Care Home: Moresk House

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What the care home does well From inspection of care records it was evident that the pre-admission assessments are carried out. From this an individual plan of care that summarises the person`s needs is implemented. The care plan forms the basis of the care and support provided. Good arrangements are in place to meet individual`s health needs and medical services are promptly accessed when required. Staff have been suitably trained to administer medication. However the current medication policy must be available at all times, and this could not be located. Flexible visiting arrangements are in place. Those that are able have ready access to local facilities. There are social/recreational activities, but more could be done to demonstrate the home`s commitment to this. The care home comprises of two buildings that are in close proximity to each other. The main building accommodates individuals that require regular care and support. The smaller accommodation is for those people that do not regularly require personal care and support. These individuals choose to spend the day in the main house. The environment is homely, clean and comfortable. The communal space is on the ground floor and bedrooms are located on all floors of the house. It was evident that positive and trusting relationships have been established between the staff and people who use the service. Staff were observed to interact with residents in a pleasant and professional manner. What has improved since the last inspection? The home now has a combined Statement of Purpose and Service User Guide, which includes the complaints procedure, and this is provided to all residents. The person`s contract and statement of terms and conditions of residency are also provided. There is a care plan in place for each resident that is regularly reviewed. Fly screens have been fitted to the kitchen window and external door to promote infection control. What the care home could do better: Care plans need to be both clear and provide more detail, effectively directing staff as to the actual intervention necessary in order to meet an individuals` care need(s). Current policies and procedures must be available at all times to ensure adherence to best practice, and the safety and welfare of the people that live at the home. Where entries for medicines are hand written on Medicine Administration Records, there should be two initials to show the entry has been checked as correct. Ensure that records better demonstrate the lifestyle of the people that live there and the efforts of the staff in providing a variety of social/recreational opportunities. A record of food provided should be kept that demonstrates the mealtime choices made by residents and the options available to them on the menu. Arrangements should be made for staff to receive training in safeguarding. Some staff supervision is happening, but training should be provided to those expected to supervise and more can be done to ensure staff supervision occurs at the expected frequency and is properly recorded. The inspector would like to thank people who use the service, staff and the registered manager for their kind assistance and cooperation during this inspection process. Key inspection report Care homes for older people Name: Address: Moresk House Pauls Terrace Truro Cornwall TR1 1HA     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Alan Pitts     Date: 2 1 0 4 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 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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 27 Information about the care home Name of care home: Address: Moresk House Pauls Terrace Truro Cornwall TR1 1HA 01872271000 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Underhill Care Ltd care home 21 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 21. The registered person may provide the following category of service only: Care home providing personal care only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category of service only: Old age, not falling within any other category (Code OP) maximum 11 places Dementia (Code DE) maximum 10 places Mental disorder, excluding learning disability or dementia (Code MD) maximum 10 places Date of last inspection Brief description of the care home Underhill Care Ltd purchased Moresk house in November 2007. The responsible individual, Mrs Bradley visits the home on a regular basis to provide support to the registered manager, staff team and people who use the service. The Registered Manager Mrs Thelma Richardson has worked at the care home for many years and Care Homes for Older People Page 4 of 27 Over 65 0 0 11 10 10 0 Brief description of the care home takes the lead role in the day-to-day running of the home. Moresk House offers care to twenty-one older people some of who may experience confusion or mental health issues. The majority of bedrooms are for single occupancy and communal space is provided on the ground floor. There is reasonable access outside and inside the home for people who experience a disability. A passenger lift is also provided. The home is located near to the centre of Truro and offers some car parking. The outside garden has limitation given the access arrangements are not user friendly. However there is a patio area that people can access. The location provides easy access to the town, leisure facilities and health services. The registered manager confirmed that the range of fees is 357 to 458 pounds per week. Toiletries, newspapers and certain activities are the financial responsibility of the individual. