Care Home: Cranwell Court

What the care home does well Staff are friendly and open and willing to co-operate with all types of agencies entering the home. They try and keep themselves up to date by attending training sessions to enhance their knowledge base about peoples` illnesses and needs, who live in the home. A robust recruitment process ensures staff are safe to work with people prior to their commencement of employment. Accurate records are kept on each person living in the home and these are evaluated on a regular basis to reflect current needs. Prior to admission an holistic assessment takes place to ensure the home can meet their needs and this is used to develop a fuller care plan. A varied programme of social events ensures that peoples social, religious and cultural needs are being met. Staff have been researching the local area to ensure people are kept up to date with community events and they do not feel isolated in the community. The Company ensures that all equipment is in safe working order and safety checks are made on the building to ensure it is a safe place to live and work. What has improved since the last inspection? Since the last inspection the pre-assessment process for admitting people in the home has improved and all documentation has been completed to enable staff to develop a fuller care plan to reflect peoples current needs. The care plans are then regularly reviewed to ensure people are not being put at risk of harm. All medication records are now signed to show that people are receiving medication that has been subscribed. Where a person has been assessed as being capable of self medicating there is now documented evidence to show this is regularly reviewed to show their capabilities. Staff are now sending us Regulation 37 notifications when appropriate, after significant events have occurred, so we can judge whether they have taken appropriate action. The senior management team are ensuring they are updating the dependency levels of each person living in the home and that this is used as a basis for ensuring there are sufficient numbers of staff on duty at all times. Company representatives visit the home on a regular basis and ensure they take into consideration the views of people living there and that the home is being run for their benefit. The reports have been open for inspection. An assessment process is in place to ensure that those who no longer have the capacity to manage their own finances are assessed and an appropriate advocate found. What the care home could do better: There is an outstanding requirement from the last inspection concerning staff supervision records being in place. This was not tested on this occasion as the time scale had not been reached, but we looked at the process which has recently been implemented. Key inspection report Care homes for older people Name: Address: Cranwell Court Cranwell Court Cambridge Road Grimsby North East Lincolnshire DN345EP     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: Theresa Bryson     Date: 2 7 0 5 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 26 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 26 Information about the care home Name of care home: Address: Cranwell Court Cranwell Court Cambridge Road Grimsby North East Lincolnshire DN345EP Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Longhurst and Havlok Homes Ltd Type of registration: Number of places registered: care home 55 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who may be accommodated is: 55 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 categories: Dementia DE; Old Age, not falling within any other category- Code OP Date of last inspection Brief description of the care home Cranwell Court is a purpose built care home providing care for those with symptoms of old age and dementia. Each person has their own bedroom space which comprises of a bedroom section, sitting area, ensuite shower,toilet and washbasin and a fully equipped small kitchen. Electrical appliances in this area can be disabled for those with memory loss. Care Homes for Older People Page 4 of 26 Over 65 55 55 0 0 Brief description of the care home There are ample communal areas and extra toilets and bathrooms. In the grounds are a couple of enclosed garden areas and ample car parking facilities. This home is on a direct bus route to other areas of the main town of Grimsby, with the seaside area of Cleethorpes near by. It is set in a residential area of the town, with in walking distance of local shops and a larger supermarket. The Statement of Purpose and Service Users Guide informs people of the services the home can offer are on display in the main reception area. Fees are set on an individual basis and are renewed annually. Cranwell Court is owned by the Longhurst/Havlok Group and has other care homes in the area. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection took place to test the compliance with out standing requirements from the last inspection. It was not necessary for The Company to send us a new Annual Quality Assurance Assessment (AQAA) as this had been sent prior to the last inspection. We were able to speak to some health and social care professionals prior to our visit. We also looked at the information The Company had sent to us since our last visit. During the visit we looked at a number of records and documents and spoke to seven people who live in the home and a number of staff. 