Care Home: Durland House

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What the care home does well The home provides a warm and friendly atmosphere which people who live there say is homely and very pleasant. Staff were seen to interact very well with the people and gave support in a discreet and professional manner. Both the people and some relatives commended the home for the caring attitude and relaxed manner of care delivery. One person said: `staff never rush me and give me just the right level of care`. Another person said: ` Life here is good, I feel very safe and well cared for`. All the people at the home praised the quality and choice of food, relatives also made positive comments on the food. One relative said that when residents have birthdays the home provides wonderful party food and all are welcomed to join in. One person who lived there said ` the food is all home cooked and the choices are good`. The people who live in the home confirmed they are always given choices about daily living skills, such as what to wear and what to eat. Bedtimes were optional and routines were flexible to meet the needs of the people. Meal times could be flexible, especially breakfast and tea times. The home was clean and fresh on the day of the site visit and all of the people looked well cared for. What has improved since the last inspection? The lounge to the front of the building had recently been decorated and had been done in keeping with the Grade One listing the building holds. New armchairs had also been provided throughout the home. The external building had also been decorated. The care plans had improved slightly, but plans were in place to completely re-evaluate them and write new ones. These will be assessed at the next inspection. The home had endeavoured to improve the amount of activities offered to the people in the home and most said they were happy with this. Some still said they would like to go out on outings. What the care home could do better: Record keeping and maintenance of staff and service user records would continue to benefit from further continuity and improvement. Policies and procedures need to be reviewed and updated as necessary. A medication policy must be produced and followed.Medication recording needed to be improved and regualrly monitored. The homes complaints procedure must be confirmed in a written policy and made available to all concerned with the home, as several people said they had not seen this document and it could not be found on the day of the site visit. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Durland House 160 High Street Rainham Gillingham Kent ME8 8AT     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 McGrath     Date: 2 5 0 6 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 31 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 31 Information about the care home Name of care home: Address: Durland House 160 High Street Rainham Gillingham Kent ME8 8AT 01634364305 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) : Mr Royston George Hartley,Mrs Margaret Agnes Hartley care home 13 Number of places (if applicable): Under 65 Over 65 13 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who can be accommodated is: 13 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either Old age, not falling within any other category - OP Date of last inspection Brief description of the care home Durland House is a listed building in Rainham High Street. The home is nicely decorated and care has been taken to ensure that it is in keeping with the age of the property. Although the house is close to the main road traffic noise is not noticeable within the property. Four rooms are shared. All bedrooms have en-suite facilities; there is a chair lift available to the first and second floors for those less able. There is a small amount of parking accessed at the side of the building and there is a small garden and patio area to the rear. As it is situated in the High Street it is close to local shops and amenities. Care Homes for Older People Page 4 of 31 Brief description of the care home The fees range at this home £360.00 - £380.00 per week. Care Homes for Older People Page 5 of 31 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 was a Key Unannounced inspection that took place in accordance with the Inspecting for Better Lives (IBL) process. Key inspections are aimed at making sure that the individual services are meeting the standards and regulations and that the outcomes are promoting the best interests of the people living in the home. The actual site visit was carried out by 1 inspector over the course of 1 day. We (the Commission) spent time touring the building, talking to all the people living in the home and relatives. We also spoke to the manager and staff and reviewed a selection of assessments, care plans, medication records, menus, staff files and other relevant documents. The registered provider was present throughout the inspection. Care Homes for Older People Page 6 of 31 Prior to our visit an Annual Quality Assurance Assessment (AQAA) had been sent to us within the required time limit. The AQAA is a self-assessment, required by law. This assessment focuses on how the service considers they are meeting the outcomes of the people using the service and where it feels it can make improvements. It also provides statistical information about the service. Information from the AQAA has been used in this report where appropriate. Judgements have been made with regards to each outcome area in this report, based on records viewed, observations and verbal responses given by those people who were spoken with. These judgements have been made using the Key Lines of Regulatory Assessment (KLORA), which are guidelines that enable the Care Quality Commission (CQC) to be able to make an informed decision about each outcome area. Overall this was a positive inspection with generally good outcomes for the people who use this service. The inspector on leaving the home was satisfied that people were both safe and well cared for and wishes to thank the manager and her staff for their assistance and hospitality. What the care home does well: What has improved since the last inspection? What they could do better: Record keeping and maintenance of staff and service user records would continue to benefit from further continuity and improvement. Policies and procedures need to be reviewed and updated as necessary. A medication policy must be produced and followed. Care Homes for Older People Page 8 of 31 Medication recording needed to be improved and regualrly monitored. The homes complaints procedure must be confirmed in a written policy and made available to all concerned with the home, as several people said they had not seen this document and it could not be found on the day of the site visit. 