Care Home: Chaltonholme

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What the care home does well Each person had a care plan which described what they like, dislike and how staff are to support and care for them. Residents are involved in making decisions about how they live their lives. They attend regular meetings to make decisions about the things that are important to them such as menus, meals and activities. Each resident has a health action plan and information about their health care needs is recorded. Staff ensure that people living in the home attend routine appointments for health checks and that they see the doctor if they are unwell. Residents general health and well being is monitored and they are encouraged to eat healthily and to participate in exercise as part of a healthy lifestyle. People living in the home can go out to local pubs, restaurants and places of interests. They have regular time with family, friends and other people who are important to them. Staff are trained to understand and support residents and to recognise and report any bad practice and so help to safeguard people who may be vulnerable. Any complaints or concerns are investigated and residents feel happy to discuss any issues with staff or the manager. Staff are recruited through a thorough process and all of the relevant checks are carried out to help ensure that only those who are suited are employed in the home. What has improved since the last inspection? The manager has appointed a specific staff member with a responsibility for nutrition that has allowed them to develop and provide more appropriate menu choices and to monitor intake and weight changes more closely for all people ensuring their health, safety and welfare. They have expanded the activities that are available, in particular the individualised programs for people who need more 1-1 and for those residents wishing to increase their independence in the community. They have recently employed a new Activities Coordinator who has set up an activities area which facilitates activities that the service users can take part in unaided. The manager is developing documentation gradually to include people as much as possible such as, menu choices are in picture format, and there is a photo board at the entrance to the home to identify staff and in particular key worker allocation. The provider is currently increasing some room sizes by converting two smaller rooms into one large room to further improve services for those residents who have high care needs such as, hoist use and the need for two staff support. What the care home could do better: The manager to revise the statement of purpose to provide a user friendly format such as use of pictures, photographs, audios and symbols. All staff to have a greater understanding of their medication responsibilities so that they can continue to support all people in a safe and fair way. Fire guards need to be fitted to bedroom doors to protect all people from an outbreak of fire. Protective equipment such as rubber gloves, pads and other items to be stored away according to the COSHH (Chemicals or substances hazardous to health) criteria and care standards act 2000. Additionally many parts of the communal areas of the home had odours and in need of a bit of attention to them, so that they continue in the future to provide a pleasant environment for all people. Key inspection report Care homes for older people Name: Address: Chaltonholme 1-3 First Avenue Westcliff On Sea Essex SS0 8HS     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: Sarah Axam     Date: 0 4 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 28 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 28 Information about the care home Name of care home: Address: Chaltonholme 1-3 First Avenue Westcliff On Sea Essex SS0 8HS 01702346534 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: lisamariegray@hotmail.co.uk The Southend on Sea Darby & Joan Organisation care home 33 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 who can be accommodated is 33 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, Dementia - Code DE Date of last inspection Brief description of the care home Chaltonholme is an established home providing 24-hour care and accommodation for up to 33 older people, including those who have dementia. The Southend Darby and Joan Organisation own Chaltonholme. The home is situated in Westcliff-on-Sea close to the seafront. Bus services pass the building (there is a bus stop directly in front of the home), and Westcliff railway station is within half a mile. Local shops are close by with town centre shopping in Southend-on-Sea. The care home premises was created by adapting, converting and joining together three domestic style houses. There were Care Homes for Older People Page 4 of 28 Over 65 0 33 33 0 Brief description of the care home 31 single and one shared bedrooms situated over the three floors of the home. Two passenger lifts provide access between levels. Communal space comprises two main lounges and one large dining area for service users. There was also a small room available for use as a quite area and a further separate smoking room. At the rear there was a well maintained garden, with sitting areas. Car parking for visitors was available on the homes drive at the front. Information provided by the home confirmed current fees as £54.71 to £70.00 per day. CSCI inspection reports are available from the home and the CSCI internet website. Care Homes for Older People Page 5 of 28 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: The unannounced site visit took seven hours to complete and was carried out as part of the annual inspection programme for this service. This visit was conducted with assistance from the manager. Feedback at the end of this inspection was given to the Manager and Provider. As part of the process a number of records relating to residents, care staff and the general running of the home were examined. We looked at all the information that we had received, or asked for, or what the service has told us about things that had happened in the service since the last inspection. Two staff were spoken with during the site inspection. Prior to this site visit, CQC (Care Quality Commission) sent out surveys to all interested parties, however none were returned to us, the reason for this (we were told by the manager) is that the home had not received them. Additionally the manager was sent an (AQAA) Annual Quality Assurance Assessment form by us. This is a self assessment required by law that asked how well the service is meeting the needs of the people who live at Chaltonholme Care Care Homes for Older People Page 6 of 28 Home. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: The manager to revise the statement of purpose to provide a user friendly format such as use of pictures, photographs, audios and symbols. All staff to have a greater understanding of their medication responsibilities so that they can continue to support all people in a safe and fair way. Fire guards need to be fitted to bedroom doors to protect all people from an outbreak Care Homes for Older People Page 8 of 28 of fire. Protective equipment such as rubber gloves, pads and other items to be stored away according to the COSHH (Chemicals or substances hazardous to health) criteria and care standards act 2000. Additionally many parts of the communal areas of the home had odours and in need of a bit of attention to them, so that they continue in the future to provide a pleasant environment for all people. 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 28 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 28 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. People who are looking for a care home can be assured that their needs will be met at Chaltonholme. Evidence: The manager told us in the Annual Quality Assurance Assessment that there is a statement of purpose and residents guide, which provides information about the home to help people decide if they would be happy there. When we visited the home we looked at the way in which nine peoples needs had been assessed. We saw that the assessment covered details of the persons health needs as well as the support the person as required to maintain physical, mental and emotional well being. In all documentation each persons communication needs, their likes and dislikes was recorded to help determine that the home would be able to meet their individual needs. The manager told us that a copy of the social services or local authority needs assessment is also obtained (these were present in all 9 Care Homes for Older People Page 11 of 28 Evidence: residents files looked at) and that people are invited to visit the home before they move in. One relative told us that they had visited twice and received the service user guide and had read the CQC (then CSCI) report before deciding if the home was appropriate for their relative and two of the residents told us that they came to visit the home before moving in. One of the areas that the manager told us that she hopes to improve is that the service user guide and statement of purpose is available and developed into different formats of the residents choosing, such as, audio, photographic and languages. Care Homes for Older People Page 12 of 28 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. Peoples assessed needs are followed through in good care plans that give staff the necessary information to provide good care outcomes. Evidence: The manager told us in the Annual Quality Assurance Assessment that each person had a care plan, looking within all 9 residents files it showed us this was the case. All 9 of the Care Plans seen were reviewed every month or more often where this was appropriate. The recording of reviews by staff were much improved and included a short summary of what had changed and why. Yearly reviews showed us that the residents, their families, social workers and community nurses or GPs were part of this process. When we visited the home we saw that residents were involved in making choices such as new activities introduced, (a new activities coordinator has been employed) having regular contact with family or friends and a choice of community activities such as using local shops, using eating facilities or walking to the sea front or around the local area with staff. Risks to residents health and safety were well managed while allowing residents to Care Homes for Older People Page 13 of 28 Evidence: participate in activities such as accessing the community. Where the level of risk to a person was assessed as high and there was the likelihood that the person may injure themselves (such as risks associated with mobility or risks associated with health care needs) then staff imposed some limitations on access to these items or areas and supervised residents as needed. Where this was necessary then it was recorded clearly. We saw that all residents were supported in attending routine appointments for health care monitoring and that had access to medical, dental and optician services when needed. It was recorded that residents enjoyed good health and residents looked well cared for. When we visited the home we saw that the administration records were maintained in accordance with agreed procedures and the royal pharmaceutical legislation. At the time of the inspection none of the residents living in the home were capable of safely keeping and administering their medicines, therefore staff administered all medication. We looked at medicine administration records and these were completed accurately to show that residents received the medicines, which were prescribed for them. We saw that all staff training was up to date. There have been two incidents reported to us around medication issues and staff practice and this would suggest that medication needs to be kept to a stricter protocol and needs to be maintained consistently to a good standard. Additionally one residents was left four days without medication and one had PRN medication everyday for 15 consecutive days due to staff lack of attention to the homes policy and procedure. Docummentation looked at however showed that the manager is good at picking up on these issues in 1-1 supervision and staff meetings. The manager discussed with us some of the issues around why this had occurred and startegies they may implement to stop this reoccurring amongst the senior staff who admninister the medication. Care Homes for Older People Page 14 of 28 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. People living in the home make decisions about how they live their lives and spend their time. Evidence: The manager told us in the Annual Quality Assurance Assessment that residents are supported in activities of their choice both in and outside of the