Care Home: Seaford Head Retirement Home

What the care home does well The home provides prospective residents and their families, with a good level of information about what services are provided at the home. The admission procedure allows for a comprehensive assessment process of any prospective resident along with an assessment visit to the home. The atmosphere at the home is relaxed, with communication between staff and residents open and friendly. The staff and management of the home are welcoming to all visitors and staff were found to be very helpful. Staff are cared for in an individual way with advice and support being provided from associated professionals as necessary. The quality and standard of the food in the home is good and residents complimented the good. The environment is pleasant and clean and there is an attractive garden area. What has improved since the last inspection? There was no requirments or recommendations made following the last key inspection. The environment in the home continues to be improved to ensure residents are provided with an attractive and homely place to stay. The home has had a new boiler since the last inspection. Staff training continues to be developed with nearly 50% of the homes care staff holding National Vocational Qualification level 2 in care or above. What the care home could do better: The care documentation needs to be improved to promote person centred care and to ensure all the residents health, psychological, personal and social care needs are addressed with suitable guidance for staff to follow. The care plans need to reflect peoples choices,preferences and any possible risks. This will ensure that staff are given clear guidelines on how to meet peoples needs in an individual way. The registered person needs to ensure suitable procedures are in place for staff to follow on all aspects of medicine handling. This will provide clear guidiance for staff to follow which will ensure the consitent and safe handling of all medicines. The registered person must ensure arrangments are adopted to ensure all areas of the home are so far as reasonably practicable free from hazards for staff and residents. Appropriate risk assessments need to be completed, recorded and responded to. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Seaford Head Retirement Home 107 Steyne Road Seaford East Sussex BN25 1AS     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: Melanie Freeman     Date: 0 8 0 1 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 29 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Seaford Head Retirement Home 107 Steyne Road Seaford East Sussex BN25 1AS 01323490851 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Sammarsphyl@aol.com Mrs Phyllis Sammars Name of registered manager (if applicable) Mrs Phyllis Sammars Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: Service users must be older people aged sixty-five (65) years or over on admission Service users with a dementia type illness only to be accommodated The maximum number of service users to be accommodated is sixteen (16) Date of last inspection Brief description of the care home Seaford Head is a small home offering support and care for individuals with a dementia type illness. It is registered with the Commission to provide this for up to 16 residents, although the double rooms are often used as single. The home is situated on a busy road in Seaford, there is parking adjacent to the building, and the town centre and seafront are within walking distance. There is no passenger lift in the home and residents are only admitted if they can access the first floor using the stairs or the chair lift, with the assistance of staff. Care Homes for Older People Page 4 of 29 care home 16 Over 65 16 0 Brief description of the care home There are two lounges on the ground floor, one is also used as a dining room and has a TV at one end. The other lounge is quieter and residents are able to listen to music of their choice if they wish. There is sufficient space for religious and social activities. There are gardens around the home and residents are able to sit outside with staff when the weather permits. The current fee for the home ranges from 425 pounds to 750 pounds per week. Additional charges are made for hairdressing, toiletries, chiropody, and newspapers. For more information about the fees and what is included please contact the Provider. Care Homes for Older People Page 5 of 29 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 reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report those living at Seaford Head will be referred to as residents. This was a key inspection that included an unannounced visit to the home on Thursday 8th January 2009, and follow up contact with visiting health and social care professionals. The allocated inspector spent approximately six hours in the home and was able to discuss matters with the registered manager who received the inspection feedback at the conclusion of the visit. Care Homes for Older People Page 6 of 29 A brief tour of the premises was undertaken and a range of documentation was reviewed including the homes statement of purpose and service users guide, preadmission assessment procedures, the systems in place for handling complaints and protecting residents from harm, staff recruitment files, quality assurance systems and some health and safety records. The care documentation pertaining to two residents were reviewed in depth and the inspector ate a midday meal in the dining room. Comments shared by residents and their representatives during the inspection process included The owner and staff are always extremely courteous and show great respect and care to the residents. Seaford Head has a lovely atmosphere and is always warm clean and welcoming Very pleased, well run, manager and deputy manager very approachable very professional Was admitted straight from Hospital so did not know what to expect but have found everything very good Staff are always very pleasant and helpful. At the time of compiling the report, in support of the visit, the Commission received survey forms about the service from eight residents, comleted with help from a representative and eight staff members. The required Annual Quality Assurance Assessment (AQAA) was completed by the registered manager and returned when requested and was used to inform this inspection report. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 Care Homes for Older People Page 8 of 29 240 7535. Care Homes for Older People Page 9 of 29 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 29 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. The statement of purpose, service users guide and terms and conditions of residency provide prospective residents, and their relatives with details of the services offered at the home, and the costs involved. An appropriate pre-admission assessment is completed, prior to the offer of a room, to ensure the home can meet the needs of prospective residents. Prospective residents and their relatives are encouraged to visit the home to spend time with the staff and residents before they decide to move into the home. Intermediate care is not provided at Seaford Head Retirement Home. Evidence: A copy of the homes statement of purpose and service users guide is available on request along with the last inspection report. These documents are also available on Care Homes for Older People Page 11 of 29 Evidence: the homes new Website. Although the service users guide and statement of purpose are of a good standard it was noted that the service users guide needed slight amendment to reflect the correct registration number, record the contact address for the Commission, and to include the homes terms and conditions of residency. An assessment of the admission process followed included the review of the documentation relating to the last two admissions to the home. These confirmed that either the manager, or a senior member of staff assesses everyone prior to admission. This ensures that only those people whos care needs can be met are offered a placement in the home. The homes management also consult with the prospective residents representative and professionals involved in their care. The assessment took into account all the needs identified within the National Minimum Standards. Residents are admitted on a trial basis and the prospective resident and their family are encouraged to visit the home and spend time in the home before an admission is agreed. Following any admission of a resident, a questionnaire is sent to the residents representative to assess how the admission process was carried out from their prospective. One of these questionnaires was seen and this confirmed a high satisfaction with the process. Intermediate care is not provided. Care Homes for Older People Page 12 of 29 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. Whilst service users care needs are being met and individual plans of care are devised these did not reflect a person centered approach to care and did not record peoples individual choices and preferences. On the whole the homes practice ensure residents medicines are stored and administered safely, although clear procedures need to be provided. Care is delivered in such a way that promotes and protects the residents privacy, dignity and individuality. Evidence: Each resident is assessed following admission and has a care action document and an ongoing assessment that is updated and changed as residents needs evolve. The care documentation relating to two residents was reviewed in depth. One of these residents was a recent admission to the home, the other having been a resident for a much longer period. The care plan (care action document) reflected the basic individual Care Homes for Older People Page 13 of 29 Evidence: framework for care. It was however highlighted that the care documentation did not clearly record an individual plan of care, that specified the care to be provided or reflected peoples choices, preferences and residents individuality. Further attention needs to be given to providing a person centered plan of care and this was discussed with the manager, who said she would look at ways of recording the individual approach that the home promotes. The care documentation included assessments for moving and handling, pressure areas, and a nutritional screening tool, that included the regular weighing of residents. There was also evidence that the care plans are reviewed on a regular basis. The deputy manager was able to confirm that residents or their representatives are involved in the planning of care, as they wish, and relatives sign one of the care documentation records to record their view on this. There was however no ongoing evidence of either the resident or representatives involvement in the review or updating with regard to the plans of care, this was discussed with the deputy manager to address. The AQAA had identified that this area of documentation needed to be improved. Specific incidents are clearly recorded and each resident has a risk assessment that covers the environment. The risk assessment process could be further improved with further emphasis on the communal areas including the stairs and communal living and the reflection of these risk within the care plan. The residents are registered with GPs and allied health professionals are contacted when required, including the Community Psychiatric Nurses (CPN) and District Nurses (DN). All feedback about the care provided was positive and comments received included Seaford Head has a lovely atmosphere and is always warm clean and welcoming have found everything very good my mother is now deceased but was in the home for two years and during this time was very well cared for. A visiting professional said they provide a good standard of care and a good understanding of the needs of residents with a dementia. The home has a small storage facilities that does not have any means of ventilation. The temperature of this room needs to be monitored to ensure all medicines are stored at the correct temperature and the manager confirmed that she would do this. It was also noted that the current Controlled Drugs storage arrangements are not adequate and need to be improved to ensure when any Controlled Drugs brought into the home are stored in accordance with current legislation. The manager acknowledged this shortfall and agreed to address this matter. Further information on this matter is available on the CSCI Internet within the guidance document The safe management of controlled drugs in care homes. Care Homes for Older People Page 14 of 29 Evidence: Practice seen during the inspection visit confirmed that medicines are administered in a safe way by those members of staff who have been trained to do so. A review of the Medication Administration Recording (MAR) charts confirmed accurate record keeping is maintained. Some residents have their medicines crushed as they have difficulty in swallowing tablets. The home ensures that this is done only following consultation with the allocated General Practitioner. Records relating to this matter need to record clearly this discussion and subsequent agreement. In addition the home needs to ensure that residents or an appropriate representative is party to this decision at the time that it becomes a problem. The home also needs to ensure that a relevant policy and procedure underpins all practice with respect to medicines handling. When medicines are administered on an as required basis this is identified separately on the medicine records. Further individual guidelines for each resident to clarify when these medicines are to be