Care Home: Clann House Residential Home

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What the care home does well There is a stable committed staff team that work hard to meet the needs of the residents. Comments received from residents and/or their relatives confirm their confidence in the staff. Many of the people who live at Clann House feel that they are offered a good standard of care. One visitor said that they did not have any concerns and were satisfied with the care provided and the kindness and politeness of the staff. What has improved since the last inspection? Requirements identified at the previous inspection have been met or partly met: Medicines are routinely and regularly audited. Nutritional supplements are included in care plans. The provision of social/recreational stimulation has improved. Staff are supervised. What the care home could do better: The overall impression of this home is one that is improving. Attention to the following will continue this process: The Statement of Purpose and Service User Guide should contain all the information specified in Schedule 1 of the Care Homes Regulations. Information could be provided in alternative formats for people with sensory deficits (e.g. audio/video). Care plans need to be more detailed and prescriptive, directing staff as to the intervention needed. Social/recreational activities are happening frequently, but it is not clear how people are offered choice and more can be done to ensure that the care records reflect the quality of life for the people living there. More can be done to ensure that choice is available and offered to people at meals, and that the record of food provided reflects the choices made. Staffing numbers are insufficient to fully meet the care needs of the people that live there, and facilitate continued improvement in the service offered. More can be done to develop the quality assurance tools in use, publishing a summary of the findings (including any action taken as a result of the finding). Key inspection report Care homes for older people Name: Address: Clann House Residential Home Clann House Residential Home Clann Lane Lanivet Cornwall PL30 5HD     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: Alan Pitts     Date: 1 5 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Clann House Residential Home Clann House Residential Home Clann Lane Lanivet Cornwall PL30 5HD 01208831305 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: julie.frape@btconnect.com John Reid Clarkson,Susan Ann Clarkson care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 34. The registered person may provide the following category of service only: Care home providing personal care only- Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category- Code OP- maximum 3 places Dementia- Code DEmaximum 34 places Mental disorder, excluding learning disability or dementia- Code MD- maximum 3 places Date of last inspection Brief description of the care home Clann House is situated in three acres of land and gardens, in a quiet rural setting a short distance from the village of Lanivet, near Bodmin. The home is registered to Care Homes for Older People Page 4 of 27 Over 65 0 0 3 34 3 0 0 3 0 3 2 0 0 9 Brief description of the care home provide accommodation and personal care for up to twenty six older people with a dementia; it is also registered to care for named residents with mental healthcare needs (3), old age (3) and one resident with a learning disability over 65 years. The adapted farmhouse offers comfortable accommodation, with level access around most of the ground floor. The bedrooms offer views of the surrounding countryside. The home offers accommodation on both the ground and first floor, with stair lift provision for those who require it. An extension has been added to the home providing eleven en-suite bedrooms. Communal rooms comprise of three lounges, and a dining room. The dining room comfortably accommodates the residents. There is a central safe courtyard garden. The home has its own car parking with space for approximately 5 to 7 cars. A further extension has been built on to the side of the premises, and provides accommodation for a further 8 people. The accommodation in this new extension is not level access and is suited to people who are more mobile and more self sufficient. Information about the home (Statement of Purpose and Service User Guide) is available from the office, and information is provided in each bedroom. The fees for the home are between 410 and 525 pounds per week; this does not include toiletries, chiropody, hairdressing, clothing or other personal items. Current fees should be confirmed with the service. Use of the vehicle is charged at 40p per mile. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection took place over approximately 7 hours. The inspector looked at documentation, toured the premises, met with residents and staff, and discussed our findings with the area manager and proposed manager of the home. We also received seven surveys completed by staff and two surveys completed by people that live there. Overall, the home has improved significantly since the last inspection, and this is reflected in the improved rating. However staffing levels have again hindered the continuing improvements. Care Homes for Older People Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: 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 7 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 8 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. Prospective residents and/or their representatives are provided with information to enable them to make an informed choice of home. Residents have their needs assessed prior to moving into the home. This is so that the home can assure the prospective resident that they are able to meet their individual care needs. Evidence: Copies of the Statement of Purpose and Service User Guide (documents that tell a person about the home) are given to prospective residents or their representative. This also includes the Complaints Procedure. The Statement of Purpose and Service User Guide were last reviewed in 2009. The Statement of Purpose and Service User Guide do not contain all the information specified in Schedule 1 of the Care Home Regulations. The benefits of providing information in alternative formats were discussed with the area manager and manager. As part of this inspection we looked at the assessments that were