Care Home: Park View Residential Home

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What the care home does well Park View was well maintained and provided a comfortable and attractive home. Standards of cleanliness were high. Living rooms were comfortably furnished and set out in a style that encouraged conversation and socialising. Outside, the rear courtyard garden provided seating areas in sun and shade where people can sit. Residents were pleased with their carers;- `The staff are a lovely group of people`, `all staff are attentive and talk to you`. Call-bell response time was said to be `within seconds`. Regular visitors said, `nothing is too much trouble for the carers,` and `we are well impressed`. People enjoyed their food. Choice and variety were provided, and people were able to help themselves to drinks and sauces. What has improved since the last inspection? Mrs Lynda Bowyer came to manage Park View in June 2008, and has registered with the Care Quality Commission. She has brought stability and confidence to the care staff, who were pleased with their training and with developing their roles as keyworkers for the residents. Mrs Bowyer was promoting `person centred care` in the home, and encouraging staff to learn about each resident as an individual and provide care in the way that suits them. New care plans have been written for each resident and discussed with them. They provide clear information for staff so that they know what support each person needs, and can encourage them where it is right for them to remain independent. A new system of medication had been introduced, to make sure residents get their medication correctly. The home`s policies with respect to recruitment and supervision have been put into practice. Improvements to the premises include new stainless steel equipment in the kitchen, a new shower, installation of another en suite toilet, and redecoration and recarpeting of the dining rooms, lounge, hallway, and installation of a new stairlift. What the care home could do better: In general, systems for checking on good performance were in place. However, we recommended that care staff should check call bells and window restrictors as part of their regular monthly checks of residents` rooms, to be sure that these are maintained in good order. Also, a better method of checking the provision of liquid soap and paper towels in communal toilets should be introduced, as these were not always seen to be present and are required for good hygiene. When staff had received fire safety awareness training, a record should be kept, in order to know who has received this, and who needs an update. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Park View Residential Home 70/72 Peverell Park Road Peverell Plymouth Devon PL3 4NB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Stella Lindsay     Date: 2 8 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Park View Residential Home 70/72 Peverell Park Road Peverell Plymouth Devon PL3 4NB 01752669541 01752669541 parkviewplym@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ashley Residential Care Ltd Name of registered manager (if applicable) Mrs Lynda Margaret Bowyer Type of registration: Number of places registered: 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 20. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old Age, not following within any other category: (Code OP) Date of last inspection Brief description of the care home Park View is situated on the edge of Central Park, in the residential area of Peverell in Plymouth. The home is owned by Ashley Residential Care Ltd, and managed by Mrs Lynda Bowyer. The home is within walking distance of local shops and close to Mutley Plain shopping precinct. Bus services pass the home into Plymouth City Centre. The majority of the accommodation is in single bedrooms spread over two floors with a Care Homes for Older People Page 4 of 27 care home 20 Over 65 20 0 Brief description of the care home stair lift providing access to the upper floor. Four bedrooms have ensuite toilet facilities. There are two toilets and one bathroom with a toilet on the ground floor and one bathroom with a toilet and a walk-in shower room and toilet on the first floor. There are two lounge rooms, two dining rooms and a conservatory on the ground floor that offer sufficient and pleasant communal space. A patio area is provided at the rear of the building. Park View is registered to provide care services to older persons (OP) whose assessed care needs on admission do not fall within the categories of dementia or physical disability. The homes service is clearly defined to meet the needs of older people who have a lower level of dependence. The weekly fees at the time of this inspection ranged from #313 to #420. Items not included in the fees were hairdressing, chiropody, newspapers and magazines, clothing and toiletries. Residents are expected to pay for transport to medical appointments, and may be charged 10 pounds if they need a member of staff to escort them. Selffunding residents or their representative are required to sign a contract which includes a notice period of eight weeks. Information regarding the services provided at Park View can be obtained directly from the home. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: The quality rating for this service is two stars. This means the people who use this service experience good quality outcomes. This inspection took place on 28th April 2009 and was unannounced. The inspector was accompanied by an Expert by Experience who met with eight residents and two visitors to the home. An expert by experience is a person who either has an experience of using services or understands how people in this service communicate. They visited the service with us to help us get a picture of what it is like to live in or use the service. Prior to the unannounced inspection we sent questionnaires to people who live at the home, and to people who work there. Seven residents and two staff completed and returned these. Care Homes for Older People Page 6 of 27 The Service Provider sent us their annual quality assurance assessment (AQAA) when we asked for it. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It gave us some numerical information about the service. During our visit we spoke the Registered Manager, the Responsible Individual for the company, and four other staff members. We met with other residents in the lounge and dining room. We case tracked two people who use the service. Case tracking means we looked in detail at the care two people receive. We spoke to staff about their care, looked at records that related to them, met with them and made observations if they were unable to speak to us. We looked at staff recruitment records, training records and policies and procedures. We did this because we wanted to understand how well the safeguarding systems work and what this means for people who use the service. All this information helps us to develop a picture of what it is like to live at Park View. What the care home does well: What has improved since the last inspection? 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 set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get Care Homes for Older People Page 8 of 27 printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good information is available, and careful consideration is given before offering accommodation, to be sure that residents needs may be well met at the home. Evidence: The homes statement of Purpose, Complaints procedure and previous Inspection report were all on display by the entrance. Information packs had been provided in each room. The Manager told us that prospective residents are offered an illustrated brochure, invited to visit, and the room is then held without obligation so they may have time to visit other homes and consider their decision. In surveys, residents confirmed that they had been to visit for a day. One said they had prior knowledge of the home, as their friends mother had lived there and been very happy. The Manager had completed a pre-admission assessment for each prospective resident, using a form for recording that has been designed to make sure all areas are Care Homes for Older People Page 11 of 27 Evidence: considered. We looked at two, and saw that the persons care needs had been properly considered and recorded, including details of what they were able to do for themself and what was a particular risk factor. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans were kept up to date and in a person centred way, so that staff knew how the residents liked their care and support to be provided. The keyworker system was working well to engage residents in contributing to their care plan. Evidence: The Manager and staff at Park View have worked with local health and social care staff to renew all care plans. They were now clearer and easier for staff and residents to understand. We examined three in detail, and found good information with regard to the persons medical history and health status communication and behaviour, nutrition, continence, tissue integrity, pain management and sleep patterns. The home owner and Manager had both recently attended advanced training on person centred care, and were enthusiastically inducting their staff. Specifics of personal care were written in personal terms and covered washing and grooming, dressing, mobility, continence, night time needs, and included what the person was able to do for themself as well as the support they needed. Each file had a chart for staff to record the monthly care plan review. We saw that changes had been recorded, for instance Care Homes for Older People Page 13 of 27 Evidence: where one person had changed their habits and started to go to their room at 7pm to listen to music. Staff told us how they sit and go through the care plan with residents. A traffic light system of highlighting the care needs and tasks helped staff to recognise easily what they should do. The paragraph is highlighted in green where the person can do the activity/task unaided, amber where they just need prompting, and red where help is needed. Psychological well being is recorded, and any known details of what is important to the persons well being. For one person this included their favourite perfume. A keyworking system had been introduced, with care staff being given particular responsibility for two or three residents, to review their care plans, spend time with them, see they had toiletries and anything else they need, and to help them compile their life stories. Staff told us how they felt this was very useful and interesting. they were getting photos from relatives to help show the persons full life. All the care staff we spoke to could tell us about the lives of the residents to whom they were key worker, and they said they considered this to be a significant part of their role as carer. We saw that records were kept of all visits from District Nurses, GPs and other health care visitors. Nutrition and weight charts were kept where necessary. One person was unable to weight-bear at the time of this inspection. The staff had been trained in the use of the hoist. This person was visited weekly by District Nurses to monitor their health, particularly weight and skin care. In surveys all the respondents said that carers listen to them and act on what they say. One said that they are ready to call for the nurse or doctor if anything is not as it should be. We looked at the homes policy with respect to administration of medication, which was kept on a shelf in one of the dining rooms, so that staff could easily refer to it. It included procedures for enabling residents to look after their own medication, following assessment of their capability to do this safely. There was a procedure to follow to enable residents to take medication with them if they needed it while out for the day. There was a procedure for staff to follow if someone refused to take their medication. We saw staff administering medication according to the procedure, and we saw that the records were well kept, including the Controlled Drugs register. The home had engaged a different pharmacy since the last inspection, and a new system for administering medication had been introduced. This was seen to be working more efficiently. Further staff training had been booked for the month following this inspection. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents preferred routines were respected. They were offered a good choice in social activities. Meals provided were of a good quality, and provided choice for the residents. Evidence: In care plans we saw that some residents were particular about the time they liked their bath or shower, and when to rise or retire, and that staff would ensure that these wishes were respected. Although there was no dedicated activities organizer there were many activities led by staff or people from outside. These included armchair aerobics, seasonal craftwork, singing sessions, Church visitors, displays and talks from a member of the staff of Plymouth Museum, Hangman, a visit from a well-behaved donkey, Scrabble and various other games. The office diary indicated that on some days there are several activities, and staff said there were activities every morning and afternoon. Residents said that they were well pleased with the range and frequency of activities some adding that they chose not to join in all events. An off-duty member of staff called in just to see how my ladies are adding this is just like a family home, all the residents get on well with one another and I really enjoy working here. Care Homes for Older People Page 15 of 27 Evidence: A Wii Nintendo had been provided, and though we did not see it in use, we were told that residents had used it to play bowling. One carer told us how they had taken a resident out for an ice cream, another said they were prepared to come in on their day off to take residents out. This should be considered during a care plan review, and included as part of the staffs job role if it is found that the resident needs this support. The Manager told us in the AQAA that she intended to increase day trips for residents. Individual records and the Communication book sometimes included records of social activities. We suggested that a specific record might be kept, to show who had engaged in group and individual activities, and to include an evaluation. This was started immediately. Residents said that visitors are always made to feel very welcome and are always offered refreshments on arrival. Evidence of this was seen. Comments about the food ranged from, Alright, Really good home made food, to fantastic with the majority of responses being very complimentary. A choice of two main courses was offered for lunch with an alternative being available. On the day of the visit there was roast pork with apple-sauce, roast potatoes, green beans, broccoli, carrot and swede or baked potato with a choice of filling and salad. Both meals were served plated in generous portions and suitably hot. Pudding consisted of a delicious home made upside-down pineapple sponge with custard. A tea pot was put on the table for residents to pour. We saw that special diets were catered for, and that a record was kept of what people had actually eaten, which may be useful for health reasons, and also showed that choices had been provided every day. Once they had served the meals, members of staff joined diners at the table engaging in friendly relaxed conversation. At teatime choices were offered, such as soup, sandwiches, sausage rolls and various items on toast or perhaps something like cauliflower cheese. During the evening drinks were served and snacks are available. The Cook told us that two residents have a supper box made up for them, so they may enjoy it in their room when they liked. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents feel safe and able to express their views. They are protected by the staffs knowledge of abuse issues. Evidence: The homes complaints procedure was on display by the entrance. Of the seven surveys returned to us by residents or their relative, six said they knew how to make a complaint, and all said they knew who to speak to if they were not happy. One person said the carers are very good and mother talks to them when confusion sets in. One complaint had been received since the last inspection. This had been responded to by the home owner, who had requested inspections by the Environmental Health service and the pharmacy who had not made any requirements in response. We had been kept well informed. The Alerters Guidance was available for staff to consult, as was Guidance for Managers of care services. Care staff knew what they must do if they suspect abuse of any sort, and were aware of whistle blowing responsibilities and rights. Ancillary staff told us they were due to attend training in the Protection of Vulnerable Adults In the AQAA, the Manager told us that her plans for the year ahead included ensuring that staff understand the new Deprivation of Liberty safeguards and attend training events. The implications of the Mental Capacity Act and understanding when a resident may need support and assessment with respect to decision making should also be included on the homes training plan. Care Homes for Older People Page 17 of 27 Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Park View provides a safe, clean and comfortable home for the residents, with choice of social areas. Residents are encouraged to personalise their bedrooms. Evidence: Everyone spoken to said they were happy with their surroundings. There is a choice of two welcoming lounges and two dining rooms. According to the manager people tend to circulate between the rooms as they wish rather than having a particular favourite chair in one location. The furnishings were of good quality, comfortable and very clean. The bedrooms visited were clean, well decorated and homely with items of personal memorabilia on display. To the rear is a conservatory and a patio with seating and tables. Three of the bedrooms at the back of the house are accessed through the kitchen. The Manager told us she takes care to ensure that only people for whom this does not pose a hazard will occupy these rooms. They have direct access to the patio. A lot of work on improving the environment had taken place during the past year. A new stairlift had been installed, and the hallway had been redecorated, and carpeted. Two more bedrooms had been fitted with en suite toilets, giving a total of four. There are six communal toilets. Commodes can be made available for people not able to get Care Homes for Older People Page 19 of 27 Evidence: to the toilet during the night. The Manager told us that planning permission was being sought to provide an extension where a sluice could be installed. The two dining rooms and one of the lounges had been redecorated, carpeted and new furniture provided. There was a sit-in bath, and a bath with a hoist. A new shower had been fitted - one resident was able to use this independently. The premises were homely and tidy without being austere and with a good standard of cleanliness, decoration and internal repair. No unpleasant odours were present. Antiseptic gel was available at the front door. Some but not all communal toilets were found to have paper towels and liquid soap, which is required for good hygiene. The training record showed that nine staff had received training in food hygiene, but their certificates had not yet been delivered. The Plymouth City Council Environmental regulation service carried out an inspection of the kitchen on 05/12/08, and found it to be satisfactory in the areas they assessed. A stainless steel cooker and hood had been installed, and shelving and cladding along with new flooring, was due to be fitted. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Manager is successfully introducing person centred practices to the team. There was a sound recruitment procedure, that was followed consistently. Evidence: We were supplied with a current rota which showed that there were two care staff on duty from 8am to 8.30pm, and by night there was one waking Carer, and one asleep. In addition, the Manager was on duty most weekday mornings and some afternoons, and cleaner also on weekday mornings, and a cook seven days per week. This was found to be sufficient for the current 14 residents. However, we saw that staff had found it necessary to come to work when they were off duty, to provide 1;1 support, for example to take a resident for a walk, as recorded in section three of this report, daily life and social activities. The training record showed good achievement in National Vocational Qualification, with eight of the 14 care staff having achieved at least level 2 in care. We examined the files of two staff who had been recently recruited. They both had written references, and the other checks needed to avoid risk of harm to residents had been received or applied for. There was evidence of induction training, and records of supervision and appraisal carried out by the Manager. Only two staff returned surveys to us, but both were satisfied with their induction and training. Staff on duty spoke with enthusiasm of their recent training in person centred care, and their new roles as Care Homes for Older People Page 21 of 27 Evidence: keyworkers. The staff training record showed that provision this year had included common induction, person centred care, food hygiene, medication workbook, Moving and handling, and dementia care. There had been sessions on Water for health, and Behind closed doors. Three staff members had attended a session on the Deprivation of Liberty safeguards. During this inspection the home owner and Manager held a session for staff in one of the lounges, sharing positive ways of interacting with people who have a dementia. Residents said they were happy with the staff saying, The staff are a lovely group of people, They know what they are doing and are gentle with me. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was well run in the best interests of the residents. Safe working practices were in operation, with regular checks in place. Evidence: Mrs Lynda Bowyer is the Registered Manager. She has worked in residential care for over 30 years. She owned and work in her care own home for many years. She also worked with a National Care provider as a deputy manager. She began to work for Ashley Residential Care in 2006 in a management capacity moving to Park View in June 2008. She has a Bachelor of Arts in Education and training which she obtained in 2002, and a management certificate at level 4, which was awarded in 1996. She attended a training course in Dementia Care Mapping in March 2009, and was promoting person centred care practices in the home. The Responsible Individual for the company is Mr Nicholas Chapman. We saw minutes of staff meetings, including a recent meeting where the manager had Care Homes for Older People Page 23 of 27 Evidence: asked staff for feedback on their new practice of sitting with residents during meals. Following discussion it was decided to serve tea a little later - they felt it had been served at 4.30pm for staff convenience, and this was too early for residents, so it has been put back to 5pm. Small amounts of cash were kept in the office safe by arrangement. We checked a sample and found them accurately recorded, with receipts kept. Charges had been made for an escort to accompany a resident to an appointment. This charge was included in the homes statement of terms, signed on admission by the resident or their representative. The resident also paid for the taxi. We saw that keyworkers included in their duties a safety check of each residents room every month. This is good practice. We recommended that they include a check of window restrictors, to keep an audit of their maintenance, and also to include call bells. One of these was not working at the time of this inspection, and the occupant of the room had climbed on furniture to reach the button rather than report the fault of the lead extension. We checked the fire safety records, and saw that the fire alarm system had been serviced professionally on 14/11/08, and the extinguishers on 15/04/09. Fire safety training had been provided six-monthly. There was a video available for staff updates in between, particularly for Night care staff who should have awareness training every three months, but there was no record of staff having watched it. Care Homes for Older People Page 24 of 27 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 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 18 Training on the Mental Capacity Act should be provided, to ensure that support is sought for residents who may not be competent to take decisions, nor have an appropriate representative. A record should be kept of fire safety awareness sessions, to provide evidence that night care staff have had up-dates at the required frequency, in order to protect residents in an emergency. Window restrictors and call bells should be added to the monthly safety checks to ensure they are maintained in good working order. 2 38 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. 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