Care Home: Dunmore

Similar services:

• The Vicarage
• Fairfields Country Rest Home
• 7 Hyde Road
• 5 Seafield Road
• Queensmount
• Poldhu
• Trevaylor Manor
• Didsbury Court Rest Home

What the care home does well Dunmore is well managed and provides a safe, comfortable and homely place in which individuals can live their lives. Everyone looked clean and well cared for. There is a good assessment process that assures people thinking of moving into the home that their needs will be met. Everyone living at the home has a care plan that sets out their needs. Staffing levels are sufficient to meet the needs of people currently living at the home and staff are well trained. People living at the home said that staff were helpful and friendly. Staff said that they felt well supported by management and each other. Staff said via survey forms, that the home `gives people choice dignity and good care`. Another said when asked what the home does well `meets all the client`s needs`. Another staff commented `I would let any member of my family be admitted to Dunmore if necessary. A very clean, well run home`. There was evidence of good multi-disciplinary working with other professionals and positive comments were received on survey forms including `Provides clean, caring, safe environment in often challenging behaviour situations`. The majority of records were well maintained. People felt that meals were very good, although one person commented on a survey form that the food could be `more imaginative`. There is always an alternative if people don`t want what is on the menu. What has improved since the last inspection? No requirements or recommendations were made at the last visit. However, the AQAA (Annual Quality Assurance Assessment) submitted prior to the visit indicated that the home had made several improvements including replacing windows in the TV room, replacing kitchen door, decorating some bedrooms and purchasing new garden furniture. What the care home could do better: Care plans could be improved if more detailed instructions were given to staff on how the identified needs of individuals were to be met. daily recordings need to evidence where identified needs have been met. Improvements need to be made to the medication administration system, including ensuring the MAR (Medication Administration Record) sheet is completed correctly, medication is secure at all times and sample signatures and initials are kept. This is to ensure there is evidence that creams are applied as prescribed, that handwritten entries are correct, that people do not have access to other people`s medication and so that it is possible to identify who has administered any particular dose. Complaints should be recorded separately so that anyone wishing to see information relating to themselves could not see information relating to other individuals. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Dunmore 30 Courtenay Road Newton Abbot Devon TQ12 1HE     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sue Dewis     Date: 1 2 0 8 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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: Dunmore 30 Courtenay Road Newton Abbot Devon TQ12 1HE 01626352470 01626361485 dunmorecare@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Buckland Care Ltd care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Dunmore is registered as a care home providing personal care for up to twenty eight people aged 65 and over, who may also suffer from dementia and/or physical disability. In fact the home principally cares for people who suffer from dementia. Currently the weekly fees range from 400 to 560 pounds per week. The home is located on a hill, and many of the rooms have magnificent views over the town, the surrounding countryside and Dartmoor. All but three of the bedrooms are single rooms, and the three double rooms are also normally used for single occupation. The bedrooms are arranged over four floors, and there is a shaft lift and assisted baths 0 0 0 Over 65 28 28 28 Care Homes for Older People Page 4 of 29 Brief description of the care home and hoists for people with reduced mobility. There are two comfortable lounges and a separate dining room, all on the ground floor. Outside the front door there is a patio area with garden furniture, and there is ample car parking on the road outside. 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: This unannounced visit took place over 7.5 hours, one day in the middle of August 2009. The home had been notified that a review of the home was due and had been asked to complete and return an AQAA (Annual Quality Assurance Assessment). This shows us how the home has managed the quality of the service provided over the previous year. It also confirms the dates of maintenance of equipment and what policies and procedures are in place. Information from this document was used to write this report. Although only one inspector undertook this inspection, throughout the report there will be reference to what we found and what we were told. This is because the report is written on behalf of the Care Quality Commission. Care Homes for Older People Page 6 of 29 During the inspection 3 people were case tracked. This involves looking at peoples individual plans of care, and, where possible speaking with the person and staff who care for them. This enables the Commission to better understand the experience of everyone living at the home. As part of the inspection process CQC likes to ask as many people as possible for their opinion on how the home is run. We sent questionnaires out to some people living at the home, some health and social care professionals and some staff. At the time of writing the report, responses had been received from 10 people living at the home, 4 healthcare professionals and 4 staff. Their comments and views have been included in this report and helped us to make a judgement about the service provided. During the inspection 2 people living at the home were spoken with individually and a large group were spoken with in the lounge, as well as observing staff and people living at the home throughout the day. We also spoke with 2 staff, the administrator and the manager. A full tour of the communal areas of the building was made and a sample of records was looked at, including medications, care plans and staff files. All key standards were inspected. 