Care Home: Ferncross

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What the care home does well The majority of people we consulted both in writing and during our visit, expressed satisfaction with the home and made some very positive comments. These included; `I cannot praise the home enough for the love, care and attention they have shown.` `We have absolutely no complaints about Ferncross, everything is excellent.` `I am glad that I am in this home, we are very well looked after.` We were also able to speak with some visitors to the home during our inspection including some relatives and a social worker. Again we received very positive feedback with one person telling us ``This home is such a friendly, caring place. Caring for people is what they do best.`` Throughout our visit we observed carers going about their duties and interacting with residents. The atmosphere was very pleasant and residents clearly got along well with the staff and the manager of the home. Residents were seen taking part in various activities including singalongs and games with the staff. Ferncross is a small home with a very low turnover of staff. This means that people receive their care from staff who know them well and understand their needs. Staff we consulted told us that they feel well supported by the manager and able to contribute their views and ideas about the running of the home. People told us that staffing levels at the home were generally adequate to meet the needs of people living there. One relative stated in their written survey `There always seems to be someone available when you need them.` The manager has a good approach to training and records showed that the majority of staff had attended courses in areas such as moving and handling and caring for people with dementia. For all those staff who had not yet completed the training, courses were booked for the near future. It was also pleasing to note that three quarters of the staff at the home hold nationally recognised qualifications in care at level 2 or above. What has improved since the last inspection? The manager has made some improvements to care planning processes. We found during this visit that care plans contained a better level of information, particularly about people`s social care needs and how they wished to spend their time. We have made some more recommendations to support further development in this area. We found that good improvements had been made in the way the home manage people`s medication resulting in safer systems. Processes for recording medicines received, administered and disposed of were much clearer which would enable the manager to carry out more effective audits.No discrepancies were found in the medication stock or records demonstrating that staff were checking records more carefully when administering people`s medicines. A number of improvements have been made to the environment including the provision of a new, accessible shower room for the use of people who live at the home. Better arrangements for the storage of residents` personal hygiene products were seen to be in place and we were also able to confirm that staff at the home were working in accordance with their COSHH (control of substances hazardous to health) policy. Arrangements for formal supervision of staff were seen to be improved and records demonstrated that a system for the regular appraisal and supervision of staff was now in place. What the care home could do better: Whilst we noted that the level of information in people`s care plans had improved, we found some examples where more detailed information and guidance would be of benefit. This was usually in relation to residents` more complex behavioural needs. Having very clear guidance in place for staff means that they can approach challenging situations consistently and confidently. Following the last inspection of the home we made a requirement that legally compliant controlled drugs storage must be provided at the home. We found during this visit that the manager had obtained new storage but that this was still not compliant with current legislation. As such, we have repeated the requirement in this report. Some residents at the home are prescribed medicines on an `as and when required` basis. It is very important in these circumstances that clear guidance is in place for staff about when such medicines should be administered, to help ensure that people receive their medication at the right time. We found some examples where this guidance was not in place. The home has a person centred approach to activities and we saw evidence that attempts are made to meet people`s individual needs in this area. However, we made a recommendation that the manager review the activities programme particularly in relation to people who have a high level of cognitive impairment. We noted during our tour of the home that some residents` bedroom doors didn`t have their names on. We have made a recommendation that either names or other visual prompts be put on residents` doors to assist them in recognising their own rooms. We were able to confirm that the manager follows safe recruitment practices when appointing new staff to help ensure only suitable people are employed to work at the home. However, we made some recommendations regarding the recording of recruitment processes to help ensure that thorough procedures are followed at all times. Key inspection report Care homes for older people Name: Address: Ferncross 4 Crossdale Avenue Cross Cop Heysham, Morecambe Lancashire LA3 1PE     The quality rating for this care home is:   two star good 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: Marie Cordingley     Date: 0 8 0 4 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 