Care Home: Dorset House

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What the care home does well Prospective residents have their needs assessed before being offered a placement at Dorset house and a care plan written and agreed prior to admission. This procedure makes sure that the person`s needs can be met at the home. Once a person has been admitted into the home further assessments are carried out with these used to develop the care plan with the resident or their representative. Generally we found that residents health care needs were being met at the home. The home provides a range of activities to meet residents recreational, leisure and social needs. Residents spiritual needs are assessed and supported. Residents are supported to maintain links with friends and families. The home provides a good standard of food. The home has well publicised complaints procedures and residents are confident that complaints would be investigated. The home has all the required policies and procedures relating to adult protection and the staff have been trained in prevention of abuse. Generally Dorset House provides a comfortable and well maintained environment for residents. The home provides staffing levels that meet the needs of the current resident group. Staff are recruited in accordance with the legislation. Staff are provided with training commensurate with the needs of the residents. The home is well managed and run in the interests of the residents. Where residents request the home safe keeps small sums of money good record keeping is maintained. What has improved since the last inspection? The home now provides staff whose responsibility is to provide meaningful activities for residents. What the care home could do better: Care planning could be improved to better meet residents` health and social care needs. Where the staff take responsibility for administering creams prescribed to residents by their doctors, records should be maintained of the administration of these creams. Daily recording notes could better reflecte how residents spend their days in the home. Action should be taken to ensure that any odours in the building are eliminated. We noted that throughout the whole building there was only one radiator that had been covered. We saw that individual risk assessments had been completed for each radiator and that action had been taken to try and reduce the risk of residents getting burnt through positioning of furniture. We strongly recommend however, that longterm the home should plan to have all radiators and hot pipework covered to eliminate the risks of residents getting burnt. We recommend that there is continual monitoring to ensure that the hot water in the communal baths is kept below 43C. Key inspection report Care homes for older people Name: Address: Dorset House Coles Avenue Hamworthy Poole Dorset BH15 4HL     The quality rating for this care home is:   one star adequate 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: Martin Bayne     Date: 2 4 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 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) 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 28 Information about the care home Name of care home: Address: Dorset House Coles Avenue Hamworthy Poole Dorset BH15 4HL 01202672427 01202673239 dorsethouse@care-homesouth.co.uk www.care-south.co.uk Care South care home 52 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: 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: 52 in the category OP (Old Age) including up to 8 in the categories DE(E) and/or MD(E). Date of last inspection Brief description of the care home Dorset House is a residential care home registered with the Care Quality Commission to accommodate a maximum of 52 people. The home is located in Hamworthy and is close to local shops, libraries and churches. Local bus services operate from outside the home into the centre of Poole. The home offers accommodation on the ground and first floors, a passenger lift is available for people with mobility problems. The three bedrooms on the first floor offer en suite toilets and shower facilities. There are also two double bedrooms. Communal lounges and dining areas are provided on both Care Homes for Older People Page 4 of 28 Over 65 8 8 52 0 0 0 2 8 1 0 2 0 0 8 Brief description of the care home floors, as are specialist baths. Dorset House is part of Care South, a not for profit organisation, providing independent care services across the South West. 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: one star adequate 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: We, the Commission, carried out a key inspection of Dorset House between 10am and 4:15pm. The inspection was carried out by two inspectors. Throughout the report the term we is used, to show that the report is the view of the Care Quality Commission. The aim of the inspection was to evaluate the home against key National Minimum Standards for older persons, and to follow up on one requirement and two recommendations made at the last key inspection of the home in October 2008. The manager was present throughout the inspection and assisted us throughout the day. Three people were identified for close examination by reading their care plan, risk assessments, daily records and other relevant information. This is part of a process known as case tracking, where evidence is matched to outcomes for people. A tour of the environment was undertaken and record keeping inspected by looking at samples of staff training, recruitment, health and safety, and staff rotas. During the inspection we had the opportunity to speak with about a third of the residents and also with some Care Homes for Older People Page 6 of 28 members of staff. Additional information that helped form the judgements contained within this report were obtained from the Annual Quality Assurance Assessment document AQAA completed by the home and from surveys returned to us from both the staff and residents of the home. Nine survey forms were returned by the staff and ten by the residents. At the time of our visit there were 43 people living at the home, of whom 10 suffered from significant memory loss. 