Care Home: Pavilion Residential Home (The)

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What the care home does well Peoples needs are suitably assessed before they move into the home in order to determine as to whether these can be met. Peoples health care needs are well met in accordance with their known wishes and preferences from staff that treat them with respect and promote their dignity and privacy. People are well supported to make decisions about their lives and daily routines and to engage in social and recreational activities, which accord with their known lifestyle preferences. People receive nutritious food in accordance with their stated preferences and assessed needs. People usually know who to speak with if unhappy or to complain and the home`s policies promote peoples protection from harm and abuse People are provided with a clean, comfortable and homely environment, which for the most part suits their needs. And with repairs and renewal to the fabric of the building, which should be to their further benefit and comfort. Peoples needs are met from staff that is effectively recruited, inducted, trained and deployed. The home is being well managed and run in peoples best interests and their health, safety and welfare is overall promoted and protected. What has improved since the last inspection? Progress has been made with a programme of upgrading, repair and renewal to the fabric of the home and in successfully eliminating stale urine odours in the environment. A review of the arrangements for the storage of peoples medicines has been undertaken resulting in their safe storage. What the care home could do better: Ensure that each existing and prospective service user is provided with accurate key service information, preferably made available in their own rooms, including as to the range of fees charged. Ensure that detailed written care plans are in place where any service user is prescribed a medicine with an as required, or variable dose instruction. So that staff are clear as to the instructions to follow and to ensure consistent practise. We made a requirement about this at our last key inspection. However, this had been misunderstood by the home in their interpretation of this. We have therefore reissued a more clearly written requirement about this, with a timescale for achievement.Ensure good infection control practise by not leaving bars of soap for people to use in communal bathrooms and toilets. Continue with the programme of upgrading, repair and renewal to the environment and seek to a loop system to assist people with hearing difficulties that may benefit. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Pavilion Residential Home (The) 36 St John`s Road Buxton Derbyshire SK17 6XJ     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: Susan Richards     Date: 1 1 0 6 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 30 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 30 Information about the care home Name of care home: Address: Pavilion Residential Home (The) 36 St John`s Road Buxton Derbyshire SK17 6XJ (01298)71422 0129877578 pavillion@guardiancarehomes.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Guardian Care Homes Ltd The registered provider is responsible for running the service care home 32 Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 32 old age, not falling within any other category Additional conditions: 0 That the home is registered for 1 place in the category of (MD) for (1) named individual for as long as they are accommodated at the home. Date of last inspection Brief description of the care home The Pavilion Care Home is a large Victorian building located close to the centre of Buxton, local public gardens and leisure facilities. The home provides accommodation and personal care for up to thirty two older people. There are twenty en suite bedrooms and six bedrooms without en-suite facilities, some of which are shared bedrooms. Accommodation is over three floors accessed by a passenger lift. Large communal lounge and dining facilities are provided to each floor and there are central kitchen and laundryservice areas. Garden areas are provided, although with limited to the rear garden. Car parking space is provided People are provided with care and support from a team of care and hotel services staff, including an activities co ordinator and led by a manager who is recently appointed and Care Homes for Older People Page 4 of 30 Brief description of the care home therefore not as yet registered with the Commission. Fees charged by way of private funding arrangements range from 540 to 567 pounds per week and are dependent on the type of bedroom. Fees charged for those eligible to local authority funding are 374 pounds per week. There are additional charges for hair dressing, private chiropody, personal toiletries and newpapers. 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection peterchart Environment Staffing Management and administration Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. For the purposes of this inspection we have taken account of all the information we hold about this service. This includes our annual quality assurance assessment questionnaire AQAA, which we ask the home to complete on an annual basis in order to provide us with key information about the service. We also received some survey returns from people who live at the home, people advocates and some staff. At this inspection we used case tracking in our methodology, where we looked more closely at the care and services that three people receive. This included speaking with Care Homes for Older People Page 6 of 30 them, with peoples advocates, observing staff interactions with people, looking at their written care plans and associated health and personal care records and also their private and communal accommodation. We received a number of positive comments about the service, including, The staff are very good. They help me only when I need help, which means I can keep as independant as possible. I usually enjoy the food provided, but there is always an alternative if you dont like what is being offered. Also at our visit, we spoke with staff about the arrangements for their recruitment, induction, training, deployment and supervision and we examined related records. We also spoke with the acting manager who is relatively new in post, about the arrangements for the management and administration of the home and we examined associated records. All of the above was undertaken with consideration to any diversity in need for people who live at the home. At the time of our visit all people accommodated are of British white backgrounds and of Christian religion. What the care home does well: What has improved since the last inspection? What they could do better: Ensure that each existing and prospective service user is provided with accurate key service information, preferably made available in their own rooms, including as to the range of fees charged. Ensure that detailed written care plans are in place where any service user is prescribed a medicine with an as required, or variable dose instruction. So that staff are clear as to the instructions to follow and to ensure consistent practise. We made a requirement about this at our last key inspection. However, this had been misunderstood by the home in their interpretation of this. We have therefore reissued a more clearly written requirement about this, with a timescale for achievement. Care Homes for Older People Page 8 of 30 Ensure good infection control practise by not leaving bars of soap for people to use in communal bathrooms and toilets. Continue with the programme of upgrading, repair and renewal to the environment and seek to a loop system to assist people with hearing difficulties that may benefit. 