Care Home: Hillport House

What the care home does well The service has introduced new person centred plans this means that each individual has information on record of their life history, their support needs and how these can be met, their likes and dislikes and their aims and goals. We saw evidence that these records are reviewed regularly to ensure that they are up to date. We saw that people using the service are supported to access health appointments. We saw that the there is a good choice of food at mealtimes, and people using the service told us they enjoyed the food that is provided. We saw that the service has an accessible complaints procedure. Staff have been trained to recognise and report suspected abuse. The management of peoples finances is robust. The number of staff available to support people using the service is high. What has improved since the last inspection? We saw that the staff team has improved the range of activities available to people using the service and we saw evidence of engagement. We saw that the there has been significant improvement in staff training and the frequency of staff supervision. What the care home could do better: Consideration should be given to how the service involve people using the service in care planning and review. Further efforts could be made to ensure that people using the service are able to enjoy activities and outings in the community more regularly. The arrangements for the management of the service should be resolved. The service must ensure that medication management is improved, there remain concerns about how the service manages the administration receipt and disposal of medication. Key inspection report Care homes for older people Name: Address: Hillport House Porthill Bank Newcastle under Lyme Staffordshire ST5 0AE     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: Wendy Jones     Date: 1 5 0 4 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 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © 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 27 Information about the care home Name of care home: Address: Hillport House Porthill Bank Newcastle under Lyme Staffordshire ST5 0AE 01782635073 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Staffordshire County Council Social Care And Health Directorate Name of registered manager (if applicable) Type of registration: Number of places registered: care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: Age: Dementia (DE) age 50 and above. The maximum number of service users who can be accommodated is: 30 The registered person may provide the following category of service only: Care Home Only (Code PC); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Dementia (DE) 30 Date of last inspection Brief description of the care home Hillport House is a local authority care home, run by Staffordshire County Council. The home specialises in the care of older people who are mentally frail or who have mental health needs. The home is registered for 30 older people, and is located in Porthill, providing good access to a wide range of local community resources. There are pleasant gardens, particularly an enclosed safe garden courtyard in the centre of the building that can easily be accessed by people using the service. Accommodation is Care Homes for Older People Page 4 of 27 Over 65 0 30 2 6 1 0 2 0 0 9 Brief description of the care home provided on two floors, with access to the upper floor being facilitated by a shaft lift and stairs. The first floor is used to accommodate people requiring a period of rehabilitation following discharge from hospital. People who may use the service and their supporters should contact the provider for information about the fees for the service. The only things not covered by fees include hairdressing, magazines, newspaper and personal items. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 was an unannounced key inspection visit of Hillport House undertaken by a regulatory and a pharmacy inspector on the 15 April 2010. The visit took approximately 9 hours. This is a second key inspection of the service for the period 2009-2010. The last visit on the 02 October 2009 concluded that the service was providing poor quality outcomes to people using the service. We completed a second visit on the 19 November 2009 to monitor the services compliance to requirements we had made and to evidence improvement. We inspected against the National Minimum Standards for Care Homes for Older People and the Care Homes Regulations 2001. The objective of the inspection is to evaluate whether people who use the service and their family carers experience services of good quality that offer and promote independence. We have noted improvements in a number of areas since our last key inspection Care Homes for Older People Page 6 of 27 including care planning, staff training and supervision, management of the home and the protection of people using the service. As a result of this visit we have concluded that the service is a 1 star service providing Adequate outcomes for people using the service. We have made requirements relating to medication and recommendations re other aspects of care. Part of our methodology is to case track this is a focused methodology that we use to analyse the care offered in the home. We case tracked two people this means that we checked all aspects of their care and the records kept for them. We also looked at other records in the home. Prior to the inspection visit the acting manager had completed a self-assessment tool which is known as the Annual Quality Assurance Assessment (AQAA). Completion of the AQAA is a legal requirement and it enables the service to undertake a selfassessment which focuses on how well outcomes are met for people using the service. Information from this AQAA is used to plan the inspection visit and we have referred to it in this report. The AQAA was returned to us when we asked for it to be and gave us a good picture of the current situation within the service. All of the people who use the service have dementia or confusion and are not able to give us a full response to some aspects of their care but the people we spoke to told us they are are happy at Hillport House and that the staff are kind. We observed very positive interactions between people using the service and the staff team throughout our visit. Following this visit we have carried out a management review, these reviews are undertaken when a service is seen to be failing to meet its legal obligations and people may have been put at risk because of this. We are also considering sending a statutory requirement notice to the provider, to inform them that they have failed to comply with the Care Home Regulations 2001 relating to medication management. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: 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 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective users of the service can be sure that they will receive an assessment of their needs and they will be provided with information about the service so that they can decide if it is a suitable place for them. Evidence: The service told us in the AQAA that, Hillport House has a statement of purpose and service user guide setting out aims and objectives of the service, philosophy of care, service provision and facilities provided. These have been made available to all service users and accessible to visitors around the home. Prior to admission all service users receive a full assessment and care plan completed by a social worker. Once admission has been agreed all service users receive an admission agreement highlighting the statement of terms and conditions. They are able to visit on a trial basis and during this time a further in depth assessment of needs will be completed identifying any risks, forming the basis of a person centred plan for the individual and is reviewed. Care Homes for Older People Page 10 of 27 Evidence: We found that the information about the service is available in the home in the main foyer and the current management team are in the process of updating it to ensure that it offers an accurate reflection of the service. The service hasnt been able to admit new people to the service since the last key inspection, but we understand that there are assessment procedures in place. This means that the service undertakes a pre admission assessment to ensure that it can meet the individuals needs before a placement is offered. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be confident that their health needs are known and met, but need to be sure that medication is managed safely by staff assessed as competent to do so. So that people using the service can be confident that administration and medication practice does not put them at risk. Evidence: The service told us in the AQAA that, All service users have a person centred care plan in place, detailing their health, personal and social care needs. The plans are working plans and are constantly being updated as service users preferences and needs change. Any risks identified are assessed and documented on the care plan and communicated to staff. Detailed information is recorded by staff on a daily basis and this is summarised and reviewed by a manager on a weekly basis. The organisation has a medication policy that sets out the procedures for the receipt, recording, storage, handling, administration and disposal of medicines and managers receive training in the safe handling of medicines. Care Homes for Older People Page 12 of 27 Evidence: We looked at the care records of three people and found significant improvements in the quality of the records since the last site visit we carried out. We saw that each person has a person centred plan which details their support and health needs, wishes, likes and dislikes. We saw that reviews of support/action plans and risk assessments are reviewed monthly and that a weekly summary of contact records is completed. We did not routinely see that people using the service are involved in care planning or review and recommend that the service considers how best to ensure that they are. We saw that people using the service have access to health services and noted that the service responds in a timely manner when health concerns have arisen. We saw that medication reviews have been carried out. During the inspection we again looked at a sample of medicines and the records and practises associated with these medicines for people who were using the service. We found that the medicines management systems within the home were still poor and were potentially putting those living in the home at risk. As a consequence of a continued breach of the Care Homes Regulations 2001 with respect to the management of medicines a number of medication records were seized under the provision of the Police and Criminal Evidence Act 1984. We found that the home had been administering some medicines that had passed their expiry date to one of the people we chose to sample. We found a solution of a lipid regulating medicine had expired on the 9th April 2010 and the home had been administering it to when it was discovered on the day of the inspection. We also found that two other medicines for this person had expired the day before the inspection and as a consequence on the morning of the inspection these medicines were also administered with them being out of date. We found further problems when carrying out an audit of the use of these medicines. We found that due to this person having swallowing difficulties the home had negotiated with the persons GP to prescribe liquid preparations. We found that these medicines arrived at the home on the 18th March 2010. We found that the home had recorded on the MAR chart the receipt of 600ml of a medicine that was used to treat mental health conditions. We found that the MAR chart indicated that since 18th March 2010 500ml had been administered so we expected to find 100ml remaining in a bottle. We found a total of 190ml present in the home. We found that the home had recorded the receipt of 200ml of a medicine that could be used to treat a number of heart conditions such as hypertension (high blood pressure) angina (chest pain) and heart failure (a condition where the pumping Care Homes for Older People Page 13 of 27 Evidence: action of the heart is reduced). We found that the MAR chart indicated that since 18th March 2010, 135ml had been administered so we expected to find 65ml remaining in the bottle. We found a total of only 40ml present in the home. We found that the home had also recorded the receipt of 300ml of the medicine that was used to regulate lipid levels in the blood. We found that the MAR chart indicated that since 