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: Care planning could be improved to better meet residents health and social care needs. Where the staff take responsibility for administering creams prescribed to residents by their doctors, records should be maintained of the administration of these creams. Care Homes for Older People Page 8 of 28 Daily recording notes could better reflecte how residents spend their days in the home. Action should be taken to ensure that any odours in the building are eliminated. We noted that throughout the whole building there was only one radiator that had been covered. We saw that individual risk assessments had been completed for each radiator and that action had been taken to try and reduce the risk of residents getting burnt through positioning of furniture. We strongly recommend however, that longterm the home should plan to have all radiators and hot pipework covered to eliminate the risks of residents getting burnt. We recommend that there is continual monitoring to ensure that the hot water in the communal baths is kept below 43C. 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. Residents benefit by having their needs assessed before being offered a placement at the home, to make sure that their needs can be met at Dorset House. Evidence: One of the residents we tracked through the inspection had been admitted since the last key inspection in October 2008. We saw that the deputy manager had been and visited the person prior to their being offered a placement at the home, to carry out a preadmission assessment of their needs. This assessment had been recorded and covered all of the topics detailed within the National Minimum Standards for older people. Nine of the ten surveys from people living at the home told us that they had had enough information before moving into the home for them to decide if Dorset House was the right placement for them. The home does not provide an intermediate care service. Care Homes for Older People Page 11 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Generally residents health care needs are met at the home, however, some improvements could still be made to care planning systems. Residents are treated with respect and dignity and medication is managed safely within the home. Evidence: Once a person has moved into the home a fuller assessment and associated risk assessments are completed; from which a care plan is developed. We looked at the three peoples care records we tracked through the inspection and saw that there was a photograph of the person concerned at the front of their records. Risk assessments had been completed for falls, tissue viability, mobility and nutrition. People had been weighed on admission to the home and this was recorded in their care plan. Generally, care plans had been reviewed monthly or when peoples needs had changed and there was evidence that residents or their representatives had been involved in developing care plans by their signing the plan. We found however, that care planning could be improved to meet peoples health care needs. The following shortfalls were identified and illustrate where improvements could be made. Care Homes for Older People Page 12 of 28 Evidence: One persons skin care assessment had not been updated since April 2009 despite the person losing 5 kg of weight in a short period of time. The care plan had been updated informing staff to monitor fluid and nutritional intake but some of the monitoring records were incomplete with dates where monitoring had not taken place. The fluid intake each day had not been totalled and there was no reference of what was a satisfactory intake of fluid or what action should be taken if the person had not had enough to drink. This person had also been subject to frequent falls but there was no referral to the falls clinic. Some of these falls had resulted in injuries but no body mapping recorded the resulting injuries. At the last key inspection a requirement had been made that care plans have sufficient detail to inform staff of how to meet peoples health care needs. In view of the shortfalls noted, the requirement remains in place. We also found that the daily care records for people were task focused and did not reflect how people spent their time at the home. We recommend that staff should record how people have been spending their time so that records give a more accurate reflection of peoples day to day lives and not just the care and support provided to them. Other health-care needs relating to dentistry, chiropody and eyesight were being met with appropriate referrals to relevant professionals. We saw that staff had good relationships with the people living at the home and were patient and encouraging. People with dementia freely approached staff and staff gave them reassurance when needed. When we spoke with the staff it was clear that they had a good understanding of recognising people as individuals, respecting their privacy and dignity and they were knowledgeable about them as a person. We discussed with the manager how responsibility for meeting residents needs throughout the day is maintained. The open layout of the building with it not being segregated into smaller units, means that there are potentially 52 residents coming and going throughout the building throughout the day. We were told that in the mornings staff were delegated to assist specific residents but that in the afternoons the staffs responsibility was to support all of the residents. The Registered Manager frequently reviews staffing arrangements to ensure that there is accountability for individual service users throughout the day. The medication systems and administration at the home are well managed. Medication policies and procedures are safe, with medication being stored safely, labelled correctly and administered safely. We looked at the medication administration records Care Homes for Older People Page 13 of 28 Evidence: for one floor of the building and found that these were being completed in full with no gaps in the recording. We recommend that where creams are prescribed and responsibility for their administration was undertaken by the staff, records of their application are maintained. We saw good practice of photographs being in place at the front of medication administration records with any known allergies also being recorded. There were also sample signatures of those staff trained to administer medication at the front of the medication administration records. 