Care Home: Lake View Nursing Home

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What the care home does well The home provided a secure and safe unit for people of all ages who were suffering from a dementia. Staff had received specific training to help them to meet people`s needs. People were given clear information about services offered at Lakeview to enable them to decide whether the home was suitable for them. Detailed assessments of people`s needs and preferences were carried out prior to admission to help to determine whether their needs could be met at Lakeview. Each resident had a detailed plan of care that recorded the action to be taken by staff to meet all aspects of their needs. Residents and their relatives were involved in decisions about their care and staff listened to them. Staff had a good understanding of people`s rights and residents said they were treated with respect. Resident`s medicines were managed safely and they received the medical care and support they needed. An activity programme showed a range of activities were provided each week. Residents confirmed they were able to make choices about how to spend their day; one resident said `I can suit myself`. The menu offered a choice of healthy and nutritious meals. Residents made positive comments about the meals included `I dont eat much but I enjoy what I can manage` and `I like the food, there is always a choice`. People knew who to speak to if unhappy and were protected by clear procedures and the skills and knowledge of staff. Residents had personalised their rooms with treasured possessions to help make them feel more homely; they said they were happy with their rooms. Staff were provided in sufficient numbers to meet residents needs; one resident said `there are enough staff, I just press the buzzer and they come to help me`. Residents had confidence in the staff team and made positive comments about them including `the staff are very helpful`, `I get on well with the carers` and `they are lovely, so kind`. One visitor said `they are the best, you couldnt ask for more`. Records showed that new staff had been recruited safely in a way that protected residents from being cared for by unsuitable people. People benifited from a safe and well managed home and their views and opinions were used to improve and develop the service. Staff made positive comments regarding the managers leadership and management approach; comments included `she is straight and fair`, `I have complete trust in her` and `I get excellent support and can discuss absolutely anything with her`. Training records showed that staff had the specialist skills and knowledge to look after the residents in the home. What has improved since the last inspection? The registered manager, Mrs Margaret Parker, had achieved a recognised qualification that would help her with her role. What the care home could do better: The provision and recording of suitable activities could be improved; staff said activities were `thin on the ground` due to the activity person being on long term leave. The home was comfortable and clean although it was clear there were some areas thatwere `shabby` and in need of improvement to make the home a pleasant place for all residents to live in. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Lake View Nursing Home Chorley Road Withnell Chorley Lancashire PR6 8BG     The quality rating for this care home is:   three star excellent 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: Marie Matthews     Date: 0 4 0 3 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 29 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 29 Information about the care home Name of care home: Address: Lake View Nursing Home Chorley Road Withnell Chorley Lancashire PR6 8BG 01254831005 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): lveuropeancare@aol.com European Care (UK) Limited Name of registered manager (if applicable) Mrs Margaret Parker Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: This home is registered for a maximum of 51 service users to include: Up to 25 service users in the category of OP (Old age not falling within any other category). Up to 26 service users in the category DE (Dementia) Up to 4 service users in the category of PD - (Physical Disability) Staffing must be provided at all times to meet the dependency needs of service users and will comply with any guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection Care Homes for Older People Page 4 of 29 care home 51 Over 65 0 25 0 26 0 4 Brief description of the care home Lakeview provides care and accomodation for up to fifty one residents requiring personal and nursing care including a specialist unit for residents suffering from mental health problems associated with dementia. Lakeview is owned by European care (UK) Limited whose headquarters are based in London. The home is located near the village of Withnell in a rural area requiring transport to reach the nearest shops and other facilities such as the post office, local pubs, and other town amenities. The home is set in extensive grounds overlooking a lake with woodland views. Accommodation is on two floors served by a passenger lift. All rooms are single occupancy and thirty-one have en-suite facilities. Information about the services offered by the home is provided in the form of a service user guide and is available, with a summary of the most recent inspection report, to existing and prospective residents and their families. On the day of the inspection the weekly fees ranged from £412.00 to £714.00. Items not included in the fee