Care Home: Clare Hall Nursing Home

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What the care home does well The home sits within its` own very large grounds which are beautifully maintained. Car parking facilities at the home are very good. The home ensure that anybody thinking about using the service have the information they need to enable an informed decision. A Statement of Purpose and Service User Guide provide people with information about the home and services offered. People are encouraged to visit the home before making a decision to move there. Before a placement is offered, the home ensure that people are fully assessed. This enables the home to be sure that it can meet an individuals` needs and aspirations. The home has effective care planning and review procedures in place and people and/or their representatives are encouraged to be involved in this process. The home ensures that people have access to a wide range of health care professionals and systems are in place to ensure that peoples` health care needs are met. Health care professionals visit the home though staff support people to attend appointments outside of the home as necessary. The home has procedures in place that reduce the risk of harm or abuse to the people living there. This includes robust staff recruitment and safeguarding adults procedures. Some people are supported by the home to manage small amounts of money and the home`s procedures ensure that people are protected from financial abuse. People have access to a wide range of social and recreational activities. Designated activity staff are employed. People are supported to make choices about their lives and life at the home. Care planning procedures ensure that records are maintained as to peoples` preferences and social history. Appropriate procedures are in place and followed to ensure the health and safety of persons at the home in the majority of areas. The home has a good internal quality auditing system. This has helped the home identify issues (such as inadequate medication systems ) and put in place rapidly any remedial actions required. What has improved since the last inspection? At the last inspection four requirements were made. These have all been addressed at this inspection. The home was found to cleaner and free from odours. Some ongoing decoration and refurbishment has been completed. More is required however in an area of the home which is currently unoccupied. The care planning system has improved and now give clear details of the care and support required for each individual at the home. Healthcare needs are now being met. This includes action with regard to weight loss, oral hygiene and the prevention of pressure ulcers. What the care home could do better: At this inspection some minor issues were identified. Part of the home is currently unoccupied as it does not meet fire regulations. This has been the case for some time now. As such the occupancy at the home is low. This area of the home will require some updating and refurbishment prior to admissions being made to this part of the home. Staffing levels at the home would not be adequate if the occupancy was to increase. Staffing levels therefore need to be kept under review and increased as the occupancy increases. The home has identified and is taking action with regard to some identified shortfalls in the management of medication. Not all staff have completed moving and handling training. Although a new activities organiser has been employed since the last inspection one organiser is off sick. The activities provision is therefore limited on a Tuesday and Friday. Key inspection report Care homes for older people Name: Address: Clare Hall Nursing Home Clare Hall Nursing Home Ston Easton Somerset BA3 4DE     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: Justine Button     Date: 1 6 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 29 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 29 Information about the care home Name of care home: Address: Clare Hall Nursing Home Clare Hall Nursing Home Ston Easton Somerset BA3 4DE 01761241626 01761241727 robins@bupa.com www.bupa.co.uk BUPA Care Homes (CFC Homes) Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Caroline Williamson Type of registration: Number of places registered: care home 57 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 57 The registered person may provide the following category of service only: Care home with nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Clare Hall is registered to provide general nursing and personal care. The home is formed from an older house and a more recent extension. Both areas have been adapted for the client group. It is situated in the village of Ston Easton, 3 miles from Midsomer Norton and 12miles from Bristol and Bath. The home is set in large, wellmaintained gardens, which provide different areas for sitting and walking. The majority Care Homes for Older People Page 4 of 29 Over 65 57 0 2 1 0 1 2 0 0 9 Brief description of the care home of the bedrooms are for single occupancy although there are a small number of double rooms. There are several large areas on the lower floors used as dining and sitting rooms. The office space, kitchens and laundry are also found on the lower floor. The home is owned by Care First Homes, a direct subsidiary of BUPA. Care Homes for Older People Page 5 of 29 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 homes completed Annual Quality Assurance Assessment (AQAA) was completed and submitted to the Commission within agreed timescales. The AQAA is a self assessment that focuses how well outcomes are being met for people. It also provides us with some numerical information. Extracts from the AQAA have been included in this report as appropriate. During this inspection we were able to meet with the majority of people living at the home and to staff working at the home. We also met with some visitors. Comments received have been included in this report as appropriate. It should be pointed out that the term we used throughout the report refers to we the Commission. We would like to thank all involved for their time and cooperation in the inspection Care Homes for Older People Page 6 of 29 process. The following is a summary of the inspection findings and should be read in conjunction with the whole of the report. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: At this inspection some minor issues were identified. Care Homes for Older People Page 8 of 29 Part of the home is currently unoccupied as it does not meet fire regulations. This has been the case for some time now. As such the occupancy at the home is low. This area of the home will require some updating and refurbishment prior to admissions being made to this part of the home. Staffing levels at the home would not be adequate if the occupancy was to increase. Staffing levels therefore need to be kept under review and increased as the occupancy increases. The home has identified and is taking action with regard to some identified shortfalls in the management of medication. Not all staff have completed moving and handling training. Although a new activities organiser has been employed since the last inspection one organiser is off sick. The activities provision is therefore limited on a Tuesday and Friday. 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 29 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 29 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. The home ensure that people have the information needed to enable them to make an informed decision about using the service. People are appropriately assessed before a placement is offered to ensure that all parties are confident that the home can meet their assessed needs and aspirations. Evidence: The home have produced a Statement of Purpose and Service User Guide which provides people with information about the home and the services offered. Copies are displayed in the main reception area of the home along with the homes last inspection report. The completed AQAA told us that these documents are due to be reviewed to reflect the recent changes in the management structure. People using the service receive a contract from the home which identifies the fees to be charged and the terms and conditions of occupancy. The homes completed AQAA Care Homes for Older People Page 11 of 29 Evidence: told us that contracts have been reviewed and updated since the last inspection to reflect the current services offered. We were able to see evidence that people were appropriately assessed by the home before a placement was offered. Care plans examined contained pre-admission assessments which identified the individuals assessed needs, abilities and preferences. Assessments had also been obtained from other health care professionals where appropriate. The homes completed AQAA told us that people are encouraged to visit the home before making a decision to move there. The home ensure that staff have received the training required to enable them to meet the needs of people at the home. Staff spoken with during this inspection were very positive about the training available Care Homes for Older People Page 12 of 29 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 have access to a range of health care professionals and the homes procedures for the management of wound care have improved. The homes procedures for the management and administration of peoples medication requires improvement to provide a safer and more robust system. People are treated with respect and are supported to make choices about their lives. Evidence: During this inspection we were able to meet with the majority of people using the service, staff and some visitors. We examined four care plans and tracked the care of those people. Care plans contained a range of assessments which had been used to formulate the plan of care. Assessments included reducing the risk of pressure sores, moving and handling, nutrition, falls and environmental factors. We were able to see that care plans had been raised where risks had been identified. Care plans contained clear information as to the individuals assessed needs and abilities and there were clear instructions for staff as to how the assessed needs should be met. It was positive Care Homes for Older People Page 13 of 29 Evidence: to note that care plans had been written in a manner which promotes a person centred approach to care. Peoples preferences and aspirations had been recorded. When we spoke to staff, they demonstrated a good knowledge of peoples needs and preferences. Staff were very clear about the importance of delivering person centred care and of the need to encourage and support people to maintain any skills they may have so as to promote Independence; Social historys had been recorded within care plans and information was recorded as to peoples preferences with regard to their care and daily life.We spoke with two relatives and both were very positive about the care their relative received; we are well informed and are always made to feel welcome when we visit, It is wonderful the care staff are excellent Throughout the day we were able to observe staff interacting with people using the service. Staff were heard communicating with people is a kind and respectful manner. Staff were also heard offering people choices about their day. People appeared comfortable and relaxed in the presence of staff and people told us that the staff are very kind. People appeared well attired. Care plans contained evidence that people have access to a range of appropriate health care professionals and that advice is sought where concerns are identified. We looked at one care plan for an individual who was being treated for pressure sores and found these to be good. Wound care plans contained information about the size and status of the wound and of the treatment prescribed. The frequency of treatment and review date had been recorded in all but one of the care plans examined. Running records reflected the treatment prescribed and photographs had been used to track the progress of wounds. There was evidence that the home had requested further specialised input where concerns had been identified with the progress of a wound. A number of people at the home are frail and as such staff had introduced charts to record such things as amount of fluids and diet taken and frequency of positional change. Some had been completed accurately while others had not. It is difficult to ascertain how the charts influence the care and support provided by staff. As part of the homes auditing system checks on the medication procedures at ht home are conducted at regular intervals. The homes auditing system has identified that the system for the documentation, storage and administration of medication is not robust. Shortfalls in recording of fridge temperatures, dates of opening on creams are not recorded and gaps on the medication administration records were seen. The registered Nurses at the home have been made aware of the results of the audit and the action they are required to take. As the home has conducted it own audit we did not review the mediaction Care Homes for Older People Page 14 of 29 Evidence: arrnagements on this occassion. Care Homes for Older People Page 15 of 29 