Care Home: Florence Shipley

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What the care home does well There was a new manager at the home. They had made some positive changes, after consulting with residents and staff. There were regular resident and staff meetings. The environment was clean, fresh and welcoming. There was always a choice at each meal time. People spoken with were satisfied with the food provided. One person said "all food is nice every day". People spoken with felt looked after. One person said, "I came here to be looked after and they do it very well". Activities are provided for people. This includes musical bingo, Sherry evening, hand and nail care, crafts, movement and music, outside entertainers and trips when the weather is good. Most staff had been at the home for a number of years and know residents well. Comments about staff included, "the staff are good" and, "we have a laugh, a bit of fun, it`s nice". There was a good induction programme for new staff, and most people`s refresher training was up-to-date. Peoples health care needs were well met. A district nurse spoken with said that, "people are looked after very well". Where possible they try to help the person to remain at the home during their final days, with support from district nursing services. Medication is managed well, following good practice guidelines and respecting people`s privacy, independence and dignity. People are encouraged to be as independent as possible. One person said, "I like a walk out sometimes, staff will walk with me if family can`t". A staff member spoken with said that although there were routines in the home, no one was made to follow them. All staff spoken with said that staff worked well together. A staff member said, "it is a happy home, staff all help each other". What has improved since the last inspection? There has been re-decorating and new carpets since the last inspection visit. A new disabled toilets has been installed, with new fittings and fixtures, new flooring and fully decorated. Plans are underway to convert an under used small lounge area into a dedicated activities room. A new assisted bath is in the process of being installed on the basement level with new flooring and decoration. Additional hours have been agreed for an administrative assistant and laundry person, as well as additional care hours. This will give the care staff and managers more time with residents. The cook and manager were working together to further improve the menu, with more home baking, less processed food and more fresh fruit and vegetables. New crockery had been purchased and some new bedding. The manager has re-organised, the office, medication room and records generally. A staff member said that although change is not always popular, the new manager had come up with some good ideas. A 2 day course was planned for staff and managers to assist them with providing care for people who develop dementia. What the care home could do better: Although records were in good order, records of GP and other health professional visits were not kept in the person`s main file, making this information less accessible. There were times when there was no tea time cook, which meant that care staff had to prepare and serve tea, taking time away from residents. However, the additional staffing that was planned should improve this situation. Bathing records were not always accurate, and people were not always able to have additional support for baths if they wanted this, although again the additional staffing that was planned should improve this. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Florence Shipley Florence Shipley Market Place Heanor Derbyshire DE75 7AA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jill Wells     Date: 1 4 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Florence Shipley Market Place Florence Shipley Heanor Derbyshire DE75 7AA 01629531803 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Derbyshire County Council care home 26 Number of places (if applicable): Under 65 Over 65 26 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 The home is situated within the community of Heanor, located at the market place, in the town centre. This establishment is a 26 bedded home with single rooms, but no en suite facilities. The home is pre-existing April 2002, therefore the references to preexisting homes within the National Minimum Standards, are applicable. It is spread over three floors and with a lift to help access to the upper floors and a call system throughout the building in case of emergencies. There are assisted bathroom and toilet facilities on all floors and the home has three lounge areas on the ground floor and a dining room. The home has a large garden although some of this area is not accessible to residents. Fees are £404.806 per week for permanent residents, but a range of prices for short term care residents. Additional charges, e.g. hairdressing, chiropody, are clearly identified in the homes Statement of Purpose and Service User Guide. Copies of inspection reports are available in the foyer. Care Homes for Older People Page 4 of 28 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: 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 quality rating for the service is two star. This means the people who use the service experience good quality outcomes. The inspection visit was unannounced and took place over 8 hours. There were 26 people living at the home on the day of the inspection, including 2 people fro respite care. 9 residents, 4 staff, 2 visitors,and the manager were spoken with during the visit. Some residents were unable to contribute directly to the inspection process because of communication difficulties, but they were observed during the visit to see how well their needs were met by staff. We also looked at all the information that we have received, or asked for, since the last key inspection on the Care Homes for Older People Page 6 of 28 7th June 2007. This included: The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. The previous key inspection report. Completed surveys from people living at the home, staff, relatives and professionals that visit. Case tracking was used during the inspection visit to look at the quality of care received by people living at the home. 3 people were selected and the quality of the care they received was assessed by speaking to them, observation, reading their records, and talking to staff. What the care home does well: What has improved since the last inspection? There has been re-decorating and new carpets since the last inspection visit. A new disabled toilets has been