Care Home: Gardens RCH

What the care home does well Information about the home is available for people to have. This information will help people to decide if the home is right for them. Health and care needs are assessed before people are admitted to the home. Care plans are generally well written and detail the care that a person requires. People living at the home told us "I feel the home cares for me very well." and "Seems to do great care. All my needs are met." The home provides a range of activities to support service users` chosen lifestyles. Visitors are welcome in the home. A good choice of meals are offered each day. "The home is very clean with a good choice of food." and "Everything (done well) including good meals and caring about me." Complaints are responded to and people are protected. The home is clean, comfortable and well maintained. "The home is very clean and tidy and it does everything well." And "Every time a room is vacated, it is decorated, there is no expense spared." The home has sufficient staff employed in the home to meet service users` needs. Staff are trained to do their jobs. Recruitment practices are generally quite good. In general, the home is managed in the best interests of the service users. What has improved since the last inspection? This is the first inspection for this newly registered service. What the care home could do better: The Statement of Purpose and Service Users Guide should be updated to show the correct name and contact details of the new owners and the correct hours worked by the activity coordinator. People should receive written confirmation that the home is able to meet their needs. More attention to detail is needed when recording in daily care records and reports. Advice from other health care specialists, for example the `Falls Nurse` should be sought when people are experiencing a number of falls in the home. Better records must be kept for medicines received into the home including controlled drugs. Consultations with health care professionals should always take place in a person`s private accommodation or a designated room for private consultations. The complaints procedure should be available in a more user friendly format. For example different font sizes. Contact numbers on the adult protection procedure should be checked and updated so that staff have the correct information available to them Door guards should be fitted to bedroom doors so that they do not have to be propped open in an inappropriate way. Dedicated storage spaces should be made available to prevent the cluttering of bathrooms and corridors. Staff could be better deployed to meet service user needs. All staff employed at the home must have criminal record bureau checks and references taken up before they are allowed to work at the home. Notes made during interviews should be kept to show that decisions to recruit have been made fairly and without prejudice. Provider visit reports are not always given to the manager. Records kept for service user finances are not in line with good practice. Key inspection report Care homes for older people Name: Address: Gardens RCH Pondfield Close Darlington Co Durham DL3 8LH     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: Jean Pegg     Date: 0 1 0 2 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 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © 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 28 Information about the care home Name of care home: Address: Gardens RCH Pondfield Close Darlington Co Durham DL3 8LH 01325487777 01325487777 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ascot Care North East Ltd Name of registered manager (if applicable) Ms Edith Marie Nicholson Type of registration: Number of places registered: care home 44 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is : 44 The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places : 44 Physical disability - Code PD, maximum number of places: 44 Date of last inspection Brief description of the care home The Gardens Care Home is a single storey building that can offer accommodation for forty four people over the age of sixty five. All but five of the bedrooms offer en- suite facilities. The home has a number of different lounge areas, bathrooms and toilets. There is a large dining room that over looks the internal courtyard. The home is Care Homes for Older People Page 4 of 28 Over 65 44 44 0 0 Brief description of the care home surrounded by well kept gardens. There is a parking area available for visitors. The fees for this home range from £431 to £484 per week. Please contact the manager for details of services and facilities included in the fees. 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: This inspection took place over two days and lasted for nine hours. This is the first inspection visit since the home came under new ownership in September 2009. All newly registered services are inspected within six months of registration. The inspection consisted of a visit to the home where we observed how people interacted with one another, checked that the building was kept clean and tidy and looked at different documents and records held in the home. We also spoke to people who live and work at the home. Before we visited the home we sent surveys out to people who live and work there. We received seven back from people who live at the home and three from people who worked at the home. The results of our observations and surveys will be included in this report. Care Homes for Older People Page 6 of 28 What the care home does well: What has improved since the last inspection? What they could do better: The Statement of Purpose and Service Users Guide should be updated to show the correct name and contact details