Care Home: Linthorpe Nursing Home

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What the care home does well The home keeps good care records so that all staff know exactly how to support people in the right way. The home works very well with other health services to make sure people get the right care when they need it. People who live here said they are are treated with dignity and respect . A relative said, " The staff are brilliant - they are very friendly and caring." People can lead their own lifestyle, and choose to do things when they want to. Visitors said that the atmosphere in the home is always "homely" and "friendly." People said the food is very good and they can make lots of menu choices. Staff are experienced, mature and well trained in care. Residents and staff get on well together. The staff have worked here a long time so they know each person`s needs very well. The home is well managed, and is run in the best interests of the people who live here. What has improved since the last inspection? The home has been involved in a special health project to help design guidance for all homes on preventing health care infections. The home has now been awarded 4 stars (out of 5 stars) by the council for its good food safety practices. The back garden now has a sheltered decked area where people can sit out. Over the past year the lounges and 13 bedrooms have been redecorated and recarpeted. The results of surveys about the home are now published for residents and their representatives to see. What the care home could do better: Only one requirement is made. The provider must continue with plans to redecorate bathrooms and toilets. Other things which would make the home better include: having a copy of information for people in audio format, so it is ready for someone if they have difficulty with reading; locks to shower rooms should be fixed; care records should be kept in the office when they are not being used; toilet roll holders should be easy to reach and use; people should be offered bedrooms door locks; and dirty light pull cords should be replaced. Key inspection report Care homes for older people Name: Address: Linthorpe Nursing Home 36 Eastbourne Road Linthorpe Middlesbrough TS5 6QW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Andrea Goodall     Date: 0 3 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Linthorpe Nursing Home 36 Eastbourne Road Linthorpe Middlesbrough TS5 6QW 01642850032 01642824092 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Linthorpe Private Nursing Home care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 28 The registered person may provide the following category of service only: Care home with nursing - Code N 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: 28 Physical disability - Code PD, maximum number of places: 28 Date of last inspection Brief description of the care home Linthorpe Nursing Home is registered to provide personal and nursing care to 28 older people. The home is situated on Eastbourne Road, Middlesbrough, and is close to Linthorpe Village and other local amenities. The home is set in its own grounds with gardens to the front and rear of the building. Internally, there are three lounge areas on the ground floor, one lounge on the first Care Homes for Older People Page 4 of 29 Over 65 28 0 0 28 Brief description of the care home floor and two dining areas. There are twenty-two single bedrooms and four double bedrooms. Nine of the bedrooms have ensuite facilities, which comprise of a sink and a toilet. All bedrooms meet with size requirements of National Minimum Standards. The cost of care at the time of the inspection visit ranged from £420 (for residential care) to £531.30 (for nursing care) per week. These are the fees that set by the local council. There are no top-up charges made by the home. 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: 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: Before the visit we looked at information we have received since the last visit on 17th September 2007, and the last annual service review on 16th August 2008. We looked at how the service dealt with any complaints or concerns since the last visit. We looked at any changes to how the home is run. We asked the Provider for their view of how well they care for people in their AQAA (an annual quality assurance assessment). We made an unannounced visit to the home on 3rd September 2009. During the visit we talked with people who use the service, their relatives, manager and staff, visitors, and the Provider. We joined residents for a meal and looked at how staff support the people who live here. We looked at information about the people who use the service and how well their needs are met. We looked at other records which must be kept by a care service. We checked that staff had the knowledge, skills and training to meet the needs of the people they care for. We looked around parts of the Care Homes for Older People Page 6 of 29 building to make sure it was clean, safe and comfortable. We checked what improvements had been made since the last visit. We told the manager what we found. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into 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 repeated, it is likely that enforcement action will be taken. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: Only one requirement is made. The provider must continue with plans to redecorate bathrooms and toilets. Other things which would make the home better include: having a copy of information for people in audio format, so it is ready for someone if they have difficulty with reading; locks to shower rooms should be fixed; care records should be kept in the office when they are not being used; toilet roll holders should be easy to reach and use; people should be offered bedrooms door locks; and dirty light pull cords should be replaced. Care Homes for Older People Page 8 of 29 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents are fully assessed before they make a decision about moving here so that they know the home can meet their needs. Evidence: Linthorpe Nursing Home has been open for around 29 years. Many of the people who come to live here are familiar with the surrounding area and some already knew of the home before they moved here. One relative said, This home was recommended to me by someone whose relative lived here. We liked it because it is so homely and