carried out prior to Care Homes for Older People Page 9 of 27 Evidence: a person moving to Clann House. The care documentation of the person most recently admitted to the home showed that pre-admission information had been obtained. As discussed at the time of the inspection, care should be taken to ensure that admissions to the home only take place if the service is confident staff have the skills, ability and qualifications to meet the assessed needs of the prospective resident before agreement is give for the admission. Prospective residents are given the opportunity to spend time in the home. A key worker is allocated to give people information and help them to feel comfortable in their surroundings, and enable them to ask any questions about life in the home. The home does not provide intermediate care, though respite care is offered. Care Homes for Older People Page 10 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. Many of the people who live at Clann House feel that they are offered a good standard of care. Each resident has a care plan. This is written in plain language. Care plans do not provide sufficient detail and direction to care staff. The care records also includes relevant risk assessments. The aims and objectives of the home reinforce the importance of treating residents with respect and dignity. Evidence: Comments received from the people who live at Clann House were positive. In talking to the people that live at Clann House we found that the attitude of the care staff to be caring, helpful and concerned. At the time of the inspection there were 26 people resident at Clann House with 4 care staff on duty, supported by domestic and catering staff. The area manager and manager confirmed that approximately 6 people had what might be considered to be low care needs, 15 medium care needs, and 3 high care needs. Five of the seven staff surveys received commented on the home being short staffed. Visiting professionals have also commented on the staffing levels evident when they visit. A requirement to Care Homes for Older People Page 11 of 27 Evidence: increase staffing levels was made at the last inspection. This is discussed later in the report. Care staff are being trained and accredited to meet the health care needs of the residents and have access to training in health care matters. Many of the people at Clann House have dementia or mental health needs and are not able to always explain their needs or difficulties. It is therefore important that there are written care plans that detail how needs are to be met to ensure that staff know the nature of the care they are to provide. Care plans give insufficient direction to staff (e.g. care need is mobility) and do not demonstrate staff understanding of the issues. There needs to be more clarity about the care needed by the individual. The care intervention needed should then give clear direction and detail to staff. Care plans were seen to be reviewed, but discussion revealed that the outcome of the review did not always reflect the changed care needs of the resident. Care should be taken to ensure the care plans show evidence of a regular review including maintenance of strengths and abilities, with the involvement of the resident or their representative where possible. We did see evidence of advice being sought from external professionals and the use of multi-disciplinary meetings to determine the best way forward to meet residents care needs. The manager (an application to be the registered manager is anticipated) showed a good understanding of the mental capacity act and deprivation of liberties guidance, and has liaised with families and relevant agencies in this respect. Supporting documentation showed that clients have access to relevant professional health care agencies as needed. All the people that live at Clann House are registered with a local GP surgery. The health care needs of those residents too frail to leave the home are managed by visits from local health care services. Residents personal aids are well maintained and the home provides the necessary aids and equipment to support both staff and residents in daily living. The daily entries generally show the care provided, but the quality of the care would be better demonstrated if these were matched to a clear, detailed care plan. Relevant risk-assessments are in place for each resident. The staff station that was used as a second office is still used for storage of care plans, but is also used as a storage area. The purpose and future use of this area was again discussed with the area manager and manager. Staff sit in the dining area to write their daily entries in the care notes. This area has significant distractions and is also Care Homes for Older People Page 12 of 27 Evidence: away from where the care plans are stored. The care plans should inform the care given, but these are currently kept separate from the daily notes. This was discussed again with the area manager and manager. The home uses key workers who build up special relationships with residents and work on a one to one basis. Clients preferred names are recorded and used. Clients have access to a telephone for private use. Rooms have been fitted with locks allowing the individual to lock their room whilst ensuring staff access in an emergency. We found that medicines were stored securely in locked cupboards and access to the keys was restricted to those people who had received training to administer the medicines. The supplying pharmacist audited the homes medicines at the time of the inspection. The home works to a medication policy supported by procedures and practice guidance. Staff are aware of and understand the guidance, and quality assurance systems confirm that practice reflects policy. Care Homes for Older People Page 13 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The records do not fully reflect the social/recreational activities available, nor is there sufficient staff to provide in this area, and improvements are needed. Visitors are welcomed to the home at anytime. Choice is not always shown to be available to residents Evidence: The manager is aware of the need to plan the routines and activities of the home in a way which meets the choice and wishes of residents. There are activity records in the daily care entries, but these do not reflect whether people were offered the chance of participating, nor do they reflect the significant improvements made since the last