Care Home: Hatfield Haven Residential Care Home

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What the care home does well Residents appear contented living at Hatfield Haven. They interact with the staff team well and enjoy the food provided, which looks very good. Residents can be assured that they would be properly assessed before coming into the home and that their day to day care needs would be met. Residents live in a clean, safe and well maintained home. The management team for the home is keen to develop the service and the new manager is efficient at addressing any issues and is promoting resident led care. What has improved since the last inspection? Since we last visited there has been a significant improvement in the home. A new, experienced manager is in post and she is developing the staff team well. Staff have attended many training sessions and the manager is working closely with the team to develop a person centred approach to care. Staff spoken to are much more knowledgeable than when we last visited and have a better appreciation of what is needed to provide good care and what constitutes a good care home. The manager and her team have addressed the majority of the regulatory requirements made in the last report and is moving the home forward. Care planning and management has improved which means that outcomes for residents are better overall. Staff are now recruited properly and are being appropriately supervised. The management of complaints and adult safeguarding has also got better. What the care home could do better: Whilst there have been improvements, which the Commission wishes to see sustained and built upon, there is still some work to do. Care planning and management for residents has improved but person centred planning needs more work along with the monitoring and planning of long term health care needs. The further training of staff in the care of people living with dementia will also help develop a person centred approach to care. Social activities that meet residents` individual needs also requires further assessment and planning. Key inspection report Care homes for older people Name: Address: Hatfield Haven Residential Care Home Stortford Road Hatfield Heath Bishops Stortford Essex CM22 7DL     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: Diane Roberts     Date: 2 8 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Hatfield Haven Residential Care Home Stortford Road Hatfield Heath Bishops Stortford Essex CM22 7DL 01279730043 01279730043 hatfieldhaven@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Hatfield Haven Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 22 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 22 persons) Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 22 persons) Service users must not be admitted to the home under the Mental Health Act 1983 or the Patients in the Community (Amendment) Act 1995 Date of last inspection Brief description of the care home Hatfield Haven is registered to provide personal care and accommodation for 18 older people over the age of 65 years of age with dementia. The home is a large detached house located on the edge of the village of Hatfield Heath that provides access to Care Homes for Older People Page 4 of 25 3 0 0 9 2 0 0 9 0 0 Over 65 22 22 Brief description of the care home public transport and shopping facilities. The home has bedrooms with ensuite facilities located on both the ground and first floors of the premises as well as three communal bathrooms. The upper floor is accessible through the passenger lift. The homes grounds are accessible to both the service users and their visitors. The home is equipped to meet the needs of the current service user group and provides aids and adaptations to assist residents with limited mobility. The current rates of fees are between £550 and £650 per week, depending on whether a room is a single or a shared room. Additional charges are made for hairdressing, chiropody, toiletries, papers and magazines. Information about the home is made available to prospective residents in the Statement of Purpose and Service User Guide. The current inspection report is also available. Care Homes for Older People Page 5 of 25 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: We visited the home for a day and met with the manager and the care team. On the day it was also possible to meet with one of the proprietors. Prior to this we reviewed all the information that we already had on the home and this included an improvement plan developed by the new manager at the home. We asked the manager to complete this plan in light of the previous rating of the home made in September 2009. On the day of the inspection we spoke to 1 resident and interacted with 2 further residents. Due to their dependency, the majority of residents were unable to help us by providing feedback on the home. Three staff at the home were also spoken to along with one relative. Some relatives completed surveys on behalf of their relatives and comments from these are used in this report. Whilst at the home we also reviewed records and undertook a tour of the home. Care Homes for Older People Page 6 of 25 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 25 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 25 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be assured that they would be properly assessed before coming into the home but they cannot always be assured that they would have all the information that they would need at the current time. Evidence: The manager is aware that the service user guide needs a review in relation to its content and the format not being user friendly for the resident group and this was discussed. Since coming into post the manager has developed new pre-admission assessment documentation. The manager and her deputy are undertaking any assessments. It was possible to review one new assessment that had been completed since our last visit. The assessment was fully completed and overall it was sufficiently detailed to enable the team at the home to make a decision as to whether they would be able to care and support the person concerned. The assessment contained some good detail Care Homes for Older People Page 9 of 25 Evidence: on the residents needs and in some areas it identified their abilities, which is positive. Information was also gained on their social interests and social support. More person centred information about, for example, peoples preferences and expectations would also be of value. This aids a smoother transition into a care home placement and helps