Care Home: Hilton Lodge

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What the care home does well The service is good at working with residents in a kind, caring manner as well as providing a friendly, informal and calm atmosphere. Residents are greatly appreciative of the care provided by staff and many positive comments were made. "The staff are very kind and helpful", was one typical comment. A visiting relative also praised the staff. Staff themselves wish to provide good care and want to provide residents with quality of life. They can work well as a team. The arrangements for serving lunch were good and considerate of residents needs for help with eating. The owner / manager has invested lots of time and energy in developing the service since he took over in 2008. He is keen to provide a good service and maintain standards. There are many aspects of the service that are good such as the care planning arrangements, the investment in staff training and relations with relatives. What has improved since the last inspection? The owner / manager has only been running the home since 2008 and there has been no previous inspection of this service under his ownership. What the care home could do better: There is a need to present care plans in a clearer more accessible format. This modest change should bring the positive elements of the care plans much more to the forefront. Other similar modifications are needed to the resident medication profiles, the staff application form and the obtaining of staff references from previous employers. There is a need to invest in ways to boost staff communication. There was some feedback received that this could be better as well as examples from the inspection that endorsed the view that communication could be increased. Developing staff communication should provide better outcomes for residents as staff should be better briefed about their needs and work better as a team. The home`s quality assurance initiatives also need to be developed with a more focused style adopted. Currently, the system does not allow a full range of feedback opportunities for residents and others. As a result the owner / manager could be missing out on feedback that could improve the service for residents. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Hilton Lodge 29-31 Hilton Avenue North Finchley London N12 9HB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Duncan Paterson     Date: 1 8 0 8 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2010) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Hilton Lodge 29-31 Hilton Avenue North Finchley London N12 9HB 02084457291 02084457291 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Hilton Lodge Ltd care home 13 Number of places (if applicable): Under 65 Over 65 0 13 dementia old age, not falling within any other category Additional conditions: 13 0 The Registered Person may provide the following categories 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: Old Age, not falling within any other category - Code OP Dementia - Code DE The maximum number of service users who can be accommodated is: 13 Date of last inspection Brief description of the care home Hilton Lodge is a privately owned care home registered to provide care for 13 older people some of whom may have dementia. In 2008 the ownership of the home changed to the current owner, Mr Ravindra Appadoo. There was no change to the registered company which continued to be registered. The aim of the home is to provide residents with a home in which they will be cared for in a supportive, caring environment and where they will feel valued, secure and happy. Hilton Lodge is in a residential part of North Finchley close to shops, local amenties and Care Homes for Older People Page 4 of 27 Brief description of the care home transport links. There are 11 single bedrooms and one double room. The home is in a converted building with a passenger lift and an extension providing two lounge areas and a dining room. There is a garden and patio to the rear. The fees charged are £515 per week. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was a key unannounced inspection which took place on 14th and 18th August 2009. The first day of the inspection was spent talking with residents, interviewing staff and inspecting a range of the homes records including care plans, staff records, policies and procedures as well as observing practice. The second day of the inspection was spent inspecting quality assurance and health and safety records and discussing the findings with the owner / manager. The service sent us their Annual Quality Assurance Assessment (AQAA) which was taken into consideration as well as surveys which had been returned to us when we carried out the homes Annual Service Review. Care Homes for Older People Page 6 of 27 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 set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 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. A strength of the service is that residents needs are carefully assessed before they move in. Caution is needed when admitting residents so that it is clear all needs can be met. Reviewing and updating the written information about the service will help people make clear choices about the service. Evidence: The statement of purpose and service users guide, although both reviewed and updated when the new owner took over in 2008, requires further updating to make clearer, more accurate and accessible for people using the service. For example, the previous owners name appears in the statement of purpose even though her links with the home have now ended. The text is quite long and a shorter, more direct style may help to identify what the home offers, the services provided and the aims. Similarly, there are no pictures or photographs in the service users guide. The use of such material can lighten and make the document more attractive. Care Homes for Older People Page 10 of 27 Evidence: A sample of four care plans were inspected to assess the arrangements made to assess residents before they move to the home. Residents were also spoken with as well as a relative who was visiting. The care planning information about assessments is on the whole good with a range of information compiled about residents and their needs. There are clear assessment forms used and in some cases, these had been complemented by local authority assessment information. The care plans were also added to by information about residents medication needs and, for some people, life histories. Residents said that they were happy at the home and the visiting relative said that she had good communication with the owner / manager and staff and felt that the care provided was good. One matter noted that the owner / manager will need to monitor is how the service will meet the range of needs of residents. Some