Care Home: Red House Residential Home

What the care home does well People who are considering moving into the home benefit from having their care needs assessed so that they can be sure the home can meet their needs. People are treated respectfully. Each person has a plan of care and access to health care services so that their health and personal care needs are met. People are able to bring personal items such as pictures, ornaments and small items of furniture into the home so that that their personal tastes and interest are reflected and a homely atmosphere is created. What has improved since the last inspection? The manager has taken steps to address all of the requirements from the last inspection. This demonstrates her commitment to ensuring people live in a safe and well run home. Care plans are available for each of the identified needs of people using the service and contain accurate information about what staff have to do to meet those needs. This should make sure people get the care they need to promote their health and well being. People continue to benefit from the ongoing refurbishment plan which is providing a clean and comfortable place for them to live in and enjoy. The manager ensures that people do not start working in the home until satisfactory pre employment checks have been undertaken. This ensures people living at the home are protected by robust employment procedures Staff members have attended a range of mandatory health and safety training that includes first aid and moving and handling. This makes sure staff work in a way that promotes and maintains the health and safety of people living in the home. What the care home could do better: The manager must ensure the safety of people by ensuring that fire exits are kept clear at all times. The manager should consider introducing picture menus to assist people make food choices at meal times. Key inspection report Care homes for older people Name: Address: Red House Residential Home 236 Dunchurch Road Rugby Warwickshire CV22 6HS     The quality rating for this care home is:   two star good 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: Patricia Flanaghan     Date: 2 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 27 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 27 Information about the care home Name of care home: Address: Red House Residential Home 236 Dunchurch Road Rugby Warwickshire CV22 6HS 01788817255 F/P01788817255 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): wolston@pinnaclecare.co.uk Pinnacle Care Ltd Name of registered manager (if applicable) Ms Stephanie Robson Type of registration: Number of places registered: care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users who can be accommodated is: 23 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: Dementia (DE) 23 Date of last inspection Brief description of the care home The Red House Care Home is located approximately one mile from Rugby town centre. It is a converted detached domestic dwelling set back off the main Dunchurch Road. It provides long-term residential care without nursing for twenty-three older people with dementia. People living in the home who require nursing attention receive this from the Community nursing service, as they would in their own homes. Accommodation is provided on two floors and consists of seventeen single and three double rooms. Ensuite facilities are available in some bedrooms there are also two assisted baths and four communal toilets. Written information about the cost of accommodation is Care Homes for Older People Page 4 of 27 Over 65 0 23 Brief description of the care home available in the service users guide and the current rates are listed as being between £530 and £630 per week. People living in the home are required to pay for extras, such as private chiropody, optician, dental treatment, personal shopping and outings. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means that that people who use this service experience good quality outcomes. We, the commission, undertook a key inspection visit to The Red House on 25 May 2009. The visit was unannounced which meant the home did not know we were visiting. The last key inspection visit to this home was on 4 June 2008. Before the inspection, we looked at all the information we have about this service, such as information about concerns, complaints or allegations, incidents and previous inspection reports. We do this to see how well the service has performed in the past and how it has improved. We looked at the Annual Quality Assurance Audit (AQAA) which the manager completed and returned to us before our visit. This is the managers review of the service and gives us information about how the service has progressed in the last 12 months. Care Homes for Older People Page 6 of 27 We sent out random surveys to ten people who live at the home, their relatives and five staff in order to gain peoples views about the service. Three residents, one relative and three staff completed and returned surveys to us. Their comments are included in this report. We used a range of methods to gather evidence about how well the service meets the needs of people who use it. We talked to people who use the service and observed their interaction with staff. We looked at the environment and facilities provided and checked records such as care plans and risk assessments. We also looked at staff duty rotas, training and recruitment records. Three people using the service were identified for case tracking. This is a way of inspecting that helps us to look at services from the point of view of some of the people who use them. We track peoples care to see whether the service meets their individual needs. Our assessment of the quality of the service is based on all this information, plus our own observations during our visit. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 8 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 9 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. People receive a full assessment identifying their needs and abilities. This ensures that the home can meet their needs and care can be planned before the person moves in. Evidence: The manager told us in the annual quality assurance assessment (AQAA) that The Red House provide each potential resident with a pre-admission assessment detailing the 12 headings required under Standard 3 of the National Minimum Standards for Older People. We develop a care plan using this information and other sources. We looked at the pre-admission assessments for two people who had recently come to live at the home. The manager explained that assessments are generally completed during a visit to the person in their own home or in a hospital. The manager or deputy usually undertakes these assessments. We saw that healthcare professionals, for example, hospital nursing staff, are contacted during the admission process to ensure that the home can meet any physical or dementia care needs. The two assessments Care Homes for Older People Page 10 of 27 Evidence: we looked at had sufficient information to help ensure the home can prepare for, and meet peoples needs. These had both been completed after information had been received from the care managment team. Care Homes for Older People Page 11 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. People living in this home can be confident their needs will be recognised and met and they will be treated with respect at all times. Evidence: Information recorded in the services AQAA states that the home devise individual support to the best possible level by providing individual informative care plans involving relatives (where possible) and other professionals. We assess each persons strengths rather than focusing on areas of dependency giving us an approach to build the strengths further. We looked at the care records for three people, two of whom were admitted to the home since the last inspection visit and a person who had lived at the home for a longer period of time. We saw that each person had a comprehensive care plan using improved formats. There was evidence demonstrating the good practice of involving the person and their relatives or representatives in the development and review of their planned care. Care Homes for Older People Page 12 of 27 Evidence: Care plans were based on comprehensive assessment information and included all essential basic information and identification of any associated risks. The manager has introduced personal preference information within the care planning documentation, called Requirements to assist the day. This is a record of each persons preferred daily routines for staff guidance to ensure that care is delivered with a person centred approach. All the files we looked at included risk assessments for moving and handling, nutrition and tissue viability. There were general risk assessments in place for issues such as falling and smoking. The assessment for one person stated they could occasionally be verbally aggressive to other people. There was a management plan in place for staff to follow, should this happen. This detailed what may lead to the behaviour and what staff should do about it to avoid it escalating. This ensured the person did not become distressed and protected other people living there from verbal abuse. Written daily reports in care files provided information on peoples day-to-day life in the home and provided details on their health and well being. Entries had been signed, dated and timed by the member of staff making the entries. This ensures accuracy provides information, if required, of the staff member deemed responsible for ensuring care needs are met. Visits by healthcare professionals were recorded on separate sheets, so they were easy to track and were cross referenced to the daily records. The records indicated that when staff identified any healthcare issues these were then followed up and monitored. There was evidence of visits from GPs, district nurses, people being admitted to hospital when necessary and check ups by dentists and opticians. A survey returned to us by the district nursing service stated that the service provides information to the district nurses as requested, care plans are accurately recorded, hand washing facilities are provided and they maintain clients privacy and dignity. We had a conversation with a visiting relative who told us, my relative is settled, I am always made welcome and the staff keep me informed of any changes. We audited the medicines of people involved in case tracking by comparing the quantity in stock against the signatures on the medicine administration records (MAR). The audits indicated that the medicines had been administered correctly. The manager explained the processes and all evidence points to good arrangements being in place for the safe administration of medications. The arrangements in place for the ordering and disposal of medication safeguard people from medication errors and misuse Care Homes for Older People Page 13 of 27 Evidence: People living in the home were observed to be treated with respect and their dignity maintained, for example, personal care was provided in private and people were spoken to respectfully. We observed safe practice when staff assisted people to move using a hoist. During observation of working practice it was evident that staff are knowledgeable about the likes and dislikes of people living in the home and were kind, caring and attentive towards them. Care staff spoken with were familiar with peoples needs and abilities, and knew what care they needed. Three staff completed surveys and returned them to us as part of the pre inspection work. Thy told us they receive enough information about the people they support 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 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 live at The Red House can be confident their social needs are met and they are supported to maintain relationships with families and friends. Meals are well balanced and nutritious. Evidence: The Red House does not employ an activities coordinator. Care