Care Home: Pymgate House

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What the care home does well Pymgate House provides a comfortable and homely environment for people to live in. Staff are warm, friendly and welcoming and are proud of the fact that many of them have worked at the home for many years, creating a very stable staff team that know each person they are caring for extremely well. There was an affectionate and respectful relationship between staff and the people living at the home and everyone we spoke to said they were very happy with the care they received. Comments included "I love it here. I am very very happy, it is the best of both worlds" and "Absolutely brilliant. X looks so well and she says she gets lovely meals. When she first came in she said she didn`t want a lot to eat but now she is eating really well. Pat (the manager) is really helpful and staff are so friendly. X is happy here and has made friends. I would give it 123/100. We can`t thank Pat enough. It`s made a big difference to X`s life". Another person told us "I`m better off than the Queen". We spoke with a district nurse that was visiting the home and she told us that staff were quick to ask for advice if they had concerns about someone and conscientiously followed any instructions that were given to meet peoples` health care needs. People said they liked the food provided at the home and the menus showed a good variety of dishes were served over a 4 week period. The owner/manager lives on the premises and said she was available the majority of the time for people to speak to. People were confident in her abilities and said she was approachable and always ready to listen to them. The home was clean and tidy and there were no bad smells. In the AQAA the manager reported that 71% of the staff had successfully completed National Vocational Qualifications (NVQ). This qualification is obtained following training in providing personal care. This meant that staff had a good basic knowledge of the care they needed to provide and the reasons such care was needed. What has improved since the last inspection? Since the last inspection the manager had appointed someone to cook the midday meal and staff told us this had given them more time to spend with people living at the home and they were able to encourage conversation and help people enjoy social interests such as playing board games or cards. The range of social activities had increased a little from the last inspection, with an entertainer coming to the home on a weekly basis to sing or organise quizzes. The manager confirmed that requirements made by the fire service prior to our last inspection had been acted on. What the care home could do better: Although people were cared for very well and said they were extremely happy living at the home, the manager acknowledged that record keeping was a weak area that doesneed further work. Pre admission assessments, care plans and risk assessments need to be more detailed so that an accurate record of the care required and given is available. Recruitment procedures were generally satisfactory but the manager must make sure that any gaps in peoples` employment histories are explained and recorded. Although people told us they regularly saw and spoke with the manager, better records of how the manager uses feedback to continue developing the service would demonstrate that quality assurance and monitoring systems were in place. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Pymgate House 149 Styal Road Heald Green Stockport Cheshire SK8 3TG     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: Fiona Bryan     Date: 0 8 0 7 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 28 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 28 Information about the care home Name of care home: Address: Pymgate House 149 Styal Road Heald Green Stockport Cheshire SK8 3TG 01614371960 01614989645 patfox@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Brian Fox,Mrs Patricia Fox care home 12 Number of places (if applicable): Under 65 Over 65 0 12 mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: 12 0 The registered person may provide the following category/ies 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, Mental disorder, excluding learning disability or dementia - Code MD, The maximum number of service users who can be accommodated is: 12 Date of last inspection Brief description of the care home Pymgate House is situated in the Heald Green area of Stockport. It is a large detached house set in its own grounds. The property dates back to the 1770s, and much of its original character has been retained. Pymgate House is registered to provide accommodation for up to twelve older people, including those who may be suffering from a mental disorder. The registered providers Care Homes for Older People Page 4 of 28 Brief description of the care home of Pymgate House are Mr Brian Fox and Mrs Patricia Fox, who live on the premises. Mrs Fox is actively involved in the day to day running of the home and is the registered manager. Accommodation includes eight single bedrooms and two double bedrooms, one main lounge and a small sitting area off the main lounge and a separate dining room. There are two bathrooms, one on the ground floor, which has a bath hoist to assist service users and a shower. The bathroom on the first floor also has a shower facility. There is a stair lift to assist service users to their bedrooms on the first floor. The home operates a non-smoking policy for service users, visitors and staff. There is a large car park to the front of the house and extensive gardens with a decked area to the rear of the property. The home has three dogs and a parrot. Two of the dogs are registered as pat-dogs. Fees for accommodation and care at the home vary between £327 and £340 per week. A service user guide is available on request. 