Care Home: Foxhill Manor Nursing Home

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What the care home does well As in previous inspections the staff team at Foxhill Manor work well together and have a calm, gentle manner when going about their duties. One person said, "They are all nice. They help me a lot." The meal served at lunchtime was plentiful, appetising, and the staff who assisted some people to eat their meal did so in a manner that was unhurried and allowed that person to enjoy their meal. The overall atmosphere within Foxhill Manor comes across as relaxed and staff were engaging people in conversations in a natural, friendly way. Staff were also observed to take time to patiently explain what they were doing when assisting people with little or no communication skills. Agreed plans of care that set out what help and guidance a person needs are consistently kept up to date and provide staff with the information they need to do their job. The staff are diligent about ensuring the communal and private living areas are consistently kept free from odours. What has improved since the last inspection? The Manager has reviewed the layout of staff records and ensured there is now a robust procedure in place for checking that all new staff have all the necessary clearances in place before they take up their duties. Refresher training for staff in all areas of care practice has been reviewed and since the last inspection in March 2009 staff have attended updated training sessions in, to quote just a few examples, protecting vulnerable adults, medication awareness, infection control, and deprivation of liberty. The Service User Guide, which is a document that provides people with all the information they need to know about the home, has been reviewed and updated, as has the Statement of Purpose which sets out what services the home provides. A development plan for improvements to the fabric of the premises has been drawn up by the Manager and these improvements, which include completing the re-decoration programme and replacement of items such as screens, curtains, and other soft furnishings, will be implemented over the coming year. Work on a newly refurbished bathroom is also due to start soon. What the care home could do better: As there is only a stairlift serving the first floor of Foxhill Manor access to the second floor bedroom accommodation remains potentially problematic for those people who subsequently become less able to manage stairs. The internal layout of the building does make installing a lift difficult but it is understood that this option is still being considered to eliminate the necessity to have to move people from their bedroom if they become unable to manage stairs. This difficulty has resulted a double room having to temporarily accommodate a third person. Although this bedroom is very large and, according to the Manager, there has been consultation and agreement with people in residence, their families, and placing Authorities, this arrangement is unsatisfactory and every effort should be made to find a better solution to what may become a reoccurring issue. Now that the programme of re-decoration is to continue on from what improvements have already been made the Manager may wish to consider ways of using the choice of decor and lighting more creatively so that there is a more homely ambience in upstairs corridors and some bedrooms. Although Foxhill Manor is a building full of character some areas within the home would greatly benefit from enhanced decor and perhaps considering getting rid of institutional style strip lighting where this is still fitted. Obviously it is important to retain good illumination but with professional advice this is an improvement to the appearance of the living environment that would enhance peoples` experience of living in the home. The considered use of colour in some areas of the home might also be a factor to consider as currently some corridors and bedrooms do appear very plain, functional, and uninspired. Key inspection report Care homes for older people Name: Address: Foxhill Manor Nursing Home Foxhill Road West Haddon Northants NN6 7BG     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: Kathy Jones     Date: 2 7 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Foxhill Manor Nursing Home Foxhill Road West Haddon Northants NN6 7BG 01788510262 01788510834 snullatamby@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Ramsamy Nullatamby care home 26 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 past or present alcohol dependence past or present drug dependence dementia mental disorder, excluding learning disability or dementia Additional conditions: Service users must fall into at least one of the following categories: past or present alcohol dependence, past or present drug dependence, dementia or mental disorder Service Users under the age of 65 years must not be admitted to the home The home may accommodate three named service users for whom variations were granted prior to April 2002, (the NCSC), who are under the age of 65 years The total number of Service Users must not exceed 26 Date of last inspection Brief description of the care home Foxhill Manor is privately owned and not part of a group of homes. It is registered as a care home providing nursing care for up to 26 people of both sexes who are over 65 years of age and within the categories of dementia, mental disorder, past or present Care Homes for Older People Page 4 of 27 Over 65 26 26 26 26 0 0 0 0 2 0 0 3 2 0 0 9 Brief description of the care home alcohol dependence and past or present drug dependence. Foxhill Manor is a large converted house set in its own extensive grounds and situated on the outskirts of a village. Bedrooms are located on three floors with the shared lounges and dining room on the ground floor. Stair lift access is limited to serving the first floor only. The majority of people share a bedroom, however there are eight single rooms. Two of the double bedrooms have an en-suite toilet. The following fees were provided by the registered provider as being current at the time of the inspection in March 2009: Weekly fees range between £500 and £975 per week dependent on assessed need. For people funded by the local authority the fee includes the nursing contribution. For people