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 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 31 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 31 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 benefit from an assessment of their needs prior to moving into the home and they and their relatives have the opportunity to visit the home prior to admission to assess the quality, facilities and suitability of the service. Evidence: We looked at the information provided to people who use the service to find out whether it was detailed and answered all their questions, and to find out how the service passed on the information. Some of the information required by regulation needed to be added. This was discussed with the registered provider who confirmed the necessary work would be completed. The provider was also advised to ensure all prospective people interested in the service, and or their families, were given a copy of the document, as one relative said she had not been given this information. We saw evidence in two files that people are provided with a written contract/ Care Homes for Older People Page 11 of 31 Evidence: statement of terms and conditions with the home. The provider confirmed all people living in the home had such a document. We viewed two files to determine how the home assesses people. This process was also discussed with the registered provider. Records showed that people were assessed prior to admission and this covered peoples history, care needs and social needs. The provider also confirmed information was gathered from Care Managers if the prospective client was funded by Social Services. The provider confirmed she encourages people to visit the home prior to admission so they can assess the care and facilities offered. All people were offered a four week trial to ensure their assessed needs could be met. One relative was spoken with and confirmed the assessment and admission procedure described above was used by the home and that she had been fully involved with the assessment and admission process. All of the staff had either completed or were undertaking a National Vocational Qualification (NVQ) in care and had attended other mandatory training. This enabled them to support people in meeting individual needs. Staff spoken with demonstrated an awareness of the individual needs of people. Feedback from the people using the service was very positive regarding the level of care offered by staff. The home does not provide intermediate care. Care Homes for Older People Page 12 of 31 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. Whilst people benefit from having individual care plans some areas of these plans need to improve so as to fully support peoples individuals needs. Health care needs are met and people have full access to all professional health care services as required. Improvements in record keeping for medication would further protect the people in the home. People can be confident they will be treated with dignity and respect and their privacy will be respected. Evidence: We wanted to look at peoples care plans to ensure that their health, personal and social care needs were set out in a way that would enable staff to deliver good care. We looked at three plans to evidence this. The registered provider discussed how these plans were in the process of being updated with help from Social Services. Staff training was due to take place in early July and then new plans would be completed Care Homes for Older People Page 13 of 31 Evidence: with the involvement of the people who live in the home. It was seen that the existing plans had improved since the last inspection but many still lacked sufficient risk assessments. Some of these risk assessments had not been dated or signed. The existing plans were assessed as adequate and the new plans will be reviewed at the next inspection. The existing plans did evidence that health care needs were well met and that all medical intervention was recorded. People living in the home confirmed they felt well cared for and said their health care needs were well met. Several said they had easy access to their own GP and that the home supported them with hospital appointments. One family member seen on the day also confirmed they were happy with the level of health care received. The medication system in the home were reviewed as part of the site visit. Medication was stored securely in locked cupboards with appropriate security measures in place. There were samples of signatures and initials for auditing and record keeping purposes. However, it was noted that several signatures were missing from the Medication Administration Records. On checking the amount of medication remaining in the blister packs it was evident that medication could had been administered but not signed for by staff. The provider must have a recorded system in place to ensure the administration of medication is regularly audited. We were unable to find a current medication policy that reflected current good practice. The provider will be required to obtain a copy of the relevant guidelines and produce a written policy and procedure for staff to follow. The provider confirmed the following week that she had ordered the relevant guidelines. Evidence seen on the day of the site visit and discussion with the people who lived in the home confirmed that staff treat them with respect and that their right to privacy was upheld. Comments made included: Could not wish for better staff The girls are so kind, they will do anything for me Could not wish for better care I have no worries at all On the day of the site visit it was noted that all of the people who lived in the home looked well cared for, were cheerful and keen to be part of the inspection process. Care Homes for Older People Page 14 of 31 Care Homes for Older People Page 15 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples individual choices and preferences on how to spend their days are respected and the current people are happy with the level of activities. People are supported to maintain contact with family and friends which ensures they continue to receive stimulation and emotional support. People benefit from a good choice of home cooked meal which are prepared to a high standard. Evidence: We wanted to look at the type of lifestyle experienced in the home and if people were happy with the level of social interaction and level of activities. We also wanted to look at if choices were given to the people and what control they had over their lives. To do this we spoke with nearly all of the people and some relatives who were visiting. Staff were also spoken with. The staff said that they arranged regular activities for the people to participate in and these were recorded on a wall chart. Unfortunately the chart was out of date and this Care Homes for Older People Page 16 of 31 Evidence: was pointed out to the provider, who explained they had only recently started recording activities and that she would would ensure