Care Home: Clifton House Residential Care Home

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What the care home does well People get good information from the home so that they can make a decision about whether to move here. People feel they are treated with dignity and respect. A relative said, "Clifton House looks after my parent with much love and the greatest of care." Visitors said that the atmosphere in the home is always "homely" and "welcoming." People said that the quality of the meals is "very good". People can choose what they want to eat and where they dine. Staff have training in health and safety, so they know how to support the people in a safe way. The home is well managed, and is run in the best interests of the people who live here. What has improved since the last inspection? All previous requirements have been addressed, for example - there is better storage for medication. - staff now have proper checks before starting work here. - everyone now has a copy of their own contract. -care plans are more detailed so staff have better guidance to support people. -people are now asked for their views and comments about the service they receive. Also there have been improvements to some bedrooms and six more rooms now have en-suite facilities. Over the past few months the home has been managed in a more robust way to make sure the service continues to improve. What the care home could do better: The provider must continue to decorate the bedrooms that need to be a better standard. There must be grab rails in toilets to help people with their mobility. It would be better if the unused shower room was made level so people could have the choice of having a shower instead of a bath.The lighting in bathrooms and toilets should be brighter, and dirty light pull cords should be replaced. Extractor fans should be cleaned on a regular basis to prevent the risk of fire. The provider should make sure there are washbasins in toilets to make sure people can wash their hands hygienically. The manager must keep staffing levels under review and increase the staffing if the needs or number of people increases. Key inspection report Care homes for older people Name: Address: Clifton House Residential Care Home 94-96 Clifton Avenue Hartlepool Cleveland TS26 0XS     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: Andrea Goodall     Date: 0 6 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Clifton House Residential Care Home 94-96 Clifton Avenue Hartlepool Cleveland TS26 0XS 01429223399 01429890632 info@cliftonhousecare.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Finest Care Limited Name of registered manager (if applicable) Mrs Andrena Piggins Type of registration: Number of places registered: care home 28 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: 28 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP, maximum number of places: 28 Date of last inspection Brief description of the care home Clifton House is a care home for older people, registered under the Care Standards Act 2000, providing accommodation and care for up to 28 older people. The home has 28 single bedrooms. 14 bedrooms have en-suite facilities. Clifton House is located in a quiet road, close to local amenities and the town centre. Most of the people who live at Clifton House personalise their bedrooms with their own Care Homes for Older People Page 4 of 28 Over 65 28 0 0 7 0 4 2 0 0 9 Brief description of the care home furniture and personal belongings. The home has a number of communal areas that are well used by residents. There are quieter areas should privacy be required. The home is situated over four levels and a passenger lift gives access to all floors. The home should be contacted for up-to-date information about fee levels. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Before the visit we looked at information we have received since the last key inspection visit on 7th April 2009. We looked at any changes to how the home is run. We looked at how the service has dealt with any complaints or concerns since the last visit. We asked the Provider for their view of how well they care for people in their AQAA (an annual quality assurance assessment). We received surveys from three residents and six staff. We made an unannounced visit to the home on 6th April 2010. During the visits we talked with people who use the service, their relatives, the manager and staff, and visitors. We joined residents for meals and looked at how staff support the people who live here. Care Homes for Older People Page 6 of 28 We looked at information about the people who use the service and how well their needs are met. We looked at other records which must be kept by a care service. We checked whether staff had the knowledge, skills and training to meet the needs of the people they care for. We looked around parts of the building to make sure it was clean, safe and comfortable. We checked what improvements had been made since the last visit. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: The provider must continue to decorate the bedrooms that need to be a better standard. There must be grab rails in toilets to help people with their mobility. It would be better if the unused shower room was made level so people could have the choice of having a shower instead of a bath. Care Homes for Older People Page 8 of 28 The lighting in bathrooms and toilets should be brighter, and dirty light pull cords should be replaced. Extractor fans should be cleaned on a regular basis to prevent the risk of fire. The provider should make sure there are washbasins in toilets to make sure people can wash their hands hygienically. The manager must keep staffing levels under review and increase the staffing if the needs or number of people increases. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents are fully assessed before they make a decision about moving here so that they are assured the home can meet their needs. Evidence: Clifton House is a traditional large Victorian villa that has been operating as a care home for many years. Many of the people who live here were already familiar with it before they moved in. The home provides good information about its service (called a service users guide) and a copy of this booklet is provided in every bedroom. Before people come to live here their needs are assessed by health and social care professionals to see what sort of care they need. The home manager then carries out a pre-admission assessment with the person to see if the home can meet the persons individual care needs. The home also encourages people to come and have look around before they make any decisions. In this way people have good information about the service before they move here. Care Homes for Older People Page 11 of 28 Evidence: At the time of this inspection there were 18 people accommodated at Clifton House. Some people were staying here for a short-break before they went back to their own homes.One person said, I would recommend it to anyone. I have stayed other places but this is the most homely. Following a requirement at the last inspection, everyone is now given their own copy of their contract, which sets out the terms and conditions of their accommodation whilst living here. Some minor amendments would make the contract clearer and upto-date. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive good support with their personal care so that their needs are well met. Evidence: Care plans are records that are used by all care services to show what sort of help each person needs and how staff will provide that care. For example how to help people with their mobility, diet and personal hygiene. The care plans at Clifton House have improved in detail over the last year and these provide staff with better guidance about how to support each person with their individual needs. For example one persons care plans shows staff how to help that person with their make-up, which is important to them. Discussions with the manager indicated that there are plans to continue to improve and personalise care plans so that staff have clear guidance about how each person would like to be supported. The care records also show that peoples health care needs are assessed and regularly checked for example their mobility, nutrition, and risk of falling. Residents are supported to access local community health care services that are brought into the Care Homes for Older People Page 13 of 28 Evidence: home, including GPs, district nursing service, opticians, chiropodists and dental services. Clifton House does not provide nursing care. It was clear from records that the home seeks the advice of health care professionals to ensure that residents receive the right health care whilst living here. For example there are records of the assessment and guidance that have been put in place by an occupational therapist for one person who uses bed rails. The home notified us of a lot of falls by people last year, although most of these did not result in any injury. The manager carried out a falls monitoring and analysis, and there are records of referrals to the Falls Prevention Nurse on behalf of individual residents. These steps have resulted in a significant reduction of the number of falls experienced by people who live here. It was stated that if a resident had the capability to manage their own medication they would be supported to do so. At this time all residents medication is managed by the home. Most medication is supplied in blister packs by a pharmacy so that it is easy for staff to administer. It is stored in a locked trolley in a locked room. Since the last inspection a new storage room is used for medication which has improved the security and storage of medication. Records of the administration of medication were up to date, and there is good guidance to show staff when someone might need their as and when required medication. It is good practice that the home scored 91 at a pharmacy inspection that was carried out in November 2009 by the PCT (Primary Care Trust). Staff were friendly and helpful towards residents during this visit. They supported people in an unhurried way with tasks such as eating, walking and washing. All the residents and visitors who took part in this inspection commented positively about the supportive and respectful attitude of staff. One resident said, Staff are very caring. They take their time, however long it takes. In written surveys people said that they felt they were treated with dignity. One relative said, Clifton House staff look after my parent with much love and the greatest of care. A resident said, All of my needs are met here. Staff are always very nice and helpful. Its like a real home. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have good opportunities to make choices about their own daily routines so they lead a lifestyle that matches their own preferences. Evidence: This home continues to encourage people to lead their own lifestyle and to spend time in whichever areas of the home that they wish. During this visit some people were spending time in the different lounges, and others were enjoying the privacy of their own rooms. Several people choose to dine in their own rooms and this is respected and accommodated. Each persons individual lifestyle is respected and if people choose to have meals at alternative times this is also supported. However at this time there is little in the way of organised activities as the activities staff has been on sick leave for some months. Staff stated that they try to provide some activities but they have to attend to peoples personal care needs first, which most people need a lot of support with. Residents did comment that the manager has taken people into town for shopping trips and to the local theatre, but said, Most of the time there is not much to do. Staff do their best but they are so busy. The manager agreed that this is an area that Care Homes for Older People Page 15 of 28 Evidence: needs to improve. There were several visitors to the home on this day. Relatives and other visitors had said that they are made to feel welcome when they visit. One visitor said The staff seem very nice and it is welcoming. A resident also said, It has a comfortable and happy atmosphere. Residents are given information so they can make informed decisions. For example there is a written menu each day in the hallway, and people are asked each morning what they would like for that day. The cook is involved in Residents Meetings so that residents can discuss their preferences and make suggestions for the menu. Residents had many positive comments to make about the catering at this home. One person said, The food is very good. We get choices for every meal, and you can have it where you choose.We even have sherry with our Sunday meal. It is good practice that during meals staff often sit with residents, either to support them or just to chat and make the dining experience a sociable event. The lunchtime meal was unhurried and pleasant occasion. The quality of meal was very good and people were offered alternatives if they did not want the main choices. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their representatives have clear information so they would know how to make a complaint. The staff team have had suitable training so they know how to protect residents from abuse. Evidence: All residents have information about how to make a complaint in their information booklet (service users guide). The complaints procedure and the providers details are also on display in the entrance hallway where it can be seen by residents and visitors. Residents and their visitors also have opportunities to discuss any concerns with the manager or staff. Residents said that that they would feel comfortable about talking to the manager if they wanted to mention anything, and were confident that she would sort it out. CQC has received no complaints about this service since the last inspection. The home has received one complaint, and the homes records show that this has been satisfactorily addressed and concluded. The home uses the safeguarding adults arrangements that are promoted by Hartlepool Borough Council, which are robust procedures for dealing with suspected abuse. The manager has completed a two day training course in the safeguarding adult processes and understands her responsibilities in this area. All staff have also received training in Care Homes for Older People Page 17 of 28 Evidence: the local council safeguarding adults procedures. In this way staff know how to protect the people who live here and how to report any poor practices. The manager is also fully aware of the mental capacity act and how this impacts on peoples rights to make their own decisions whilst living at this home. She is also fully aware of deprivation of liberty safeguards and has worked with the local authority to support one person who has been assessed as at risk of trying to leave the home without support. There has been one safeguarding adults investigation at the home last year. This related to the use of the wrong moving & assisting equipment for a resident, which was contrary to their care plan. During the investigation by the council there was a temporary suspension of placements to the home. However this was lifted last year and there have been no further concerns in this area. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is warm and comfortable, but some areas are worn or not well-equipped so it is not a fully well-maintained environment for the people who live here. Evidence: Clifton House is a large Victorian property close the centre of Hartlepool. It offers single room accommodation for up to 28 people. Residents described the home as warm and comfortable. Some people are pleased with the standard of their accommodation, especially those rooms in the top of the main part of the house that have been refurbished. However some vacant rooms remain shabby with worn furnishings, threadbare carpets, and peeling wallpaper. These are not of an adequate standard to be used at this time. The provider has been carrying out a programme of refurbishment to vacant rooms, and this is continuing. Although most communal areas are satisfactorily decorated and inviting to use, the dining room chairs are very uncomfortable as the padding has worn away. The manager confirmed that these are to be re-upholstered. The home has a good range of sitting areas for people to choose from. There are two lounges at the front of the home and a central dining room. The home also has a Care Homes for Older People Page 19 of 28 Evidence: large, bright conservatory room, and there is wheelchair access to a small patio area at the side of the home. There are bathrooms on all floors and most are fitted with hoisting equipment which is dated but still functioning, and regularly serviced. However there is a large shower room on the first floor that is redundant as there is high step up into the shower area. The people who live here could not use this facility because it is not adapted for their use. This means that there is no choice of shower facility for those people who might prefer a shower. Also there are no grab rails in most toilets, even though most of the people who live here are frail or have mobility needs. Some bathrooms and WCs have no natural light and are fitted with environmentallyfriendly low watt lights that make these rooms very dim. This low level of lighting could present a tripping hazard for the people who live here. Some extractor fans in toilets and bathrooms had become very furred-up, and this could present a fire hazard. Since the last inspection six bedrooms have been fitted with small en-suite facilities. Unfortunately most of these contain only a toilet, with the washbasin sited in the main part of the bedroom. This arrangement compromises hand hygiene as people will have to touch the door handle and negotiate the bedroom before they can wash their hands. The home has achieved a 4* Food Safety award from Environmental Health, for its good food hygiene standards. Since then the home has had a new kitchen fitted which may improve its rating. On the day of this visit there was a box of examination gloves being stored on a handrail in the corridor, where anyone could touch them. This could also compromise infection control and the manager removed them. Overall the standard of odour control and cleanliness around most parts of the home was good, and it is clear that housekeeping staff work hard to keep this home clean and hygienic. However light pull cords in toilets and bathrooms are becoming grubby, and they are difficult to clean in their current state. This could compromise infection control within the home. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides suitable, competent, trained staff to ensure that the needs of the people who live here are met. Evidence: The staff team consists of a manager, deputy manager, senior care and care staff. The home also employs catering staff, domestic staff, activity and maintenance staff. The home provides three care staff (including at least one senior) throughout the day and afternoon. There are two staff (including one senior) through the night. This is the minimum level to meet the needs of the people living here people, most of whom need support with their mobility, washing, dressing, bathing and using the toilet. Six people need two staff to help them with all their personal care and mobility. At this time the homes dishwasher is broken, so one care staff also has to wash teatime dishes which removes them from their care duties. One resident said, Its alright here, but I would like to have more attention from staff. Several residents made comments about how staff are rushed off their feet and always so busy. In discussions the manager confirmed that staffing levels are kept under review, and is fully aware that any increase in dependency levels would require an increase in staffing in order to meet those needs. She has made changes to the staff rota to Care Homes for Older People Page 21 of 28 Evidence: ensure a good skill mix on each duty, and has introduced telephone on-call arrangements so that staff always have a point of contact for advice. The provider is an equal opportunities employer. Personnel records show that the home uses robust recruitment and selection processes so that only suitable staff are employed here. Since the last inspection the home now makes sure that no staff starts work here until satisfactory checks, references and police clearance (called a CRB disclosure) have been received. Over the past year staff have received a lot of updated training in health & safety matters such as moving & assisting, first aid, fire safety and infection control. Most care staff have also had some introductory training in dementia care. It is good practice that all but two of the care staff team have achieved a national qualification in care, called NVQ level 2, or above. In this way staff know how to support the people in the right way. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed so that it is run in the best interests of the people who live here. Evidence: Since the last inspection a former manager has returned to the home. She has many years experience of managing care services and has suitable qualifications to carry out this role. Shortly after this inspection she was registered with CQC as the manager of the home. Discussions with residents and relatives indicated that the manager has made a number of improvements to the service. Staff also commented that there have been good improvements to the home since the manager returned. The management team is further strengthened by a deputy manager, who has also has experience of running the home. Since the last inspection the provider has improved the quality assurance processes. Care Homes for Older People Page 23 of 28 Evidence: The provider visits the home frequently, and now keeps at least a monthly record of visits when he checks on its operations and progress. Also there are Residents Meetings to gain peoples views of the service, and their comments have influenced changes to the menu and to activities.The home also uses residents questionnaires and staff questionnaires to get feedback about the home and to see how it can continue to improve. The home benefits from a maintenance staff who attends to routine maintenance tasks and checks. At this time the records of hot water checks showed that the water is too cool. As a result the homes boiler is to be replaced. In the meantime the home is using immersion heating to ensure a satisfactory temperature for people to bathe and wash. There is a small area of uneven flooring on the first floor which may present a tripping hazard. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 23 The programme of refurbishment and redecoration must continue to bedrooms. This is ensure a satisfactory standard of accommodation throughout the home. 30/09/2010 2 22 23 There must be suitable adaptations in place, including grab rails to WCs and bathing facilities. This is to ensure the home can meet the physical support needs of the people who live here. 30/05/2010 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 5 The contract should be updated and amended to show the details of the CQC, to show the level of insurance cover for residents possessions, and to show the choices around selfadministration of medication rather than discourage it. Page 26 of 28 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 2 12 The home should ensure that people have sufficient opportunities to engage in activities, even in the absence of an activities staff. Consideration should be given to adapting the unusable shower room into an accessible shower area so that people could choose to have a shower if they prefer. Lighting in bathrooms and toilets should be improved for the benefit of the people who live here. Extractor fans should be cleaned on a regular basis to prevent a fire hazard. The provider should ensure that there are handwashing facilities in all toilet that are accessible by the people who live here.This is to ensure good hand hygiene and to prevent the possible spread of infection. Dirty light pull cords should be replaced and be included on the cleaning schedule. The manager should continue to keep staffing levels under review in line with the dependency needs of the people who live here. The uneven flooring on the first floor landing outside the bathroom should be made good to prevent a tripping hazard. Hot water checks to baths and showers should be carried out weekly, especially given the current problems to the system. 3 21 4 5 6 25 25 26 7 26 8 28 9 38 10 38 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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