Care Home: Grove House

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What the care home does well The surveys we received told us the home had a homely atmosphere and that the staff were caring. The resident`s told us that staff respected their dignity and all residents we spoke with were well dressed in cared for clothing. All staff and residents we spoke to told us the Provider and Manager were approachable and they could talk to any of them about anything. Some residents considered the food to be excellent and we observed branded quality foods in stock. The home was generally well maintained and comfortable, a number of surveys from staff and residents liked the standards of cleanliness in the home. What has improved since the last inspection? There were no requirements listed on the last inspection report for this service. The Aqaa told us that a new large screen television had been purchased since our last visit. Some new variable height beds had been purchased to make it easier for staff to care for residents with mobility problems. What the care home could do better: The medications trolley was left open and unattended when we arrived at the home. The home does not yet have dedicated controlled drug storage, this is now required as guidance has changed since our last visit. Staff were being recruited and commencing work at the home without references, Pova first or Criminal Records Bureau checks being in place, this could place residents at risk of them being cared for by unsuitable staff. The Fire Officer had visited and made some requirements regarding fire safety, the work was in progress though the timescale for completion had not yet passed. There was not a skill based induction pack in place and the home was using its own checklist type induction. There was not a planned approach being taken to ensure that training was delivered on a regular basis. Some training had not been delivered to all staff such as safe guarding adult training and for some training such as health and safety and infection control only a few staff had completed these and no training on these had been delivered since 2007. The records for residents were being stored in an open area which did not ensure their privacy and confidentiality was being protected. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Grove House Moor Road Ashover Chesterfield Derbyshire S45 0AQ     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Bridgette Hill     Date: 0 8 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Grove House Moor Road Ashover Chesterfield Derbyshire S45 0AQ (01246)590222 01246590287 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) : Peak Care Limited care home 31 Number of places (if applicable): Under 65 Over 65 0 30 learning disability old age, not falling within any other category Additional conditions: 1 0 1 place in the category LD for service user named on proposal of conditions notice. Date of last inspection Brief description of the care home Grove House is a care home registered to provide care and accommodation for up to 31 older people including 1 place for a named individual with learning disabilities. The home is well established and is part of a care complex that also provides services for very sheltered housing. The home is set in its own grounds and overlooks fields and mature trees in the surrounding countryside. Amenities are available in the village of Ashover including pubs, a post office and small shops. The accommodation is a mixture of older buildings combined with a purpose built extension. There is a choice of lounges and dining rooms. 13 single bedrooms have en suite facilities, there is 1 double bedroom and the remainder are single accommodation. Car parking space is provided. Copies of the latest inspection report, statement of purpose and service user guide are available in the foyer. Care Homes for Older People Page 4 of 30 Brief description of the care home Current charges range from £360.00 to £420.00 per week additional top up fees of around £15.00 per week are payable depending on the type of room chosen. Additional charges are made for hairdressing, chiropody, trips out, opticians and toileteries Care Homes for Older People Page 5 of 30 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: one star adequate 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 was an unannounced one which took place over 8 hours. The purpose of this inspection was to assess all key standards to see how these were being met. Various records including care planning records were examined the findings are recorded in the body of this report. Discussions were held with residents and staff during the visit and by phone. An Annual Quality Assurance Assessment was completed by the Manager of the home prior to the visit and where relevant the content has been included in the body of this report. Care Homes for Older People Page 6 of 30 Prior to this visit surveys were also sent to service users and staff. Staff had assisted residents to complete the surveys we received back. We have used the information from returned surveys to plan our visit and recorded the views given in this inspection report. The Manager Jannine Stevens was on duty during the inspection. We also had opportunity to meet the Provider during our visit. What the care home does well: What has improved since the last inspection? What they could do better: The medications trolley was left open and unattended when we arrived at the home. The home does not yet have dedicated controlled drug storage, this is now required as guidance has changed since our last visit. Staff were being recruited and commencing work at the home without references, Pova first or Criminal Records Bureau checks being in place, this could place residents at risk of them being cared for by unsuitable staff. The Fire Officer had visited and made some requirements regarding fire safety, the work was in progress though the timescale for completion had not yet passed. There was not a skill based induction pack in place and the home was using its own checklist type induction. There was not a planned approach being taken to ensure that training was delivered on a regular basis. Some training had not been delivered to all staff such as safe guarding adult training and for some training such as health and safety and infection control only a few staff had completed these and no training on these had been delivered since 2007. The records for residents were being stored in an open area which did not ensure their privacy and confidentiality was being protected. Care Homes for Older People Page 8 of 30 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 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 30 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. Suitable admission procedures are in place which include assessments being obtained and opportunities being given to