installed, with new fittings and fixtures, new flooring and fully decorated. Plans are underway to convert an under used small lounge area into a dedicated activities room. A new assisted bath is in the process of being installed on the basement level with new flooring and decoration. Additional hours have been agreed for an administrative assistant and laundry person, as well as additional care hours. This will give the care staff and managers more time with residents. The cook and manager were working together to further improve the menu, with more home baking, less processed food and more fresh fruit and vegetables. New crockery had been purchased and some new bedding. The manager has re-organised, the office, medication room and records generally. A staff member said that although change is not always popular, the new manager had come up with some good ideas. A 2 day course was planned for staff and managers to assist them with providing care for people who develop dementia. Care Homes for Older People Page 8 of 28 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 set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 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 10 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. Peoples needs are fully assessed prior to admission so the individual and the home can be sure the placement is appropriate. Evidence: There was information available for people, including a statement of purpose about the home and a service user guide. These documents needed some minor amendments. For example one said that there were monthly questionnaires completed, which was no longer the case. These were done on an annual basis. The document had the old address of The Commission, as this office has since closed down. The service user guide also had in places the incorrect name of the home. Information in the entrance hall included the last inspection report, peoples rights to access their own social care records, and information about an advocacy service that was available. Three peoples files were seen. Within these files were a copy of the placement Care Homes for Older People Page 11 of 28 Evidence: agreement, signed by the individual. Each persons needs had been assessed before being admitted to the home. The care manager from Social Services had completed a detailed care plan which gave information on the persons health and social care needs as well as their reason for admission and social history. Several people spoken with said that they had stayed at the home several times for respite care before deciding to stay. One person said, they give you plenty of time to decide if you want to stay. Care Homes for Older People Page 12 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs are met and the principles of respect, dignity and privacy are put into practice. Evidence: The annual quality assurance assessment completed by the manager said that each resident has a plan of care drawn up with the resident, generated from a comprehensive assessment, and provides the basis for the care to be delivered. This is reviewed by care staff on a monthly basis and updated to reflect changing needs. All managers have received training for safe administration of medication. The medication room has been rearranged to provide greater storage facilities. The hairdressing room when not in use can be used as a treatment room for visiting health professionals. A visiting district nurse was spoken with. She explained that a resident at the home was terminally ill and she was visiting regularly. She was very pleased with the care provided to this person. she said that generally people were looked after very well, and that the managers were very quick to contact the district nursing service if anyone had problems. Care Homes for Older People Page 13 of 28 Evidence: The manager confirmed that the Liverpool Care Pathway (end of life care) was being used to support the person that was terminally ill. Staff were spoken with about this. They said that the person seemed very peaceful and their skin integrity was good. They believed that this was due to the good care provided by staff. They also spoke of supporting the family through this difficult time. One care worker spoken with felt that good care was being provided to the person, but they felt ill equipped to cope with the emotional aspects of terminal illness and bereavement. Three peoples files were seen. Each person had a personal service plan in place. These were reviewed on a monthly basis by the care staff. Although there was evidence of people receiving healthcare from GPs, chiropodist, dentists and other outside health professionals, this information was not recorded in peoples individual files. The manager needed to look at the management diary to obtain information about a persons visit to the dentist. Also the monthly reviews were not kept in peoples files, but in a separate file. These separate systems increased the risk of the main service users file not being used as a working tool. A care worker spoken with said that the expectation was that they read new peoples personal service plans, but this does not always occur. Although she was very knowledgeable about the individuals care needs of a person who had been at the home for three weeks, she had not read the useful information available concerning their background, hobbies and interests. A resident spoken with said, they are very good at calling the doctor quickly if you need one. Each persons file that was seen had screening tools concerning tissue viability, nutritional assessment and personal handling. Although they had all been reviewed regularly, one persons weight records showed that they had lost significant weight over a period of time. This had not been reflected in any of the assessment tools. However it was evident from discussion that action had been taken to address the weight loss and the person was now maintaining their weight. The medication administration and recording systems were checked and found to be in good order. The manager was observed administering medication, and good practice guidelines were being followed. They were seen to be sensitive and patient when necessary, as well as respecting peoples choice and privacy. Medication was kept securely, including controlled drugs. The Derbyshire County Council medicine code was available for reference. The system for recording and storing medication that had been refused or spoilt did not give a clear audit trail. The manager was advised to contact the local pharmacist about this. One person had been at the home for three weeks on respite care. Their care plan said that they