Care Home: St Margarets`

What the care home does well The home had maintained good outcomes for residents who use the service. The interim manager and staff have a good relationship with the residents who use the service and their family members, and relevant care professionals. Most of the residents receive the care and support needed to be well presented. The premises were clean and tidy throughout and all of the residents who use this service appeared to enjoy the meals and activities provided. The complaints and safeguarding issues are being managed well. What has improved since the last inspection? The home continued to make improvements to the environment of the home by undertaking regular internal and external decoration. The home was in the process of reorganizing staff files to include all the relevant documentation and to aid audit procedures. The home continued to work with relevant external professionals and appeared to have maintained good relations with them and sought their timely services in the best interest of the residents. What the care home could do better: The most important area for improvement is to complete the recruitment of a permanent team of staff to ensure the residents receive care that is consistent and that staff with the correct skills and training who are regularly supervised are available. Some areas of care need more attention to ensure no one is rushed when taking medication and that activities are provided to people who are harder to engage. Where agency staff are used they need sufficient basic training to be able to work safely in the home. Key inspection report Care homes for older people Name: Address: St Margarets` 84 West Heath Road Hampstead London NW3 7UN     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: Pursotamraj Hirekar     Date: 2 8 0 4 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 Margarets` 84 West Heath Road Hampstead London NW3 7UN 02087317737 02087318688 claire.cunden@camden.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): London Borough of Camden Name of registered manager (if applicable) Mrs Nuala Margaret Ward Type of registration: Number of places registered: care home 44 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: Date of last inspection Brief description of the care home St Margarets is a modern care home owned and managed by the London Borough of Camden and is situated near Hampstead Heath. The home is registered under the Care Standards Act 2000, to provide support for up to forty four (44) Older People with dementia. St Margarets opened in July 1999. The house was acquired by the London County Council in 1953 and acquired by London Borough of Camden in April 1965 and has been used as a care home at least since that date. The home has five storeys including lower ground floor and has a 2-storey extension to the rear. The home is accessible to people with disabilities. The entrance leads into a smart reception area and reception room. 0 Over 65 44 Care Homes for Older People Page 4 of 27 Brief description of the care home The home is set out in five units. Four units accommodate nine residents and the fifth unit accommodates eight residents. There are 36 single rooms and 4 shared double bedrooms. Each unit has its own kitchenette with dining area and lounge. There are two additional lounges with television and stereo. One is normally used as a quiet area. The managers office and general office are on the ground floor, with the laundry to the rear. The main kitchen is on the lower ground floor. The home is set in its own grounds, has a large garden, terrace, and parking to the front. The home is about twenty minutes walk from Golders Green and Hampstead stations. 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: This is the report of the unannounced inspection carried out on 23 and 28 April 2010 by Jenny Finch (23 April 2010 only), Expert by Experience and PursotamRaj Hirekar over 10 hours. The interim manager was present during the inspection. The inspection was carried out by talking to residents, speaking to staff, looking round the home and reading records. We also used the information from surveys completed by residents and the self assessment prepared by the home (AQAA). The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. Care Homes for Older People Page 6 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 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 7 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 8 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. The pre-admission assessments were completed in sufficient detail to assess the care needs of people considering using the service. Evidence: The annual quality assurance assessment (AQAA) received from the interim manager prior to this inspection stated that all prospective new residents have a full comprehensive needs assessment, which is completed by a Social Worker before admission. We screen the referral to ensure that we can meet the needs of the prospective new resident and we gather information from other health/social care professionals and also from families and friends where possible. We encourage the person and their families to be involved in the process. The Statement of Purpose and Service Users Guide seen during the inspection. Both these documents were comprehensive and included information about the admission procedures, management, staff, various services and facilities and complaints Care Homes for Older People Page 9 of 27 Evidence: procedure as well. These documents were given to the prospective residents and their family members to offer an opportunity to know about the home. The statement of purpose needs an update to include the interim management details and the correct name and address of the Commission. On this inspection, 5 people who use the services were case tracked. All people admitted to the home were part of the care management approach and their preadmission assessments were carried out by the Camden Adult Social Services. These assessments had been completed in sufficient detail to ensure that an informed decision could be made as to whether the staff team could meet the needs of the person. In addition to these assessments the home offered a trial visit. A placement review is carried out at the end of the trial visit which is usually six weeks. The people living in the home have diverse needs and diagnoses. The permanent staff spoken to have confirmed that