residents to allow them to visit the home. Evidence: The Annual Quality Assurance Assessment told us a Statement of Purpose is available to residents and trial stays are offered to prospective residents. We were also told a guest room for visitors is available should this be required to help settle residents in or if residents were ill and visitors wished to stay. We talked to the Manager about the admission process and found that procedures for planned and emergency admissions were in place. The Manager said they always did pre admission assessments and that information from Social Services Care managers were sought where residents were funded by local authorities. Care Homes for Older People Page 11 of 30 Evidence: Residents we spoke with told us that sometimes family had assisted them to find the placement at the home and that one of the reasons given for choosing the home was that it had a good reputation locally. We were told by the Manager that one resident has chosen to do a trial visit to the home but had stayed, not returning home as they had liked it so much. The surveys we received indicated to us that residents had been given terms and conditions of residency contracts to tell what to expect from their stay. The home does not provide intermediate care so standard 6 was not assessed Care Homes for Older People Page 12 of 30 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. There are care plans in place which ensure staff have access to information on how to meet the residents needs. Evidence: We looked at 3 care files to assess how staff were recording peoples care needs.The care files were recorded on handwritten formats, these were lengthy and the Manager told us it was difficult to update the form without rewriting a lot of information that may not have not changed. The care plans were considered to be descriptive of the residents needs and recorded their choices and promoted dignity and respect. There was some scope to improve these by including specific care details such as type of incontinence aids used and what bathing equipment was required. A system for ensuring care plans and other aspects of care were reviewed monthly was in place and had been completed within the last month. Care Homes for Older People Page 13 of 30 Evidence: A range of risk assessments were in place including moving and handling, nutrition and dependency. Some residents used aids and equipment to help prevent tissue breakdown but no routine risk assessment was in use to trigger referral to the District Nurse for further assessment and input. Residents were weighed each month to monitor changes and the records we viewed indicated stability for the 3 residents whose files we looked at. We examined the storage and administration of medicines during our visit. On our arrival the drugs trolley was in an open position and was not being directly supervised by staff. The administrative systems for recording medicines in and out of the home were well completed. Storage in use was suitable however there is new guidance that dedicated controlled drug storage must be available and this was not yet in place. Staff were recording drug administration correctly and the records indicated that residents were receiving medications regularly. The home used one local GP surgery and said that they had a good relationship with the staff there. Where nursing care was needed the District Nurse visited to provide this to residents. Other healthcare services available at the home were described in the Statement of Purpose and included visiting chiropodists, optician and dentists for extra charges. Visits from these services were typically annually or on request should the need arise. The care records we viewed indicated what healthcare services residents had accessed. Residents told us that staff respected their dignity and staff were observed knocking on bedroom doors before entering. There was one bathroom in the home that was a designated fire exit so therefore for safety reasons a lock was not fitted. There was no sign or other way of indicating to people that the bathroom was in use so therefore dignity could possibly be compromised. The bedrooms we viewed had information on the outside of wardrobe doors on incontinence needs; dignity could be better protected by this being inside the wardrobe door. One resident told us they had a shower each day usually assisted by the same staff member. The care plans contained some personal preferences such as dietary choices and bedtimes, some residents enjoyed a whisky each night before bed. All residents were smartly dressed in clean clothes and we saw residents wearing Care Homes for Older People Page 14 of 30 Evidence: jewellery and watches with the correct time showing. Care Homes for Older People Page 15 of 30 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 offers residents good food, makes visitors welcome and organises some activities to enhance residents everyday lives. Evidence: Some activity hours were included on the rota and we were also told that all staff undertook a role in offering activities to residents. Unfortunately due to sickness the activities planned on the day we visited did not take place. The home has a smaller lounge where some activities take place. We were told that film afternoons with popcorn are held and some craft sessions take place. A hairdresser visited the home each Monday to do residents hair. The home has a number of pets including a dog, rabbit and cats. Residents and staff seemed to enjoy this. A notice board informed residents what activities and outings were planned. A menu board was also on display. Care Homes for Older People Page 16 of 30 Evidence: One resident survey told us they would like more activities outside of the home such as outings. Another resident told us they would like more in house activities. During the Summer months a fortnightly schedule of outings is arranged using community transport which enables residents with mobility needs to go out too. The home was within a short walking distance of a local post office/shop and we were told that some residents did go out on thier own where they were able. The residents religion was usually recorded and we were told some residents attended the local church and that the Vicar occasionally visited the home to see residents. Many residents had newspapers and some books were available. A loop system was located in the front lounge of the home to aid those with hearing difficulties. Some residents had regular visits from families and the visits were recorded. Residents told us they enjoyed having the telephone in their room as this enabled frequent contact with family and friends in private. Residents told us their visitors were welcomed by staff and offered drinks. The surveys from staff and residents told us they considered the food at home to be excellent. We observed branded foods in the kitchen and