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 Care Homes for Older People Page 8 of 29 following this report, you can contact them using the details set out 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. There is a good assessment and admission process in place, which means that people thinking of moving into the home can be sure that their needs will be met. Evidence: There is a Statement of Purpose, Service User Guide and Brochure available to people thinking of moving into the home. The manager told us that these are usually given to people when they first look around the home. The manager explained the admission process from when she first receives a referral. She said that she, and sometimes her deputy will go to see the individual in their own home or hospital and complete an assessment form. She said that she will also collect as much other information from as many sources as possible. People are always invited to look around the home, but many people rely on their relatives to do this on their behalf. The manager told us that she always emphasises Care Homes for Older People Page 11 of 29 Evidence: the trial period, especially when there is the possibility of aggressive behaviour. We spoke with 2 people who had not been at the home for very long, both said that they had received enough information to help them decide if Dunmore was right for them. Admission records that were looked at showed evidence of good assessments and risk assessments undertaken prior to the person moving in. The home writes to people to confirm that their assessed needs can be met before they move in. The AQAA (Annual Quality Assurance Assessment) submitted prior to the visit indicates that in order to improve the service the home intends to revise the Service Users Guide and produce a new brochure. The home does not provide intermediate care. 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. Everyone who lives at the home has a care plan which provides staff with information to enable them to meet peoples health and social care needs on a day to day basis. The management of medication is generally good but some areas need attention. Evidence: The home uses the Standex care planning system. The care plans of three people living at the home were looked at. All three contained evidence of detailed assessments including nutrition and moving and handling as well as more generalised assessments relating to personal care needs. The plans contained good detail of the individuals assessed needs and in some instances there were good directions to staff on how needs should be met. For example, one care plan stated X can become agitated and confused - take to their room - do not tell them to sit down. However, on some there was little detailed information for staff on how needs should be met. For example, one care plan indicates that the individual can become very tearful, but the care plan does not tell staff how to deal with this situation. Although it was clear through discussions with Care Homes for Older People Page 13 of 29 Evidence: staff that they knew the people they care for very well and knew how best to meet their needs, the lack of detailed information in care plans could lead to inconsistent care being provided. There was evidence that care plans had been reviewed regularly and updated as needed but there was no evidence to show that the individual or their representative had been included in the care planning process. However, care plans are kept in the main office with care staff having easy access to them and care staff told us that they take the care plans to the person and write the notes with them. Daily notes that were seen were not always very helpful and did not evidence that identified needs had been met. For example there was a lot of slept well and no problem. There were also some rather judgemental recordings made such as X was very rude and unco-operative this morning, with no exploration as to what may have led to the behaviour. There was evidence on file that peoples health care needs were being met, and that a range of health care professionals visited the home, including GPs and District Nurses. For example, it was possible to see where a GP or paramedics had been called following falls. Many positive comments were received via survey forms including They get to know their service users and their individual needs well. There is a policy and procedure for the administration of medicines and evidence was seen to show that people are supported to look after their own medicines if they wish to. All medicines were seen to be stored correctly when not in use and staff were seen administering them appropriately and signing the MAR (Medication Administration Record) as needed. We were told that all staff who administer medication have received appropriate training and that no-one administers medication until they feel confident to do so. However, as we arrived for the visit we saw that the medication trolley had been left unattended with blister packs of medication on top of the trolley. This is unsafe practice as there is the risk that someone may take medication that has not been prescribed for them. This was discussed with the manager who assured us that steps will be taken to remind staff of the dangers of leaving an open trolley unattended. MAR sheets do not indicate when prescribed topical creams have been administered, which may lead to creams not being applied or being applied more than prescribed. Handwritten entries to the MAR sheet must be double signed to confirm the entry is correct and a sample of the signatures and initials of staff should be kept in order to quickly identify who has administered any particular dose. Care Homes for Older People Page 14 of 29 Evidence: All people we saw during this visit looked well cared for, were treated with respect by the staff and their right to privacy was upheld. Personal care was seen to be offered in a discreet manner. Staff told us how they respect peoples privacy when helping them with personal care and we heard staff speaking with people in a kindly, friendly way. There was an obvious affection between staff and the people they care for. Individuals told us that staff were very kind to them and were helpful and respectful at all times. The AQAA (Annual Quality Assurance Assessment) submitted prior to the visit indicates that in order to improve the service the home intends to introduce Memory Books for those who wish them, to help provide happy memories and comfort. 