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 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Older People Page 7 of 26 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 8 of 26 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 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive an holistic assessment prior to their admission to see whether the home can look after them and staff are given opportunity to train in topics to ensure they have the skills to deliver relevant care. Evidence: Since the last key inspection the Company has been working on putting together a new brochure and information about the home. This was presented to us and was in a more user friendly format in a modern layout. This will help people to make informed decisions about using the home and give them information as to whether the service can meet their needs. We were able to look at the care plan of a person who has been newly admitted into the home on respite care. Prior to admission there was written evidence to support an holistic assessment had taken place. This has enabled the staff to develop this into a fuller plan of their care during their stay. Some progress has also been made in the topics covered in staff training to ensure Care Homes for Older People Page 10 of 26 Evidence: they have the knowledge base to look after people currently resident in the home. The senior management team acknowledge this is still work in progress and have been developing a fuller training planner for all staff, taking into consideration the needs of people resident in the home, mandatory topics and needs of individual staff members. We were able to see the typed matrix the Company produces to record training completed as well as individual records of staff, where topics have been discussed. The home does not provide intermediate care and therefore Standard 6 is not applicable. Care Homes for Older People Page 11 of 26 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. Care plans appeared to reflect peoples current needs and these are more frequently updated to ensure people are safe and free from harm. Evidence: As this was a key inspection to check compliance against outstanding requirements we did not need to ask the service to send us another Annual Quality Assurance Assessment (AQAA), as this had been received earlier this year. The senior management team did assure us there were no major changes since last we visited and they had sent their last AQAA. We also did not send out survey forms but were able to talk to health and social care professionals prior to our visit and also spoke to seven people resident in the home and eight staff, plus the management team. There have been improvements in the way events are now recorded for each individual in the home and more documented evidence to support that peoples care needs and expectations are being evaluated on a regular basis. There is also more written documented evidence where other health and social care professionals have been involved in assisting the homes staff with advice. For example where people had ulcerated legs this was clearly identified on the preCare Homes for Older People Page 12 of 26 Evidence: assessment documentation. Staff had then developed a fuller core care plan around this specific need and identified with a manual handling risk assessment where this affected their mobility. A nutritional risk assessment showed how staff could assist better healing of this with an appropriate diet. The general skin integrity assessment identified possible other areas of risk. This has ensured staff are aware of a specific problem and have details of how to manage this type of need. We also saw better written assessment and recording of peoples cognitive difficulties. A pre-assessment had recorded that where people were suffering from a form of dementia, a comprehensive plan had been developed to ensure staff were aware of this persons needs and difficulties in coping with daily living. There was documented evidence to support help had been requested of the local Community Psychiatric team and that different assessments such as mobility, managing money and an assessment covering aspects of the Mental Capacity Act had taken place. When we spoke to staff they appeared more confident that coping mechanisms had been put into place to ensure this person was not put at risk of harm. This was also so for people with more severe episodes of challenging behaviour. In this case all of the assessments mentioned above had taken place but additional risk assessments were also in place. Such as, how to assist them at meal times, how to deal with, what is sometimes recorded as agitated days, keeping the bedroom clean, dressing techniques, ensuring they receive their prescribed medication. For severe episodes the staff complete an incident form detailing what happened prior to the incident, their behaviour during the incident and consequences from the incident. Where necessary the care plan was up dated immediately, but there was written evidence to support regular reviews of all sections. The management team have aknowledged that some work and training is still taking place with staff to ensure they use plain English when writing daily report entries. so any one can understand the entries made. When speaking to people living in the home, they told us how much they liked living there and made particularly complimentary comments about the attitude of staff. Saying girls are fine and we have fun with the staff. Staff also told us they felt more supported by the current management team and were now given clear instructions on what to do and we feel we can go at any time and get answers to queries. During the course of the day we observed staff assisting people with personal needs and over a lunchtime period. Staff appeared more confident when approaching those with more challenging behaviour. There was also some improvement in how they dealt with people suffering from symptoms of dementia to enable them to cope with daily living tasks. This has ensured people are less of risk of harm and staff are monitoring their health and well-being. We also randomly checked some drug administration records of some people resident Care Homes for Older People Page 13 of 26 Evidence: in the home. The recording appeared to be more accurate and people were receiving medication as prescribed by medical practitioners. The management team are looking into a drug auditing tool to ensure they are aware of any specific needs of people living in the home and the ability of staff to ensure they are practicing safely in this area. Staff were able to show us the reference information they keep on drugs in use to ensure they are aware of any side effects and indications with other drugs in use. The self assessment tool to show whether people are still capable of administrating some or all of their medication had now been updated. One part has been kept in the drug administration records and the evaluation in the care plan notes. This could cause extra work for staff as they currently need to look in both places before allowing people to self administer, but are currently reviewing this situation. Temperatures