Care Home: St Lukes Care Home

What the care home does well There is a very good pre admission assessment process in place, giving the assurance that peoples` needs are satisfactorily identified, in order to determine if those needs can be met at St Luke`s. The care planning documentation is good. It was stated that, `future care plans will be more `Person Centered`, which would clearly show peoples` likes,dislikes, wishes and aspirations`. The provision of activities is of an excellent standard, with two activity coordinators being employed. This helps to give the assurance that people are receiving appropriate motivation and stimulation. The home is well managed and organised. The general feedback received demonstrates that positive changes have taken place since the previous inspection. This helps give assurance that vulnerable people are receiving a good service. What has improved since the last inspection? The provision of safeguarding adults training is now being provided in a more robust and measurable manner. This helps to give the assurance that vulnerable people are being protected. The members of staff who were interviewed all had a good awareness of the safeguarding procedures, especially the `whistleblowing` process. This helps to show that people will be protected from harm. It is evident that the provision of formal supervisions are now more frequent. This was particularly evident on nights. This helps give the staff team an assurance of being valued and also gives people the opportunity to raise any concerns or issues they may have. There is more of managerial presence during the night. This helps to promote consistency and promote unity between the day and night staff. The improved provision of team leader meetings, relatives meetings and staff meetings is a positive action, promoting quality assurance monitoring. What the care home could do better: The present manager to be registered with CQC. This would give further stability to St Lukes. Continue with the improved measurable training and regularly assess people`s competency. Continue with the improved supervision programme. This gives members of staff the opportunity to voice their opinions and any concerns they may have. Key inspection report Care homes for older people Name: Address: St Lukes Care Home Palace Fields Avenue Palacefields Runcorn Cheshire WA7 2SU     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: Phil McConnell     Date: 0 3 0 6 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: St Lukes Care Home Palace Fields Avenue Palacefields Runcorn Cheshire WA7 2SU 01928791552 01928759244 stlukes@c-i-c.co.uk www.c-i-c.co.uk Community Integrated Care Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Irene Marsden Type of registration: Number of places registered: care home 60 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users who can be accommodated is: 60 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: Dementia Code DE Date of last inspection Brief description of the care home St. Lukes is a purpose built establishment for the provision of nursing care for up to sixty residents diagnosed with dementia inclusive of 2 places registered for physical disability. This service is provided within four separate suites located over two floors, each unit has its own lounge, dining room, utility kitchen and staff team. Each unit provides accommodation for a maximum of 15 residents. The design features include passenger lifts, safety alarmed exit doors, single level flooring with external access, Care Homes for Older People Page 4 of 27 Over 65 0 60 1 5 0 1 2 0 1 0 Brief description of the care home grab rails, and adaptations in all communal areas, bathrooms and toilets. Externally there is a central patio area and sensory garden accessible to all residents. St Lukes is located in a large residential area on the outskirts of Runcorn. The home is on a main bus route and rail links are within two miles of the home at Runcorn East station. The service is provided by Community Integrated Care, a not for profit organisation. The present fees are between £382.43 - £650.00, depending on individual needs. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Various information was gathered to in order to be able to assess the National Minimum Standards for Care Homes for Older People, including: The Annual Quality Assurance Assessment, this is a document which the manager completes every year and it contains information about the service being provided. We use this information, in part to focus on our inspection activity. The previous report (15/01/10) that had been completed by the Care Quality Commission was also used to obtain relevant information. An unannounced inspection visit to St Lukes took place on the 1st of June 2010, with a subsequent unannounced night inspection being carried out on the 3rd of June 2010. In total the visits lasted approximately 10 hours. Throughout the inspection visits, there was the opportunity to speak to some of the Care Homes for Older People Page 6 of 27 people who use the service, speak to some visitors and discussions also took place with a number of the staff team, both during the day and at night. Peoples files were examined, with all relevant documentation being in place including, initial assessment documentation and care plans. Staff files were examined and they also contained all of the necessary documentation needed for inspection purposes including, recruitment information and evidence of various training that has been provided including, the Safeguarding of Adults training. Throughout the site visits there was the chance to observe the support and care that was being provided to individuals, which was done in a caring, appropriate and professional manner. The organisations policies, procedures and the health and safety documentation were examined and they were found to be up to date and satisfactory. A tour of the premises was carried out and it was found to be clean, safe, hygienic, comfortable and very well decorated throughout. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 8 of 27 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 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Satisfactory and appropriate pre admission assessments are completed prior to a person going to live at St Lukes. This helps to show that peoples needs will be provided for. Evidence: There have been no new admissions to St Lukes since the last inspection visit. Although the inspection in January 2010 identified that the there was a good pre admission assessment process in place. We were informed by the managers that the home still maintains a thorough assessment process and improvements have been implemented to help ensure that systems are quality monitored. The manager said, the Quality Clinical Governance department, are constantly looking to update care plan documents, taking into account best practice and personalisation including, all assessment procedures. The information received during the initial assessment period is used to formulate a Care Homes for Older People Page 11 of 27 Evidence: care plan for the person receiving the service. We had a discussion with the manager regarding assessments and it was evident that there are satisfactory systems in place to ensure that peoples nursing and care needs will be appropriately assessed, before a service is offered. We observed that relevant information is made available to people to help them decide about living at St Lukes, some of the information included, service users guide and statement of purpose. There are notice boards in all parts of the home and these contain information about the home and activities and daily life and the home have also produced their own booklet on dementia and also on infection control so that relatives and people living in the home can be made more aware. This helps people to orientate and settle into the home. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health care needs are satisfactorily provided. This helps to demonstrate that the provider is committed to ensuring that peoples health and wellbeing is promoted. Evidence: Some of the service users care plans in each of the homes four units, were observed and it was evident that they had been reviewed on a monthly basis, with any changes to nursing or care needs being documented. This helps to give the assurance that peoples assessed needs are regularly monitored and provided for. It was mentioned by the manager, Our future plan is to make care plans more Person Centered, which would clearly show peoples likes, dislikes, wishes and aspirations. There were records to show that peoples health care needs are being appropriately provided for including, records of GP visits, Chiropodist, dietitian, optician and evidence of other health professional appointments and consultations taking place, for example a consultant psychiatrist regularly attends the home for reviews. Care Homes for Older People Page 13 of 27 Evidence: The medication procedures were examined in each of the units and it was evident that generally the recording, storage and administration of medication was correctly carried out, with only qualified nurses administering medication. We saw that all medication was stored in locked trolleys and in cupboards in each of the units clinical rooms. Each persons Medication Administration Record (MAR) contained a photograph of the person. This helps to assist with the identification of individuals. The PCT recently carried out a medication audit, which was assessed to be good. The manager informed us that St Lukes will soon be changing their pharmacy provider. This is to access additional medication training and the new pharmacist also provides more frequent medication audits. We were informed that full medication reviews were being carried out for people, in order to determine, what is the best for each person. During both of the inspection visits, members of staff were observed treating service users with dignity and respect. Some of the comments received from staff were, I treat everyone like it was my mum or dad I came to work here because I want to look after people. I love working here and I have recently done dignity in care training, it was really good. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a very good provision of relevant, regular and appropriate activities available. This helps to demonstrate that people are encouraged, motivated and stimulated as much as possible. Evidence: Activities for service users are organised on a daily basis. These are provided in each of the four units in rotation.The home has two committed staff who are employed to coordinate the activities. The two members of staff were observed providing activities during the first visit and they were also in the home at 10 pm on the night visit, where they had been attending a relatives meeting. The ongoing activities programme includes in house events and activities, which are advertised on each unit. We saw that each person had activities recorded and there are also very good pen portraits of the people in the home [memory books] which are the result of a recent project so that staff can become aware of peoples history and preferences regarding social activities. We spoke to staff who were very knowledgeable about the people they were supporting. Staff reported that there are a lot of care tasks to perform in the morning Care Homes for Older People Page 15 of 27 Evidence: but good staffing levels ensure that care is not hurried. There were good comments regarding the provision of meals and in discussion with some of the kitchen staff it was apparent that they have a good understanding of any specific dietary needs of individuals, for example if people have diabetes. Satisfactory records are maintained, with evidence of varied menus and alternatives being offered at all times. We saw that dining tables on the units were well presented and tables were laid appropriately so that people with dementia can be clearly orientated. There was a menu available and this was also posted on a board in the dining room. The ground floor units have easy access to an enclosed garden and the units are designed so that people with dementia can be orientated with level access to bedrooms for example. There is also good use of assisted technology with sensors in peoples bedrooms that can be activated if people are at risk of falls for example. This shows that care is organised around trying to remove any barriers for people with disability [dementia] so that they can make decisions about their daily life. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The feedback received from the recent robust safeguarding training helps to give the assurance that vulnerable people will be protected from harm or abuse. Evidence: There was a comprehensive complaints policy and procedure in place at St Lukes. The complaints procedure is prominently displayed in each of the four units in the home. No complaints have been received since the previous inspection visit. In the feedback received it is evident that members of staff and relatives would know how to make a complaint and would be sufficiently confident to be able to do so. The previous inspection report highlighted the evident failures in the homes safeguarding procedures, namely in that members of staff failed to inform the relevant bodies of their alleged witnessing of abuse to service users by another member of staff. Although it was clearly identified that there was a satisfactory policy and procedure in place and relevant training had been provided by the organisation. During this inspection it was evident that the provider has been proactive in ensuring that all members of staff have received up to date safeguarding training and they are fully aware of the whistleblowing process. The nurses within St Lukes have all received the Safeguarding of Adults referrers course that was provided by Halton Borough Council. A considerable number of staff members were interviewed, with the Care Homes for Older People Page 17 of 27 Evidence: emphasis being about the safeguarding of vulnerable adults. People were very positive about the recent training they had received and generally expressed how good the course was, for example, I did my training a couple of weeks ago, it was really good I went on safeguarding training, it really made me think, it was very interesting and It opened my eyes, things that I didnt realise were abuse are; like not giving someone enough to drink or not offering an alternative or not giving a choice or option. Overall the people interviewed were very complimentary about the training and also about working at St Lukes. This helps to show that staff are satisfactorily trained in protection issues. Halton Borough Council have also carried out their own inspection programme, which was to specifically assess if the identified safeguarding failings had been addressed. The inspection was undertaken by the Quality Assurance Manager and the completed report stated that 14 of the 15 actions had been completed. The conclusion in the report of their visits said, Halton are satisfied that this action plan has in the most been completed. The new management team have made considerable improvements to this service . There were no areas of concern that were highlighted in these visits. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environmental standards at St Lukes are good. This will help give assurance that people live and work in a safe, comfortable and pleasant home. Evidence: A full tour of the premises was carried out and throughout it was found to be of a very good standard. It was found to be clean and hygienic, with anti bacterial hand gels strategically situated around the home. This is regarded as good practice, helping with the management of cross infection. The decor and furnishings within the home are maintained to a good standard. A good range of aids and adaptations in each of the units in the home were observed including, wheelchairs, walking frames, specialised chairs, specialised beds and fully equipped bathrooms and toilets. This helps to show that the organisation provides care and support for people with varying diverse needs and disabilities. The day areas are bright and there are plenty of visual stimuli with art projects and pictures and photos displayed. The bedrooms observed were highly personalised, displaying evidence of peoples individual lifestyles and past histories. There is a sensory room (Snoozelen) which is adequately equipped to provide stimulation, relaxation and calmness for service users. It was commented, this room is used a lot and people really enjoy coming in here. Care Homes for Older People Page 19 of 27 Evidence: The kitchen was observed to be clean and hygienic with sufficient equipment in place, with cleaning rotas displayed. The previous inspection (15/01/10) reported that the kitchen would benefit from being updated. Although considerable work has been carried out in the kitchen, it was discovered that the backs of the ovens, the grill and the fryer still have exposed pipes. This looks unsightly and could potentially be a risk to safety. In discussion with the manager and the area manager, an assurance was given that this issue will be correctly addressed. There are smaller kitchens on each of the four units that have facilities for making drinks and snacks. The laundry was seen to be very well organised, with adequate machinery to cater for the needs of the people living at St Lukes. The feedback received was very positive regarding, the cleanliness, comfort and decor of the home. For example, the home is really well decorated and well maintained. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is evidence to show that the staff team are committed and dedicated to the service users that they nurse and care for. Evidence: Staff files were observed to be well organised, with all of the necessary recruitment documentation being in place including, application forms, two written references for each person, Criminal Record Bureau (CRB) checks, Protection of Vulnerable Adults (POVA), contracts of employment and job descriptions. This helps to demonstrate that the recruitment of staff is thoroughly carried out. During the two inspection visits to the home it was observed that there were sufficient numbers of staff on duty including, nursing staff and carers. The previous report highlighted the shortfalls regarding safeguarding procedures in St Lukes, as already mentioned the failure of some staff to whistleblow. It was apparent at this inspection visit that the provider has consistently provided relevant, appropriate and necessary training. The safeguarding of adults training has been paramount in the months since the last inspection. Some of the comments from staff who have accessed the safeguarding training was, I went on safeguarding training in Widnes, It was good and very interesting the Care Homes for Older People Page 21 of 27 Evidence: training opened my eyes a bit more I had training a couple of weeks ago with Social Services and I am fully aware of how to whistleblow. We were informed that staff working on nights have been moved around the different units. The feedback received was generally positive about this, with some of the comments from staff being, We were moved about recently, worked on all of the units. I love my job Been moving staff around, its been good. Its been good for the mixing of skills etc and moved us all around, its been a good idea, got to know all of the service users. The telephone number for the local authority safeguarding team was observed on the notice board in the office on each unit. Members of staff were fully aware of what to do in the event of of needing to raise the alarm if they had any concerns, regarding suspected or alleged abuse. There was evidence that all relevant and satisfactory training is being provided by the organisation. Some of the other training being provided included, Dementia awareness, infection control, first aid, nutrition, fire training, crisis prevention intervention (CPI), moving and handling and the management of challenging behavior. It is evident that there has been a thorough and consistent training programme in place, particularly the safeguarding of adults. This clearly demonstrates that CIC is committed to ensuring that vulnerable people are protected as much as possible. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. St Lukes is well organised and managed. This helps to give the assurance that peoples health and safety is continually monitored, demonstrating that peoples heath and safety is promoted. Evidence: The present manager has been in post since September 2009. We are aware that she has applied to CQC to be the registered manager for St Lukes. The manager is a registered nurse, with over seventeen years experience in social care and with ten years managerial experience. She has a number of relevant qualifications including, The Registered Managers Award (RMA), English National Board Qualifications, Care of the Elderly, Care of the person with Dementia and their family, training and assessing of others and Care of the dying. It is evident that the manager is sufficiently qualified and experienced to manage St Lukes. In the feedback received it was apparent that the manager has made some very positive changes during her time at the home. Some of the comments regarding the Care Homes for Older People Page 23 of 27 Evidence: present manager were, The manager is very approachable and she has made some positive changes The manager makes time for everybody, very fair and The staff have responded to her very well, its the way she is , so easy to to approach. During the two inspection visits, the general feedback regarding the management was positive. It was evident that there has been an increased presence of management presence at night times. On the recent unannounced night visit, the manager was on the premises at 10 pm, she had been attending a relatives meeting. We were informed by members of the night staff that the manager is often around during the night or early in the morning. The increased management presence during the night has had a positive impact, helping to give the full staff team an assurance of equality and a more evident, seamless workforce between days and nights. The procedures in place regarding peoples finances were observed to be appropriate with satisfactory records being maintained. This helps to ensure that peoples finances are safeguarded. There was documented evidence to show that staff supervisions regularly take place, with a full documented record of all night staff having had frequent supervisions. This helps to show that staff members are given the opportunity to raise any concerns they may have and also helps to give them a sense of being valued and included in the overall running of St Lukes. There was evidence that staff meetings are taking place on a monthly basis, monthly meetings for heads of departments and as already mentioned, relatives meetings are taking place. The provider is being proactive in obtaining the views and opinions of others, demonstrating that quality assurance monitoring is taken seriously by CIC. The health and safety policy and procedures were examined and they were found to be up to date and all of the homes health and safety inspection certificates were also observed including, electricity, gas, fire extinguishers, portable appliances (PAT), hoists and the passenger lift inspection certificate. The inspection certificates were all up to date and correct. The home now has a full time maintenance man, who has the responsibility to maintain up to date, accurate records of health and safety checks. The maintenance and repairs around the home were observed to be carried out to a good standard. This helps to show that the health and safety of the people who live and work at St Lukes is maintained and appropriately monitored. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 19 It is recommended that the exposed pipes and electrical wiring in the kitchen, either be covered or the equipment is relocated. This would improve the safety of people using the kitchen. Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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