residents had specific needs, such as mental health issues or age related issues, which staff at the home may not be used to and which the service was not originally intending to meet. The owner / manager may need to decline some referrals to enable the primary focus of the service on older people and people with dementia. This aspect of the service was being well provided for. A number of the residents were frail or had dementia related needs and staff were observed to be providing a caring, supportive and sympathetic service. Residents praised staff with many saying how well they were being looked after. The service has established a number of ways of working positively in relation to equality and diversity matters. The service is organised in establishing information about residents individual needs of race, culture and religion. One resident was supported to attend a mosque for example. Other residents were supported in terms of language and others to take part in individual activities and retain contact with families. There is an equal opportunities policy and the staff team is mixed. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care planning arrangements are detailed and overall allow positive work with residents that respects their needs and individual preferences. Presenting the care plans more clearly should further improve the care planning arrangements. Medication is handled safely and carefully although the resident medication profiles need updating. Evidence: The sample of care plans inspected provided evidence that there are a number of positive features to the care planning system. For example, there are a range of assessment forms, care plan objectives are generally clear and there are also risk assessments in a variety of areas including falls assessments and pressure area risk assessments. Residents and relatives were also signing care plans. However, the presentation of care plans can be improved which the owner / manager acknowledged. A more detailed index system would help find the relevant form more quickly. For example, the risk assessment forms (there were generally four of these for each person) were kept in a plastic wallet within the file rather than in an indexed section of Care Homes for Older People Page 12 of 27 Evidence: the file. There was also a need for some pruning and re-ordering of care plans so that staff could read through them more easily. Other monitoring tools, such as weight records, were kept separately but there were also older weight records on care plans. This made reading care plans a little confusing. Overall though, there were clear records of residents needs and the objectives set to meet those needs. In a number of cases there were local authority review notes with the service conducting additional internal reviews. Information about the new Deprivation of Liberty Safeguards and any assessments completed about this in respect to residents were not seen on care plans. The owner / manager has attended training on this and can introduce these type of assessments to care plans over the coming months. There were records seen of residents health care needs including a log kept of times when GPs and other health care professionals had been consulted with. One care plan had a record of an occupational therapy and physiotherapy assessment and another contained details about the need for a service from the district nursing service. The medication arrangements were inspected including storage and administration records. A medication file was seen which contained comprehensive information about residents medication as well as details of the staff who were assigned to administer medication. Medicines are stored in a locked trolley in a locked storage area. The records, including the medication administration records (MAR) were well ordered with no gaps. There were also records for the receipt into the home and for returns to the pharmacy which allows an audit of medication to take place. At the time of the inspection there were no complex medication arrangements such as use of controlled drugs, warfarin or self-administration by residents. Although there were medication profiles for each resident they were not up to date. The profiles seen were dated April 2008. They must now be updated as medication for residents may have changed in this time. Staff were observed to work kindly with residents and to interact with them in a warm, friendly manner. Staff were patient and in the staff interviews held demonstrated a commitment to residents quality of life. There was a positive atmosphere. However, one aspect noted should be reviewed. Residents spectacles (although all labelled) were kept in a box in the lounge. This practice should be reviewed to see if there is a more person centred way to mange the wearing and storage of spectacles. Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from the variety of activities provided by staff as well as opportunities to follow their own interests. The planned introduction of regular activity sessions from an external activities organiser will extend opportunities for residents. Meal time arrangements are good with residents needs responded to carefully by staff. Asking for resident feedback about the food served will extend resident choice and involvement. Evidence: There were a variety of group activities during the inspection. Staff provided music and ball exercises with residents in the lounge. A number of residents chose to follow their own interests and either spent time in their bedrooms or in the garden or meeting relatives. One of the staff members spoken with felt that the care staff needed more help with activities as sometimes other duties, such as laundry, meant that there was no time to provide activities. This was discussed with the owner / manager who advised that an activities organiser, who used to come to the home, was now to return to provide activity sessions. A musical entertainer also visits monthly. The owner / manager and staff have created a pleasant, homely environment where Care Homes for Older People Page 14 of 27 Evidence: there are opportunities to relax and take part in activities. There are two lounge areas as well as a dining room for activities and much use was being made of the garden and patio seating area by residents. The lunch time meal on the day of the inspection was observed. Staff worked well as a team during the meal with the owner / manager also taking a role in assisting residents to eat. The resident group is made up of a number of people approximately one third of whom are able to eat with little or no help, one third who need some help or encouragement and one third who need a great deal of help. Staff managed the meal well, assisting people kindly and carefully and speaking nicely to people to encourage them to eat. They were able to create an enjoyable relaxed