Care Home: Grosvenor House

What the care home does well Residents and staff spoken to were positive about the standard of care offered in the home. A visitor commented that her friend was well looked after. The home is presented in immaculate condition and provides a bright, homely place for residents to live. Mobility aids to assist frail elderly are available throughout the home. Infection control procedures are closely followed to reduce the risk of infection to residents. The in-house and community activities offered in the home by the activity co-ordinator are excellent, and provide residents with a wide variety of social interests. Staffing levels on the day of the inspection were appropriate with staff having the qualifications and training to meet the residents needs. Recruitment procedures are stringent ensuring that prospective staff are appropriately vetted prior to taking up employment in the home, therefore reducing the risk of abuse to residents. All health and safety practises are observed to ensure that residents live and staff work in a safe environment. What has improved since the last inspection? There were no requirements made at the last Key Inspection of Grosvenor House. What the care home could do better: Details in care plans need to improve to reflect the choices made by residents. The quality assurance system needs improvement to make sure all care needs of residents are identified and met. These issues were discussed with the Registered Manager who accepted that recording could improve and that systems in the home need to be monitored more closely. There was a recommendation made at the last inspection that - Copies of staffing records including recruitment checks carried out by the care worker agency who periodically supply staff, are kept in the home - this was adhered to but has recently lapsed and the registered manager should ensure that agency staff have been appropriately recruited so that residents are not placed at risk of abuse. Key inspection report Care homes for older people Name: Address: Grosvenor House 11-14 Grosvenor Gardens St Leonards-on-Sea East Sussex TN38 0AE     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: June Davies     Date: 1 5 0 9 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: Grosvenor House 11-14 Grosvenor Gardens St Leonards-on-Sea East Sussex TN38 0AE 01424423831 01424443586 Grosvenor@greensleeves.org.uk www.greensleeves.org.uk Greensleeves Homes Trust care home 33 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 33 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: Old age, not falling within any other category - OP Date of last inspection Brief description of the care home Grosvenor House is a care home providing personal care and accommodation for up to 33 older people. The home is owned by the Greensleeves Homes Trust, a London based charity that operates 18 care homes throughout England. Grosvenor House is located on the west promenade of St Leonards on Sea. About 1 miles from the centre of Hastings, there are shops, pubs, and other community facilities nearby. The property forms part of a Victorian terrace and overlooks a garden area and bowling green. Service users accommodation is on four floors. The home has had a new modern lift installed, which gives access to all floors. All bedrooms are offered as single person accommodation unless people choose to share, such as Care Homes for Older People Page 4 of 27 Over 65 33 0 Brief description of the care home married couples. The home is currently offering services to 27 people. The extensive building work, which started in June 2005, is now finished. This work has created en-suite shower rooms in all bedrooms, substantial communal space with level access throughout, and new level access entrance area in a previously unused area of the building. Information on the range of fees charged is within the homes current statement of purpose/service user guide this can be obtained by contacting the Registered Manager. Fees are base on room size and facilities. Charges for extras include personal items beyond the basics and activities provided by the home. Such items include newspapers, perfumes, chiropody, and hairdressing. Inspection reports are not routinely sent out to families and advocates after each publication although a copy is kept on display in the reception. 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: This key unannounced inspection was carried out on Tuesday 15th September 2009 over a period of 7 hours. During the inspection the inspector viewed documentation relating to the key standards inspected. Discussion also took place with six resident, six members of staff and one visitor to the home. The inspector also observed and checked administration of medication on a lunch time medication round. Observation also took place of a lunch time meal, staff respecting the privacy and dignity of residents including staff interaction with residents, the cleanliness, decoration and maintenance of the home and a conversation taking place between two residents and the activities co-ordinator. Care Homes for Older People Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. 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 7 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 8 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Grosvenor House provides both prospective and existing residents with a good level of information. Prospective residents are encouraged to visit the home for a day or a week prior to making the decision to move in. Pre-admission assessments are based on levels of risk so that the registered manager is able to accurately assess if they are able to meet the residents needs. Evidence: Statement of purpose and service user guide was last updated in 2008. Residents and their relatives/representatives are given a clear range of information about Grosvenor House prior to making the decision to move into the home. Six residents spoken with said that they had been given all the information they needed prior to moving in. Three pre-admission assessments were viewed from the most recent residents who have moved into Grosvenor House. Each