Care Home: St George`s Nursing Home

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What the care home does well Service users have their needs assessed before they move to the home, to ensure that their needs can be met. Service users are treated with respect and have their dignity maintained. Visitors are made to feel welcome and communication between relatives and staff is good. Access to appropriate medical services in the community is enabled in a timely manner. There is appropriate equipment which is well maintained and which staff are trained to use, to assist service users in their daily living. Service users are safe, and confident that complaints will be listened to. What has improved since the last inspection? The general care and presentation of service users, together with the way in which staff relate to service users had improved significantly. The way in which mealtimes are managed had improved so they were a more relaxed, unhurried and pleasant experience than observed at the last inspection visit. Cleanliness throughout the home had improved. What the care home could do better: Several areas of administration could be improved. These included ensuring that all aspects of the written care plans are updated following a change in circumstances; maintaining a central record of how complaints have been investigated and ensuring there is a clear record of what training staff have received. Records relating to the vetting of prospective staff could be maintained with more rigor. Issues identified in connection with the record keeping did not appear to have an immediate negative impact on service users. However, it did have a negative impact on the home`s ability to be accountable for their care and safety. More thought could be given to the visual presentation of food. Inspecting for better lives Key inspection report Care homes for older people Name: Address: St George`s Nursing Home Northgate Lane Northgate Lane Oldham Lancs OL1 4RU     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: Steve Chick     Date: 2 7 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 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: St George`s Nursing Home Northgate Lane Northgate Lane Oldham Lancs OL1 4RU 01616264433 01616782473 admin@stgeorgescarecentre.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): St George`s Nursing Home (Oldham) Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 77 Number of places (if applicable): Under 65 Over 65 0 0 77 0 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: 77 77 0 77 The registered person may provide the following category of service only: Care home with nursing - Code N To people 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 Dementia - Code DE Mental Disorder, excluding learning disability or dementia - Code MD Physical disability- Code PD The maximum number of people who can be accommodated is: 77 Date of last inspection Care Homes for Older People Page 4 of 28 Brief description of the care home St Georges Nursing Home is a purpose built nursing home, which was first registered in October 2002. The home is owned by St Georges Nursing Home (Oldham) Limited and is registered to provide nursing care to 77 people, primarily to older people with dementia type illnesses. The home also offers general nursing care unit,an enduring mental health unit and an early onset dementia facility. St. Georges is situated in Moorside, approximately three miles away from Oldham Town Centre. Access to the Pennine Moors is literally minutes away. Local amenities and access to local bus services are readily available. Close to the home is a new housing estate and a medical practice centre has recently been built. Outside the home, some borders have been planted, patio areas developed and other areas around the building have been grassed. Limited car parking facilities are available. Accommodation is provided over two floors. There are three units on the ground and two units on the first floor. Keypad security locks are used in the home. All bedrooms are spacious single rooms providing en-suite facilities. Varied bathing facilities are available on each floor. Facilities are also available for service users and visitors to make a drink. An extension to the home was completed in April 2007. A copy of the homes last inspection report was available from the main reception of the home. The current weekly fees range from 436 pounds to 1200 pounds dependent on the package of care required. Further details regarding fees are available from the 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: The quality rating for this service is two star. This means the people who use this service experience good quality outcomes. We (the Commission for Social Care Inspection) undertook a key inspection, which included an unannounced visit to the home. This meant that no one at St Georges knew that the visit was going to take place. We returned on a second day, when people did know we were coming, to talk to more service users and staff. On the first day we were accompanied by an expert by experience. This is a person who has experience of using services for older people and has received training in taking part in and contributing to the inspection process. Care Homes for Older People Page 6 of 28 For the purpose of this inspection four service users were interviewed in private, as were five relatives of service users and three staff members. Additionally discussions took place with the acting manager and the companys Director of Nursing. All the key inspection standards were assessed at the visit. We also looked at information we have about how the service has managed any complaints, what the service has told us about things that have happened in the service, these are called notifications and any relevant information from other organisations. Before the visit, we asked for surveys to be sent out to service users, and staff, asking what they thought about the care at the home. Four residents, and two staff returned their surveys to us. Some of the information from these surveys is included in the report. We also asked the management of the home to fill in a questionnaire, called an Annual Quality Assurance Assessment (AQAA). This is a legal requirement. The AQAA told us what they thought they did well, what they need to do better and what they have improved upon. Where appropriate, some of these comments have been included in the report. We undertook a tour of the building and looked at a selection of service user and staff records as well as other documentation, including staff rotas, medication records and the complaints log. We have not received any complaints about the service since our last Key Inspection. The majority of comments we received were positive about the care at St Georges. One relative said personally Im very pleased I picked St Georges. A service user said that they treat you like a real person and another said the best thing about the home was caring for my needs. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 28 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. Service users are only admitted to the home after an appropriate assessment to ensure the home can meet their needs. Evidence: The manager told us in the AQAA (Annual Quality Assurance Assessment) that prior to admission a pre-admission assessment would be undertaken by an appropriately qualified nurse to confirm if the home is able to meet the needs of the individual. This assessment would also identify if there were any items of equipment or adaptation required for their accommodation. A selection of service users files was looked at. All had a copy of an assessment which, it was reported by the acting manager, had been undertaken before a decision was made that St Georges was able to meet the service users needs. Care Homes for Older People Page 11 of 28 Evidence: Some examples were seen where the assessment was not dated. This made it difficult for the management to demonstrate when the assessment had been undertaken. However, relatives, service users and staff who were asked, all confirmed that an assessment did take place before anyone moved into the home. St Georges does not offer intermediate care. 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. Service users health and personal care needs are met by the implementation of the policies and procedures. Staff practices also serve to promote the dignity of service users. Evidence: The manager had told us that the care plans were specific and service user focused and addressed health, social, emotional and spiritual care needs. A selection of service users files was looked at. All had a copy of a written care plan and there was some documentary evidence that the care plans were reviewed. There was variation in the quality and ease of access of the information in the files seen. There were some basic housekeeping flaws in the administrative system which could serve to discredit the information contained in the files. For example files contained pre-printed sheets with various titles such as monthly observation record, communication with relatives and professional visits which were either not completed or only occasionally completed. In the examples seen relevant information Care Homes for Older People Page 13 of 28 Evidence: was maintained but not necessarily in the right places as determined by St Georges own administrative system. Examples were also seen where due to a change in circumstances the care plan had been amended, but information and instructions which had become invalid as a consequence of the amendment were not themselves deleted or changed. This sometimes confusing way of recording could lead to care practice errors by staff if they had no other sources of information about the correct way to meet an individual service users needs. Staff who were spoken to reported that communication between shifts was, in practice, effective and they were kept up to date about each service users needs. One staff member who returned a survey felt that the carers (as opposed to the nurses) did not always get information passed on to them. Discussion with visitors and service users indicated a good level of satisfaction with the care given by the staff at St Georges. One person described the care as marvelous, another said all the staff were good and you cant fault them. One service user said in a survey returned to us I am pleased to say confidently that I have always received the care and support I need and if there has been something extra I wanted to do they have always supported me in achieving this. Service users and visitors who were asked were very positive about being treated respectfully and having their dignity maintained. One visitor noted that staff always knock on the door and say excuse me X. This visitor also noted that they could hear staff being respectful to service users even when staff did not know the visitor was there. The expert by experience noted that service users looked well cared for and were spoken with in a respectful manner by staff who were aware of the character of individual residents. The manager had told us in the AQAA that the company employed a GP adviser whose role it was to advise on best practice and to act as the leading clinical governance. There was documentary evidence that service users had access to community based medical services. All service users and visitors who were asked, were confident that medical support was obtained when necessary, in a timely manner. Medication was seen to be stored appropriately in the home. A small sample of medication records was looked at. These presented as appropriately maintained to demonstrate that service users were receiving the correct medication in the correct dose at the correct time. Care Homes for Older People Page 14 of 28 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. Appropriate social contacts and activities are facilitated within the home to give service users the opportunity for social fulfillment. The dietary needs of service users are catered for with a balanced and varied selection of food. Evidence: The manager had told us in the AQAA that the company employed two full-time activities coordinators who assessed, planned, organised and participated in the social care of the service users. The expert by experience reported seeing little evidence of activities being undertaken during her visit. Records were maintained of activities undertaken by each service user. A selection of these was looked at and indicated a big difference between individual service users in their involvement in activities. Discussion with the acting manager indicated that this was a reflection of the desire or ability of individuals to participate. Service users and visitors who were asked, confirmed that activities did take place, although some visitors said their relative did not participate. Another visitor Care Homes for Older People Page 16 of 28 Evidence: told us that service users received plenty of stimulation. One service