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 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People do not usually move into the home without having their needs assessed and being assured that these can be met. Although access to key service information could be better promoted for people. Evidence: At our last key inspection we found that the homes needs assessment process meant that people could be confident their needs woul be met there. In our annual quality assurance questionnaire completed by the home, they told us they ensure people are provided with the information they need to assist them in choosing the home and that their needs are fully assessed with them. They did not identify any improvements made or that they would like to make that are relevant to the standards this outcome section. However, they gave us some statistical information that we asked for about the numbers and needs of people accommodated. Care Homes for Older People Page 11 of 30 Evidence: At this inspection two people told us that they received the information they needed, including a written contract on moving into the home. However, two people said that they did not receive any written information about the home and its services. Both said that they would have found this helpful to do so. And that they were learning about the home, its services and daily living arrangements as they go along. We saw that a copy of the homes Statement of Purpose and Service Guide is displayed in standard type format, and in a glass cabinet fixed up on the wall near the front entrance. This meant that they were not readily accessible to people. The Service Guide did not contain any information about fees charged, what they cover and arrangements for payment. Although the Statement of Purpose did contain some information about fees. We also saw that our contact details provided in these for people not correct. People told us that their needs are usually met from the home. With the exception of one person, we found peoples individually recorded needs assessment information to be up to date, person centred and to account for for their holistic needs. The manager advised us of action she was going to take to ensure that those omissions of recording that we identified would be effectively completed. Which is satisfactory in principle. And we found from speaking with staff that they were fully conversant with that persons needs. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health care needs are well met in accordance with their known wishes and preferences from staff that treat them with respect and promote their dignity and privacy. Evidence: At our last key inspection we found that a consistent and structured approach to care planning meant that people received the individual care and support they needed in accordance with their preferences. We made two requirements and one recommendation at that inspection about medicines practises. At this inspection we found one of the requirements that we made about medicines storage is being met. But that the other, relating to medicines instructions for medicines that are prescribed to be taken as required was not met. The quality recommendation that we made about the use of clear codes for recording why a medicine is not given for any reason, is also met. Care Homes for Older People Page 13 of 30 Evidence: We also made one other quality recommendation about care planning at that inspection, which is met at this inspection. In our annual quality assurance questionnaire completed by the home, they told us that they ensure each person has suitable written care plans in accordance with their assessed needs. That they ensure peoples access to outside healthcare professionals and promote peoples daily living and personal routine choices. They told us about management difficulties experienced earlier in the year and the impact this had on some of their record keeping practises. They also told us about the action they are taking to ensure that these are all well maintained and up to date. At this inspection people told us that they usually receive the care and support they need, including medical support. And peoples relatives told us that they are always kept up to date with important issues and that their service user receives the care that is expected and agreed. We saw that overall peoples written care plans were in accordance with their risk assessed needs and known personal wishes, lifestyle and routine preferences. They were also regularly reviewed and were reflective of recognised national guidance concerned with the care of older people. We received many positive comments relating to peoples care and support, including from one person who told us, The staff are very good. They help me only when I need help, which means I can keep as independant as possible. Inputs from and access to outside healthcare professionals were also well accounted for within peoples individual care records and people described effective arrangements for these, which they said suited them. With the exception of an outstanding requirement that we made about medicines at our last key inspection. We found the arrangements for the ordering, storage, administration and disposal of peoples medicines were in accordance with recognised guidance concerned with these. Following discussion and further clarification with the manager as to our expectations,we have agreed an extended timescale for achievement that outstanding requirement. We could also see from the information that the home gave us in our AQAA, as referred to above, the action being taken by the home to address care planning omissions. Care Homes for Older People Page 14 of 30 Evidence: However, staff were not able to locate the whereabouts of the spare set of medicines keys. The manager agreed to take action to ensure these were established. Care Homes for Older People Page 15 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. People are well supported to make decisions about their lives and daily routines and to engage in social and recreational activities, which