inspection in actually providing activities (an activity that took place the day before had not been recorded). There was a musical event provided on the day of the inspection. There is no system to ensure that all the residents are given the opportunity to participate in activities. More stimulation is now offered, but the staffing levels are insufficient to offer the twice daily activity programme indicated on the duty rota. The duty rota shows a staff member to be allocated to activities am and pm every day, but there is no defined time limit for this, nor any monitoring to ensure this takes place. The daily entries in the care documentation now provide more information about how the resident spent their day, but there is still room for improvement. Care Homes for Older People Page 14 of 27 Evidence: Several people are fit and active and able to walk to the nearby village. One resident attends a day centre and also an evening activity in a local school on a weekly basis. Where possible residents manage their own money or have someone do so for them. The home has no involvement in managing peoples money, though they will look after small amounts of money if requested to do so. The visitors book and comments from residents confirm that contact with loved ones and friends is encouraged. The daily entries seen showed people can make choices in respect of times of waking and retiring. Rooms are personalised with plenty of evidence of personal possessions being brought in. The home maintains a personal property record to reflect this, though care should be taken to ensure the accuracy of these records. There was no indication of an alternative being available at meals. It is not clear how people are enabled to make a choice as there is no evidence of them being asked. There is a record of food provided, but this reflects the days menu and does not demonstrate choices being made. Lunch was seen to be attractively presented and hot when served. The area manager said that a full range of items including cooked food is available for breakfast, but this is not evident from the menu. Tea consists of a variety of sandwiches and perhaps something on toast, or quiche. Some people choose to take their meals in their bedrooms. Provision is made for people who prefer to have the main meal in the evening and those returning late from trips out. A visitor to the home confirmed they had had meals at the home and thought the food to be good. Care Homes for Older People Page 15 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. The people at Clann House are confident that their concerns will be listened to and acted upon. The people that live at Clann House are protected from abuse by appropriate procedures and ongoing staff training. Evidence: There is an easy read complaints procedure displayed in the entrance to the home. A copy of the complaints procedure is available in the Statement of Purpose and Service User Guide. The benefits of providing information in alternative formats were discussed with the area manager and manager. Comments received confirm that people have confidence in the staff and manager, and know how to complain. The policies and procedures regarding protection of residents are regularly reviewed and updated. One of the responsibilities a care home has is to protect people from abuse, and the Commission expects homes to be proactive in this matter. There is ongoing safeguarding training taking place, with 11 of 23 care staff having received this training (this should continue). The area manager and manager have attended Deprivation of Liberties training. Safeguarding is included as a topic at team meetings. People are protected by the homes adherence to a robust employment procedure. Comments from residents and others show that they feel safe and supported by an organisation that has their protection and safety as a priority. Policies, procedures and Care Homes for Older People Page 16 of 27 Evidence: the homes documentation reflect the rights of the individual. The home is involved in one ongoing safeguarding process. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at Clann House benefit from accommodation that for the most part has been designed to meet their needs. The accommodation is clean and odour free Evidence: There have been no significant changes to the environment since the last inspection that we were advised about. We looked around the home and the rooms seen were all clean and in good order, there were no unpleasant odours. The carpets in the main corridor around the courtyard are showing signs of wear and tear despite being regularly cleaned. Some of the people had brought items of their own in to decorate their rooms. All of the rooms are of a good size and many have ensuite bathrooms or showers. The most recent extension to the home can provide accommodation for a further eight people. These rooms are down a corridor where there is a door with a keypad; there are a few steps even for rooms on the ground floor. The manager is aware of the type of people who could be accommodated in these rooms. People who needed more care and support live in other parts of the home. There is a central courtyard around which there are bedrooms the dining room and Care Homes for Older People Page 18 of 27 Evidence: lounge. This means that people are free to wander freely in the rooms and corridors that surround the courtyard, or use the courtyard itself. This part of the home provides for people who may have dementia or memory problems to walk safely and not to be enclosed. The garden area to the side of the house would benefit from further planting and seating facilities. Bedroom door locks have been fitted to provide a facility for residents to lock their doors, whilst allowing staff overriding access in case of emergency. The staff have a master key for all the doors. The management has an infection control policy, though the provision of training in this could be improved. The kitchen and laundry areas were not inspected at this time though the former was seen to be clean and organised. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The numbers of staff on duty are not sufficient for all care needs or the efficient management of the service. The recruitment procedures are robust to safeguard residents. Training is encouraged and facilitated, and has progressed since the last inspection. Evidence: Information provided by the Home shows that twelve (12) of twenty three (23) care staff have a National Vocational Qualification Level 2 or above, with a further eight (8) having started this training. A new training manager has been appointed by the registered providers, and a training matrix is now implemented so that staff training needs can be better monitored. The service uses a company trainer to deliver training, and also makes use of online training courses. This training can be small scale and individualised in order to promote the delivery of person centred services. There has been a significant improvement in staff training and the monitoring of training, though the training matrix shows that further improvements are still needed. We were advised that new staff undertake a National Training Organisation compliant induction programme, though training records for this were with the individual staff. The service clearly defines the roles and responsibilities of staff through accurate job descriptions and specifications. Care Homes for Older People Page 20 of 27 Evidence: There is an area manager and a manager, but the position of registered manager is vacant at the moment (an imminent application is anticipated). We were advised that the home are looking to recruit a deputy manager. The duty rota and discussion confirms that at the time of the inspection there were 26 people living at Clann House and routinely 4 staff on duty during the day. Residents needing the input of two care staff clearly has implications for the numbers of staff left available for the other residents. We also received comments from staff about the home being short-staffed, and similar comments have been made by visiting professionals. The manager has at times also had to work on the floor instead of focusing on management and the homes continuing improvement. The duty rota should clearly distinguish between the managers managerial hours and the times when she is counted as one of the care staff. Staff comments and records show that the lifestyle of the residents is not being afforded the importance it should with existing staff numbers. Staff training will also improve with increased staff numbers. A requirement to increase staffing levels was made at the last inspection. Examination of personnel files showed that the home is adhering to a robust employment procedure. All encounters seen and heard between staff and residents were appropriate with staff addressing people by their preferred name. Staff were heard to be respectful when talking with service users and seen to be gentle when directing and assisting them. Staff were seen and heard to knock on doors before entering bedrooms. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager has yet to register with CQC therefore the legal responsibilities are with the registered provider at this time. The residents will benefit from the appointment of a registered manager Evidence: The home is managed on a day-to-day basis by the manager with support from the companys area manager. The manager has the required qualifications and experience and is competent to run the home. She works to continuously improve services and provide an increased quality of life for residents. The home has sound policies and procedures, which the manager effectively reviews and updates. We anticipate that an application for the position of Registered Manager will be submitted shortly. As a result of the Commissions confidence in the registered providers proceeding with this appointment the requirement to appoint a registered manager has been removed from this report. Care Homes for Older People Page 22 of 27 Evidence: There are team and resident meetings, but these are not regularly and properly documented. There is a formal quality assurance system in place to ascertain the views of those that use the service and other stakeholders, but this needs developing and a summary of any findings published. The home has no involvement in the management of individuals finances, though will look after small amounts of money if requested to do so. Staff supervision is now happening and is being properly recorded. The premises and equipment within are regularly maintained and checked. There is appropriate insurance in place. Care Homes for Older People Page 23 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 registered provider must 01/04/2009 ensure there are sufficient numbers of staff on duty to meet the care needs of residents. The numbers of staff on duty need to be sufficient for all care needs and the efficient management of the service. Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 The registered provider must review the care plans to ensure they detail how care needs are to be met and to ensure that staff know the nature of the care they are to provide. This is to ensure consistency in quality and approach to care delivery. 01/02/2010 2 27 18 The registered provider must increase staffing numbers by at least one carer on early and late shifts. This is to ensure that people receive the care and quality of life they need, and to ensure there is efficient management of the service. 01/02/2010 Care Homes for Older People Page 25 of 27 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 1 The registered provider should ensure the Statement of Purpose and Service User Guide contains the information specified in Schedule 1 of the Care Homes Regulations. The registered provider should provide information in alternative formats for people with sensory deficits (e.g. audio/video). The registered provider should ensure the care plans show evidence of a regular review including maintenance of strengths and abilities, with the involvement of the resident or their representative where possible. The registered provider should ensure that social/recreational stimulation is monitored and properly recorded to demonstrate the opportunities offered and the choices made by the people that live at Clann House. The registered provider should ensure that choice is available and offered to people at meals, and that the record of food provided reflects the choices made. The registered provider should continue to assess training needs and prioritise training provision. The registered provider should develop the quality assurance tools in use, publishing a summary of the findings (including any action taken as a result of the finding). 2 1 3 7 4 12 5 15 6 7 30 33 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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