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. Social interaction and activities are available, and there is good daily variation for people living in the home. Evidence: A monthly newsletter is produced that shows future activities.We saw records of regular activities taking place and details of who had participated in them. However, there was no indication as to how much they had been enjoyed. The manager told us that new entertainers had been introduced including a guitarist. Brixham Activities are employed and provide a wide variety of activities and outings. However, several people commented on their survey forms that they would like more activities and outings and would prefer them to be in smaller groups. We spoke with one person who has been encouraged and enabled to continue with their hobby of watercolour painting. People told us that they can choose how and where they spend their time and routines within the home are flexible. The manager and staff told us how they encourage people to make choices for themselves. We were told people decide what time they get up and go to bed, that there is always an alternative at meal times and that Care Homes for Older People Page 16 of 29 Evidence: people can choose whether or not they join in with activities. However, we saw forms within some peoples care plans that stated they were unable to make decisions due to their high needs. We discussed this with the manager who told us that they will soon be attending training on the Mental Capacity Act. People living at the home told us that their family and friends can visit them at any time and that they are always made welcome. We saw several visitors coming into the home during our visit. People told us that the food was very good and there was always plenty. However, one person said on their survey form that the food could be more imaginative. The four week menu is displayed on the noticeboard so that if people do not like what is on offer they can ask for something else. We were told that vegetarian and diabetic meals are also supplied if needed. The AQAA (Annual Quality Assurance Assessment) submitted prior to the visit indicates that in order to improve the service the home intends to provide more outings on a more regular basis and to include some outdoor activities. 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. There is a clear complaints procedure and people can be confident that their concerns will be listened to. Suitable procedures are in place to ensure that people are protected from abuse. Evidence: There is a clear and simple complaints procedure in place to help people who may wish to, to raise concerns. A copy of the procedure is displayed around the home. A complaints book is kept that shows a record of written complaints received by the home, and lists any moans and groans that are dealt with immediately. The book also contains details of how the complaint was investigated and the outcomes. Any complaints received by the home should be recorded separately and not in a book. This is so that anyone wishing to see information about themselves cannot see recorded information about anyone else. Some people living at the home who were spoken with during this visit were unsure about about the homes formal complaints procedure. However, those who were spoken with were able to tell us who they would speak with if they were unhappy about anything, which was usually the manager. This was echoed on survey forms with people telling us that they knew who to speak with if they were unhappy, but didnt know how to make a formal complaint. Records show, and staff told us that they had received training in Protection Of Care Homes for Older People Page 18 of 29 Evidence: Vulnerable Adults (POVA) issues. Both staff that we spoke with were able to discuss differing forms of abuse and said that they would report any suspicions they had to the manager. They were also able to tell us who they would report any concerns to, outside of the home. The AQAA (Annual Quality Assurance Assessment) submitted prior to the visit indicates that in order to improve the service the home intends to ensure staff receive regular training in POVA issues and to introduce a suggestions/comments book for people to write in. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a pleasant, comfortable and safe environment for those living in, working at and visiting the home. Evidence: A full tour of the communal areas of the home was made and some individual bedrooms were looked at. All areas of the home were clean, well ventilated and there were no unpleasant odours. Peoples bedrooms contained many individual items and reflected the personality of the occupant. People told us that they had been able to bring things from their home when they had first moved in. One person had their painting equipment set up in their room. Communal areas consist of 2 comfortable lounges and a large separate dining room. All areas are nicely furnished and decorated and have a comfortable, homely feel. The home cares for people who have some degree of dementia, and there are signs on doors indicating bathrooms and toilets and there is a noticeboard that displays the day of the week. However, there is no colour coding of areas or bedroom doors that may help people with a dementia remember where they are. There is level access to the outside of the premises, where there is a safe and Care Homes for Older People Page 20 of 29 Evidence: pleasant garden area. The patio area at the front of the home was unusable at the time of the visit, the manager told us that she was waiting for quotes to get it repaired. The home has a range of equipment including grab rails, handrails, standaids and hoists, to aid staff and individuals with their mobility . The laundry area is sited in an outbuilding and has commercial equipment installed. An impervious floor covering is fitted to minimise the risk of cross contamination. Peoples clothing looked well laundered and individuals were smartly presented. Staff confirmed that disposable gloves and aprons were available to them in order to minimise the risk of cross infection. They also confirmed and records show that they have received training in this area. There are policies and procedures in place in relation to infection control and laundry. The AQAA (Annual Quality Assurance Assessment) submitted prior to the visit indicates that in order to improve the service the home intends to redecorate bedrooms as required, replace carpets as necessary and to repair the patio at the front of the house. 