Care Home: Prior Bank House

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What the care home does well The People who may wish to use the services of Prior Bank House are able to get copies of the service user guide to find out about the home and therefore able to make an informed decision. The staff put into practice the principles of respect, dignity and privacy whilst caring for the people at the home. The people are involved in decisions about their lives, and they are encouraged by the staff to have an active role in planning the care and support they receive. People who use the service are able to express their concerns to the management and they have access to a complaints procedure, which was available at the entrance. The home has policies to protect people from abuse and promote their rights. The physical design and layout of the home enables people who use the service to live in a safe environment, which encourages independence. The care staff are trained and skilled to carry out their jobs. The management and administration of the home is based on respect . What has improved since the last inspection? The maintenance of the building has improved. An activities co-ordinator has been employed. What the care home could do better: These are the requirements and recommendations that we have made to improve the service and ensure compliance with the Care Home Regulations. The service user plans must set out in detail the action which needs to be taken to ensure all aspects of health, personal and social care needs are met. So that the people living at the home are set to receive appropriate care. The management must review the care practices at the home and ensure that the care staff follow advice from the community health care professionals. e.g. continence care. This will help care staff meet the assessed needs of the people living at the home. The pharmacy audit results must be shared with staff who handle medication. The staff must take action on the findings of the pharmacy audits to maintain safe administration of medicine at the home. The manager must make sure that the people living at the home are given opportunities for stimulation through leisure and recreational activities in and outside the home. So that the peoples` needs, preferences and capacities are taken into account. Particular consideration needs to be given to those with dementia, sensory impairment and those with physical disability due to old age. All allegations and incidents of abuse to service users or the staff must be followed up promptly by the management at the home. The management have a duty of care not only towards the people living at the home but also to the staff who work at the home. The management must ensure that as part of continence management appropriate floor covering is provided in the individual bedrooms. So that all bedrooms are clean and smell fresh. Ensuring people who occupy the rooms are comfortable. The management should ensure that the home has an adequate number of washing machines which are fit for the purpose of providing clean laundry. Staffing numbers need to reflect the dependency levels of the people, their assessed needs and the layout of the home. So that service users` needs are met by the number of staff working during each shift. The quality assurance system at the home needs to include continuous self-monitoring and seeking the views of people living and working at the home. The results from the surveys and self-monitoring will help the management find out whether the home is run in the best interest of the service users. Monthly visits by the provider need to produce reports (Regulation 26) on the findings. The manager needs to produce an action plan outlining how the improvement was to be carried out. It is expected that progress would be checked by the provider in their subsequent visits. The records did not evidence this. All staff need to be competent and receive regular updates and training of safe working practices such as moving & handling, health & safety, first aid, adult protection and infection control. So that the manager can ensure safety and wellbeing of the service users and the staff. Key inspection report Care homes for older people Name: Address: Prior Bank House 74 Cherry Tree Road Sheffield South Yorkshire S11 9AB     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Marina Warwicker     Date: 0 8 0 5 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC 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 28 Information about the care home Name of care home: Address: Prior Bank House 74 Cherry Tree Road Sheffield South Yorkshire S11 9AB 01142552115 01142550477 jackie.coulson@anchor.org.uk www.anchor.org.uk Anchor Trust Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Jane Debra Wood Type of registration: Number of places registered: care home 32 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Prior Bank House provides personal care for a maximum of thirty-two older people. It is part of a group of care homes operated by Anchor Trust. Prior Bank House is an adapted Victorian house surrounded by mature garden and woodland. It is situated in the residential area of Nether Edge in Sheffield. On the ground floor there are communal areas such as lounges, dining areas and a conservatory. In addition there are service areas and fourteen bedrooms. On the first floor are the remaining eighteen bedrooms. There is a lift for people to use when accessing the first floor. Fee was 446 GBP per week during our visit. There were additional charges for hairdressing, chiropody, toiletries, papers and magazines. Care Homes for Older People Page 4 of 28 0 Over 65 32 Brief description of the care home Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The quality rating for this service is 1 star. This means that the people who use this service experience adequate quality outcomes. An inspection of this care home was carried out on Thursday 7th May between 9:30am and 3:30pm and Friday 8th May between 1:30 pm and 4pm 2009. We made the second visit since we were unable to check some details due to the manager not being present. The staff, the management, the people using the service or the visitors were not Care Homes for Older People Page 6 of 28 informed of our first visit and therefore it was unexpected. Nine people who use the service and one visitor were consulted on the day. We also spoke with seven staff that were on duty. Time was also spent observing and chatting with staff and the people using the service. The management, which included the registered manager and the operations manager were present during the second visit. We informed them of our findings which helped both parties to verify some issues. The premise was inspected, which included bedrooms of people using the service and communal areas. Private areas were accessed with the permission of the people and/or the staff at the home so that we respected the peoples wishes. Samples of records such as the care plans, staff recruitment and training files were checked. We would like to thank the people who live at Prior Bank House, their relatives, the staff who took part and the management for their contribution towards this process. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: These are the requirements and recommendations that we have made to improve the service and ensure compliance with the Care Home Regulations. The service user plans must set out in detail the action which needs to be taken to ensure all aspects of health, personal and social care needs are met. So that the people living at the home are set to receive appropriate care. The management must review the care practices at the home and ensure that the care staff follow advice from the community health care professionals. e.g. continence care. This will help care staff meet the assessed needs of the people living at the home. The pharmacy audit results must be shared with staff who handle medication. The staff must take action on the findings of the pharmacy audits to maintain safe administration of medicine at the home. The manager must make sure that the people living at the home are given opportunities for stimulation through leisure and recreational activities in and outside the home. So that the peoples needs, preferences and capacities are taken into account. Particular consideration needs to be given to those with dementia, sensory impairment and those with physical disability due to old age. All allegations and incidents of abuse to service users or the staff must be followed up promptly by the management at the home. The management have a duty of care not only towards the people living at the home but also to the staff who work at the home. The management must ensure that as part of continence management appropriate floor covering is provided in the individual bedrooms. So that all bedrooms are clean and smell fresh. Ensuring people who occupy the rooms are comfortable. Care Homes for Older People Page 8 of 28 The management should ensure that the home has an adequate number of washing machines which are fit for the purpose of providing clean laundry. Staffing numbers need to reflect the dependency levels of the people, their assessed needs and the layout of the home. So that service users needs are met by the number of staff working during each shift. The quality assurance system at the home needs to include continuous self-monitoring and seeking the views of people living and working at the home. The results from the surveys and self-monitoring will help the management find out whether the home is run in the best interest of the service users. Monthly visits by the provider need to produce reports (Regulation 26) on the findings. The manager needs to produce an action plan outlining how the improvement was to be carried out. It is expected that progress would be checked by the provider in their subsequent visits. The records did not evidence this. All staff need to be competent and receive regular updates and training of safe working practices such as moving & handling, health & safety, first aid, adult protection and infection control. So that the manager can ensure safety and wellbeing of the service users and the staff. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 28 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 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who may wish to use the services of Prior Bank House have the information they need to make an informed decision about the home. Evidence: During the tour of the premise we noted copies of the service user guide in most bedrooms enabling people to find out about the home. It had been identified at the monthly provider audit that the information needed to be updated to reflect the changes and the changing needs of the people living at the home. Our findings confirmed this. We checked four contracts belonging to residents and the needs assessments from the placing authorities. The contracts were agreed and signed by both the provider and the service user or their representative. In most cases the home had not received the care managers assessments from the placing authorities; but the manager at the home had carried out assessments prior to admission and the information had been Care Homes for Older People Page 11 of 28 Evidence: used to plan the care for individuals. Service users we spoke with said that their families had visited the home and chose the home for them. One person said, My daughter said that this was the only home which smelt clean & fresh when she visited. Another said, We received some good recommendations from relatives of people who used to live here. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is not always based on their individual needs. The staff in general put into practice the principles of respect, dignity and privacy whilst working at the home. Some individuals are involved in decisions about their lives, and they are encouraged by the staff to have an active role in planning the care and support they receive. Evidence: Three care plans were checked. The care plans did not set out detailed action which needed to be taken by the care staff to ensure that all aspects of the health, personal and social care needs were to be met. These were some of our findings. A service user had diabetes which was controlled by diet and tablets. This was not mentioned in the care plan and the plan did not identify the needs relating to the condition and how the staff were to support the individual. We also checked the file of a service user who was incontinent. The continence specialist assesment and the recommended action to address the incontinence was not specified in the care plan. The information from the advisor was kept separately Care Homes for Older People Page 13 of 28 Evidence: from the care plan and therefore not easily accessible to people who were caring for the person. We were informed by the care staff that service users who used pads during the day were cared for on Kylees (a sheet protecting the bedlinen from getting soiled) at night times. This practice is not acceptable and we instructed the manager to investigate this. The lack of appropriate assessments of peoples mobility and therefore not seeking advice from the community specialist has resulted in several falls by the service users. Direct observation of service users higlighted that several service users needed aids and support when mobilising. To maintain independence these people needed assessments and provision of mobility aids. One of the Team leaders said that medication was checked and ordered by him/her. The home used medication supplied by the pharmacy and the pharmacist had carried out three monthly i.e. quartely audits. We had access to these audits on the second day of our visit. The management could not evidence