staff undertake activities with people throughout the day. These are decided upon on a daily basis. For example, we saw some people playing dominoes in the afternoon with a member of staff and another person was doing a newspaper crossword with the help of a care assistant. A record of activities is maintained and we saw that people had recently enjoyed lunch at a local pub. This appeared to be a regular outing enjoyed by a majority of people. There had also been a recent outing to a garden centre for a look around the garden and a coffee. The manager said that they would also be having a summer fete in the garden of the home and families and friends would be invited to attend. Outside entertainment includes, reminiscence therapy, mobility exercise sessions and musical entertainment. Representatives from a local church visit on a monthly basis. A hairdresser visits weekly. People who use the service have the opportunity to develop and maintain important Care Homes for Older People Page 15 of 27 Evidence: personal and family relationships. We spoke with a visitor who confirmed that they can visit the home at any time and are always made welcome. Those people living at the home who are able to express an opinion also confirmed they could receive visitors at any time. The manager told us in the AQAA that families and friends are encouraged to become actively involved in the life of the home if they so choose and may also attend the residents/relatives meetings which are held approximately twice a year. We saw copies of the minutes of recent meetings and the manager showed us the agenda of a relatives meeting which was due to be held in June. We observed staff throughout the day being very patient, understanding, caring and assisting people with care needs in a discreet and respectful way. People were offered choices throughout the day, for example which television programme to watch, selection of drinks or help with personal care. Several people who use the service told us that the quality of the food was good and surveys from residents and relatives also confirmed this. People also said there was always a choice. Comments received include: The food is good, we have nice meals and Mum always seems to enjoy her dinner. We spoke with catering staff, observed a well-managed kitchen and noted that the home received a Gold star rating from the Environmental Health Officer recently. This means the kitchen staff practice excellent standards of food hygiene. The menu is not presently available (only in the kitchen), the service should consider providing this information around the home so people who use the service can recall what they have chosen. The home should also consider the needs of the people who use the service and it may be of benefit to offer pictorial information too. Staff were observed to be sitting with people who required help to eat and drink and were very patient, discreet and encouraging. 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 who use the service can be confident that any complaints or allegations of suspected abuse are taken seriously and managed appropriately. Evidence: We saw that the home had an up to date complaints procedure which was displayed in the reception area and contained in the service users guide. The document gave clear, concise details of how to raise a concern or complaint about the service. Information supplied as part of the homes AQAA indicated that no concerns or complaints have been raised with the service during the last twelve months. We discussed this with the manager and she feels this is due to the good relationships formed with residents and their families so that any niggles can be sorted out quickly. We have not received any complaints or concerns about The Red House. A person who lives at the home told us that they would speak with their family or the staff if they had any concerns, but everything was satisfactory at the moment. A visitor told us If I had a concern I know the manager would deal with it immediately. The manager told us in the AQAA that all staff had received appropriate training on safeguarding vulnerable adults. Staff training records show that the most recently recruited staff members had completed training in April 2009. It was evident through discussion with the manager that she was aware of how to respond to an allegation of abuse in the care home using local social services guidelines. We also spoke with two Care Homes for Older People Page 17 of 27 Evidence: care staff who showed understanding of safeguarding and whistle blowing procedures. The three surveys received from staff indicate that they know what to do if they have concerns about people they support. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well maintained home that is homely, clean and hygienic. Evidence: A tour of the home was undertaken and some bedrooms were seen. The home was generally well maintained, safe and comfortable. The people living there appeared comfortable and indicated on the surveys returned to us that the home was always fresh and clean. One relative commented in their survey there are never any unpleasant smells here. There are attractive gardens and garden furniture for the comfort and enjoyment of people. The tour of the building identified that improvements claimed in the AQAA had been made and a programme of redecoration and refurbishment had been continued. For example, we saw new chairs and sofas had been purchased for the main lounge. We also saw that the requirement made at the last inspection visit to replace cracked tiles surrounding a hand wash basin had been actioned. We looked at a sample of bedrooms with peoples permission where possible. All were attractively decorated and personalised according to individual preferences. There was evidence of personal possessions such as family photographs, ornaments and some small items personal furniture. The laundry is small and equipped with one commercial washing machine and one Care Homes for Older People Page 19 of 27 Evidence: tumble dryer. The laundry service was generally well organised and the staff demonstrated good standards of infection control. There were supplies of disposable gloves and aprons readily available at all times. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient staff who are appropriately trained and recruited to meet peoples needs and keep them safe. Evidence: The manager told us in the AQAA that the home provide a good ratio of staff to compliment assessed needs. All staff, but four new starters, have NVQ 2 or above in care, three of the new starters have been enrolled. All staff are inducted using the Common Induction Standards. All staff have a one day and a three day training course in dementia awareness with a trainer accredited by the Alzheimers Society. We were able to verify the good practices claimed in the homes AQAA during observations, discussions and examination of samples of records during this visit. The manager told us there were 21 people living in the home. She explained that she reviewed staffing levels on a regular basis, taking account of the occupancy and dependency levels of the people living in the home. We saw sufficient staff cover on the day of the inspection and staff spoken with told us the staff ratio is generally good. Three staff that completed surveys as part of our pre inspection work told us there are always enough staff available to meet the individual needs of the people living at the home. Care Homes for Older People Page 21 of 27 Evidence: We looked at the files of two staff employed since our last inspection visit. The manager had improved the recruitment and selection process to demonstrate robust practice with well ordered staff files and essential documentation. The manager showed us a training needs analysis and training plan she had developed for the staff. Each person had an individual staff training profile and this shows commitment to staff training and development. We looked at the training certificates for some staff and these showed they had undertaken training in dementia awareness, moving and handling, first aid, fire safety and safeguarding awareness. The homes induction process, consistent with Skills for Care guidelines, is thorough and conducted over a period of time. We saw evidence of this on the files of two new carers appointed since our last inspection visit. During discussions it was evident that staff felt supported. The comments received from staff included, staff are trained regularly to update their knowledge, and we get all the training we need. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager ensures the home is run in a competent manner and in the best interests of people living there. Evidence: The registered manager of the home has been in post for over two years and has the necessary qualifications and experience to manage the home. She demonstrated throughout the inspection that she have a very good knowledge of the needs of the people living in the home and how they liked to be cared for. The people living in the home were very comfortable in the presence of the manager and could speak to her at any time. One of the visitors spoken with said the manager was very approachable and kept them up to date on their relatives life in the home. The staff spoken with during the inspection were positive in their comments about the manager and felt that they could talk to her at any time. The manager returned an AQAA before our inspection visit. This document was Care Homes for Older People Page 23 of 27 Evidence: completed to a satisfactory standard. Improvements were identified with supporting evidence and future improvements are planned where the home has identified shortfalls in the service. Information recorded was consistent with our findings. Senior managers visit the home and complete Regulation 26 visit reports which tell us about the quality of service being offered at the home. For example, a senior manager had undertaken an audit of peoples medication at the home on the morning of our visit. The organisation has a number of audits in place to monitor the service provided and had recently sent out customer satisfaction questionnaires. The responses from these will be collated into a report and shared with people who live at the home. We saw there were regular residents and relatives meetings with minutes available for inspection. We saw evidence that the home listened to peoples suggestions for improving the service. For example, people said they would like their main meal to be provided in the evening rather than the middle of the day. This had been implemented and staff and people said they were happy with this arrangement. We were told that the home was not responsible for any persons finances and did not hold any monies on their behalf. Invoices are sent to families monthly for any purchases such as hairdressing or chiropody. We saw documents and certificates relating to the weekly, monthly and annual health and safety checks that are carried out. Risk assessments for the premises are maintained and reviewed annually. These checks ensure that the health, safety and welfare of people living in, working in and visiting the home are promoted and protected. During our tour of the home we saw that one of the fire exits was blocked with a walking frame, a hoist and other equipment. We pointed this out to the manager who immediately made arrangements to remove these objects. All fire exits must be kept clear at all times to ensure the safety of people and staff in the home. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 38 13 Fire exits must be kept clear 06/07/2009 and free from obstruction. This is to ensure people are able to exit the building in a safe and an appropriate manner in the event of a fire. 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 12 We recommend the home ensure the menu is available in a format applicable to the people who use the service. This will assist people make real choices for their meals. Care Homes for Older People Page 26 of 27 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!