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. A wide range of training is provided and the numbers and skill mix of staff on duty are sufficient to meet the needs of people currently living at the home. People are protected by recruitment procedures that ensure people who may be unsuitable to work with vulnerable people are not employed at the home. Evidence: On the morning of the visit there were 4 care staff on duty plus a senior carer and the manager. There was also a cook, a kitchen assistant and a domestic on duty, with care staff doing the laundry. There are 2 waking care staff on duty each night. People that were spoken with felt that there were enough staff at the home to meet their needs. Care staff that were spoken with also said that they did not feel rushed and had the time to spend with people meeting their needs. However, we received several survey forms that had been completed by representatives and by a health care professional that said they felt there were not enough staff on duty or that they were sometimes difficult to find. The staff that we spoke with were able to tell us about the care needs of individuals and about how these needs were best met. Care Homes for Older People Page 22 of 29 Evidence: Three staff files were looked at. One file contained all the required information including satisfactory CRB (Criminal Records Bureau) checks, two written references and proof of identity. Two files contained only one written reference that had been obtained by the home. Although they each also contained a letter addressed To whom it may concern these letters are considered to be testimonials rather than references and are not acceptable. However, the manager told us that she had received one of these testemonials following a request for a reference. Records show and staff confirmed that they receive a wide variety of training, including Fire procedures, Moving and Handling, Food Hygiene, First Aid and Infection Control. Staff are also encouraged to work for NVQs (National Vocational Qualifications) and 11 staff currently have NVQ level 2 or above. All staff have received training in POVA (Protection Of Vulnerable Adults) issues and training for staff working with people with Dementia has also been provided. All new staff receive a full induction in line with Skills for Care recommendations. Staff were praised by people living at the home when we spoke with them and we received many positive comments via survey forms including, Staff are kind and listen to you when you require advice on a problem, The staff show a great deal of kindness and patience at all times and Friendly, helpful staff. The AQAA (Annual Quality Assurance Assessment) submitted prior to the visit indicates that in order to improve the service the home intends to continue to encourage staff to gain NVQs and to provide more dementia related training. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed resulting in practices that promote and safeguard the health, safety and welfare of people who live and work in the home. Evidence: Fiona Snow is the registered manager and has 22 years experience of working at the home, including 12 as a manager. The home is managed efficiently and she and the staff team work together well to create a homely environment for the people who live at the home. Staff that we spoke with during the visit told us that they felt supported by the manager to do a good job. One staff told us that Fiona is very approachable so we can make suggestions if we are unhappy about something. Another said on their survey form Manager very experienced and supportive. Individuals or their representatives generally manage their own financial affairs. However, the home holds a small amount of money for some people. We saw individual records for these people that had recently been started. Care Homes for Older People Page 24 of 29 Evidence: The home has an annual quality assurance survey that seeks to gain the views of people living at the home and from this an annual development plan is produced. In line with Regulation 26 of The Care Standards Act 2000, the Responsible Individual (the representative of Buckland Care Ltd) carries out monthly quality audits covering all aspects of the provision of the service, to ensure that standards are maintained. A report on this visit is held at the home. Staff told us and records confirmed that they receive regular supervision. The manager told us that she receives regular supervision from the responsible individual for the company. The AQAA (Annual Quality Assurance Assessment) submitted prior to the visit, provided evidence that Dunmore complies with health and safety legislation in relation to maintenance of equipment, storage of hazardous substances, fire precautions, health and safety checks and risk assessments. Policies and procedures are not always inspected during the visit but the information provided on the AQAA helps us form a judgement as to whether the home has the correct policies to keep people living and working at the home safe. Information provided by the home, evidenced that policies and procedures are in place and along with risk assessments are reviewed regularly and updated where necessary, to ensure they remain appropriate and reduce risks to people living and working at the home. So that the risk of burning from hot surfaces is minimised, radiators within the home have been covered. All windows above ground floor level are fitted with restrictors, in order to minimise the risk of anyone falling from these windows and all taps are fitted with thermostats to minimise the risk of people being scalded. 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 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 2 3 7 7 7 You are recommended to ensure that daily notes evidence that identified needs have been met. You are recommended to evidence that people or their representatives are consulted about their care plans. You are recommended to ensure that care plans provide staff with more detail on how individuals care needs are to be met. You are recommended to ensure that MAR charts are completed when topical creams are applied. You are recommended to keep samples of signatures and initials of everyone who administers medication. You are recommended to ensure that all handwritten entries on MAR charts are double signed. You are recommended to ensure that all medications are kept securely at all times. You are recommended to provide evidence when decisions are taken on behalf of people. You are recommended to ensure all complaints are Page 27 of 29 4 5 6 7 8 9 9 9 9 9 14 16 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 recorded seperately. Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!