Care Home: Caton House Nursing Home

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What the care home does well There is information available and the opportunity to visit the home to help people decide whether they wish to move to the home. People`s health and social care needs are assessed before they move to the home, to ensure they can be met. The home can meet a diverse range of faith and cultural needs. People`s diverse personal, health and medication needs are met in a manner which protects their dignity, promoting their wellbeing. The General Practitioner visits regularly, as do other members of the healthcare team. Residents are supported to visit hospital outpatient clinics when necessary. Medication is managed well and people are supported to manage their own medication if they wish. They are supported to maintain their personal hygiene and to dress as they wish. Resident`s cultural values are respected. There is a varied menu and a choice of main meal. The dining room is attractive and the main meal of the day was seen to be a sociable occasion. There are complaints policies and procedures in place which are well advertised. People living at the home told us that they knew who to speak to if they had any concerns and that they knew how to make a formal complaint. Staff have received training in safeguarding older people and the home has copies of the local inter agency procedures and knows who to contact if they have concerns. We have not received any complaints and have been notified of one safeguarding referral made to the local authority, which is the lead agency in these matters, since the last inspection. The home is homely, clean and well maintained providing a pleasant environment for people to live in. People have a choice as to whether they use the communal areas, where they sit and how they spend their day, promoting their independence and autonomy. The infection control standards are good reducing the risk to people of acquired infection. People receive care from kind, well trained staff who can meet their diverse health and care needs in a timely way. There is a consistent staff team and staffing levels are good. Residents were positive about the care they received making comments such as `they are always very helpful`, `they have the right attitude and have a cheerful disposition`, `kind and friendly staff, everyone is helpful`, ` the on site maintenance man is very helpful`. Recruitment procedures are thorough protecting residents from unsuitable carers. The home is well managed in the interest of the residents. Residents, families and staff said that the manager was always available and was receptive to their wishes and comments. Services and maintenance records are up to date and ongoing safety checks are made to ensure equipment is safe for residents to use. A fire risk assessment has been undertaken and fire safety checks are made. Staff training records showed that they have had training in safe working practices, including moving and handling, infection control, first aid and food hygiene, to minimise the risk to residents from harm arising from their care. Senior staff have had training in the Mental Capacity Act and know about the deprivation of liberty safeguards. They have not made any referrals as yet under the new safeguards. What has improved since the last inspection? There has been an ongoing programme of redecoration and some carpeting has been replaced. Staffing levels have been improved and the staff `bank` has been developed to provide continuity and a familiar face for residents. Staff training has been developed with staff receiving training in caring for people with dementia and the implications of the Mental Capacity Act. Training to understand the Deprivation of Liberty safeguards, which have recently been introduced, is planned to ensure that no one is deprived of their liberty unnecessarily. What the care home could do better: People told us that they would like more activities and that they would like to go out more. Snacks should be available to people who are hungry in the evening and at night. People also told us that they would like some `little luxuries` such as butter and whipped cream rather than margarine and artificial cream. Resident`s views should be taken into account when devising the menus. Staff should have training in the correct use of the nutritional risk assessment tools in use in the home to ensure that they accurately identify anyone at risk of weight loss or malnutrition. Key inspection report Care homes for older people Name: Address: Caton House Nursing Home Epsom Grove Bletchley Buckinghamshire MK3 5NR     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: Chris Sidwell     Date: 0 1 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 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: Caton House Nursing Home Epsom Grove Bletchley Buckinghamshire MK3 5NR 01908630670 01908630730 donna.stewart@sanctuary-housing.co.uk www.sanctuary-care.co.uk Sanctuary Care Ltd The registered provider is responsible for running the service care home 68 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): 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: The maximum number of service users to be accommodated is 68. The registered person may provide the following category/ies of service only:Care home with nursing only - (N) 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 (OP) Dementia (DE) Date of last inspection Brief description of the care home Caton House is a purpose built home providing care for up to sixty-eight older people, some of who may require nursing care. It is managed by Sanctuary Care. The home is situated in a quiet residential area a short distance from the towns of Bletchley and Milton Keynes. There is a small shop near the home and further amenities can be Care Homes for Older People Page 4 of 26 Over 65 0 68 68 0 Brief description of the care home found in Milton Keynes and Bletchley. The home is close to bus routes. There are single and shared rooms although the current policy is that rooms are shared only at the express wish of the resident. All rooms have ensuite facilities. There are communal lounges and dining rooms and an attractive garden with good access for those with disabilities. There are care staff on duty at all times and qualified nurses on duty on the nursing floor. Residents are registered with their own general practitioner or the local general practitioner who visits regularly. 