home. Observation showed us that a large percentage lot of the residents chose to sit within the lounge area and chat, laughed and talked together about things in general. People chose to watch the television, reading magazines and newspapers, knitting and other chosen pursuits. A couple of people chose to spend time in their rooms listening to the radio or spending their time as they wished. Since the last inspection the home has employed a Activities Coordinator. They have been in post for the last three months and have set up an activities area which facilitates activities that the service users can take part in unaided. Alongside this the staff have expanded with regard to individualised programs the increased use of equipment to enhance tactile stimulation, this is particularly helpful to those people with dementia etc. Also the manager has suitably risk assessed and increased the Care Homes for Older People Page 15 of 28 Evidence: number of people (who are able) to use facilities independently out in the local community. Staff supported residents to eat a healthy and well balanced diet and to monitor weight on a regular basis. The staff at the home cook all meals for people. Information showed us that they held the relevant qualifications need for this role such as, food hygiene and infection control. Kitchen equipment and regular checks were all in order. There was a four week menu in place that showed us that the likes of residents that were recorded in their information were reflected in the meals provided and that they had a varied and good quality of diet. The manager told us that she has appointmented a specific member of staff with the responsibility for nutrition. She expalined that the revision and introduction of additional nutritional screening tools has increased their awareness of individual needs. We saw this by the menu choices provided, how staff monitor the intake and weight changesof people. The menu choices is now provided in a picture format to enable informed choice and improve communication. Care Homes for Older People Page 16 of 28 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 are treated well and their concerns or complaints are dealt with appropriately. Evidence: We were told in the Annual Quality Assurance Assessment that any complaints or safeguarding alerts would be dealt with openly and thoroughly. The manager told us that residents relatives are provided with information on how to complain and how their concerns would be dealt with. The manager told us that there had been no formal complaints made about the service within the past twelve months. They also told us that staff received information about dealing with complaints and whistle blowing when they commence work at the home. Each of the four people living in the home told us that they knew who to speak with if they were unhappy or needed to make a complaint. Some residents identified staff who they would report to. Three members of staff told us that they were aware of the homes policy for dealing with complaints and safeguarding people from harm. When we visited the home we looked at the policies and procedures. We saw that there was detailed information available for residents to assist them in understanding how to complain if they were unhappy. There was also detailed information made available to staff once they commenced work at the home, which described their roles and responsibilities in reporting bad practice. This included a whistle blowing policy. This helped to assure staff that they Care Homes for Older People Page 17 of 28 Evidence: would be protected from harassment should they need to raise concerns. We looked at how staff were recruited to work in the home and saw that all of the checks such as employment references, Criminal Records Bureau disclosures and PoVA First checks were obtained before a person started work at the home. This helped to ensure that only people who were suitable were employed. We saw that all staff had undertaken training in recognising and reporting abuse or bad practices. There had been no complaints or concerns raised about the home since the last inspection. During the inspection we spoke with four of the residents told us that they felt staff treated them well. We saw that staff treated residents with respect and that residents were very comfortable and open in the company of staff. Care Homes for Older People Page 18 of 28 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. People have plenty of facilities for their use and the home is comfortable and suitable for their needs. Evidence: The manager told us in the Annual Quality Assurance Assessment that it is clean and was comfortable. The provider told us that there are longer term plans to eventually redecorate the whole of the home. we carried out a tour of all rooms within the house, including all of the residents bedrooms. We saw that these rooms were bright, clean and reflected each persons individual taste. The manager told us that in each bedroom were a nurse call point which was in easy reach for each person to use, these were also provided in all toilets, bathrooms, lounges and the dining room. This was seen by us when a tour of the building. We saw that the home in certain areas such as, the front room had odour issues which may have stemmed from the cleaning of carpets not being carried out at that point, as later on the odours where neutralized. Some peoples bedroom doors were left open and had no fire guards attached(protection to close doors automatically if a fire broke out). Many of the communual and bedrooms kept rubber gloves, continence pads and protective clothing and were easily accessible to all people within the home. On a couple of persons commode chair, wardrobes and walls, were instructions to staff and other information, this did not protect this persons privacy or Care Homes for Older People Page 19 of 28 Evidence: dignity. We saw by documentation looked at that the manager carried out monthly environmental checks, that included equipment checks, such as, hoists, kitchen equipment, call systems, lift, stairs, fire doors, toilets, walking aids, commodes and wheelchairs. We saw that there were procedures in place and that staff had training to promote and to reduce the risk of infection. Care Homes for Older People Page 20 of 28 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 are offered positive relationships by well supported