Care Home: Rushey Mead Manor

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What the care home does well Information about the service is readily available. A statement of purpose and a service user guide are displayed in the reception area and a brochure is also available. People living in the home are treated with dignity and respect at all times and care and support is provided in a relaxed and friendly manner. There is a multicultural staff team and there is always someone on duty who is able to speak in the language that people prefer. Recruitment processes ensure that all required checks are carried out before a new member of staff commences work in the home. This protects the people living in the home from possible abuse. Two menus are offered on a daily basis, one Asian, one English. Both menus offer a choice at every mealtime and meals can be taken ether in the main dining area, one of the lounges or in the person`s own room. Visiting is strongly encouraged; visitors are always made welcome and made to feel part of the home. The acting manager continues to meet with staff on a daily basis to discuss day to day operations and offer support and guidance where needed. What has improved since the last inspection? The complaints procedure has been made available in different formats, taking account of the different languages spoken by people living in the home and the communication difficulties that some people experience because of dementia. This includes providing it in large print and translated into Punjabi. The registered provider is also looking at providing the service user guide in the same formats. The care plan and risk assessment documentation has improved and although some shortfalls were identified during this visit, it was evident that the acting manager has worked hard to bring these documents up to an acceptable standard. Some work is still required to ensure that they remain accurate, complete and informative to the reader, but spending time reviewing these documents would ensure that they were fit for purpose. The acting manager now obtains an assessment of need for anyone interested in living in the home. This is obtained from their social worker before they move in so that she can see whether their needs can be met. She also completes her own assessment documentation, though of those seen, some were more thorough than others. Work to improve the environment has continued since our last visit in October 2009. New carpets have been laid and further decoration has been carried out. On the day of our visit work was being carried out on the outside of the home to replace some of the facia boards situated under the roof of the home.The walls in the 1st floor corridor have been stripped and are ready for redecorating and work to improve the bathrooms in the home has commenced. What the care home could do better: When completing an assessment prior to someone moving in, ensure that as much information as possible is obtained, this will give the person carrying out the assessment a really clear picture of the persons needs, identify as to whether their needs could be met and assist in the planning of their care once they move into the home. The registered provider must ensure that each persons care plan and associated documents are up to date and accurate and any changes to the person`s health or plan of care are included as they arise. Care workers and nurses need to have up to date information to enable them to care properly for the people in their care. The registered person must ensure that all risks involved in the day to day care and support of those living in the home are identified, recorded and continually reviewed. It is crucial that all risks, however small, are assessed as to how it could affect the person`s welfare. Ensure that the work commenced in the bathrooms and 1st floor corridor are completed in a timely manner. People living in the home must be provided with a comfortable and homely place to live. Provide the acting manager with more managerial time. It is really important that she has the opportunity to regularly monitor and review the records required by regulation and ensure that they remain accurate, up to date and include all relevant information at all times. Key inspection report Care homes for older people Name: Address: Rushey Mead Manor 30 Coatbridge Avenue Rushey Mead Leicester LE4 7ZS     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: Diane Butler     Date: 1 9 0 1 2 0 1 0 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: Rushey Mead Manor 30 Coatbridge Avenue Rushey Mead Leicester LE4 7ZS 01162666606 01162660708 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Midland Healthcare Ltd care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: No one falling within category OP may be admitted into Rushey Mead Manor where there are 40 persons of category OP already accommodated within this home. No one falling within category PD(E) may be admitted into Rushey Mead Manor where there are 5 persons of category PD(E) already accommodated within the home. No person to be admitted to Rushey Mead Manor in categories MD or DE when 17 persons in total of these categories/combined categories are already accommodated in this home. No person to be admitted to Rushey Mead Manor in categories OP, PD(E), DE or MD when 40 persons in total of these categories/combined categories are already accommodated in this home. No person who requires nursing care are to be admitted into Rushey Mead Manor in categories OP, DE, MD or PD(E) when 20 persons in total of categories/combined Care Homes for Older People Page 4 of 28 17 17 0 0 Over 65 0 0 40 5 categories are already accommodated in this home. Date of last inspection Brief description of the care home Rushey Mead Manor is registered to accommodate forty older people in need of residential or nursing care. The home has a multicultural service user group and the staff team is also multicultural. Both English and Asian diets are catered for. There is a small temple and chapel situated in the building. Accommodation is on three floors with a lift and stairs for access. There are thirtyeight single bedrooms and one double bedroom. Two of the single bedrooms and the double bedroom have ensuite facilities. There are five lounges, two dining rooms, and one smoking room. The home is situated close to Leicester City Centre with good transport links and other local amenities. Current charges range from £337.00 to £800.00 depending on care and nursing needs and additional charges are in place for personal items such as newspapers, toiletries, and chiropody treatment. Details of what additional charges people can expect to pay can be found in the service user guide, which is available to everyone living at the home. A copy of the latest Inspection report is available at the home, or it can be accessed via the CQC website: www.cqc.org.uk. Further information is available from the registered provider or acting manager. 