staff to care and support the resident as a individual. Information in relation to the residents level of dementia was quite good, outlining how this affected them and skills they retained. On reviewing the care plan, information gained at the time of assessment had been transferred over into the plan of care. No letter of confirmation is currently sent that confirms that following assessment the team at the home can either meet or not meet the persons needs. This should be addressed. The most recent inspection report was not available in the home for information. Care Homes for Older People Page 10 of 25 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. Residents will have their care needs met in an individual way. Evidence: Since our last visit the manager has introduced a new care planning system into the home and the team have been working hard to develop these and ensure that the care management of residents improves. The manager is currently developing an assessment of need tool, on which to base the care planning system on an ongoing basis, which ensures that all areas of potential need are considered at each review. Overall, residents had the care plans that they required in place to meet their day to day care needs and these were up to date and covered, for example, personal care, nutrition, mobility etc. More attention should be given to putting plans in place for the monitoring/potential management of long term medical conditions, such as asthma, mental health or renal failure, in order to bring this to the attention of staff for ongoing consideration. The care plans relating to personal care contain a good level of detail in order to guide and inform staff. Many of the care plans contained person centred information, showing residents preferences and choices in day to day life, however this was variable and should be continued to be developed with input from Care Homes for Older People Page 11 of 25 Evidence: residents and/or their families. Relatives who commented said they provide good care for my relative, staff are always available to discuss any changes in care or my relatives welfare and the staff communicate with residents all the time and they are never left on their own, someone will always talk or interact with them. Residents had a range of up to date risk assessments in place, including those for falls, nutrition, manual handling etc. These were seen to contain sufficient detail on the risk and management. Risk assessments were also in place for the risk of pressure sores. Those at particular risk had associated care plans in place that were up to date and detailed any preventative measures such as equipment or the use of creams. Records show that residents are seeing their doctors in a timely manner along with other health care professionals such as community psychiatric nurses. Doctors are also visiting the home to undertake proactive health care reviews. Residents we spoke to said I feel safe and well looked after and I see the chiropodist and now they weigh me once a month. We looked at the management of medication in the home. Overall this was in order with generally good signing and the use of codes when items are omitted etc. Medication profiles and photos are not in place but the staff team confirmed that these were planned in the near future. There was evidence that residents were having their medication reviewed appropriately. Staff should note that hand written prescriptions need signing by the responsible person transcribing and items that come into the home after the main delivery should also be checked in. At the current time the team are not administering any controlled medications. A new controlled medication cupboard is on order and it is planned that this will be sited in an appropriate place. The manager plans to introduce a regular medication audit as at the current time one is not in place and since we last visited all the senior care staff administering medication have undertaken training on the safe administration of medication. The manager has reorganised the laundry and introduced a new labelling system in order to improve residents dignity by getting their own clothes back to them. Care Homes for Older People Page 12 of 25 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can expect to be offered choice in their day to day life and be offered some social activities. Evidence: From records, observation and discussion with residents and staff, the routines of the day have changed and are now primarily resident led. Residents describe having choice in their daily routines and staff confirm changes in the routines of the home and describe giving choice. Staff spoken to also showed more appreciation of residents rights than they had previously. Residents who commented said they dont question what time I get up or go to bed. Staff were heard and seen to be interacting with residents more at this visit to the home. The atmosphere in the home was more friendly and inclusive of the residents. A new large activities board has been put up so that residents can see what activities are coming up during the coming week. The activities officer who previously worked at the home is now working solely on activities rather than being pulled into undertaking a care role as she was previously. She currently works every afternoon and has been coming in on the occasional weekend to help, for example, with a fish and chip Care Homes for Older People Page 13 of 25 Evidence: supper. This has helped with the development of the new activities programme. A plan for key events in 2010 were also displayed and included any entertainers booked etc. The staff team have developed an indoor bowling league with the residents and this was evident on a notice board in the main lounge. Staff spoken to said that more activity equipment had been purchased that they could use and that a poetry and newspaper group was also being set up. The manager said that they would be working on involving more local groups in the home as far as possible. Current activities include quizzes, arts and crafts, trips to garden centres and flower arranging. There was more recorded evidence of group rather than any individual activities being offered at the current time. The team have yet to fully assess residents individual social care needs and complete social care plans, that identify the more therapeutic or individual activities that promote self worth/wellbeing, independence and the retention of skills. This needs to be addressed in order to ensure that residents social care needs are met. Residents we spoke to said one carer helped