Care Home: Eastgate House Residential Home

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What the care home does well Observations at this time did show that staff consider the dignity of people living in the home. People were chatting and laughing with the staff and among themselves when we undertook this inspection. One resident told us that the staff could not be faulted and also that the staff work hard to help residents. One person said that the food was alright and another said that they had enjoyed a cooked breakfast that was really good. Staff were laughing and undertaking a game of bingo with a lively group of residents in the lounge during the morning of this inspection. Residents were talking among themselves and were also happy to talk to visitors. Any health matters are dealt with by staff calling the appropriate healthcare services for support when necessary, this is documented and the required care is also recorded and continued as needed. Visitors were welcomed into the home and the residents we spoke to confirmed this and we also saw visitors coming and going in the home. What has improved since the last inspection? The home has had a new boiler installed that will ensure continued heating and hot water that can be regulated to the appropriate temperatures. A new fire alarm system has also been installed as has a new emergency call system, both of which were needed to support the safety and well being of residents. What the care home could do better: While staff told us that residents could have a different meal at lunch if they asked, we were told by residents that there is no choice given before meal time and residents eat what is served. There was no alternative meal on the serving trolley at this time but the food was hot and looked and smelt appetizing. However, a choice must be provided by the home before any meal is cooked and staff must get to know what residents enjoy eating and what they would like as choices on a varied menu plan. The daily meals should also be written on a menu for residents to read at their leisure and to give them information about what they will be eating. There are many areas of the home that currently pose a risk to people and further details can be found in the full body of this report under the section for the environment. Key inspection report Care homes for older people Name: Address: Eastgate House Residential Home 17 Littleport Street Kings Lynn Norfolk PE30 1PP     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: Brenda Pears     Date: 1 6 1 0 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: Eastgate House Residential Home 17 Littleport Street Kings Lynn Norfolk PE30 1PP 01553691054 01553691054 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: IntegratedNursingHomesLimited Integrated Nursing Homes Ltd care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 20 The registered person may provide the following categories of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Eastgate House is a residential home for 19 older people. It is situated in a large historic 17th century detached house which is situated close to the town centre of Kings Lynn and was opened in 1987. All local amenities are close by. The accomodation covers the ground floor and first floors. Some stair lifts are in place to enable people with less mobility to access their rooms upstairs and the accomodation takes the form of single and double rooms. The current charges at the home are set according to the level of support that is Care Homes for Older People Page 4 of 28 Over 65 20 0 2 7 0 2 2 0 0 9 Brief description of the care home required by an individual wishing to move into the home. Further details and information such as a service user guide can be obtained by contacting the home direct. 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: This was an unannounced inspection undertaken on the 15th October 2009 and started at 10.00am. The focus of this inspection was on the previous requirements, on the core national minimum standards and on the quality of life for people who receive support in the home. The methods used to complete this inspection consisted of looking at the care a resident receives and the records that support this. Information was provided to us by the home on an assessment form known as an Annual Quality Assurance Assessment (AQAA). During the visit to the home we spoke to deputy manager, with members of staff, four residents and also with groups of people living in the home. These methods plus observations undertaken at this time and previous findings all inform the outcomes of this report. Care Homes for Older People Page 6 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. 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 7 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 8 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. Assessments are undertaken before any admission into the home is undertaken. Evidence: Assessments are carried out by the home before any decision is made to move into the home, the plan of care is then reviewed following a trial period. This enables both the home and the new resident to make an informed decision as to the suitability of the placement. One file we reviewed for a new admission to the home did not have a pre admission assessment. The reason for this was that this person had been admitted as an emergency placement and the local authority had completed their own assessment that informed the home what the support needs were. The file contained a copy of the assessment made by the local authority. Care Homes for Older People Page 9 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. Care plans are in place, reviewed regularly and contained some detailed sections. However, risk assessments are not always completed, leaving residents and staff at risk. Evidence: We were informed that staff have been part of a pilot scheme with regard to the monitoring of falls and new paperwork is being developed following this. This area of care will continue to be reviewed and work will be assisted by a local falls team and enable access to equipment as needed. Care plans evidenced that the need for a pressure relieving mattress