they had the necessary skills and qualifications to meet residents needs. A contract in relation to the terms and conditions of services had been prepared for each of the residents. Care Homes for Older People Page 10 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. The care plans and risk assessments had been written in sufficient detail to ensure that the care needs of the people at the home would be met in a consistent and safe way. The staff and the people using the service have a good working relationship. Evidence: The annual quality assurance assessment (AQAA) received from the interim manager prior to this inspection stated that the home support and maintain positive links with doctors, pharmacists, community nurse, dietitians, chiropodists and opticians to provide a holistic approach to care, by utilizing the skills and knowledge of the community practitioners. All the 5 people who were case tracked had care plans that clearly identified their care needs. These plans had been written in sufficient detail to ensure that anyone working at the home could provide the necessary care. The care plans have been regularly reviewed and updated to reflect the changing needs of the people who use the service. The care plan documents included a number of assessments and the associated risk assessments as well. Their care related documents indicated that they had seen Care Homes for Older People Page 11 of 27 Evidence: various health care professionals including doctors and community nurses as well. The medication administration records were checked for 5 residents and those indicated that there were no gaps and as required medications were used appropriately. We were able to see that the medication reflected the records. None of the people were self-medicating at the time of the inspection. A system is in place to check the medication in the home. Storage of medication was noted to be in locked cupboards that was stored on the respective floors of the home. We observed a rushed administration of lunch time medication of a resident. The resident was having difficulty eating food and in the middle of his lunch he was repeatedly asked to open his mouth to take medicine. This was brought to the attention of the manager who informed us that this is not a normal practice but he will speak with the staff concerned. Throughout the inspection, we noted that staff treated people living and visiting the home with respect. Residents spoken with said staff were nice to them. However, there were some circumstances which appeared to have compromised dignity. For example a man was observed using toilet, with the door wide open. One resident was very unsettled, constantly wandering around the ground floor, in her night dress, unkempt and acting in a clearly disturbed way. The manager explained that they are in the process of assessing the suitability of the placement, with input from Psychiatric Nurse and Care manager. The manager has further written to us that Psychiatric nurse and care manager have carried out an assessment on 29/04/2010 and have agreed that the home is unable to meet the needs of the resident and recommended the resident to reside in a smaller home that can meet her needs. It was noted that the people were nicely dressed in their own clothes and clean. Through out the inspection staff were seen talking to people and that they were treated as individuals. The people using the service had a good rapport with the staff. However, it was observed that one resident was having difficulty with the zip of his jacket, which had become stuck. Staff were aware of this , but no-one helped him. In the end, he forced the jacket open, breaking the zip. He actually said he was going to have to do this, but still no-one helped him. Care Homes for Older People Page 12 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 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 committed to and promotes good relationships with residents who use this service, and enable them to participate in a wide range of activities. However, the home needs to make further improvements to meet the aspirations of each individual resident to enhance their quality of life. Residents are offered a varied menu. In general, staff are sensitive to the needs of those people who find it difficult to eat and give assistance with feeding. Evidence: The annual quality assurance assessment (AQAA) received from the interim manager prior to this inspection stated that residents have the opportunity to take part in a variety of activities including art and crafts, music therapy, gentle exercise, reminiscence, drama therapy, painting. card and board games. We recognize that a resident with poor mobility may not be able to dance to the music but will enjoy clapping or watching others. A resident may no longer be able to fully participate in a hobby or interest due to their dementia but we can help him/her to maintain his/her interest at some level. Residents seemed to have a good degree of choice and freedom to make decisions. Care Homes for Older People Page 13 of 27 Evidence: For example, there was a choice over the menu for lunch, and all the residents spoken to have said they liked the food, and that the portions were adequate. One resident said that lunch has been always good and staff were polite. Observation of the lunchtime meal showed it to be unrushed and enjoyed by the people using the service. In general staff are sensitive to the needs of those people who find it difficult to eat and give assistance with feeding. However, in one of the unit, one resident was observed having difficulty feeding himself. The staff appeared to be unaware of this, and no-one offered him any assistance. During the time observed, little or no food was entering his mouth. This was brought to the attention of the manager during the inspection feedback. All service users were encouraged to participate in activities that suit their preferences , cultural and spiritual beliefs. A variety of activities take place on different floors including afternoon activities by care staff to encourage social interaction. Activities also include birthday celebrations and special occasion celebrations, and planned outings. Residents were actively engaged and appeared to have enjoyed the activities throughout. Some residents did not take part in the planned activities. For example, two residents who lived on an upper floor talked of the activities hall