Care Home: Coombe Grange Residential Home

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What the care home does well Prospective residents are able to make an informed choice about whether or not to move into the home and the home carries out assessments to check that they are able to meet people`s needs before accommodating them. Each person has a care plan outlining how his or her care needs are to be met. Residents and professionals report that the home meets the health and personal care needs of those living there. Residents are treated with respect and their privacy is promoted. There are a range of activities and residents confirm that they are able spend their time as they wish. Individual preferences and routines are recorded and residents confirmed that these are catered for. There is a choice of food at each meal time and residents have a varied, nutritious and balanced diet. There is an effective complaints procedure and residents confirm that there is someone available to speak to if they are not happy. The environment is homely and residents are able to personalise their bedrooms. Adequate numbers of staff are deployed and residents report that staff are available when they need them. Residents, relatives and professionals report that the staff are kind, welcoming and helpful. There is a staff training programme. Staff recruitment procedures ensure all the required checks are carried out before staff start work. Since the last inspection the home has appointed a new manager who is registered with the Commission. She has completed the National Vocational Qualification level 4 in care. Staff report that she is supportive and approachable. It was clear throughout the inspection that she is committed to improving the service provided by the home. Steps are taken to ensure the health and safety of the staff and residents. What has improved since the last inspection? The system of assessing residents` needs and the recording of care plans has been been revised and developed by the manager. The activities programme has been developed. The environment has been improved including the refurbishment of 4 bedrooms, replacement of carpets, new kitchen equipment, replacement of 14 beds and repairs and redecoration to the exterior. Staff training continues to be developed. A friend and relatives group has been set up where matters about the home can be discussed. What the care home could do better: Some improvements are needed in the home`s medication procedures as there are some instances where there is insufficient guidance for staff to follow of when occasional medication is needed. Staff supervision needs to be improved as there is no system for one to one supervision of individual staff. Key inspection report Care homes for older people Name: Address: Coombe Grange Residential Home Coombe Lane Sway Lymington Hampshire SO41 6BP     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: Ian Craig     Date: 1 9 0 1 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 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: Coombe Grange Residential Home Coombe Lane Sway Lymington Hampshire SO41 6BP 01590682519 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): coombegrange@bmlhealthcare.co.uk www.coombegrange-rh.co.uk Coombe Grange Limited Name of registered manager (if applicable) Mrs Tarina Price Type of registration: Number of places registered: care home 40 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 to be accommodated is 40. The registered person may provide the following category/ies of service only: Care home only ? (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) Dementia (DE) Mental disorder, excluding learning disability or dementia (MD) Date of last inspection 40 40 0 Over 65 0 0 40 Care Homes for Older People Page 4 of 29 Brief description of the care home Coombe Grange is a registered care home set in a rural location on the edge of the village of Sway in the New Forest, with limited access to local amenities. It provides accommodation and personal care for up to 40 elderly residents, some of who may have dementia. The home is on ground, first and second floors and there is a lift between ground and first floors. There are a variety of aids and adaptations to allow residents to move about more independently. Twenty-four of the bedrooms are single, and eight are doubles. There are two communal toilets and a bathroom on the ground floor, and one toilet, two bathrooms and two showers on the first floor. There are large, accessible, gardens around the building. 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 inspection consisted of a site visit of 5 hours, during which time communal areas and a number of bedrooms were seen. Discussions took place with the manager. Two staff were also spoken to. A residents relative was spoken to. 3 residents were spoken to. Residents were observed taking part in activities and making use of the homes facilities. Surveys were sent to residents, staff and health and social care professionals asking for their views on the service provided. These were returned by 11 residents, 9 staff and 5 health and social care professional. Some of the residents surveys were completed with the help of a relative. Records, documents and policies and procedures were looked at. Care Homes for Older People Page 6 of 29 Care services are required to complete an Annual Quality Assurance Assessment (AQAA). This was completed by the home and returned to the Commission. Information contained in the AQAA has been used for this report. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? The system of assessing residents needs and the recording of care plans has been been revised and developed by the manager. The activities programme has been developed. The environment has been improved including the refurbishment of 4 bedrooms, replacement of carpets, new kitchen equipment, replacement of 14 beds and repairs and redecoration to the exterior. Care Homes for Older People Page 8 of 29 Staff training continues to be developed. A friend and relatives group has been set up where matters about the home can be discussed. 