is identified and also for the use of bedrails, through the assessment process. However, we saw only one care plan that contained a risk assessment and all others read at this time did not have risk assessments in place for the use of bedrails. This was brought to the attention of the deputy manager. Where a resident was assessed as needing two people to hoist or use other mobility Care Homes for Older People Page 10 of 28 Evidence: aids, we again found no direct instructions as to when or how such items must be used by staff and no risk assessments had been completed. Files contained other information that shows that the health and well being of residents is part of the care and support provided in the home. These include consent forms for flu vaccinations, appointments with specialists, GP, district nurse and screening for diabetes. We also looked at the records relating to three falls that had previously occurred in the home. We were able to track these details in the daily records, on the record for healthcare professional visits and also where essential information had been passed onto staff at handover. We were informed that a new format is being developed for care plans and the four residents we reviewed at this time did contain observations that had been made by staff and these were shown to be followed up on documentation. Night care plans showed accountability, routines and clear reporting systems. Further information is required when observations are made. For example we saw the comment that staff had to monitor for signs or symptoms of a certain condition on one file, but there were no directions as to when or how this would be undertaken. Another stated that the resident needed assistance with the management of continence, but again there were no instructions or descriptors of how this would be carried out and recorded or who would monitor this situation. One person has recently been moved to a bigger room to support their needs. Specific information regarding their medical condition and additional needs were seen on the relevant care plan. We were told that the home washes all hoisting aid material on a regular basis in line with infection control. Care Homes for Older People Page 11 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents do undertake activities and celebrate events, but a choice of meals is not currently offered and people are therefore not enjoying meals as much as they could. Evidence: We observed visitors being welcomed into the home during this inspection. Two residents also confirmed that visitors are made welcome at all times and that staff are very helpful. However, two residents did say that faces of staff seem to change so much and they feel they do not know the staff on duty. When discussed with the deputy manager, we were told that some staff have moved over the last few months but not in great numbers. This has been due to other opportunities arising and the staff team is usually stable in the home. However, we stated that if staff from the neighbouring home assist with serving at meal times, this will cause confusion for residents. One resident explained that they do not like eating meat and just have vegetables and potatoes. When asked about saying what they would like with their meals, we were told they did not want to cause the staff any problem or extra work. We observed this person having their served and they were if they wanted mince and dumplings for lunch, the residents explained they did not want meat, just the potatoes and Care Homes for Older People Page 12 of 28 Evidence: vegetables. The member of staff asked if they were sure and then went and served the meal requested. The resident was not offered any alternative or suggestions for the meal. Meals are cooked and brought over from the neighbouring home. ON the day of this inspection we asked what was for lunch and residents had no idea. We observed the lunchtime period that was calm and unhurried. However, the food consisted of mince, dumplings, mashed potatoes, carrots and broccoli. When staff were asked about an alternative, we were informed that if a resident did not want the meal, then staff in the other home would cook something else. When we spoke to three residents, they stated they do not have a choice of meals and just eat what is brought over from the other home. The food looked and smelt appetising but there was no immediate alternative on the serving trolley or offered at the meal time. This was discussed with the deputy manager who thought residents were given a choice the day before and were then served with their choice the next day. There is no menu on display for residents to know what is for lunch. We also asked if the transfer of food and temperature checks are in line with requirements set by the environmental health department and were told that the deputy did not know. The person serving the meal stated that food is checked when served in the kitchen in the neighbouring home but that she was unaware of any further temperature checks. When discussing the temperature of the food with residents, we were told that they had never felt it was not right and we saw that food was steaming at the lunch table. One resident also mentioned about snacks being offered during the evening as from five, when the evening meal is served, until eight the following morning is a long time to wait for something to eat. The resident said they were going to stock up on snacks as they often got hungry. When this was relayed to the deputy manager, we were told that if a person asks, they can have whatever they want. However, snacks are not offered by staff as part of the routine in the home. One resident told us how they had enjoyed the breakfast recently as they had poached egg on toast. They felt this was good for such a big home and said that staff get full marks for their care. Activities offered in the home include a daily backing session, after which the food is eaten with a hot drink. Art, craft, bingo and coffee mornings are also undertaken in the home. We saw residents having a lively session of bingo in the lounge where staff and residents were chatting and laughing. A bus is also hired for day trips out when the weather