and caring staff and are protected by staff recruitment, induction and training. Evidence: The manager told us in the Annual Quality Assurance Assessment that the home did not rely on the use of temporary agency staff. That all staff were recruited thoroughly, that staff were well trained and that staffing levels meet the needs of all residents. When we visited the home we saw by observation and by looking at the staff rota that there were enough staff to cater for all residents needs. When we visited the home we saw by observation that, staff interact well with residents, were motivated, competent and listened to people. The manager told us that all staff had been at the home for some years. She told us that all staff had a detailed job description in relation to their jobs, that they had an induction to the home when they started work and that they received both mandatory and specialist training to best support residents. Staff told us that checks such as Criminal Records Bureau disclosures had been obtained before they commenced their employment. Staff also told us that they received training, which was relevant to their roles, helped them understand the needs of residents and kept them up to date with new way of working. When we visited the home we looked at staffing levels (which are Care Homes for Older People Page 21 of 28 Evidence: good) and how staff were recruited, trained and supported to meet the needs of residents. We looked at the recruitment files for eight members of staff. We saw that before they commenced work that satisfactory employment references, Criminal Records Bureau disclosures and PoVA First checks had been obtained and a full ten year employment history was checked for both people. Staff who told us, that their induction covered everything that they needed to know about the job. In addition we saw that staff had detailed job descriptions and information about their roles and the conduct expected of them. We saw that staff were supported well by the management team by means of good supervisions and staff meetings and yearly appraisals. There was an ongoing programme for staff training and development. Staff undertook training in a wide range of topics including communication, assessing risks, dementia, diabetes and safe handling of medicines. Staff were also trained to recognise and report abuse or poor practices and they had specific training in understanding the needs of the people they supported. Four of the residents told us that staff show an interest in their individuals needs, listen to them and act on what they say. Care Homes for Older People Page 22 of 28 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 management strategies of the home were stable which ensures the health, safety and welfare of all residents. Evidence: The registered manager has been in post for five years, has achieved much and holds a wealth of experience and knowledge of the current resident group. This goes towards securing the health, safety and welfare of all people. It also provides consistency of care and supports staff to maintain the quality of care given to people. We looked at the arrangements for ensuring that the home was maintained safely. We saw that regular checks were carried out on equipment such as hot water and heating systems, fire alarms and fire fighting equipment, gas and electrical installations and equipment. All equipment was well maintained and repaired as required. The manager showed us that she knew her role well, worked well with the fire officer and had competent fire risk assessments completed. Care Homes for Older People Page 23 of 28 Evidence: Residents finances are all looked after by their relative or the organisation. Monies coming into the home from relatives for residents use are well looked after, recorded and accounted for and go towards protecting all people from financial abuse. We looked at how the views of residents, their families and other people who were important to them were obtained and acted upon. Relatives who visited the home told us that staff were available to speak with them. Questionnaires were sent to residents and other people each year to ask them for their views about the home and the findings from these were analysed as part of the overall system for monitoring and improving the quality of the service. Additionally the provider carries out regualry monthly checks of the premises, speaks to staff, residents, professionals and relatives to monitoer the quality of care provided. (reguations 26 visists) This and the AQAA forms part of the annual quality review of the home and forms the following years annual dveeploment plan for the home. This ensures that peoples views are in the forefront of improving the service and the home. Care Homes for Older People Page 24 of 28 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 25 of 28 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 That all staff who administer 30/11/2009 medications received into the home, including booking in disposal of, administration, safe handling, recording of and making sure supplies are in stock are doing so in accordance with the royal pharmaceutical guidelines and care standards act 2000. This is because there have been a couple of incidents where staff who administer medications have made errors, not made sure reviews have taken place in time for medication to be reordered and administered and have failed to follow PRN protocols and have administered medication unnecessarily. Care Homes for Older People Page 26 of 28 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 2 22 23 That all precautions against the risk of fire, including the suitable proviso of fire is in place. This is because many of the people living within the home prefer to keep their bedroom doors open. At present no fire guards are attached to these doors and are propped open. If a fire occurred then fire doors would not be properly used for their purpose. 31/12/2009 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 1 19 That all continent pads, notes to staff regarding commodes etc and that rubber gloves are kept secure and away from people to ensure protection, privacy and dignity. That the carpets in all areas are kept free of odour so that the premises is kept fit for purpose. 2 26 Care Homes for Older People Page 27 of 28 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. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!