me with my nails yesterday and I do more activities now, I am not outgoing but I like gardening. We observed the lunchtime routine and this has improved a great deal. The tables were nicely laid and residents had access to condiments etc. There was more interaction with staff, who were seen to be helping them sensitively and good sized meals were being offered. The food at the home looked very good and residents were observed to be eating well. Residents were seen to be offered a choice and residents were also observed to have alternatives not on the main menu. Residents we spoke to said The food is quite good really and there is plenty of choice. Relatives who commented said the food is very good and always gets eaten. Nutritional records are not in place and should be held to help staff monitor residents intake over a period of time. Care Homes for Older People Page 14 of 25 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 can now be assured that any concerns would be listened to and acted upon and that as far as possible they would be protected from abuse. Evidence: A new complaints procedure has been put up in the main reception area. The new procedure is worded well, is simple and in large print. Since our last visit the manager has dealt with one complaint. She has introduced a logging system and the records showed that the matter had been dealt with promptly and appropriately. The matter was upheld and related to staff attitude and care. Records show that the manager has an objective approach to complaints. Residents we spoke to said if I had a concern I would raise it with the person in charge and they dont mind. Up to date guidelines relating to the safeguarding of vulnerable adults are easily available to staff. Staff spoken with showed an understanding of adult protection matters and training records show that since we last visited all but three staff have attended training in adult safe guarding. The manager plans to fit in these staff for safeguarding training with new staff who are due to commence employment at the home. Care Homes for Older People Page 15 of 25 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. Residents live in a clean, safe and well maintained home. Evidence: Since we last visited the home the work on the new extension has been completed and we are aware that the proprietor will be applying for registration for the new bedrooms increasing the number of places available. A new ramp has been fitted to the front door, making wheelchair access easier. The signage has improved around the home with regard to communal areas and toilets etc. but residents bedrooms doors are yet to be done. Consideration should also be given to developing more interactive items to have around the home for residents to see, touch and discuss with staff. Residents are making full use of the new lounge and dining area, which has been decorated with pictures and plants etc., making it quite homely. Residents we spoke to said everything in my room is fine, the cleaning is very good and my room has been decorated. Work on improving the bathrooms has commenced and we saw that builders were converting a downstairs bathroom into a fully tiled shower room. The corridors have been painted and new automatic lighting has been installed which comes on when movement is sensed. The manager plans to develop one of the bathrooms into a Care Homes for Older People Page 16 of 25 Evidence: hairdressing salon. The bedrooms have all had new beds and bedroom furniture installed and this includes chairs and lighting. Many of the bedrooms have been painted and the manager said that they are steadily replacing all the carpets. New curtains and bedding have also been purchased. The rear courtyard garden has been cleared and now provides a pleasant area in which to sit in the warmer weather. The manager has plans to develop all areas of the garden. There is a new garden linked to the extension, but it was noted that the secure railings cut the garden in half, restricting much of its use for residents. This should be reviewed to make full use of the area. At this visit we noted that domestic cupboards containing chemicals etc. are now kept locked. The maintenance man has now been trained to be a fire marshal and systems/records are now in place for checking fire alarms etc. These were seen to be in order. A fire drill for care staff was held in December 2009 and a fire safety risk assessment was completed in October 2009. Care Homes for Older People Page 17 of 25 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. Residents are benefiting from a more stable staff team whose knowledge base is steadily developing. Evidence: Since commencing in post the manager has employed new senior care staff and this is helping with the development of the team. Seniors now have areas of responsibility that they oversee, for example the laundry, infection control or activities. The use of agency staff has reduced greatly, down to 1 or 2 shifts per week, and the manager reports that she is still recruiting care staff into post. The current staffing levels are in the morning 1 senior carer and 3 care staff and in the afternoon and evening 1 senior and 2 care staff. At night there is 1 senior carer and 1 carer both awake. The manager is looking to recruit further staff to the afternoon shift so that care staff are not lost to kitchen duties at tea time. The rotas we looked at showed that these levels are maintained and the use of agency staff is minimal. Relatives who commented said the staff are very friendly and helpful, the home has some good staff and the staff are very approachable even though they are very busy. The manager is encouraging staff to sign up for NVQ qualifications and this should improve the percentage of staff with a completed NVQ in the future. At the current Care Homes for Older People Page 18 of 25 Evidence: time only 4 out of 17 staff have this qualification. We looked at two staff files to check the robustness of the recruiting procedures in the home. These have improved since our last visit and all the required checks and documentation were in place. The manager has also introduced interview records. There was evidence of staff induction in the records and staff that we spoke to confirmed that they had been inducted into the home undertaking a basic induction that included some time observing staff caring for residents. Staff confirmed that they are also undertaking the Common Induction Standards with Skills for Care. Staff induction has been put in place since our last visit. Staff spoken to confirmed that they go to and are