of the new owners and the correct hours worked by the activity coordinator. People should receive written confirmation that the home is able to meet their needs. More attention to detail is needed when recording in daily care records and reports. Advice from other health care specialists, for example the Falls Nurse should be sought when people are experiencing a number of falls in the home. Better records must be kept for medicines received into the home including controlled drugs. Consultations with health care professionals should always take place in a persons private accommodation or a designated room for private consultations. The complaints procedure should be available in a more user friendly format. For example different font sizes. Contact numbers on the adult protection procedure should be checked and updated so that staff have the correct information available to them Door guards should be fitted to bedroom doors so that they do not have to be propped open in an inappropriate way. Dedicated storage spaces should be made available to Care Homes for Older People Page 7 of 28 prevent the cluttering of bathrooms and corridors. Staff could be better deployed to meet service user needs. All staff employed at the home must have criminal record bureau checks and references taken up before they are allowed to work at the home. Notes made during interviews should be kept to show that decisions to recruit have been made fairly and without prejudice. Provider visit reports are not always given to the manager. Records kept for service user finances are not in line with good practice. 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 8 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 9 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. Information about the home is available for people to have. This will help them to decide if the home is right for them. Health and care needs are assessed before people are admitted to the home. People do not receive written confirmation that the home is able to meet their needs. Evidence: We looked at the information about the home that is available to the public. This information can be used to help people decide if the home is right for them. Although the home had a good range of information available, it had not been updated since the sale of the home in September 2009. The information reflected the name and contact details of the previous owners and provided incorrect information about the number of hours worked by the activities coordinator. This information should be updated to ensure that people are given accurate information about the home. The seven people who live at the home who returned surveys to us all said that they had received sufficient information about the home before they moved in. We looked at the Care Homes for Older People Page 10 of 28 Evidence: contracts or statements of terms and conditions provided by the home and found them to be satisfactory. For example they identified what facilities and services were provided within the fees paid and those that required extra payments. We saw examples of private client contracts and local authority contracts. We looked at the pre admission assessments that are completed by the home before people are admitted. The assessments followed a structure associated with the activities of daily living ensuring that all aspects of health and care are considered. We asked to see examples of letters sent to people following their pre admission assessments, confirming that the home would be able to meet their needs. We were told that the home did not provide people with written confirmation that their needs could be met. Care Homes for Older People Page 11 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. Care plans are generally well written and detail the care that a person requires. More attention to detail is needed when recording in daily care records and reports. Evidence: We looked at one individual care plan in detail and others in less detail. For the care plan we looked at in detail, we followed the plan and other associated records to see if they were consistent and held the same information. For this individual we found that the different records maintained by the home were not consistent. We found that accident reports were not consistent with entries made in the individuals daily record and that care plan evaluations did not fully reflect the individuals experience. We also found that the daily reports were mainly completed by night staff and as such did not provide a full picture of that individuals care or daily activity. We also questioned the manager about the actions taken following the analysis of an individuals accident reports. The reports showed this person to be having a lot of falls. We believed that all possible solutions had not been fully explored that could have reduced the risk of falls. Although the manager had taken some action, she agreed that she had not fully explored all the options available and said that she would follow up on our Care Homes for Older People Page 12 of 28 Evidence: suggestions. We were told that staff would also be spoken to about improving the quality of recording in the care plan, associated records and daily reports. People living at the home told us I feel the home cares for me very well. and Seems to do great care. All my needs are met. We observed a general practitioner visiting someone in the home and records held in the home showed that other health care professionals visited on a regular basis. We looked at the system for managing medication in the home and found it to be unsatisfactory. We noticed that some of the medication administration records did not have photographs of the service users on them which can make identification