pre-admission assessment recorded the Care Homes for Older People Page 9 of 27 Evidence: physical, mental, personal and social needs of the residents. On the pre-admission format answers are colour coded according to the needs of the resident, this then gives the manager a clear picture where the residents would be at risk. Once the preadmission assessment and the overall risk assessed the manager is then able to tell if the environment and staff experience and knowledge would be able to meet the residents needs. Where residents are to be funded by local authority, the registered manager always requests a care manager plan of care prior to admission. Residents are encouraged to visit the home prior to moving in, so they are able to meet with other residents and staff. Residents are also given the opportunity to take a meal in the home. In some cases residents have been into the home for respite care on several occasions prior to making the decision to move in on a permanent basis. Grosvenor House does not offer intermediate care. Care Homes for Older People Page 10 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 do not show a person centred approach to care planning, which takes into account each residents wishes, choices and equality and diversity. Individual risk assessments should be in place that accurately describe the risk the level of risk and steps that staff can take to help reduce the risk to residents. All staff in the home have regard for the residents rights to privacy and dignity. Evidence: Pre-admission assessments form the basis of residents care plans. Care plans were found to be well order and tidily sectioned off. There was no evidence to show that care plans are person centred and take into account each individual residents likes, dislikes, choices and preferences, or that residents are actively encouraged to maintain their independence or to set goals for themselves, although residents told the inspector that they are given choices in their everyday living routines. The inspector viewed three care plans in depth, and found there are risk assessments in relation to fire and handling, but these are generic and do not take into consideration Care Homes for Older People Page 11 of 27 Evidence: individual residents and do not give staff clear steps they must follow to reduce the risk to the residents. It was also noted that where there are health issues with residents that could place them at risk these had not been risk assessed, for example residents who are diabetic, epileptic, prone to falls etc. Daily reports are very basic, with remarks like all personal care given or is well. This does not show that staff recognise the individuality of each resident or their wishes and preferences. There was some evidence in care plans that the home has good working relationships with health care professionals. During the inspection a District Nurse visited the home following on from staff concerns in regard to a resident who is catheterised, so while concerns and contact with external health care professionals may be good, information is mostly passed on by word of mouth and not recorded on daily records or in individuals care plans. Issues found in regard to care planning were discussed with the registered manager who fully understood and will raise the issues at staff meetings and make arrangements for further care planning and report writing training. Generally medication is received, recorded, administered, stored and disposed of in accordance with the homes medication policies and procedures and pharmaceutical guidelines. The medication room is well ordered clean and tidy as is the medication trolley. A list of staff trained to administer medication is available together with their initials. Controlled drugs are kept safely in the appropriate controlled drugs cupboard and all controlled drugs entered into the controlled drugs register and appropriately signed off. It was noted that eye drops are dated on the day of opening on the box and not on the bottle, a senior carer said that she has already made arrangements with the supplying pharmacy to place prescription directions onto the bottle so that there is room to date when opening and that prescribed directions are available should the box get destroyed. At the present time the home does not have policies and procedures in place to guide staff in relation to PRN (as required) medicines. The registered manager said that she would obtain this information and ensure that it applied to all those residents who are on PRN (as required) medications. While many residents are prescribed external creams, these are not signed off after application by staff, therefore there is no evidence that creams have been applied as requested by residents general practitioners.During the inspection the inspector observed that staff at all times considering residents privacy and dignity. Through observation the inspector noted that staff talk to residents in a friendly and professional manner, and take into account their disabilities. Discussion took place with six residents all who said that they were treated kindly by the staff. Nothing is too much trouble and staff always respect their privacy and dignity. Some resident said that they had never been asked if they preferred a male or Care Homes for Older People Page 12 of 27 Evidence: female carer, most would prefer personal care to be carried out by a female carer. Care Homes for Older People Page 13 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Daily living routines are flexible and residents have a large choice of in-house and external activities they can participate in if they wish to. Meals in the home are excellent and provide residents with a nutritious, well balanced diet usually sourced from fresh locally produced food. Evidence: Six residents spoken to said that they are able to make choices in regard to their daily living routines, getting up and going to bed, food choices, visitors, going out, being involved in daily activities, what clothes they like to wear and watching television programmes of their choice and they felt that the home offered an excellent service. Care plans and