18th March 2010 187.5ml had been administered so we expected to find 112.5ml remaining in the bottle. We found a total of only 80ml present in the home. We also found that the home did not have a system for recording the disposal of dispersible medicines which had been refused by this person and therefore some medicines could not be accounted for. This person had also been prescribed a number of medicated creams and gels. The MAR chart to record the receipt and administration of these creams and gels was kept in a separate file to the MAR charts for the internal medicines. We found that the home had not recorded the receipt of a gel and a cream on the MAR chart. We found that the home was using the abbreviation / to identify when these creams and gels had been refused and when they were not required. As a consequence it was impossible to distinguish whether the cream or gel had been refused by the person concerned of whether staff had decided that it was not required. We found a number of gaps in the signatures on the administration records and as a consequence we were unable to determine if the creams and gels had been applied on these occasions. We also found that one of the gels which had been prescribed on a twice daily basis had been applied three times a day on the 18th March 2010. The home had introduced a practise of formulating a protocol to describe how the creams and gels were to be administered. Unfortunately the protocol for the administration of this person creams and gels could not be found. This protocol would have helped in solving the differences in the administration of an emollient cream between the current monthly cycle and the previous monthly cycle. We looked at the administration record for another person who was using the service and found that the home had failed to record the receipt of an antibiotic which was received mid way through the monthly cycle. We also found that this person had been taken to hospital for part of a day and as a consequence the home had recorded H on the MAR chart. We could find no evidence of whether the medicines that required administration over this period of time had been taken to the hospital with the person or whether they had been discarded as the person was not in the home at the time of the administration rounds. We found that the home was monitoring the maximum and minimum temperatures of the fridge on a daily basis and was maintaining the fridge temperature within the Care Homes for Older People Page 14 of 27 Evidence: required range of between 2 and 8 degrees Celsius. We found that the home was not holding any Controlled Drugs at the time of the inspection. We found that an audit of the medicines present in the home was taking place on a monthly basis. It was clear that the frequency of these audits was too long to ensure that the medication records were accurate and could evidence that the home was administering medicines as prescribed by the doctor. We found that the home had still not carried out any formal assessments to determine whether the staff who were administering medicines were safe and competent to do so. We found that one staff member was not complying with the homes policies and procedures for the administration of medicines because it appeared that this person was signing the MAR charts before administration had taken place. Care Homes for Older People Page 15 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service have increased opportunities to be involved in activities both in and out of the home. Evidence: The service told us in the AQAA that, We have a flexible approach with regards to the daily routine for each individual in order to meet their needs, preferences and capabilities. Various activities take place through out the day and are tailored to meet individuals needs. The home has a catering manager who ensures the provision of a well balanced and nutritious menu on a daily basis. Staff support service users to choose at the time of meal service from the options available. Through care planning and monitoring the Catering manager has a system in place that charts individual service users special dietary needs and likes and dislikes. Service users whos fluid and dietary intake requires monitoring is done so with the support of catering staff and we have a flexible and relaxed approach to mealtimes with support staff providing assistance where required. We found that people using the service are engaged in a range of activities in the home, and benefit from the high staffing levels. We have been told that they also are supported to go out of the home more frequently. Care Homes for Older People Page 16 of 27 Evidence: We saw that people using the service have a choice of meals at all mealtimes and have been told by individuals that the meals they have are lovely. We observed people using the service being sensitively and respectfully supported at meal times. We saw that where people need to have their fluid and dietary intake is monitored that the records for this have improved since the last time we visited this service. We saw that mealtimes have been reviewed since our last visit to the home, to ensure adequate time is provided between each meal. Care Homes for Older People Page 17 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are being protected by robust complaints policies and procedures and because staff have been trained to ensure they are safeguarded. Evidence: The service told us in the AQAA that, There is an organisation complaints procedure in place and booklets are available highlighting how complaints can be made and how they will be dealt with. We have a safeguarding of vulnerable adults and whistle blowing policy in place and any allegations of abuse or suspected abuse are followed up straight away in accordance with the policy and organisational procedures. We also have a Management of violence and aggression policy in place and staff also receive MAPA training. The service has a complaints procedure that is displayed in the home and is included in the Service User Guide for the service. We spoke to the team leader about complaints management and spoke to staff to ensure that we are confident that they know how to deal with and report complaints if they receive them. We also spoke to staff about safeguarding, we have been told that they have received training in recognising and reporting