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 inspection was conducted over three days, which included preparation and a review of the information we hold about the service, an unannounced visit to the home of six and a half hours and time taken to write the report. The key standards for older peoples services were assessed. Information received about the home since the last inspection was taken into account in the planning of the visit. The manager completed an annual quality assurance assessment. This was completed in full and returned on time. Questionnaires were sent to the home for distribution to residents, families and staff. Fifteen residents or family members, four healthcare or social care professionals and three members of staff returned these. Residents were spoken to on the day of the unannounced visit. Discussions took place with the manager, nursing, care and ancillary staff. Care practice was observed and the care of a small number of residents was followed through in detail. The homes approach to equality and diversity was considered Care Homes for Older People Page 6 of 26 throughout. Care Homes for Older People Page 7 of 26 What the care home does well: There is information available and the opportunity to visit the home to help people decide whether they wish to move to the home. Peoples health and social care needs are assessed before they move to the home, to ensure they can be met. The home can meet a diverse range of faith and cultural needs. Peoples diverse personal, health and medication needs are met in a manner which protects their dignity, promoting their wellbeing. The General Practitioner visits regularly, as do other members of the healthcare team. Residents are supported to visit hospital outpatient clinics when necessary. Medication is managed well and people are supported to manage their own medication if they wish. They are supported to maintain their personal hygiene and to dress as they wish. Residents cultural values are respected. There is a varied menu and a choice of main meal. The dining room is attractive and the main meal of the day was seen to be a sociable occasion. There are complaints policies and procedures in place which are well advertised. People living at the home told us that they knew who to speak to if they had any concerns and that they knew how to make a formal complaint. Staff have received training in safeguarding older people and the home has copies of the local inter agency procedures and knows who to contact if they have concerns. We have not received any complaints and have been notified of one safeguarding referral made to the local authority, which is the lead agency in these matters, since the last inspection. The home is homely, clean and well maintained providing a pleasant environment for people to live in. People have a choice as to whether they use the communal areas, where they sit and how they spend their day, promoting their independence and autonomy. The infection control standards are good reducing the risk to people of acquired infection. People receive care from kind, well trained staff who can meet their diverse health and care needs in a timely way. There is a consistent staff team and staffing levels are good. Residents were positive about the care they received making comments such as they are always very helpful, they have the right attitude and have a cheerful disposition, kind and friendly staff, everyone is helpful, the on site maintenance man is very helpful. Recruitment procedures are thorough protecting residents from unsuitable carers. The home is well managed in the interest of the residents. Residents, families and staff said that the manager was always available and was receptive to their wishes and comments. Services and maintenance records are up to date and ongoing safety checks are made to ensure equipment is safe for residents to use. A fire risk assessment has been undertaken and fire safety checks are made. Staff training records showed that they have had training in safe working practices, including moving and handling, infection control, first aid and food hygiene, to minimise the risk to residents from harm arising from their care. Senior staff have had training in the Mental Capacity Act and know about the Care Homes for Older People Page 8 of 26 deprivation of liberty safeguards. They have not made any referrals as yet under the new safeguards. 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 9 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 10 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. There is information available and the opportunity to visit the home to help people decide whether they wish to move to the home. Peoples diverse health and social care needs are assessed before they move to the home, to ensure they can be met. Evidence: There is information available to prospective residents in the form of a statement of purpose, which describes the services provided by the home and a home brochure. Prospective residents and their families are welcome to visit the home and stay for a trial period before deciding whether the home is for them. The care files of three people who have moved to the home since the last inspection were checked. Their needs had been assessed before they moved to the home to identify with them their needs and wishes for care. The assessment documentation prompts staff to take note of peoples faith and cultural wishes as well as their health and social care needs. The manager said that privately funded residents had contracts and those who were Care Homes for Older People Page 11 of 26 Evidence: supported by their local authority or primary care trust had a copy of the terms and conditions of their stay at the home. The home does not offer intermediate care for people needing intensive rehabilitation. Care Homes for Older People Page 12 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. Residents diverse personal, health