that they had taken action on areas for improvement and there was no system in place to monitor compliance. The manager was made aware of this. During our visit we observed the care staff speaking to service users with respect and they were friendly and helpful. These are some comments we received from the people who live at the home. The staff will do anything for us. They are very kind. Its a good staff team and they are generally very good in helping me if I want anything. I am happy with the care I get from these girls. The carers we spoke with said that they have had experience looking after people who were at the end of life and supporting their families. The manager said that the staff received formal Palliative Care training. Care Homes for Older People Page 14 of 28 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. The people who use services are on the whole able to make choices about their life style, and receive support to maintain their life skills. Social, cultural and recreational activities in general did not meet the individuals preferences, capacity and expectations. Evidence: On the first day of our visit the people at the home did not have any activites. They looked bored and many were sleeping between mealtimes. However, on our second visit we noticed the activities person reading to a group of service users. We were informed by the manager that they had not had an activities person for sometime and that the present activities co-ordinator started work recently. There were records kept of activites and those who took part in them. The role of the activities person and the responsibilities of the key workers need to be explored so that more time could be allocated to activities. These were some comments we received with regards to this outcome area. I like reading and watching some TV programmes. But rest of the day there is very little I could do. I like to go out. That is not always possible. Staff are busy with their work. When I have visitors staff are very good and offer them a drink and make Care Homes for Older People Page 15 of 28 Evidence: them welcome. When the activities person is around we get to do things, but s/he cant be here all the time. My family visit me and I get to see people. I am happy here. We saw visitors entering the home and chatting with people in their own rooms or in the communal areas. There was no restriction on visitors. We were informed that personal finances were handled either by the service users or their relatives. We saw people having breakfast and dinner. There was a choice of meals available to people. The food looked appetising, appealing and was served as attractive portions. Five people said how much they enjoyed the meals and praised the quality of cooked food at the home. We witnessed staff helping people and giving people plenty of time to finish each course. The cook was present at mealtime and received comments from the people about the choice of food served. We had lunch at the home and it was tasty and we were offered a choice too. Care Homes for Older People Page 16 of 28 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 who use the service are able to express their concerns to the management. The people have access to a complaints procedure, which is available at the entrance. The home has policies to protect people from abuse and promote their rights. Evidence: A record was kept by the manager of the complaints and the outcome of the investigations. The care staff said that they knew what to do if a complaint was raised by a service user or the visitors to the home. Two people living at the home said that if they were not happy they would talk to the Team Leaders and they knew them by their names. Three care staff knew what to do if they were informed of any abusive situation. They said that they had attended training on Protection of Vulnerable Adults. The manager said that there had not been any referrals made to the Local Authority Safeguarding team in the last 12 months. However, we noticed one instance where a referral should have been made. We discussed this with the manager. Care Homes for Older People Page 17 of 28 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. The physical design and layout of the home enables people who use the service to live in a safe environment, which encourages independence. Evidence: A tour of the premise which included bedrooms, communal areas and service areas. The handy person said that there was a programme of maintenance and redecoration which was ongoing. We saw bedrooms being redecorated and carpets renewed. Although the premise was generally clean some bedrooms smelt of urine and we were informed that the people who occupied the rooms suffered with incontinence. (Further information under section Health and Personal Care). The care staff said that there were hoists and aids to help people with moving & handling. There were grab rails to aid people mobilise. The laundry facilities were sited at the home. We were informed that due to the increased dependency levels of the service users and the number of people who have become incontinent, the amount of washing had increased and that they require additional washing machines to complete the washing within the set times. Care Homes for Older People Page 18 of 28 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. The care staff in the main, are trained and skilled to carry out their jobs. The number of staff during each shift need to be sufficient to support the people who use the service and promote the smooth running of the service. Evidence: We spoke with staff and observed them at work. On the second day we checked the training and recruitment files of three staff. We asked the people living at the home and their relatives of their opinion of the service. The staff on duty on the first day of our site visit said that they were one staff short and that the manager, the deputy and the administrator were out at meetings. The acting team leader was left in charge. S/he said that it was too much to take on without support. The staff informed us that due to the occupancy levels at the home staffing levels had been adjusted by the manager and that there had not been any recognition of the increased dependency level of the service users who were at the home. Later that morning a Team leader who was off duty was summoned by the manager (who was away from the home) to work so that the staff received support. Service users occupied two floors and there were 26 people requiring service. Three Care Homes for Older People Page 19 of 28 Evidence: care staff were not adequate for the dependency levels of the people. We witnessed people having to Wait from 7 to 10 minutes before the staff attended to the calls. The team leader was administering medication, as well as being in charge of the home attending to visitors and answering the phone calls. Three staff files were checked on