downstairs as if they did not really identify with it. One of those was aware of drama and music activities, but he was not interested in these. He said they were all right, if that was what you were interested in. Another resident said she was lonely. She said she likes playing cards, but if she plays, others take over. She said she likes to read detective novels, but she did not seem to have as many as she would have liked. It is recommended that activities are developed further for people who are more isolated. Residents using the service had the opportunity to meet with their visitors in the lounge or in their own rooms. Visitors reported that they were welcomed into the home, could come and go as they pleased and felt part of the home. For example the husband of one resident, who lives in another care home, comes to visit her three times a week, and seems to spend a large part of the day with her and have lunch with her. Care Homes for Older People Page 14 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents using the service and staff said that they are happy with the service provided, feel safe and well supported. Evidence: The annual quality assurance assessment (AQAA) received from the interim manager prior to this inspection stated that all complaints have been managed in line with procedural timescales and process requirements for receipt and acknowledgment, options for resolution, complainant management and concluding response. The home manager signs off complaints and identifies learning from each complaint. The home had a complaints policy and procedure that gave simple guidance on how to make a complaint and gave timescales in which the home would respond to a complainant. Residents using the service spoken to knew how to put across a view or a concern to staff. One person using the service said, I am happy here, staff are good. Another person said I have no problems or had any concerns living at the home. The home reported 3 complaints in the last year and these have been resolved using the complaints procedure. The Commission has not received any complaints or concerns about the home. The home has made 3 referrals to the adult safeguarding team and has cooperated in their investigations and strategy meetings. As a follow up to strategy meetings, the home had taken appropriate measures in the best interest of the residents. For Care Homes for Older People Page 15 of 27 Evidence: example one residents risk assessment was updated and night shift hourly checks introduced. Another residents bedroom plan was assessed and adjusted to aid transferring that included the use of hoist. Staff demonstrated a good awareness of their role, responsibility, and procedures they are required to follow in relation to any allegation or suspicion of abuse. Staff spoken to were confident in whistle-blowing procedure and confirmed that the manager is available at all times should any concerns arise. The manager also, through discussion, demonstrated a good understanding in this area and was aware of the local guidance in reporting procedures. Care Homes for Older People Page 16 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was clean, tidy, and free of any offensive odors and the environment was well maintained in the interest of the residents. Evidence: The annual quality assurance assessment (AQAA) received from the interim manager, prior to this inspection stated that health and safety inspections including fire safety, PAT testing and kitchen safety inspections have all been carried out and recommendations implemented in line with urgency and timescales. Fire marshal training has been rolled out to 75 of the staff team. The AQAA further stated that the layout of the home provides distinct living and dining areas which are easily accessible for people with mobility problems. People with dementia and impaired sight are assisted to find their way by differing colors being used for different areas of the house. Well maintained ramps and passenger lifts ensure all residents can move around freely day to day. The home has 5 living areas with a communal lounge and kitchenette, a communal dining area, a bathroom with seat hoist to bathe and a shower and toilet, a separate toilet and wash hand basin and a clean laundry store. Other shared facilities are 2 larger lounge areas used for quiet times or parties depending on residents mood and events of the day. Varied interests and activities take place in communal areas Care Homes for Older People Page 17 of 27 Evidence: depending on where residents prefer. A tour of the premises was undertaken and all the communal areas were found to be clean, tidy, and free of any offensive odors. The residents rooms that were seen contained personal items, photographs, pictures, and furniture. Grab rails were also in place to assist with their mobility. The rooms were clean and tidy and no odours were detected. The home has a regular maintenance for the repair and upkeep of the house. Care Homes for Older People Page 18 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. The need to recruit a team of permanent staff means that the residents can not be sure of receiving consistent high quality care from staff with the correct skills and training. Evidence: The annual quality assurance assessment (AQAA) received from the interim manager prior to this inspection stated that the staff team are being supported by regular supervision and regular staff meetings with the focus on the learning experience. There are sufficient staff working in the home. The home has been using agency staff in significant numbers. For example the interim manager reported that number of shifts, in the past 3 months, which have been covered by temporary staff or staff from an agency were 212 for care. Sometime up-to 4 agency staff were deployed on a shift. The manager explained that the home was in the process of recruiting to fill vacant positions. This recruitment is a high priority to ensure a consistent, well trained team of staff is available. On this inspection we have looked at 12 staff members records and spoken with 7 staff members. The interim manager stated that all aspects of recruitment process are recorded and the required documents such as CRB checks, references are obtained Care Homes for Older People Page 19 of 27 Evidence: before the person is given a starting date. Staff recruitment records are held centrally at the Camden Social Services. The interim