and medication needs are met in a manner which protects their dignity, promoting their wellbeing. Evidence: The care of six people living at the home was followed through. All had care plans which had been updated regularly. Peoples diverse healthcare needs were recognised and recorded. Their risk of developing pressure damage had been identified and appropriate steps had been taken to prevent this. Peoples risk of falling had been assessed and they had care plans in place to prevent this as far possible. The home uses a recognised nutritional risk assessment tool, although this was not always completed correctly. Residents are weighed regularly and there was evidence that people who were losing weight saw the dietician and their weight stabilised. The manager agreed to seek training for her staff in the correct use of the nutritional risk assessment tool. The care files showed that residents see a general practitioner and other members of the local primary healthcare team regularly and are supported to visit hospital outpatient departments when necessary. Care Homes for Older People Page 13 of 26 Evidence: Residents are supported to maintain their personal hygiene and to wear clothing of their choice. The atmosphere was noted to be relaxed and staff were speaking to residents politely and gently. They were not seen to hurry and residents were given time to express themselves. No one was restrained and everyone was able to move about the home and to go into the garden if they wished. Care staff said all care is given in residents rooms. Residents and their families made positive comments in the surveys saying staff are very caring and supportive, they have right attitude and cheerful disposition, staff are kind and friendly. There are medication policies and procedures in place and the staff spoken to were aware of these. The storage facilities were satisfactory. Controlled medication was stored and recorded correctly. Records are kept of medication delivered and disposed of by the home. Residents individual medication administration records were completed in full and appropriate steps were taken to ensure that supplies were received regularly. One resident is supported to maintain her independence and to manage her own medication. She has locked storage in her room. This is good practice. The staff spoken to said that medication was never given covertly. If a resident did not want to take their medication, this would be recorded. If the medication was essential and the resident lacked capacity, the doctor and family would be told and a way forward agreed. Care Homes for Older People Page 14 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are insufficient activities in the home to provide interest for residents on a regular basis. The standard of meals is good but snacks should be available to people in the evenings and at night if they are hungry. Evidence: There are two activities coordinators in post who coordinate a range of activities. One is away at the moment and the number of activities available for residents has decreased. People who returned the questionnaires said that they would like more to do and that activities were only sometimes available. One commented that she would like to go out more. The manager said that she was hoping to develop this aspect of life in the home over the next year. She is also hoping to develop more therapeutic activity with people who have dementia. Church leaders from a number of different denominations visit the home to hold services and offer communion to those residents who wish to attend. There is a varied menu. A cooked breakfast is available and a choice of main meal every day. A light cooked supper or soup and sandwiches is served at about 5.30 pm. The meal on the day of the unannounced visit was appetising and resident said they enjoyed it. The downstairs dining tables were laid attractively and meals were seen as Care Homes for Older People Page 15 of 26 Evidence: a sociable occasion. There is no dining room on the upstairs nursing wing and residents were eating in their rooms or at small tables in front of their chairs in the lounge. Three residents had gone downstairs to the downstairs lounge. Comments about the food in the questionnaires varied. Most people said they always or usually enjoyed their meals. Others however felt that the food lacked little luxuries, there is no butter only margarine and artificial cream. One person said that supper was more like a snack and that it was a long time, about fourteen hours, between supper and breakfast. One person commented that if her mother asked for ice cream in the evening she was told it was unavailable. These comments were discussed with the manager. A milky drink, biscuits and bread is available in the kitchenettes on each floor in the evening and at night. All other food is locked in the main kitchen. This must be reviewed and people must be able to have a more substantial snack in the evening or at night if they are hungry. Care Homes for Older People Page 16 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. People who live at the home are protected from harm and their concerns are listened to and addressed. Evidence: People in the home told us that they know who to speak to if they have a concern and how to make a formal complaint. There is a copy of the complaints procedures in the home and information about local advocacy services. The complaints records were checked and showed that verbal and written complaints are recorded. There were nineteen written and verbal complaints since the last inspection, all of which had been responded to within the timescales set by the companies policy. The response showed that concerns were taken seriously and addressed. The home has a copy of the local multi agency safeguarding policies and procedures and staff have a received training in safeguarding vulnerable people. There are whistle blowing policies and procedures in place and the staff spoken to said that would have no hesitation in reporting any concerns. The manager said in the annual quality assurance assessment that they had made one safeguarding referral since the last inspection. The records showed that this had been dealt with