suspected abuse. Since the last key inspection visit of 02 October 2010, we have attended a safeguarding meeting re concerns that had been identified about the care people have Care Homes for Older People Page 18 of 27 Evidence: been receiving at the service. Concerns regarding the well being of people using the service identified intially have now been investigated and satisfactorily resolved. But safeguarding of people using the service is continually monitored to ensure their well being and welfare. We couldnt tell from the information available to us if staff have received training relating to the Mental Capacity Act. But have been informed that this training has taken place. Care Homes for Older People Page 19 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service benefit from a comfortable, clean and well maintained environment. Evidence: The service told us in the AQAA that, Hillport House is a local authority care home, run by Staffordshire County Council and specialises in the care of older people who have a dementia type illness or have mental health needs. There are various aids and adaptations about the home assisting service users to maximise independence and there is a nurse call system in place in all rooms. We have an infection control policy in place and all staff receive training and refresher training on an annual basis. We have not carried out a detailed inspection of the environment during this visit. We observed that the home is well maintained, comfortable and clean. The service has policies and procedures in place relating to infection control and staff have received training. We have been told in the AQAA that equipment necessary to support people living at Hillport House is serviced regularly to ensure that it is in good working order. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be sure that the staff team are well trained and provided in sufficient numbers to meet their needs. Evidence: The service told us in the AQAA that, We have a staff rota that is designed to ensure that there is adequate staffing throughout the day and night. Staff receive induction training on commencement of employment and 65 of support staff currently hold a NVQ 2 award or above. The organisation has a recruitment and selection policy in place and the home is supported by the human resource department having an allocated HR adviser. Staff have received CRB, POVA checks and statement of terms and conditions. We saw that the staffing numbers per shift are high, which ensures that people using the service receive and individualised service. We looked at records of staff training and can confirm that staff have received updates and the training we had evidenced was lacking at the last key inspection visit. We saw that staff meetings are now being held more regularly and staff told us that they feel well supported by the management team. Care Homes for Older People Page 21 of 27 Evidence: We looked at the recruitment records of 3 staff and found that the information we expect to see is on file, including Criminal Records Checks, application forms and evidence of identity. We recommend that staff receive training relating to equality and diversity. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service currently benefit from interim management arrangments but need to be confident that all areas of concern identified during inspection are addressed to ensure they are not placed at risk. Evidence: The service told us in the AQAA that, A financial policy is in place and records are kept of all financial transactions. Staff receive formal supervision. We have a recording and access to information policy in place and all individual records are held securely. Risk assessments are carried out where a risk has been identified, documented and communicated to staff. We found that the service continues to be managed by a registered manager of another service pending the outcome of disciplinary action relating to the previous management team. We have been consulted about these arrangements by the organisation. Care Homes for Older People Page 23 of 27 Evidence: We also found that the organisation has recruited two team leaders to support the current manager and to provide support and guidance to the staff team. Staff we spoke to during this visit, confirmed that they have received very regular supervision sessions and have had a staff appraisal since the last key inspection visit of October 2009. We can confirm this from the records made available to us. We saw from the information in the AQAA that policies and procedures are subject to review on a regular basis and the quality of the service is monitored monthly. The last report we saw on the conduct of the service undertake 04/03/2010 gave a positive account of the performance of the home. We are concerned that although there has been a number of improvements in the service the management has not been sufficiently robust to address the medication management arrangements at the home. This has resulted in the service failing to continue to meet satisfactory standards. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 13 The provider must ensure that staff that are trained to administer and follow medication administration procedures. Have been assessed as competent. to ensure that people are safeguarded from the risk of mistakes. To ensure that people are safeguarded from the risk of mistakes. 18/01/2010 2 9 13 The provider must ensure that the receipt, administration and disposal of all medication is recorded accurately. So that the home can evidence that each persons medication has been administered as prescribed. 18/01/2010 Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The provider must ensure 17/06/2010 that the arrangements for the management and administration of medication is suitable. To ensure that medication is managed safely. 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 7 Where possible people using the service should be included in the implementation and review of their care plans and risk assessments. The service should ensure that staff receive training in relation to equality and diversity. The provider should ensure that the management arrangements at the home are resolved and a permanent manager is in place. 2 3 30 31 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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