Care Home: Oakland Grange

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What the care home does well New residents have their needs assessed and this gives staff the required information when delivering care and support. Personal and health care needs of residents are being met consistently and safely. Ten residents completed questionnaires and returned them to us before our inspection. With regard to medical care nine state the home `always` ensures they receive this and one that they `usually`. Residents confirmed their satisfaction with activities arranged by the home. For example one person informed us, "life is full of surprises here, they are having a clothes party this morning". Dietary needs are catered for and choices available. Residents that we spoke with confirmed their satisfaction with the meals provided. For example one person stated, "I like the meals, we are always given a choice. Staff come round and ask what we want every day". Residents are supported to express their concerns and have access to a robust complaints procedure. The environment is clean, warm and homely. Residents praised the staff working at the home and the support they receive. For example one person informed us, "staff are wonderful, nothing is too much trouble" and another "they always have a smile on their faces, it makes a difference. You only have to call the night staff and they bring you a drink". What has improved since the last inspection? A welcome pack has been introduced that gives information about the home and services it provides. The AQAA also informs us of improvements made over the last twelve months stating `The new care plan system has helped to raise standards. The manager and deputy attended training on person centred approaches to care of older people. The deputy attended training in palliative care and staff participated in the End of life course Macmillan which included sharing experiences both professional and personal. The manager and deputy attended training in planning for the flu pandemic. Night Care Policy introduced to reflect the CQC work in this area. Swine flu action plan and file prepared and updated as information is announced.` Weekly tea and chat sessions have been introduced to support residents to raise informal comments. New carpets have been laid in the majority of communal living areas and a screen has been built to hide the bin area at the front of the home. Records are now maintained that evidence new staff have the required recruitment checks undertaken, ensuring residents are protected by the homes recruitment practises. What the care home could do better: Improvements to some medication practises will offer further safeguards. These must include accurate recording of all medication entering the home, ensuring the temperature is monitored in any facility where medication is stored, obtaining the GP`s consent to change the dosage of medication give and including information in medication care plans of foods and drinks that must be avoided with certain medicines. Key inspection report Care homes for older people Name: Address: Oakland Grange St Floras Road Littlehampton West Sussex BN17 6BB     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: Lesley Webb     Date: 1 4 1 2 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: Oakland Grange St Floras Road Littlehampton West Sussex BN17 6BB 01903715995 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): www.oaklandcare.co.uk Oakland (Littlehampton) Limited Name of registered manager (if applicable) Ms Julie Patricia Van Biene Type of registration: Number of places registered: care home 42 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 42 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - OP Date of last inspection Brief description of the care home Oakland Grange is a privately owned care home registered to provide accommodation for up to forty two service users in the category OP, old age, not falling into any other category. The home is situated in the village of Littlehampton. Littlehampton shopping centre, train and bus services are nearby. The home occupies three floors with a vertical lift servicing each floor. The majority of rooms are for single occupancy, however some rooms are double rooms, which can be shared if requested. All rooms Care Homes for Older People Page 4 of 29 Over 65 42 0 Brief description of the care home have ensuite facilities. There is a large and well maintained accessible garden at the rear of the home. Fees range from £520 to £920 per week depending on the room occupied, the upper end of fees reflects either double occupancy and or a two room suite with bedroom, lounge and bathroom facilities. Fees cover all hotel and care costs. 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: We visited this home on Monday the 14th December 2009, arriving at 8.40 am and staying until 4.00 pm. The purpose of this inspection was to assess how well the home is doing in meeting the key National Minimum Standards and Regulations. Since our last key inspection in February 2009 the registered manager has resigned and a new manager appointed. The manager was present during our visit and assisted us throughout by providing documentation and answering any questions we raised. The Responsible Individual for the organisation was also present, also offering assistance. During our visit to the home we examined the care records of four residents and recruitment records of the newest staff to commence working at the home. Also we looked at other documentation maintained in the home such as training records, medication and activity records. We spoke with eight residents and sat and observed activities taking place during our Care Homes for Older People Page 6 of 29 visit and interactions between staff and individuals. Prior to our visit the home supplied us with a copy of its Annual Quality Assurance Assessment (AQAA) and ten residents completed questionnaires and forwarded them to us. Information from all of the above sources was assessed and used to help us form judgements on the quality of service provided to people living at the home. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? A welcome pack has been introduced that gives information about the home and services it provides. The AQAA also informs us of improvements made over the last twelve months stating The new care plan system has helped to raise standards. The manager and deputy attended training on person centred approaches to care of older people. The deputy attended training in palliative care and staff participated in the End of life course Macmillan which included sharing experiences both professional and personal. The manager and deputy attended training in planning for the flu pandemic. Night Care Policy introduced to reflect the CQC work in this area. Swine flu action plan and file prepared and updated as information is announced. Weekly tea and chat sessions have been introduced to support residents to raise informal comments. New carpets have been laid in the majority of communal living areas and a screen has been built to hide the bin area at the front of the home. Records are now maintained that evidence new staff have the required recruitment checks undertaken, ensuring residents are protected by the homes recruitment Care Homes for Older People Page 8 of 29 practises. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 provided with all the information they need to decide whether or not the home can meet their needs. They have their needs assessed and this gives staff the required information when delivering care and support. Evidence: The home sent us the Annual Quality Assurance Assessment (AQAA) prior to our visit. With regard to pre admission processes it states Adopting the new more holistic care plan system (standex) has brought about an improved pre-assessment and letter to confirm our meeting care needs. The Manager or Deputy spends time with the potential residents and their relatives showing them around the home and listening to their needs. The Manager and deputy are on duty over 7 days a week which provides more flexibility to visiting families making enquiries. During our visit to the home we spoke with residents, the manager and the responsible individual for the home. We also looked at the admission records for three Care Homes for Older People Page 11 of 29 Evidence: residents. Evidence from all of these sources confirms the contents of the AQAA as accurate. For example pre admission assessment forms were found to be completed in full, identifying the potential residents individual health and social care needs. The assessment process takes into account peoples level of mobility, self help skills, medical history, health, care and emotional needs. Also one of the newest residents to move into the home confirmed they had visited before deciding if the home could meet their needs. The AQAA informs us of improvements made with regard to admissions processes since we last visiting the home. For example it states that a welcome pack has been introduced that gives information about the home and services it provides. Ten residents completed questionnaires and returned them to us before our inspection. All state they received enough information about the home to help them decide if it would be the right place for them. The home does not provide intermediate care. 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. The personal and health care needs of residents are being met consistently and safely. Some medication practises must improve to safeguard residents. Residents are treated with respect and their rights to privacy upheld. Evidence: With regard to health and personal care the homes AQAA states as what is done well The care planning system is comprehensive and involves residents. Different channels for resident feedback as well as their families are in place. We are flexible and open to families staying especially at the end of life stages. Although we do not have designated facilities we do enable empty rooms to be utilised or at least family members to sleep in the same room if this is their wish. Meals are offered at these times. We involve the expertise of external professionals such as the hairdresser, optician and activity therapist. The AQAA also informs us of improvements made over the last twelve months stating The new care plan system has helped to raise standards. The manager and deputy attended training on person centred approaches to care of older people. The deputy Care Homes for Older People Page 13 of 29 Evidence: attended training in palliative care and staff participated in the End of life course Macmillan which included sharing experiences both professional and personal. The manager and deputy attended training in planning for the flu pandemic. Night Care Policy introduced to reflect the CQC work in this area. Swine flu action plan and file prepared and updated as information is announced. During our visit to the home we spoke with residents, the manager and the responsible individual for the home. We also looked at care records for three residents. Evidence from all of these sources confirms the contents of the AQAA as accurate. For example each residents records included plans of care for areas such as mobility, personal care and health related needs. All plans had been reviewed on a monthly basis. Residents files also contained risk assessments for areas including falls, nutrition and skin. As at previous inspections records show that each person is registered with a GP and has access to health care professionals. When a person is visited by a health care professional records are kept to detail the reasons why and the outcome of the visit. Ten residents completed questionnaires and returned them to us before our inspection. Seven state they always receive the care and support they need, one they sometimes and two they usually. With regard to medical care nine state the home always ensures they receive this and one that they usually. Throughout this visit to the home we indirectly observed staff treating residents with respect and maintaining their rights to dignity. For example staff were heard calling residents by their preferred names as described in their care plans. Residents were very satisfied with the staffs approach to privacy and dignity. As one person explained, the staff are wonderful, nothing is too much trouble for them, they always check that I am happy with the care they provide. We looked at the systems for management of medication. These include secure storage for medication and records for the administration of medication undertaken by staff. For one resident medication administration records state they should be administered Lactose twice daily but signatures were in place to confirm this is being given once a day. Two residents medication administration records inform of certain foods and drinks that must be avoided due to medication they are prescribed. This information was not included in any care plans. Some medication that we viewed instructs that it must be stored below 25 degrees Celsius. The manager confirmed that Care Homes for Older People Page 14 of 29 Evidence: the temperature in the medication cabinet is not monitored. 