Care Home: Falcon House Care Home

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What the care home does well Detailed assessments are carried out so that it is clear that a person`s needs can be met at Falcon House before they come to stay there. People are consulted about the care they wish to receive and have opportunities to discuss what is working well or what needs to change. There are opportunities for people to participate in activities. Staff ensure people receive a suitable diet. People know that their concerns or complaints would be taken seriously and the provider attends meetings at the home where people are invited to discuss issues that inform the improvement of the services provided. Falcon House provides homely and comfortable accommodation for the people who live there and the staff welcome the involvement of families and friends. What has improved since the last inspection? The provider has improved the information available to prospective residents to ensure the information provided is fully up to date. They have ensured that people receive a proper assessment before agreeing admission and they are consulting with people about how they wish to be supported and cared for at the home. People`s health is being monitored better and there is prompt referral for assessment by external health care professionals as required. Care plans are up to date and staff are trained to plan care appropriately. People are supported in a way that upholds their privacy and dignity. People with nutritional problems have all their diet recorded each day to ensure staff are alerted to any changes in their condition that may require referral to the dietitian or Doctor. There is an activities worker now employed who is developing lots of opportunities for people to participate in events and activities. Complaints are taken seriously and regular consultation is taking place through care planning reviews and resident / relative meetings with the provider and acting manager. Work has been completed to improve the environment and address issues of health and safety as required. There is a programme of learning for all staff and they have undertaken lots of training to bring them up to date with their practice. There is an acting manager appointed who tells us she is applying to register with the commission as required. What the care home could do better: The provider has recently received our random pharmacy inspection report that demonstrates areas of non compliance with safe medication practices. Medication must be managed safely for the health and wellbeing of people who live at the home. Care plan reviews that determine changes to the way someone is supported should inform the development of a fully revised care plan that describes the detail of how the person is to be supported. You must complete risk assessments for the safety and vulnerability of the people living at the home. Key inspection report Care homes for older people Name: Address: Falcon House Care Home 2 Middle Street Beeston Nottingham NG9 1FX     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: Mary OLoughlin     Date: 1 3 0 5 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Falcon House Care Home 2 Middle Street Beeston Nottingham NG9 1FX 01159228151 01159223759 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Minster Care Management Limited Name of registered manager (if applicable) Mrs Jacqueline Gamble Type of registration: Number of places registered: care home 46 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 46 The registered person may provide the following category of service only:- Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories:- Old age, not falling within any other category- Code OP Dementia - Code DE Date of last inspection Brief description of the care home Falcon house is a purpose-built modern home providing accommodation for up to 46 people. The care home provides personal care for people who have needs due to older age and or dementia. There are bedrooms, bathrooms, lounges and dining rooms on ground and first floor levels. The first floor can be accessed via a shaft lift or stairs. The home is in the centre of Beeston near to local shops and amenities. There is a car Care Homes for Older People Page 4 of 29 Over 65 0 46 46 0 Brief description of the care home park to the rear of the home. Bus routes operate along the road outside the home. The range of fees are from £366.00.00 to £475.00 per week. The last inspection report is made available within the reception area of the home. 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: 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: The focus of inspections undertaken by the Care Quality Commission(CQC) is upon outcomes for the people using the service and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of the service that need further development. Prior to our visit an analysis of all the information we have received about the home since our last inspection was undertaken. We looked at what the manager had told us in the Annual Quality Assurance document(AQAA) and the responses we received from our Have Your Say surveys which we sent to residents at the home. Care Homes for Older People Page 6 of 29 The main method of inspection used was called case tracking, which involves looking at the quality of care received by a number of people living at the home.We use evidence from our observations, from speaking to people about their experience of living at the home, talk to staff about their understanding of peoples needs and the training they receive to support them in their role. Nottinghamshire County Council sent us a report following their monitoring visit to the home on 31/03/10 and we used this information to inform our inspection. We also received a report from the Environmental Health Officer following their compliance visit and inspection of the premises as a result of a reportable accident on 26/04/10. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? The provider has improved the information available to prospective residents to ensure the information provided is fully up to date. They have ensured that people receive a proper assessment before agreeing admission and they are consulting with people about how they wish to be supported and cared for at the home. Peoples health is being monitored better and there is prompt referral for assessment by external health care professionals as required. Care plans are up to date and staff are trained to plan care appropriately. People are supported in a way that upholds their privacy and dignity. People with nutritional problems have all their diet recorded each day to ensure staff are alerted to any changes in their condition that may require referral to the dietitian or Doctor. There is an activities worker now employed who is developing lots of opportunities for people to participate in events and activities. Complaints are taken seriously and regular consultation is taking place through care planning reviews and resident / relative meetings with the provider and acting manager. Work has been completed to improve the environment and address issues of health and safety as required. There is a programme of learning for all staff and they have undertaken lots of training to bring them up to date with their practice. There is an acting manager appointed who tells us she is applying to register with the Care Homes for Older People Page 8 of 29 commission as required. 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 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. The service ensures that they obtain a comprehensive assessment of each persons individual needs before they agree admission. Evidence: Following our last key inspection of the home the provider sent us an improvement plan that told us he would review the information they provide to prospective residents to ensure they provided clear information to support peoples choice about admission. They also told us that each time they assessed a prospective resident they would ensure they liaised with the person and their representative to ensure the information contained in the assessment was an accurate reflection of the persons needs and wishes regarding their care. They told us the person would be asked to sign the assessment and that they would provide a letter confirming the outcome of the assessment to the prospective resident. Care Homes for Older People Page 11 of 29 Evidence: During the inspection visit we looked at the admission records of three people. We saw records for two people showed that a detailed assessment was carried out before they moved into the home. This helps staff to be confident that the persons needs can be met there. We also found that the staff had obtained another assessment which was completed by social workers involved with each person, they used the information within those assessments to build a clear picture of each person. One person had incomplete records but relatives told us that the acting manager had visited them and ensured an assessment was undertaken. The assessments contained information about the individual needs of each person and staff told us they had ensured that people were involved in decisions about their care or represented by relatives in their best interests, the assessment was not signed by the prospective resident or their representatives. A relative told us In the few weeks my relative has been here she is much happier and we feel confident in the staff team. We saw how information about the home has recently been reviewed and updated by the provider, this provides people with information about the home, its facilities and services and is displayed in the main entrance to the home. On 31/03/10 we received six responses to our surveys from people living at the home which told us that all six felt they had received enough information about the home before they came to stay. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their health and personal care provided according to their needs and wishes and medicine management is improving. Evidence: Our last inspection in February 2010 found that people were not always consulted about the care they wished to receive and care plans did not set out in detail the up to date health and personal care needs of each individual. The provider sent us their improvement plan which told us that a more comprehensive care management plan was being introduced, staff would receive training in how to produce written records and person centred care planning, residents and their representatives would always be consulted and health issues would be referred to the appropriate agencies for any health care needs. On this inspection we looked at three care plans which showed that staff had consulted with the individual and their representatives about the care and support they wished to receive. The plans were reviewed regularly but the actual written care Care Homes for Older People Page 13 of 29 Evidence: plan did not fully reflect updated needs and may not provide clear guidance to staff who are not familiar with the individual. We spoke to the relatives of those people we case tracked and they told us that they were consulted and found that the staff team were much improved, ensuring that people received their diet as required and were helped to mobilise to maintain their independence. One visitor told us My relative had been very ill in hospital and since her return to the home the staff had worked very hard, helping to feed her, she said she also visited many times during meals and she observed staff always helping to feed those that needed help. She said the staff had helped her relative become more mobile. She said she had seen the care plans and had signed them in agreement. She said the staff team are much better now, the home is better all round, her relative is safe and well, and management more responsive. A recently admitted resident told us that she had settled into the home well and found the staff knew how to look after her, always communicated with her and supported her needs. We received six responses to our Have Your Say surveys from people living at the home and all of them felt they received the medical care they needed. Nottingham County Council have recently monitored the home, reviewing the care that people receive and they tell us they have no new concerns about the home, they saw lots of improvements taking place including staff training in how to plan care. The staff training records we looked at demonstrated that they had received person centred care planning training. Our last key inspection made requirements for the improvement of medicine management at the home. The Care Quality Commission also undertook a random pharmacy inspection at the home in April 2010 and made requirements as a result of issues that were identified. Care Homes for Older People Page 14 of 29 Evidence: During this key inspection we spoke to the provider and he told us that they would continue to work towards improving the management of medicines. We saw evidence that the acting manager is going to undertake competency assessments for all staff that administer medicines with the help of the local Primary Care Team Medicine Management Co-coordinator. The acting manager also told us that she has endorsed the Governments dignity challenge which sets out a national expectation of what constitutes a service that respects peoples dignity. They have appointed staff members as dignity champions to raise awareness of the issues and implement changes in the home to improve the outcomes for people living there. 