are now being taken in the drug storage area to ensure all medication is kept at the correct temperature. The Company are looking into an air conditioning unit to combat any high temperatures during hot weather periods. Care Homes for Older People Page 14 of 26 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 can maintain a balanced diet in a relaxed and comfortable environment. A varied programme of social events are on offer to satisfy peoples social, cultural and religious needs. Evidence: Since our last inspection The Company have been reviewing the roles of staff. They have now recruited a second person to help facility the role of organizing social activities. These two people now have specific tasks and cover all aspects of life to ensure peoples social, cultural and religious expectations are being met. When speaking to staff this appears to be covering a more person centered approach to peoples lives. For example, those with memory loss are being encouraged to take part in meaningful daily tasks such as assisting in general housekeeping of their rooms, with staff support and assisting the laundry staff with folding their freshly laundered bed linen and towels. To encompass peoples specific needs there was documented evidence that people were being encouraged to take part in for example a hobbies class. This has recently involved men and women, with examples recorded of knitting, baking and scrapbook making. A themed afternoon of the 1940s was being planned whilst we were on our site visit. Care Homes for Older People Page 15 of 26 Evidence: The management team have recognised training still needs to take place with some staff on how they integrate a more person centered approach to the specific needs of individuals but staff also told us they had a mind shift on how to tackle certain problems. Better links are being made with the local community on how the people living in the home can access local clubs and events in the surrounding area so they are not so isolated. We did not tour the kitchen on this occasion, but the cook told us there had been no major changes since last we visited earlier this year. Some differences had been made in the dining room, with tables being rearranged to ensure some people are not disturbed during meal times by those having difficulty maintaining an adequate diet and who need assistance at meal times. The staff have been working with the people in the home to explain general needs of some of the client group, and some have wanted to help those with particular problems. There was a better use of space in the dining area and staff were observed assisting some people by encouraging them to maintain an adequate diet. There was more staff interaction at this time and staff appeared more confident when speaking to individuals. Care Homes for Older People Page 16 of 26 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. A more robust system is in place to ensure people are protected from harm and can live safely in the home. Evidence: Since our last inspection staff have been sending in Regulation 37 notices for appropriate significant events. There appeared to be a better understanding by staff of what constitutes an event. When we spoke to staff they could confirm that they have received some more instruction on this topic and the management team confirmed that senior levels of staff will be able to cascade this down to others in the staff group. We had notified to the Responsible Individual for the Company prior to this visit of a concern that had been raised to us by a relative. We were able to confirm at this visit that a suitable investigation had been undertaken and the staff continue to liaise with the person living in the home and family members. The policies for complaints, safe guarding vulnerable adults and whistle blowing procedure for staff had been reviewed over the last year and we could see they held current information for staff to follow. The local safe guarding team of North East Lincolnshire have been liaising with CQC and the home on investigations over the last few months and conclusions are waiting to be confirmed. The Company has given all investigating parties full cooperation. This ensures that procedures are in place to protect people from harm and staff are more aware of how to recognise abusive situations. Care Homes for Older People Page 17 of 26 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. People can live in a safe and comfortable environment suited to their needs. Evidence: Since our last visit The Company has drawn up plans to possibly alter part of the buildings so those with more challenging behaviour can live peacefully in a more suitable unit. We saw these plans and were also told that they have been liaising with the local Fire Brigade over the use of stair ways. A quiet room has been developed in a spare residential room, so if people want to have quiet conversations with relatives or friends and do not want to use their own bedrooms this is now available. When not in use for this purpose it is used as a quiet area to bring those people who are agitated in their behaviour and need some quiet and peace to sit. The staff have also looked at the locks on bedroom doors and found a way for each person to have their own key, if required, but for staff to have an access key in the event of an emergency. This ensures people can have their own privacy but know staff can get to them should the need arise. The senior management team are working on an on going maintenance plan to ensure all areas of the home are maintained to a high standard. People living in the home told us that they are happy with the standard of cleanliness and one person told us how they enjoy dusting, when I can, because the staff encourage me to contribute. The garden area was tidy and there was some evidence that people living in the home Care Homes for Older People Page 18 of 26 Evidence: were helping with some border planting with the equipment which was in use and in discussion with some people. All areas are accessible for wheelchair users and staff appeared more aware of when they can leave some people unattended in garden areas and which people required an escort. Care Homes for Older People Page 19 of 26 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. A robust recruitment