accord with their known lifestyle preferences. People receive nutritious food in accordance with their stated preferences and assessed needs. Evidence: At our last key inspection we found that peoples social and recreational needs and preferences were not met due to a lack of organised activities. In our annual quality assurance questionnaire completed by the home, they told us about their appointment of an activities coordinator who assists people to access a range of fun and enjoyable activities. They also told us that they provide people with choice and variety of freshly prepared food and that they encourage people to manage their own finances where possible, providing suitable storage facilities for this. They told us that they have good contact with a local church and that the minister of Care Homes for Older People Page 16 of 30 Evidence: that church makes regular visits to the home. However, they advised of further improvement they were seeking to improve connections and contacts with the local community and to provide more outings for people. At this inspection people told us that there are activities that they can join in and that they usually enjoy the meals provided. Peoples relatives told us they feel the home supports people to live the life they choose. We saw that peoples past interests and hobbies and known daily living preferences and routines were well recorded in their individual needs assessment and care plans. And that information about activities is posted in the main entrance and also on a board detailing weekly activities to be provided. People said that the activities coordinator consults with them about preferred activities and we saw that an activities plan is then agreed on a weekly basis. People told us about a range of activities that are regularly provided. These include quizzes, food tasting, memories and reminscence, bingo, arts and crafts, poetry, chair based exercises, DVD, cards and board games. Outside entertainers come into the home on a regular basis including an accordionist. And a violinist was also due to entertain people. Television and music systems are provided in each lounge area, with a range of books and magazines in the first loor lounge, along with a cold water machine for people to use when they choose. A number of residents were looking forward to going to Buxton Opera House to see a show. People told us their visitors are made welcome in the home at any time and we saw one resident spending time gardening during the afternoon of our visit. Another went out for a short walk and a group of people spent time engaged in activities assisted by the activities cordinator during the afternoon. We saw that breakfast and lunches were served to people in a variety of locations. Some choose to come to the dining room and some ate in their own rooms. Tables were attractiely set and people received assistance and support from staff in a unhurried and calm manner. People told us that they are consulted about meals and the menu was displayed, although one of the courses served did not match with that stated on the menu. However, people were asked at the point of serving their meal as to their preferences of food and drink. People also told us that they could have whatever they wanted at breakfast time ranging from a full cooked breakfast to a lighter choice. Care Homes for Older People Page 17 of 30 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. People usually know who to speak with if unhappy or to complain and the homes policies promote peoples protection from harm and abuse. Evidence: At our last key inspection we found that people were protected from harm and their concerns effectively dealt with. And the home has told us in our annual quality assurance questionnaire, that they continue to ensure that all complaints are dealt with and responded to. They feel they could improve by communicating further with people about how to complain and to provide a suggestions and complaints box. They also told us that they have undertaken further work to ensure all their staff are effectively trained and instructed in recognising and responding to abuse and that they aim to continue with this. At this inspection most people told us that they knew who to complain to or speak with if unhappy. Although some people felt that having copies of key service information in their own room, including the homes complaints procedure would assist. We have made a recommendation about this under the Choice of Home section of this report and also relating to ensuring that accurate contact details of Commission are provided for people. Care Homes for Older People Page 19 of 30 Evidence: Staff that we spoke with were conversant with their role and responsibilities in dealing with complaints and procedures to follow in the event of suspecting or witnessing the abuse of any resident. The home keeps records of all complaints they receive, including records of action taken and outcomes. The home has received two complaints via the Commission and two complaints which they correctly reported via local joint agency safeguarding procedures for investigation. The home has kept us informed and worked with and listened to outside agencies concerned with safeguarding people to ensure their health, safety and protection at the home. Care Homes for Older People Page 20 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 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 a clean, comfortable and homely environment, which for the most part suits their needs. And the commenced programme of repairs and renewal to the fabric of the building should be to their further benefit and comfort. Evidence: At our last key inspection we found that there were areas of the home requiring attention to ensure a safe and pleasant environment for residents. And we made a requirement that the home be kept in a good state of repair, with some itemised matters raised. We found these to be met at this inspection. We also made two recommendations including that a loop system be provided, which has not been achieved. Although information that the home gave us on our AQAA questionnaire told us that there are four people accommodated with hearing difficulties, including one person that we case tracked. Although this person told us that they preferred to watch TV in their own room. Our second recommendation referred to the eradication of offensive urine odours. And since that inspection we have also received a written complaint about this, which we referred to the home for them to investigate and act on. The home wrote to us and told us what they were going to do to address this and we found this to be achieved at Care Homes for Older People Page 21 of 30 Evidence: this inspection. In our annual quality assurance questonnaire they told us that they aim to provide a fresh, clean and safe home for people. And that they have made a number of improvements, including by way of infection control