user who we spoke to was very positive about how staff worked to enable them to maintain their lifestyle, including the use of the homes gym and an ability to go out when they chose. Visitors who were asked, confirmed that they could visit at any time and were made to feel welcome. One visitor appreciated being able to have a laugh and a joke with the staff. The building has a therapy kitchen, which the acting manager reported as being underused. The kitchen was available to be used as part of a planned rehabilitation, or as a private meeting place where service users could act as the host for visitors, in the more usual setting of a kitchen environment. The building also had a gym which was a welcome facility for at least one service user. Information was provided on noticeboards about the availability of independent advocates. The acting manager told us that these advocates had been used on occasions. One meal was sampled during the visit. The visual presentation of the food was not good as there was little differentiation in colour between most of the food. The expert by experience found the main course to be poorly cooked, with some roast potatoes undercooked and others burnt, and tasteless. The desert however, was enjoyable and tasty. The expert by experience also observed that all service users on the unit where they dined had the same food, which called into question the availability of a choice. However, the acting manager told us that service users on all units had a choice of menu. Service users and visitors who were asked, expressed the view that the provision of food was good and that there was a choice. One visitor said that their relative loves the food and the variety ... breakfast is excellent. The expert by experience also observed service users drinking thirstily and queried if enough drinks were available. The acting manager reported that drinks were always on offer. Positive observations during the meal included soft diet portions being presented pleasantly and not amalgamated into one puree It was also noted that ample staff numbers at the meal time allowed it to be unhurried and people who needed assistance got help in a friendly and sensitive manner. 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. Service users are protected from abuse or exploitation by the homes policies and practices and are confident that any complaint they may have would be dealt with appropriately. Evidence: The home has a written complaints procedure which was not looked at on this visit. The manager had told us that their complaints system was robust and all complaints would be taken seriously. All surveys returned from service users said they knew who to talk to if they were not happy. All but one said they knew how to make a complaint. All service users, visitors and staff who were asked, expressed confidence that any complaint would be listened to and acted upon. Comments included very much so and definitely. The complaints log was looked at. The complaints which were in the log presented as being appropriately investigated and well recorded. Whilst there was no evidence that complaints were not dealt with appropriately, there was some evidence that they were not always recorded in the complaints log. There is an advantage for service users in the staff keeping one comprehensive record, which is to enable easy management overview of any recurrent themes so that action can be taken at an early stage to modify any policies or practices. Care Homes for Older People Page 18 of 28 Evidence: All service users and relatives who were asked, expressed the view that service users were safe - as in protected from abuse or exploitation - at St Georges. One relative said one of the best things about St Georges was that I can go away and feel safe and at ease. Another relative told us that [I am] happy when I leave, X is well looked after. Almost half the staff had received POVA (protection of vulnerable adults) training in the last two years. The acting manager reported that more training opportunities in connection with POVA were being brought in for staff who needed updated training. All staff who we asked, told us that they believed that service users were safe. They also told us they were aware of their responsibility to be vigilant about the possibility of abuse. They also told us they were aware of what action to take should they believe any service user to be a possible victim of abuse. We are not aware of any complaints or safeguarding issues, since the last key inspection, which had not been dealt with appropriately by the management of the home. 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. The home is appropriately maintained, decorated and cleaned to enable service users to live in a pleasant, safe and hygienic environment. Evidence: During this Key unannounced inspection a tour of the premises was undertaken. This included communal areas and a selection of service users bedrooms. The building presented as clean and tidy with no unpleasant smells. This was described as the usual state of the building by all service users, visitors and staff who were asked. One visitor said they liked the fact that mams room is always clean. All surveys returned indicated that the home was always fresh and clean. Observation confirmed that service users could personalise their bedrooms. There were electronic keypad locks between the different units at St Georges. There were also two entrances, with one being a dedicated entrance for Brookdale unit. The expert by experience thought the building lacked the warmth of a homely atmosphere and found the public areas very quiet. There was evidence that the acting manager was in the process of planning to display a series of large photographs taken by service user and recently donated by their relative. Care Homes for Older People Page 20 of 28 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. Recruitment and vetting procedures are usually effectively applied to minimise the risk to service users of inappropriate staff being employed. The numbers and skills mix of staff on duty promotes the independence and well-being of service users. Evidence: St Georges comprises five distinct units, each offering a service to different numbers of people with distinct needs. At the time of this visit one unit (planned for service users with acquired brain injuries) was not in use. Staffing levels in each unit varied to reflect the different needs of the service users resident. We were given copies of the staff Rota for