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 inspection took place over one day in January 2010. We (the Care Quality Commission or CQC) arrived at the home on Tuesday 19th January at 08:55am and completed the visit at 15:00pm. The inspection was unannounced and this means the service was not aware that we were coming. When undertaking key inspections CQC focuses on the outcomes for people receiving a service. In order to do this we case tracked four people receiving care and support. This means we checked records held in the office, spoke with them, relatives who were visiting on the day of the visit and care workers providing the care and support. Further planning for the inspection visit included checking the service history of the service and last Inspection report and looking through the AQAA document (Annual Quality Assurance Assessment), which was submitted to the CQC prior to the visit. The AQAA document is the main way that providers inform us of how well their service is Care Homes for Older People Page 6 of 28 delivering outcomes for the people using it. We checked all the standards that the CQC have decided are key standards during this inspection. The information below is based only on what we checked at this inspection. We have kept details about individual people out of the report to make sure we respected their confidences. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? The complaints procedure has been made available in different formats, taking account of the different languages spoken by people living in the home and the communication difficulties that some people experience because of dementia. This includes providing it in large print and translated into Punjabi. The registered provider is also looking at providing the service user guide in the same formats. The care plan and risk assessment documentation has improved and although some shortfalls were identified during this visit, it was evident that the acting manager has worked hard to bring these documents up to an acceptable standard. Some work is still required to ensure that they remain accurate, complete and informative to the reader, but spending time reviewing these documents would ensure that they were fit for purpose. The acting manager now obtains an assessment of need for anyone interested in living in the home. This is obtained from their social worker before they move in so that she can see whether their needs can be met. She also completes her own assessment documentation, though of those seen, some were more thorough than others. Work to improve the environment has continued since our last visit in October 2009. New carpets have been laid and further decoration has been carried out. On the day of our visit work was being carried out on the outside of the home to replace some of the facia boards situated under the roof of the home. Care Homes for Older People Page 8 of 28 The walls in the 1st floor corridor have been stripped and are ready for redecorating and work to improve the bathrooms in the home has commenced. 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 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. Peoples needs are assessed to ensure that they can be met. Evidence: Information is available to anyone interested in living at Rushey Mead Manor. A statement of purpose and a service user guide are displayed in the reception area and a brochure is also available. These documents inform the reader of the services that can be provided, charges that will be made and who a person should contact if they were unhappy about something. The service user guide is available in large print and the provider is looking into providing this document in other languages. This will enable him to meet the diverse needs of those living in the home and those interested in living in the home. The brochure is currently available in both Guajarati and English. Care Homes for Older People Page 11 of 28 Evidence: People who are interested in living in the home are invited to look around to see what facilities are available and whether it would be the right place for them to live. A visitor to the home explained, We looked around first to see what it was like. We were told that peoples needs are assessed before they move in to ensure that their needs can be met. We checked the records for three of the most recent people to move in and found that an assessment of need had been obtained from their social worker prior to them moving in. The acting manager also completes her own assessment. All three files checked included a copy of this assessment, which had been completed on the day of their admission. These documents varied in content with some having more information included than others. We were told that no one would be admitted to the home without the relevant paperwork. Intermediate care is not currently provided at Rushey Mead Manor. 