daily reports do not reflect the standard of residents choices and how they are treated as individuals. The home employs an activities co-ordinator. She works hard with the residents, offering them a variety of in-house activities as well as interesting talks and entertainment from external entertainers. During the course of the inspection the inspector witnessed the activities co-ordinator talking to residents about a visit to the local theatre and discussing with them what facilities are available for people who are Care Homes for Older People Page 14 of 27 Evidence: less mobile. Each month the activities co-ordinator produces an activities plan for each day in the month. Resident spoke highly of the activities co-ordinator as said that she works very hard, and is always available to talk to them one to one, and to do different activities with them. Residents said that they like all the activities and they can participate if they wish to. One visitor said that she had visited many homes in the area and this home offers the best and most interesting of activities. Residents are able to access the local community and be involved in local community activities if they choose to. When residents move into Grosvenor House they are able to personalise their own bedrooms with items from home. Residents can choose to have their own telephone in their bedrooms if they wish to. The meals in the home are excellent and are prepared by a chef who has worked in the home for over five years. There is evidence that residents are offered a variety of choices and fresh locally produced food is used as and when possible. The chef has an excellent understanding of residents likes and dislikes. On the day of this inspection the lunch time meals comprised of toad in the hole, with fresh carrots, peas and choice of mashed or sauteed potatoes, or vegetable lasagna, and the desert dish was either lemon meringue pie or spotted dick and custard. Dining room tables were attractively laid with choice of condiments, and drinks. Every Sunday residents can meet in communal lounge for a pre-lunch drink. The chef said that he is able to cater for specialised diets and residents who require light softer diets. All the residents spoken to said that the food in the home was excellent. Menus are produced in large type so that resident are able to read them more easily and make informed choices. Discussion took place in regard to more residents being admitted to the home with mild Dementia type illnesses, and that pictorial menus are being considered. Residents are able to come into the communal dining room for meals or to have their meals taken to their own bedrooms. Care Homes for Older People Page 15 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. Residents know that their complaints and concerns will be listened to and acted upon. Staff have good knowledge of Safeguarding Vulnerable Adults that helps to protect residents from abuse. Evidence: Complaints are well managed by the home and feedback is given to complainants in accordance with time scales outlined complaints policy and procedure. The complaints policy and procedure does need to be reviewed to reflect the Care Quality Commission contact address and telephone number. Four residents spoken to during this key inspection said that they had been given information about making a complaint and that they would know who to make a complaint to. Policies and procedures are in place relating to the Safeguarding of vulnerable adults and these had been reviewed in 2008. Any safeguarding issues are managed appropriately and reported to the relevant to the authorities. Two safeguarding referrals made since the last key inspection have now been appropriately investigated and closed. Recruitment practises are good and new staff are appropriately vetted prior to being deployed to work in the home. Staff have a good understanding of Safeguarding Vulnerable Adults, and the majority have receive training in this subject. It was noted that some staff training in Safeguarding Vulnerable Adults had taken place four years ago. The registered manager confirmed that further Safeguarding Care Homes for Older People Page 16 of 27 Evidence: Vulnerable Adult training has been arranged so that new staff are trained and long term staff have updated this training by December 2009 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is kept in excellent condition providing residents with an attractive and homely place to live. Evidence: Grosvenor House is maitained to an excellent standard offering its residents a homely comfortable place to live. The whole home is bright and cheerful, and kept in an immaculately clean and hygienic condition. Communal lounges and dining room are furnished to a high standard and are bright and cheerful. Residents also have use of a small library/computer room on the third floor. All floors can be accessed by a passenger lift. Radiators throughout the home are of the low surface temperature type to prevent residents from being burnt. There are several small patio type areas that are safe and accessible for residents to use. Communal bathrooms are domestic in style and fitted with specialised baths and shower units to aid mobility. Communal toilets are also fitted with mobility aids. There is evidence throughout the home that infection control procedure are adherred to, with a good supply of plastic aprons and disposable gloves for staff to use when carrying out personal hygiene tasks. All communal bathrooms and toilets are supplied with liquid soap and paper handtowels. Care Homes for Older People Page 18 of 27 Evidence: Visitors to the home are requested to use achohol hand liquid to prevent infections being brought into the home. The laundry room is kept in a clean and tidy condition, and is provided with industrial washing machines and tumble driers, hand washing facilities with liquid soap and paper hand towels. Red alginate bags are used for foul linen. 