Care Home: Hepworth House

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What the care home does well Each individual had a plan of care that included the information necessary to deliver the person`s care. The home had an efficient medication policy supported by procedures and practise guidance, which staff understood and followed. Medication records were fully completed, contained required entries, and were signed. People who used the service had the opportunity to develop and maintain important personal and family relationships. We spoke to one relative visiting on the day of the inspection who said to us, "I have nothing but good to say about this home, they are all such lovely people". She went on to explain that he relative had been admitted to the home more than a year previously and had much higher needs than she had now. The food was well presented and met the dietary needs of residents. Staff helped those who needed help with eating in a sensitive way. The home was clean and tidy and people were encouraged to personalise their bedrooms. The staff team was small and appeared to work well together. All the staff that we spoke to during this inspection indicated that they felt supported by the manager. We received comments such as `she works hard` and `she is fair`. What has improved since the last inspection? Since the last inspection the manager had updated the statement of purpose and service user guide to contain all the required information. These documents still needed more detail about the layout of the home and the possible restrictions it could cause to people living at the home. Care plans had been improved and were now written for all areas of care and recorded sufficient information about health issues. Medication storage systems had improved. The safeguarding policy had been reviewed and all the staff had attended an updated training on how to keep people safe and identify possible abuse. All visitors were entering the home via the front door and not through the back via the kitchen. Staff were having regular periods of off-duty each week. What the care home could do better: Requirements and recommendations were made as a result of this inspection. These included:Staff must be able to demonstrate the philosophy for care is person centred.The health and safety of people using the service must not be compromised by locked doors that can not be appropriately opened. The environment of the home should be regularly reviewed to ensure it meets the needs of the people using the service. The practise of having one member of staff on duty for a period during the night should be kept under review and risk assessed. Key inspection report Care homes for older people Name: Address: Hepworth House 1 St Georges Road Bedford Bedfordshire MK40 2LS     The quality rating for this care home is:   one star adequate 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: Sally Snelson     Date: 0 3 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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 28 Information about the care home Name of care home: Address: Hepworth House 1 St Georges Road Bedford Bedfordshire MK40 2LS 01234262139 01234272927 hepworthhouse@waitrose.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr and Mrs Hepworth Lloyd care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Hepworth House is situated in a pleasant residential area of Bedford. It is within easy walking distance of the town centre and close to local amenities such as local shops, schools, and Churches. The home is converted from two domestic style properties. There is a garden surrounding the home, which is laid to lawn and flower beds. There is unrestricted road parking in the area for staff and visitors. The home has undergone many changes in the last few years and currently provides accommodation for 18 residents over the age of 65 years. 16 of the rooms are single rooms with ensuite facilities. There are two lounge/diners and a sunroom on the ground floor and a lounge on the first floor. Communal bathrooms, a shower room and toilets are located on the ground and first floor. The fees for this home vary from £425.86 per week to £455.00 per week. 1 0 0 8 2 0 0 9 0 0 Over 65 18 18 Care Homes for Older People Page 4 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 carried out in accordance with the Care Quality Commission (CQC) policy and methodologies which require review of the key standards for the provision of a care home for older people that takes account of service users views and information received about the service since the last inspection Evidence used and judgements made within the main body of the report include information from this visit. The home had been rated a zero star service following the last Key Inspection in August 2009. A random inspection had taken place in October 2009 and information from that inspection is included within this report. During this inspection we picked two residents to case track in detail. We spent time observing care practises and informally chatting with staff and residents and spoke to visitors to the home. Care Homes for Older People Page 5 of 28 We examined three staff files, all documentation relating to their recruitment, and other records relating to staff training and supervision. Documentation relating to health and safety checking procedures, medication administration, complaints, accident and incident reporting and residents finances were also inspected. The home manager was present to assist throughout this inspection. Feedback was given periodically throughout, and at the end of the inspection. We would like to thank everyone involved for their assistance and support. Care Homes for Older People Page 6 of 28 What the care home does well: What has improved since the last inspection? What they could do better: Requirements and recommendations were made as a result of this inspection. These included:Staff must be able to demonstrate the philosophy for care is person centred. Care Homes for Older People Page 7 of 28 The health and safety of people using the service must not be compromised by locked doors that can not be appropriately opened. The environment of the home should be regularly reviewed to ensure it meets the needs of the people using the service. The practise of having one member of staff on duty for a period during the night should be kept under review and risk assessed. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has produced information for residents and prospective residents but more detail is needed to clearly identify that staff have the skills, ability and qualifications to meet the assessed needs of the prospective resident. Evidence: Following the last inspection the manager had updated the Statement of Purpose and the Service Users Guide to provide more specific information and ensure that the information provided was correct. The Statement of Purpose was complete but did not include details about the environment and its suitability for certain client groups, for example those people using a wheelchair. This is important to ensure people are aware they may need to leave the home if they became frail and need certain mobility aids. There had been no new residents admitted to Hepworth House since the last inspection, As this standard had been met when the home was last inspected in Care Homes for Older People Page 10 of 28 Evidence: August 2009 we have agreed that this standard remains met. The home was registered for, and admitted those people, with a diagnosis of dementia. However we were unsure how the service clearly met these needs. For example we were aware of one resident who could exhibit challenging behaviours, which the home admitted did not have the resources or environment to manage. The manager told us she had discussed the possible need to move this person with family members. Hepworth House admitted residents for respite care, but were not equipped to take people who needed intermediate care Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each individual had a plan of care that included the information necessary to deliver the persons care. However the plans did not show that the resident had been involved. The home had an efficient medication policy supported by procedures and practise guidance, which staff understood and followed. Medication records were fully completed, contained required entries, and were signed. Evidence: Since the last inspection the service had altered the method of care planning to a new system that covered all aspects of daily living. The plans in the two files we looked at were in sufficient detail to ensure consistent care; and because they had been recently written the information was current. The manager told us that she was planning to involve the whole staff team in the care planning process and not complete them all herself. Care staff told us that they were happy to be involved. The plans had been signed by the manager, but we did not see any evidence that the resident had been involved in the plans that we looked at however following the inspection the manager Care Homes for Older People Page 12 of 28 Evidence: sent us evidence of residents who had agreed their plans. The AQAA told us that the care plans were person centred but we did not see much evidence of this and believed more work needed to be done on this. At the inspection in August we had been concerned that plans had not included guidelines for staff to follow, for example on wounds and diabetes. We appreciated that the district nurses also provided care for these conditions but it would be the care staff at Hepworth House who would observe changes and need to know what to do. We reported following the random inspection visit to the home on 28/10/09 The manager showed us that wound care is now detailed in the care plans when needed. Good infection control guidelines for MRSA were in one persons file. We also saw evidence at this inspection that a pressure ulcer had been healed with the support of the community nurses and people had been referred appropriately as their condition altered. We saw that staff were regularly assessing people for risk of malnutrition, tissue viability and moving and handling. From talking to the staff we were aware of how they had addressed deviations. For example a resident with a history of falls had been referred for a physiotherapy assessment and a person with weight loss to a dietitian. In the random report we were able to write We looked at the way medication is handled. Staff had completed the Medication Administration Record (MAR) charts carefully using the correct omission codes when necessary. We also noted that medications were correctly recorded when they were received into the home. The MAR charts were stored in a medication file. The manager has developed a detailed profile for each of the people who lives here which includes a photograph of the person, details of their medications, their GP and any special instructions about their medication. Controlled drugs are now correctly stored in the CD cupboard. This statement remained current. Throughout the inspection we witnessed staff interacting well with the residents and addressing them in an appropriate manner. We saw two female residents speaking to a male carer and asking for his attention. One said, hes a nice boy. The manager informed us that all residents were asked about their wishes regarding having their care provided by a carer of the opposite sex. Each file we looked at indicated that the resident or someone on their behalf had been asked about their preferences for the end of life, including who to contact if there should be an emergency situation. Three staff had completed a palliative care course and were able to talk about a particular end of life plan, known as the Liverpool Care Care Homes for Older People Page 13 of 28 Evidence: Pathway, which they were planning to introduce. Care files included the documentation for mental capacity assessment and for lasting power of attorney details but these had not been completed in the files we sampled. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who used the service had the opportunity to develop and maintain important personal and family relationships. The food was well presented and met the dietary needs of residents. Staff helped those who needed help with eating in a sensitive way. Evidence: The home had an activity plan and employed an activity co-ordinator for three afternoons a week. He was due to attend on the day of the inspection, but just before he was due the manager had a telephone call to say he was not available. During the morning we had seen little stimulation for the residents. The TV was on with the volume turned down and music was put on periodically during the day. When the music was playing staff and residents reacted to it by singing and dancing along, but nothing more. Staff interacted well with those residents who spoke to them and communicated but there was nothing for those who sat and dozed. We saw a photo album that reflected the various planned activities such as a celebration of Valentines day, Mothers day and other events including birthday celebrations. Staff were planning to celebrate Christmas with an event for residents, relatives and friends the next weekend. On the wall in the lounge were some pictures that residents had Care Homes for Older People Page 15 of 28 Evidence: coloured in to make greeting cards. We were pleased to see that staff were recording activities and how any activities had been received. The activity plan included group activities, trips out and one to one time with key workers. We were told that friends and family were encouraged to visit at any time. During the last inspection we became aware that some visitors were entering via the back way and not signing into the home. This had been resolved and all visitors used the front door to gain access. A visitor told us she was always made to feel welcome and staff kept her appropriately informed about her loved ones condition. At lunch time the meal was served already plated. We were told that people were offered a choice before the meal was served. The meal looked appetising and contained a good variety of food groups. It was homemade meatballs, potatoes and mixed vegetables, followed by fresh fruit salad. We also saw people having alternatives, but these meals were not advertised on the menu. People living at the home told us that on the whole they enjoyed the food and looked forward to mealtimes. The AQAA told us that mealtimes were flexible, although we saw people being woken and told it was dinner time. However one persons dinner was kept for later, because he was unable to wake up fully. People were asked to choose between orange, blackcurrant juice or water to accompany their dinner. Staff offered help to those residents that needed it in an appropriate manner. At the last inspection all of the residents had had their meals served in bowls. At this inspection we saw a variety of crockery being used according to the size of the meal provided and the residents wish. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints procedure was available to everyone living at the home. The whole staff team now understood the procedures for safeguarding adults. Evidence: The home had a complaints procedure that well publicised and allowed residents and visitors to make a complaint to the management of the home. The complaints procedure advised the complainant about the expected timescale for a response and offered alternative agencies if the complainant was not satisfied with the outcome. We had been concerned at the last inspection that the staff team, including the manager and the provider, were not clear about safeguarding processes and that the policy available at the time was out-of-date. We made an immediate requirement that this area should be addressed. When we returned to check compliance we were able to report The manager showed us that all staff had received Safeguarding of Vulnerable Adults (SOVA) training or an update by 27/08/09. This training was provided to some of the team by Bedford Borough Council and to others by a training provider to ensure it was completed in the timescale given. The manager had also made sure an up to date SOVA policy was available. We spoke to the manager and the senior carer about how they would deal with a potential safeguarding issue. They were able to answer correctly and were clear Care Homes for Older People Page 17 of 28 Evidence: about who should be informed. During discussion with the manager she showed that she knew the correct procedure for disciplining staff should the need arise. The manager had undertaken training on the deprivation of liberty and the mental capacity act. It would now be important to start to document peoples capacity and how decisions were made. Later in this report we detail that the front door is kept locked, but it is not clear from the documentation why this is necessary Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was clean and tidy and people could personalise their own bedrooms according to their wishes. Fire safety was compromised by the way the front door was kept secure. Evidence: There had been no major changes to the environment since the last inspection with the exception of a walk-in shower being fitted on the ground floor. We were concerned that the front door was opened and closed via a Yale lock. The carer in charge carried the key around with them and we were told that another key was in a drawer, but it was not found. The manager appeared to be aware that this did not comply with fire regulations, but stated that one of the residents removed the key when it was left available. A key safe was on the wall next to the front door but it was not in working order. The manager agreed to make the home safe immediately, by having a key available near the door. A fire officer visited shortly after the inspection and had to reiterate our concerns. This meant that the manager had not kept her agreement to ensure the safety of the residents. We were however aware that the manager had had to take unexpected leave after the inspection. The home was clean and tidy and people were encouraged to personalise their Care Homes for Older People Page 19 of 28 Evidence: bedrooms. The home had some narrow corridors and the lift was not large enough for a wheelchair, so the homes environment was not suitable for all, and as already stated this should be recorded in the Statement of Purpose. On the day of the inspection the lounges were warm enough but the dining area did not have any additional heating. When the kitchen window was open and when the door into the kitchen was opened this area of the home became draughty. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The current staff team did not all have experience of caring for people with dementia. Evidence: Staff rotas confirmed that there were a minimum of three staff on duty at all times during the day. The manager was supernumerary and a cook and a cleaner were also employed. At night two carers were available, but one slept-in from 11:hrs-05:hrs if not required. The AQAA told us that five residents needed two carers at night and that 13 had continence problems. We were concerned therefore that care may not be delivered to meet the needs of the residents but rather for the convenience of the staff team. The manager told us that the sleep-in staff member could be called at anytime. We did not see any evidence of poor pressure area care, or speak to any resident who were not getting care when they required it. Therefore we recommend that this practise is kept under regular review. At the last inspection it was identified that staff were working long periods without a break. Staff confirmed that the manager now insisted that they had a minimum of one day off a week. The staffing section of the AQAA had not bee completed, but we were told, and saw evidence in the files we sampled that staff had, or were working towards, NVQ qualifications. A new member of staff had completed a thorough induction and another Care Homes for Older People Page 21 of 28 Evidence: was in the process of doing so. We were concerned that not all of the staff had training in dementia awareness. Following the inspection we were sent a list of the staff who had received denmetia training During the inspection we looked at the files of three staff including one that had been appointed since the previous inspection. Each file contained fully completed application forms, appropriate references, Criminal Record Bureau (CRB), POVA first checks, interview notes, job descriptions and terms and conditions of employment. All documents were signed and dated appropriately. One new member of staff had come from abroad and was employed to complete NVQ level 4 while working. A letter from the supplying agency advised the home that he could work full time, but the manager had not requested to see the home office documentation that supported this. The visa stated student entry, which usually means a maximum of 20 hours a week. The provider promised to ensure she had all the relevant documentation. By the time this report was published the provider had acquired the information we would have expected to have seen to confirm authenticity. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The majority of the AQAA was completed and the information gave a reasonable picture of the current situation within the service. There were areas where more supporting evidence would have been useful to illustrate what the service has done in the last year, or how it is planning to improve. It gave us limited detail about the areas where they still need to improve. Evidence: The manager presently working in this home, Mrs Roy, had a number of years of experience working in care. She had worked at Hepworth House for three years and had successfully become the registered manager. All the staff that we spoke to during this inspection indicated that they felt supported by the manager. We received comments such as she works hard and she is fair. She had worked particularly hard since the last inspection to bring the home from zero to one star but there were still some areas of identified gaps and omissions, for example the locking of the front door, with no emergency exit immediately available. Care Homes for Older People Page 23 of 28 Evidence: There were questionnaires that were used to audit the standard of care. However as in previous years these questionnaires had been sent out and we were told that they had been evaluated and the results acted upon and we saw written comments on the forms, but a formal evaluation was not available. This years AQAA had been completed in more detail but there were gaps in the staffing section. The provider told us that this information was with skills for care but we did not have the expected access to it. We were also concerned that the areas identified in the AQAA for improvement were mainly those we had identified at our last inspection. It is expected that the provider and manager has a continual plan of audit, planning, action and review that identifies areas for improvement. No capacity assessments had been completed although decisions were made for residents who were deemed not to be able to make decisions for themselves. Staff files included supervision records. These had become more frequent since the last inspection but because they were sporadic in the past to fully met this standard we need to see this improvement continue. Residents personal money that was held within the home was audited against any expenditures and the stored receipts and found to be correct. Residents monies were now appropriately stored. Accidents and incidents were being appropriately reported via the regulation 37 notice processes, and where necessary referrals were being sent to the Safeguarding team. Health and safety checks including water temperatures, fire call bells, freezer and food temperatures were being recorded appropriately, and issues were addressed in a timely fashion. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 14 Staff must be able to demonstrate the philosophy for care is person centred. This ensures that care is delivered to a resident in the most appropriate way for them. 01/01/2010 2 19 12 The health and safety of 10/12/2009 people using the service must not be compromised by locked doors that can not be appropriately opened. This ensures people are kept safe 3 33 12 Capacity assessments must 01/02/2010 be completed where decisions are being made on behalf of a person using the service. This ensures decisions are made in a persons best interest. Care Homes for Older People Page 26 of 28 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 1 The provider should ensure that the Statement of Purpose reflects the conditions and the abilities of the service users that they are able to care for. The environment of the home should be regularly reviewed to ensure it meets the needs of the people using the service. People using the service should not be exposed to draughts. The practise of having one member of staff on duty for a period during the night should be kept under review and risk assessed. 2 22 3 4 25 27 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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