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. Peoples needs are currently being met, however, continual monitoring of the care plan documentation is vital to ensure consistent care and support is provided. Evidence: We looked at some care plans and risk assessments to see if they contained all the information the nurses and care workers needed to meet the needs of those they were caring for. On the whole those checked did include relevant information, though some still needed updating and needed further information adding. One persons care plan talked about actions to take before they retired to bed, even though this person had been nursed in bed for some time. The acting manager explained that the person did at one time get out of bed for a little while, but no longer. The care plan needs to be amended to reflect this. Another person who had been identified as at risk of falls in their initial assessment had yet to have a risk assessment completed. Care Homes for Older People Page 13 of 28 Evidence: One person didnt like wearing shoes and walked around in stockinged feet, this was not included in their care plan or a risk assessment carried out even though there was a risk of slipping or of injuring themselves. Relevant assessments were in place but not all were completed accurately, this included not recording a persons height on their BMI record. This information is needed so that an accurate assessment of the persons nutritional risk is obtained. The acting manager stated that these shortfalls would be addressed immediately. Improvements were found within the recording of certain tasks and we found more consistency between the records held. Some care plans looked at stated that the persons fluid and dietary intake needed to be monitored as the person had lost weight, on checking the records fluid and diet charts were being completed and were up to date. Some care plans stated that the person required two hourly turning, on checking the records it was evident that this was being carried out. For one person who was diabetic the care plan and risk assessment stated that their glucose levels should be monitored daily, on checking the records it was evident that this was being carried out, though a gap of four days in January was noted. The acting manager assured us that the task had been carried out but staff had been lack in their recording. Relevant professionals were being involved in the care and support of the people living in the home. For one person who had been identified as losing weight, a referral had been made to the dietician. For another person who had developed a sore on their toe, their GP had been contacted and input from the district nurse had been sought. The care plans looked at had all been evaluated on a monthly basis or sooner where issues had arisen. We checked the medication records for four people currently living in the home. Medication records were in order with a signature for each medication given. On the day of our visit the acting manager was also the nurse in charge and therefore responsible for giving people their medication. We observed people receiving their medication appropriately though the acting manager was interrupted on a number of occasions by the telephone ringing. Controlled medication was being appropriately stored, with accurate records being kept. We spoke with people living in the home and their relatives and we were told that they Care Homes for Older People Page 14 of 28 Evidence: were treated well and their care needs were being met. Comments received included: The girls are good. He is quite content. She is treated very well. At the moment I am happy. Throughout our visit nurses and care workers were speaking to people in a respectful manner and providing care and support in an unhurried, relaxed and friendly way. 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 enjoy a varied diet, which meets their individual needs. A more structured activity programme would provide more stimulation than currently being offered. Evidence: People are offered choices daily; these include when to get up and when to go to bed, what to wear, what to eat and when and where they wish to take their meals. We were told that care staff provide activities twice a day. No real activities were provided during our visit, and a visitor told us I havent seen any activities. However, one care worker told us that she provides activities in the morning which includes games of skittles, ball games and sing a longs. People living at the home have access to Sky television, providing Asian channels in one of the lounges whilst English channels are available in another lounge. There are two cooks, cooking two menus each day, one Asian and one English. Both menus offer a choice at each mealtime and the meals served during our visit looked Care Homes for Older People Page 16 of 28 Evidence: nutritious, appealing and hot. The menu on the day of our visit offered, mixed pepper curry, potato curry, dudhi channa dhal, rice and chapatti or Chicken and Mushroom pie, potato, cauliflower and broccoli. People who require special diets such as diabetic, soft or pureed diets are catered for and supplements are provided if needed. Soft and pureed meals are well presented, with each element of the meal pureed separately rather all together, making the meal more appetising. Visiting is encouraged. Relatives and friends were visiting throughout the day and they told us that they were able to visit at any time and were always made welcome. One person said I am always made welcome, another visitor told us, you can come at all different times. 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. People feel safe and staffs understanding of safeguarding procedures protected them from harm. Evidence: People are informed of how to make a complaint, or share a concern, when they move into the home and a copy of the complaints procedure is included in the service user guide and is displayed in the reception area. The complaints procedure has been translated into Punjabi since our last visit in October 2009 and a copy of this is displayed on the notice board in the downstairs corridor. The provider has received one complaint since our last visit in October 2009. This complaint was thoroughly investigated by the registered provider and no evidence was found to substantiate the concerns raised. People told us that they knew who to talk to if they werent happy about something and they felt safe at Rushey Mead Manor. They told us: Hes safe enough. I would talk to xxxx. [Acting manager] Shes definitely safe here. Care Homes for Older People Page 18 of 28 Evidence: I would talk to xxxx. She seems very nice and helpful. Nurses and care workers have received training in the safeguarding of adults and are aware of whom to go to if they had any concern of any kind. We were told: I would tell xxxx. I would tell the nurse on duty, if she took no notice, I would tell the acting manager. I would report any concerns, they always listen and there is always someone available. 