Care Home: Green Hill

What the care home does well There is a detailed and informative Statement of Purpose and Service Users Guide that gives prospective residents and their families the information required to enable them to make an informed choice about where they live. There are robust admission processes to the home. A full needs assessment by a competent person is undertaken and they are assured in writing that their needs will be met before they move in. Some residents were able to confirm that they were visited by the assistant manager prior to admission to the home and two relatives confirmed they they were involved in the admission process. The menus evidence a well thought out balanced diet with a varied choice of food in line with residents` preferences. A comment received was ` The food is varied and my mother enjoys it`. Quality assurance systems are in place which enables the service to monitor and improve their service and ensure that the home is run in the best interests of residents. Comments received included: `The staff are approachable, understanding and readily discusses any issue I want to raise`. There is an open-house policy which welcomes visitors at all reasonable times. Satisfactory arrangements are in place to safeguard residents` finances. The atmosphere of the home is pleasant with good interaction seen between residents and staff. The Comments received from residents and families regarding the care received included, `Loving care of the individual, couldn`t be better`, `The staff are always kind and courteous, and the whole premises clean and bright`. What has improved since the last inspection? The requirements set at the last key inspection have been met. The staff have worked hard on the care plans and risk assessments to ensure that a person centred approach is used along with involvement with the residents. There was evidence of regular review and monitoring of residents health needs. The medication practices now seen in the home promote and safeguard the health needs of the residents. The recruitment proocesses are now thoroght and protect the residents living in the home. The AQAA stated that activities are an area that are constantly being reviewed and improved to meet the residents social needs in the home. The staff team is more stable now and all staff are recieving the training they need to perform their job. What the care home could do better: As discussed during the inspection visit there are areas in respect of care planning and risk assessments that still need developing, but these are areas that the management team have identified and were fully discussed. Therefore there are no requirements made at this time. Key inspection report Care homes for older people Name: Address: Green Hill Station Road Crowhurst Nr Battle East Sussex TN33 9DB     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: Deborah Calveley     Date: 0 8 1 2 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: Green Hill Station Road Crowhurst Nr Battle East Sussex TN33 9DB 01424830295 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Rooks (Care Homes) Ltd care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users to be accommodated is 30. The registered person may provide the following category/ies of service only: Care home only ? (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Date of last inspection Brief description of the care home Green Hill is registered to provide care for up to 30 older people with a dementia type illness. The home is a large detached property situated in a semi-rural area close to the local railway station in the village of Crowhurst, near Battle in East Sussex. Due to the rural location access to community facilities are limited. Accommodation is on two floors and comprises twenty single and five double rooms, all of which have a wash hand basin. The home has four bathrooms and aids and adaptations have been installed throughout the home to suit the needs of service users. These include assisted baths toilet riser seats and grab rails. Communal areas comprise a dining room and a large lounge separated into one large area and two smaller ones giving service users the Care Homes for Older People Page 4 of 27 1 2 0 7 2 0 0 9 30 Over 65 0 Brief description of the care home opportunity to sit quietly, a further lounge is situated off the dining room. There is a large amount of refurbishing that is being undertaken by the new provider and there may be changes to the communal bathrooms and double rooms. There are attractive well maintained gardens to the front and rear of the property which are accessible via ramps. 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 reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report those living at Green Hill Care Home will be referred to as residents. This was a key inspection that included an unannounced visit to the home and follow up contact with residents representatives and visiting health and social care professionals. This unannounced inspection was carried out over 5.5 hours on the 08 December 2009. There were 19 residents living in the home on the day of the site visit of which four were case tracked and spoken with. Five other residents both male and female were also spoken with. The purpose of the inspection was to check that the requirements of previous inspections had been met and inspect all other key standards. Care Homes for Older People Page 6 of 27 During the inspection visit, a range of documentation was viewed. These included the Service Users Guide, Statement of Purpose, care plans, medication records and recruitment files. Five members of the care team were spoken with in addition to discussion with the appointed manager. Telephone contact was made with visiting professionals following the visit and one health professional was spoken with during the inspection visit. The information received from those and received verbally have been incorporated into this report. An Annual Quality Assurance Assessment was received from the assistant manager completed in full prior to this key 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: Care Homes for Older People Page 8 of 27 As discussed during the inspection visit there are areas in respect of care planning and risk assessments that still need developing, but these are areas that the management team have identified and were fully discussed. Therefore there are no requirements made at this time. 