appropriately. We have not been notified of any safeguarding referrals made to the local authority, which is the lead agency in these matters, since the last inspection. Care Homes for Older People Page 17 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 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 well maintained and provides a clean, comfortable and safe home for people living there. Evidence: The home is purpose built and is on two floors. People needing nursing care have rooms on the first floor and those needing residential and personal support on the ground floor. There are attractive landscaped gardens which are accessible to people with disabilities. Everyone has their own bedroom with an ensuite consisting of a toilet, hand basin and shower. People are encouraged to personalise their rooms and many had chosen to do so. The home was clean and tidy on the day of the unannounced visit. There were some offensive odours but these were limited and in general the home was clean and fresh. There has been an ongoing refurbishment programme. Some areas of the upstairs corridor carpet appeared to be stained and the manager said she was considering whether it should be replaced. The communal areas were well decorated and there were a number of places for people to sit and choose whether they wanted company or would prefer to sit alone and read or look into the garden. The home was last inspected by the Environmental Health Officer in January 2009 when a number of requirements were made. The manager and chef confirmed that these have been addressed. The home last had a fire safety inspection in October Care Homes for Older People Page 18 of 26 Evidence: 2008 when all matters were deemed satisfactory. The fire risk assessment has been updated regularly. There are infection control policies and procedures in place. There are separate paper towels and soap for the use of carers in residents ensuite and bathrooms. The manager said that people do not share sliding sheets which are used to help them move in bed, although they may share hoist slings. This should be reviewed. Care staff were observed to wash their hands and to wear protective clothing regularly. The laundry is well run and the washing machines have programmes which have sluicing and disinfection programmes. Care Homes for Older People Page 19 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. People receive care from kind, well trained staff who can meet their diverse health and care needs in a timely way. Recruitment procedures are thorough protecting residents from unsuitable carers. Evidence: There is a consistent staff team. There are two Registered Nurses (RN) on duty in the mornings supported by six carers, two RNs and five carers in the afternoons and two RNs and two carers at night on the nursing floor. One senior carer and three carers are available on the residential floor during the day and one senior carer and two carers at night. People told us that they always or usually received the care and support they need , that staff listen and act on what they say and that staff are available when they need them. They made positive comments about the staff team saying they are always very helpful, they have the right attitude and have a cheerful disposition, kind and friendly staff, everyone is helpful, on site maintenance man is very helpful. There is an ongoing training programme. Training records were in good order and showed that staff have had training in safe working practices. Staff also receive training in specialist topics such as caring for people who have dementia, clinical skills training for registered nurses, first aid and training as to how to prevent and deal with Care Homes for Older People Page 20 of 26 Evidence: choking incidents which may be experienced by people who have difficulty swallowing. The manager said in the annual quality self assessment that twenty seven of the forty four care staff hold the National Vocational Qualifications in Care at Level 2. The recruitment files of three members of staff who had started at the home. All had the required documents. There was evidence of the staff members identity and work permits were in place where necessary. Criminal Records Bureau disclosures and references had been sought before the staff member started work. The application form showed the staff members work history and interview records were kept. There was evidence that staff had had an induction programme. Staff told us that they were given the opportunity to attend training and that they were supported to care for residents. Care Homes for Older People Page 21 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 home is well managed in the interests of the residents. Evidence: There is an experienced manager and senior staff team. People told us that they were always available and listened to them. Staff told us that the atmosphere in the home was relaxed and friendly and that if they had any concerns they were always dealt with. There are regular residents and family meetings. The organisation has a quality assurance system in place and monitors the quality of care on a regular basis. The home does not manage residents money on their behalf. A small amount of personal allowance can be kept in the homes safe for safekeeping. Receipts are given and the balances were correct on the day of the unannounced visit. There are health and safety policies and procedures in place. Equipment, such as hoists, is checked regularly and staff have had training in safe working practices, Care Homes for Older People Page 22 of 26 Evidence: including moving and handling, first aid, infection control and food hygiene. Care Homes for Older People Page 23 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 24 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 15 16 The home must ensure that food is available in the evenings and at night for residents who may be hungry and particularly for those with dementia who may need to eat little and often. To ensure their dietary needs are met 30/10/2009 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 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). 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