Care Home: Spring Bank

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What the care home does well People told us the staff are kind, caring and helpful. People who completed surveys sent by the home in April and May this year made the following comments about staff; "very kind and understanding staff", "a wonderful team of staff". The home is clean, well maintained and decorated to a good standard. This means that people have a pleasant and comfortable place to live. People are encouraged to bring some of their personal belongings with them when they move in and this helps to make their rooms more homely. People told us they enjoy the food and said there is plenty of it. People are given the opportunity to help plan the menus and this helps to make sure people`s likes and dislikes are catered for. People are offered the opportunity to take part in a variety of social and leisure activities which are appropriate to their interests. The home is constantly looking for new and interesting activities which people might enjoy and benefit from. The home does not have any restrictions on visiting and this helps people to keep in touch with their family and friends. People or those close to them are involved in drawing up their care plans and this helps to make sure that people`s care is given in a way that takes account of their abilities and preferences. People are encouraged to visit the home before making a decision about moving in and this helps them to be sure the home is the right one for them. What has improved since the last inspection? There were two requirements following the last inspection and the home has dealt with them. The home now has an up to date complaints file which has details of any complaints they have received and the action taken. This shows that complaints are taken seriously and acted on. Staffing levels in the home are reviewed and changed where necessary in response to changes in people`s conditions. This helps to make sure there are always enough staff to meet people`s needs. There has been an improvement in staff training and this has helped staff to have a better understanding of people`s needs and how to respond to those needs. The home has changed some of their working practices to make sure that people`s dignity is promoted, for example, by helping people to use their own en-suite facilities rather than the communal facilities. Two mechanical sluice machines have been provided to clean and disinfect equipment such as commodes, this has improved infection control procedures and reduced the risk to people of cross infection. What the care home could do better: In their self assessment the home told us about improvements they are planning to make over the next 12 months. For example, they plan to make improvements to the outside seating areas so that it is easier for people to go out and enjoy the gardens in nice weather. They also want to improve the quality rating they have been given by Environmental Health for their standards of food hygiene and safety. They currently have a 3 star rating, the highest possible rating is 5. The owner and new manager should attend the safeguarding training for service managers provided by Bradford Social Services so that they are fully aware of multi agency approach to safeguarding. This will help to make sure that people in the home continue to be protected. The home should make sure that people`s ability to make decisions is assessed and recorded. When people lack the capacity to make decisions and decisions are made about their care in their best interests this should be recorded. This will help to make sure that people`s rights are protected. Nursing staff should attend training on pressure area care and wound management to make sure they are up to date with current best practice. This will help to reduce the risk of people suffering from skin damage or pressure sores. Key inspection report Care homes for older people Name: Address: Spring Bank Howden Road Silsden Keighley West Yorkshire BD20 0JB     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: Mary Bentley     Date: 1 2 1 1 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 29 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 29 Information about the care home Name of care home: Address: Spring Bank Howden Road Silsden Keighley West Yorkshire BD20 0JB 01535656287 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Diane Hudson Name of registered manager (if applicable) Type of registration: Number of places registered: care home 31 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 31 The registered person may provide the following category of service only: Care home with nursing - Code N, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Spring Bank is a converted extended property situated in a residential area of the town of Silsden. The town has good road and public transport links. Accommodation is provided on 2 floors. There are double and single rooms. The single rooms with en-suite facilities are in the newer part of the home: shared rooms are in the older part of the building. There are assisted bathrooms and communal toilets on Care Homes for Older People Page 4 of 29 Over 65 31 0 1 3 1 1 2 0 0 8 Brief description of the care home both floors. There is level access to the home and gardens. Inside the home has a passenger lift to the first floor. People have a choice of 2 lounges and there is also a dining room. There are attractive gardens and parking is available in the grounds. Information about the service including inspection reports is available on request from the home. In November 2009 the fees ranged from 540.00 to 600.00 pounds per week. Please contact the home for full details of the fees and additional services which are provided at an extra cost. 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: This is what we used to write this report: The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. The results of any visits that we have made to the service in the last 12 months. We have not made any additional visits since the last inspection on 13 November 2008. Surveys returned to us by people using the service. On this occasion we did not send any surveys. Information we have about how the service has managed any complaints. Care Homes for Older People Page 6 of 29 What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. Relevant information from other organisations. A site visit carried out by one inspector between the hours of 9:00 am and 5:00 pm. The visit was unannounced. During that time we spoke to people living in the home, staff and management. We looked at various records including care records,looked at some parts of the home and observed staff as they carried out their duties. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated it is likely enforcement action will be taken. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? There were two requirements following the last inspection and the home has dealt with them. The home now has an up to date complaints file which has details of any complaints they have received and the action taken. This shows that complaints are taken seriously and acted on. Staffing levels in the home are reviewed and changed where necessary in response to changes in peoples conditions. This helps to make sure there are always enough staff to meet peoples needs. There has been an improvement in staff training and this has helped staff to have a better understanding of peoples needs and how to respond to those needs. The home has changed some of their working practices to make sure that peoples dignity is promoted, for example, by helping people to use their own en-suite facilities rather than the communal facilities. Two mechanical sluice machines have been provided to clean and disinfect equipment such as commodes, this has improved infection control procedures and reduced the Care Homes for Older People Page 8 of 29 risk to people of cross infection. 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 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. People are given information about the service and their needs are assessed before they move in. This helps people to be sure the home is the right one for them. Evidence: People we spoke during the visit told us that they or their families had been involved in choosing the home and had visited before making a decision about moving in. Peoples needs are assessed before they move in. This is to make sure the home will be able to meet their needs. We saw completed pre-admission assessments in the care records and they had detailed information about peoples needs. An initial plan of care is drawn up using the information obtained during the pre-admission assessment so that staff have information about peoples needs when they arrive in the home. The home told us they are continuing to make improvements to the pre-admission procedures. For example, the owner is preparing a letter which will be given to people Care Homes for Older People Page 11 of 29 Evidence: when they express an interest in the home. The letter explains what will happen before people move in and gives a summary of information about the service. The owner recognises that it can be a difficult time and people cannot always remember everything they have been told. Therefore, copies of the service user guide are provided in the bedrooms so that people can refer to them at a later date. 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. People or those close to them are involved in planning how their care needs will be met and this helps to make sure care is given in a way that takes account of peoples preferences and abilities. Peoples privacy and dignity is respected. Evidence: During the visit we looked at three peoples care plans. The plans have information about peoples personal, health and social care needs and the support people need to meet these needs. In most cases the care plans were up to date. In two peoples care records some of their plans needed to be changed to reflect recent changes in their conditions. For example, one person had started to walk with support from staff since moving into the home and the care plan relating to mobility needed to be updated to reflect this. This was discussed. Staff we spoke to were aware of peoples needs, changes in peoples conditions and of what they needed to do to support people to meet their needs. There are risk assessments in place to identify areas of potential risk such as pressure Care Homes for Older People Page 13 of 29 Evidence: sores, nutrition and falls. When people are identified as being at risk care plans are in place to show how the risk will be managed. Peoples weights are recorded and we did not identify any concerns about how peoples nutritional needs are met. Earlier this year there were some concerns about how the home had managed the care of one person with pressure sores. The home has learnt from this and improved the way they record pressure area care and wound management. They have developed links with the tissue viability nurse specialist who is able to provide them with expert advice on skin care. Nursing staff have not attended training on tissue viability recently and this was discussed. We saw evidence in the care records that people are involved in planning and reviewing how their care needs will be met and people we spoke to confirmed this. The home told us that one person is going to write her own care plans. This is good practice. We did not see any evidence that peoples capacity to make decision is assessed and recorded. This is particularly important for people who have dementia or similar illnesses which effect their ability to make decisions about their lives. This was discussed. During the visit we saw one person using a recliner chair. Staff explained this is for her safety and comfort as she is at risk of falling from a conventional chair. However, there was no information in the care records to support this and show how the home had come to the decision that this was in her best interests. This was discussed. There is very little information about peoples wishes in relation to how they want to be cared for at the end of their lives. The owner is aware this is an area that needs to be developed. The home has been looking at ways of improving working practices to do more to promote peoples dignity. For example, they now use the communal toilets less and instead they take people to their rooms where they can use their own toilets. During the visit we saw that staff were kind and respectful to people and people told us the staff are kind and caring. Overall, the systems for managing medicines are safe and people get their medicines as prescribed. There were some gaps on the medicine charts. Care should be taken to make sure medicines are always signed for when they are given to avoid any Care Homes for Older People Page 14 of 29 Evidence: confusion about whether or not people have had their prescribed medicines. One person who is in the home for a short stay in managing their own medicine and this is helping them to maintain their independence. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given the opportunity to take part in a variety of social and leisure activites and are supported in following their personal interests. Evidence: Daily routines are flexible, people can get up and go to bed at the time they prefer. People can spend their time in the communal rooms or in their bedrooms. However, people are encouraged to spend some time in the communal areas so that they do not become isolated in their rooms. One person told us the home had helped to get them a specially equipped wheelchair. They said this meant they could now get out of bed for a few hours everyday and they were looking forward to being able to join in some of the activities when they were able to spend more longer periods of time out of bed. The home continues to offer people the opportunity to take part in a range of activities. These include visiting entertainers, table top gardening, games, quizzes, baking and painting. The home recently had a Music for Health session. This is run by an outside organisation, they play music and encourage people to join in by playing musical instruments. People really enjoyed this and the home have booked them to visit again. Care Homes for Older People Page 16 of 29 Evidence: One of the more unusual activities involved having a batch of eggs delivered to the home in an incubator so that they could hatch in the home. It proved very successful and people enjoyed watching the chickens develop. There is photo album of people with the chickens and this is used for discussions and as a reminder. One of the staff has taken the chickens and is keeping people informed of their progress. The home has a volunteer who visits mainly in the evening and spends time talking to people. The owner said people have benefited from this because staff are often busy in the evenings and dont have as much time to spend with people. The home is currently working with people and their families to develop personal history profiles with information about peoples past lives and their interests and hobbies. These include photographs of family, friends and events that are are important to people. These are being kept in peoples rooms and are used by staff to help them have a better understanding of the people they are looking after. The home has no restrictions on visiting and this helps people to keep in touch with their family and friends. People are supported to follow their chosen faith, Christian services are held in the home for people who want to attend. People told us they enjoy the food. They said they are offered a choice and can have a cooked breakfast if they want it. The home has menus for breakfast and supper which are available for people and they are working on a tea time menu. The meal service at lunch time was well organised and people were given time to enjoy their food. Staff helped people discreetly where necessary and talked to people while helping them to eat. 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 know how to make a complaint and complaints/concerns are taken seriously and acted on. There are suitable systems in place to make sure that people are protected. Evidence: The home has a complaints procedure. Every bedroom has a copy of the Service User Guide which includes information on how to make a complaint. The results of a survey carried out by the home in April and May 2009 showed that people using the service know how to make a complaint if they need to. The home told us they have had one complaint in the last 12 months. This was recorded with details of the outcome of the complaint. We have not received any complaints about the service. There are policies and procedures in place to protect people from abuse. Staff told us they had attended safeguarding (adult protection) training provided by Bradford Social Services. They are aware of how to report any concerns or suspicions they might have. The owner has not attended the safeguarding training for service managers. The registered manager had attended this training but has now left the home. The owner and new manager should attend this training to make sure they are up to date with the multi-agency safeguarding procedures. Care Homes for Older People Page 18 of 29 Evidence: There has been one safeguarding referral since the last inspection. The home cooperated fully with the investigation and the matter has been resolved. 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 is clean and provides a pleasant and comfortable place for people live. Evidence: The home was clean and free of unpleasant odours when we visited and people said it is always clean. The standard of decor throughout is good and there is an ongoing programme of redecoration and refurbishment. For example, the lounge and dining room chairs have been replaced and the dining room has been decorated with a blue theme which extends to co-ordinating blue drinking tumblers. Peoples bedrooms are suitably furnished and equipped and people told us they like their rooms. One person said they particularly liked being able to watch the birds, squirrels and other wildlife in the garden. The home told us they are planning to improve the outside seating areas for next year to make it easier for people to be outside and enjoy the gardens. People are encouraged to have personal belongings such as ornaments, photographs and small items of furniture in their rooms. There are suitable systems in place to reduce the risk of cross infection. Since the last Care Homes for Older People Page 20 of 29 Evidence: inspection the home has provided two mechanical sluice machines which are used to clean and disinfect equipment such as commodes. The home has been given a 3 star (the highest is 5) rating by Environmental Health for its standards of food hygiene and safety. 