had a shower three times per week at home. Record showed that they had only been supported to bathe twice since they came. The manager said that he was confident that they would have been offered a bath once a week, but this had not been recorded. The person confirmed that they liked to shower regularly. Care Homes for Older People Page 14 of 28 Evidence: Staff observed and spoken with were very aware of the importance of treating people with respect at all times. A resident spoken with said, staff are always kind. Care Homes for Older People Page 15 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The range of activities and standard of meals offered was good, which met the needs and wishes of people living at the home. Evidence: The annual quality assurance assessment completed by the manager said that improvements in this area have been made since last inspection visit. These included more activities available to residents and they exercise the choice and control over the range of activities provided. More outings are available and the residents choose the destination and the activity. More professional entertainers visit Florence Shipley and feedback from residents is sought to enable the management team to book entertainers of their choice. The agreed increased investment in staffing levels will allow more time not only for communal activities but more one to one time with residents. Plans have been made for a dedicated activities room to be fully decorated with new flooring in this new financial year. Resident spoken with were satisfied with the activities provided. During the inspection visit movement to music session was offered to people. They had recent entertainment over Easter including making Easter cards, Easter bonnets and a special buffet tea. Care Homes for Older People Page 16 of 28 Evidence: There was an activities worker 19 hours per week over three days, although some of this time was undertaking care duties. The activities displayed in the hallway that were planned for April included reminiscence group, musical bingo, Sherry evening, hand and nail care, outside entertainers and crafts. The activities diary showed significant gaps where no activities were recorded. It was unclear whether activities had taken place on these days or not. Most people spoken with were satisfied with the meals provided. Comments included, all food is nice every day and, the meals are quite good. A group of residents spoken with said that they enjoyed the buffet in the lounge for Easter. Minutes of residents meetings showed that people had requested more home-made baking and more fresh vegetables rather than frozen. The cook was spoken with. She explained that there had been a recent meeting with the cooks and manager to look at how the food and menu could be improved. It had been agreed to reduce processed meat and frozen vegetables, offer fresh fish on Friday and prepared fruit as an alternative to biscuits with drinks. The menu was displayed in the hallway. The cook had made some changes to the menu that day, but had not amended the menu. There had not been a record made of the reason for the changes. Lunchtime was observed. If people did not want the main meal they were offered salad, omelette or jacket potato. There is communion held fortnightly. One person spoken with said that they walked to the local church and staff walked with them if they needed help. Another resident said, I like a walk out sometimes, staff will walk with me if family cant. Two visitors spoken with said that, they were always made to feel welcome and were offered a drink. Care Homes for Older People Page 17 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 are able to express their concerns and are protected from abuse. Evidence: There was a complaints leaflet in a file at the entrance to the home. This needed to be updated to reflect the name change and correct address and telephone number of the Care Quality Commission. There were five complaints recorded in the last 12 months. These were informal complaints, mainly between residents. The record showed that they were taken seriously and dealt with appropriately. There had been one safeguarding adult referral. This was concerning two residents. The relevant professionals were involved and the matter was dealt with well. Several residents spoken with said that they felt confident that if they had any concerns they would go to a manager and would be listened to. Training records showed that staff had undertaken training in safeguarding adults. A staff member spoken with was aware of her responsibilities under the whistleblowing procedures and the need to report any potential abuse. Care Homes for Older People Page 18 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe, clean and comfortable environment, which encourages independence. Evidence: The annual quality assurance assessment completed by the manager said that a programme of routine maintenance and renewal of the fabric and decoration of the premises is produced. Dedicated bedrooms are available for people on short-term care. Residents are provided with keys if they wish to keep their rooms locked. The home has been decorated throughout and new carpets have been fitted. A new disabled toilet has been installed with new fittings and fixtures. Plans are underway for a little used lounge area to become a dedicated activities room. The garden is to be made more accessible to residents, with more suitable seating and fencing to offer greater privacy. A new assisted bath is about to be installed on the basement level. During the inspection visit communal areas and two bedrooms were seen. There were several lounge and dining areas where people could choose to sit in larger groups or in small quieter rooms. There was a large screen TV in one lounge area. One of the bedrooms that was seen was for people on respite care. It was described by the person using the room as adequate. There are no ensuite bedrooms at the home and one person commented that this would have been nice. Bedrooms were of varying size. One persons bedroom that was seen had their own furniture and other items to Care Homes for Older People Page 19 of 28 Evidence: personalise their room. The home was clean and fresh, with a bright, welcoming entrance area. The outside handrails that were in poor condition at the last inspection visit were now improved. The laundry area was not inspected on this occasion. One toilet area was seen during the inspection visit. The tiling was in need of replacement as they were cracked and had holes in tiles where dispensers had been removed. The manager explained that they were part of the