atmosphere for residents. Having said that the actual meal, fish and chips and mixed vegetables, did not look as appetising as it could. It was made from oven ready fish pies and over ready chips which were heated before serving. Most residents ate the meal and enjoyed it although two residents spoken with afterwards described the meal as, too salty and could have been better. This was discussed with the owner / manager, who said that there was lots of variety in the meals served with lots of fresh vegetables used. Evidence of this was seen of vegetable and fruit stocks as well as the menus. The owner / manager advised that residents are asked for feedback about food and meals at the regular resident meetings. The evening meal, a light supper, was also carefully cooked with residents given a choice. However, it is recommended that meal provision is reviewed with input and feedback from residents. On the plus side the cook was knowledgeable about residents dietary needs and the kitchen had received five stars at a Barnet Council kitchen safety inspection in September 2008. Five stars is the maximum awarded. Care Homes for Older People Page 15 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints and safeguarding arrangements are suitable. Information is provided as to how to make a complaint and there are additional opportunities to comment on the service. Evidence: The complaint records were inspected. There have been no complaints recorded since 2005 and therefore no complaints since the owner / manager took over in 2008. The owner / manager also keeps a comment and suggestion book in the hallway and asks visitors to comment. The book was viewed. There were a number of comments from visitors, relatives and professionals. All were positive. This book provides some useful feedback about the service and can be used in quality assurance initiatives. There is a safeguarding policy and procedure. Abuse is defined in the policy and there is a clear procedure for reporting safeguarding matters to the local authority. Staff were knowledgeable about safeguarding matters and what they were expected to do. Some new staff will need safeguarding training and the owner / manager will need to provide staff with Deprivation of Liberty safeguards training. Following the inspection the owner / manager advised that two staff members have attended safeguarding training. Care Homes for Older People Page 16 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. The home provides a pleasant, comfortable environment for residents and there are arrangements made to assist residents who may have mobility difficulties. Work is needed to redecorate and refurbish parts of the home to make sure that current standards are maintained. Evidence: A tour of the premises was carried out with the owner / manager and a number of bedrooms were visited at the invitation of residents. There are many pleasant features to the home and it is mostly well presented. The bedrooms seen were clean, tidy and well furnished. There are a range of communal rooms as well as a passenger lift to assist residents move around the home. However, there is a need to invest in redecoration as well as provide some refurbishment at the home. Some of the decor and some furniture is now looking worn. The garden areas appearance , although containing attractive plants and vegetable areas, was spoilt by the fact that old items such as walking aids and toileting aids, had been stored there awaiting disposal. The white garden chairs also needed to be cleaned and there was insufficient bin storage for the clinical waste. All this was cleared up by the time of the second day of the inspection but there is a need to keep valuable garden space clean, attractive and tidy. Care Homes for Older People Page 17 of 27 Evidence: The decorative matters needing attention include some peeling external window frames to one side of the home, some marked internal skirting boards and a torn chair in the lounge. The owner / manager advised that he had plans to redecorate these areas and had already redecorated parts of the home. There is a mobile hoist at the home to assist with mobility. Some staff members raised the use of the hoist with us and felt that additional equipment was needed. This was discussed with the owner / manager who advised that staff could use the hoist when required and that this had been discussed with staff. There is a need for increased team communication and the guidance about the use of the mobile hoist may be part of this. More detail about team communication is provided in the next section. The laundry is sited in an external outbuilding at the end of the garden. Clothes and sheets were being dried on the garden washing line during the inspection and staff were folding and sorting out clean laundry in one of the communal areas. There are window restrictors in use at the home. However, a number of these were seen which allowed quite a wide opening. It is recommended that the window restrictors in use at the home are reviewed taking into consideration health and safety guidance and updating risk assessments as needed. Care Homes for Older People Page 18 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. The current staffing levels can mean that provision for residents is tight at times. Staff are highly valued by residents and provide good care. However, investing in increasing team communication should improve overall staff performance. The staff recruitment process is patchy and needs to be made more robust. Evidence: The practice at this home is to have two care staff on duty in the morning and three in the afternoon. There is a cook and cleaner who work in the morning and the owner / manager works as well and provides care support. There is no laundry person but there is a maintenance person. There are two waking night care staff at night. This level of staff cover can make things quite tight at times. For example, the staff comment that sometimes the laundry work meant that activities could not be provided. In addition, one of the three afternoon staff has responsibility for preparing the evening meal and this could lead to pressure on the other two staff. The flexibility of these staff arrangements will depend on the needs of residents especially if the resident group has a number of people who require lots of input from staff. The serving of lunch was a time of great demands on staff, for example. It is recommended that the owner / manager reviews the staffing levels at regular intervals taking into consideration the needs of residents. Care Homes for Older People Page 19 of 27 Evidence: This inspection has identified that team communication is an issue that needs to be addressed by the owner / manager. There was some feedback from staff that the team did not work together and communicate with each other as well as it could. Examples seen were