Care Home: Penkett Lodge

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What the care home does well People wishing to move into Penkett Lodge are offered an opportunity to come and look around and decide if the home can meet their needs. One person told us how she had spent the day in the service deciding if she wanted to live there . People who cannot visit the service are visited by the manager to discuss the home with them and to look at their individual needs. Relatives told us that they are supported to maintain contact with the people who live in the home. Those spoke with said they were made to feel welcome by the home. One person told us " whenever I visit staff are always lovely and offer me a cup of tea. It helps me feel that they look after her well". People living in the home are able to make their bedrooms their own. All bedrooms had family pictures and ornaments available. Some had furniture that they had been brought from their previous home. What has improved since the last inspection? The home had been issued with an improvement plan following the last visit. The majority of areas identified on this plan had been completed. When we looked at the management of medications we noticed that the majority of people in the home are now having their medications safely. The manager had made sure that people who manage their own medication have a risk assessment in place. This helps staff to support people taking their own medications in a more safe manner. Significant improvement has been put into place with regards to medications. New systems, training and guidance to staff has made sure that people living in the home receive their medications as appropriate. Staff have received training in the protection of vulnerable adults. This training and clearer understand of staff in recognising and report any issues of this nature can now appropriately actioned by the manager. Staff spoken with were now confident that they would be able to appropriately recognise and report to the manager with any serious concerns. Staff told us that their morale has improved. They felt that the new manager was having a positive effect on the home and that there were opportunities for them to develop new skills. Some decoration and refurbishment has begun and there are plans to further develop the home to make it a more comfortable and welcoming place to live. The information available people living in the home has been reviewed. This is now available in different formats to meet people`s needs. The service has also looked at its admission and assessment practices and updated these to make sure that staff are aware of the proper process for people moving into the home. What the care home could do better: Information available in the home although updated does not clearly detail the needs of people that the home can meet. Additionally there is no clear criteria in place that would help staff be aware of how to make sure that only individuals whose needs the home can meet are admitted. Care plans do not reflect the needs of the individuals living in the home and as such do not provide staff with clear guidance. This was mentioned on the last report, the manager takes responsibility for all care plans and this has lead to them not always being up to date. The manager discussed with us how she would involve all people who live in the home and staff in writing and keeping care plans up to date. If put into practice this will be good practice and mean that care plans will reflect people`s needs and provide staff with correct guidance. There is a format in place that does cover individual social needs and personal preferences. This was brief and did not contain sufficient detail to make sure that people`s preferences, choices and needs were recognised and used to influence the running of the home such as activities and meals available. There are a number of areas in the home that are in need or redecoration and refurbishment. It is not possible to determine what plans the home has in place to make sure that these areas are addressed in line with individual preferences. Medications management although improving is in need of further improvement, documentation needs to be clearer in order for the manager to be able to carry out audits (checks) to sure that medications are given correctly. Other records also need to be improved such as clear instructions in using items such as creams. without proper instructions staff run the risk of not giving these items correctly. There is no on-going quality arrangements in the service such as regular checks on medications, staff training, care plans, activities, meals and the environment that would identify the areas of development. Without regular quality checks the manager will not always be able to recognise areas that need to be developed to increase the quality of the service provided. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Penkett Lodge 39 Penkett Road Wallasey Wirral CH45 7QF     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: Julie Garrity     Date: 0 3 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 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: Penkett Lodge 39 Penkett Road Wallasey Wirral CH45 7QF 01516912073 F/P01516912073 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Ann-Marie Allen Type of registration: Number of places registered: Mr Russell Stanley Oakden care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP. The maximum number of service users who can be accommodated is: 27 Date of last inspection Brief description of the care home Penkett Lodge is registered to provide personal care for 27 with an age related condition who do not need nursing care. The service is a converted detached three storey Victorian building close to other similar properties in a quiet suburban area of Wallasey. There are 17 single bedrooms and 4 shared bedrooms. However there are Care Homes for Older People Page 4 of 27 Over 65 27 0 Brief description of the care home plans to change this to fewer double rooms and more single rooms. Penkett Lodge is a no smoking home, there is the opportunity for people who wish to do so to smoke in the garden at the rear of the home. A variety of communal space is provided there are two lounges and a dining room. There is a passenger lift that accesses all the floors of the building and handrails throughout. External space includes a garden that has recently been landscaped and car parking facilities at the front of the building The home is within a mile of a town centre, local shops, a post office and other community facilities such as the riverfront are only a short walk away. Bus routes run nearby. Fees range from £421. Additional care needs may incur a further cost and this is discussed at assessment. Information about Penkett Lodge is available in the main entrance of the service. 