Care Home: Holly House

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What the care home does well They provided people with information to help them make an informed choice about the home. The home provided a wide variety of communal space and different places to sit. The atmosphere was warm and friendly and the environment homely. The home was clean tidy and well maintained. The gardens were attractive and secure and accessible to the people who lived in the home so the gardens could be enjoyed safely. Garden furniture and raised flowerbeds had also been provided. The people who lived in the home said that the staff were good. They felt they were treated with respect and their privacy was upheld People were able to look after their own medications and were well supported in this task by the staff. People generally enjoyed living at the home and the meals provided. They were enabled to maintain contact with relatives and friends as they wished. Procedures were in place to ensure that complaints were taken seriously and acted upon. There were systems in place to ensure that people were protected from abuse. They had provided mandatory training for staff such as training in moving and handling, medication and safeguarding adults and refresher training had been provided since the last inspection. They had made sure that management changes had not affected the care people received and had continued to try to improve the home. The activities for people were varied and appropriate to their interests and abilities. What has improved since the last inspection? They had changed their processes to ensure that contracts/terms and conditions are provided to people. They had improved care plans and out how peoples assessed needs were to be met. They had improved the way people`s health was monitored, care was provided as planned and monitoring records were completed. They had made sure that bed rails were regularly checked to ensure that they are safely fitted. What the care home could do better: They should ensure that all elements of the care plans are evaluated monthly and careplans are updated as required. They should monitor the temperatures of the medication fridge on a consistent basis to preserve the quality of the medication. To ensure a pleasant environment for the people who live in the home the home must be kept free from unpleasant odours. Where there is a change of use of any areas in the home the management should ensure that this complies with fire department and building control requirements. To evidence that all recruitment checks have been completed and the staff member is fit to work in the home the recruitment records for all staff employed in the home must be held at the home. To ensure that the equipment is safe for people to use they must provide evidence that hoists have been serviced at six monthly intervals. They must provide evidence that the home has current insurance cover. Where people are assisted with their finances the management should complete regular management checks to ensure accurate record keeping. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Holly House 124 High Street Burringham Scunthorpe North Lincolnshire DN17 3LY     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: Kate Emmerson     Date: 0 8 0 5 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 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Holly House 124 High Street Burringham Scunthorpe North Lincolnshire DN17 3LY 01724782351 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) : hollyhouse5@aol.com PB Residential Care Limited care home 49 Number of places (if applicable): Under 65 Over 65 0 49 dementia old age, not falling within any other category Additional conditions: 49 0 The maximum number of service users who can be accommodated is: 49 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: Old age, not falling within any other category, Code OP, maximum number of places 49 Dementia, Code DE, maximum number of places 49 Date of last inspection Brief description of the care home Holly House is situated in the centre of the village of Burringham close to Scunthorpe and local transport links. The home had consisted of three separate buildings known as Holly House, The Cottage and Trent House. The addition of a conservatory linked the Cottage and Holly House. An extension linked Holly House to Trent House forming a dining room, meeting room, reception area, kitchen and office. The older parts of the property had accommodation over two floors. A mechanical stair climber had been provided in The Cottage and Holly House to assist service users with the stairs. A lift in Care Homes for Older People Page 4 of 28 Brief description of the care home the Cottage is a more recent addition. The accommodation at Trent House was purpose built and on one level. Attractive secure garden areas were provided for service users. At the time of the inspection fees at the home were £387.34 - £438.34. There were variable third party top up fees for larger rooms and those with ensuites. Other additional charges included Chiropody, Hairdresser, Escort duty and Newspapers. Care Homes for Older People Page 5 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection peterchart Environment Staffing Management and administration Poor Adequate Good Excellent How we did our inspection: This inspection was unannounced and took place over one day in May 2009. To find out how the home was run and if the people who lived there were pleased with the care they received time was spent in the home watching how the care was given. We spoke to people who lived in the home and were able to answer some questions about the home. Time was also spent with other people who were not able to say much about the care they got or how the home was run but were able to say if they were happy at the home. We spoke to staff that were on duty at the time of the inspection. We also spoke to the Care Homes for Older People Page 6 of 28 Responsible Individual and the manager from another home that was assisting in the management of the home and the training of the staff. Records kept in the home were also seen, this was to make sure checks that staff were safe to work in the home were completed before they started and that they had been trained to do their job safely. Records were checked to make sure that the home and the equipment used in it was safe and checked regularly. We have reviewed out practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward in to this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is reapeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: They should ensure that all elements of the care plans are evaluated monthly and care Care Homes for Older People Page 8 of 28 plans are updated as required. They should monitor the temperatures of the medication fridge on a consistent basis to preserve the quality of the medication. To ensure a pleasant environment for the people who live in the home the home must be kept free from unpleasant odours. Where there is a change of use of any areas in the home the management should ensure that this complies with fire department and building control requirements. To evidence that all recruitment checks have been completed and the staff member is fit to work in the home the recruitment records for all staff employed in the home must be held at the home. To ensure that the equipment is safe for people to use they must provide evidence that hoists have been serviced at six monthly intervals. They must provide evidence that the home has current insurance cover. Where people are assisted with their finances the management should complete regular management checks to ensure accurate record keeping. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 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 10 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were provided with detailed information about the home to assist them to make an informed choice. People had had their needs assessed before moving into the home. Evidence: The home had a detailed statement of purpose and service users guide, which gave information about the services provided. Information provided by the home to the Commission prior to the inspection stated that the statement of purpose and service users guide had been reviewed. This makes sure the documents were up to date in respect of the management changes in the home. People living in the home stated in surveys that they had received sufficient information about the home before they had moved in. Contracts/terms and conditions were examined. These provided detailed information Care Homes for Older People Page 11 of 28 Evidence: about the services and outlined conditions of residency although one had not been signed. The acting manager assured us that processes had been changed to ensure that these documents would be completed in future. There was evidence in the care files examined that people had had assessments of their care needs completed usually prior to being offered a place at the home. The manager or another member of the senior staff would visit the person before admission to complete the assessment. Social services assessments and care plans had been obtained. The assessment process had improved in that the assessments were more detailed. This means that the staff have all the information they need to care for the person when they are admitted to the home. The home does not provide intermediate care. Care Homes for Older People Page 12 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The majority of peoples health and personal care needs were recorded in care plans. There was evidence that through regular detailed management audit the systems and records in the home were improving. People were enabled to self medicate if they wished. Medication processes and record keeping had improved to a satisfactory level through regular management audits. People who lived in the home felt they were treated with respect and their privacy was upheld. Evidence: Six care plans were examined at this inspection and these had continued to improve. There were improvements in the care planning relating to health monitoring. For example where one person was observed receiving regular pressure area care there was a detailed support plan for this and daily charts detailing the care provided were Care Homes for Older People Page 13 of 28 Evidence: maintained. Daily diary records detailed the action taken where it was recorded that staff were concerned about a persons health. The home was part of the hospital admission diversionary scheme. As part of this scheme a district nurse visited the home on a daily basis and had provided some staff training. The visiting district nurse stated that generally the home had improved in terms of meeting peoples health needs. Details regarding peoples dietary needs were recorded on assessment and the information was provided to the cooks. The care plans showed that people had been weighed monthly. Appropriate scales were available for people who were unable to weight bear. There was evidence of regular evaluation in the majority of the care plans and care plans had generally been up dated as needs changed. However it was noted in one case that where a persons mental health had deteriorated this element of the care plan had not been evaluated and updated. A relative commented in a survey that the the home takes good care of my fathers needs, he is in very poor health so needs lots of assistance now. Another said the carers know mums needs and look after her very well, especially the experienced ones who have been there for some time. A policy and procedure for the safe handling of medication was available in the home. People were enabled to self medicate if they wished and one person was selfmedicating eye drops. Generally medication records had been consistently maintained. Improvement in this area had been achieved through periodic medication audits as part of the quality monitoring process and staff training. Records of temperatures of the medication fridge and storage areas had not been consistently completed on a daily basis. This is important to ensure the quality of the medication is maintained. There was evidence from observation and peoples comments that staff respected peoples privacy. People said that their privacy and dignity was respected during care tasks. Staff used preferred term of address and this was recorded on care plans. Observation of staff interaction with people confirmed that there was good communication with people who lived in the home. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People enjoyed living at the home and the meals and activities provided. People were enabled to maintain contact with relatives and friends as they wished. Evidence: There had been continued efforts to improve the activities in the home and people were engaged in activities during the inspection. A new activities coordinator had been employed for the past six months for sixteen hours per week and detailed records of activities provided were maintained. She was extremely motivated to provide stimulating activities for people which met individuals needs. The activities coordinator had arranged fund raising activities and outside entertainers and was implementing regular meetings with people and their families. Records showed that activities were individualised and varied. More detailed individual assessment and development of social care plans will make sure that this area continues to develop to meet peoples needs. Staff were seen to engage people in discussions, dancing and games during the inspection. Generally people enjoyed the activities on offer although one person commented