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. People are given access to social and recreational activities inside the home and the community. The service actively encourages the involvement of relatives and friends. Evidence: Following our last inspection the provider has improved the way activities are organised at the home. A newly appointed activities worker has made many improvements to the day to day opportunities for people to participate in activities. We saw a weekly event calender that is displayed within the main entrance to the home which reflects activities take place such as Bingo, sing a longs and exercise class. Residents we spoke with confirmed that they take part in these activities and feel events are suited to their needs. Our recent Have Your Say surveys were positive showing all respondents felt they had opportunities for activities and they liked the meals provided. Care Homes for Older People Page 16 of 29 Evidence: The provider has also shows he has listened to the concerns people had expressed that they could not recognise who staff were, by providing staff with brightly coloured shirts it makes them instantly recognisable and clearly visible for people who may have visual impairment. We saw photographs of a recent Sunday lunch time where relatives had been invited to have lunch at the home sharing a table as a family. The provider told us that this was going to be a regular event where residents could have their family over for Sunday dinner, they are not charged for this but donations to the residents fund is appreciated. We saw fresh fruit and drinks were available in the lounge and dining area. We saw records of diets provided for people at nutritional risk and an audit report for analysis of each persons weight on a monthly basis which the providers improvement plan tells us is used to determine if people need to be referred to the dietician. We case tracked one person at nutritional risk and identified that staff had ensured appropriate support was in place, however the weight analysis and nutritional risk assessment was not referred to within the review section of the diet care plan to determine what action would be required to meet the current nutritional need. 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. People are now being listened to and there is a robust complaint procedure in place. Staff are trained to respond to any suspicion or allegation of abuse. Evidence: Our recent Have Your Say surveys told us that people felt the staff listened to them and acted on what they said, they said they knew how to raise a complaint and had someone they could speak with if they had concerns. We looked at the homes complaint records and saw that the operations manager had documented concerns but did not always identify the dates these were responded to or sign the records, this would not ensure that the homes policy to respond to people within a timescale would be suitably met. There have not been any safeguarding investigations since our last inspection. We saw that people are consulted on their experiences at the home through care plan reviews and regular meetings with the management to ensure they have an opportunity to say what is working well for them and if anything needs to change. The Operations manager told us that all the staff have received training in how to safeguard people from abuse and the two staff files we examined had evidence of this through retained certificates. They have also trained staff to deal with any challenging Care Homes for Older People Page 18 of 29 Evidence: behaviour to ensure any aggression is dealt with safely and people are protected. The Care Quality Commission has received one complaint since our last inspection which is presently being investigated by the provider. 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 environment is suitably maintained. Evidence: The acting manager told us that they now have a maintenance file that provides a record of routine maintenance. During the inspection we saw that the home was clean and well maintained. We saw that flooring in three bedrooms had been changed to laminate after re-surfacing to provide a more level flooring that did not pose a trip or fall hazard. The acting manager also informed us that they have recently changed energy saving light bulbs to more efficient lighting to prevent the risk of trips and falls. The provider told us that work had been completed on an external garden area to make it safe and that they were looking to obtain suitable seating to enable people to sit outside during the summer months. Care Homes for Older People Page 20 of 29 Evidence: The acting manager told us that some mattresses had been replaced as part of the improvements around the home. We did not re-inspect the infection control standards at this inspection as our last inspection in February 2010 found no shortfalls in infection control procedures and we have not received any information to suggest there are any changes in the homes adherence to safe practice. 