this was kept up to date. The records evidenced that last month people were given the opportunity to participate in film shows, board games, reminiscence groups, bingo, craft work, quiz nights and visits from a hairdresser. The provider also arranges for a motivational session on a monthly basis. The majority of the people said they were happy with the level of activities offered but some said they missed going out. This was discussed with the provider who said she would try to arrange some outings later in the year. This has been highlighted in previous reports. All of the people spoken with said staff always were polite and gave them choices over all everyday decisions, such as what clothing to wear and what to have to eat or drink. They confirmed that they could go to bed when they liked and get up at any time. They also confirmed that they could have their meals either in the dining room , lounge or own bedroom. The following comments were made: It is so relaxed here, I can do what I want when I want and I have no worries The staff offer me help when I need it and leave me alone when I want to be alone On the day of the site visit groceries were being delivered and it was noted that a wide range of high quality food had been purchased. The menus were varied and everyone spoken with commented on the high quality of the meals. The people in the home confirmed they always had a choice over all food and the provider would always try to provide what was asked for. A relative said that on birthdays the people have a special tea which was of a very high quality. Comments made by two of the people in the home: The food is excellent and we always have a choice and I always look forward to mealtimes. The provider said that sometimes the local schoolchildren come to visit the home and this is enjoyed by the people who live in there. Religious needs were taken into consideration and services arranged as required. Care Homes for Older People Page 17 of 31 Evidence: Relatives said they are encouraged to maintain contact with the people in the home and to continue be involved with their care where possible. One relative confirmed she was always made welcomed by the staff and could have a cup of tea or a meal with her relatives if she wanted to. Relatives spoke of the good relationship with the provider and staff. It was seen during the site visit that staff interacted very well with all of the people in the home and demonstrated an awareness that people can have a diversity and range of different needs and that a key part of addressing this was talking and listening to peoples wishes. Care Homes for Older People Page 18 of 31 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. People living in the home know that their concerns and complaints are taken seriously and will be dealt with by the home. The written complaints procedures requires updating Whilst service users are protected from the risk of abuse the homes adult protection policy and procedures need updating. Evidence: We wanted to ensure that all people concerned with the home were aware of the complaints procedure and felt confident their concerns would be listened to and acted upon. We also wanted to ensure all people were protected from any form of abuse. The provider stated that she had not received any formal complaints regarding the home, however she stated she did have a procedure in place to deal with any concerns. The written policy seen was not clear and needs to be reviewed and made more accessible to the people in the home and their relatives. One relative said she was unsure how to officially complain, but she also said had never needed to do so as any concerns were always dealt with quickly by the provider. Another relative confirmed she was not aware of the complaints procedure. The provider confirmed she held a copy of Kent and Medways Policy and procedure for Care Homes for Older People Page 19 of 31 Evidence: the Protection of Vulnerable Adults. She stated that if needed she would follow these guidelines. Most staff had received training in Adult Protection and one staff spoken with was able to display a sound knowledge of the subject. The staff training was completed in 2006 and should now be refreshed. CQC have not received any information regarding any safe guarding alerts. Care Homes for Older People Page 20 of 31 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 benefit from living in an environment that is homely and well maintained Evidence: We wanted to ensure that people lived in a well maintained environment and had safe access to comfortable indoor and outdoor communal facilities. We also wanted to ensure that bedrooms were clean and comfortable and met good environmental standards. The home is part of a listed building and is tastefully decorated and maintained to a high standard. There was a maintenance programme in place to ensure an ongoing high standard. The front lounge had recently been decorated and new armchairs had been purchased throughout the home. A new television has been purchased for the main lounge area last year. There was also a quiet lounge at the rear of the building for those who preferred a more quiet environment. All areas looked comfortable and very homely. The majority of the bedrooms were viewed and apart from some bedside cabinets that needed replacing, were of a high standard. The home has four double rooms. All of the people spoken with were very happy with their rooms and said they were Care Homes for Older People Page 21 of 31 Evidence: always clean and comfortable. On the day of the site visit the home was clean and fresh. There was a garden area to the rear of the property where people could sit out in summer months. It should be noted that the home does not have a lift, there is, however, a stair chair lift to the first and second floor but this makes the stairs narrow and, therefore only the ground floor is suitable for people with poorer mobility. There are toilet facilities on the lower floor. The laundry area is situated on the lower floor close to the back door and is a main thoroughfare into the home. This area was clean and tidy. Care Homes for Older People Page 22 of 31 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. People can be confident that their care and support needs are met by trained and competent staff, who respect their preferences and choices. Evidence: We wanted to ensure that sufficient staff were employed, who were suitably trained and had a good understanding of the needs of older people. We wanted to ensure they had been appropriately recruited to ensure the safety of the people in the home. The home employs twelve staff. Staff rotas were examined and evidenced that there were sufficient staff on duty at all times. The provider also works hands on with the staff for a substantial amount of time during the week and is available at night on call in case the two waking night staff have any problems. Several