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 have access to a range of activities and people are supported to make choices about their day. People benefit from a wholesome and varied menu and staff are aware of peoples preferences. Evidence: Since the last inspection the home has recruited an additional activities organiser. It is however unfortunate that one of the organisers is on sick leave. This has resulted in activities not being available on a Tuesday and Friday. Despite this the level and opportunity for social and recreational opportunities has improved sine the last inspection. It is hoped that this will continue to develop when the activities organiser returns from sick leave. An activity programme was seen. Activities included individual one to one sessions, singing, visit by the salvation army and then the local school to sing carols, a movie afternoon and communion. During the inspection we observed visitor coming and going. People living at the home confirmed that they were able to meet friends and relatives at any time and that staff made people feel welcome. Care Homes for Older People Page 16 of 29 Evidence: Lunch was observed on the day of the visit. A choice of meal was available. The choices included Irish stew or cottage pie. Mashed potato and vegetables were also served. The potatoes and vegetables were served in dishes to the table which allows people choice of not only what they would like but also of portion sizes. The tables were nicely set with linen tables cloths and napkins. A choice of juices and water was available. Baked apple and cream was served following the meal. People living at th home were complimentary about the meals provided. Some people require staff support to eat their meals. This was observed by us. Staff supported people in a dignified and unhurried manner. On the day of the visit drinks available between meals. There was no evidence of snacks for those with specialist diets and for people with swallowing difficulties. Such things as yoghurts and fruit should be available in addition to cakes and biscuits. It should be noted however that the incidents of weight loss and pressure ulcers at the home were low. Interactions between staff and people living at the home were observed to be good with staff acting in a kindly and respectful manner. Care Homes for Older People Page 17 of 29 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 home has a satisfactory complaints procedure in place and people feel confident in raising concerns. Robust procedures are in place to reduce the risk of harm or abuse to the people living at the home. Evidence: The home displays an appropriate complaints procedure. The complaints procedure is also available in the Statement of Purpose and Service User Guide. People who were able to express a view told us that they would feel confident in raising concerns if they had any. Staff confirmed that they found the manager very approachable and would not hesitate in raising concerns. They also stated that they felt confident that any concerns would be taken seriously and acted upon. This was also confirmed by the visitors we spoke to. The home maintains records of all complaints received. We were able to see that complaints had been responded to within agreed timescales and that complainants had been satisfied with the outcome of the homes investigations. No complaints have been received by the Commission since the last inspection conducted in April 2008. The home has a range of policies and procedures in place to reduce the risk of harm or abuse to people using the service. Training records indicated that staff had received Care Homes for Older People Page 18 of 29 Evidence: training in abuse awareness. During this inspection we were able to speak with the majority of staff on duty and all confirmed that they were aware of action to be taken should they suspect abuse. Staff were also aware of the whistle blowing policy. Care Homes for Older People Page 19 of 29 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 suitable for purpose however requires some updating and refurbishment in some areas. People are able to personalise their own rooms. The home was odour free on the day of the inspection. Evidence: At the last inspection we were informed by the manager that the house area of the home was currently not in use as it had been identified that this did not comply with the changes to the fire regulations. As such occupancy at the home is reduced. This remains the case on this inspection. People and staff living at the home are very anxious about this and expressed fears that the home may close. The manager assured us that this is not the case and that the home will remain open. The bedrooms in the house area of the home will require decoration and up grading prior to them being occupied again. This was agreed with the home and area manager at the end of the inspection. Since the last inspection one of the shower rooms has been refurbished and upgraded. This has been completed to a high standard. In addition a hair dressing salon has been developed. Some of the communal areas have been painted. Care Homes for Older People Page 20 of 29 Evidence: The majority of the home was odour free on the day of the inspection. There were odours in one area of the home but this was due to a broken drain. Repairs were taking place on the day of the inspection. During this inspection we saw all communal areas and sampled some bedrooms. The standard of cleanliness was noted to be very good. The home has appropriate procedures in place to reduce the risk of the spread of infection and the majority of staff have completed training in infection control. Staff hand washing and sluice facilities are appropriately sited throughout the home and staff have access to a good supply of protective clothing. Care Homes for Older People Page 21 of 29 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. Staffing levels are not always sufficient to meet the needs of people using the service. The homes procedures for staff recruitment are satisfactory Newly appointed staff receive a thorough induction programme and this, along with the ongoing training programme, ensure that staff have the skills needed to meet the needs of people living at the home. Evidence: At the time of the inspection we were told that there was 27 people living at the home. Feedback from people living at the home and staff was that staffing levels were not always adequate. One person living at the home told us that reduced staffing levels had impacted on the care and support provided as they had to wait longer than usual when they rang the bell or assistance. We