Care Home: Cherry Lodge Rest Home

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What the care home does well The home`s Statement of purpose and Service User Guides include the required information and provide accurate and helpful information for people who are considering moving into the home. People who live at the home benefit from the support of a range of health care professionals, and their health care and physical needs are well met. Visitors are welcomed to the home and residents are supported to keep in touch with their families and friends. People are protected from abuse. The home is attractively decorated, well maintained and presents as a comfortable place for people to live. People are protected through sound recruitment procedures. They can be confident that staff are adequately trained to meet their needs. More than 50% of the care staff have been trained in care to a National Vocational Qualification level 2 or above. People are protected from harm through good policies and procedures and safe working practices. What has improved since the last inspection? People can be confident their care needs will be adequately assessed before they move into the home. Care plans are now signed by the resident or their representative to show their involvement .Care plans for individual residents have been reviewed and changes have been noted. A copy of the Royal Pharmaceutical Society guidelines for the administration of medication in care homes has been obtained to provide management and staff with up to date knowledge regarding all aspects of medication administration to enable them to ensure the safety of people who live in the home. People who live in the home are benefiting from the increased choice of activities available since the appointment of an activities coordinator. The menu and programme of activities are now displayed to enable residents to see what is offered and to enable them to make choices. The home has developed a restraint policy and procedure, so that staff aware of the actions that can be considered as restraint and the circumstances when this may or may not be applicable. Liquid soap and paper towels are now provided and used in the home to maintain hygiene, to prevent infection and the spread of infection. Radiators in the home have all been covered to prevent anyone from risk of burning. A record is maintained of the food served in the home to ensure people are adequately nourished and in case of the outbreak of any food related illness. People who live in thehome are being offered increased choices in their daily lives, specifically in what they wish to eat. What the care home could do better: Staffing levels must be kept under review to ensure there are enough staff to meet all the needs of people who live in the home and reflect the increased numbers accommodated. All complaints or concerns expressed, from any source, about the service provided, should be recorded. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Cherry Lodge Rest Home 75 Whyteleafe Road Caterham Surrey CR3 5EJ     The quality rating for this care home is:   two star good service 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: Ruth Burnham     Date: 0 9 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. 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. 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 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. Care Homes for Older People Page 2 of 27 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. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Cherry Lodge Rest Home 75 Whyteleafe Road Caterham Surrey CR3 5EJ 01883341471 01883347706 cherrylodge@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Cherie Margaret Callender Name of registered manager (if applicable) Mrs Cherie Margaret Callender 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 19. The registered person may provide the following category/ies of service only: Care home only - (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 (OP) Dementia (DE) maximum number 6 . Date of last inspection Brief description of the care home Cherry Lodge is able to provide accommodation and care for up to nineteen older people. Some of the people living at the home may also have dementia. The home is a large detached property located in Caterham, Surrey and accommodation is provided on two floors accessed by a stair lift. The accommodation comprises of an office, lounge, dining area, kitchen, laundry room, toilets, bathrooms, showers, thirteen single and three double occupancy bedrooms. The home has a garden to the rear of the Care Homes for Older People Page 4 of 27 care home 19 Over 65 0 19 19 0 Brief description of the care home property that is well maintained, private, secure and has wheelchair access. The home is close to the local shops and amenities. Limited parking is available to the front of the home. Fees at this service range from 350 to 600 pounds per week. The home welcomes enquiries from local authorities regarding placements at the home and funding levels. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the care home was an unannounced Key Inspection. We arrived at the service at 09.00 and were in the home for six hours. It was a thorough look at how well the home is doing. It took into account detailed information provided by the homes manager, and any information that CSCI has received about the service since the last inspection. We returned on 20 January 2009 to provide feedback to the provider, at this time we were in the home for one hour and were pleased to note that action had already been taken to address issues raised at the first visit. Care Homes for Older People Page 6 of 27 We looked at how well the service is meeting the standards set by the government and in this report we have made judgements about the standard of the service. Documents sampled during the visit included the care plans, daily records and risk assessments, training records, policies and procedures and records of food. The home has submitted the Annual Quality Assurance Assessment (AQAA) prior to the inspection, this contained all the information we asked for. There have been no complaints about the service since the last inspection. However since this visit took place information has been received that the Local Authority Social Services Department is conducting a safeguarding investigation. The outcome of this is not known. There is one Required Development in this Report. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. We would like to thank everyone at the home who assisted us during our visit for their time, assistance and hospitality during this visit. What the care home does well: What has improved since the last inspection? People can be confident their care needs will be adequately assessed before they move into the home. Care plans are now signed by the resident or their representative to show their involvement .Care plans for individual residents have been reviewed and changes have been noted. A copy of the Royal Pharmaceutical Society guidelines for the administration of medication in care homes has been obtained to provide management and staff with up to date knowledge regarding all aspects of medication administration to enable them to ensure the safety of people who live in the home. People who live in the home are benefiting from the increased choice of activities available since the appointment of an activities coordinator. The menu and programme of activities are now displayed to enable residents to see what is offered and to enable them to make choices. The home has developed a restraint policy and procedure, so that staff aware of the actions that can be considered as restraint and the circumstances when this may or may not be applicable. Liquid soap and paper towels are now provided and used in the home to maintain hygiene, to prevent infection and the spread of infection. Radiators in the home have all been covered to prevent anyone from risk of burning. A record is maintained of the food served in the home to ensure people are adequately nourished and in case of the outbreak of any food related illness. People who live in the Care Homes for Older People Page 8 of 27 home are being offered increased choices in their daily lives, specifically in what they wish to eat. 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 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. Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are considering moving into the home are provided with helpful information to help them decide if the home will be suitable for them. People can be confident their care needs will be adequately assessed before they move into the home. Evidence: Helpful information is available for people who are considering moving into the home to enable them to make an informed decision as to whether the home will be suitable for them. This is contained in the Statement of Purpose and Service User Guide. These documents have been updated and include all the required information. Three people have moved into the home since the last inspection visit. These people were visited before they moved in and a thorough assessment carried out and recorded to ensure their needs are understood and can be met in the home. Care Homes for Older People Page 11 of 27 Evidence: Conversations with the care coordinator and staff indicate that understanding of current good practice has improved. This was demonstrated by the improved assessment records and in conversation with staff during the visit. The majority of staff have had some training in caring for, and understanding the specialist needs of, people with dementia. The home uses an in house training programme, this includes a training module on dementia, which all staff are undertaking. Some concern remains that this training is not being delivered by, or the competency of staff is being assessed by, anyone with the relevant qualification in the field. Intermediate care is not provided at the home, so Standard 6 does not apply. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident their physical and health care needs will be met. Peoples spiritual, emotional and social are given less priority. People who live in the home are now involved in planning their care. People are protected from harm through safe systems for handling medication. Evidence: Care plans have been updated since the last inspection visit and they are being reviewed every month. Six care plans were sampled, these were up to date and contained information about peoples individual care needs. A care coordinator has been recruited since the last inspection and it is her role to update care plans. Unfortunately where initial care plans have been superseded, the original documents were not available at the time of the visit so a complete audit of care records could not be made during this visit. It was clear throughout the visit that a high priority is given to meeting the physical and health care needs of people who live in the home. People who were spoken to Care Homes for Older People Page 13 of 27 Evidence: throughout the visit were happy with the care they receive. Additional in house training has increased the understanding of staff in the area of caring for people who have more complex needs such as dementia to ensure their social and emotional needs can be met. Care plans still contain little information about peoples lives and interests before they moved into the home, the care coordinator is in the process of reviewing all the care plans and intends to expand this information as part of the review process. Some information is recorded about peoples spiritual needs, and a minister from a local church visits to provide communion for those who wish to take part. People who live in the home are protected from harm through risk management processes. Individual assessments of risks have been recorded as part of the care plan. These cover some activities of daily living, including mobility, the risk of falls and the use of bed rails. People who live in the home are involved in drawing up their care plans wherever possible. Care plans have been signed by them or their representative, where appropriate. People can be confident their health care needs will be met. People are able to see a wide range of health care professionals in the home such as the dentist, optician, chiropodist and hearing specialist. Records show people receive regular health checks. Comments received in response to surveys sent out to health professionals before the visit were very positive. These included: There is a high level of concern for clients. peoples privacy is respected. medication management seems appropriate to the level of clients cognitive function. There is a relaxed and friendly atmosphere and clients dignity is maintained. The safe handling of medication in the home protects people from harm. The manager has obtained a copy of the latest Royal Pharmaceutical Society guidelines. These relate to medication practice in care homes to ensure that current storage and administration arrangements comply with recommendations. Controlled drugs are not currently being used in the home. Medication administration records were seen and were well maintained and up to date. The lunchtime administration of medication was observed to be carried out in a calm and unhurried manner, giving people time to take their medication. People who were spoken to or who responded to surveys sent out before the visit said staff are very good, helpful and kind. Staff were observed to treat people with respect and to assist with personal care in a discreet way that ensured peoples dignity is upheld. Staff speak to residents in a friendly, informal way, using their preferred Care Homes for Older People Page 14 of 27 Evidence: names. There has been an increase in the number of shared rooms in the home, those in use as shared