include hairdressing, newspapers, some toiletries and chiropody. Care Homes for Older People Page 5 of 29 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: three star excellent 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: The key unannounced inspection, including a visit to the home, took place on 4th March 2009. The last key inspection on this service took place on 6th March 2007 with an annual service review on the 6th March 2008. The inspection process included looking at records, a tour of the home, discussions with the registered manager, two staff, six residents and two visitors. The home sent us their annual quality assurance assessment (AQAA) before the inspection visit; this gave us a good picture of what had improved over the last twelve months and where further improvements were needed. Information was also included from survey forms filled in by five residents. Care Homes for Older People Page 6 of 29 The inspection also looked at things that should have been done since the last visit and a number of areas that affect peoples lives. What the care home does well: What has improved since the last inspection? What they could do better: The provision and recording of suitable activities could be improved; staff said activities were thin on the ground due to the activity person being on long term leave. The home was comfortable and clean although it was clear there were some areas that Care Homes for Older People Page 8 of 29 were shabby and in need of improvement to make the home a pleasant place for all residents to live in. 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 29 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 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were given clear information about services offered at Lakeview to enable them to decide whether the home was suitable for them and whether their needs would be met. Evidence: Prospective residents and their families and existing residents were given clear information about the services available at Lakeview; this had helped them to decide whether Lakeview was the right place for them. The registered manager said the information would be made available in other formats; this would ensure everyone understood what to expect. A monthly newsletter was also available and helped keep people up to date and informed. Each residents had been issued with a contract or statement of admission; this would inform them of their rights and obligations whilst living at the home. Care Homes for Older People Page 11 of 29 Evidence: Three residents care files were looked at in detail. Detailed assessments of peoples needs and preferences were carried out by experienced staff prior to admission and information had also been collected from other significant people; this would ensure all aspects of the residents needs were considered and would help to determine whether their needs could be met at Lakeview. Each resident had a detailed care plan developed from the assessment information that recorded what care they needed; this would ensure staff would know what care they needed. Letters confirming residents needs could be met had not been sent although the registered manager said this was done verbally; prospective residents and their relatives should be assured in writing that they would be looked after properly. Prospective residents and their relatives would be invited to spend some time at the home to meet with residents, visitors and staff. One resident said her relatives had been to look around as she had been unable; she said they had made a good choice. Training records showed that staff had the specialist skills and knowledge to look after the residents in the home. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents individual health and personal care needs were met. Evidence: Three care plans were looked at in detail. Each resident had a detailed plan of care that recorded the action to be taken by staff to meet their needs. The care plans also included details about residents individual likes, dislikes and preferences; this would ensure they received the care they both needed and wanted. It was clear that residents and their relatives and been involved in the development and review of their care plan; this made sure they were involved in decisions about care. Records showed residents health care needs were monitored and action taken to respond to any changes. Staff should always ensure residents short term health needs were recorded in the care plan to reduce the risk of residents not receiving the care as prescribed. Qualified nurses were in charge of the units and care staff had received training in health care matters; this would ensure that appropriate medical attention was sought when needed. Residents had the aids and specialised equipment they Care Homes for Older People Page 13 of 29 Evidence: needed to maintain their comfort and to help them to maximise their independence. Residents said they received the care and support they needed. Assessments of any risks to residents had been recorded and showed the action to be taken to reduce or remove the risks; this would ensure peoples safety. Regular checks were completed to ensure care plans were detailed and that residents care needs were being met. Staff had a good understanding of peoples rights and residents said they were treated with respect. Staff were observed interacting with residents and visitors in a friendly but respectful manner. One resident said she had been seen by her GP in the privacy of her own room. The majority of the bedroom doors did not have suitable locks in