Care Home: Oldbury Grange Nursing Home

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What the care home does well People`s needs are assessed so they can be confident the home can meet their needs before they move in. People are treated respectfully and care plans are developed to make sure their needs are met. Comments from people about the way the service meets health and personal care needs included, `Dad likes it here, much better than being at home.` `There has been a great improvement in my relative since she became a resident ... she has settled well and is happy here.` Visitors are welcome to the home at any time so residents can continue to enjoy their enduring relationships. Sensitive assistance is available for people to enjoy the nutritious food available. People living in the home can be confident that their concerns will be listened to and acted upon. Staff know how to recognise and respon to suspicion or allegations of abuse to make sure people living in the home are protected from harm. Staff have access to training to meet the needs of residents. People are safeguarded by robust recruitment procedures. The home is managed in the best interests of people using the service. What has improved since the last inspection? Care planning procedures have improved, which should make sure people`s needs are met. The service has improved the way it responds to complaints, so people can be confident their concerns will be listened to and they will get an objective response. What the care home could do better: Action must be taken to improve the way medicines are managed so that people`s health and safety is promoted Action must be taken to make sure there are enough staff on duty to meake sure people`s needs are met. A planned programme of person centred activities for people with varying levels of need and ability should be developed so that all residents have opportunity to maintain life skills and benefit from recreational opportunities that reflect their individual preferences. Key inspection report Care homes for older people Name: Address: Oldbury Grange Nursing Home Oldbury Road Hartshill Nuneaton Warwickshire CV10 0TJ     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: Michelle McCarthy     Date: 2 2 0 1 2 0 1 0 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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: Oldbury Grange Nursing Home Oldbury Road Hartshill Nuneaton Warwickshire CV10 0TJ 02476398889 02476398881 shroprivatecare@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Dr B Sidhu,Mrs C Sidhu care home 44 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: 44 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 (OP) 44 Date of last inspection Brief description of the care home Oldbury Grange Nursing Home is situated in the Warwickshire countryside a short distance from Hartshill. Dr and Mrs Sidhu currently own the home. The home is registered to provide nursing care for 44 older people. The accommodation is purpose built with service user accommodation provided on two floors. Access to each floor is possible via passenger lift or stairs. Garden and patio areas are easily accessible to service users, including those that use wheelchairs. The accommodation provides excellent views over the local countryside. Care Homes for Older People Page 4 of 29 Over 65 44 0 1 6 0 3 2 0 0 9 Brief description of the care home At the time of the inspection the fees charged range between £500 and £700 per week and payable usually in advance by either cheque, direct debit or standing order. The fees do not include newspapers, toiletries, and the services of a chiropodist, dentist, optician or hairdresser. 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: 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: Before the inspection, we looked at all the information we have about this service, such as information about concerns, complaints or allegations, incidents and previous inspection reports. We do this to see how well the service has performed in the past and how it has improved. We visited the home on 22nd January 2010. We did not tell the home we were coming on that day. We made a second visit to the home on 4th February 2010. There were 37 people living in the home at the start of our inspection. The manager told us that most people using the service had moderate nursing care needs. We used a range of methods to gather evidence about how well the service meets the Care Homes for Older People Page 6 of 29 needs of people who use it. We talked to people who use the service and observed their interaction with staff. We looked at the environment and facilities provided and checked records such as care plans and risk assessments. We talked to the manager, the matron, two nurses, four care staff, kitchen staff and laundry staff. Four people using the service were identified for case tracking. This is a way of inspecting that helps us to look at services from the point of view some of the people who use them. We track peoples care to see whether the service meets their individual needs. We chatted informally with other people living in the home and two visitors. At the end of the visit we discussed our preliminary findings with the home manager. 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: Action must be taken to improve the way medicines are managed so that peoples health and safety is promoted Action must be taken to make sure there are enough staff on duty to meake sure peoples needs are met. A planned programme of person centred activities for people with varying levels of need and ability should be developed so that all residents have opportunity to maintain life skills and benefit from recreational opportunities that reflect their individual preferences. 