30 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 30 Information about the care home Name of care home: Address: Ferncross 4 Crossdale Avenue Cross Cop Heysham, Morecambe Lancashire LA3 1PE 01524850008 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Draycombe House Care Ltd Name of registered manager (if applicable) Mrs Ann Withers Type of registration: Number of places registered: care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The home may accommodate eleven service users in the dementia (DE) category and four named service users in the category of old age (OP). All further admissions to the home must be of the dementia (DE) category. No more than fifteen service users may be accommodated in the home at any one time. Date of last inspection Brief description of the care home Ferncross is situated in Heysham and is a home for older people who have a dementia. The home can accommodate a maximum of fifteen people in mainly single bedrooms. A double bedroom is available. The bedrooms are located on the ground and first floor. A passenger lift gives access to the first floor for those who require it. There are 2 Care Homes for Older People Page 4 of 30 Over 65 0 4 11 0 0 1 0 7 2 0 0 9 Brief description of the care home lounges and a separate dining room. There is also a well-maintained garden where the people can sit/walk in safety. The current fees for receiving care at this home are 390 to 425 pounds per week according to the assessed needs of the individual. Draycombe House Care Ltd owns the home and Mrs Ann Withers one of the Directors of the company manages the home on a day to day basis. Care Homes for Older People Page 5 of 30 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: The inspection of this home included a site visit which was carried out on an unannounced basis. This meant that the manager and staff did not know the visit was to take place until we arrived. During the visit we spent time with residents, talking to them and observing their daily routines. We also held discussions with staff at the home and the manager. We carried out a tour of the home looking at communal areas and a selection of residents private accommodation. We also viewed a variety of paperwork including residents care plans and staff personnel files. Prior to our visit we wrote to the manager and asked her to complete a very comprehensive self assessment. This gave us a lot of information about how the home is managed. In addition, we wrote to a selection of residents and staff and asked them Care Homes for Older People Page 6 of 30 to take part in a written survey about their opinions of the service provided. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? The manager has made some improvements to care planning processes. We found during this visit that care plans contained a better level of information, particularly about peoples social care needs and how they wished to spend their time. We have made some more recommendations to support further development in this area. We found that good improvements had been made in the way the home manage peoples medication resulting in safer systems. Processes for recording medicines received, administered and disposed of were much clearer which would enable the manager to carry out more effective audits. Care Homes for Older People Page 8 of 30 No discrepancies were found in the medication stock or records demonstrating that staff were checking records more carefully when administering peoples medicines. A number of improvements have been made to the environment including the provision of a new, accessible shower room for the use of people who live at the home. Better arrangements for the storage of residents personal hygiene products were seen to be in place and we were also able to confirm that staff at the home were working in accordance with their COSHH (control of substances hazardous to health) policy. Arrangements for formal supervision of staff were seen to be improved and records demonstrated that a system for the regular appraisal and supervision of staff was now in place. 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. Care Homes for Older People Page 9 of 30 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 10 of 30 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 11 of 30 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. Carers have a good understanding of peoples needs from the point that they are admitted to the home. Evidence: A Service User Guide is available to anyone making enquiries about the home. This is a useful document which provides a great deal of information about the service including the facilities available and fees charged. In addition, the guide gives the reader a picture of daily life at the home by describing arrangements in areas such as mealtimes and activities. Currently the Service User Guide is only available in a standard written format which may not be accessible to some people. As such, we have made a recommendation that the manager considers making the guide available in other formats such as audio and easy read for example. Care Homes for Older People Page 12 of 30 Evidence: We were able to confirm that the manager ensures that a pre-admission assessment is carried out for all prospective residents before they are offered a place at the home. This is important because it means that the manager can be sure that the home can meet the prospective residents needs and that it is the right place for them. It also means that carers have some understanding of new residents care needs and can plan their care accordingly. In line with a recommendation made at the last inspection, the home have now started to use a standard format for