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The Commission approved the registration of Moresk House with the Underhill Care Ltd in November 2007. This unannounced key inspection took place on 21 April 2009 and lasted for approximately six hours. The purpose of the inspection was to ensure that the needs of people who use the service are properly met, in accordance with good care practices and the laws regulating care homes. The focus is on ensuring that peoples placements in the home result in good outcomes for them. Information received from and about the home since its opening has also been taken into consideration in making judgements about the quality of outcomes for the people living there. The inspection would normally include meeting with some of the people currently living at Moresk House, but on this occasion we met with only one resident due to consideration of infection control needs as the staff were managing an infectious outbreak at the time of the inspection. On the day of inspection fourteen people were Care Homes for Older People Page 6 of 27 resident in the home. Other activities included an inspection of the premises, examination of care, safety and employment records and discussion with the registered manager. The overall rating largely reflects managerial issues and does not reflect on the good standard of care and attention given by the care staff on a daily basis. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: Care plans need to be both clear and provide more detail, effectively directing staff as to the actual intervention necessary in order to meet an individuals care need(s). Current policies and procedures must be available at all times to ensure adherence to best practice, and the safety and welfare of the people that live at the home. Where entries for medicines are hand written on Medicine Administration Records, there should be two initials to show the entry has been checked as correct. Ensure that records better demonstrate the lifestyle of the people that live there and the efforts of the staff in providing a variety of social/recreational opportunities. Care Homes for Older People Page 8 of 27 A record of food provided should be kept that demonstrates the mealtime choices made by residents and the options available to them on the menu. Arrangements should be made for staff to receive training in safeguarding. Some staff supervision is happening, but training should be provided to those expected to supervise and more can be done to ensure staff supervision occurs at the expected frequency and is properly recorded. The inspector would like to thank people who use the service, staff and the registered manager for their kind assistance and cooperation during this inspection process. 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 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents and/or their representatives are provided with good information to enable them to make an informed choice of home. Residents have their needs assessed prior to moving into the home. This is so that the home can assure them the prospective resident that they are able to meet their individual care needs. Evidence: We were advised that a copy of the Statement of Purpose and combined Service User Guide (a document that tells a person about the home) is given to prospective residents or their representative. This also includes the Complaints Procedure. The Statement of Purpose and Service User Guide were last reviewed in 2008, though the document was not dated. The registered manager showed us copies of individual contracts and a statement regarding the terms and conditions of residency, and confirmed that these are also provided to each resident or their representative. Documentation evidenced a pre-admission assessment had occurred taking into Care Homes for Older People Page 11 of 27 Evidence: account the prospective residents physical, emotional, social and diverse needs. The home does not provide intermediate care, though respite care is offered. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care, which a resident receives, is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: All the people case tracked had written care plans. The care plans did note peoples personal routines and preferences and their religious beliefs on admission. The care plans would benefit from further detail so that care staff are informed, guided and directed as to what caring interventions are needed to ensure consistent care to individuals. For example, avoid the use of generic terms such as needs assistance with..., rather state what it is that actually needs to be done for the individual in order to meet their needs and promote their capabilities. Some of the care plans gave confusing guidance to staff in what the current care need was (e.g. one stated the person used a walking aid, but elsewhere said that the person needed a wheelchair. Old care plans are also kept with the current care plan, rather than archived, and this can alo cause some confusion. This was discussed at the time of the inspection with the registered manage manager. Staff knew the individuals well and were able to describe what assistance a person needed. Care Homes for Older People Page 13 of 27 Evidence: It is recommended that when people who use the service or their representatives are consulted in the care planning or review process that this be recorded so that the home can evidence their participation more fully. Risk assessments were present on files and did identify if a certain activity was a low, medium or high risk and what actions/ equipment is needed to assist a person for example if they had a fall. The daily records for people who use the service evidenced the care provided that day. People who use the service are registered with local GP practices. Care records show that health care needs are monitored and attention obtained promptly when needed. Residents are regularly weighed. Staff were seen and heard to interact with residents in a respectful and relaxed manner whilst carrying out their duties. Staff responsible for administering medication has been suitably trained and clear records are maintained. There is a clear audit trail of PRN medication so that all medication kept in the home tallies with MAR records. The pharmacist safely disposes of any medicines that are no longer required. Staff were unable to locate the current medication policy and therefore it was not inspected on this occasion. The policy should be available at all times, and this was also said at the previous inspection. Where entries for medicines are hand written on Medicine Administration Records, there should be two initials to show the entry has been checked as correct. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The records do not fully reflect the social/recreational activities available. Visitors are welcomed to the home at anytime. Choice is not always shown to be available to residents. Evidence: Individual care plans detail peoples social and activity interests. The home has a member of staff with specific responsibility for organising activities. The home aims to provide a range of planned activities such as outings, music, bingo, beetle juice, painting and karaoke, but recent records show that bingo took place on nine consecutive days. There was evidence in the dining room of recent Easter activities. The registered manager said that there were other activities, such as external entertainers provided, but the records do not reflect this. Discussion took place regarding the variety of activities, activity records and the need to comply with data protection, and also to ensure that the records give more detail; e.g. whether the individual enjoyed the activity (or not), participated (or simply watched). The registered manager and the visitors book show the visiting arrangements to be open and flexible. People can bring in possessions and furniture at admission by agreement with the provider, and this is recorded. Many bedrooms are personalised with individual belongings and pictures. Care Homes for Older People Page 15 of 27 Evidence: The daily menu is on display in the dining room. Each persons preferences and choices are recorded. The chef is properly qualified and operates a 4-week rotating menu. The menu does not currently show that a choice is available, though the chef confirmed that she is aware of peoples likes and dislikes. A record of food provided, reflecting choices made by the people that live there, is not kept and this was discussed with the chef. Hot and cold drinks are served between meals. The kitchen was seen to be clean and ordered at the time of the inspection, and had recently had a satisfactory inspection from a Environmental Health Officer. Fly screens have been fitted to the kitchen window and external door. Meals were served in peoples rooms at the time of the inspection, and the lounge was also not in use due to infection control systems in operation. Normal routines were expected to resume in a further 24-48 hours. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have access to a robust, effective complaints procedure. Staff knowledge protects residents from abuse. More can be done to promote best practice and staff training. Evidence: The complaints procedure is appropriate and provided to each resident and/or their representative in the homes Statement of Purpose. The complaints procedure includes relevant contact details. No complaints have been received either by the home or by the Commission. The registered manager said the Responsible Individual is reviewing the homes adult protection policy and procedure, but this was also the situation at the last inspection. The registered manager and senior carer were aware of what procedure needs to occur if there is a suspicion/allegation of abuse. At the previous inspection the responsible individual said they would ensure that staff attend the relevant external and internal training in this area, but the training records and discussion with the registered manager show that this has not happened. Residents are protected by the homes recruitment procedure. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is accessible, well maintained and safe. A homely, clean and comfortable environment is provided that is maintained to the required standard. Evidence: The care home comprises of two building in close proximity to each other, which are located on the same site. The majority of care takes place in the main building and the smaller separate accommodation offers a home to people that are independent and do not require regular care and support to meet their needs. During the day people who are in the smaller separate accommodation come to the main unit, and at night waking care staff visit the unit on a regular bases with sufficient on call facility available. The environment is furnished and maintained to a satisfactory standard. People have personalised their own bedrooms. Communal space is located on the ground floor and comprises of a sitting room and a dining room. Both are normally popular areas for people who use the service. There are a range of toilets and bathrooms distributed throughout the homes that are within a reasonable distance from peoples bedrooms and the communal areas. The space and layout of certain bathrooms have some limitations but there are a number of bedrooms that have their own en-suite facilities. Care Homes for Older People Page 18 of 27 Evidence: A range of aids and adaptations are provided at the home to assist people to be as independent as possible. In addition individual people are provided with disability equipment when this is required and following a specialist assessment. There is a passenger lift in the main building to assist access between floors, though there is a small step to negotiate on the ground floor. The registered manager should consider the usefulness of the top stair lift in the annexe as this is not currently used and may pose a hindrance to safe passage. The garden area has been partly landscaped, to provide a small patio area, and the registered manager said that the cut down bushes and graden rubbish would be removed this week. There is a fenced pond in the garden area, but this is not currently maintained. Good standards of health and hygiene are maintained at all times. The housekeeper and care staff were aware of the importance of cleanliness, promoting infection control and COSHH. The registered manager said that she would obtain red dissolving laundry bags for use with fouled laundry. Staff have ready access to other equipment such as aprons, gloves, and handwash solution. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels are sufficient to meet peoples needs safely. Staff are qualified and competent to work with the people who use the service, though there is room for improvement. Staff are recruited on the basis of fair, safe and effective recruitment and selection policies and practices. Evidence: There are 16 care staff including the registered manager, of which 13 have achieved NVQ Level 2 training or above. Further training in 1st Aid and infection control has been arranged for 10 staff in May 2009. Training is generally provided by either a known external agency or by an internal trainer. Where the latter, the home should be able to show the trainers competency to provide training to others. There is generally 3 care staff in a morning until 2pm, then two care staff in the evening and at night. The duty rosta was seen to be inaccurate, showing the handyman as being on duty when in fact he wasnt. The duty rosta only shows first names and does not indicate role. The registered manager said that the company aims to have two team leaders on duty, to allow her to undertake her management duties. Care staff are supported by additional staff such as cook and housekeeper. A sample of the homes recruitment records were inspected, and the sample showed adherence to a robust recruitment procedure, though care should be taken to ensure Care Homes for Older People Page 20 of 27 Evidence: at least one reference is from the most recent employer. The registered manager does not keep a record of interview, and the benefits of this were also discussed. We were shown the induction training record for the most recently appointed member of staff. This record was signed off as completed on one day, and does not demonstrate a thorough training or reasonable effort to ensure the understanding of the trainee. The registered manager was not aware of the National Training Organisation induction training available for all new care staff (www.skillsforcare.org.uk). Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents will benefit and be further protected by improvements in the management systems at the home. The environment is well maintained and safe. Evidence: The Registered Manager has worked at the care home for many years and has completed her Registered Managers Award. The Responsible Individual plays an active role in the management of the home and visits the home on a regular basis. The requirements and recommendations identified in this report largely reflect managerial issues though, especially where these have been repeated from the previous inspection. Quality assurances systems have been introduced and we were shown a sample of survey returns. The responses seen were positive. Discussion took place with the registered manager as to summarising the findings (including any action take), and publishing these. There are regular meetings with people who use the service and staff to gain their views. Care Homes for Older People Page 22 of 27 Evidence: Some staff supervision is happening, but training should be provided to those expected to supervise and more can be done to ensure staff supervision occurs at the expected frequency and is properly recorded. We were shown an example of staff supervision documentation, which was a tick box record of a staff member having been watched carrying out their duties (e.g. making a bed). We were shown other blank supervision records, which were not yet in use. Staff are receiving an annual appraisal. Policies and procedures are incomplete, some identified as being needed at the previous inspection (e.g. medicines and safeguarding). We were advised by the registered manager that a representative of the registered provider visits regularly, but this does not result in a written report as required by legislation. The Commission are not being notified of accidents/incidents/injuries/illness. Measures are in place to promote safe working practices and the equipment and services to the care home are regularly maintained and serviced. Appropriate insurance cover is in place. The registered provider confirmed that the home has no involvement with personal finances. If necessary the registered manager will use the petty cash funds for a resident and retrospectively invoice them. Fire systems maintenance and checks, and fire training is now provided by an external company. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 38 13, 12 Staff must be aware of the location of policies and procedures, eg medication, so that they can refer to them when needed. 30/05/2008 2 38 37 (all) All incidents/ events must be 30/04/2008 notified to the Commission as described under regulation 37 of the Care Standards Act Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 32 26 The registered providers must visit the home at least monthly and make available for inspection a written report in respect of each visit. Residents will be protected by the registered provider having a good understanding of the running of the home. 01/06/2009 2 36 18 The registered manager 01/07/2009 must arrange for staff to receive supervision at least 6 times per year that includes: all aspects of practice; philosophy of care; career development needs. Residents will benefit from skilled and supervised staff. Care Homes for Older People Page 25 of 27 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 9 Where entries for medicines are hand written on Medicine Administration Records, there should be two initials to show the entry has been checked as correct. Ensure that records better demonstrate the lifestyle of the people that live there and the efforts of the staff in providing a variety of social/recreational opportunities. A record of food provided should be kept that demonstrates the mealtime choices made by residents and the options available to them on the menu. Arrangements should be made for staff to receive training in safeguarding and local safeguarding procedures. The registered manager should ensure the duty rosta is accurate, indicates role (e.g. care staff or cook), and readily identifies staff by initial and surname. The registered manager should implement a National Training Organisation compliant induction programme for all new staff. The registered manager should summarise the findings gained from quality assurance surveys, take action where necessary, and publish the findings. 2 12 3 15 4 5 18 27 6 30 7 33 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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