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 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. Prospective residents are able to make an informed choice about whether or not to move into the home. The home takes steps to ensure that it accommodates only those whose needs it can meet. Evidence: The home has 3 documents, which provide information about the service. The Statement of Purpose contains the homes aims and objectives, its philosophy of care, details of the manager and staff and other service details. There is also a Service Users Guide, which has details such as the homes care arrangements and the complaints procedure. The home also has a brochure which is given, along with the Service Users Guide to those considering a move into the home. Each person who returned a survey says that he or she received enough information before moving in, which helped them to make a decision about whether or not to move into the home. Care Homes for Older People Page 11 of 29 Evidence: Residents and their relatives say that they were able to visit the home before making a decision about moving in. Care records were looked at for 7 people living at the home. This included those who have moved into the home in the more recent past. The manager described how she visits those individuals referred for possible admission to carry out an assessment, which is recorded. This assessment includes the following needs: nutritional assessment, mental health, personal hygiene, pressure areas, continence and toileting, mobility, safety and the environment, sensory assessment, a social history and psychiatric needs. A resident confirmed that he/she was visited and assessed by the manager before moving in to check his/her suitability to reside at the home. Records show that the pre admission assessments are carried out prior to the move in to the home and that a fuller assessment takes place following admission. Where applicable the home obtains copies of referring social services care managers assessments and care plans. The manager explained that these were not always readily available from social services. Copies of hospital discharge summarised are also held with care records. Health and social care professionals say that the services assessment arrangements ensure that accurate information is gathered and the right service planned for people. 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. Residents health and personal care needs are met although improvements are needed to the medication procedures as there is the potential that residents may not receive medication in a consistent way. Evidence: Shortly after admission to the home a care plan is devised which is followed at a later date by a more comprehensive plan once the home has had time to assess the persons needs in more detail. The care plans include details of each persons daily preferences such as routines, times for getting up and the preferred name the person likes to be called. A resident confirmed that he/she was asked what name he/she would to be addressed by as well as his/her daily routines. Assessments are completed and recorded following a move into the home and include the following: falls assessment, moving and handling assessment, pressure care assessment, nutritional assessment, dependency assessment and Mental Capacity Act 2005 assessment. Individual care plans include the following: health, diet and weight, preferences, skin care, communication, oral health, foot care, mobility and dexterity, Care Homes for Older People Page 13 of 29 Evidence: falls, continence, toileting, mental state, social interests, religion, family involvement, medication personal safety and personal care. There is space in the care plans for residents to record their involvement in the care planning. Copies of care plans signed by residents were seen. One person said that he/she is aware that he/she has a care plan but is not interested in seeing it. Daily running records are maintained when staff deliver daily care and these are held in each persons room. Care plans are regularly reviewed and updated. Residents say that they get the care and support they need and that arrangements are made regarding their medical care. Records show that health services are contacted when needed such as auditory service, the General Practitioner and district nursing services. A health care professional said, The staff communicate effectively with the district nursing team. The carers are willing to learn and know how to identify and report any clinical problems. Health and social care professionals say that the home meets the social and health care needs of the residents. One professional said that the home always seeks advice and assistance on complex issues. Staff say that the home looks after residents well. A residents relative made the following comment: Gives outstanding care and support to each and every resident. Informs relatives whenever there are medical problems. The homes medication procedures were looked at. Staff sign a record each time medication is administered to a resident. It was noted that there was an omission to this where staff had failed to record that one medication had been given on one occasion. The quantity of medication indicated that the medication had been given. For 2 people with medication prescribed to be taken when required there were no written records of the signs and symptoms of when staff should administer the medication. Where residents are able to handle and administer their own medication there is an assessment of the persons ability to do this along with the signed agreement of the person, their General Practitioner, and the homes manager. For another person who self administers just one medication, there was no assessment of the persons ability to do this. Care Homes for Older People Page 14 of 29 Evidence: Staff receive training in medication procedures by attending a Safe Handling of Medicines course at a local college. The homes manager also carries out and records an assessment