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. Activities are offered that meet the needs of all residents. Residents are helped to exercise choice and control over their lives. Visitors are made welcome. Dietary needs are catered for and choices available. Evidence: As at previous inspections we found evidence that local community groups visit the home e.g. the local nursery school at Christmas and the local church visit regularly to provide church services. We saw photographs of the celebrations at Christmas and of other social events and celebrations in the home. Ten residents completed questionnaires and returned them to us before our inspection. Six state the home always arranges activities that they can participate in, three they usually and one they sometimes. During the morning of our visit residents were observed participating in a clothes party whilst others sat reading newspapers, doing knitting and receiving visitors. Residents were observed to enjoy all activities they were participating in. A notice board in the hallway gives information about forthcoming activities such as voice movement therapy, a Christmas party, film afternoons, church services and Carols Care Homes for Older People Page 16 of 29 Evidence: and bingo. Residents that we spoke with confirmed their satisfaction with activities arranged by the home. For example one person informed us, life is full of surprises here, they are having a clothes party this morning. Residents told us that their visitors are always made welcome and that there are no restrictions on visiting times. During our visit to the home we sat and ate lunch with residents in the dining room. Staff assisted residents discreetly, residents were offered choices of hot and cold drinks and were able to choose from two meals. Residents appeared to enjoy their meal. The atmosphere at lunch time was relaxed. Residents were heard to laugh and join in conversations with other residents and staff. We viewed residents individual meal records. These demonstrate that residents are offered choices everyday and that alternatives are given when the two main options that day are not wanted. Ten residents completed questionnaires and returned them to us before this inspection. Four state they always and six they usually like the meals provided. Residents that we spoke with confirmed their satisfaction with the meals provided. For example one person stated, I like the meals, we are always given a choice. Staff come round and ask what we want every day. 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 who live in the home are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse and have their rights protected. Evidence: With regard to complaints the homes AQAA states as what it does well record and respond to complaints with an ethos that it is better to know and understand our service shortfalls so that we can attend to these as soon as possible or explain if we cannot. The complaints procedure is included with the welcome pack so it is introduced to people as soon as the relationship with the home commences. The meal comment book captures dissatisfaction with meals provided. Staff are familiar with the complaints procedure. We have membership of Care aware advocacy service. The AQAA also informs us that since our last inspection weekly tea and chat sessions have been introduced to enable a more informal comment/complaint process. When we visited the home we looked at the concerns raised in the home and can confirm that they had all been responded to appropriately. Ten residents completed questionnaires and returned them to us before our inspection. All state there is someone they can speak to informally if not happy. Eight state they know how to make a formal complaint and one that they do not. One Care Homes for Older People Page 18 of 29 Evidence: person did not respond to this question. Policies and procedures for safeguarding adults are in place and training records confirm that all staff have received training in this area. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home provides people who live here a safe environment which encourages independence. The home is clean, warm and homely. Evidence: With regard to the environment the homes AQAA states as what it does well encourage the residents to bring their own possessions to personalise their rooms to help them feel at home. Our maintenance technician is available to help with this type of personalisation hanging pictures, making shelves. This personalisation may include using a picture on the door so that a resident can easily locate and identify their room. All rooms are en suite and there is specially assisted bath and shower facilities. Rooms are refurbished after discharge or as needed after long time residents. Residents are offered keys to their room. The garden is accessible throughout the year and there is a summerhouse which is large enough for seating for several people. The lounges offer privacy and flexibility due to their selection and layout. The kitchen and laundry are spacious for the job and equipment renewed as necessary. We listen and respond to residents and staff who have ideas for how we can improve the home. We looked around communal areas and viewed some residents rooms, all of which reflected the contents of the AQAA. All areas of the home were clean, hygienic and in a good state of repair. On the ground floor in the hallway there is a post box and ample storage area for walking aids under the