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. There are usually enough staff to meet peoples needs. People are protected because all the required checks are done before new staff start work. Staff are supported to develop their knowledge and skills and this helps to make sure that people are cared for properly. Evidence: People told us the staff are caring, willing and helpful and are available when they need them. One person said you just ring the bell and they come. There are usually 5 care staff on duty in the morning and 4 in the afternoon and evening. In addition there is always one nurse on duty and the owner is in the home most days. Overnight there are a total of three staff, one nurse and two care staff. The home employ separate staff for housekeeping and catering. During the visit we saw staff quietly going about their duties in an organised way. They did not appear to be rushed and had time to talk to people. Staff told us they enjoy working in the home. They said there has been a big improvement in the amount of training they get and they feel this has helped them to give people better care. They were able to give examples of how they have changed some of their working practices following recent training on the care of people with dementia. Care Homes for Older People Page 22 of 29 Evidence: Information provided by the home showed that 70 of care staff have achieved an NVQ (National Vocational Qualification) at level 2 or above. When we visited one member of staff was working toward NVQ level 2 and two were about to be enrolled on this training. Three staff are working toward NVQ level 3. This shows that the home is committed to making sure people are cared for by trained and competent staff. Training records are kept in individual staff files. The records showed that over the past year staff have received training on a dementia care, adult protection, moving and handling and the Mental Capacity Act. We looked at the files of three newly appointed staff and they showed that all the required checks were completed before they started work. This includes two written references, PoVA (Protection of Vulnerable Adults) and CRB (Criminal Records Bureau) checks. Records of induction training are kept in the staff files. Staff confirmed they received induction training when they started work and said this told them what they needed to know to meet peoples needs. The owner told us that name badges have been ordered to help people identify individual staff members. 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. There are suitable arrangements in place to make sure the home is appropriately managed. People using the service are given the opportunity to share their views and contribute to the improvement and development of the service. Evidence: The registered manager left approximately two weeks before the inspection. The owner, who is a registered nurse, is in day to day charge of the home until a new manager is appointed. The owner is in the process of appointing a new manager. People told us the owner is approachable, they said they would not hesitate to talk to her if they had any concerns and they felt confident their concerns would be taken seriously. The home completed the annual quality assurance assessment (AQAA) and sent it back to us in good time. It gave us the information we asked for and showed that the home has identified areas where they can continue to make improvements. Care Homes for Older People Page 24 of 29 Evidence: The home has information about the Mental Capacity Act and the Deprivation of Liberty Safeguards and some staff have attended training on this. The owner and one of the nurses were booked to attend training at the end of November. There was no information in peoples care records about their capacity to make decisions and this was discussed. The home sent surveys to people using the service in April/May 2009. We saw some of the responses, they showed that people are satisfied with the service. The home does not have formal meetings for the people who live there but there is a lot of informal consultation. The home also sent surveys to people during the year asking for their suggestions on changes to the menus. There are regular staff meetings and the records showed that staff receive one to one supervision. Staff supervision is not happening as often as recommended, (six times a year) and the home should address this to make sure staff continue to get the support they need to to carry out their roles effectively. The home does not hold any personal money for people. There are safes in the bedrooms where people can keep money and valuables if they want to. If people are not able to manage their own money any extra services they have are added to their invoices. Information provided by the home showed that there are systems in place to make sure equipment and installations are maintained and serviced at the recommended intervals. The records showed that the fire alarm system is tested every week. The yearly gas safety checks were due in November 2009 and the owner said she would send us a copy of the gas safety certificate as soon as it available. 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 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 7 Peoples capacity to make decisions should be assessed and recorded. Decisions made in peoples best interests should be recorded. This should include details of the reasons, the alternatives and the people involved. Nursing staff should attend training on tissue viability to make sure they are up to date with current best practice on the prevention and treatment of pressure sores. More attention should be given to making sure that medicines are signed for when they are administered to reduce the risk of errors. The owner and new manager should attend the safeguarding training for service managers provided by Bradford Social Services so that they are fully aware of the multi-agency safeguarding procedures. This will help to make sure people are properly protected. The owner should keep us informed about the management arrangements and the new manager should apply for registration within 6 months of their appointment. Staff should have one to one supervision 6 times a year to make sure they continue to receive the support they need Page 27 of 29 2 8 3 9 4 18 5 31 6 36 Care Homes for Older People 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 to carry out their roles effectively. 7 38 The home should send a copy of the annual gas safety certificate to the Commission as soon as it is available. Care Homes for Older People Page 28 of 29 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). 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