refurbishment plan. There were handrails around the home and other equipment to assist people with poor mobility. Care Homes for Older People Page 20 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The recruitment practices and staff training programme were good and ensured that people were protected by competent, well-trained staff. Present staffing levels may not always meet the needs of people who use the service, however the planned increase in staffing will have a positive impact on the service received. Evidence: The annual quality assurance assessment completed by the manager said that all new employees attended an induction programme to ensure that appropriate training was provided. Additional investment has been made for a laundry assistant and an administrative assistant, as well as some additional hours for care duties. The new post will allow more one-to-one time with residents and additional time for bathing if people want this. During the inspection visit the staff rotas were seen. These showed that there was a minimum of two care staff on duty on each shift as well as a person working a short shift on most shifts during the daytime. There had been some difficulties covering the cook shift in the afternoon, which meant that care staff sometimes had to prepare the tea-time meal. Staff working in the community with additional hours spare would come and assist when available. As the home was full at the time of the inspection visit, with up to two additional people for day-care as well as caring for a person that was Care Homes for Older People Page 21 of 28 Evidence: terminally ill, the present staffing levels were not ideal, however this is likely to shortly improve with the additional staffing that was planned. Several people commented about the staffing levels. One person living at the home said, staff are often overworked, there is often no tea-time cook so carers have to work harder. A staff member said, the extra hours that are planned will help us, well have more time for residents. People who would like another bath should be able to have one. Two staff files were seen. All relevant checks had been made including a criminal record bureau check and references, before they were employed. Training records were seen. Most staff had undertaken the relevant mandatory training courses, and other refresher courses were planned. The manager had arranged for a two-day dementia course for staff and managers at the home. As mentioned previously some care staff may benefit from terminal illness and bereavement training. Residents spoken with said that staff were kind and helpful. There were many thank you cards from relatives. Comments in these cards included, thank you for the excellent care and kindness you showed and, many thanks for everything you did for Dad. A residents spoken with said, I know the staff will sort out any problems that I have. Care Homes for Older People Page 22 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed, with effective quality assurance systems, ensuring that people are listened to and the home continues to develop and improve. Evidence: The annual quality assurance assessment completed by the manager said that the manager had 8 years experience as a manager. He has obtained NVQ 4 in health and social care and is working towards the leadership and management award. Staff and residents were spoken with about the new manager. They said that he had made changes in a planned and determined way. A staff member said that, change is not always popular, but the manager tries to be fair and is making changes gradually. A resident spoken with said, it is strange having a man as a manager but he does seem nice and you can have a laugh with him. The manager was spoken with. He was clearly organised and methodical. He had reorganised the office and service users files. He had previously worked at another care Care Homes for Older People Page 23 of 28 Evidence: home and was bringing good practice ideas from this home. Fire records were seen and found to be in good order. A sample of service records were seen and found to be up to date. Residents had recently completed surveys, and the manager was in the process of analysing this information and completing an action plan in response to this. There was an annual development plan for 2009. Some of the work had already been undertaken. The service manager responsible for the service visited on a regular basis. They completed monthly reports. These were seen and showed that they checked the environment, medication systems, records, as well as talking to residents and staff. There were regular staff meetings taking place. Minutes of these showed that they were given the opportunity to make suggestions and raise any concerns. Staff raised at a recent staff meeting the need for new crockery, and this had been purchased. Minutes of residents meetings showed that people were asked if they had any concerns or complaints and were consulted about the meals, activities and outings. Staff had up-to-date training in fire safety. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 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 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 statement of purpose and service user guide should be revised to ensure that the information is accurate and upto-date. Records of GP and other health professional visits should be available to care staff completing care plan reviews and ideally kept in the persons main file for easy access when reviews take place. Records concerning bathing should be accurate and anyone that wishes a bath more often than once a week should be offered this to promote peoples choices. There should be an audit trail for medication that has been refused or spoilt to ensure that all medication systems are safe. There should be a record of activities that have taken place, including the names of residents involved. This is to evidence that regular activities are taking place and to a assist staff to assess whether each individuals social needs are being met. The displayed menu should accurately reflect the meal provided. A record of changes to the planned menu should be made, including the reason for the change. This is so Page 26 of 28 2 8 3 8 4 9 5 12 6 15 Care Homes for Older People that residents have the correct information about the meals provided. 7 16 The written complaints procedure should be amended to include the correct name, address and telephone number of the Care Quality Commission. Staff should be offered training in terminal illness and bereavement to assist them in their role. 8 30 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!