stairs. Care Homes for Older People Page 20 of 29 Evidence: There are bedrooms on the ground, first and second floors and all either have en suite bathrooms or en suite shower rooms. Suites are also available providing lounge, bedroom and bathroom facilities. There are specially assisted bathrooms and a shower room allowing everyone to have the opportunity to have a bath or shower. Passenger lifts are available at either end of the building. The AQAA informs us of improvements that have been made to the environment over the last twelve months. These include carpet refurbishment in the majority of communal living areas, higher standards of soft furnishings as rooms are renovated to match expectations of residents today, additional two room suite completed, we improved the bin area by hiding it with a brick built screen which is located unavoidably on the front of the building and overlooked by some rooms. This has also made it more secure and usable by the staff safely. We are changing to low energy bulbs in the building which is reducing our wastage. The recycling scheme introduced is also a positive initiative. As we complete the AQAA we have changed the hours of the housekeeping team so their working hours are spread over the weekend. This should improve the service to residents. Ten residents completed questionnaires and returned them to us before our inspection. Nine state the home is always fresh and clean and one that it is usually. When asked the question what does the home do well additional comments were recorded of cleanliness laundry service and clean tidy room. 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. Peoples needs are met by the numbers and skill mix of staff. Residents are protected by the homes recruitment practises. Evidence: At our visit the manager informed us there are between five and six staff on duty of a morning and afternoon. During the night we were informed there are three wake night persons. The home employs separate ancillary workers for kitchen and domestic tasks. Ten residents completed questionnaires and returned them to us before our inspection. Seven state there are always, two there are usually and one there are sometimes staff available when needed. Six state staff always, three usually and one sometimes listen and act on what they say. When asked the question what does the home do well additional comments were recorded including efficient and quick response when called during the night nothing is too much trouble for the staff and helpful friendly staff. All residents that we spoke with during our inspection also praised the staff working at the home and the support they receive. For example one person informed us, staff are wonderful, nothing is too much trouble and another they always have a smile on their faces, it makes a difference. You only have to call the night staff and they bring Care Homes for Older People Page 22 of 29 Evidence: you a drink. We examined the recruitment records of the three newest members of staff to commence employment at the home. All contained the required documentation including completed application forms and references. We did note that the homes application form only asks for the past five years employment history. The manager said she would amend the form immediately. As at previous inspections an examination of records and discussions with staff confirmed that all staff complete an induction prior to working unsupervised in the home. Mandatory training is completed within the first six months of employment were ever possible. Feedback from staff on our questionnaires in respect of training and induction was positive. The training matrix for the home details nineteen staff and informs that seventeen have undertaken first aid, all have undertaken fire, seventeen food hygiene and sixteen infection control. Other training that staff have undertaken includes safeguarding, dementia, palliative care and nutrition and health. 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. Management of this home is now meeting the needs of residents safely. Quality monitoring systems ensure residents receive a consistent service. Staff have started to receive regular supervision. Residents health, safety and welfare is promoted and protected. Evidence: The manager of the home has submitted an application for registration with us and was due to have an interview with us the day after we visited the home. The manager was present throughout our visit and demonstrated knowledge and commitment in providing a quality service to older people. As at previous inspections there are quality assurance and quality monitoring systems in place and they include seeking the views of people who live and work in the home. Reports in line with Regulation 26 of the Care Home Regulations 2001 were viewed. The format of these has altered since our last inspection with the reports now containing greater detail with regards to the views of people. The home sent us its Care Homes for Older People Page 24 of 29 Evidence: AQAA when requested. The contents of this are detailed, informative and demonstrate quality monitoring and reviews undertaken by the home. There is an established system for residents money and financial arrangements. Small amounts of money are kept on behalf of residents and records and receipts are kept. We sampled a number of health and safety records, finding all to be in good order and up to date. 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 9 13 In line with Regulation 13(2) 14/01/2010 The registered person must review the homes medication practises to ensure that people in the home receive their medication as prescribed. Particular attention must be paid to 1. Accurate recording of all medication entering the home. 2. Ensuring the temperature is monitored in any facility where medication is stored. 3. Obtaining the GPs consent to change the dosage of medication given. 4. Including information in medication care plans of foods and drinks that must be avoided with certain medicines. This must happen to offer greater protection to residents. 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 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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