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. The home provides prospective residents and relatives with a good level of information about the home, its facilities, services and the costs involved. The admission procedures allow for the needs of prospective residents to be assessed by a competent person before admission. Evidence: The homes Statement of Purpose and Service Users Guide was available on request. These are also available in the entrance area of the home. These documents were informative and contained information about the home and the services it provides along with the qualifications of the staff fees and additional costs. These documents have just been reviewed and updated. A review of the care documentation confirmed that pre-admission assessments are completed by the assistant manager prior to moving into the home. The last two admissions to the home were identified and the records relating to the admission Care Homes for Older People Page 11 of 27 Evidence: procedures followed were reviewed. This confirmed that pre-admission assessments are completed and provide an adequate assessment of prospective residents care needs. The assistant manager confirmed that these are used to ensure new admissions to the home are appropriate and that the home have the staff, equipment and environment to meet their care needs. A recommendation of good practice was made in ensuring that enough information is recorded to make that decision taking in to account medical conditions and past history. Prospective residents are seen either in their home or hospital before admission and the input from relatives and other professionals is used whenever possible. The home now confirms in writing that having regard to the assessment that the home can meet the assessed needs of the prospective resident. The assistant manager was able to verbally demonstrate her knowledge and awareness of the varying conditions of the residents. Mrs Rooks ensures that the carers employed are provided with the opportunity to attend the relevant courses to deal with the needs of the elderly and have an understanding of dementia type illnesses. Trial visits to the home can be arranged. The assistant manager confirmed that residents are invited to a trial period to ensure suitability of the home and this is clearly stated in the Statement of Purpose and in the statement of terms and conditions. Green Hill also provides respite care and short stay visits. Intermediate care is not provided at Green Hill Care home. 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. Care plans provide a good framework for the delivery of care which give clear guidance to care staff on all the care needs of all the residents. The home was found to be meeting residents health and general needs with accessed additional specialist support when needed. Medication practices in the home promote and protect the health needs of residents and the privacy and dignity of residents are promoted. Evidence: The care documentation pertaining to four residents was reviewed in depth as part of the inspection process. The home staff are using a new computerized care plan which guides staff in the preparation of risk management and care. It is acknowledged that the staff have worked hard on the care plans to ensure they are specific to the individual. As discussed there are some areas that need to be developed to ensure staff have a full understanding of the residents health needs. Risk assessments for health needs are included in the care planning format used by the home and all risk assessments were found to be completed and followed through Care Homes for Older People Page 13 of 27 Evidence: with an appropriate plan of action when identified as required. There are areas that need to be filtered to ensure the risk highlighted is pertinent to that specific resident and that further risk assessments are introduced in respect of on-going health problems. The homes documentation ensures that the residents receive the care and support they need to protect and promote their health and well being. Doctors input in to the residents care is recorded and evidenced that the staff are proactive when identifying a health need and in contacting the relevant health professional. The home support and enable residents to access services from other health care professionals in order to promote their physical and mental well being. The district nurse was visiting on the day of site visit and was happy to give his opinion of the home: The home is clean and welcoming, the staff are friendly and courteous. Two relatives spoken with were satisfied with the care provided at the home. Comments received included Very good, They are very supportive, Residents are clean and cared for. There are policies and procedures in place for staff to refer to regarding the safe administration, storage, disposal and recording of medication. Practices for medication administration ensure the health and safety of the residents are protected by safe practices. Staff were seen to be respectful and considerate to all residents whilst attending to their needs. Residents were dressed in appropriate clothing and care had been taken with their appearance, men were clean shaven and the ladies evidenced clean and manicured nails and nicely cared for hair. Residents are encouraged to have their personal items with them such as handbags and caps, but care must be taken with eye glasses as there were 4 pairs of glasses on a table, which means four residents were without their glasses at that time. 