our second visit. The information in the files complied with the regulations. The manager informed us that care staff were given opportunities to train and develop and that Staff supervision helped this. Care Homes for Older People Page 20 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on respect . The validity of the quality assurance systems needs to be reviewed so that improvements are evaluated and staff roles and responsibilities are transparent and fit for the purpose of the home. Evidence: The manager is an experienced nurse and has had management experience. She became the manager of Prior Bank in June 2008. The present staff structure at the home has created confusion to those who live and visit the home. Some people referred to the team leader as the manager. One relative was not sure of the staff structure. Staff said that they were worried about the responsibilities they have been given and that they were unable to fulfill them. The team consisted of the manager, the deputy manager, heads of departments, team leaders, acting Team leaders, care staff and domestic staff. Care Homes for Older People Page 21 of 28 Evidence: We received comments that there were too many managers and the teams were pulled in different directions. We observed this during our visits and shared our concerns with the manager and the operations manager. The manager said that they had yearly quality assurance by the company audits but she was unable to locate the outcome for the last year. There had been a staff meeting held by the retired deputy manager however there had not been any since January this year. There had been monthly heads of department meetings held by the manager and records have been maintained. Several staff mentioned that there was a lack of communication between the manager and the workers. They said that decisions were made at the heads of department meetings and the information was not passed on to the workers and that the staff only found out when they had done something wrong. They gave us some examples to illustrate the poor communication between the management and the workers. The operations manager said that s/he had visited the home every month but had not prepared a report on his/her findings each time. We had access to two reports from January and April 2009. We were unable to establish the people and the staff who had been consulted during the visits and the monitoring of the action points from the previous visit. We shared this at the feedback. Staff said that they received supervision and that the team leaders were supportive. The policy on incident reporting needed to be reviewed. Once an incident has been notified the manager needs to identify the cause and ensure action is taken to reduce the risk of the same incident reoccurring. These were not clearly documented in the regulation 37, Notification of events. The manager and the operations manager were made aware of this. Three staff training files were checked. One senior member of staff needed to improve his/her attendance at the mandatory training. Care Homes for Older People Page 22 of 28 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 23 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 12 The service user plans must set out in detail the action which needs to be taken to ensure all aspects of health, personal and social care needs are to be met. So that the people living at the home are able to receive appropriate care. 02/07/2009 2 8 13 The management must review the care practices at the home and ensure the care staff follow advice from the community health care professionals. e.g. continence care. This will help care staff meet the assessed needs of the people living at the home. 02/07/2009 3 9 13 The management must ensure the safe handling and management of medication. The pharmacy audits must 02/07/2009 Care Homes for Older People Page 24 of 28 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 be shared with staff who handle medication. The staff must take action on the oucome of the pharmacy audits to maintain safe administration of medicine at the home. 4 12 14 The manager must ensure that the people living at the home are given opportunities for stimulation through leisure and recreational activities in and outside the home. So that the peoples needs, preferences and capacities are taken into account. Particular consideration must be given to those with dementia, sensory impairement and those with physical disability due to old age. 5 18 12 All allegations and incidents of abuse to service users or the staff must be followed up promptly by the management at the home. The management have a duty of care not only towards the people living at the home but also by the staff who work at the home. 02/07/2009 02/07/2009 Care Homes for Older People Page 25 of 28 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 6 24 23 The management must ensure that people with incontinence receive the correct support and the flooring in the bedrooms must be replace to suit the needs of the people. So that all bedrooms are clean and smell fresh. Ensuring people who occupy the rooms are safe and comfortable. 11/07/2009 7 27 18 Staffing numbers must be appropriate to the up to date assessed needs of the service users and the layout of the home. So that service users needs are met by the number of staff working on each shift. 11/07/2009 8 33 24 The quality assurance system at the home must include continuous selfmonitoring and seeking the views of people living and working at the home. Monthly visit reports by the provider, action plan by the manager and the outcome from the action need to be evidenced. The results from the surveys and self-monitoring will help the management to find out 11/07/2009 Care Homes for Older People Page 26 of 28 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 whether the home is run in the best interest of the service users. 9 38 13 All staff must be competent 11/07/2009 and receive regular updates/ training at safe working practices such as moving & handling, health & safety, first aid, adult protection and infection control. So that the manager can ensure safety and wellbeing of the service users and the staff. 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 The service user guide should be updated and should include the qualifications and experience of staff to reflect the changing needs of the people who live at the home and the views of the service users who live at the home to support the running of service. The management of the home should make every effort to obtain a summary of the care management assessment from the placing authorities e.g.social, health authorities before admitting the service user. The management should ensure that the home has an adequate number of laundry equipment for its needs. 2 3 3 26 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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