Care Home: Ovenden House

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What the care home does well Information is available at the home for people to take away that gives details about the service provided, this helps people decide if it is the right place for them to move to. The staff are friendly and they make visitors very welcome. Staff have a good rapport with people living at the home. Activities take place regularly and outings are organised. When we asked people to tell us what they thought the service does well they said: "They look after me very well". "All the girls are really good and very caring". "The food is very good and my mum is well looked after". "All the staff are helpful and always pleasant, they keep us in the loop with everything that is going on". What has improved since the last inspection? The care plan format has improved since our last visit and the quality of recording in the daily records has also improved. Work is underway to redecorate bedrooms. Those that have already been redecorated look much brighter. What the care home could do better: If the home is unable to meet someone`s needs because they can no longer use the facilities in the home, the management team need to make arrangements for a reassessment to take place as soon as possible. Whenever there is an indication of risk, steps must be taken to put a management plan in place showing what staff must do to make sure people are safe. Medication records must be improved so that all medication coming into the home can be accounted for. People are entitled to expect to live in pleasant, clean and hygienic condition at all times. There needs to be a system in place to make sure that standards of cleanliness and hygiene are monitored on a regular basis. The conservatory must be shaded so that people do not have to endure unacceptably high temperatures in that room.Drinks must always be available and offered to people, especially in hot weather. Ensure that the TVs are correctly tuned so that people do not endure two TV sets echoing each other in the same room. The TVs should be moved so that the picture is not obscured by the sun. Key inspection report Care homes for older people Name: Address: Ovenden House Ovenden Road Ovenden Halifax West Yorkshire HX3 5QG     The quality rating for this care home is:   zero star poor 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: Lynda Jones     Date: 2 1 0 4 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 30 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 30 Information about the care home Name of care home: Address: Ovenden House Ovenden Road Ovenden Halifax West Yorkshire HX3 5QG 01422362487 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): ovenden@pcslimited.net Pennine Care Services Ltd Name of registered manager (if applicable) Vanessa Denise Kukuruzovic Type of registration: Number of places registered: care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Ovenden House is owned by Pennine Care Services Limited and is registered to provide accommodation and care for up to twenty-three older people. It is a stone built detached period property situated in a residential area in the Ovenden district of Halifax, with easy access to the town centre by public transport. Accommodation is provided in thirteen single and 5 shared rooms. Externally, there are garden areas for people to enjoy in the warmer weather with parking facilities for staff and visitors. The current weekly charge at the home is between 368.75 pounds and 371.00 pounds. People pay for their own personal toiletries, hairdressing and chiropody. Care Homes for Older People 0 6 0 5 2 0 0 9 0 Over 65 23 Page 4 of 30 Brief description of the care home A copy of the last inspection report and information about the facilities is available at the home. Care Homes for Older People Page 5 of 30 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: zero star poor 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: This inspection was carried out to assess the quality of care provided to people living in the home. During the visit we spoke to people living in the home, the staff on duty and the manager. We observed care staff delivering care, looked at various records and looked around the home. We sent an Annual Quality Assurance (AQAA) document to the home so that they could tell us how they think the home is doing, any improvements they have made or have planned and any problems they may be facing. The document also provides us with some numerical information about the home to assist us in our inspection process. Surveys were sent to a sample of people living in the home and to staff, the surveys provide an opportunity for people to share their views of the service with us. Care Homes for Older People Page 6 of 30 Information received in this way is shared with the home without identifying who has provided it. We received four surveys from people living there, some were completed with the help of relatives. Three surveys were sent back to us by staff. Their comments have been used in this report. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: If the home is unable to meet someones needs because they can no longer use the facilities in the home, the management team need to make arrangements for a reassessment to take place as soon as possible. Whenever there is an indication of risk, steps must be taken to put a management plan in place showing what staff must do to make sure people are safe. Medication records must be improved so that all medication coming into the home can be accounted for. People are entitled to expect to live in pleasant, clean and hygienic condition at all times. There needs to be a system in place to make sure that standards of cleanliness and hygiene are monitored on a regular basis. The conservatory must be shaded so that people do not have to endure unacceptably high temperatures in that room. Care Homes for Older People Page 8 of 30 Drinks must always be available and offered to people, especially in hot weather. Ensure that the TVs are correctly tuned so that people do not endure two TV sets echoing each other in the same room. The TVs should be moved so that the picture is not obscured by the sun. 