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 lifestyle and meals experienced by residents at this time meets their expectations choices and preferences. Evidence: The home have individually assessed the residents capabilities and have with the help of families and friends built up a life history of the residents living in the home. The staff have created with the help of the residents a life box that contains pictures, objects and information of particular interests and past hobbies of the residents. Throughout the day staff were seen inviting residents to the area designated for activities and interacting with residents on a one to one basis. Photographs displayed on the wall evidenced residents participating in various activities. There is no set activity programme as the residents have varying capabilities and this works well with the mix of residents currently living in the home. This will be reviewed regularly along with residents input where possible. It was lovely to see a group of residents sitting together and enjoying each others company, this was encouraged by the staff. The staff were observed playing ball games with residents in the morning and skittles was played in the afternoon. The assistant manager confirmed that they are Care Homes for Older People Page 15 of 27 Evidence: constantly looking at different ideas to encourage participation and interaction with the people who live in the home. The staff keep record of the individual residents participation in daily activities. The minister visits the home regularly and it was confirmed that the residents wishes regarding their religious needs are taken into consideration and upheld as far as is possible. There are no set routines in the home and this allows the care and services to be flexible depending on the residents mood and wishes. Green Hill has an open visiting policy and all visitors are warmly welcomed. Two relatives visiting were very positive in respect of the care and support provided for their relative: They really care for the people, Really nice staff who care. The assistant manager works well with residents and staff to ensure that the freedom and protection of individuals rights is maintained. Where restrictions are in place the staff have ensured that this is appropriately risk assessed and in line with the Deprivation of Liberty guidelines. This includes the keypads that are in use in the communal areas. The meals prepared are based on the residents preferences and choices. The cook completes the safer cooking better business book as supplied by the Environmental Health Organisation. Residents appetites are recorded and fortified food or an alternative is offered for those who have not eaten or are known to losing weight. The dining area is attractively decorated in a homely fashion. The furniture is matched to the needs of the residents and no residents were seen eating lunch from a wheelchair. This has enabled the residents to maintain their Independence for eating. Residents were seen to be supported by staff in a dignified and respectful manner. There were no time constraints to the two meal times observed residents could eat at their own pace. Clear records are kept of the meals eaten and amount on a daily basis for each resident living in the home. 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. The home has a formal complaints system with evidence that residents feel that their views are listened to and acted upon. Staff receive training to protect residents from abuse. Evidence: A complaints procedure is available in the home. A review of this documentation identified that it was clear and had set response times detailed. Everyone spoken to as part of the inspection process confirmed that they would feel comfortable in raising any concern with the assistant manager and were sure that she would deal with any matter in an effective way. There have been no complaints received since the last key inspection. There is a Safeguarding Vulnerable Adults procedure in place, which clearly identifies the importance of reporting any allegation or suspicion of abuse to Social Services who are the lead authority. The assistant manager confirmed that she had completed train the trainer training on Safeguarding Vulnerable Adults and was able to demonstrate a good understanding of the issues. All staff have received formal training on Safeguarding 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Green Hill provides a comfortable clean and safe environment for those living in the home and visiting. Evidence: Green Hill is well maintained and safe and meets its stated purpose and the aims and objectives of the home. There are attractive gardens with seating areas which are safe and accessible to residents who live in the home. It was confirmed that routine maintenance issues are attended to alongside the refurbishment programme. The communal areas are decorated in calm, neutral colours and provide attractive and comfortable areas for the residents. The second smaller lounge is still decorated in an older style, but old style pictures and books have made this in to a comfortable remembrance room. The gardens and patio areas are well looked after and attractive and the patio is enclosed for the residents safety. Residents bedrooms are attractively decorated and furnished and evidence the personal effects of the residents. There are adequate communal bathrooms in the home, one has a specialist chair to ensure all residents can have a bath. One bathroom on the ground floor has been converted in to a hairdressing salon and beauty therapy room. There is written evidence that staff test temperatures of baths before bathing a resident. It was Care Homes for Older People Page 18 of 27 Evidence: confirmed that hot water temperatures are checked and recorded regularly by the maintenance person. There are systems in place for monitoring safety issues, all the rooms are routinely checked for safety and maintenance issues. The completed AQAA confirmed that these are up to date. The visit to the home confirmed that staff are aware of the fire safety policies, no doors were found inappropriately wedged open during the inspection. Call bells are provided in all bedrooms and communal areas and risk assessments are in place for the residents that do not have the capacity to use a call bell. The use of bed rails is assessed clearly and reflected in the individual care plans. The laundry room was found clean and tidy and the residents clothes are well looked after. The cleanliness in the home was found to be of an improved standard. The cleaning is undertaken by one of the care team at this time and this time is set outside the busiest care time so as not to impact negatively on the residents . All Staff attend training in infection control and in the main good practice was observed. The staff are to be reminded of the appropriate guidelines in place for the use of aprons while giving personal care. 