place which could impact on residents rights to privacy (see standard 24). Staff were given training regarding maintaining residents privacy and dignity to help them to understand the principles. Records showed that residents medicines were managed safely. Staff had access to safe policies and procedures and regular checks were done to make sure staff were following the guidance. Care and nursing staff had been provided with training to help them to manage medicines safely. It was recommended that the prescriptions were seen by the nursing staff prior to dispensing, handwritten entries to be witnessed and any PRN or as needed medicines were supported by clear instructions; this would reduce any risk of mis handling or error. Medicines were stored securely although it was recommended that the temperatures of storage areas were regularly checked and recorded as they were very warm on the day of the visit; storage at the incorrect temperatures could make reduce the effectiveness of medicines. Information regarding residents wishes concerning death and dying were recorded in the care plan. One visitor whose relative had died in the home commended the care and support he and his wife had received and said it was the best. There were procedures to support staff with death and dying. Care Homes for Older People Page 14 of 29 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 were able to make choices about their lifestyle and to participate in suitable activities that met their social needs and expectations. Evidence: There was an activity programme that showed a range of activities were provided each week. Residents confirmed that there were sometimes and usually suitable activities provided for them to enjoy; one resident said I would like more activities and more one to one chats. Other residents preferred to stay in their rooms and this was respected by staff. Records did not show who had participated or enjoyed the activity and staff said activities were thin on the ground as the activity person was on leave. A number of residents had enjoyed decorating cakes on the day of the visit. Residents spiritual needs were discussed on admission and met by visiting ministers and bible study sessions. Care plans included detailed information regarding residents routines, preferences, likes and dislikes prior to admission; this would help staff to provide suitable and meaningful activities for them. Residents confirmed they were able to make choices about how to spend their day; one resident said she enjoyed reading her newspaper in Care Homes for Older People Page 15 of 29 Evidence: the dining room each morning, another said I can suit myself. The home had developed good links with the local community and residents said their visitors were made welcome. The registered manager said family and friends could stay for meals. The menu offered a choice of healthy and nutritious meals. The lunch time meal was attractive and nutritious and residents said they had enjoyed it. Surveys indicated that residents sometimes or usually enjoyed the meals; other residents made positive comments about the meals including I dont eat much but I enjoy what I can manage and I like the food, there is always a choice. Dining areas were bright and spacious and staff were avialble for residents that needed extra support and assistance. Care Homes for Older People Page 16 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were protected by clear procedures and the skills and knowledge of staff. Evidence: People had access to a clear complaints procedure. Records showed that any concerns or complaints had been dealt with appropriately. Complaints were monitored by senior staff and people were actively encouraged to discuss their concerns and complaints with the registered manager; information from previous complaints were used to improve the service. Residents knew who to speak to if unhappy; four residents said the registered manager often visited them in their rooms to enquire whether they were happy or not. One resident said Margaret (the registered manager) asks me how everything is and sorts things out if Im not happy. Staff knew how to respond appropriately to any complaints and concerns. There were clear whistle blowing procedures that would support staff with reporting any poor practice in the home which would help to keep residents safe from harm. Safeguarding procedures were clear and staff had recieved training that would help them to respond appropriately to protect residents from abuse and neglect. Staff had received training that would help them to respond to any verbal or physical aggression; this would ensure residents and staff were protected. The use of any Care Homes for Older People Page 17 of 29 Evidence: restraint measures such as bed rails was fully documented, discussed with the resident or relative and clearly understood by staff. Additional training had been provided to ensure peoples rights were protected and respected. Residents said they were well looked after by staff. Care Homes for Older People Page 18 of 29 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. Areas were in need of redecoration and re furbishment to ensure the home was a safe and pleasant place for residents to live. The absence of a recorded improvement programme did not support any ongoing or future improvements were planned. Evidence: The home was comfortable and clean although it was clear there were some areas that were shabby and in need of improvement to make the home a pleasant place for all residents to live in. Areas in need of attention included damp areas to a