of staff medication abilities. The manager says that there is a regular audit of the medication but that this is not recorded. Since February 2009 there have been 4 notifications of errors when administering medication. The manager confirmed that action was taken by the home to address any shortcomings in the medication procedures. A Commission pharmacy inspection was carried out on 2 September 2009. There was 1 requirement from this inspection for safe storage of controlled medication. This has been addressed. Health and social care professionals say that the home respects residents privacy and dignity. Residents report that the staff treat them with respect and kindness. Comments included: The staff cannot do enough for you. Residents have personalised their rooms with their own furniture, televisions, pictures and IT equipment. Each bedroom has its own telephone. Residents are able to use a lock for privacy when they are in their rooms. Residents are not offered a key to their bedroom door so that they can lock it when they go out. The manager acknowledged that this is a facility that the home should offer. 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. Residents benefit from a range of activities and stimulation and are able to exercise choice in how they spend their time. Meals are nutritious and choice is available. Evidence: The home employs a staff member for co ordinating activities. There is an activities programme which is displayed in the home and includes the following for the month of January 2010: quizzes, games, skittles, arts and crafts, word games, musical entertainment from a visiting musician and reminiscence games. Activities were taking place at the time of the visit. Residents, relatives and staff confirmed that activities are provided and that they can choose whether or not they wish to join in. One person said that he/she likes to spend time in his/her room reading books from the visiting mobile library and that he/she has a daily newspaper delivered. Health and social care professionals report that activities are provided. One person commented, The residents are well stimulated with daily activities. Care Homes for Older People Page 16 of 29 Evidence: Residents confirmed that outings sometimes take place to places such as Milford on Sea. A relative said that the provision of outings could be improved and the manager said that this is being looked into. Religious needs are addressed. A resident said how much he/she enjoys the church services. The home has a menu plan which shows varied and nutritious meals. Residents said that there is a choice of food at each meal time and that they are asked in advance what they would like to eat. This is recorded by the kitchen staff. Residents also said that they can have a wide choice at breakfast and that this includes cooked breakfasts if they wish. This is recorded in care plans. Residents can eat in their rooms if they wish. Fresh fruit and vegetables are said to be available in plentiful supply. The midday meal on the day of the visit was chicken in gravy sauce or fish pie served with chips, sweetcorn and runner beans. Dessert was jam tart or cheese and biscuits. 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 an effective complaints procedure and deals with any concerns that are raised. Evidence: The homes complaints procedure is contained in the Service Users Guide. Residents say that there is someone available to speak to on an informal basis if they are not happy and that they are aware of how to make a complaint if they need to. The AQAA states that there have been 9 complaints to the home in the last 12 months, some of which resulted in referral to social services for investigation under the safeguarding vulnerable adults procedures. These include errors in medication, staff performance and a suspected theft. The manager has maintained a record of the complaints and how the home dealt with each one. The manager reports that each of the complaints has been resolved. Social services report that the home acts swiftly to resolve any issues and that any concerns are dealt with appropriately. Other health and social care professionals report that the service responds appropriately if there any concerns. Staff receive training in protecting vulnerable adults from possible abuse. This was evidenced from staff and training records. Care Homes for Older People Page 18 of 29 Evidence: The manager has attended training in the Mental Capacity Act 2005. Staff are provided with information about the Mental Capacity Act 2005 and the manager states that in house training is provided in the subject. 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 environment is clean, homely and promotes the dignity of the people who live there. Evidence: Communal areas and a number of bedrooms were seen. All bedrooms are single and all but 8 have either an en suite toilet or en suite bathroom. Residents bedrooms contain personal items and residents say that they were encouraged to bring their own furniture and belongings if they wished. The AQAA states that residents are consulted about colour schemes and redecoration. A residents bedroom was decorated by his/her relatives. Residents said that they like their room and that cleaning takes place at suitable times of the day. Communal areas include a lounge and a dining room. Residents were seen using both these facilities. Health and social care professionals, as well as residents relatives, commented that the service has a homely environment. The manager said that the residents make use of the garden in the summer time. A relative commented that the paving areas are potentially dangerous to residents. This was also raised as a complaint by a relative. The manager states that a ramp has Care Homes for Older People Page 20 of 29 Evidence: been installed to improve access to the garden and that the paving area is to be improved. There are 2 communal bathrooms and 3 shower rooms. Specialist baths are provided for those with mobility needs. There is a redecoration and refurbishment schedule. Furniture was found to be intact although there are some signs of wear and tear such as on a sink surround in a bedroom. The home was found to be clean. Residents commented that the home is fresh and clean. Staff receive training in infection control. One staff member is completing a National Vocational Qualification in housekeeping. 