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 30 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 30 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. People are assessed before they move in, this tells the home about the type of support and care people need. Information about the home and the service it provides is available for people to take away and read. Evidence: There is a service user guide which people can take away which gives information about the home and the service provided. In the surveys, people told us they were given information about the service before they moved in. People are welcome to visit to see for themselves if they think the home is suitable before making any decision about moving in. The manager said that before people are offered a place, an assessment of their care needs would be carried out. This is to make sure that staff at the home have the skills Care Homes for Older People Page 11 of 30 Evidence: to meet that persons needs. We looked at two assessments for people who had moved in recently and we could see that relevant information had been gathered before they moved in. The assessments give a good overview of peoples needs. The shower on the ground floor is not suitable for people with restricted mobility. This needs to be taken into consideration when peoples needs are assessed. Care Homes for Older People Page 12 of 30 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People do not always receive the care they need and the medication system is not being managed safely, which could put people at risk. Evidence: In the surveys, people told us they were receiving the care and support they required. Everyone said the staff were around when they were needed. When we visited staff were available in the areas where people were sitting. We looked at care plans for four of the people living at the home. Two people had lived there for some time, two had moved there within the last four months. The care plan format has changed since we last visited, it is now more comprehensive and gives staff clearer instruction about what they must do to make sure people receive the care and support they require. We found an overall improvement in the quality of the daily records since we last visited the service, they now contain much more detail. In the AQAA the manager said We have improved the recording of information in the care plan, we have reveiwed Care Homes for Older People Page 13 of 30 Evidence: and improved the way the daily reports are written and the information recorded on them taking into account the individuals mood. We could tell from the records that the plans are being reviewed regularly and although there is provision for people living at the home and their relatives to sign the reviews, to show they are satisfied with their care and support, none of the plans we looked at had been signed. The manager said this is something she is working on currently, therefore we would expect to see this in action when we next visit. It is important that people are asked whether their care and support needs are being met and whether this could be improved upon. Evidence indicates that although there has been an improvement in the format of care plans and content in the daily records, there is no guarantee that peoples care needs are always being met. We looked at one plan for an individual who has lived at the home for seven years. This persons health has deteriorated over this time and the home does not have the facilities to continue to meet her needs. According to the care plan this person can weight bear but a wheelchair is used to transport her round the home. We saw the wheelchair in use during the morning without the foot rests in place. This individual was wearing socks but no shoes or slippers and her feet were dangling on the floor. This means her feet could have caught on the floor when the wheelchair was being moved causing injury. When we pointed this out to the manager the footrests were put in place. When we talked to staff they said this person could no longer weight bear and they moved her by supporting her entire weight with a moving and handling belt. This is extremely unsafe practice that could result in this person and staff injuring themselves. According to the records this individual has only had one shower since the beginning of March 2010 and last had a hairwash at the beginning of February 2010. We looked at the shower cubicle on the ground floor and found it to be unsuitable for use by anyone with restricted mobility. There is limited access to the seat located at the back of the cubicle, the right hand half-door was falling off and the seal round the door was broken. The flooring at the entrance to the shower room was damaged and raised presenting a trip hazard. We asked staff if they were able to assist this person to use the shower and they confirmed that they had great dificulty in doing so. This means that personal care needs are not being met. According to the daily records, staff had noted on two occassions that this individual Care Homes for Older People Page 14 of 30 Evidence: had skin tears which seemed to be causing some pain. The records instructed staff to observe and contact the district nurse if necessary. We could find no evidence that any monitoring had taken place and nothing to indicate whether further advice had been requested. We asked the manager about this and we were unable to discover anything further. There was no plan in place to reduce the risk of this individual developing pressure sores. We asked the manager whether this person had a specialist mattress and we were informed that an assessment had taken place but a specialist mattress was not required. We asked to see a copy of the assessment and details of when this had taken place but the records could not be found. There is no guarantee that people are being cared for with any consitency. We found conflicting information about this persons needs during the night, according to the care plan she could move herself about in bed during the night. The manager told us the staff turn her in bed during the night. In one of the bedrooms there was a strong smell of cigarette smoke. The waste bin in the room contained cigarette ends and burnt cigarette papers; the domestic confirmed that the occupant smoked in his room although he had been asked not to. The home has a policy that smoking is only allowed in designated areas. When we looked at the risk assessment in this persons care plan it said if he wishes to smoke he must go to one of the designated areas. Review daily. We could find no evidence of any reviews. This means that the other occupants of the household are being placed at serious risk if smoking continues in one of the bedrooms. We talked to the manager about our serious concerns about the well being of people living at the home due to the excessively high temperature in the conservatory during the day. There are no roof and window blinds in the conservatory where most people sit. We visited on a sunny April day and recorded teperatures of 31 degrees centigrade at 9:55am and 36 degrees centigrade at 12:10pm. During the morning people were offered a cup of tea or coffee but there were no cold drinks available at all during the course of our visit. One person who was sweating and uncomfortable asked us if we could get her a cold drink. Staff had been present in this area throughout the morning but they made no attempt to ease peoples discomfort by providing them with additional drinks. We looked at systems for receipt, storage and administration of medication and we found that people are being put at risk due to poor management of the medication system. Care Homes for Older People Page 15 of 30 Evidence: These are some of the things we fed back to the manager during the visit: Some of the MAR sheets (Medication Administration Records) are handwritten and there are no staff signatures and no dates showing when medication is booked in. No date of opening was recorded on a box of eye ointment. This date is important because the efficacy of the medication reduces over time. There are no guidelines for the use of PRN medication (as required) which means staff have no written information about when they need to administer this medication. A tube of ointment dispensed in March still had the metal seal on indicating that it had not been used. Medication that is in stock is not being brought forward on the MAR sheets making it impossible to conduct an audit. The records indicate that staff have been using the supply of stock Paracetemol for themselves. This practice is not acceptible. Paracetemol medication dispensed for one individual could not be located in the medication trolley. Care Homes for Older People Page 16 of 30 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. There are activities on offer to keep people stimulated. There is plenty of choice on the menu and special dietary needs can be catered for. Evidence: The staff at the home are friendly and they make visitors to the home feel welcome. People we talked to said they liked the staff and got on well with them. They said they get up and go to bed when they want to and follow the sort of daily routine that suits them. We saw a list of activities on display which included board games, arts and crafts, sing a longs and movement to music. People we talked to cofirmed that these activities take place and everyone is free to choose whether they want to take part. People were asked if they wanted to play dominoes or do a jigsaw during the morning. There are plenty of books and magazines around the conservatory for people to read. For most of the morning the majority of people were sitting in the conservatory. Two TVs were switched on to the same channel but the picture was not visible on either of them because of the bright sunlight and the sound was not synchronized, resulting in a sound delay from one of them. We saw a member of staff sit next to someone and Care Homes for Older People Page 17 of 30 Evidence: comment on the lack of picture but no attempt was made to remedy the situation. Most people spent the morning in this room with the temperature rising and the sun beating down on them. Several people fell asleep. At the end of the visit we talked to the manager about re-arranging the seating in the conservatory so that people could see the TV and the possibility of moving one of the TVs to another lounge area. After lunch the conservatory doors were opened allowing some fresh air into the room but the glare from the sun still made it impossible to see the picture on TV. Several people were asleep soon after lunch, some moved into the dining room where they sat chatting to staff. In the surveys people said they liked the meals provided and