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: 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: This key unannounced inspection, which included a visit to the home, took place on Wednesday 8th July 2009. The staff at the home did not know that this visit was going to take place. All the key standards were assessed at the site visit and information was taken from various sources, which included observing care practices and talking with people that lived at the home, their visitors, the manager and other members of the staff team. Key standards refers to those standards we feel are particularly important in ensuring the health, safety, welfare and quality of life of people living at the home. The care and services provided to two people were looked at in detail, looking at their Care Homes for Older People Page 6 of 28 experience of the home from their admission to the present day. A selection of staff and care records was examined, including medication records, training records and staff duty rotas. Before the inspection, we asked for surveys to be sent out to people living at the home and one person responded. We also sent surveys to staff and five were returned. Comments from these surveys are included in the report. We also asked the manager of the home to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This helps us to determine if the management of the home see the service they provide the same way that we see the service. The manager completed the form quite well and we discussed ways in which she could give us further evidence of improvements to the service the next time we request an AQAA. What the care home does well: What has improved since the last inspection? What they could do better: Although people were cared for very well and said they were extremely happy living at the home, the manager acknowledged that record keeping was a weak area that does Care Homes for Older People Page 8 of 28 need further work. Pre admission assessments, care plans and risk assessments need to be more detailed so that an accurate record of the care required and given is available. Recruitment procedures were generally satisfactory but the manager must make sure that any gaps in peoples employment histories are explained and recorded. Although people told us they regularly saw and spoke with the manager, better records of how the manager uses feedback to continue developing the service would demonstrate that quality assurance and monitoring systems were in place. 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 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given accurate information about the home so they can make a decision about if they want to live there. Evidence: Information about the home was provided in a statement of purpose and service user guide which were displayed in the reception area of the home. The information had been updated since the last inspection to show that accommodation could be provided for another 2 people. One person told us she had been to visit the home before she decided to move there and had been told all about it by the manager. The information she had been given had proven to be an accurate reflection of the services offered at the home. We looked in detail at the care provided to two people living at the home. As at the last inspection full assessment information was not available in a written format for Care Homes for Older People Page 11 of 28 Evidence: either of the two people. However, one of the carers told us that when someone new is admitted to the home the manager or the deputy manager liaise with any relevant health or social care professionals and with the person themselves, or their representatives and then pass that information to the rest of the staff. In this way staff are aware of the reason someone has been admitted to the home and the care they need to provide. It is however recommended that a more formal system for recording the information obtained during the assessment process is developed. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although record keeping is weak, strong links with other health care professionals and good follow up on the part of staff in responding to advice and instructions mean that peoples health and personal care needs are met in a way that respects their privacy and dignity. Evidence: None of the people that are assessed as being suitable to live at Pymgate House have very complex needs and most have a fair degree of independence. Anyone with a higher level of care needs would not be able to live at this home because it would be assessed that their needs would be unable to be met, due to the physical layout of the building and the amount of aids and equipment provided at the home etc. We looked at the care provided to 2 people in detail. Each person had a care plan that generally covered the main aspects of personal, health and social care although in a very basic way. Because peoples care needs were generally quite minimal the amount of information in the care plans was enough to tell the reader what help was required. Care Homes for Older People Page 13 of 28 Evidence: We noticed that some parts of the pre-printed care plans were not completed for one person and the manager said this was because no problems had been identified in those areas. It is recommended that all sections of the care plan are completed, even if it is only stating that there are currently no problems, so that it is clear that this is the case and it isnt that sections have been missed out. Risk assessments were also very limited although this did not appear to have any impact on the delivery of care for people due to the small numbers of people being cared for and the very stable and long standing staff team that knew and understood the people they are caring for very well. The deputy manager told us she was planning to buy some training material, some of which was about care planning and risk assessment and this would be very beneficial to staff to give more direction as to the type and amount of information that should ideally be included in peoples care files. All the people living at the home appeared well cared for, clean, tidy, comfortable and relaxed. We spoke with several people living at the home and several visitors and they were all extremely positive about the care they or their relatives received. Comments included, I love it here. I am very very happy, it is the best of both worlds and Absolutely brilliant. X looks so well and she says she gets lovely meals. When she first came in she said she didnt want a lot to eat but now she is eating really well. Pat (the manager) is really helpful and staff are so friendly. X is happy here and has made friends. I would give it 123/100. We cant thank Pat enough. Its made a big difference to Xs life. We spoke with a health care professional that was visiting the home to attend to several of her patients. We were told that staff listened and followed their instructions and would