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. Adequate staffing levels are maintained and staff are trained in the needs of the people they are caring for. Recruitment practices show people are safeguarded from those who may be unsuitable to work with vulnerable adults. Evidence: We examined the recruitment files of two people and we saw that the records demonstrated that the recruitment procedure is robust and is followed in practice. We saw that each staff file contained all the paperwork that is needed, including proof of identity, satisfactory references and a CRB (Criminal Records Bureau) Enhanced Disclosure. We also found that there was evidence that staff had an induction soon after starting work to ensure they were not put in situations they could not handle. The induction programme is a recognised Skills for Care programme that sets out minimum learning outcomes for new staff over the first twelve weeks of their employment to ensure they are prepared for their expected roles. The operations manager told us that all the staff have completed training to ensure they are regularly kept up to date and the staff records we examined showed that a Care Homes for Older People Page 22 of 29 Evidence: full training programme had been completed. The operations manager has ensured that all new staff are enrolled on a National Vocational Training (NVQ) course but as many new staff are in post the home has not yet met the minimum 50 for the numbers of staff trained to level 2 NVQ. The Nottingham County Council Adult Social Care monitoring officers told us that they had evidenced training being completed when they visited the home recently as part of their monitoring of the service. All six respondents to our Have Your Say surveys tell us that people feel they receive the care they need and that there is always enough staff on duty. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of the home is improved and through consultation the quality of the services are being continuously reviewed. Evidence: Since our last key inspection which identified many areas of concern the provider has engaged with the Care Quality Commission and other agencies including Nottingham County Council Adult Social Care and Health department, Environmental Health Department and the Primary Care Teams pharmacy advisors. There has been continuous improvement in the quality of the services provided at the home identified by all agencies. The service had all admissions suspended by the local councils until identified improvements had taken place. The admission suspension is now lifted as the County Council monitoring officers have told us all the required improvements have now taken place. Care Homes for Older People Page 24 of 29 Evidence: The provider sent the Care Quality Commission an action plan following our last inspection which told us how improvements in the service would be made. This inspection has identified many of the agreed improvements as completed and work is continuing to improve the outcomes for people who live at the home. The provider told us in the improvement plan that they would keep records of all safeguarding investigations. We recognise that there have been no safeguarding investigations since our last inspection, however, information should be held about the investigations over the last year to inform the quality of the service and ensure lessons are learnt. The provider has appointed a new acting manager and tells us that this person will be applying to register with the Care Quality Commission. During the acting managers induction period she is being supported by the providers Operations Manager. Our inspection found that there has been improved consultation with people using the service and their representatives and regular meetings have been held at the home for people to have a say in how the home is run, discuss what is working well or what needs to change. The last inspection found that the home does not manage peoples finances and when we asked the the acting manager about this she confirmed that they do not manage any personal finances for residents. We were notified of an accident occurring at the home recently and we received information from the Environmental Health Department regarding areas that required improvement. We saw during this inspection that the provider has addressed these required improvements to ensure floors that were uneven have been re- surfaced and made safe and the operations manager told us, areas that had reduced lighting because of energy saving bulbs have been risk assessed and suitable lighting is in place. The acting manager could not confirm if environmental risk assessments were in place and we saw no record of assessments on the care records of those people we case tracked. Care Homes for Older People Page 25 of 29 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 9 13 You must ensure that there 28/02/2010 is a policy and staff adhere to procedures, for the receipt, recording, storage, handling, administration and disposal of medicines, and service users are able to take responsibility for their own medication if they wish, within a risk management framework. To ensure that service users receive their medicines as prescribed. 2 28 18 You must ensure that the 30/11/2010 home has a minimum ratio of 50 of care staff trained to level 2 National Vocational Qualification. To ensure staff are trained in the needs of people in the home. 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 1 8 15 You must ensure that 17/06/2010 following a care plan review where changes are indicated that these changes are reflected in the actual care plan and not left as part of the running review records. To ensure that staff looking at the actual care plan are informed of the full up to date actions that are necessary to support the individuals safely. 2 38 13 There should be a record of environmental risk assessment within each persons care plan. To ensure the health, safety and welfare of people living at the home. 30/07/2010 Care Homes for Older People Page 27 of 29 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 3 Ensure that the pre- admission assessment document contains the names of all those involved and wherever possible is signed by the prospective resident or their representatives. Always confirm your decision in writing to prospective service users following pre- admission assessment, and wherever possible they should sign the assessment. Ensure that the pre- admission assessment informs a care plan from the start of admission which will ensure staff are fully informed and proper arrangements are immediately in place to address the identified needs. Ensure that the care plan review shows that information from weight analysis and nutritional risk assessment is used to determine the support required for the individual to maintain safe nutrition. This information will also provide evidence of the date people are referred to the dietician. Ensure complaint records are signed and dated. Ensure that safeguarding records are held and that the issues arising are followed up promptly and action taken is recorded. 2 3 3 3 4 15 5 6 16 33 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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. 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