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. Peoples needs are assessed so they can be confident the home can meet their needs before they move in. Evidence: The manager said that it was usual practice for a senior member of the nursing staff to visit people who are considering moving into the home to undertake an assessment of their needs and abilities. We looked at the care files of two people who had moved into the home since the last inspection. Both files contained a pre admission assessment of each persons needs and abilities, which means that sufficient information was available so that the home could confirm they could meet their needs and develop care plans. For example, the pre admission assessment identified one person at high risk of pressure sores, we saw a pressure relieving mattress in use and a care plan in place Care Homes for Older People Page 11 of 29 Evidence: to minimise risk. The home does not offer intermediate care services. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are treated respectfully and care plans are developed to make sure their needs are met. Medicines are not managed safely, so people cannot be confident their health will be promoted. Evidence: We observed that people living in the home looked cared for, they were well presented and wore clothes that were suited to the time of year. People who were nursed in bed because of their physical condition looked comfortable. It was evident from observation that the personal care needs of people living in the home are met. Comments from people about the way the service meets health and personal care needs included, Dad likes it here, much better than being at home. There has been a great improvement in my relative since she became a resident ... she has settled well and is happy here. Care Homes for Older People Page 13 of 29 Evidence: We looked at the case files of four people identified for case tracking.Each person had a care plan, daily records and monitoring records. Care plans were based on information secured during the pre admission assessment and supplemented by continual assessment following their admission. Care plans were available for the identified needs of each person and supplied staff with the information needed to make sure the persons needs were met safely and appropriately. For example, the care file for one person admitted to the home with pressure sores included a care plan for treatment of the wounds. Wound assessment charts and photographs demonstrated improvement in the wound. The service uses risk assessments for falls, nutrition and pressure sores, which are reviewed monthly. When the outcome of the assessment identifies an increased risk, action is implemented to minimise the risk. For example, the pre admission assessment identified one person at high risk of pressure sores, we saw a pressure relieving mattress in use and a care plan in place to minimise risk. The nursing staff we spoke to were knowledgeable about the needs of people in the home. Nursing staff communicate effectively and are observant of changes in peoples health. Staff monitor peoples blood pressure and weight at least monthly to monitor their general well being. Visits from healthcare professionals such as the GP, optician, chiropodist and dentist are recorded in peoples care files which shows peoples healthcare needs are supported. We looked at the way the service manages peoples medication. A monitored dosage (blister packed) system is used. Medication is safely stored in locked trolleys, which are kept a locked room. A medicines fridge is available for medicines that need to be refrigerated. We observed a digital thermometer in use to monitor the fridge temperature, however, daily records show the temperature as 8.1 degrees centigrade every day for several Care Homes for Older People Page 14 of 29 Evidence: months. This suggests the digital thermometer may need to be recalibrated. The room temperature is not monitored or recorded so staff cannot be certain that medicines are stored at recommended temperatures so they remain stable and effective. The facility for storing controlled drugs (CD) was satisfactory and complies with legislation. The contents of the controlled drug cabinet were audited against the controlled drug register and the quantities were correct. This has improved since the last inspection and complies with the requirement we made to maintain accurate records of controlled drugs. Prescriptions are ordered for the medication required each month and are returned to the home before they are sent to the pharmacy for dispensing. The home maintains the practice of retaining photocopies of each prescription, which means they can be compared to the Medicine Administration Records (MAR) produced by the pharmacy. We looked at the medicines of the people involved in case tracking. We audited five medicines by comparing the quantity in stock against the signatures on the medicine administration records. The signatures on the MAR sheet did not tally with the number of tablets remaining in stock in three out of five medicines audited. This suggests that medicines were not given as prescribed or records of receipt and administration of medicines are not accurately maintained. This does not promote the health of people using the service. People living in the home were observed to be treated with respect and their dignity maintained. For example, personal care was provided in private and people were spoken to respectfully. During observation of working practice it was evident that staff are knowledgeable about the likes and dislikes of people living in the home and were kind, caring and attentive towards them. People appeared to be well supported by staff to choose clothing appropriate for the time of year which reflected individual cultural, gender and personal preferences. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are limited opportunities for people living in the home to participate in meaningful and stimulating activities so their social and recreational needs are not always met. Visitors are welcome to the home at any time so residents can continue to enjoy their enduring relationships. Sensitive assistance is available for people to enjoy the nutritious food available. Evidence: The care files of people involved in case tracking recorded information about their interests, life history, spiritual beliefs and enduring relationships. This means staff have comprehensive information about the cultural preferences of residents. The home employs an activities co-ordinator for two hours each weekday to support activities. The activities programme offers one session daily and included bingo, music and movement, quiz and reminiscing. We did not observe any activity sessions during our visits. Several people living in the home spend much of their day in bed because of their care needs which. The activities co-ordinator makes time to give one to one sessions with these people but the opportunities for them to engage in meaningful and stimulating Care Homes for Older People Page 16 of 29 Evidence: activity to enhance the quality of their lives could be improved. The home has an open visiting policy. People are encouraged to maintain links with their family and friends. Visitors told us they are made welcome and the visitors record demonstrated that people could visit when they want to. We observed a lunchtime meal service during our first visit and joined people for the evening meal service on our second visit. A choice of meal is always available, and we observed staff provide an alternative for one person who preferred neither of the meal choices. We talked to the head cook who was knowledgeable about the people who required special diets, their ability and needs and their individual preferences. Staff gave timely and sensitive assistance to those requiring it and the mealtimes were a sociable and enjoyable occasion. Peoples comments about the food included, The meals that I have are enjoyable. I like the food. 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 living in the home can be confident that their concerns will be listened to and acted upon. Staff know how to recognise and respon to suspicion or allegations of abuse to make sure people living in the home are protected from harm. Evidence: The home has a formal complaints policy which is accessible to people living in the home and their families. People are encouraged to raise their concerns with the manager. The homes newsletter advertises time set aside each weekday during which the manager has dedicated time available to listen to people living in the home and their relatives. A record of complaints and concerns received by the home is maintained along with the action taken by the home regarding each issue raised. There have been no complaints or concerns sent directly to us. The service has recorded two verbal complaints since the last key inspection. These complaints have been resolved to the satisfaction of the complainants. The homes complaint register and action file demonstrates that all concerns, including those raised verbally, are listened to and acted upon and timely and objective responses are made. The home has a safeguarding policy to give staff direction in how to respond to Care Homes for Older People Page 18 of 29 Evidence: suspicion, allegations or incidences of abuse. Senior staff have been updated in local Social Services and Police procedures for responding to allegations of abuse. Staff have received abuse awareness training. We talked to three care staff who were knowledgeable about types of abuse and how they would respond if they 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. People are provided with clean, homely and comfortable surroundings to live in and enjoy although the standards of decor and furnishings in communal areas and individual rooms is variable. Evidence: The home is traditionally and comfortably decorated. It was warm, bright and welcoming during our visits. The home was clean and no unpleasant odours were evident. The communal areas in the home were cosy and homely. Peoples personal belongings were near the seats where they would usually sit, which suggested people felt at home to leave their possessions around. We looked at several bedrooms including those belonging to people involved in case tracking. Some rooms offer a good standard of accommodation with good quality furniture, coordinating soft furnishings. Other rooms appeared dated in comparison and in need of updating, but are decorated to a satisfactory standard. All the rooms were personalised with peoples own belongings and looked as though it belonged to the person. Privacy screening was available in shared rooms. Care Homes for Older People Page 20 of 29 Evidence: Specialist equipment, including beds, assisted baths, pressure relieving mattresses and hoists are available to support peoples individual needs. Systems are in place for the management of dirty laundry and control of infection. Protective clothing such as plastic gloves and aprons were available and arrangements are in place for the disposal of waste. The Environmental Health Officer inspected the kitchen in March 2009 and made 3 minor requirements, which the manager told us were actioned within one month. The Environmental Health Officer did not make a return compliance visit. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient numbers of staff are not always on duty to make sure peoples needs are met. Staff have access to training to meet the needs of residents. People are protected by robust recruitment procedures. Evidence: The manager told us the planned staff complement for the home is: Two registered nurses and five care staff between 7.30am and 2.30pm Two registered nurses and four care staff between 2.30pm and 9.30pm One registered nurses and two care staff between 9.30pm and 7.30am The managers full time hours are supernumerary. There are sufficient laundry, catering, cleaning, maintenance and administrative staff to ensure that care staff do not spend undue lengths of time undertaking non-caring tasks. It became evident through discussion with the manager and matron during our first visit on January 22nd that there were shortfalls in maintaining the planned staff complement of registered nurses because two registered nurses were on leave for several weeks at the same time. This meant there was only one registered nurse on Care Homes for Older People Page 22 of 29 Evidence: duty between 2.30 and 9.30pm. We discussed with the manager what contigency was in place to cover the planned absence of two nurses, other than working short. The manager stated. Were managing, and there was no other contigency. It was not clear how one registered nurse can meet the identified needs of people when the organisation has decided that two are necessary. We discussed whether peoples needs could be effectively met. For example, the safe administration of medicines during the 6pm medicine round when only one nurse is on duty instead of two. The manager committed to cover the 2.30 - 9.30pm shifts with her supernumerary hours until the regular nurses returned from leave. On our second visit on 4th February, the regular nurses had returned to duty. Duty rotas confirmed that the manager had covered their absence between our first visit and our second. Training records demonstrate that 12 out of 26 care staff permanently employed in the home have a qualification in care at NVQ (National Vocational Qualification) level 2 or above, which, at 46 , falls just below the National Minimum Standard for 50 of staff to be qualified. A further 8 staff are working towards the award, which means people can be confident they are care for by competent staff. The personnel files of two recently recruited staff were examined and each contained evidence that satisfactory checks such as Criminal Record Bureau (CRB), Protection of Vulnerable Adult (PoVA) and references are obtained before staff commence employment in the home. These robust recruitment procedures and pre- employment checks safeguard the vulnerable people living in the home from the risk of abuse. There was evidence of induction for new staff members in their personnel files. Staff training records demonstrate that staff receive mandatory training in food hygiene, fire safety, abuse awareness, infection control, nutrition and moving and handling. 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 managed in the best interests of people using the service. Evidence: The manager is a registered nurse and is experienced in the care of older people The registered manager takes care of the administration side of the management of the home. She is supported in running the home by a care manager (matron) who is responsible for the care practices in the home. It was evident from discussion with the matron that she is familiar with the needs of the people using the service. There are clear lines of accountability within the home with the matron reporting to the manager. Staff spoken with said that the management team are approachable. An improvement plan was developed in response to our requirements made at the last inspection. The implementation of the improvement plan is evidenced by compliance with the requirements made and improved outcomes for people using the service, particularly in Complaints and Protection and Management and Administration. Care Homes for Older People Page 24 of 29 Evidence: The manager returned a completed AQAA within the timescale required. The matron completes an audit system for monitoring working practices and the quality of care delivered to people living in the home on a monthly basis. Evidence was available to demonstrate that an action plan is developed to address areas requiring improvement. We saw evidence that the opinion of people using the service and their families are surveyed. The results were collated and analysed. An action plan was developed from the results and a summary was made available for people to see. This means people have some say in the way the home is run. Peoples personal monies held by the service for safekeeping are securely kept in individual named bags. Individual account sheets are maintained along with receipts for income and expenditure and are available for people to see. We sampled the account sheets for two people and audits of their income and expenditure was accurate, with receipts available to explain expenditure. Information sent to us in the AQAA tells us that servicing, tests and maintenance in respect of health and safety for utilities, appliances and equipment such as electricity, fire, emergency lighting and hoists are serviced or tested as recommended by the manufacturer or other regulatory body and this should ensure they are safe to use. For example, hoists were last serviced in November 2009 and portable electrical equipment was tested in August 2009. 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 Arrangements must be 31/03/2010 made for peoples medicines to be administered as prescribed. This is to promote peoples health. 2 9 13 Accurate records must be maintained for the receipt, administration and disposal of peoples medicines. This is to safeguard people from medicine error and misuse. 31/03/2010 3 27 12 The numbers and skill mix of 31/03/2010 staff must be appropriate at all times to meet the health, welfare and social needs of people living in the home. This is to make sure there are sufficient competent staff on duty to meet the needs of people living in the home and promote their health and well being. 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 1 9 Arrangements should be made to accurately monitor the temperature of medicine storage areas, including the clinical room and medicines fridge. This should make sure that medicines are stored at recommended temperatures so they remain effective. A planned programme of person centred activities for people with varying levels of need and ability should be developed so that all residents have opportunity to maintain life skills and benefit from recreational opportunities that reflect their individual preferences. 2 12 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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