always liaise and ask for advice if they were unsure about anything. The health care professional told us a couple of people had died over recent months so staff had been involved in end of life care and in her opinion they had managed it very well and delivered a high level of care. This person commented that people living at the home always seemed happy and staff were very pleasant and helpful. She concluded by saying she had no concerns at all about the standard of care being provided to people. The manager has established a system with the local GP where he visits the home once a month and reviews each person living there. We looked at how medicines were managed for a small number of people and found Care Homes for Older People Page 14 of 28 Evidence: that systems were generally satisfactory. It was recommended that the manager sought advice from her pharmacist to ensure that the controlled drugs cupboard met the legal specifications required. Care Homes for Older People Page 15 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. People had choice and support to meet their expectations and preferences regarding their daily lifestyle. Evidence: Since the last inspection the manager has increased the opportunities for providing social stimulation by increasing staffing levels so staff have more time to spend with people and staff reported that this was working well. People told us that routines in the home were flexible. One person told us they had breakfast in bed and took their time getting up, another said she liked to have breakfast in the dining room in her dressing gown and then spend some time in her own room before getting dressed. A number of people regularly went out with friends or family and said they could come and go as they wished and meals would be saved for them if they were going to miss a mealtime. An entertainer visits the home weekly and people said they enjoyed taking part in quizzes and singsongs. Individual interests were encouraged, for example one person enjoyed drawing and reading magazines and we noticed that paper and felt tip pens Care Homes for Older People Page 16 of 28 Evidence: were placed close at hand together with the persons favourite magazines. People also told us about children having visited from the local school, which they really enjoyed and the manager had several videos that people liked to watch with archive footage of Stockport and Manchester; these resources were used as an aid for reminiscence sessions. A visitor told us that he saw staff playing cards and dominoes with people and that when he visited the previous week everyone was out in the garden really enjoying themselves. The manager has 2 dogs and a parrot that are a much loved part of the home. Most people told us the food provided at the home was very good (only one person was less enthusiastic, saying it was not always great, but not too bad). The main meal of the day was served at lunchtime and the menus showed a good variety of dishes were offered. Although no second choice was formally provided on the menu, people told us that if they did not like what was being served that day they could request an alternative. On the day we visited one person did not like bananas and custard, which was the dessert at lunchtime and was therefore offered treacle sponge instead. The manager said she had just introduced a system where one person each day could choose something they especially wanted for tea. Everyone else could also have this choice if they wished or they could opt for the meal already on the menu. Since the last inspection three smaller dining tables have replaced the one large dining table that was previously provided, presenting a cosier setting for people to sit in smaller groups and chat over their meals. The dining room was homely and comfortable with large bookshelves filled with books and a CD player and collection of Cds. When we visited lunch was served at 12.30pm and consisted of minestrone soup, lamb chops, mashed potato, carrots, broccoli, mint sauce and gravy. Everyone said it was very tasty. Care Homes for Older People Page 17 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. There is an open culture in the home where concerns can be raised and freely discussed so people feel confident they will be listened to. Evidence: The complaints procedure is kept in the reception area of the home and forms are provided for anyone wishing to make a formal complaint. The manager had received no complaints since the last inspection and we have not been made aware of any complaints about the home. People we spoke to said they felt they would be able to raise any concerns should they need to do so and were confident that the manager would deal with them appropriately. The manager is in the home the majority of the time and lives on the premises and is therefore constantly in touch with everyone living at the home and their friends and families. A great deal of confidence was shown in the manager in the remarks made to us, which included it is absolutely great and all the staff are lovely and Pat is wonderful. All the staff give you a cuddle and that makes you feel you belong and are part of it all. Staff we spoke to were aware of the procedures to follow if they suspected someone was a risk of harm or abuse and it was reported that 4 staff had been nominated to attend training in July 2009 about Safeguarding Adults run by Stockport Local Care Homes for Older People Page 18 of 28 Evidence: Authority. The manager said that all staff would attend this training as places became available. The manager had received some information about the Mental Capacity Act Deprivation of Liberty Safeguards and was awaiting information about when training about this was available so she could arrange for staff to attend. At the present time no one in the home was subject to an application made under these requirements. It was recommended at the last inspection that the manager ensured policies and procedures for safeguarding adults were made more accessible in the home so staff could use them for reference. The manager had not acted on this recommendation but took steps while we were at the home to rectify this. Care Homes for Older People Page 19 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A clean, pleasant and comfortable environment is provided Evidence: A partial tour of the home was undertaken. Since the last inspection 2 additional bedrooms have