smaller than the new, purpose-built homes. The home provides each prospective resident with an information booklet about the service (called a service users guide) which gives good details about the service. At this time the information is in quite small print, and the home does not currently have the booklet in other formats, for example in audio for people with sight or reading difficulties. Care Homes for Older People Page 11 of 29 Evidence: Before people come to live here their needs are assessed by health and social care professionals to see what sort of care they need. The assessment records were clear and detailed. The manager uses these assessments to decide whether the home can meet the main needs of the potential new resident. It was clear that the home has very good working relationships with other care professionals. If the person is selffunding or has particularly complex needs, the manager also carries out her own assessment to check whether their needs can be met at Linthorpe. Prospective residents are then offered a trial period of up to six weeks. During this time the home carries out another assessment to see whether the home is suitable for them. This is followed by a review with the PCT and/or a social worker to make sure that the placement is successful for both the resident and the home. In this way people can be assured that their needs can be met by 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. People who live here receive good support so that their personal and health care needs are well met. Evidence: Care plans are records that are used by all care services to show what sort of help each person needs and how staff will provide that care. For example how to help people with their mobility, emotional well being, and hygiene. The sample of care plans seen at Linthorpe were very detailed and provided clear guidance to staff about how to help to meet each persons needs. The care plans are written in a sensitive and respectful way that promotes the individuality and preferences of each person. The care plans show how peoples continued abilities and independence are supported, so that people can retain their skills wherever possible. Monthly evaluations of each care plan provide good details of any progress or change in needs. The care records also show that peoples health care needs are regularly assessed and Care Homes for Older People Page 13 of 29 Evidence: are well managed by the nursing staff at the home, and with the involvement of community health care professionals. The homes detailed assessment records include moving & assisting, nutrition, risk of falling, and pressure care. At this visit not all weight records were being recorded monthly, which would show whether peoples nutritional needs were changing. The care records show that the home supports people to have good access to community health care services such as GPs, dentists, opticians and so on. It is clear that the home works well with health services. A visiting relative said, They are very good at getting other health services involved when necessary. When one resident had a pain behind her eye, the home got an optician to do a home visit straight away. It is good practice that the home is about to register with the Gold Standard Framework in Care Homes, which means it will work as a team with other professionals to support the best possible care for people when they are nearing the end of their life. It is also good practice that the home has taken part in a year-long special pilot (with around 50 other care homes in the North East) led by the Improvement Foundation health service to look at how homes can manage health care associated infections. The findings from this will be used to produce national guidance and training for all care homes. The home would support people to manage their own medication if they chose to and were assessed as capable of doing so. For most residents the nursing staff manage their medication. It is good practice that some care staff have also attended training in safe handling of medication in case they ever needed to support people with their medication. Individual peoples medication is delivered to the home by the pharmacist in individual blister-packs for each person, so that it is easy for staff or residents to use. Medication is securely stored on each floor, and medication records were up to date and in good order. Residents, relatives and other visitors had many positive comments to make about the manner in which people are supported here. One regular visitor said, The attitude of staff is very good. Everyone is treated respectfully. Throughout this visit staff approached residents in a supportive and valuing way. A relative said, Staff talk to residents in a friendly, caring way. Even if they are just passing by they have a chat and check if a person is okay. They always make sure that people are presentably dressed and that the men are clean shaven - because Care Homes for Older People Page 14 of 29 Evidence: thats what people would want. One resident said, The staff are very good to me. I couldnt ask for a better service. There is very limited office and storage space within the home. At this time daily care records and the medication records are being kept in part of the dining room for easy access by staff during their handover sessions. However this means that residents and any visitors to the home could access other peoples confidential records. A senior member of staff acknowledged this and stated that these would now be kept in an appropriately secure area for staff access only. Care Homes for Older People Page 15 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. People have good support so that they lead a flexible lifestyle that meets their individual and cultural preferences. Evidence: All the people who took part in discussions said that they can spend their day where they wish. Some people prefer to spend part of their day in the privacy of their own room, then join others for meals in the dining room. The home has three homely lounges where people can watch TV or chat. One visitor said, This home is so flexible in its care. People can choose to do things when they want to. Ive been to other homes where everything is so regimented because they are so big, but Linthorpe is more like a family home. The home tries to provide activities and entertainment every week. For example, twice a month a Motivation Company visits