who are funding their own care the nursing contribution is additional. Additional charges include chiropody and hairdressing. A copy of the most recent inspection report is available at Foxhill Manor and is usually displayed in the front hall. Care Homes for Older People Page 5 of 27 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 focus of inspections undertaken by the Care Quality Commission is upon outcomes for people who use the service, taking in account their views and experiences of the service provided. This inspection was unannounced and carried out over one weekday by two Regulation Inspectors. This inspection followed on from the last inspection conducted in March 2009 and we looked for evidence that this service had improved since then. Our judgments within each outcome area in this report were reached as a result of drawing together information from a range of sources. For example, we looked at the administrative practices followed by staff working at the home to ensure that the information they need to enable them to care for people is up to date and accurate. We inspected a sample of staff records to ensure that there is now a robust process for checking clearances before new staff take up their duties. We also used the inspection Care Homes for Older People Page 6 of 27 method of case tracking. Although we found that not everyone was able to communicate their views about their experiences we selected a sample of people in residence and then tracked the care they receive. We did this by inspecting their records, including their agreed plan of care, and observing the interactions between staff and these people. We also talked with individual members of staff on duty to establish how well they are informed about the people they support. We accompanied a staff member on a tour of the premises and were able to view the living accommodation, including bedrooms and communal lounge areas. We were also able to observe people taking lunch in the dining room and talked with the chef about the menu choices. Prior to lunch being served we talked to people and ask them if they enjoyed their meals. After we completed our inspection we met with the Manager, who is also the owner, and discussed our findings. We confirmed that the requirements made at the last inspection had now been met. No new requirements were made following this inspection. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: As there is only a stairlift serving the first floor of Foxhill Manor access to the second floor bedroom accommodation remains potentially problematic for those people who subsequently become less able to manage stairs. The internal layout of the building does make installing a lift difficult but it is understood that this option is still being considered to eliminate the necessity to have to move people from their bedroom if they become unable to manage stairs. This difficulty has resulted a double room having to temporarily accommodate a third person. Although this bedroom is very large and, according to the Manager, there has been consultation and agreement with people in Care Homes for Older People Page 8 of 27 residence, their families, and placing Authorities, this arrangement is unsatisfactory and every effort should be made to find a better solution to what may become a reoccurring issue. Now that the programme of re-decoration is to continue on from what improvements have already been made the Manager may wish to consider ways of using the choice of decor and lighting more creatively so that there is a more homely ambience in upstairs corridors and some bedrooms. Although Foxhill Manor is a building full of character some areas within the home would greatly benefit from enhanced decor and perhaps considering getting rid of institutional style strip lighting where this is still fitted. Obviously it is important to retain good illumination but with professional advice this is an improvement to the appearance of the living environment that would enhance peoples experience of living in the home. The considered use of colour in some areas of the home might also be a factor to consider as currently some corridors and bedrooms do appear very plain, functional, and uninspired. 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 27 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 27 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. A thorough pre-admission assessment of each persons needs ensures that they get appropriate care and now that written information about Foxhill Manor has been updated people are better informed about the home and the choices they have. Evidence: There is a Service User Guide setting out current information that people need to know about the home. This document has recently been updated to include more specific information about the range of services provided and the environment within the home. People likely to take up residence at Foxhill Manor are encouraged and enabled to visit the home where this is a practical option. Relatives of people in residence at Foxhill Manor have also confirmed that they were encouraged to look around before a decision was made about whether the home was suitable. There is documentary evidence on files inspected that assessments of need continue to be carried out. Care plans arising from these assessments of need appear to Care Homes for Older People Page 11 of 27 Evidence: accurately reflect the actual level of care and support being provided. Care Homes for Older People Page 12 of 27 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 living at Foxhill Manor can rely upon getting the help they need from the staff and from other community based professionals who have a role in meeting their routine and emergency healthcare needs. Evidence: Staff were observed interacting with service users and they presented as gentle yet encouraging in their approach to people when providing support and guidance. People are encouraged to do as much as they can but assistance is readily to hand if a person is unable to manage. There was a good level of interaction between individuals and staff, with staff mindful of taking time to explain what they were doing if the person required their assistance. Staff members appeared unhurried and this in turn had a calming effect so that people were not left