of the service user difficult for new staff or new service users. We also noticed that some signatures were missing form the medication charts making it unclear as to whether or not medicines had been given. There were hand written entries for medicines on medication administration records which had not been signed by the person making the entry or counter signed by a second person to say that the entry was accurate. The system for recording PRN medication had not been followed making stock control difficult to monitor. We counted three boxes of medications and compared the number of tablets in each box with what should have been available. In each instance there was a discrepancy. We also found a discrepancy with the controlled drugs held in the home. We shared our concerns with the manager. On our second visit to the home the manager told us that she had made arrangements to change pharmacists and had spoken to staff and organised training to take place to improve practice. During our two visits we observed interactions between staff and service users and found that a respectful attitude was adopted. We noticed that a number of service users preferred to spend time in their rooms and that this right to privacy was respected. We observed one incident that we felt did not show appropriate respect and dignity in that a service user was seen by a general practitioner in the managers office. We said that this consultation should have taken place in the privacy of the persons private accommodation. The manager agreed and said that what we had witnessed had been standard practice in the home but that this would change. Care Homes for Older People Page 13 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 home provides a range of activities to support service users chosen lifestyles. Visitors are welcome in the home. Community contact is maintained. A good choice of meals are offered each day. Evidence: During both our visits we saw that there are a number of activities available for people to take part in. The home currently has two activity coordinators who organise both group and individual activities. When we first arrived there was a residents meeting taking pace that nineteen people attended. We also witnessed a group of people going out to attend a local fund raising coffee afternoon. We spoke to the activities coordinator who told us about the range of activities and entertainment in the home. And future plans for themed nights and holidays away from the home. Six people who returned surveys to us said that the home always has activities arranged that they can take part in. During our visits we also noticed family members and friends visiting the home. We observed a number of examples of people being helped to make choices in the home for example, choosing where to eat, what to eat and whether or not to take part in activities. Six people who returned surveys to us said that they always liked the meals at the Care Homes for Older People Page 14 of 28 Evidence: home. We observed two meal times, lunch and tea on two different days. On both occasions we witnessed people being offered a range of choices of things to eat. For example, for lunch we saw people having soup, jacket potatoes, salad and sandwiches. We saw that some people were offered individual tea pots and others had their tea poured for them from the large communal tea pot. We saw that some people had been provided with aids to help them eat independently. Three people needed help with eating and although this was not a problem during the lunch time meal, at tea time when there were less staff available, this was not managed as well. The Environmental Health Officer had visited the home on 22 September 2009 where a high standard of compliance had been observed and the home was awarded a five star rating for food hygiene. When we asked people to give us examples of what the home did well they told us The home is very clean with a good choice of food. and Everything, including good meals and caring about me. Care Homes for Older People Page 15 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. Complaints are responded to and people are protected. Evidence: We were shown the complaints procedure which was produced in a small font making it difficult to read for people who may have sight problems. Some of the references within the procedure also need to be updated and this was discussed with the manager. In the complaints folder we looked at the complaints recorded. We saw that a recent complaint had been investigated and a resolution agreed with the complainant. Five people who returned surveys to us said that they knew how to make a complaint and seven said that there was someone they could speak to informally if they were not happy. Of the three staff that returned surveys to us, all three said that they knew what to do if someone had concerns about the home. We looked at the procedure in place for protecting adults and again noted that some updating of contact numbers was required for example the Independent Safeguarding Authority. The home has made two adult protection referrals and has notified the Care Quality Commission on both occasions. The manager told us that they had also had a service user who had been subject to a deprivation of liberty. The home had followed the correct procedure in this instance. Care Homes for Older People Page 16 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. The home is clean, comfortable and well maintained. Evidence: We walked around the building to see if it was kept clean, tidy and in good repair. The manager told us that Every time a room is vacated, it is decorated, there is no expense spared. We saw that there was a decorator at work in the building, decorating bedrooms. The