rooms are occupied by people who are experiencing some degree of dementia. A discussion was held with the manager at the last visit that only people who have made a positive choice to share a room should be accommodated in these bedrooms. In practice it is the relatives of people who share these rooms who are making these decisions, it therefore remains unclear if people who are sharing bedrooms in the home have been able to make a positive choice to share with one another. Care Homes for Older People Page 15 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home are benefiting from the increased choice of activities available since the appointment of an activities coordinator. Visitors are welcomed in the home and residents are supported to keep in touch with their families and friends. Meals served in the home are appetising and nutritious. Evidence: Since the last inspection visit, an activities coordinator has been appointed and people are benefiting from the introduction of an activities programme. The activities coordinator works in the home on 3 days each week. At other times care staff do some activities with people, but they are unable to carry out any social activities with residents during the mornings. This is because they are too busy helping residents with their personal care and carrying out housekeeping tasks. The manager is in the process of recruiting a cleaner. Some activities were taking place during the afternoon of the visit. People are encouraged to maintain contact with their families and friends, and visitors to the home are made welcome. Visitors were seen in the home at the time of inspection and made positive comments about being able to visit at any time of day Care Homes for Older People Page 16 of 27 Evidence: and the home contacting them if their relative required anything. The lunch time meal was being served during the course of the inspection visit and it was clear that this was the main meal of the day. Meals are served in the dining room, which was attractively decorated and furnished with tables for varying numbers of residents. It was recommended following the last inspection visit that the menu should be displayed or provided to residents, to enable them to know what meals were being offered and to enable them to choose an alternative if preferred. This has been done and the menu is now displayed for people to see. Some discussion took place about how to present choice to people who are experiencing dementia in a way they can understand. Staff advised that residents could request an alternative meal if they do not like what is on the menu. A new system is being introduced whereby people are asked each day what they would like to eat from the choices on offer. The meal served looked appetising. Changes are being made to the way in which meals are being served to offer more choice to people about quantities and content of meals. Although meals are still plated up in the kitchen staff now serve gravy and sauces at the tables to ensure peoples individual tastes are catered for. Care Homes for Older People Page 17 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are listened to and protected from abuse through the homes policies and procedures relating to complaints, whistle blowing and safeguarding adults. No complaints have been recorded in the last year. Guidance is provided to staff about dealing with aggression and the use of restraint, to ensure the safety of residents and staff. Evidence: People who live in the home are encouraged to express their views about the service through day to day contact with staff and the manager. The new care coordinator plans to hold resident meetings in the near future. There is a clear complaints policy and procedure, a copy of which is included with the homes statement of purpose, which is made available to each resident in their room. The home has no record of any complaints received and the manager informed us that they would only record formal complaints, she said that day to day concerns are listened to and resolved at the time. Advice was given that all complaints, whether formal or informal, from any source should be recorded in line with the Care Homes Regulations. People who live at the home who were spoken to or contacted before the visit said they would know who to speak to if they had any concerns or were unhappy about anything. No person had contacted CSCI about any complaint made to the home before this visit, however we have now received information that there is a Care Homes for Older People Page 18 of 27 Evidence: safeguarding investigation currently in progress, the outcome of which is not known at the time of writing this report. There are policies and procedures in place to protect the people who live in the home from abuse. The safeguarding policy and procedure refers to the Surrey local authority multi-agency guidelines, which the home would follow in the event of a suspicion or allegation of abuse. Staff receive training and are aware of differing types of abuse and understand their role in safeguarding those living at the home. From the staff training records seen at the time of inspection, and from the full staff training plan that was supplied to CSCI last year, it was noted that the majority of staff have received training in safeguarding adults or safeguarding adults awareness. There is a clear restraint policy. Care Homes for Older People Page 19 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience 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 attractively decorated, well maintained and presents as a comfortable and safe place for people to live. Evidence: The new extension to the home is now complete and provides additional rooms where a further 5 people can be accommodated. Most areas of the home were seen. The new hairdressing room is now in use. All areas that were seen were clean and well maintained. Bedrooms are generally comfortable and well furnished, although one of the people who shares a ground floor room is disadvantaged by having no access to the window. Most of the furniture in peoples bedrooms is supplied by the home, but they can bring in their own televisions, pictures, ornaments and photographs to make their rooms more personal. All the radiators in the home have now been covered to minimise risk to those living and working in the home. Bathrooms and toilets now have liquid soap, and paper towels provided, to protect from risk of infection. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A small team of staff are employed to meet the needs of people living at the home, care staff are also required to do all the cleaning and laundry although a cleaner is now being recruited. Staffing levels should be reviewed to ensure there continue to be enough staff to meet all the needs of those living in the home as the number of people accommodated has now increased. People are protected through sound recruitment procedures. They can be confident that staff are adequately trained to meet their needs. Evidence: A small team of staff are employed to meet the needs of the people living at the home. The team consists mainly of care staff, but a part-time cook, an activities coordinator and an administrator are also employed. There has been an increase in numbers of people living in the home, no housekeeping or laundry staff have been employed. These tasks are carried out by care staff, in addition to providing personal care and support to residents. Care staff advised that they also carry out social and leisure activities with residents when they have time. Following the visit the provider informed us that a cleaner is being recruited. Responses received to surveys sent out before the inspection indicated that people would like to have the opportunity to go out in the community from time to time. Care Homes for Older People Page 21 of 27 Evidence: The staff rota was reviewed. No distinction is made on the rota of how much time care staff spend on housekeeping tasks rather than in providing direct care to people who live in the home. It was therefore difficult to make a judgement that current staffing levels are adequate to meet the needs of people who live in the home. A requirement was made following the last two inspections that staffing levels in the home must be reviewed, to ensure there are enough staff working in the home to meet the health and welfare needs of the residents. A timescale of 26th February 2008 was given. Whilst there is no evidence to suggest current staffing levels pose any risk of harm to the people who currently live in the home the requirement has been carried forward to take account of the increase in the registered numbers of people the home may now accommodate. This was discussed with the provider at the feedback visit and the requirement was clarified. It was agreed that a review of staffing levels would be carried out based on the current numbers and levels of dependency of people who live in the home. People who live in the home are protected through robust staff recruitment procedures. Staff recruitment files were randomly sampled and the appropriate checks had been carried out, including two written references, checks with the POVA (Protection Of Vulnerable Adults) register and Criminal Record Bureau (CRB) disclosures. The specified records and documents had been obtained before applicants had been allowed to work in the home. People can be confident staff are trained to provide care and understand their needs. The home exceeds the recommended 50 of staff trained to NVQ level 2 or above. Training records seen indicate staff had received training at a fire safety workshop, in first aid awareness, moving and handling awareness and food safety. Most of the training was arranged in the home uses a care training package that is used on the computer. The manager supports staff using this training package. Throughout the visit it was noted that people who live in the home and the staff who were caring for them appeared relaxed in each others company and staff were seen to treat the people living the home with respect and dignity. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Progress has been made to improve outcomes for people living at the home since the last inspection. The provider understands what needs to be done to ensure outcomes continue to improve. The majority of requirements and recommendations made following the last inspection have been met. Good policies and procedures and safe working practices ensure the health and safety of people who live and work in the home is promoted. Evidence: The manager has owned and run the home for many years. She has completed the course work for the Registered Managers Award and is waiting for verification processes to be completed. A great deal of progress has been made in improving the outcomes for people living at the home and all but one of the requirements made at the last inspection have now been met. The Annual Quality Assurance Audit which was completed by the provider Care Homes for Older People Page 23 of 27 Evidence: as part of this inspection shows that the provider has reviewed the quality of the service and recognises where further improvements should be made. The views of people who live in the home are sought through annual surveys and day to day contact. The manager confirmed following the last inspection that the results are assessed and acted upon. All the comments received to surveys we sent out before our visit were positive and people who live in the home and their relatives expressed their satisfaction with the way the home is run. The home does not hold money for safekeeping on behalf of residents. Any additional expenses such as for hairdressing or chiropody are paid for by the home, and are then invoiced to the resident or their representative for repayment. The homes policies and procedures have been reviewed and updated, to ensure that they provide staff with effective guidance in good practice and staff are informed of updated changes to the law as it affects their work. A sample were seen during our visit. People who live in the home are protected from harm through safe working practices. Staff work in accordance with the homes policies and procedures and have received relevant training. The staff rota was reviewed to ensure that enough staff are provided to meet the needs of people living at the home. The home is organised in a way which promotes the health and safety of the people who live there. Radiators have now all been covered.There was a problem with the fire door on the first floor which was not closing properly, the care coordinator confirmed this was being addressed on the afternoon of the inspection. Information provided in the Annual Quality Assurance Survey show that safety checks are carried out on all installations and equipment. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes R 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 1 27 18 The staffing levels in the 26/02/2008 home must be reviewed to ensure that there are enough suitably qualified, competent and experienced staff working at the home at all times, to meet the health and welfare needs of residents. Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Care plans should be expanded to contain more information about likes and dislikes, background and social histories and interests. All complaints or concerns expressed, from any source, about the service provided, should be recorded. Staffing levels should be kept under review to reflect changing dependency levels and numbers of people accommodated in the home. The provider must ensure all requirements made following inspections are met within the timeframes given. 2 3 16 27 4 33 Care Homes for Older People Page 26 of 27 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. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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