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. There is sufficient trained and competent staff on duty at all times to meet the assessed needs of the residents. Robust recruitment procedures and appropriate staff training ensure the safety and protection of residents. Evidence: The residency levels at the home currently run at 19 and the staffing levels are at present sufficient to meet the residents needs. Four carers are on duty for the day shift and two carers on at night. The assistant manager lives in the home and provides on call cover. It was confirmed by the manager that there is flexibility of the staffing levels and they are adjusted according to the changing needs of the residents. In addition to the care staff there is a full time cook in post, a registered manager, assistant manager and a maintenance person. The carers currently cover the cleaning and the laundry, this will be reviewed once the residency ratio increases. An induction programme has been introduced for all new staff, two members of staff have recently commenced work and are working alongside a senior carer on the Skills for Care induction programme. A selection of staff recruitment files were viewed and demonstrate that a robust recruitment process is now in place now to protect residents and contained all the relevant information required. All the paperwork is kept within a locked room. Care Homes for Older People Page 20 of 27 Evidence: A training matrix is in place and evidenced that there is a rolling plan of training. Staff spoken with said that training opportunities at the home are good and they are well supported by the senior staff and the assistant manager. This ensures that all staff receive the training required to perform their job competently and therefore promoting the health and well being of the residents living in the home. 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. The overall management of this home is good with effective systems in place to protect residents. Evidence: The registered manager Mrs Rooks, has been in post since February 2008 and became the registered provider and manager of Green Hill in June 2008. She has experience in managing and owning a care home for older people in Kent. There is an assistant manager that is in day to day charge when Mrs Rooks is away from the home. The management structure of the home has strengthened and improved since the random inspection and this has improved the overall running of the home ensuring that the outcomes for residents are positive. The requirements that were set at the random inspection have been met. There is an acknowledgment that the care planning system in place still needs to be monitored and improved, but with new staff coming on board, this is a work in progress. The atmosphere in the home was pleasant, welcoming and inclusive, residents were Care Homes for Older People Page 22 of 27 Evidence: calm and were seen to be interacting well with each other and the staff. Quality assurance systems are in place and these are performed annually and include seeking the views of families, friends and stake holders. Regulation 26 visits are now carried out by the registered manager of the sister home and forms part of the quality assurance systems. The home does not handle any of the residents monies and any extra charges such as chiropody are invoiced to the residents family or representative. There is evidence of staff supervision having been being commenced for all the staff employed in the home. There are policies and procedures in place that evidence regular review and updating. Two policies were reviewed and were found to be service specific and relevant to the homes category. The staff employed in the home have received the training necessary in order to promote good practice and ensure the health safety and well being of the residents living in Green Hill. Green Hill looked well maintained and systems are in place to report any problems to the maintenance team that need attention. The staff were observed working safely in the home in all aspects of care. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 15 17 That the registered person 20/09/2009 ensures that there are records of the food provided for service users in sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory, in relation to nutrition and otherwise and of any special diets prepared for individual service users. That service users are assured a nutritious and varied diet. 2 26 12 That the registered person 20/09/2009 ensures that the home meets is stated purpose in respect of cleanliness. That the home is clean and hygienic and meets it stated purpose and aims and objectives. 3 27 18 That the registered person 20/09/2009 ensures that at all times there are suitably qualified, competent and experianced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. That service users needs are met by the numbers and skill Care Homes for Older People Page 24 of 27 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 mix of staff. 4 29 19 That the registered person 20/09/2009 operates a thorough recruitment process ensuring the protection of the service users. That service users are protected by the homes recruitment policy and practices. Care Homes for Older People Page 25 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 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). 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. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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