wall papers used were individual and of a nice quality. The home has a range of communal lounges which had been made to look and feel homely. There was a large dining room that over looked the internal courtyard garden. All tables were dressed nicely with flower arrangements. The communal bathing areas were clinical in appearance but functional. They could be improved through decoration to make the bathing experience more relaxing. All but five of the bedrooms in the home have en- suite facilities and the manager told us that there were plans to add the additional en- suites which would result in all rooms being able to offer en- suite facilities. We were told that there were also plans to renew all the external doors and windows, decorate and lay new flooring. We did notice some clutter in the sluice rooms which the manager has since disposed of. When we walked around the building we noticed quite a lot of bedroom doors wedged open. We suggested that the installation of door guards might be a safer solution if people wanted to have their bedroom doors open during the day. Externally, there are nicely kept gardens and an accessible inner courtyard. In the hall way there is a pay phone for people to use. Care Homes for Older People Page 17 of 28 Evidence: Some people had their own telephone lines installed in their bedrooms. Throughout the building there was lots of evidence of people bringing in their own possessions and personalising their own private accommodation. As stated earlier, the Environmental Health Officer had visited home on 22 September 2009. Their report stated that a high standard of compliance had been observed. The Fire Officer had last visited the home on 20 January 2009. We did not notice any bad odours in the building and the home looked clean and well cared for. The people who returned surveys to us all said that the home was always fresh and clean some one added The home is very clean and tidy and it does everything well. Care Homes for Older People Page 18 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 home has sufficient staff employed but not deployed to meet service user needs. Staff are trained to do their jobs. Recruitment practices are generally quite good. Evidence: At the time of our visit, the manager said that forty one people were resident in the building. We were told that from 8am until 4pm that there are six staff on duty and four from 4pm until 8pm. From 8pm until 8am there are three staff with a manager on call. In addition to this there are two activity coordinators that work from 10 am 2pm. Domestic and catering staff, a training officer, administrator and registered manager are also employed at the home. The three staff and seven service users who returned surveys to us said that they felt that there were always or usually enough staff on duty to meet service user needs. When we observed the two different meal times we did notice that the lunch time experience was more relaxed that the tea time experience. During the tea time observation we were concerned to see that the member of staff who was administering medication was also having to answer the phone. They were disturbed on two occasions. This is not good practice when giving out medication. We also noticed that there were insufficient staff on duty to ensure that those who needed assistance with feeding got it at the same time. We were told by staff that they staggered the meals for those that needed assistance. We suggested to the manager that staff might be deployed differently to ensure better staff cover was available at tea time to improve the dining experience. Care Homes for Older People Page 19 of 28 Evidence: The training officer confirmed that twenty two of the twenty six staff employed at the home have a National Vocational Qualification in Care at level two. Fifteen of those staff also have a level three qualification in Care. Three staff are currently enrolled on a National Vocational Qualification in Care at level two and three are enrolled onto level three. We checked three recruitment records for staff who had recently been employed by the home. For two of them we found that all checks had been completed as required but one person had not had all of the required checks completed. We told the manager that in all cases, the proper recruitment checks must be completed. The manager said that this would be rectified straight away. The home has a dedicated training officer who showed us evidence of staff training in th home. The training is a mixture of in house and external training events. We were told that staff had received training in the Mental Capacity Act but not Deprivation of Liberties. We recommended that arrangements for this training should be put into place. We were also told that they had planned for the Falls Nurse to visit and train staff in falls awareness. The staff who returned surveys to us were all very positive about the training they received. Care Homes for Older People Page 20 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. In general the home is managed in the best interests of the service users. Provider visit reports are not always given to the manager. Records kept for service user finances are not in line with good practice. Evidence: The manager of the home has been registered with the Care Quality Commission for four years. She holds the Registered Managers Award and the National Vocational Qualification at level four in Care. The registered manager has only ever worked at the Gardens Care Home. We talked about the benefits of experiencing other care settings and attendance on external training events and meetings. The responsible individual for the home has agreed that opportunities for the personal and professional development of