number of ceiling tiles and above the window or room 14, a number of rooms where wallpaper and plaster was damaged, torn seating, broken handle on the domestic room door and gaps around the door lock including removal of the old mortice lock on room 53. There was no recorded programme to support plans for ongoing and future improvement; records showed that some improvements to residents rooms had been completed over the past twelve months although this had been done on an ad hoc basis. It was recommended that a tour of the home was undertaken to identify any areas in need of improvement and a plan for improvement developed. Grounds were attractive, safe and well maintained; there were patio and seating areas for residents and visitors to enjoy the gardens in warmer weather. One resident said I Care Homes for Older People Page 19 of 29 Evidence: like to sit by the window and look at the lovely gardens and the lake. There had been recent visits from the fire safety service and environmental health departments; the registered manager advised any work that had been identified had been complied with. Communal areas were bright and spacious however, as identified previously, some of the furnishings were in need of replacement. There were a number of quiet seating areas to enable residents and their visitors to enjoy the views of the gardens. Residents and their visitors were provided with a seperate smoking room. A number of rooms had en suite facilities although there were toilets and bathrooms located close to bedrooms and communal areas. Toilets, bathrooms and en suite facilities were identified with pictures on the dementia unit. There was a range of specialised aids and equipment to maintain residents comfort and safety and to help them to maintain their independence wherever possible. Some picture signage was in place to support residents with dementia although this could be improved. All rooms were fitted with a nurse call alarm but the alarm was not always accessible as call leads were not always provided; call leads would enable residents, who were able, to call for assistance from staff. Risk assessments should be in place to determine whether call leads could be provided. All bedrooms were being used as single occupancy. Fittings and furnishings varied according to the needs of the resident. Some residents had personalised their rooms with treasured possessions to help make them feel more homely. Some of the bedrooms, particularly on the dementia unit, were in need of improvement. Not all residents had a lockable storage area to store money or personal items and most bedroom doors were not fitted with a suitable lock; failure to provide these affects residents rights to privacy. The registered manager advised that locks would be provided if requested and risk assessments were in place to support non provision; this should be reviewed. There was an ongoing requirement regarding unsafe hot water and hot radiators. Most of the pipes had been protected but the surface temperatures of radiators remained hot and a risk to residents. Hot water outlets were tested regularly as records still showed temperatures above and below the recommended safe levels. The registered manager said a number of heating engineers had visited the home but further progress had not yet been made. Care Homes for Older People Page 20 of 29 Evidence: Residents said the home was always clean and fresh; this was noted on the day of the inspection visit. Laundry areas were organised and suitably equipped. Care Homes for Older People Page 21 of 29 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. Staff were suitable, competent and provided in sufficient numbers to meet residents needs. Evidence: Staffing rotas were available for each unit; they showed that each unit was suitably staffed to meet residents needs in a flexible way. Staff and residents said there were enough staff; one resident said there are enough staff, I just press the buzzer and they come to help me. Records showed that changes to the staff team were infrequent and agency staff had not been used; this made sure residents received care from people that knew their needs and preferences. The staff group were mixed gender, ages and cultural backgrounds; this allowed residents to receive care from a carer who understands their needs and preferences. Residents had confidence in the staff team and made positive comments about them including the staff are very helpful, I get on well with the carers and they are lovely, so kind. One visitor said they are the best, you couldnt ask for more. It was clear that the home recognised the benefits of a skilled and trained workforce. Most care staff have an recognised qualification in care which would give them the skills to do their job properly. New staff were supported through a period of induction Care Homes for Older People Page 22 of 29 Evidence: and supervised practice and existing staff received the training they needed to meet the needs of the residents in their care. One member of staff said we get plenty of training, there is always something going on. A visiting assessor said that the management is very supportive of staff. There was a detailed training plan provided for inspection although this did not clearly show the recent training that had taken place; further evidence was found in staff training files and through discussion with staff. The home had an employee of the month scheme which recognised care staff work and effort. Three staff records were looked at in detail. The records showed that a safe and fair recruitment procedure had been followed