assessment. This is good practice because it helps the manager ensure that all areas of a persons care needs are taken into account during the assessment process. Assessments we viewed contained a good level of information about peoples daily care needs and also included more person centered information such as peoples social histories, preferences in relation to how they spend their time and valued relationships. Obtaining a good level of person centered information during the assessment process helps ensure that carers can tailor care and support to meet peoples individual needs and preferences. Care Homes for Older People Page 13 of 30 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. People who live at the home are provided with a good standard of care that is in line with their individual needs and wishes. Evidence: The people we spoke with during our visit and those who responded to our written survey told us that they were happy with the way their care was provided. We also spoke with a visiting social worker who had reviewed the care for a number of people who live at the home. She told us that she felt the home did very well in meeting residents needs and described the home as very friendly and welcoming. As part of our case tracking exercise we viewed a number of residents care plans. We found that care plans were generally comprehensive in terms of peoples physical and health care needs. Some examples were particularly good and provided a good level of information about peoples preferences in relation to their daily routines and how they wanted their care to be provided. We noted that efforts had been made to make care plans more person centered and in Care Homes for Older People Page 14 of 30 Evidence: most cases, care plans addressed areas such as social activities, relationships and emotional wellbeing. However, we did view some examples where this sort of information was still missing, particularly in relation to peoples more complex behavioural needs. Despite some gaps in care planning information we were able to determine that carers had a good understanding of peoples needs and how to support them. As such, we were satisfied that the shortfalls in paperwork had not led to any short falls in the care provided to people. However, we did make a recommendation that the manager continue to develop residents care plans to ensure that they contained detailed guidance. Residents daily records demonstrated that carers were quick to identify any problems and take the appropriate action, for example seeking advice from community health care professionals on behalf of any residents who needed it. The home have systems in place for the safe receipt, storage, administration and disposal of peoples medication. We viewed a number of records relating to medication and found these to be in good order and well maintained. We found some general improvements in the way medicines records and stock were organised. Records of medicines received, given to people and disposed of were clearer and a better system of stock control had been developed that made accounting for medicines much more straight forward. We checked a sample of medicines and found they usually added up showing they had been given correctly. We found no discrepancies in the stock and records we checked. Some people who live at the home are prescribed medicines on an as and when required basis. We advised the manager to ensure that comprehensive information about how and when such medicines should be given is in place in all cases. We looked at how medicines were checked and audited. We saw evidence of regular checks carried out by the manager. This is good practice as it enables the manager to quickly identify and address any errors. We were able to confirm that the home has a system in place for checking the competence of all staff who deal with residents medication. In addition, these competence checks are regularly reviewed which helps ensure that staff have the necessary skills and knowledge to manage peoples medicines safely. Care Homes for Older People Page 15 of 30 Evidence: Following the last inspection we made a requirement that the home have legally compliant storage in place for controlled drugs. The manager had arranged new storage for controlled drugs, however, on viewing this we noted that it was still not fully legally compliant. As such, we have repeated the requirement in this report. Care Homes for Older People Page 16 of 30 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 enabled to choose how they spend their time and are supported to take part in activities they enjoy. Evidence: Residents we consulted told us that the homes routines were flexible and that they were able to make choices in their daily lives, such as when to get up or have their meals. This was also evident when viewing peoples daily care notes which often referred to people deciding to have lie ins, or having their meals at later times for example. In general, people we spoke with during our visit and those who responded to our written survey told us that they were satisfied with the range of activities provided at the home, although two people stated that they felt the home could improve by increasing the number of organised activities. The majority of peoples care plans we viewed contained information about their hobbies and how they liked to relax and spend their time. The manager advised us that she had attempted to use a more person centred approach to activities meaning that more one to one time was provided for people, particularly those who chose not Care Homes for Older People Page 17 of 30 Evidence: to take part in group activities. We made a recommendation that the manager further explore the area of