the service were being asked for feedback every 3 months. The format used included pictures and photographs and used plain english. Comments included, an excellent respite service and I think the service is fine as it is. Other comments indicated concerns about helping people with dressing and people going to their day care centre when poorly. It was not clear whether anything had been done in response Evidence: to these concerns. Systems monitoring health and safety were in place and copies of records and certificates were seen. A fire risk assessment was in place which was being regularly reviewed. Fire records were being completed frequently and fire drills were taking place. Other records were being completed at appropriate intervals for the monitoring of fridges, freezers, cooked food temperatures and water temperatures. Are there any outstanding requirements from the last inspection? Yes  No  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 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 Description 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 Description Timescale for action 1 34 19 The registered person must 27/02/2009 make sure that the necessary records are obtained before new staff are appointed. This is in respect of a full employment history, two satisfactory references and proof that identity was verified. This is to safeguard people from possible harm. 2 37 38 The registered person must 27/02/2009 inform the Commission when the registered manager is absent from the home for more than 28 days. This is to make sure we are aware of the arrangements for the management of the home. 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 2 3 4 5 9 20 24 34 39 Where hazards are identified they should be reflected in the corresponding care plans or risk assessments. The temperature of the medication cabinet should be monitored and recorded. Review security arrangements and access to the rooms on the first floor used by a local day centre. Copies of application forms for new staff should be kept in the home. Systems should be put in place to provide feedback to people expressing concerns in their surveys and recording of the outcome or action taken. Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.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) Commission for Social Care Inspection (CSCI). 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. 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