each unit for the four weeks up to 01/02/09. The manager had told us in the AQAA that staffing in the home was generally in excess of requirements. The acting manager told us that staffing levels were appropriate to meet the needs of the service users. We were also told by the acting manager that staffing levels were continually under review and that lead nurses on each unit were expected to tell the manager if staffing levels were not sufficient. Service users and visitors who we asked, described staff as being very busy and sometimes rushed off their feet. However they also told us that the care was very good and staff are all good, and the nurses are hands on and you cant fault them Care Homes for Older People Page 22 of 28 Evidence: and [ there are] always staff around to help. The acting manager told us that in addition to the qualified nurses there were 61 carers employed at the home. 32 of these had achieved an NVQ (National Vocational Qualification) II in care, which is qualification intended to demonstrate that the person has achieved a level of knowledge and skill in this area. We looked at a small sample of certificates to verify this. We were also told that a further 15 staff were undertaking NVQ II and five were doing NVQ III. The manager had told us all potential members of staff had pre-employment checks to assess their suitability for working in this environment. This was also confirmed by staff who returned surveys and staff who were asked during the visit. We looked at a selection of records relating to the recruitment and vetting of care staff since the previous inspection. There was good evidence that most of the required checks and references to indicate the person suitability to work with vulnerable adults, had been obtained. Two examples were seen where written information about the applicants employment history was incomplete. No records could be located to indicate if these gaps had been satisfactorily explored with the person. Without this evidence it is difficult for the management team to demonstrate that all reasonable steps had been taken to minimise the risk of exposing service users to inappropriate staff. There was some uncertainty in connection with the training records which were available. The electronic database did not appear to have been kept up to date, but the acting manager had worked hard to gather what information she could to identify which staff may have some gaps in their training needs. The acting manager and the companys director of nursing services undertook to address training needs within three months. Staff who were asked, told us that they felt supported by the management team to pursue training opportunities. Appropriate interactions were observed between staff and service users. One service user told us that they [staff] treat you like a real person. One visitor said particular staff are commendable, knowledgeable, caring and compassionate. 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 management systems in place in the home serve to maintain the health and safety procedures for the benefit of service users and staff, protect the financial interests of service users, and seek the views of service users and their representatives to further improve the service. Evidence: The registered manager had left Georges shortly before this unannounced inspection. The acting manager has several years experience in a senior position, including having been the registered manager at a different care home. The Director of Nursing told us that recruitment to the managers post was to take place in the week following this inspection. There was evidence that the management team had received satisfaction surveys from service users, relatives and staff in June 2008. The results of this survey had been collated to give a comparison of satisfaction perceptions between the previous two Care Homes for Older People Page 24 of 28 Evidence: years. However, while this did indicate an improvement in satisfaction, it did not appear to have resulted in an annual development plan which addressed ways in which outcomes for service users might be further improved. Regular meetings for relatives and service users were held. Minutes of some of these meetings were seen. One relative confirmed in a survey returned to us, that they had been consulted via a family forum meeting and that as a consequence of that meeting a communication book system had been introduced on one unit, which had a positive impact. A selection of records relating to money held by St Georges on behalf the service users was looked at. These records presented as protecting the interests of the service users and included receipts for any items purchased on their behalf. We were told by the manager that equipment and building health and safety checks and maintenance were regularly undertaken. A small sample of records was looked at which confirmed this. Staff who we asked confirmed that they were expected to draw any health and safety issues to the attention of management and that action was taken in a timely manner. Staff who were asked also confirmed that personal protective equipment (such as disposable gloves and aprons) were always available and used to minimise the risk of cross infection. The expert by experience observed two carers using a hoist to move a service user in a practised and appropriate way. 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 7 Service users files should be periodicaly audited to ensure that they only contain up to date and relevent information, to minimise the risk of staff, who do not have other knowledge of the individual service user, not offering appropriate care. Care should be taken in the presentation of each meal to ensure the food is visually appealing, including for people with poor eyesight. A central record of all complaints should be maintained to enable management to identify quickly any patterns or trends which may require intervention. Records must be thoroughly maintained to demonstrate that all reasonable steps have been taken to minimise the risk of employing people who may be unsuitable to work with vulnerable people. This particularly relates to the investigation of any gaps in an applicants employment history. The quality audit systems should be used to create an annual development plan which addresses ways in which outcomes for service users might be further improved. 2 15 3 16 4 29 5 33 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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