the home to provide quizzes and reminiscence sessions. The manager is also arranging for a staff to provide entertainment and singalongs every other week. People have occasional chances to go out to local shops with staff, and twice a year there are trips to concerts at the local theatre. The manager commented on the difficulties in arranging suitable transport for more trips out, but is keen to improve this area for the people who live here. Care Homes for Older People Page 16 of 29 Evidence: Relatives said that they are made to feel welcome at any time, and there was a steady stream of visitors during this inspection. Visitors described the service as homely, caring,familiar and comfortable. There are clearly good relations between relatives and staff. Menus are displayed on a cafe-style menu board in the dining room so people can see what the main choices are for each meal. It is also good practice that staff ask people what they would like for their main meal about an hour before so they can make an informed choice just before their meal. It is good that people can choose something other than the two main options if they do not fancy those. For example, on the day of this visit one person chose eggs on toast and some people preferred sandwiches for their lunch. The catering staff are happy to oblige, and one cook said, Its up to them, well make whatever they would like. In discussions with the catering staff it was clear that they have a very good understanding of each persons individual preferences and special dietary needs. One resident said, I have decided to have lighter lunches because I like to have a big breakfast. I have chosen to have snacks at lunchtime and they make me what I want. Everyone commented on the good quality of the meals. One relative said, The food is smashing. Im surprised they dont put more weight on. The menus reflect traditional, home-made dishes as well as modern dishes. People can dine where they prefer. Some people dine in their rooms because of their health, some people like to dine in the television lounge, and others dine in the dining room. Most tables were well set with tablescloths, placemats, appropriate cutlery and condiments (although a couple of tables had been missed out at the back of the room.) Some tables had not been provided with serviettes, although people were offered a tissue at the end of the meal. Where people needed physical support with their meal, this was provided in a sensitive and engaging manner. People here enjoy a very pleasant dining experience. Care Homes for Older People Page 17 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have clear information so they would know how to make a complaint. The staff team have had suitable training so they know how to protect residents from abuse. Evidence: All the people who live here have a copy of the homes complaints procedure in their bedrooms. This includes clear details of how to make a complaint and how the home will respond within set timescales. In discussions residents and relatives said that the manager and the Provider have an open door approach and make themselves available to residents and visitors. Residents and their relatives said that they would feel comfortable about discussing any comments or concerns about the service with the manager or other staff, and would be confident that it would be put right. There have been no complaints made to CQC or the home about the service it provides over the past year. The home has an adult protection policy and staff have had training in the protection of vulnerable adults. The manager is conversant with the Middlesborough council-wide Safeguarding Adults procedures. There have been three safeguarding adults referrals over the past year. The home has worked well with Middlesborough council and other agencies to look into these. It is good practice that there is a poster in the office detailing the Care Homes for Older People Page 18 of 29 Evidence: contact number for staff to ring if they suspect any poor practice. In this way staff are clear about how to report suspected abuse. Care Homes for Older People Page 19 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. The home is warm, safe and comfortable, but some areas are worn so it is not a fully well-maintained environment for the people who live here. Evidence: Linthorpe is a large older house that has been converted into a 28 place nursing and residential home. As with many older buildings the home needs a continuous decoration programme, and over the past year the lounges and 13 bedrooms have been redecorated and recarpeted. The home has three lounge areas for people, including a television lounge within the dining room. Overall lounge areas are pleasant, homely and comfortable. However the lack of storage room in the home means that part of the dining room is used as a parking area for many wheelchairs, which makes it look cluttered. At the time of the last inspection the home had received a grant which was being used to improve the large back garden for residents. This has now been achieved and there is a very pleasant decked seating area that provides a sheltered place for residents to sit in any weather. At this time the Provider has begun to refurbish one shower room, however most other bathrooms and toilets are in a worn state with scuffed paintwork and tired decor. This makes them appear shabby and uninviting, and detracts from the Care Homes for Older People Page 20 of 29 Evidence: otherwise homely accommodation. The Provider acknowledged this and indicated that there are plans to upgrade the bathrooms very quickly. The toilet roll dispensers in toilets are difficult to operate and out of reach. This does not support people with reduced dexterity to be independent. The locks to some shower rooms and bathrooms do not work. The majority of bedrooms are not fitted with locks so that people cannot choose whether to lock their door or not. There are protective gloves on public display in the entrance hallways. There is continence equipment on display in bathrooms. These issues do not support the dignity or privacy of the people who live here. Overall the standard of odour control and cleanliness around most parts of the home was very good, and it is clear that housekeeping staff work hard to keep this older building clean and hygienic. However light pull cords in toilets and bathrooms are very grubby, and they are difficult to clean in their current state. This could compromise infection control within the home. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides suitable, competent, well trained staff to ensure that the people who live here are protected and that their needs are met. Evidence: The care staff team currently consists of the registered manager, five qualified nurses and 16 care assistants. There are also catering and housekeeping staff, an administrator, and a maintenance staff. The staffing levels allow for one nurse and four care staff in the morning, one nurse and three care staff in the afternoon, and one nurse and two care staff during the night. These are satisfactory levels of staffing to meet the number and needs of the people who currently live here. There was good staff presence around the house, and staff also supported people to go out into the garden whenever they requested. Residents and relatives had many positive comments to make about the care provided by this staff team. One relative said, Whenever I visit the staff are friendly and welcoming. Another relative commented, There is good staff availability. There are always staff around when people need them - you dont have to go looking for them. Care Homes for Older People Page 22 of 29 Evidence: The home enjoys a very low staff turnover, and only two staff have left in the past year. At this time there is only one vacant post, for a qualified nurse. The manager commented on the increasing difficulties in recruiting nursing staff and occasionally the home uses staff from another home, or agency staff. The Provider is an equal opportunities employer and there is a good mix of age and experience amongst the staff team. All necessary recruitment checks and police clearance (called a CRB disclosure) are taken up before a new staff starts to work here. Several residents and relatives commented on the good continuity of care provided at Linthorpe. One regular visitor said, Its great that the staff are always the same, and the manager and owner have been here for years. It was really important for my relative that there is familiarity of staff like there is here, its not different strangers all the time. It is good practice that 13 out of the 16 care staff have achieved a national qualification in care (called NVQ level 2). Training records show that staff have good training opportunities, and all receive updated health & safety training at the correct intervals. Staff also had many positive comments to make about working at this care home. One said, The owner and manager are good to work for. They care about the staff as well as the residents. Another staff said, We all work well together. We are like a family, and we try to offer that to residents too. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and is run in a way that upholds the best interests of the people who live here. Evidence: The registered manager has been at Linthorpe since 1981 and has been the manager here for around 23 years. She is responsible for the day to day running of the home. She is a qualified nurse and has many years experience of working in health and social care for older people. She has also attained the Registered Managers Award and NVQ level 4 in Management, which are suitable qualifications for the manager of a care home and also demonstrate her on-going commitment to her own professional development. Residents and relatives commented on the approachable, open management style. Staff also commented positively about her management of this service. One said, She is very fair and supportive. Another staff said, She is still enthusiastic and dedicated. Care Homes for Older People Page 24 of 29 Evidence: The Provider has an office on-site to the rear of the home so is able to check on its operations and to informally gain the views of residents, visitors and staff. The home also uses questionnaires to formally seek the views of residents and relatives as part of its quality monitoring processes. The overall results of the most recent survey will be published soon so that residents can be informed of the outcomes and any suggestions for change. If requested the home will support residents to keep small amounts of their personal monies securely stored for safekeeping. The records of this were found to be up-todate and include receipts of any transactions made on behalf of a resident. These records are managed by the administrator and the manager. On the day of this inspection a routine Food Safety inspection was carried out by Environmental Health Officers. The home has now achieved a 4 star (out of 5 star) rating for its good food hygiene arrangements. The maintenance staff carries out and records routine health & safety checks of the building and equipment, for example water temperatures. Staff training and practices show that the home promotes and protects the health and welfare of the people who live here. Care Homes for Older People Page 25 of 29 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 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 21 The Provider must continue with plans to redecorate bathrooms and toilets. This is to ensure that all areas of residents accommodation is of an acceptable standard. 01/12/2009 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 1 It might be better if the information booklets were in bigger print to make them easier to read. The home could also consider making its information available on audio tape for those people who have visual or reading difficulties. Nutrition records should include a monthly weight record of each person. Care and medication records should be stored confidentially when not in use by staff. The manager should continue with plans to improve the opportunities for activities both within and outside the home. 2 3 8 10 4 12 Care Homes for Older People Page 27 of 29 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 5 6 7 21 24 26 Toilet roll holders should be fitted in a way that makes them easily accessible. Residents should be offered suitable bedrom door locks so that they can choose whether to lock their door or not. Boxes of latex gloves and continence equipment should be discreetly stored out of sight in order to protect residents dignity and to uphold infection control. Dirty light pull cords should be replaced and be included on the cleaning schedule. 8 26 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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