process ensures staff are safe to work with people prior to their commencement of employment and they are then trained to do their job. Evidence: The Company have reviewed the provision of staff in the kitchen area and are currently looking at the provision and job descriptions of the domestic and laundry staff. The staffing matrix had identified needs of people taking into consideration the dependency of each person living in the home. This is now being maintained on a regular basis to ensure there are sufficient staff on duty to meet peoples needs. People living in the home told us that they can have assistance where necessary from staff and that even at night their call bells are being answered promptly. We were given copies of the training matrix from January 2010 which identified which staff had completed which topics in training sessions. These included not only mandatory subjects but also other topics such as continence care, accident reporting, basic food hygiene and welfare rights. Staff told us how much they had appreciated this and felt it was enhancing their roles within the home. The management team are exploring ways of delivering certain topics for training by staff and identifying staffs individual needs. We tracked three staff personal files and found sufficient evidence to support that adequate safety checks had been made prior to their commencement of employment to ensure they were safe to work with people in the home. Care Homes for Older People Page 20 of 26 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. People can express their views and The Company ensures this is notified to staff to ensure the home is being run for the benefit of people living there. Evidence: We looked at the last couple of Regulation 26 site reports which had been completed by a Company representative. These were detailed and showed what records had been seen and who had been spoken to. There was also good follow through when an issue had been raised in one report from a person living in the home and this had been followed through on the next occasion, to ensure the person was happy. A new manager has now been appointed and is progressing their application with us to be come registered. Staff told us that the current management team are approachable and they have an open door policy, so we feel relaxed to go and have queries answered. The Company is continuing in tidying up, as it was described, their quality assurance system, but we could see that certain audits, such as care plans and supervision of staff were well under way. Care Homes for Older People Page 21 of 26 Evidence: The recording of information generally had improved. Staff appeared more confident in what they need to record and which was the most appropriate document to record information on. For example they are now more certain on how to record accidents and when these may need reporting to CQC on Regulation 37 forms, so we can make a judgment as to whether the appropriate action has been taken. This has improved since training had been undertaken by some staff. We tracked three personal allowance records of people living in the home. There appeared to be accurate recording and money was being used for each persons personal use.Checks are made by the administration team on a regular basis, which is well documented, but The Company may benefit from an audit taking place by other suitable Company representatives at times, to counter check the balances and use of these funds. There is now a system in place to ensure those who lack the capacity to manage their own funds are assessed and further advocacy services sought. We also saw details of the residents comfort fund, which again showed accurate recording and appropriate use of funds for social activities. The signatures for these accounts are currently under review. There is now a planned schedule for supervision sessions with staff and some more sessions had taken place since our last visit. Staff were able to tell us how useful these sessions are and they can identify their own needs and plan for the future. One staff member told us this had allowed staff to blossom. There is an outstanding requirement for supervision whose time scale had not been reached on this occasion. Care Homes for Older People Page 22 of 26 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 23 of 26 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 36 18 Supervision records must be 30/07/2010 in place for all staff. To ensure they can safely do their jobs. 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 4 Staff should continue exploring topics where they may need to up date their knowledge to enable them to effectively look after people resident in the home. Staff training should continue to ensure they have the latest knowledge base to look after peoples needs, currently in the home. Particularly those exhibiting more challenging behaviour. Some instructions should be given to staff to enable them to write reports in plain English for every one to understand. The Responsible Individual should further explore options in keeping the temperature regulated in the drug storage area to ensure all medication is safe to use. Staff training should continue to enable them to understand how a person centered approach can benefit those living in this home regardless of their physical or mental condition. Page 24 of 26 2 7 3 7 4 9 5 12 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 6 19 The Responsible Indivudal should continue with the maintenance plan and set some time scales to ensure all areas of the home receive required attention when necessary. The Responsible Individual should continue exploring other ways to deliver training to staff and ensure they have a broad knowledge base to enable them to look after people who live in the home safely. The Responsible Individual should pursue the process to ensure there is a Registered Manager with CQC in position. The Responsible Individual should continue to ensure it has an effective quality assurance programme. The Responsible Individual should explore the options for auditing the personal allowance funds of people living in the home and the Residents Comfort fund. 7 30 8 9 10 31 33 34 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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