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 visit was carried out over a period of one day. We arrived at Penkett Lodge at 10:15 and left at 18:10. During the day we spoke with five people who live in the home, one relative, six staff, the homeowner and the manager. The service completed a document known as an Annual Quality Assurance Assessment (AQAA). This documented is completed and sent to us by the service before we visit. The AQAA told us what Penkett Lodge believes they do well and what their plans are to increase the quality of the service. When we visited the home we looked at many of their records these included care records, staff records, menus and activities records, duty rota, staff training, policies and procedures. Information sent to us from the service and Social Services was also informed this visit. We sent surveys to staff and people living in the home we received Care Homes for Older People Page 6 of 27 two surveys from staff and two from people who living in Penkett Lodge. Comments from these are included in this visit report. What the care home does well: What has improved since the last inspection? What they could do better: Information available in the home although updated does not clearly detail the needs Care Homes for Older People Page 8 of 27 of people that the home can meet. Additionally there is no clear criteria in place that would help staff be aware of how to make sure that only individuals whose needs the home can meet are admitted. Care plans do not reflect the needs of the individuals living in the home and as such do not provide staff with clear guidance. This was mentioned on the last report, the manager takes responsibility for all care plans and this has lead to them not always being up to date. The manager discussed with us how she would involve all people who live in the home and staff in writing and keeping care plans up to date. If put into practice this will be good practice and mean that care plans will reflect peoples needs and provide staff with correct guidance. There is a format in place that does cover individual social needs and personal preferences. This was brief and did not contain sufficient detail to make sure that peoples preferences, choices and needs were recognised and used to influence the running of the home such as activities and meals available. There are a number of areas in the home that are in need or redecoration and refurbishment. It is not possible to determine what plans the home has in place to make sure that these areas are addressed in line with individual preferences. Medications management although improving is in need of further improvement, documentation needs to be clearer in order for the manager to be able to carry out audits (checks) to sure that medications are given correctly. Other records also need to be improved such as clear instructions in using items such as creams. without proper instructions staff run the risk of not giving these items correctly. There is no on-going quality arrangements in the service such as regular checks on medications, staff training, care plans, activities, meals and the environment that would identify the areas of development. Without regular quality checks the manager will not always be able to recognise areas that need to be developed to increase the quality of the service provided. 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 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. All the people who live in the home have an assessment done before they move in. This supports the staff to determine what the needs of individuals are and if the service can meet their needs. Evidence: The AQAA from Penkett Lodge told us A full assessments is always undertaken with prospective service users. The manager told us that she makes sure that assessments (looking at peoples needs) was available from all other people involved in the support or care of the individual. This included social services, families and the person themselves. The homes policy is available for assessments but is out of date and does not reflect the current practice. We looked at four assessments for people who live in the home done before the person moved in. These have continued to improved and have a section for mental health and social needs. Good assessments help the staff in the home help decide if they can meet the persons needs. Care Homes for Older People Page 11 of 27 Evidence: The home does have information about how they will deliver the services they provide. Copies of this were available for review in the foyer. We looked at the information in the service called the statement of purpose (information as to what services Penkett lodge provides|) and the service users guide (information to people as to how Penkett Lodge will deliver its services). We noticed that the information did not contain clear details as to the needs of individuals that the home can meet or the criteria of admittance. Without clear information both staff and individuals wishing to move in will not have clear information as to the needs that the service can meet. Discussions with the manager showed that the information was available in the home in different formats including larger print. Although the home does have individuals with visual impairment or need assistance with reading no different formats have been given to the people living in the home. This did not support individuals equality and diversity needs or make sure that information people needed was accessible to them. 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. Individual health and welfare care needs are meet by the staff team. Evidence: All of the people who live in the home are registered with local doctors of their choice. District nurses are contacted as appropriate for nursing care. Records regarding external professionals visits and instructions were available. This information was not always used to update the plans of care. External professional instructions need to be included in the care plans in order for the staff to be fully aware of how to meet medical needs. The AQAA for the service told us that care plans reviewed monthly. We looked at four care plans. All had been reviewed monthly in all cases information regarding changes of need had not been used to update the care plans. The manager explained that she currently does all care plans and finds it difficult to keep them all up to date. She is planning to train the senior staff and develop a simpler systems. These actions should help provide clear instructions to staff that are kept up to date. Several people needed external preparations the care plans did not mention the use of the cream and the medication administration records were unclear as to where and Care Homes for Older People Page 13 of 27 Evidence: how often creams were to be applied. Additionally there were no records on the medications records that detailed when creams had been used. We looked at whether people were receiving their medications as they should and noticed that the majority of people living in the home had their medications given to them correctly. One persons medications had been put aside to take later. This had not been dealt with correctly. The manager informed us that she would deal with this later and remind staff of the correct way to give medications. Medication management continues to improve. All staff giving out medications during the have received training. The manager has arrangements in place for homely remedies such as painkillers for a headache and has contacted relevant GPs to obtain their agreement. One individual deals with some of their medications themselves, a risk assessment was available that detailed to staff how they were to support the person safely. Discussions with the person showed that staff did not monitor the medications but they felt better supported to take their own medications. Observations of the staff during the day detailed that they did treat individuals with dignity. The majority of staff demonstrated a genuinely kind and caring attitude towards the people who live in the home. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A choice of activities and menus are supplied on a daily basis. The needs, personal choices and preferences of individuals living in the home are not used to determine the activities or the menus in place. Evidence: The AQAA told us that the home employs a dedicated activities co-ordinator. An activities co-ordinator works in the home six afternoons a week and delivers a variety of activities. Records from the co-ordinator showed a list of activities delivered to each individual. There was no programme available on display in the home that would inform people of what is available that day. The manager and the activities coordinator told us that activities are supplied depending on what people want to do that day. This practice whilst flexible to the needs of those who can say what they want does not meet the needs of people less able to express and opinion. The activities coordinator explained that she was booked to attend a course that would help her plan activities to meet the needs of those individuals less able to communicate. This training has not been put in place. The activities programme in operation is not taken from individuals expressed needs and is not available for them to review. Surveys from the home showed that the majority of the people who live in the home liked the activities in place. Two people living in the home did not think that activities in place Care Homes for Older People Page 15 of 27 Evidence: were for them. The main meal is served at lunchtime and the teatime meal has the option of a cooked snack as well as sandwiches and provides different choices for individuals. A blackboard is available to show people what choices are available at mealtimes. This is not always completed and this information is not available to people who do not choose to eat in the dinning room. The chef explained that the menu is not based on individuals expressed preferences and choices and there are no records available to determine this. The menus available do not detail specialised diets such as diabetic or weight lose programme. The chef say that both staff in the kitchen have now received training in this area and found this very useful. Individuals are asked what he or she would like for their meal on occasions this is not written down and used to determine individual preferences. The opportunity to determine exactly what people who live in the homes preferences were has not been taken. 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. People living in the home have confidence that their concerns would be taken seriously and proper action taken to resolve any issues. Evidence: Information on how to make a complaint in the home is available. The AQAA from the home told us the home has a complaints policy on display if a complaint is made it is logged. This is displayed in the entrance of the home. Surveys sent to the home show that all individuals living in the home felt that their concerns would be looked at and addressed. Those spoken with said that the staff were very lovely. One complaint has been made to us, this was reported to the manager. When we looked at records regarding complaints we noticed that none were available. All complaints need to be fully investigated under the services own policy and procedure and records kept to help with investigating complaints. All staff receive an training that covers serious concerns (Protection of Vulnerable Adults) and how to recognise and deal with issues. Staff spoken with confirmed that they were aware of the policy in the home and of how to raise their concerns. Staff spoken with were able to explain to us how serious concerns would be dealt with that would protect the people living in the home. Care Homes for Older People Page 17 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. People living in Penkett Lodge are able to have an environment that is reasonably maintained and adapted to help meet their needs. Evidence: The AQAA in the service told us that they need to develop an on-going maintenace plan. When we looked around Penkett Lodge we noticed that a number of araes had been redcorated such as the kitchen. A recent environmental health report had made recommendations the majority of which had been adressed. The service needed to replace fly screens on windows and doors into the kitchen. The laundry room was also viewed specific equipement to prevent cross-infection such as gloves and aprons could not be located. There are still araes of the home that need to redecorated including bare plaster in one bedroom and around the lift which has been replaced. The manager informed us that she intends to audit (check) the environment every month and make sure that maintenance araes are addressed. Individuals are encouraged to make their bedroom spaces their own and those bedrooms we viewed included personal items such as pictures, storage furniture and other furniture brought from peoples own homes. We spoke to one person who has moved rooms, they told us its a lovely room its much nicer, Im glad the manager sorted this for me. There are fifteen single bedrooms six double rooms. Of those double rooms viewed all had the facility to screen one bed from another Care Homes for Older People Page 18 of 27 Evidence: There is a dining room that has been re-arranged to provide people who live in the home easier access to dining facilities. There is one less table than used to be and this makes it easier to move around. Two different lounge areas are available for individuals to choose were to sit in, additionally personal bedrooms are available if people wish to see family in private. The staff support people who prefer to be in their bedrooms, by making sure they get their meals and drinks during the day. Care Homes for Older People Page 19 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff training and recruitment is not sufficient to meet the needs of the people living in the home. Evidence: The AQAA for the service told us, we have a stringent recruitment and vetting. We looked at staff files and noticed that not all staff had both references or an explanation of gaps in their working