activities specifically for people with dementia who experience a high level of cognitive impairment. People we consulted told us that they were satisfied with the quality and variety of meals provided at the home. One person who responded to our written survey told us The meals are always of the best quality. We discussed menus and were advised that although people werent offered a choice of main meal on a daily basis, staff were aware of all the residents likes and dislikes and ensured that everyone was provided with a meal according to their personal tastes. We also saw evidence in residents daily diary notes that any individual requests were catered for. We made a recommendation that consideration be given to providing all residents with a choice of at least two main meals on a daily basis. This would increase opportunities for people to make decisions and choices on a daily basis. We also repeated a recommendation made following the homes last inspection, that pictorial menus be provided for people who are unable to access written information. Care Homes for Older People Page 18 of 30 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 enabled to raise concerns and their concerns are taken seriously. Evidence: The home has a complaints procedure in place which is clearly written and easy to understand. We viewed the procedure and found that it contained all the appropriate information required and contact details of relevant people. In discussion, the acting manager advised us that the procedure has now been made available in large print. We made a recommendation that the guide also be made available in formats such as audio to help ensure more people have got access to the information. The home keeps a record of all complaints or concerns raised. We viewed this and found that the home had not received any complaints since the last inspection. In addition, no concerns or complaints have been raised with the Commission about the home since their last inspection. The manager and staff we consulted showed a good understanding of safeguarding procedures. Carers were aware of whistleblowing procedures and told us that they felt confident that any reports of abuse or bad practice would be dealt with appropriately. Training records held within the home showed that about half the staff team have Care Homes for Older People Page 19 of 30 Evidence: completed training in the Safeguarding of Vulnerable Adults. We also noted that further training was planned for remaining staff. Care Homes for Older People Page 20 of 30 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 who live at Ferncross are provided with comformatble and homely accommodation. Evidence: Ferncross is a spacious home with a variety of communal areas for residents to spend their time in, including well maintained outdoor space. Currently, all accommodation is provided on a single room basis and we were also able to confirm that residents can be provided with key for their rooms should they wish. We carried out a tour of the home and found all areas to be clean, warm and comfortable. Residents bedrooms were nicely decorated, furnished and personalised with pictures, ornaments and other treasured possessions. However, we did notice that some of the residents bedrooms didnt have their name on or any way of helping them to identify their room. We have made a recommendations that this be addressed. We noted that a number of improvements had been made to the environment since the homes last inspection including the provision of a new shower room for the use of residents. In addition, more appropriate storage has now been found for residents personal hygiene items which had previously been stored in a communal bathroom. Care Homes for Older People Page 21 of 30 Evidence: The manager confirmed that there is guidance in place for staff in the area of infection control and records showed that the majority of staff had carried out training in this area. Care Homes for Older People Page 22 of 30 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 receive their care from a consistent and well supported staff team. Evidence: During our visit we viewed a selection of staff personnel files to assess the homes recruitment processes. We found that in general, the manager followed careful procedures to ensure that only suitable people were employed at the home. In all the files we viewed we found evidence that the manager had carried out appropriate background checks before offering employment. Such checks included references and Criminal Records Bureau Disclosures. However, we made some minor recommendations to further support improvements in this area, which included ensuring that references were dated and that the relationship between the applicant and the referree was made clear on each individual reference. During our visit we noted that staffing levels appeared to be appropriate to meet the needs of people living at the home. Carers were observed spending time with residents and providing care in a relaxed and unhurried manner. People we consulted told us that they felt staffing levels were adequate. One relative told us There always seems to be someone available when you need them. We were able to confirm through viewing records and through discussion, that all staff Care Homes for Older People Page 23 of 30 Evidence: are provided with induction at the start of their employment. In addition, ongoing training is provided which includes the key health and safety areas such as moving and handling, as well as other areas to help people carry out their roles well including caring for people with dementia. Records in the home showed that three quarters of all the carers at the home hold nationally recognised