feeling rushed. Each person has an agreed care plan specific to their individual assessed needs. There is documentary evidence that these plans are being regularly updated as these identified needs change. There is also evidence on individual files that healthcare professionals are being routinely consulted and do visit the home on a regular basis. Care Homes for Older People Page 13 of 27 Evidence: Medication continues to be appropriately and effectively managed, with stocks kept to what is necessary. There is evidence that peoples medication is being reviewed by their GP so that they are getting the appropriate medicines they need. Care Homes for Older People Page 14 of 27 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 relaxed atmosphere within Foxhill Manor is evident, with visitors always welcome, enjoyable food served at mealtimes in an unhurried manner, and activities organised with respect for each persons preferred daily routine. Evidence: People have their preferences respected, for example one person was able to tell us that he goes to bed as and when he wants to. Another person was observed to get up late and the staff catered for this by ensuring he had his meal prepared for him when he came down to the dining room. Activities are regularly organised, with events posted on the public noticeboard. External input with organised activities takes place twice weekly. Staff were observed working with a small group of female service users who were enjoying having their fingernails painted. Visitors are encouraged, with no unreasonable restrictions as to when relatives or friends can arrive. Comments made by visitors at time of the March inspection were that visiting times are entirely flexible and that staff are invariably very welcoming. Care Homes for Older People Page 15 of 27 Evidence: Large attractive grounds surround home, but care is needed due to uneven surfaces surrounding the premises which preclude unsupervised access. The home does have access to a minibus. People who expressed their opinion about the quality of the food said that meals were very good, enjoyable, with plenty to eat. Actual comments included, I get plenty to eat here. Very nice. I like the food. You get what you want. The Chef asks what people would like each morning and alternatives are offered if the choices of the day are not to their liking. Staff were observed assisting individuals who required help with eating. The staff presented as patient and encouraging so that the person had plenty of time to manage to eat their food and enjoy the meal. Care Homes for Older People Page 16 of 27 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. Improvements to recruitment practices and refresher training for staff in the protection of vulnerable adults means that people living at Foxhill Manor are better protected from any risk of harm or abuse of their rights. Evidence: There are leaflets encouraging suggestions, compliments, or complaints kept available in the public hallway. The registered manager informed us that there have been no complaints since the last inspection in March 2009. None have been received by the Care Quality Commission either. The improvements in recruitment practices as detailed in the staffing section mean that people who use the service are better safeguarded. Staff know what to do if they suspect a colleague of poor practice and as a team the staff have had recent training on the implications of the Mental Capacity Act that serves to protect people who may not have the capacity to make decisions that will directly affect them. Staff have also had refresher training on the protection of vulnerable adults. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst clean and free from odour, some areas of the living accommodation would be enhanced by imaginative attention to the choice of decor and lighting, particularly in the access corridor where there are undiffused fluorescent lights and in some bedrooms where the decor appears uninspired and somewhat tired looking. Evidence: This is an old building with character that does not easily lend itself to internal modifications and this is highlighted in information provided to people intending to use the service. A pre-admission visit to Foxhill Manor is very much encouraged so that the limitations can be seen at first hand. There are currently plans to create better bathroom facilities on the ground floor. Last year bed occupancy was reduced from 29 to 26 to increase the availability of single bedrooms within the property. Again, last year the boiler system was replaced, with two boilers operating to improve heating and water supply throughout the property. Foxhill Manor was awarded a 5 star Hygiene Rating by Daventry District Council in February 2008. The inspection of premises included communal lounge areas and all bedrooms except for one bedroom as this person had chosen to rise late. Some minor repairs requiring attention were noted, for example torn paper border in Room 5, and the armchair in Room 4 appeared worn and faded. This was not the persons own chair. It is acknowledged that the Manager has provided a programme of Care Homes for Older People Page 18 of 27 Evidence: improvements to be made over the coming year and this includes replacing items of furnishings that appear worn. Room 17 had a broken door handle which was being repaired that day. Room 1 is very large and normally two people share this room. This room was, however, being used to accommodate a third person who, because of a period of poor health, has recently found it difficult to return to her own bedroom on the upper floor. According to the Manager this arrangement was discussed with families concerned, as well as with appropriate placing Authorities, and there was no objection made to this temporary arrangement that we have been made aware of. We were informed by the Manager that the person occupying the third bed has her bedroom upstairs kept empty for her to return to at the earliest opportunity. Although not ideal this temporary arrangement has allowed the person concerned to remain in the home until she is able to use her room again. Premises appeared clean throughout. There were no odours, either in the communal areas or in private bedroom space. The decor is neutral in corridor areas, as well as in most