training for staff and with a programme of redecoration, upgrading and repair. At this inspection people said the home is kept fresh and clean and that they were generally satisfied with their environment, including their own rooms, which people can lock for their privacy. And with suitable arrangements in place to enable staff to gain entry in the event of any emergency. All areas of the home that we saw were fresh and clean, comfortable and homely and mostly suitably equipped, with areas of upgrading, redecoration and renewal in progress, including recent total refurbishment of the central laundry facilities. Staff are provided with some hand washing facilities. Although we observed that numerous bars of hand soap were left out in communal bathroom areas and some hand towels,which is not best infection control practise. Care Homes for Older People Page 22 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. Peoples needs are met from staff that is effectively recruited, inducted, trained and deployed. Evidence: at our last key inspection we found there were satisfactory staffing arrangements to meet peoples needs. In our annual quality assurance questionnaire completed by the home, they told us that they continue to ensure that staff receive comprehensive induction and training. And tell us that a revised staff training matrix and plan has been introduced and that they monitor staff training status and achievement by way of monthly audits. They told us that just above 50 percent of staff have achieved at least NVQ level 2 or above and with a number of staff undertaking these. At this inspection people told us that most staff listen and act on what they say and are usually available when they need them. And that they mostly seem to have the right skills and experience to care for people. Staff described satisfactory arrangements for their recruitment, induction, training and Care Homes for Older People Page 23 of 30 Evidence: deployment and associated records that we examined reflected this. Care Homes for Older People Page 24 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 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 being well managed and run in peoples best interests and their health, safety and welfare is overall promoted and protected. Evidence: At our last key inspection we found the home to be well managed with peoples health, safety and welfare promoted and protected. We made a requirement about the manager submitted an application for her registration with the Commission. However, that person no longer manages the home. In our annual quality assurance questionnaire completed by the home, they told us that they manage and run the home so as to make peoples lives as comfortable as possible and with robust quality assurance systems. They told us about some difficulties that arose earlier in the year, due to unforseen Care Homes for Older People Page 25 of 30 Evidence: and tragic personal circumstances for the then manager and a senior staff member, resulting in the need for urgent interim senior management and staffing changes. They told us about some areas they aim to improve, which included some record keeping practises and staff training and development arrangements. And they gave us some information that we asked for about their arrangements for the annual servicing and maintenance of equipment at the home, which tells us there are suitable arrangements in place for these. At this inspection, staff described effective arrangements for their supervision and support, including for communication systems in the home. All people spoke with postive regard and expressed confidence in the newly appointed manager who they said was open, supportive and approachable. The new manager told us about her plans to submit an application for registration with the Commission forthwith. We saw that effective quality assurance systems are in place for the continous monitoring and review of the services the home aims to provide. These include for formal consultation with service users, their families and advocates and also outside health and social care professionals that vist the home. We found the arrangements for the handling and safekeeping of peoples monies to be in accordance with recognised good practise, with suitable safekeeping facilities for people. Staff described satisfactory arrangements for the reporting and recording of accidents and untoward incidents in the home and for ensuring safe working practises. Including the provision of equipment necessary for them to perform their role. And records that we looked at reflected these. Care Homes for Older People Page 26 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 27 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 1 5A Information must be 31/08/2009 provided for people in the homes Service Guide as to the actual range of fees charged, including what they cover and the arrangements for their payment. So as to provide people with clear and transparent information about fees. 2 9 3 For medicines prescribed for 31/07/2009 any service user with an as required or variable dose instruction. There must be a detailed written care plan in place for each of these providing clear instructions for staff to follow for their correct and safe administration. So that these medicines are administered to people in a consistent and safe manner. In accordance with recognised practise guidance concerned with medicines management and Care Homes for Older People Page 28 of 30 administration in care homes. Such as the Royal Pharmaceutical Society of Great Britain. 3 26 13 Bars of soap must not be 31/07/2009 left out for communal use in bathrooms and toilets. With dispensible soap and disposable paper towels only for hand washing in communal areas. So as to prevent infection, toxic conditions and the spread of infection at the care home. 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 1 Information should be provided within the statement of purpose and service guide as to their availability in alternative formats as may be necessary. Such as large print, audio, language. People should be provided with accurate information as to how to contact the Care Quality Commission. A copy of the homes Service Guide, containing all key service information should be provided in each persons own room. So as to ensure they can independantly refer to this as they choose. The location of the spare set of medicines keys should be established and known by all staff responsible for medicines administration. A copy of the homes complaints procedure should be provided in each persons own room, in such as format as may be necessary to assist them. A loop system should be provided to assist the needs of people with a hearing impairment. Page 29 of 30 2 3 1 1 4 9 5 16 6 22 Care Homes for Older People 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. Care Homes for Older People Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!