the manager could be facilitated though visiting other homes in the group. The home holds resident forums every six months. These forums are also attended by relatives. They also hold regular service user meetings. We were shown copies of the Care Homes for Older People Page 21 of 28 Evidence: minutes to confirm this. The home has an annual development plan which includes plans for the refurbishment of the home and staff training. We asked to see copies of the monthly provider visit regulation 26 reports. We were given a copy of the report for the January 2010 visit. When we asked for copies of earlier reports we were told that none were available. The manager did confirm that the responsible individual was a frequent visitor to the home. We asked to see the records of finances held on behalf of service users. We were not satisfied with the standard of record keeping that we found. The records were difficult to audit and did not follow good practice. For example good chronological accounts and double signatures. We were also not happy with the account used for paying service user cheques into as the same account was also being used to bank money from fund raising events. We have since been told that recording will be improved and a new account opened. Staff told us that they received regular support from their manager. We were shown copies of the staff meeting minutes and supervision records. We were satisfied with what we saw. We looked at a sample of maintenance records and found them to be up to date. Care Homes for Older People Page 22 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 23 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 4 14 Following assessment, 31/03/2010 written confirmation must be given to service users stating if the home is suitable for the purpose of meeting the service users assessed needs. This will ensure that service users know that the home will be able to meet their needs and that they will receive the appropriate care. 2 9 13 Accurate records must be kept for medicines received into the home including controlled drugs. This will ensure that people receive their medications correctly and that the treatment of their medical condition is not affected. 31/03/2010 3 29 19 All staff employed at the home must have criminal record bureau checks and references taken up before 31/03/2010 Care Homes for Older People Page 24 of 28 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action they are allowed to work at the home. This ensures that all precautions have been taken to ensure that only staff suitable to work at the home are employed. 4 33 26 A copy of the regulation 26 31/03/2010 monthly provider visit report must be given to the manager of the home. This will ensure that the manager receives written feedback of the visit and that a copy is available in the home for inspection purposes. 5 35 17 Clear and accurate records of service user finances must be kept. This will ensure that a clear audit trail can be made of monies held on behalf of service users 6 35 20 Money belonging to service users must only be paid into an account that is in the name of the service user or service users, to which the money belongs. This will ensure that service user monies are kept separate from funds that 31/03/2010 31/03/2010 Care Homes for Older People Page 25 of 28 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action may be used in connection withe the carrying on or management of the home. 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 Users Guide should be updated to show the correct name and contact details of the new owners and the correct hours worked by the activity coordinator. Advice from other health care specialists. For example the Falls Nurse should be sought when people are experiencing a number of falls in the home. Handwritten entries and changes to MAR charts should be accurately recorded and detailed. This will ensure that people receive their medication as prescribed. Consultations with health care professionals should always take place in a persons private accomodation or a designated room for private consultations. Contact numbers on the adult protection procedure should be checked and updated so that staff have the correct information available to them The complaints procedure should be available in more user friendly formats. For example different font sizes. Dedicated storage spaces should be made available to prevent the cluttering of bathrooms and corridors. Door guards should be fitted to bedroom doors so that they do not have to be propped open in an inappropriate way. Staffing levels and the deployment of staff should be kept under review to ensure that a sufficient number of staff are on duty to meet individual service user needs. Notes made during interviews should be kept to show that decisions to recruit have been made fairly and without prejudice. Page 26 of 28 2 7 3 9 4 10 5 16 6 7 8 9 16 19 19 27 10 29 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 11 12 30 31 Staff shold receive training in Deprivation of Liberties so that they understand how to protect people. The registered manager should gain experience of other care settings and attend external meetings and training events as part of their continuing professional development. The registered provider visit report should show evidence of consultations with service users, their representatives and staff working at the home; inspection of the premises of the care home; its record of events and records of any complaints. Two signatures should be used to confirm when money has been received from or given to service users or their representatives. 13 33 14 35 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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