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. Residents benefit from a well trained staff team supplied in sufficient numbers to meet residents needs. Staff recruitment procedures protect residents. Evidence: The home aims to provide 7 care staff from 8am to 2pm each day and 4 care staff from 2pm to 8pm each day. 2 waking and 1 sleep in staff cover the night time period. The managers working hours are in addition to this. The staff rota and observation showed that these staff hours are being maintained. The following staff are also provided: a cook and a kitchen assistant for 7 days a week, 2 domestic staff 7 days a week, a cleaner 7 days a week, 2 maintenance staff and 1 administrator. 6 staff surveys say that there are enough staff on duty to meet residents needs and 3 surveys say that there are sometimes enough staff to meet residents needs. Residents say that there are enough staff on duty and that staff are available when needed. Residents report that staff always respond promptly when they ask for help by using the call points in their rooms. Residents report the staff to be kind, helpful, cheerful and friendly. Comments include the following: The staff are always at hand if Care Homes for Older People Page 22 of 29 Evidence: needed, and friendly, and, The staff cant do enough for you. Health and social care professionals also made favourable comments about the staff such as, All staff are pleasant, polite and friendly. The home manager creates good working relationships. Staff were observed working with residents with patience, warmth and humour. Staff confirmed that they received an induction which prepared them for the job. Records of induction are maintained in 2 parts and were seen for 3 staff who have started work at the home recently. 10 of the 19 care staff are trainined at National Vocational Qualification (NVQ) level 2 or above and 4 are studying for NVQ level 2. The deputy manager is enrolled to start the NVQ level 4 in care. Staff confirmed that they receive training which is relevant to their role and that the training helps them understand the needs of residents as well as giving enough information about health care and medication. Recruitment procedures were checked for 4 staff who have recently started work at the home. These show that the required checks were carried out before they started work including obtaining an employment history, 2 written references, a verbal reference and a criminal record bureau (CRB) check. 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. Improvements have been made to the way the home is managed, although staff supervision needs to be addressed as there is the potential that this may affect the service provided to residents. The health and safety of residents is promoted. Evidence: The manager has National Vocational Qualification level 4 in care as well as the Registered Managers Award. Staff report the manager to be supportive and approachable. The following comments were made: The manager works very well in making sure all staff fill in relevant paperwork concerning all service users and how important this is. There is good communication between staff and management. The home has improved a lot over the last year. The new manager has worked very hard, and is still working very hard to improve things for the residents and the staff. Care Homes for Older People Page 24 of 29 Evidence: Health and social care professionals made the following comments about the homes management and manager: A particularly good, well run home. The manager is an excellent communicator. The home has methods for checking its own performance including satisfaction surveys supplied to residents, staff and residents relatives. There is a Friends and Relatives Group, which has input into the home, such as raising funds for residents activities. There are no residents meetings where matters about the home can be discussed but the manager confirmed that this is being looked into. The home does not look after the monies or valuables of any of the residents. Residents have their own secure space to store valuables. There was a mixed response form staff regarding supervision. Some staff say that they meet regularly with their manager to discuss their work but others said that they do not receive one to one supervision. Records of supervision with staff were looked at for 3 people. One person did not have any supervision records and the 2 others had only 1 record of supervision in the preceding 8 months. The manager acknowledged that this needs to addressed and states that since becoming manager she has had to prioritise areas that need attention. The last recorded staff meeting was in June 2009 and 2 staff commented that there should be more staff meetings. Staff receive training in first aid, moving and handling, fire safety, infection control and food hygiene. The AQAA confirms that the homes appliances and equipment are tested and serviced by suitably qualified persons. 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 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 Where a resident 22/02/2010 administers his or her own medication the home must assess the persons ability to do this. So that residents receive medication as prescribed. 2 9 13 Where residents receive medication as required, there must be clear guidance for staff to follow of the signs and symptoms of when this is needed. So that residents receive medication as prescribed. 22/02/2010 3 36 18 Staff must receive regular 1:1 supervision. So that staff performance is monitored. 16/04/2010 Care Homes for Older People Page 27 of 29 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 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. 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