discussed this with the manager who confirmed that there were issues with staffing and particularly with the numbers of registered nurses employed and for this reason the company would continue to keep the occupancy at the home at a low level. The manager told us that staff recruitment is ongoing. We reviewed the staffing rotas following the inspection and these confirmed that on some occasions staffing levels were less than is usual at the home. The home also employs a full time administrator, catering staff, domestics, laundry staff and a full time maintenance person. Two activity coordinators are also employed Care Homes for Older People Page 22 of 29 Evidence: (one of these is currently off sick) . The homes completed AQAA told us that of the 15 permanent care staff employed, 8 have achieved a minimum of an NVQ level 2 in care. We looked at recruitment files for four staff . We examined the homes procedures for staff recruitment and found this to be satisfactory in all but one file. Three records were found to be very well organised and all required information was available. There was evidence that staff had not commenced employment until receipt of two satisfactory references and an enhanced criminal record check (CRB) and check against the protection of vulnerable adults register (POVA). In the fourth file it could not be confirmed that a reference had been obtained from the last employer. This was discussed with the manager who agreed to complete this. All newly appointed staff follow a 12 week induction programme which meets with the recommendations of the Skills for Care Common Induction Standards. Staff spoken with during the inspection were positive about the induction programme and confirmed that they had received the training needed to enable them to care for the people living at the home We reviewed the staff training matrix following the inspection. This showed that the majority of mandatory training had been completed. It was noted however that 12 staff had not completed moving and handling training in the last year. Only four staff have undertaken dementia training and mental Capacity training. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is appropriately managed. The manager is registered with us and has the necessary skills to run the service. The home have effective quality assurance procedures in place which seek the views of people using the service and other stakeholders. Safe systems are in place for the management of peoples money. The home has arrangements for ensuring staff are appropriately supervised . The home follows appropriate procedures to ensure the health and safety of persons at the home. Evidence: The home has a manager who has been in post since 2008. Staff spoken to at this inspection told us that they felt the acting manager was very approachable and that positive changes had taken place and were on-going. Care Homes for Older People Page 24 of 29 Evidence: The home have effective quality assurance programmes in place which seek the views of people using the service and other stakeholders. We were able to view the results of a recent survey and comments were noted to be very positive. Regular meetings are held for staff, people using the service and their representatives. On behalf of the registered provider, the operations manager conducts the homes regulation 26 visits on a monthly basis. These demonstrate that the quality of the service provided in all areas, is audited and reviewed. At the request of people using the service or their representatives, the home manage small amounts of pocket money for people. Monies are held in individual accounts and a record of all transactions is maintained on individual computerised statements. Receipts are also maintained. A float of money is held at the home to ensure that people have easy access to funds as required. This is managed by the homes administrator and overseen by the company. Since the last inspection the home have taken steps to ensure that all staff receive formal supervision sessions . Appropriate records were in place and staff spoken with told us that they felt very well supported and confirmed that they received formal supervision. The AQAA told us about checks that are in place to ensure the health and safety of persons at the home and found all records to be up to date. FIRE SAFETY - Up to date in-house checks and external servicing were up to date. Training records indicated that staff had received training in fire safety. EQUIPMENT SERVICING - Up to date servicing records were available for the homes hoists and passenger lift. ELECTRICAL SAFETY - The home has an electrical hardwiring certificate and there was evidence that appropriate checks had been made on portable appliances. ACCIDENTS Appropriate records are maintained for all accidents in the home and the home have ensured that the Commission have been informed of all significant events. All hot water outlets are fitted with thermostatic valves and the home conducts monthly checks to ensure that temperatures remain within safe upper limits. To ensure the safety of people using the service, windows above ground floor level have restricted openings, any free standing wardrobes have been secured to the wall and any wall mounted radiators have been fitted with a guard. Not all staff have received training in moving and handling (see outcome area 6 with regard to staff training) Care Homes for Older People Page 25 of 29 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 26 of 29 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 1 19 23 Prior to being occupied the 13/04/2010 bedrooms in the house will require a programe of refurbishment and upgrading This will ensure that the rooms are suitable for use and provide a plesant enviroment. 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 38 13 All staff must receive training in safe moving and handling This will ensure the safety of people living at the home and staff 13/03/2010 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 8 Charts used to record such things as fluids, diet and a change of position should be accurately completed. These should be used to influence the care given by staff. The management must ensure that they continue to action the finding of the medication audit. Staffing levels must be kept under review in line with the Page 27 of 29 2 3 9 27 Care Homes for Older People 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 homes occupancy. Recruitment should be ongoing. Care Homes for Older People Page 28 of 29 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 29 of 29 - 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!