the use of the mobile hoist and the planned return of the activities organiser. The owner / manager was clear that he had briefed staff about these matters but care staff were not clear about them. One reason for this could be the frequency of team meetings. Records of these were seen which provided evidence that there had only been two meetings so far in 2009. Another reason may be the fact that the owner / manager is relatively new and had inherited staff as well as brought in new staff. These type of ownership changes can often make staff communication and encouragement difficult. Whatever the reason this inspection has identified that there is a need for the owner / manager to invest in team communication and support. The owner / manager should look at ways to do this and a recommendation about this is given. The owner / manager advises that he was looking at appointing a deputy manager and this may be a useful way of sharing management tasks and supporting staff. A sample of three staff recruitment records were inspected. The application forms used should be amended as two of the three forms contained an unclear work history for the applicants. One of the three also did not have a reference from the most recent employer which is required under The Care Homes Regulations 2001. The training records were viewed and these were clear. Training information is held on staff files. Evidence was seen that staff had been provided with a range of training and staff confirmed that they had received training when they were interviewed. Care Homes for Older People Page 20 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The current quality assurance system is not very sophisticated and does not allow a wide range of opportunities for residents and others to provide feedback about the service. Health and safety arrangements are generally of a good standard although there is a need to draw up a money handling risk assessment to offer further safeguards to residents. The owner / manager has been successful in setting out his ethos and plans for the service. Evidence: The owner / manager has been running the home now for more than one year. He has been able to move the service forward setting out his own ethos and method of working. This has been done working largely alone as he works as both the owner and manager. There has been a good degree of success in that there is positive feedback from residents as well as visiting professionals. The owner / manager has adapted the homes systems and set out plans for the future development of the service. Care Homes for Older People Page 21 of 27 Evidence: This inspection has identified that a challenge facing the owner / manager is the development of the quality assurance initiatives. The current quality assurance systems are modest and do not make the most of the possible opportunities. For example, the use of surveys to obtain feedback from residents, relatives and others is a bit hit and miss rather than being focused and the result of careful planning. At the inspection the owner / manager advised that surveys were not carried out other than to rely on the surveys work carried out by the regulator. However, after the inspection the owner / manager advised that in fact surveys had been completed. A more targeted approach would be useful such as looking in detail at particular aspects of the service such as food provision or activities. There are a number of initiatives currently carried out such as the comment and suggestion book, regular reviews and resident meetings that can all contribute to useful findings about the service. All these need to be pulled together into one overall planned quality assurance approach so that the findings can be used to amend the service in line with peoples wishes and feedback. Staff supervision records were inspected. There was evidence that regular sessions were provided to staff and this was confirmed in staff interviews. Again, staff supervision sessions can be used to develop team communication. One relatively recent member of staff had only received one staff supervision session despite having been at the home for a number of months. The owner / manager said that he had carried out a recent session but not yet written up the notes. Money is only looked after for one resident. Records of money credited and debited to the resident were seen but there is a need to complete a risk assessment for the process followed. Parts of the process are potentially risky. The health and safety records as well as fire safety and the records of the servicing of equipment at the home were inspected. These were well organised with relevant certificates available. Care Homes for Older People Page 22 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 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 1 4 Update the statement of purpose and service users guide so that accurate information about the service is provided. Updating these documents will ensure that information is clear and that it is provided in as clear a style as possible. 01/10/2009 2 9 13 Medication profiles for residents must be updated. This will ensure that there is an accurate profile for each resident that reflects current prescribed medication and how it should be administered. 01/11/2009 3 19 23 Set out a timetabled plan for 01/11/2009 the redecoration and refurbishment of selected parts of the home. Care Homes for Older People Page 24 of 27 This will ensure that there is a clear programme with timescales for improvement to the physical standards. 4 33 24 A more detailed quality 01/11/2009 assurance system must be adopted to enable residents, relatives and others to provide feedback about the service. This will enable the home to find out peoples views and make sure that the service aims and systems meet peoples needs and wishes. 5 35 16 Draw up a risk assessment for the safe handling of residents money given to the home for safekeeping. This will enable a safe system to be introduced for keeping residents money. 01/11/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 3 4 7 10 15 19 The care plans should be reorganised so that they are presented in a clearer, more accessible format. The practice of keeping residents spectacles in a box in the lounge should be reviewed. Meal provision should be reviewed taking into consideration the views of residents. The garden area should be kept free from clutter with additional bins or one large purpose bin for the clinical waste. The window restrictor openings should be reviewed 5 19 Care Homes for Older People Page 25 of 27 adjusting the openings if needed. Risk assessments should be updated accordingly. 6 36 Staff supervision records should be kept up to date. Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2010) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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