qualifications in care. This means that the home have exceeded the national target in this area. We noted when viewing information provided by the manager, that the home have a very low turnover of staff. This benefits people who live at the home because it means they receive their care from people they know well and who understand their needs. Care Homes for Older People Page 24 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home benefits from strong leadership and is run in the best interests of people who live there. Evidence: Ferncross is a small, friendly home which is managed by the homes owner on a daily basis. The manager works in a hands on manner and knows residents and staff well. People we consulted told us that they found the manager very approachable and supportive. One relative told us I know I can go to her straight away if I had any concerns, her door is always open. The home has processes in place to ensure that quality is monitored in all aspects of the service. These include regular internal audits and an external quality assurance system, namely the Investors in People Award. There is a health and safety policy in place which is supported by a number of procedures in areas such as infection control, fire safety and COSHH (control of Care Homes for Older People Page 25 of 30 Evidence: substances hazardous to health). Information provided by the manager confirmed that these procedures are regularly updated to ensure that they are in line with the most recent legislation and good practice guidance. In addition, the manager confirmed that all necessary safety checks are carried out of the homes facilities and equipment at the appropriate intervals. Staff training records confirmed that the manager has processes in place to ensure that all staff receive training in the key health and safety areas such as moving and handling as soon as possible after their employment. This helps ensure that staff have the knowledge and skills to work with people in a safe manner. Care Homes for Older People Page 26 of 30 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 Appropriate storage for controlled drugs must be provided at the home. This is to help ensure the safety and wellbeing of people who live and work at the home. 14/07/2009 2 9 13 Appropriate storage for medicines requiring refrigeration must be provided at the home. This is to help ensure residents safety and wellbeing. 14/07/2009 Care Homes for Older People Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 1 The Service User Guide should be made available in a variety of different formats. This is to help ensure that more people have access to the information. Evidence that residents and where appropriate, their representatives have been involved in the development of their care plans should be obtained. The manager should continue to develop residents care plans to ensure that they contain detailed guidance for carers about all aspects of residents needs. This is to help ensure that people receive the care they need. All hand written entries on medication administration records should be witnessed and double signed. This is to help reduce the risks of errors. Clear guidance should be in place for all residents who are prescribed medicines on an as and when required basis. This is to help ensure that people get their medicines at the right time. The manager should explore the area of activties for people with dementia and ensure that the current programme meets the needs of all the people who live at the home. Page 28 of 30 2 7 3 7 4 9 5 9 6 12 Care Homes for Older People Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 7 8 9 15 15 16 Consideration should be given to the use of pictorial menus for those people who cannot access written information. All residents should be offered a choice of main meal on a daily basis. The homes complaints procedure should be made available in a variety of different formats. This is to help ensure that more people have to access to the information. All carers should be provided with training in the Mental Capacity Act and Deprivation of Liberty Safeguards. All staff should be provided with training in the area of Safeguarding Vulnerable Adults. All residents bedrooms should have their name on the door or an alternative visual prompt which helps them identify their bedroom. Evidence that CRB disclosures have been obtained for all staff members should be kept in the home at all times. All references should be clearly dated. This is to help ensure that only suitable people are employed to work at the home. All prospective employeees should be asked to provide a reference from their current or most recent employer. If this is not possible then a record should be made of the explanation provided. This is to help ensure that only suitable people are employed at the home. The nature of the relationship between an applicant and a referee should be made clear on the reference provided. This is to help ensure that only suitable people are employed at the home. Any gaps in a candidates employment history should be investigated and a record kept of any explanation provided. This is to help ensure that only suitable people are employed to work at the home. It is recommended that training be provided to carers in relation to appropriate language for record keeping. This is to help ensure that residents dignity is promoted at all times. 10 11 12 17 18 19 13 14 29 29 15 29 16 29 17 29 18 37 Care Homes for Older People Page 29 of 30 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. © 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. Care Homes for Older People Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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