given would ensure they are given in a consistent way. Observation and contact with people during the inspection process confirmed that residents are treated with respect. When referring to private requests staff lower their voices and any care is provided in the privacy of their own room or in a discreet area. Residents were addressed according to their individual wishes and rooms are very personalised. All residents are well know to all the staff and are spoken to as individuals that happen to live in one place. The feeling and atmosphere was very much like a communal home. Care Homes for Older People Page 15 of 29 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. Where possible residents are enabled to exercise choice in their lives and there are opportunities to participate in social and recreational activities provided. Residents are encouraged to maintain contact with family and friends as they wish. Residents receive a wholesome and appealing diet and are provided with some choice. Evidence: During the inspection visit staff were seen to be engaged with residents enjoying conversations, and some individual and group activity, including indoor skittles and puzzles. Residents responded to close contact with the staff and in some cases to each other very well. Social events within the home, like birthdays are celebrated and the AQAA indicated that individual needs relating to peoples faiths are respected and supported. The manager advised that there is no strict programme of activities as they are organised daily depending on what the residents would like to do. One visiting professional said that there was always something going on when visiting the home. Outings are not part of the activity provision and further consideration should be given to these in either small groups or individually. The AQAA recorded that the home was open to visitors who are particularly welcome Care Homes for Older People Page 16 of 29 Evidence: to attend any social events. Visitors are seen as an important addition to the home and during the inspection visit the arrival of a visitor accompanied by a small child, was greeted with a warm welcome by staff and residents. Although choices and preferences were not well reflected within the care documentation practice observed indicated that staff understood how important it was for residents to maintain autonomy. This was demonstrated when staff assisted a resident who had decided to change her skirt, and in the way that breakfast was available to residents when they wanted it. A meal was eaten with the residents and the standard of this was found to be very good and included sausage casserole carrots, mashed potatoes and peas, with coconut sponge and custard for pudding. Residents were given time to eat their meal and there was plenty of space for residents to eat at a dining table comfortably and to enjoy the social interaction this promoted. They were given time to finish their meal and were encouraged by staff when reluctant to eat. Specialist needs were well attended to and included specialist eating equipment, specific dietary needs, and dislikes being addressed. The last Environmental Health Officers report was seen and this was satisfactory. The main meal is prepared at the other home owned by Mrs Sammars which is located nearby and transported in heated containers to the home. During the inspection visit the residents said that the food was very good and that it was always nice. Care Homes for Older People Page 17 of 29 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 are confident that any complaint made would be listened to and responded to appropriately. Staff awareness and information in the home ensures that any Safeguarding Vulnerable Adult issue would be responded to appropriately when identified. Evidence: A complaints procedure is available in the home and residents confirmed that they would say something if they were not happy. There have been no complaints since the last inspection and the surveys indicated that people knew how to complain and would do so if necessary. A suggestions box is accessible in the front entrance and recently all staff have had the opportunity to raise any issues directly with the manager anonymously with a form and pre-paid envelope being supplied. The home has a Safeguarding Vulnerable Adults procedure and staff have received training on this subject within this year. The up to date local policies and procedures are available in the home. The home has dealt with two safeguarding referrals over the past three months. The management of the home referred appropriately to social services, and worked with them to resolve the concerns raised. Although the home has logged these alerts they have not recorded clearly the subsequent investigation, findings and action the home Care Homes for Older People Page 18 of 29 Evidence: has taken in response.The manager has confirmed that she will improve the records held in respect to any Safeguarding referral. Staff recruitment files confirmed that staff have a POVA check completed along with a Criminal Records Bureau check (CRB). Care Homes for Older People Page 19 of 29 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. The home provides a comfortable, homely, safe, well maintained and clean environment for residents to reside in. Evidence: Seaford Head Retirement Home is a converted detached building within a residential area of Seaford. There is a secure garden area with a patio and seating facilities and unrestricted parking is available in local roads. There is a door entry system in operation, to enable staff to be aware when people are entering or leaving the building for security reasons. The home has two sitting rooms, which are spacious and provide dining facilities and room for separate activity in the home. Whilst the home is well furnished it was noted that the sofa and armchair seating is rather low and staff need to ensure that seating is not only comfortable but provide suitable support and do not restrict residents mobility. The home has accommodation on three floors and is not designated to provide a service to people with physical disabilities as the stairs and other access arrangements would make it unsuitable for residents with a permanent restricted mobility, albeit that a chair lift is available to access the first floor. Care Homes for Older People Page 20 of 29 Evidence: The home has 13 bedrooms (three of which can be used as shared accommodation) all apart from one have en-suite facilities. A tour of the home confirmed that residents rooms are well maintained and were personalised reflecting the occupants likes and interests. All bedrooms have a door lock and residents on leaving their bedroom are not able to get back into the room without the key held by staff. This ensures that residents do not enter the wrong room which may