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. Residents benefit from their recreational and social needs being met, by being able to maintain contact with friends and family and through being provided with a good standard of food. Evidence: The assessments completed when a person moves into the home include information about peoples usual daily living, interests and likes and dislikes. This information is then used to try and provide meaningful activities for people living at the home. The AQAA informed us that the activities coordinator post that had been vacant for some period was now being covered by several designated staff. Surveys had been carried out with residents as to what activities they would like to see provided in the home. We saw that the homes quality assurance survey had found that 75 of the residents who responded said they were satisfied with their daily life styles supported within the home. Eight of the surveys returned to the Commission by the residents, informed that the home arranged activities that they can take part in if they want. We saw that both communal activities and individual activities take place with residents. As recommended in the previous section of this report daily recording notes could better inform on how residents were spending their days. Care Homes for Older People Page 15 of 28 Evidence: We saw that residents spiritual needs are assessed when they enter the home and the AQAA told us how residents were supported to worship. During the inspection we had the opportunity to speak with two sets of relatives visiting the home that day. They told us that they were kept informed about their relatives progress in the home and that they were free to visit at any time. They told us that they were always made welcome at the home. We observed people during the lunchtime period. We saw that residents who needed support with eating were seated in a separate area. The atmosphere was relaxed and there were enough staff to serve the meal at a suitable pace. All meals were served hot and any support needed from staff was given discretely and sensitively. There was generally good feedback when we spoke with residents about the standard of food provided in the home and we were told that there was choice of main meal and that individual likes and dislikes were respected. The returned surveys reflected this finding. 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 benefit from their being a well-publicised complaints procedure and through complaints being investigated thoroughly. They also benefit from the staff being trained in the protection of vulnerable adults and through relevant policies and procedures being in place. Evidence: The home has a formal complaints procedure which is accessible by this being displayed at the front reception to the home. The procedure is also detailed within the homes service user guide, a copy of which we saw was provided again at the front reception area. Nine of the ten surveys returned to us informed that residents were aware of how to make a formal complaint. Staff spoken with and surveys told us that they know what to do if a individual or relative or friend had concerns about the home. We looked at the complaint records kept at the home. Four complaints had been made to the management since the last key inspection. There were good, clear records of the complaint investigation, the outcome and the actions taken to reduce any recurrence. Staff have attended training in the Protection of Vulnerable Adults (POVA) so that they are aware of the different ways vulnerable people are at risk of abuse, and would know how to respond. Staff spoken with and surveys told us that they were confident on how to whistle blow and how to report any allegations of abuse. Care Homes for Older People Page 17 of 28 Evidence: There have been two adult protection safeguarding referrals made to and coordinated by the local authority since the last key inspection. The home assisted in the investigations and in their resolution. 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. Residents benefit from a well maintained, clean and comfortable environment, however, some improvements could be made to maintain a safe environment. Evidence: The home was purpose built and the accommodation is over two stories with a shaft lift providing access between floors. Communal areas of two lounges and a large dining room are provided on the ground floor. Dorset House also provides day-care facilities for 12 residents in a separate area of the building. Staffing to the day-care unit is separate to that provided in the main home, although some staff work in both areas. The home has a well maintained, enclosed garden to the rear of the home and suitable garden furniture is provided. On the day of our visit the home was found to be clean, in reasonable decorative order with furniture and fittings in a good state of repair. We did find however, that there were odours in many areas of the home. We discussed this with the manager, who told us that currently the home was experiencing difficulties in managing the continence needs of two residents. During the inspection we spoke with two relatives. One of whom told us that it was very unusual for the home to have odours and that normally these were well managed. We recommend that the home take action to ameliorate this for the benefit of all residents in the home. Care Homes for Older People Page 19 of 28 Evidence: During the inspection we had the opportunity to speak to about a third of the residents accommodated with some of these discussions taking place within their bedrooms. We saw that residents were able to personalise their rooms with their own belongings and furniture and that call bells were available to them. We noted that in one residents bedroom the window restrictor was broken. This was brought to the attention of the manager and repaired on the day of inspection. We noted that throughout the whole building there was only one radiator that had been covered. We saw that individual risk assessments had been completed for each radiator and that action had been taken to try and reduce the risk of residents getting burnt through positioning of furniture. We strongly recommend however, that longterm the home should plan to have all radiators and hot pipework covered to eliminate the risks of residents getting burnt. We saw that the home had sufficient assisted bathing facilities