history. One staff member did not have a police check and was working on nights with one other member of staff. There was no records available that this person had worked supervised at all times. There was no record of a risk assessment in place. Another staff file viewed showed that the majority of staff were recruited appropriately, although another member of staff was in post before the police check was obtained and there was no evidence that they had received full induction. The guidance for police checks (CRB) states that the home can recruit staff without a police check in exceptional circumstances as long as the people in the home are protected. This protection includes a full induction, all references and supervision at all times until a police check is obtained. There is no evidence that the recruitment of the staff member was managed in a manner that safeguarded the people living in the home. The home has a training records in individual files that showed planned training for Care Homes for Older People Page 20 of 27 Evidence: staff. The amount of training in place has improved since the last site visit. On the day of the visit several staff were in attendance to speak to the assessor for a qualification they were undertaken, others were attending training in another home. It was difficult to identify from the staff records what training staff had received. A number of gaps in staff training were identified. Staff have all received medications training and this is an improvement from previous visits. It was not possible to identify that all staff were up to date with their training or that they had received training specific to the needs of people living in the home. The manager assured us that there were staff that needed training updating and arrangements were in place for them to receive this in the next few weeks. She also discussed developing a training plan that would identify when staff had received training and when it was due. Due to the fact that there are less people living in the home at the moment the owner has reduced the number of care staff. Staff spoken with and people living in the home all said that in their opinion there was enough staff. Comments from the staff included a good team. People who live in the home said, staff are great and they are always happy to help. Care Homes for Older People Page 21 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. A quality system has been implemented that makes sure that the manager can identify areas of development and plan how to increase the quality of the service provided. Evidence: The manager is not registered with us but was due to attend an interview the day after this visit took place. At this visit it was clear that the manager assessed all individuals, wrote and renewed all care plans, supervised staff and maintained all the administrative work. This meant that on several occasions she was working above and beyond her allocated hours and was not always able to commit fully to her role as a manager. This has reflected in some areas of quality in the home, such as keeping care plans up to date. Areas have increased in quality such as a greater choice over meals, management of medications and redevelopment of the assessments.The manager is intending to review the quality of the service provided and to make sure that an action plan is in place to develop the quality. The service undertook an external quality assurance process know as residential domiciliary benchmarking Care Homes for Older People Page 22 of 27 Evidence: (RDB). Surveys were sent to people living in the home and comments were generally very positive. At present there has been no on-going quality audits (checks), such as medicines, staff training, staff files, care planning and environment. This has lead to some areas not being addressed. Staff spoken with said that morale in the home was very good and that the manager organised the home in a good way. They all said that they found her supportive and keen to improve the quality of the home. The majority of staff have undertaken training in health and safety and arrangements are in place to make sure that the rest of the staff also have the appropriate training. There are several areas of health and safety that need to be developed such as appropriate risk assessments for all individuals. This includes areas such as nutritional assessments which are not fully developed to highlight issues. The manager told us that she would be looking at a system know as MUST to help in this area. The home managers personal allowances for individuals as requested. Receipts are kept for all spending and records are available that detail how the money has been spent. Some individuals take all their own funds and manage this themselves, others instruct the manager as to how they want their money managed and which bank account they prefer their money to be in. Funds can only be accessed when the manager is on duty and this will not support people who may wish to access their funds at other times. date Care Homes for Older People Page 23 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 24 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 1 9 13 All medications need to have 22/07/2009 clear instructions availiable including external preperations, supplementary foods and handwritten instructions. This is done in order to make sure that staff give out medications correctly. 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 Update the statement of purpose and service users guide to include clear information about the service. This needs to include a clear criteria for admission into the home. The manager needs to make sure that all care plans reflect changes in peoples needs as they occur. Audits on medications for such araes as written instructions, understanding of staff, logging in the correct amount into the home and other araes as discussed with manager would help maintain good practice. Activities and menus need to be developed from people Page 25 of 27 2 3 7 9 4 12 Care Homes for Older People 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 who live in the homes, choices, preferences and needs. Opportunities to determine and give people choices needs to be developed in-line with their individual equality and diversity needs. 5 16 All complaints received by the service need to have a full investigation record available that shows how the concerns were addressed and any actions necessary taken to resolve these concerns. Were staff are recruited with a police check they need to have full references (two validated), full induction, PoVA first check and work supervised at all times. A system that easily identifies what training staff have received and what is due needs to be in place in order that the manager can monitor this at all times. The manager needs to undertake regular on-going audits on practice in the service to make sure that standards are maintained. 6 27 7 27 8 33 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. 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