been provided and the home is now registered to provide care for up to 12 people. The home was clean and smelled fresh. A health care professional who visited the home regularly commented that the home always smelled clean. The grounds of the home were well kept and attractive. The lounge and dining room were an open plan design that facilitated residents chatting and socialising together. An additional small sitting area was available for residents to entertain visitors or sit quietly if they wished. Since the last inspection three smaller dining tables have replaced the large dining table. This has provided opportunity for people to engage in conversation in smaller groups at mealtimes. A number of residents rooms were seen. These were homely and personalised with ornaments, furniture and mementos. With peoples permission some of their Care Homes for Older People Page 20 of 28 Evidence: possessions were used for everyone in the home, for example one person had a tea set that belonged to her mother and staff used it to serve drinks after lunch. Staff were very careful with the china and people enjoyed and took pleasure in having and using possessions that meant something to them. Basic aids such as raised toilet seats and grab rails were provided, although the home does not have aids designed for people with high physical disabilities. The first floor is accessed by a stair lift as there is no passenger lift. The manager confirmed that all the actions required following the last inspection by the Fire Service had been complied with. Care Homes for Older People Page 21 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive care and support from staff who have the skills to support them correctly. Evidence: Since the last inspection a person has been appointed to work from 11am until 2pm six days a week for the purpose of cooking the midday meal. Previously the care staff undertook this task as part of their morning duties but did tell us at our last inspection that they sometimes felt this left them with little time to spend with people living at the home. Staff said the extra help had made a big impact on the amount of time they spent with people, which they used to encourage conversation and provide additional social activities. Without exception everyone we spoke to said they felt staff were extremely good and helpful and understood their care needs well. Since the last inspection the deputy manager has started to develop a staff training file with records of what training staff have undertaken and when refresher training is due. The deputy manager planned to access more training materials in the form of DVDs that covered a wide range of topics and it is recommended that this is implemented as soon as possible. Staff had undertaken some training since the last inspection. The Care Homes for Older People Page 22 of 28 Evidence: deputy manager had qualified to deliver training in moving and handling and all staff had received updates. Some staff had completed a distance learning course in the management of medicines. In the AQAA it was reported that 71 of care staff had successfully completed NVQs. We looked at the personnel file for one member of staff that had started working at the home since our last inspection. Criminal record checks had been made and references had been obtained, although the reference from the persons last employer was not written by the general manager but by the applicants direct senior. References should be obtained from the most senior person in the organisations structure. An employment history had been provided on the persons application form but there were some gaps for which there was no written explanation. The manager should make sure that any gaps in employment history are explored and recorded. Care Homes for Older People Page 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Pymgate House is being run in the best interests of people who live there and their welfare is promoted and protected. Evidence: The registered manager does not hold a relevant qualification in care. She is an experienced carer and has held the post of manager at Pymgate House since 1986. The manager operates an open door policy and is very actively involved in the care of the residents. It was clear from observing her interactions with residents and visitors that they all knew her very well and vice versa. Record keeping in general in the home is an area of weakness and does need addressing. Although the manager said she does obtain feedback on an informal basis from people living at the home and this was confirmed by the people we spoke to, the lack of records means she can not evidence this or use it as part of her system for Care Homes for Older People Page 24 of 28 Evidence: monitoring how the home is running. Despite this we received strong feedback that people felt very well cared for and that health care professionals were confident that the service was able to deliver care in a way that met peoples needs. Only small amounts of money were kept in safekeeping for residents. Ledger books were maintained which itemised all transactions and receipts were kept. We checked one persons account and found it to be in order. Weekly checks had been made of the building and equipment in respect of fire prevention and health and safety. Care Homes for Older People Page 25 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 26 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 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 3 The manager should ensure that detailed written assessments are in place for each resident, which clearly identify their abilities and care needs. Care plans and risk assessments should contain more detail to provide a better record of the care needed and to enable staff to accurately review whether the care being given is still meeting peoples needs. The manager should seek advice to ensure that the cupboard used to store controlled medicines complies with the legal specifications required. The manager should ensure that all staff receive formal training in safe guarding adults and should ensure the procedure to follow in the event of suspected abuse is available and known to all staff in the home. The manager should develop a more formal system for recording how the quality of the service is monitored. 2 7 3 9 4 18 5 33 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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