people said there was plenty of choice on the menu. In the AQAA the manager said we had a meeting with service users regarding menus and as a result of this meeting we have adapted the menus to include their choices. Mid morning we saw the cook asking everyone individually what they would like from the menu for their lunch. The lunchtime meal was well presented and people sat at pleasantly laid tables but there were no condiments available for people to use. Care Homes for Older People Page 18 of 30 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. Staff have received training about making sure that people in their care are protected and safe from harm. Evidence: The complaints procedure is on display in the entrance area and people are given information about it when they first move in. Since we last visited in May 2009 we have not received any complaints and none have been sent directly to the home. In the surveys people said they knew how to make a complaints and they confirmed they had someone they could speak to informally if they were unhappy. Staff have received training about their responsibility to make sure that people in their care are safe and free from harm. All of the team are currently taking part in refresher safeguarding training to keep their practice up to date. The home has a whistleblowing procedure and staff are encouraged to report any practice that causes them concern. In the AQAA the manager said We have an up to date complaints procedure and this is reviewed regularly. Staff are given safeguarding training and they have the knowledge and understanding of what they are expected to do if a situation arises. If a complaint arises this is dealt with professionally and the procedure is followed to ensure the situation is rectified quickly.We listen to service users and families . Care Homes for Older People Page 19 of 30 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of cleanliness and infection control is poor and suggests a lack of respect for people using the service. Evidence: We looked round most parts of the home during our visit. Bedrooms are all different shapes and sizes. Some rooms are carpeted, some have non slip floor covering. People are encouraged to bring some of their personal possessions with them when they move in, some people have done this and this has improved the appearance of their rooms making them look more homely. Some rooms look bare. The home was not particularly clean when we visited. Several bedrooms were covered in dust, some rooms had cobwebs on the lampshades, over-bed lamps, photographs and ornaments. There was a smell of urine in some areas. The chair base cushion in one room was soaking wet with urine, we saw faeces on a commode frame and a broken lid on a chair like commode which could have injured anyone who sat on it. Some of the commode pans were stained and had not been cleaned properly. In one room the wardrobe door could not be closed; in another room we saw a TV and handset covered in a sticky substance that had been smeared over the screen. Care Homes for Older People Page 20 of 30 Evidence: Some rooms did not have waste bins where people could dispose of used paper towels. One room had a stained carpet next to the bed and no bedside cabinet to place things on. A drink and a pair of glasses had been left on the floor beside the bed from the night before. We saw foot rests for a wheelchair under the bed in this room although the occupant did not use a wheelchair. In the same room we found prescribed cream in a drawer which did not belong to the occupant of the room. Dirty bed linen was still on the bed in an unoccupied room. We looked at a double room that was occupied by one person. The commode pan in this room was not clean. The floor covering was ripped, the room was dark, bare and impersonal. All of these issues pose potential cross infection risks to the people living at the home. The bathing facilities need to be improved so that they can be used by people with limited mobility. Earlier in this report we referred to the inaccessibilty of the ground floor shower room. This needs to be addressed so that personal care needs of everyone living at the home can be met. We have also already referred to the excessive temperature in the conservatory due to the lack of suitable blinds. We spoke to the manager about this as it needs to be addressed urgently as we approach summertime. We made a safeguarding referral to the local authority about this issue because of the risk to peoples health and safety. Care Homes for Older People Page 21 of 30 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. There are sufficient staff on duty to meet peoples needs at present but this will need to be reviewed if occupancy levels increase. Evidence: The manager informed us that the home is staffed throughout the day by two staff; one is a senior member of the team. The manager is also present during the week. Two staff are on duty during the night. In addition, the cook is available six days a week and an additional member of the care team is on duty to cover catering duties when the cook is off. Domestic cover is available for five hours, three times a week. We looked at a sample of staff recruitment files to see what checks are being carried out on prospective staff before they start work in the home. References are taken up and gaps in employment history are explored with the applicant and checks are carried out with the Criminal Records Bureau (CRB) to make sure that staff are suitable to care for the people that live there. on one file relating to a recently recruited member of the team we could not find details of a satisfactory CRB check. The