to meet the needs of residents. Thermostatic mixer valves have been fitted to hot water outlets of baths to protect residents from scalding water. We tested the hot water temperature of one of the communal baths and found that this was above 50C. The service has advised use that they have systems in place to test the thermostatic mixer valves regularly to ensure that the hot water temperature does not exceed 43C. The home has systems and procedures in place to maintain good infection control. We saw that paper towels, liquid soap and bins were provided in communal bathrooms. Staff are supplied with protective clothing such as gloves and aprons. The home has a sluicing area and the laundry room meets environmental standards and is fitted with equipment sufficient to meet meet the laundry needs of the home. We saw that alcohol gel dispensers were strategically placed around 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. Residents benefit from adequate levels of staffing the their needs, from staff being recruited in line with best practice and through the staff being sufficiently trained to meet the needs of the residents. Evidence: On the day of the inspection there were 43 people living at the home. We were told that between 7 a.m. and 3:30 p.m. there are six care staff, one senior carer and a care team manager on duty and between 3 p.m. and 10 p.m. six care staff. During the night-time period there are three night staff and one sleep in member of staff. We were shown staff duty rosters that reflected this level of staffing. We were told that night staffing was to change. A team leader will be appointed for each night shift so that there will be one team leader and two care staff on duty during the night-time. From speaking with residents, relatives and staff and from the information received through returned surveys we found that there were adequate levels of staff to meet the needs of people living at the home. The manager uses a recognised tool for calculating the numbers of staff needed to meet the needs of the people at the home. She was aware of the need to balance the dependency of the residents with the number of staff available. In addition to the care staff the home employs dining room assistants for all meals, domestic and laundry staff, care team managers and the deputy manager. An Care Homes for Older People Page 21 of 28 Evidence: Administrative Assistant, Chef, Assistant Chef and Kitchen Assistants are also employed. The AQAA informed that a recruitment drive had resulted in less use of agency staff. We looked at the recruitment records for the last three numbers of staff recruited to the staff team. We saw that all the recruitment checks as detailed within Schedule 2 of the Care Homes Regulations 2001 had been complied with. These checks include the taking up of references, a Criminal Record Bureau check and a check against the register of adults deemed unsuitable to work with vulnerable adults. The AQAA, discussion with staff, surveys and the staff training records demonstrate that staff complete an induction programme. The training matrix provided showed that staff attend a range of training programs to be able to meet the needs of the people living at the home. 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 and run in the interests of the residents. Evidence: The home has a registered manager who has worked in the home for many years and has acquired the necessary qualifications. The manager is supported by a deputy manager and care team managers. The management of the home is also overseen by a senior manager within the organisation who visits the home unannounced, inspects the premises, looks at samples of records and speaks with people living at the home. We saw reports relating to these visits that are required under Regulation 26. During the visit staff appeared confident in their roles, the home was relaxed and people appeared at ease and comfortable. Staff spoken with commented positively about the style of management and leadership from the manager, their job role and the people living at the home. The home holds small sums of money on behalf some residents. We checked the Care Homes for Older People Page 23 of 28 Evidence: records against the balance of money held and both tallied. The AQAA informed us that the home carries out regular quality assurance surveys with both residents and parties with an interest in the home. There is a quality assurance system in place that includes new monthly clinical audits, a monthly monitoring of accidents, incidents and falls analysis. The AQAA also informed us that relevant health and safety checks and maintenance were being carried out at the home. There are also organisational systems in place for the routine servicing of equipment, fire, heating and electrical systems. Equipment seen during the inspection was in good order. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 7 17 Maintain up to date records 02/04/2009 within the service users care plan. Ensure all care plan records have sufficient detail so that staff are aware and can meet residents needs. 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 7 15 We require that care plans are kept up to date and inform staff of how to meet health care needs of individual residents. In order to meet needs of residents. 21/12/2009 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 7 We recommend that daily recording notes made by the staff in relation to residents record how residents spend their days and not just report on care tasks that had been carried out. We recommend that body maps be completed following any injury or fall. We recommend that where the staff take responsibility for administration of creams are prescribed to residents by their GPs, records are maintained of their administration. We recommend that there is continual monitoring to ensure that the hot water in the communal baths is kept below 43C. 2 3 8 9 4 19 Care Homes for Older People Page 26 of 28 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 5 19 We strongly recommend that a programme is put in place to have all hot pipework and radiators covered to protect residents from hot surfaces. We recommend that action is taken to ensure that the home is free from unwanted odours. 6 19 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. 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