manager had further written to us that the home identified 11 permanent staff members CRB renewals are due and immediate action is taken to complete in-house application and forward onto CRB in May 2010. The annual quality assurance assessment (AQAA) received from the interim manager prior to this inspection stated that of the total 35 permanent care staff members, 33 staff members have attained National Vocational Qualification (NVQ) level 2 or above. Permanent staff spoken to have confirmed that they have attended a variety of training programmes including training in falls awareness, dementia awareness, infection control,and manual handling, which reflected the needs of the service users at the home. However, the agency staff training record showed that all agency staff have not received training that is relevant to meet the needs of the residents of this home. For example of the total 13 agency staff, only 1 agency staff member had received training in dementia, only 2 agency staff received training in infection control and 1 in equality and diversity. Care Homes for Older People Page 20 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. The interim manager and staff have good working relationship with the residents and key stakeholders that promotes the quality of life of residents using this service. Not all staff are receiving regular supervision to help them provide high quality care to the residents. Evidence: The annual quality assurance assessment (AQAA) received from the interim manager prior to this inspection stated that effective quality assurance and monitoring systems remain in place including residents meetings and surveys. This year we plan to commission an independent external consultant to undertake our service user satisfaction survey with residents. We continue to hold staff meetings and officers meetings monthly. Currently, the home has an interim manager from an agency, who has an extensive experience in residential social care. The interim manager has confirmed that he has been waiting for CRB check to make an application for registered manager. It was Care Homes for Older People Page 21 of 27 Evidence: apparent that the staff team worked well together and respected the interim manager. The AQAA further stated that the staff team are being supported by regular supervision and regular staff meetings with the focus on the learning experience. The staff received supervision that covered a wide range of topics that are relevant to their day to day work with residents as well as to their learning and development. Concerns raised by staff are addressed in the best possible way, which benefits the residents who use this service. However, we found during the inspection some staff had not received regular supervision and there were considerable gaps between supervisions. The interim manager explained to us that a new supervision template has been developed to monitor staff supervisions. The annual quality assurance assessment (AQAA) received from the interim manager prior to this inspection stated that effective quality assurance and monitoring systems remain in place including residents meetings and surveys. This year we plan to commission an independent external consultant to undertake our service user satisfaction survey with residents. We continue to hold staff meetings and officers meetings monthly. The home had an internal quality assurance system and procedure, to ensure that the quality of care provision and delivery is always of a high standard. The home implemented this through residents meetings, staff meetings, monthly reviews and residents feedback that include the views of residents and their relatives and relevant key stakeholders. However, the results from the residents feedback and how the home, then use these views to influence and further improve the care provision and delivery was not available during the inspection at the home. The monthly managers monitoring check list is not being completed regularly. The moving and handling techniques observed during the inspection were good, with appropriate use of slings, and the use of footrests on wheelchairs to avoid injury to staff and people who use the service. The interim manager further stated that the health and safety is well established and supported by policies and procedures. The annual quality assurance assessment (AQAA) received from the interim manager prior to this inspection stated that there is a programme of servicing and testing of equipment, maintenance, and fire detection and emergency equipment. Staff spoken to have confirmed that they had been trained in a variety of Health and Safety areas including moving and handling and food hygiene. Care Homes for Older People Page 22 of 27 Evidence: The residents, who use the service spoken to, reported that they found the staff and the manager to be a good listener and all felt that they were easy to talk to. Care Homes for Older People Page 23 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 24 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 1 7 12 The home must ensure residents receive a high standard of care at all times with a good attention to the specific needs of each person. This is to ensure specific needs of all residents are met. 15/06/2010 2 9 12 Staff should administer medication slowly and with care. This is to ensure medication is given safely. 15/06/2010 3 30 18 The home need to complete recruitment of permanent team of staff. This is to ensure consistency of care to residents. 15/07/2010 4 36 18 The home need to ensure 15/06/2010 that all the staff have received regular supervision. Care Homes for Older People Page 25 of 27 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 This is to ensure staff are appropriately supported and training needs are identified. 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 1 The home needs to update the statement of purpose to reflect the current interim management arrangements and name and address of the commission as well. The home needs to make further improvements to meet the aspirations of each individual resident by introducing additional activities to enhance their quality of life. The home need to ensure that all the agency staff have got the relevant training and update their knowledge and skills that match the diverse needs of the residents. 2 12 3 30 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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