permits. Care Homes for Older People Page 13 of 28 Evidence: Relatives, friends and residents meetings are being planned to provide an opportunity to discuss plans for the future and to allow an update of events in the home. Meetings are undertaken every other month with residents but staff are available for immediate discussions when needed. Care Homes for Older People Page 14 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. People who use the service can express their concerns and staff have training regarding recognizing abuse to support the protection of residents. Evidence: Residents said they can talk to staff and they are very caring and hard working. There is a complaints procedure in place and a complaints policy to support staff and the complaints process. The deputy manager explained that there have been no formal complaints since the last inspection, however, some residents have had discussions about minor things that have been dealt with quickly. The deputy manager was advised to record all matters that are brought to the attention of staff and dealt with, no matter how small. This is a legal requirement under the care standards as a summary of actions taken must be available for inspection on request. Care Homes for Older People Page 15 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. The environment is in need of upgrading and this is currently in progress, however, some areas pose a risk to people in the home. Evidence: Eastgate House is a large residential care home on the edge of the town centre, providing easy access to local shops, the town centre and a walkway along the local waters edge. The home has opened the fence up in the back garden to provide a bigger external space for residents to enjoy. This additional land backs onto the neighbouring home that is owned by the same organisation. We were told that there are plans to merge the two homes but these are currently registered independently. The grounds are in need of some attention and the entrance lobby does require upgrading as this does not currently provide a welcoming space for visitors. We were told that this is being considered but the side entrance is currently being used the most at this time. Staff do interact with visitors and residents in a lively way that gives the home a relaxed and welcoming environment. The lighting around the home currently presents a very dull atmosphere that will not help those people who may not have perfect eye sight. Care Homes for Older People Page 16 of 28 Evidence: The deputy manager explained that future plans for the home are to install wooden flooring in the dining room, fire doors are to have new closers following which redecoration will be started. The lounges are to be redecorated and current fundraising is to purchase a large flat screen for residents. The external areas of the grounds are also to receive attention. The recent upgrading in the home includes a new boiler, new fire system and a new emergency call system. There is a space allocated on the ground floor in the corridor area for use by the deputy manager. We were told that this is to be moved to the upper level to provide more space and ensure confidentiality. On touring the home we noted that rooms and bathrooms contain a great many toiletries that are accessible to all residents. This was discussed with the manger as toiletries should not be shared and do not therefore need to be stored in the bathrooms. We also asked about risk assessments regarding all toiletries as these were not seen on care plans. The upper floor landing now houses the new boiler but the pipes and various wiring connected to this boiler are exposed and therefore pose a risk to people in the home, particularly those with rooms on this floor. New curtains have been ordered that will replace the currently old and damaged curtains in place in some areas. Doors have kick closers to comply with fire regulations. Two rooms had objects holding the windows open such as piqued paraffin and a block of wood as the windows are broken and have not been repaired. We saw that this was noted in the maintenance book but no action had been taken since this was recorded. This currently leaves residents and staff at risk, the deputy manager said she would deal with this today. We saw one bathroom that is in need of upgrading as this presents a very dull and gloomy room. This bathroom also has a light pull that is directly over the bath and hanging very low to the bath, presenting risk to residents in a number of ways. This again was discussed with the deputy manager. Care Homes for Older People Page 17 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are trained and supervised but staffing numbers are not currently sufficient to fully meet the needs of residents. Evidence: There were three care staff on duty at the start of this inspection and it took some time before one member of staff was able to answer the front door. We were told that two members of staff were dealing with the personal care of a resident. There was also one domestic person and one housekeeper who oversees Eastgate House and the adjoining home that is registered independently by the same organisation. There is one maintenance person and a gardener, two kitchen assistants and one cook. The home is currently recruiting for a tea time cook to assist at this busy time and allow care plans to be updated. Two laundry posts are also being planned to allow staff more time with the residents. Discussions were undertaken with care staff and the deputy manager at this time regarding the care needs of residents. We were told that two residents need to be hoisted when necessary and one or two others may also need two staff depending on their physical condition on a day to day basis. We therefore questioned the suitability of having three care staff on duty with residents needing two staff. The deputy manager explained that she is on duty during the day and was actually over at the Care Homes for Older People Page 18 of 28 Evidence: adjoining home at the time of our arrival. Staff have completed training regarding such areas as Parkinsons disease and diabetes. If insulin is requred the district nurse would deal with this but there are no