manager was unable to locate a copy and the method of recording when CRBs are received at the home is disorganised. We discussed this with the manager who agreed and she said she would review her recording system. The manager subsequently confirmed by e mail that this CRB check was satsifactory. Care Homes for Older People Page 22 of 30 Evidence: Out of fifteen care staff employed at the home, ten have a completed NVQ training. The remaining care staff are enrolled on NVQ training at present. The manager told us that most of the mandatory training that staff are required to undertake is now due for an annual update. Discussions have started about sourcing this training but at the time we visited no final arrangements had been agreed. It is important that all staff undertake this training in order to keep their care practice up to date and make sure that the health and safety of people living there is not placed at risk. Care Homes for Older People Page 23 of 30 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are a number of areas that the manager is required to improve in order to best meet the needs of the people living there. Evidence: The registered manager is experienced and qualified to run the home. People have told us she is approachable and they feel that she listens to their concerns. There is also a general manager who is responsible for the group of homes owned by the company, he visits the home every week to provide support to the manager and staff. There have been some improvements since we last visited; a new care planning format has been introduced, the daily records are more detailed. A handyperson has been employed and some of the bedrooms are in the process of being decorated. However, we have raised several concerns throughout this report about cleanliness Care Homes for Older People Page 24 of 30 Evidence: and hygiene, the standard of decor in some of the bedrooms, risks to the health and safety of people living there and healthcare needs not being met in some cases. All of these issues indicate that the home is not being run in the best interests of the people who live there. Arrangements need to be made to provide the staff with refresher training in all mandatory areas as soon as possible. Measures need to be in place to ensure that smoking only takes place in designated areas to make sure that people living in the home are safe and the fire risk is minimised. The home sends out questionnaires periodically throughout the year asking people to comment on the service provided. Residents and family meetings are also held regularly. The manager told us a meeting had been held the week prior to our visit. We checked a sample of personal money held for safekeeping on behalf of some of the people living at the home. The balances we checked could be reconciled with the finance records. According to the AQAA all of the equipment used in the home is serviced regularly and safe for use. Care Homes for Older People Page 25 of 30 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 30 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 7 15 Everyone living in the home 30/06/2010 must have a care plan which sets out in detail how their assessed needs in relation to health, personal and social care are to be met. This is to make sure that people get the care they need in the way they prefer 2 8 13 Drinks must be available at all times and offered regularly, especially in hot weather. To make sure that people do not de-hydrate. 19/06/2010 3 8 13 Risk assessments must be kept up to date and be accurate. They must show clearly what action is going to be taken in order to reduce or eliminate the identified risk. To protect people and keep them safe from harm. 19/06/2010 Care Homes for Older People Page 27 of 30 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 4 9 13 Systems for managing and storing medications must be made safe. This must include recording of medication received into the home, correct recordings of administration and making sure that people are given their medication as prescribed. To make sure that people receive their medication safely. 19/06/2010 5 19 18 Systems must be in place to make sure that all parts of the home are clean and the risk of cross infection is minimised. So that people can live in a clean and tidy home. 19/06/2010 6 25 13 Action must be taken to 19/06/2010 shade the conservatory from direct sunlight. To make sure that the room temperature is comfortable for people to sit in. 7 38 23 The homes fire risk assessment must take into account the arrangements for smoking on the premisies. 19/06/2010 Care Homes for Older People Page 28 of 30 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 To keep people living and working at the home safe and to reduce the risk of fire. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 21 24 The seal and door on the ground floor shower needs to be repaired. Bedrooms should be equipped with bedside tables so that people have somewhere to place their drinks and other belongings. Waste paper bins should be available in all of the bedrooms, so that paper towels can be disposed of properly. The system of recording CRB checks needs to be improved so that information is more easily accessible. Arrangements need to be in place to ensure that all staff have access to refresher training in all mandatory areas to keep their care practice up to date and ensure that people are cared for in a safe manner. 3 26 4 5 29 30 Care Homes for Older People Page 29 of 30 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. © 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. 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