lead to the damage of peoples belongings. This however may restrict access for all residents, although it was noted that staff are very attentive to residents movements and take them to their own rooms when they wanted to. The use of door locks was discussed with the manager along with the need to individually assess any restrictions with relevant documentation, to ensure practice is not routine based and takes into account the individuality of each person living in the home. The home was found to be clean and fresh throughout. The standard of cleanliness was good. Care Homes for Older People Page 21 of 29 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. Staffing numbers and skill mix provides a competent and well-motivated staff team that meets residents health and personal care needs with a commitment to staff training. Residents are protected by the recruitment practice followed. Evidence: At the time of this inspection visit the home was occupied by 12 residents (two of whom were in hospital) and staffing levels observed were found to be appropriate to meet the needs of residents residing in the home. Staff spoken to during the visit also said that suitable staffing was provided. A duty rota is maintained and this confirmed that staffing levels are maintained throughout the week and include two care staff throughout the waking day and two waking care staff at night. In addition the deputy manager provides some extra hours, for example she was extra to the two carers from 11.00 to 14.00 during the inspection visit. The manager is also in the home at various times and a domestic is employed to work each week day. Staff surveys indicated that staffing could be a problem with one recording There are Care Homes for Older People Page 22 of 29 Evidence: only two carers on shift sometimes you need two carers to do a particular job. Therefore there in no one left spare in case someone else needs help whilst the other two carers are busy. The staffing arrangements were discussed with the manager who advised that the staffing time had been increased by half an hour at the beginning and at the end of the day. She also said that extra staff are provided if the dependency of a resident indicates more one to one care is required. Staffing levels must be kept under constant review and need to reflect the occupancy and the dependency of the residents to ensure staff are available to meet all residents care needs throughout the day and night. All feedback received about the staff working in the home was very positive and comments included The owner and staff are always extremely courteous and show great respect and care to the residents Staff are always very pleasant and helpful. The recruitment practice in respect of three staff members was reviewed and were found on the whole to be full, records checked included an application form, two references and the necessary Protection Of Vulnerable Adults and Criminal Records Bureau checks had also been obtained. Information provided by the home indicated that there is a commitment to staff training and that this is well organised and comprehensive. The AQAA confirmed that the home has a commitment to supporting staff through their National Vocational Qualification with nearly 50 of staff attaining an NVQ at level 2 or above. Feedback from staff indicated that they liked working in the home and staff retention was high. Care Homes for Older People Page 23 of 29 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 management arrangements provide clear leadership and an appropriate management structure. Systems for monitoring the quality of care take account of residents views. Residents financial interests are safeguarded. The health, safety and welfare of residents and staff are generally promoted and protected, although further routines checks and risk assessments need to be established. Evidence: The registered manager is also the owner of Seaford Head and has considerable experience caring for people with dementia and has completed the Registered Managers Award. She is well supported by a team of staff and was seen to have a good rapport with them and the residents. All feedback received in respect to the homes management was complementary with one relative saying Very pleased, well run, manager and deputy manager very Care Homes for Older People Page 24 of 29 Evidence: approachable very professional The manager confirmed that yearly questionnaires are used to monitor the services offered at the home, and the appropriateness of the support and care provided by the management and staff. These questionnaires are audited and reported on. The manager also confirmed that she does not have any involvement with residents monies and all residents have an identified person who deals with their finances with any extras being invoiced on a monthly basis. Records in the home illustrated that maintenance matters in the home are well attended to and that most Health and safety checks are completed. It was however noted that although the hot water supply was being controlled regular checks on the temperature of the water accessible to residents was not being maintained. When this was raised with the man anger she made arrangements for all hot water to be checked straight away and for a system to be adopted to ensure hot water is supplied at a safe temperature. Routine environmental risks assessments are not completed and suitable systems need to be established to ensure all risks are identified quickly and minimised as far as possible. Care Homes for Older People Page 25 of 29 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 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 That individual plans of care 01/04/2009 providing specific guidance on person centered care to cover the health, personal, psychological and social care needs of each resident are devised. These should reflect peoples choices,preferences and any possible risks. This will ensure that staff are given clear guidelines on how to meet peoples needs in an individual way. The registered person needs 02/03/2009 to ensure suitable procedures are in place for staff to follow on all aspects of medicine handling. This will ensure staff have clear guidance to follow and ensure consistent and safe handling of medicines. 2 9 13 3 38 13 The registered person shall make arrangements to ensure areas accessible to 02/03/2009 Care Homes for Older People Page 27 of 29 residents are so far as reasonably practicable free from hazards to their safety. Appropriate risk assessments need to be completed recorded and responded to. This will ensure any risks are identified and responded to. 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 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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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