that they would like trips out. Care Homes for Older People Page 15 of 28 Evidence: People were able to choose daily routines and how care was to be delivered. Preferences were recorded in care plans and information regarding likes and dislikes were provided to cooks. Staff were observed to have a good understanding of peoples likes and dislikes. Religious services were held in the home fortnightly. Information regarding arrangements for maintaining contact with relatives and friends was included in the service users guide and statement of purpose. There was access to private space to receive visitors either in their own rooms or the training/meeting room. People were able to choose whom they wished to see and with only one point of access to the home this could be easily managed. People who lived in the home stated that they enjoyed the meals provided, comments included the food is good although one commented it could be hotter. Menus had been developed in consultation with people who lived in the home and showed there were at least two choices at breakfast, lunch and tea. Individuals confirmed that they could also request an alternative to the menu if required. Vegetarian diets and diabetic diets were catered for. Meals observed were well presented and appropriate for peoples dietary needs. Differing portion sizes were provided. People could choose where they took their meals and the majority ate in the spacious and well planned dining room. This gave the opportunity for people from both units to meet and socialise together. There was a pleasant and calm atmosphere during the meals observed. Staff routines were organised to make sure that staff were available to assist people in taking their meals and they were observed to offer assistance in an appropriate manner. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Procedures were in place to ensure that complaints were taken seriously and acted upon. There were systems in place to protect people from abuse. Evidence: Records of complaints and actions taken were available. The home identified in the information provided to the Commission that they had received ten complaints. Records showed that these had been investigated and appropriate actions had been taken. A relative commented that the owner has responded promptly to my complaints and has been available when ever I have needed him and has readily discussed issues. The complaints procedure was displayed in the home and was also contained in information about the home given to people on admission. The home also had detailed policies and procedures to support practice to protect people from abuse and these were made available to staff in the handbook provided on employment. Staff had received training in safeguarding vulnerable adults and referral procedures. A training plan provided after the inspection showed that there was ongoing training. Care Homes for Older People Page 17 of 28 Evidence: The information provided by the home indicated that there had been three safeguarding investigations undertaken by the Local Authority. At the time of the inspection the local Authority had not informed the Commission of the outcomes of the investigation. 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 offered spacious homely accommodation which was well maintained. The management were generally proactive in dealing with issues affecting the environment. However they had not informed the appropriate agencies or taken sufficient action to ensure safety when changing the use of service users bedrooms. Evidence: The home provided a homely atmosphere which was clean and tidy through out. There were a number of communal areas available for people including a smoke room, conservatory and very spacious dining area. The gardens were attractive, safe, secure and accessible. The programme of redecoration and refurbishment in the home had been maintained. The majority of bedrooms had been redecorated and provided with new carpets. Some of the communal rooms had also been redecorated. The bathrooms and toilets were in the process of being upgraded. The acting manager stated that there had been some problems with the central heating but this was being addressed. A new nurse call system had been fitted which integrated Holly and Trent units enabling staff to hear the call bell even when they were on a different unit. People had been consulted about the decoration of their rooms. One person told us that she had been consulted about Care Homes for Older People Page 19 of 28 Evidence: redecoration of her bedroom but she had decided not to go ahead with this at this time. The Trent unit communal areas had a very unpleasant odour. The management were aware of this and had taken action to try and address this. Staff stated that carpets had been cleaned and new furniture provided in an effort to address this problem but with little effect. Other options were being considered, for example, the compatibility of the cleaning materials used. People living in the home thought the home was usually kept fresh and clean although one relative commented about the unpleasant odour on the Trent unit. One of the toilets in the Holly unit had a folding door which one of the people living in the home raised concerns about. They were concerned that door did not offer adequate privacy as even when locked from the inside it could not be fully closed. The managemetn said this would be addressed as it was due for refurbishment. During the inspection it was found that staff were living in the home on the first floor in Holly unit. The facilities on this floor had not been used by service users for some time as there is no passenger lift in this area. One of the bedrooms was being used as a kitchen, the fire door to this room did not close fully and had been left propped open, in the event of a fire this would not have provided adequate protection for the rest of the home. The handy man adjusted this door on the day of the inspection. The management could not provide any evidence that the fire officer or building control had been consulted on this change of use and they were strongly advised to do so. The inspector followed this up with a call to the fire officer who, after visiting the property, assured the us that the area was safe as far as fire safety and the fire officer had referred the changes to building control. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst there were adequate staff employed as per Residential Forum guidance this was not the experience of some of the people living in or visiting the home. Staff had received training relevant to their role. The home could not evidence in all cases that a robust recruitment process had been followed as some information was not available for inspection. Evidence: Staffing had been planned using residential forum guidelines and at the time of the inspection five care staff were provided on day shifts and three on night shifts. The majority of both staff and people who live in the the home who completed surveys for us stated that there were usually enough staff on duty. However there were some comments which indicated that there may not be sufficient staff at all times. These comments included I can walk through the EMI unit (Trent) and there is no one there although this has improved in the last two weeks, insufficient staff on the face of it, I dont feel they have enough staff, they are run off their feet and you have to wait up to fifteen minutes for help when you ring the bell as only two staff. Rotas evidenced and staff stated that staff from the providers other homes or agency staff had been used to support the staffing in the home if there were gaps in the rotas. Care Homes for Older People Page 21 of 28 Evidence: They said that the providers would always try and get cover. Staff confirmed that new staff had been appointed recently. The rotas showed where new members of staff were supernumerary on rotas as part of their induction. There were positive comments about the staff the majority of staff are lovely and caring, and all the carers work hard and are pleasant and friendly and look after us well. Due to the turnover of staff since the last inspection the percentage of care staff with NVQ qualifications had been significantly reduced. The pre inspection information provided by the home stated that five of the 14 care staff had achieved at least NVQ 2 and four were training for this qualification. The information stated that NVQ training was on going. Examination of files for five staff that had most recently commenced employment showed that recruitment checks had been completed although in one cases only one written reference instead of two had been obtained prior to employment. All checks must be obtained prior to employment to make sure that the person is suitable for the post. In two cases there were no files available for inspection , one was held at the sister home as the staff member had recently been transferred to Holly House and in the other case the acting manager stated that provider had the file to complete some paper work. There was evidence that mandatory training had been provided. This training included moving and handling, safeguarding adults, infection control and food hygiene. Whilst some training was due the management had identified this and a training plan was being developed at the time of the inspection to address any shortfalls. This was provided to us following the inspection. Staff confirmed that there had been training in a variety of subjects including training relating to the needs of those living in the home such as dementia. There was evidence that induction training had been provided using common induction standards. Workbooks were provided for new starters although these were not available in all cases in the home as they are given to staff. The rotas and comments from staff evidenced that induction also included some shifts where new staff shadowed other staff and were extra to the required numbers on the shift. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There have been five managers in the home in 2007 and the home had not had a registered manager since April 2007. However there has been continued improvement in all areas of the home since the last key inspection and this has been as a result of more effective management, quality monitoring and support by the providers. Evidence: There had been an unstable period of management in the home since the last inspection. Two managers had left employment since the last inspection but a new manager had been employed and was due to start work the week following the inspection. The Responsible Individual Wayne Willis had been managing the home in the period since the last manger had left in April 2009. There was evidence that they had maintained quality assurance and management monitoring systems in the home to improve the quality of the service provided and ensure that the home is run in the best interests of the people living in the home. This Care Homes for Older People Page 23 of 28 Evidence: included audits of the systems in the home and surveys. The home had achieved the Investors in People award since the last inspection. Where the home held money on behalf of people living in the home records were held. The records held balanced with cash held in all but one case. These records were not complete and did not correspond with receipts held. Mr Willis audited these records during the inspection and following this process these records balanced. There was no evidence of regular management audits of the records or handover between managers. This is recommended. Requirements arising from the previous inspection relating to health and safety were checked for compliance. These had been met. Policies and procedures and staff training supported safe working practices to protect the health, safety and welfare of people living in the home. The homes Liability Insurance and hoist servicing had become due at the time of the inspection and Mr Willis was asked to provide evidence to the Commission that these had been brought up to date. 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 29 19 Two written references must be obtained for staff prior to them commencing work in the home. To ensure staff are fit to work in the home 01/09/2009 2 26 16 The home must be kept free from unpleasant odours. To ensure a pleasant environment for the people who live in the home. 01/09/2009 3 29 17 The recruitment records for all staff employed in the home must be held at the home. To evidence that all recruitment checks have been completed and the staff member is fit to work in the home. 01/09/2009 4 38 23 To provide evidence that 01/09/2009 hoists have been serviced at six monthly intervals. Care Homes for Older People Page 26 of 28 To ensure that the equipment is safe for people to use. 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 7 9 19 To ensure that all elements of the care plans are evaluated monthly and care plans are updated as required. To monitor the temperatures of the medication fridge on a consistent basis to preserve the quality of the medication. To ensure the safety of people living in the home where there is a change of use of any areas in the home the management should ensure that this complies with fire department and building control requirements. To provide evidence that the home has current insurance cover as set out in this standard. To complete regular management checks of the records held where people are assisted with their finances to ensure accurate record keeping. 4 5 34 35 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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. 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