staff told us they knew the residents preferences well. A vegetarian and diabetic diet was being catered for. At lunch we observed various residents using special plates, cups and cutlery to help them eat independently. The dining room was presented well with table cloths and cruets on tables. Some residents chose to eat in other parts of the home and at drink times we observed staff taking drinks into residents rooms for them. Care Homes for Older People Page 17 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Suitable procedures are in place to handle concerns and allegations however staff are not receiving training which may affect their ability to recognise and report abuse of residents, this may place residents at risk. Evidence: The Annual Quality Assurance Assessment indicated that no safeguarding adult referrals had been made however since the completion of this the home had made a referral to Social Services for consideration under safeguarding procedures. This was in the process of being investigated but has been appropriately handled by the homes management. The procedure for reporting allegations was in place and had been followed through. The procedure also considered any interim emergency care that may be needed to protect residents. The Annual Quality Assurance Assessment told us that all staff had received training in adult protection however records and discussions with staff indicated this was not the case. One staff member we spoke with told us that they had not received any training, another staff member told us they had done a course in the past but had not done a Care Homes for Older People Page 18 of 30 Evidence: course recently. It was evident from the discussions that some staff did not wholly understand the concept of different types of abuse or who could possibly abuse residents. The training records showed that there were gaps for 14 staff on the matrix where training in safeguarding adult had not been completed. The Manager told us that there were currently no courses scheduled. The majority of the surveys we received from residents told us that people knew how to make a complaint, only one indicated they didnt have this information. In the home there were comment cards for residents to complete if they had any concerns. The complaints procedure was included in the Service User Guide and included suitable timescales for any complaints to be resolved. Some guidelines regarding restraint were in place and we discussed if there had been any episodes of restraint but was told that there hadnt. Some residents used a Wanda guard bracelet this triggered an alarm to alert staff if they left the building. This was included as part of the care plan but was not included as part of the restraint policy. The is also new guidance and practice in place which covers where people may be subject to Deprivation of Liberty and as the bracelet effectively prevents residents from leaving the building when they choose a referral for consideration of this should be made to Social Services. Care Homes for Older People Page 19 of 30 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 provides a clean and well maintained environment for residents to live in. Evidence: The home is an extended previously private residence, it is a period property retaining some original features such as fireplaces. Bedrooms are situated over three floors with a shaft lift being available to aid those with mobility problems. Some new variable height beds had been purchased since our last visit to enable staff to care more easily for residents with mobility needs. The home is set within a quiet rural village with stunning views over adjacent countryside. It has well tended gardens with seating and bird tables, other wildlife such a semi tame rabbit also visit the home and residents told us they enjoyed feeding the rabbit. One resident survey told us they felt that the gravel outside the home was not very wheelchair friendly; this was considered a little difficult to walk on. Another survey from a resident told us the home was clean and bright with another resident telling us that hygiene levels are very high. One survey indicated that the outdoor smoking area could be improved with heaters Care Homes for Older People Page 20 of 30 Evidence: for the winter time. The home was found to be in generally good decorative order. We visited residents in their rooms and found that they had many personal possessions to make the rooms homely and individual. All residents had the option of Sky television and a direct dial telephone in their rooms for an additional cost. Residents told us they liked to be able to speak to family and take calls in private at anytime they wished. We looked at fire safety records and was told that a recent visit from the fire officer had highlighted that some works needed doing, these were partially completed but the timescale given by the fire officer had not yet passed. 3 Staff commented on the surveys that they felt the staff room and the facilities they had could be improved. This did have some patches of peeling decor. One resident survey told us that clothes were always kept clean and were well laundered and the residents we spoke with all appeared to be well dressed. Staff we spoke with said that if spills occurred residents clothing was always changed to ensure they were well presented. The laundry area was large enough and suitably equipped to deal with the residents laundry needs. One resident told us clothing was beautifully laundered and we observed residents in clean, smart clothing. Staff wore their own clothing for work but suitable aprons and gloves were provided to them to use when caring for residents. As staff were not in uniform it was difficult to identify who was a visitor and who was staff at the home as name badges were not worn. Care Homes for Older People Page 21 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are not systems in place to ensure staff were robustly being recruited and the provision of staff training was not in place to ensure staff were up to date in all areas this may place residents at risk. Evidence: The staffing rota was arranged in a way which required names to be allocated against the number of staff required on duty. This was typically 4/5 staff each morning, 3 in the afternoon and 2 on night duty additionally one senior carer was on duty for each shift. A management support rota was also in place should staff need support whilst at work. The Manager told us there was little staff turnover at the home. We examined two staff files to establish if recruitment procedures were being followed. In both staff files it was evident from the dates of commencement of duty on the rotas and the dates on references and Criminal Records Bureau checks that both staff had commenced work prior to references being obtained and no Pova first check or Criminal Records Bureau checks were