bedrooms, although one person had personalised his room with a collection of clocks and other personal possessions. He was able to articulate that he is very happy living at the home and enjoys relaxing in his room. Other bedrooms were simply furnished, functional in appearance, without much evidence of personal belongings or the creative use of colour or lighting to create a more homely environment. Corridor area lighting on 1st floor is undiffused strip lighting. This is appears rather stark and institutional and it was discussed with the Manager how changes to the style of lighting might be improved to create a more homely ambience without sacrificing the need for good illumination. A Proposed Development Plan for 2009 to 2010 has been submitted by the owner. This sets out actions for improvements to the environment, such as, for example, replacement of bedroom furniture in some bedrooms, replacement of screens and curtains in all areas, and completing the second phase of painting and decorating throughout the premises. External grounds not specifically viewed, but garden areas appear attractive and well maintained. There is a record of a full fire drill involving all staff and people in residence. This major drill is held annually, with weekly testing of the fire alarm system held according to guidance. It was suggested that in addition to the evacuation drill the Manager should consider impromtu fire alert scenarios that do not disturb the people living in the home but which involve a contrived situation that staff will have to react to. This would be particularly useful for night staff members. Staff spoken to appeared confident that they knew what to do in the event of a fire. Care Homes for Older People Page 19 of 27 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. All staff are appropriately recruited and with regular refresher training put in place for existing staff this means that people living at Foxhill Manor are supported by a staff team who are able to provide a safe, effective service. Evidence: At the time of inspection staffing levels appeared to be satisfactory. Staff on duty included the Manager, the house keeper, the Chef, one domestic, a handyman, and four care workers, as well as the Nurse in charge. There were also two young staff members employed to involve people in activities, either on an individual or small group basis. Staff appeared to be going about their duties in an unhurried, relaxed manner. Staff were able to demonstrate a clear understanding of the needs of the people they are currently supporting. One person commented, Staff are nice and kind. People seated in the communal areas appeared well groomed and appropriately dressed in clean clothes. Training for events for staff since the last inspection include, for example, Safeguarding of Adults, the Mental Capacity Act, Deprivation of Liberty, Infection Control, and Medication Awareness. A new programme of Dementia Care training has also been introduced since May 2009. Advice was given to the Manager to consider using a better overview method for being able to see at a glance which staff have had refresher training, rather than each staff members file having to be individually Care Homes for Older People Page 20 of 27 Evidence: accessed. He agreed to look at different ways of capturing this information. A sample check of staff recruitment records found that new staff have the appropriate Criminal Records Bureau clearance on file. Since the last inspection the Manager has reviewed procedures for ensuring that all necessary clearances are in place for each newly recruited member of staff before they take up the care duties. Care Homes for Older People Page 21 of 27 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. Improvements made to the administration of routine recruitment checks for new staff means that people are not being put at risk from unsuitable staff and that the home is now being effectively managed Evidence: The Manager, who is also the owner, has had many years experience managing Foxhill Manor. He is friendly, approachable by his staff, and by people living in the home. He presents as co-operative with the Commission and recognises the need to continue improving standards and provide vulnerable people with a happy, safe, living environment. Record keeping, particularly with regard to staff recruitment has greatly improved since the last inspection. A review of daily activities, staff training and development, the recruitment of new staff, and quality management are all referred to in the Managers development plan for the coming year. There were no Health and Safety issues identified during this inspection with regard to staff practice. Once again staff were observed to be using appropriate moving and Care Homes for Older People Page 22 of 27 Evidence: handling techniques and equipment when assisting people who are physical frail, for example, when escorting them to take their meal at the dining table, or assisting them rise from their chair. Care Homes for Older People Page 23 of 27 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 24 of 27 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 19 It is recommended that the Manager considers the selective use of lighting, decor, pictures or prints, perhaps decorative borders, to create a more homely ambience in those bedrooms where people have little or no personal possessions. The creative and selective use of colour is a valuable tool for creating a homely living environment that may contribute to peoples sense of wellbeing. 2 25 It is recommended that the undiffussed fluorescent strip lighting on the first floor corridor area is replaced with lighting of a domestic character of a recognised standard fit for purpose. This will enhance the living environment. 3 30 It is recommended that the Manager considers using a training matrix or similar method of his own devising to provide an at a glance overview of current training needs for each staff member. This will ensure that scheduling of re-fresher training will Care Homes for Older People Page 25 of 27 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 be simplified and more efficient. Care Homes for Older People Page 26 of 27 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). 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