offered lots of training. Since we last visited the home the manager has organised a significant amount of training for the staff team and this is continuing. The majority of staff have now been trained in manual handling, food hygiene and fire safety. Approximately half the team have also been trained in infection control, health and safety and some have attended training in managing challenging behaviour and care planning. Records show that the manager has booked further training in managing challenging behaviour and first aid. Staff training on the care of people with dementia, whilst undertaken by nearly all of the care team, has consisted of a 3.5 hour introduction course. As a home primarily for people with dementia, we would expect that the management of the home look to develop this further so a percentage of the staff have more advanced training in this subject. The manager is aware of this and is looking to develop this training for staff and already has six staff booked on an advanced 2 day course in March 2010. The manager also plans to arrange training for staff on medical conditions associated with old age, such as diabetes. Senior staff have been assigned key areas of responsibility in the home to oversee, such as infection control and health and safety and will have a role in monitoring and supporting staff with these subjects. Care Homes for Older People Page 19 of 25 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. Residents now live in a home that is being run with their best interests in mind. Evidence: The manager has been working in residential care for many years and has worked her way up through different roles. She has a certificate in management and has completed the registered managers award. She is aware that she needs to undertake some specific training in the care of people with dementia as she too has only completed a basic introduction to the subject. This is key to the ongoing care of residents and the development of the home as a whole. On discussion the manager feels that she is able to manage the home unhindered and is getting the support and investment that she needs to do this well from the proprietors. The manager completed an improvement plan and following this inspection we feel that this plan has nearly been completed. The manager is being supported by an external consultant who is visiting the home on a monthly basis. A new administrator has been employed at the home for 20 hours per week and this is Care Homes for Older People Page 20 of 25 Evidence: helping the manager to address some of the previous shortfalls noted at the home. Staff spoken to feel that the new manager is firm but fair and approachable. Staff say that the manager is around at the home a lot and keeps an eye on what is going on. The manager has yet to formally meet with the care staff but this is now planned as the full team are in place. The manager has met with the new senior care team. With regards to quality assurance, the manager has developed a new feedback questionnaire to send out to residents, relatives and visiting health care professionals. It was possible to see the new tool and the subject areas covered are appropriate. The manager is also planning to hold a residents and relatives meeting in the near future to update them about changes in the home and to get their opinion on these changes and the home in general. In addition to this format the manager has developed a tool for auditing the quality of the care plans/care management and she plans to undertake a monthly health and safety audit. Relatives who commented said we are always made to feel welcome when we visit my relative, the home is friendly and homely and the home has improved immensely with decor, staff, management and is well run and inviting. The manager has started a staff supervision programme in January 2010 and the records seen are detailed and cover, for example, practice and training. The manager plans to train and support senior care staff to undertake some of this role. The accident book was reviewed and records were seen to be satisfactory with sufficient detail. Where appropriate, residents had been referred to the falls prevention team. The manager plans to complete accident audits to help monitoring and/or reduce the number of falls etc. in the home. On touring the home we did not note any health and safety issues. Care Homes for Older People Page 21 of 25 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 12 16 Residents or their representatives should be consulted and their social needs assessed and care planned for. So that both their individual and group social needs are met in a proactive way. 14/12/2009 Care Homes for Older People Page 22 of 25 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 8 12 Continue to develop care 30/04/2010 plans for the monitoring and management of residents long term health care needs. So their health care is adequately monitored. 2 12 16 Residents social care needs should e individually assessed and care plans developed. To ensure that residents social care needs are met and that they are optomised. 30/04/2010 3 30 18 Continue to provide training 31/05/2010 to the staff team so that they are equipped to carry out their responsibilities competently, especially in relation to the care of people living with dementia. So that residents needs can be fully met. Care Homes for Older People Page 23 of 25 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 4 31 18 The manager needs to 31/05/2010 undertake some formal training in the care of people living with dementia in order to lead the development of care practices in the home into the future. So that the care provided is in line with current thinking. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 1 Review the service user guide and ensure that the format is user friendly for the residents group and that it is easily available to them. Following assessment, a letter should be sent to the appropriate individual confirming whether the assessed needs can be met at the home or not. Continue to develop a person centred approach to care planning/management. Nutritional records should be kept in order to monitor residents intake over a period of time. Continue to develop the signage in the home so that residents independence is promoted and consider making more interactive items available. Continue to improve the number of care staff in the home with NVQ qualifications. 2 3 3 4 5 7 15 19 6 28 Care Homes for Older People Page 24 of 25 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. 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