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. Ongoing improvements to the environment will ensure that people are provided with a clean and comfortable place to live. Evidence: Accommodation at Rushey Mead Manor is provided on three floors. Some parts of the home are currently not in use, including a second kitchen, lounge area and a number of bedrooms on the first floor. These areas are secure and only accessible by staff. Communal areas include a large dining room and smoking room and there are numerous lounges situated throughout the home that people are able to use. Decoration and furnishings within these areas are good providing a comfortable environment for those living there. Further work has been carried out since our last visit in October 2009 to improve the environment. This includes further replacement of carpets and redecoration. External work was also being carried out on the day of our visit, with the wooden facia boards being replaced. The areas of the home seen during this visit were clean and tidy and free from any Care Homes for Older People Page 20 of 28 Evidence: odours. The walls in the 1st floor corridor have been stripped and are ready for redecoration and work to improve the bathrooms in the home has commenced. We discussed the situation of the bathrooms with the acting manager, as although they are in the process of being refurbished they are still being used by the people living in the home. It is vital that whilst refurbishment is being carried out, the bathrooms are kept as clean, tidy and as safe as possible. An ongoing decoration and carpet replacement schedule is in place and the registered provider is confident that all necessary work to bring the environment up to standard would be carried out. 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. Staff are appropriately trained and competent to do their jobs. Evidence: We looked at the staffing rota and this told us that there is a registered nurse and four care workers on the morning shift, a registered nurse and four care workers on the afternoon shift and a registered nurse and two care workers on the night time shift. All staff spoken with felt that the current staffing levels were appropriate to meet the current needs of the people they care for and they were able to carry out their duties without feeling rushed. The acting manager told us that no new staff members had been recruited since she took over the management of the home in June 2009, so we looked at the file for the last person to be employed, to see whether recruitment practices had been followed. This file included all the necessary checks including references and police checks and all these checks had been obtained before the person started work. The provider checks the personal identification number or PIN of each registered nurse employed to ensure that they are suitably qualified to provide the nursing care required of them. Care Homes for Older People Page 22 of 28 Evidence: All new staff work through both an in house induction and a formal induction to make sure that they know how to provide the necessary care and support to the people living in the home. We looked at the training file of the most recent member of staff to be employed to see what training they had been provided with. We found that they had received training in the protection of vulnerable adults, basic first aid, moving and handling, Infection control and health and safety. Staff spoken with also told us that they had received training in Dementia awareness and basic food hygiene and one person explained that they were about to commence medication training. 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. The intended work to up date the records which are required by regulation will ensure that the interests of those living in the home are safeguarded. Evidence: The current acting manager has been in post since 1st June 2009. She is a registered nurse and has many years experience in the nursing field. We were told that the acting manager was always available for help and advice should staff need it. One care worker explained: She is always available, I feel very much supported. Staff meetings have recommenced, providing staff with the opportunity to air their views on the service being provided. Surveys are also sent to people using the service, their relatives and staff on an annual basis in order to gain their views on the service being provided. Comments Care Homes for Older People Page 24 of 28 Evidence: included in the surveys returned are then collated and included in the service user guide, which is displayed in the reception area. We checked money held on behalf of one person to see if this was held in line with company policies. Accurate records were being kept, receipts were in place and the signatures of those involved in any transaction were obtained. Care workers and nurses are provided with health and safety training and a health and safety audit of the home has been carried out in the last six months. We looked at a number of records during our visit and it was evident that improvements have been made since our last key inspection in October 2009. There are still some short falls that need addressing, including ensuring that care plans are accurate and up to date and risk assessments are completed and include all the relevant risks. The acting manager stated that it was her intention to spend dedicated time in reviewing all the documentation. It is imperative that the acting manager develops a system for the regular monitoring and reviewing of records to ensure that they remain accurate, up to date and include all relevant information. 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 registered person needs to ensure that as much information as possible is obtained before someone moves in. The registered provider needs to ensure that each persons care plan and associated documents are up to date and accurate and any changes to the persons health or plan of care are included as they arise. The registered person needs to ensure that all risks involved in the day to day care and support of those living in the home are identified, recorded and continually reviewed. The registered provider needs to ensure that the work commenced in the bathrooms and 1st floor corridor are completed in a timely manner. The registered provider needs to provide the acting manager with more managerial time. 2 7 3 8 4 19 5 31 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. 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