current insulin dependent residents in the home. Training has also been completed for moving and handling, fire safety, health and safety, COSHH and infection control. Appropriate practices are in place regarding the recruitment of new staff. These include criminal record checks, two references and the issue of contracts to staff. Care Homes for Older People Page 19 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home does not currently have an appointed manager and the complete safety and well being of people is not fully supported. Evidence: The home does not have a registered manager but the current deputy manager assisted us at this inspection and with documentation. However, the registered manager in the home next to Eastgate House, that is owned by the same provider, did give us a tour of the premises and is also on hand to oversee Eastgate House when needed. The lack of continuous management in the home is evident as there is an absence of monitoring systems in place to ensure all areas of safety and well being are maintained. The completion of a notification known as regulation 37 was discussed with the deputy manager. While these have been completed, certain additional reports have been needed for certain incidents that have occurred in the home. Care Homes for Older People Page 20 of 28 Evidence: There is a quality assurance manual in place in the home along with policies and procedures. Supervision of staff in undertaken every other month. There are planed improvements to the home that include an external walkway and the installation of security cameras. However, there needs to be a completed environmental risk assessment to ensure the safety and well being of residents, staff and visitors is supported at all times. Care Homes for Older People Page 21 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 31 9 The Registered person must 10/04/2009 consider the effectiveness of current management arrangements at the Home This is so that the Home is properly managed during the current period of change. Care Homes for Older People Page 22 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 13 The plan for residents in the 18/12/2009 home meets relevant clinical guidelines produced by the relevant professional bodies concerned with the care of older peopole and includes a risk assessment with particular attention to prevention of falls. That risk assessments are on every care plan to support the health and safety of residents and staff. 2 9 13 The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the home. A more appropriate area must be identified for the storage of medication. To ensure the appropriate 26/03/2010 Care Homes for Older People Page 23 of 28 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 storage and handling of medication is met. 3 15 16 The registered person 27/11/2009 conducts the home so as to maximise the residents capacity to exercise personal autonomy and choice. Meals must be discussed with residents, individual preferences recorded and reflected in the menu that must be on display in the home. 4 15 16 A snack meal should be offered in the evening and the interval between this and breakfast the following morning should be no more than 12 hours. Snacks must be offered during the evening to cover the time scale before breakfast the following day as residents will not always ask for snacks themselves. 5 16 22 A record is kept of all complaints made and includes details of investigation and any action taken. All complaints, minor or otherwise, are to be fully recorded at all times. 27/11/2009 27/11/2009 Care Homes for Older People Page 24 of 28 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 6 19 13 That all parts of the home to 04/12/2009 which residents have access are so far as reasonably practicable free from hazards to their safety. All areas of the home are assessed (in this instance specifically broken windows, pipework, accessible toiletries and light fittings) to provide a safe environment for people. 7 20 23 Lighting in communal rooms is domestic in character, sufficiently bright and positioned to facilitate reading and other activities. Lights need to be bright enough to support the needs of all residents and staff. 31/12/2009 8 27 18 Staffing numbers and skill mix of qualified/unqualified staff are appropriate to the assessed needs of the service users, the size, layout and purpose of the home at all times. That the needs of current residents must be reviewed and the appropriate staffing numbers reflected on all shifts. 04/12/2009 9 31 8 The registered provider shall 31/05/2010 appoint an individual to Care Homes for Older People Page 25 of 28 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 manage the care home where there is no registered manager in respect of the care home and the provider is not in full time day to day charge of the home. The home requires a registered manager who is appropriately trained, is not responsible for more than one home and to provide clear lines of accountability within the home. 10 38 23 The registered manager 31/12/2009 ensures so far as is reasonably practicable the health, safety and welfare of service users and staff. The home must be kept in a condition that ensures, so far as is practicable, the health and safety of all persons using the premises. 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 15 It would benefit residents if they have information about the staff who are due on duty or a board with staff pictures and names available for them to refer to. This would help residents to feel they knew all the staff and also act as a prompt if a person has some memory loss. It is recommended that a system is developed to ensure all 2 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 maintenance jobs are fully completed in an acceptable timescale for the well being of residents and staff. 3 38 It would be practical to ensure that staff are allocated the responsibility of checking the safety of the premises, both internally and externally, on a regular basis. Such checks should be fully recorded and then addressed where necessary. 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. 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