of the people who lived in the home said they felt there were sufficient staff and that they never had to wait too long for assistance. One member of staff also confirmed she felt there were sufficient staff on duty. The AQAA provided evidence that the homes does not employ any agency staff and the provider said that staff would cover for any sickness and annual leave of other staff. It was mentioned by both the provider and some staff that the staff work well as a team and that morale was high. There were low sickness levels amongst staff. Care Homes for Older People Page 23 of 31 Evidence: Two staff files were reviewed and evidenced that the home had robust employment procedures in place. All staff held current CRBs and the provider stated she always applied for POVA first checks prior to commencement of work. Staff training was also viewed and the provider was given 48 hours to produce a training matrix as records were muddled and unorganised. The completed matrix evidenced that all staff except three had completed an NVQ level 2, those three were currently undergoing their award. Seven staff had completed NVQ level three and others were hoping to start their level three award soon. Apart from newer staff, all staff had completed mandatory training, although Adult Protection training was completed in 2006 and should be refreshed. There were no staff who held a First Aid at Work qualification and the provider stated she would arrange this. 8 staff had attended a one day first aid course. The provider was currently looking to access training in the Mental Capacity Act. The homes staff undertake a very basic induction programme, which the provider was aware was insufficient and did not meet with TOPPS guidelines. They have been provided with a more robust procedure by Medway Council and intent to use this for future staff. The provider was aware of the importance of ongoing training and was actively ensuring that staff were able to access appropriate training courses. Care Homes for Older People Page 24 of 31 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 people in the home benefit from living in a home where the providers are very experienced with the care needs of older people. People also benefit from living in a safe and and inclusive atmosphere. Improved record keeping would further support the changing needs of people living in the home. Evidence: We wanted to look at the skills of the management team and if the service benefited from the ethos, leadership and management of the home. We also wanted to see if the home was run in the best interests of the people who lived there. We also needed to ensure their health and safety was protected and promoted. Care Homes for Older People Page 25 of 31 Evidence: The providers of the service have over twenty years of experience in running the home. They do not have the formal qualification required but do participate in all training sessions that are provided for the care staff. Feedback from the people who live in the home, their relatives and other professionals demonstrated they were aware of good care practises and of the needs of older people. The management of the home is open and transparent with staff and the people living in the home expressing confidence in the owners. The providers openly admit that paperwork is not their forte, but are endeavouring to improve their record keeping. The outcomes for the people in the home remains their top priority. Quality assurance is an ongoing process in the home with regular feedback questionnaires to the people in the home and yearly questionnaires to relatives. The providers listen to their clients and try to react where possible. This was confirmed by people in the home and their relatives who said they felt they could always discuss any aspect of the home with the providers. Personal monies were not inspected at this site visit as previous visits have shown that money is managed in accordance with peoples needs and safeguarded. The providers prefer not to handle peoples personal monies and prefer to pay for any extras such as hairdressing and chiropody and then invoice the person or family where necessary. Record keeping and maintaining accurate and ongoing records have always been an issue within the home, however the owners are willing to work with the Commission at all times and openly admit they do not find this area easy. However, the providers must ensure that all policies and procedures are updated and are robust, these include the complaints policy and a medication policy. This was discussed during the inspection and they are working closely with Medway Council to improve this area. Risk assessment must be regularly reviewed, dated and signed by the person completing the assessment. That person should have the necessary experience and training to complete risk assessments. The AQAA confirmed that all safety checks were carried out in accordance with their due dates. Time was spent discussing how the home should manage the recording of hot water temperatures to ensure the people in the home are not at risk from hot water. The home does not currently have thermostatic mixer valves fitted on all hot water outlets and should therefore complete a robust risk assessments to identify why they have taken this decision. Several radiators in the home remained uncovered, but the provider confirmed this work had been authorised and that they were waiting for their carpenter to fit the covers. Care Homes for Older People Page 26 of 31 Care Homes for Older People Page 27 of 31 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 28 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The registered person shall make arrangements for the recording, handling, safekeeping and disposal of medicines received into the home. In that a wriiten medication policy be written and adhered to . 30/09/2009 2 16 22 The registered person shall establish a procedure for considering complaints made to the registered person by a service user or person acting on their behalf. In that the registered person ensures that there is a simple, clear and accessible complaints procedure which includes the stages and timescales for the process, and that complaints are dealt with promptly and effectively. 30/09/2009 Care Homes for Older People Page 29 of 31 3 38 13 The registered person shall ensure that unnecessary risks to the health and safety of service users are identified and so far as possible eliminated. In that a risk assessment should be carried out to identify potential scalding risks from hot water temperatures and to assess the vulnerability of those who have access to bathing or washing facilities. 30/09/2009 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 Care Homes for Older People Page 30 of 31 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 31 of 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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