that protected residents from being cared for by unsuitable people. Residents were not yet involved in the recruitment and selection of new staff. All staff files should include a recent photograph as a means of identification. Staff meetings were held on a regular basis and staff confirmed they were able to raise any issues for discussion. The registered manager also met with night staff to discuss any issues they had; this ensured all staff members were included as part of a valued team. Care Homes for Older People Page 23 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benifited from a safe and well managed home and their views and opinions were used to improve and develop the service. Evidence: The registered manager is Mrs Margaret Parker; she has the necessary qualifications, skills and competence to manage the home and regularly updates her skills and knowledge. Mrs Parker has been responsible for the day to day management of the home for a number of years. Staff made positive comments regarding her leadership and management approach; comments included she is straight and fair, I have complete trust in her and I get excellent support and can discuss absolutely anything with her. There are clear lines of accountability and Mrs Parker is supported by a senior person within the company and meets regularly with other managers. Mrs Parker is involved in making budgetary decisions to ensure people receive a good standard of service. Care Homes for Older People Page 24 of 29 Evidence: There were a number of ways in which the home monitored the quality of the service they offered and showed that peoples views were valued. These included annual surveys, meetings with staff, residents and their families and regular checks to ensure staff were following procedures. The results of these processes were used to improve and develop the service. The home had achieved the Investors In People award; this is a nationally recognised quality award that monitored the management of the home and staff training and development. The home sent us their annual quality assurance assessment (AQAA) before the inspection visit; this gave us information about the changes and improvements that had been made in the last twelve months. Records showed that residents money was managed safely. All records were accurate and stored securely and residents could access them whenever they wished. Policies and procedures were up to date and reviewed regularly; this ensured staff had access to safe guidance. Staff were also provided with a handbook and had access to a range of training to develop their skills. Working practices were safe and staff received regular safety training to ensure people were protected from harm. Health and safety was monitored to ensure people were not at risk. Care Homes for Older People Page 25 of 29 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 25 13 (4) Steps must be taken to 31/05/2007 ensure that surface temperatures of radiators do not exceed 43(c. The risk assessments must be kept under review and radiator guards fitted if needed. Care Homes for Older People Page 26 of 29 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 19 23 A programme of routine maintenance and renewals must be implemented. To ensure the home is kept in a good state of repair and is a pleasant place for residents to live in. 01/05/2009 2 25 13 Steps must be taken to ensure residents are not at risk from the hot surface temperature of radiators. To ensure residents are safe from harm. 01/05/2009 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 3 8 8 Residents or their relatives should receive written confirmation that their needs would be met. Handwritten entries on medication administration records should be witnessed to reduce the risk of error. Staff should ensure residents short term health needs were Page 27 of 29 Care Homes for Older People recorded in the care plan; this would ensure residents received the care they had been prescribed. 4 9 PRN or as needed medicines should be supported by clear directions to support staff with their decisions and to reduce the risk of error. The prescriptions should be checked prior to dispensing to reduce the risk of mis handling or error. The temperatures of medication storage areas should be regularly recorded and appropriate action taken as needed; this would ensure medicines are stored at the correct temperature and remain effective. Records should show the activity provided, who had attended and whther it had been enjoyed; this would help to determine whether residents social needs were being met. A tour of the home should be undertaken to identify and record any areas in need of improvement. A plan of improvement should then be implemented. Each resident should be provided with an accessible alarm facility unless a risk assessment indicates otherwise. Each resident should be provided with a key to a lockable storage space unless a risk assessment indicates otherwise. Doors to residents private accomodation should be fitted with a suitable lock that is accessible to staff if needed. Residents should be provided with keys unless a risk assessment identifies otherwise. The recruitment checklist should include the dates that documents are returned. Staff files should include a recent photograph as a means of identification. The training matrix should be kept up to date to reflect the current skills of staff. 5 6 9 9 7 12 8 19 9 10 11 22 24 24 12 13 14 29 29 30 Care Homes for Older People Page 28 of 29 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. 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