on file at the time they commenced work. These had since been received and were satisfactory but there were insufficient systems in place to ensure that all checks were completed prior to staff working with vulnerable adults. The recruitment policy was also not clear in stating checks needed to be in place before staff started. Care Homes for Older People Page 22 of 30 Evidence: We discussed the induction process with the Manager and found that a checklist type induction was completed but that a skill based induction was not being used. We looked at the training records and matrix in place during our visit. As indicated earlier in this report there were some gaps in staff training with 14 staff having no date for completing safeguarding adult training. Moving and handling training was generally up to date apart from some staff who were currently off sick. No infection control training had been completed since 2007 with 1 staff member completing this. No health and safety training had been completed since 2005. It was found that all staff doing medications had received training somewhere between 2004 and 2009. 4 staff had completed dementia awareness training. There was no training planner available for the coming year that would ensure that the training gaps would be addressed. The home has a staff team of 27 staff of whom 14 have achieved national vocational qualification level 2 or equivalent. Additional staff were also in the process of doing national vocational qualification courses. One staff survey told us they thought the training they received was excellent. The staff surveys we received told us that staff considered that residents received high quality care. Residents told us on surveys say staff are excellent and give very good quality care, they are very caring. Staff told us there was good team work and communication between each other and that care plans were read and information was accessible to ensure residents needs were met. Care Homes for Older People Page 23 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Some areas of the home are being managed in residents best interests whilst aspects relating to poor management of recruitment and training may place residents at risk. Evidence: The Manager of the home is long serving and suitably trained having gained the Registered Managers Award NVQ Level 4. Our discussions with staff informed us that the Manager and seniors were approachable and supportive to staff. All staff said that they enjoyed working at the home and it was like an extended family. One resident survey told us that they considered Grove House to be well run and organised. We found that the recruitment procedures in place were not being sufficiently managed to ensure that all checks were in place before staff started and some staff had commenced work on the basis on only an application form being in place. There Care Homes for Older People Page 24 of 30 Evidence: was also irregular provision of staff training which had lead to some updates and training not being in place for staff. Surveys had recently been sent to residents and we looked at the results although the results had not yet been collated. General responses were found to be positive with most rating the home as very good or excellent. Comments were written to say the carers were brilliant and that one relative considered that the resident was treated with respect and dignity. Some suggestions were made regarding more outdoor activities and walks to into the village. Residents meetings were held where food preferences and aspects of living at the home were discussed and residents opinions recorded. The small office area in the home used by the care staff was an open plan area and the residents care plans and personal information was not being stored securely and was potentially accessible to unauthorised persons and therefore confidentiality and privacy for residents was not protected. A Personal Data Protection Policy was in place but this dealt with access to information and was not clear on secure storage of data. We looked at some records for residents money which was stored securely but as the administrator finished work we did not get opportunity to fully look at all systems and records. We found that some monies were stored jointly in a non interest bearing bank account with some cash being kept for when residents required money out. The records indicated that some residents owed monies with the money they owed being provided out of the monies that belonged to other residents without permission being asked for this. The accident records we looked at were generally well completed with only one not indicating what action had been taken after the accident. The records we looked at for the service checks of equipment in the home indicated that all were in date. Care Homes for Older People Page 25 of 30 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 26 of 30 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 9 13 The home must have a dedicated controlled drug cupbaord This will ensure suitable and storage for controlled drugs which does not allow unauthorised access 30/10/2009 2 9 13 All medicines must be secured stored at all times This is to prevent theft, tampering or accidental ingestion taking place 31/07/2009 3 18 19 All staff must receive training in safeguarding adults This will ensure staff have suitable knowledge and skills to identify and report any concerns they have 30/09/2009 4 19 23 The requirements listed in the fire officers report must be actioned 30/09/2009 Care Homes for Older People Page 27 of 30 To ensure all possible fire safety measures are taken to protect staff and residents 5 26 13 All chemical cleansers must be securely stored This is to prevent accidental ingestion, spillage and inappropriate use or access 6 35 12 Residents monies must not 31/08/2009 be in accounts where other residents without monies are loaned money from the accounts This is to ensure residents monies are not mishandled or loaned without their permission 7 37 17 Care records and other information containing personal data must be held securely This is to ensure confidentially and good data handling practices are in place to protect information from unauthorised persons 31/08/2009 14/08/2009 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 10 The bathroom with a fire exit route through it should have a notice on the outside to alert people whenit is in use, this will protect residents privacy and dignity Residents continence needs should be located inside wardrobe doors to protect dignity Care Homes for Older People Page 28 of 30 2 18 Where practices are in place where residents are potentially deprived of their liberty a referral for an assessment of this under the Deprivation of Liberty Safeguards should be made Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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