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. Staff at the present time are employed in sufficient numbers to meet residents needs. Recruitment procedures are stringent and ensure that staff are appropriately vetted prior to being employed to ensure that residents are not placed at risk of abuse. The opportunity for staff to gain qualifications and undertake mandatory training are good, and this helps staff have the skills and knowledge to meet residents needs. Evidence: At the time of this key inspection there are sufficient staff on duty to meet the residents needs. Rotas are monitored by the registered manager to ensure that staff levels are adjusted to meet the needs of the residents. Residents said that they usually find there are enough staff on duty to meet their needs. Ancillary staff are employed in sufficient numbers for cooking meals, cleaning and maintenance work. 82 of staff in the home have achieved their NVQ level 2 or above in Social Care. The registered manager stated that when new staff are employed and have not got there NVQ qualification they are signed onto an NVQ course. Three staff personnel files were viewed by the inspector and it was found that prospective new staff have the appropriate Protection of Vulnerable Adults and Care Homes for Older People Page 20 of 27 Evidence: Criminal Records Bureau checks carried out prior to being deployed to work in the home. All new staff are expected to complete an induction package. The majority of staff were found to have received mandatory training, although some of the training had been carried out several years ago. Discussion with the registered manager confirmed that further mandatory training courses have been booked to ensure that new staff receive mandatory training and long term staff update this training. Staff were positive about the opportunities for training and gaining qualifications. Staff also told the inspector about a new training programme that was available through Sky T.V. that offered distance training to staff who working in care. 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 manager has the skills and knowledge to manage the home and ensure that residents needs are met. The quality assurance system needs to be developed further to ensure that residents are receiving a good quality of care throughout. The safety and welfare of resident who live and staff working in the home is given top priority. Evidence: The registered manager Janet Fox has managed Grosvenor House for a number of years, she has an NVQ level 4 in Social Care and a Registered Managers Award. From the training matrix there is evidence to show that she regularly updates her training. The manager holds regular staff meetings and carries out regular staff supervision. Staff said that the manager is approachable. Resident spoke highly of the manager and said that she always makes herself available if one of the residents wishes to Care Homes for Older People Page 22 of 27 Evidence: speak to her. The inspector looked at the Quality Assurance System used in the home, and there was evidence that opinions of the residents, visitors, and external stakeholders are sought, and that these views are published on an annual basis. The responsible individual for Greensleeves Trust who own Grosvenor House, visits the home once a month to carry out a Regulation 26 visit and produces a report on their findings. There was very little evidence on the day of the inspection that the Registered Manager carries out regular monitoring of systems with findings of this monitoring recorded. Lack of monitoring is evidenced especially in relation to care planning, and the lack of individual information, likes, dislikes and preferred choices recorded in these documents. Evidence is available to show that Fire, Health and Safety risk assessments are carried out both internally and externally. Some more work needs to be carried out to ensure that a comprehensive quality assurance system is in place to ensure that a high standard of care is offered and recorded throughout. The home does not hold any of the residents personal allowances. If residents wish to make purchases this is paid for out of petty cash with a receipt retained, and residents or their relatives/representatives are billed at the end of each month. Four residents told the inspector that they look after their own money and have a secure place to keep it in their bedrooms. Two other residents said that their relatives look after their personal allowances, but if they wish to make a purchase especially from the homes trolley shop they can have what they want, and the home then bills their families. The majority of staff have receive mandatory training but in some cases these needs to be updated. The inspector viewed maintenance certificates for equipment used in the home and found them to be up to date. Regular weekly checks are carried out in relation to the fire systems, hot water temperature delivery and emergency lighting. Health and Safety checks are carried out regularly. Magnetic door closures are also checked on a regular basis. The accident book is completed appropriately if a resident has an accident. 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 1 7 12 The registered person shall, for the purpose of providing care to service users, and making proper provision for their health and welfare, so far as practicable ascertain and take into account their wishes and feels. The registered person shall make suitable arrangements to ensure that the care home is conducted with due regard to the sex, religious persuasion, racial origin, and cultural and linguistic background and any disability of services. Residents should be allowed to express their likes, dislikes, preferences and choices as to the care they wish to receive, the residents equality and diversity as an individual 14/12/2009 Care Homes for Older People Page 25 of 27 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 must also be taken into account. 2 7 12 The registered person shall 14/12/2009 ensure that unnecessary risk to the health or safety of service users are identified and so far as possible eliminated. Risk assessments must be in place, and give staff clear steps to follow so that the element of risk is reduced to a minimum 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. 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