Care Home: Stockton Lodge Care Home

Similar services:

• The Highlands
• Turret Villa Retirement Home
• Blenheim House
• 1 Lanark Close
• Mendip House
• Beaconsfield Court Care Home
• Ann Charlton Lodge

What the care home does well There is a good information available and an assessment procedure in place to help service users decide if Stockton lodge is able to meet their needs. There are activities available and relatives can visit the home any time they want too. The food is good with plenty of choices. There is a good complaints procedure in place so that service users know that their views will be listened too. And staff training helps protect service users from abuse. The home is clean and well maintained. There are plenty of staff around to help to meet the needs of service users and staff training is on-going and good. The manager has many years experience of managing this care home. Service users said about Stockton lodge: "it makes people feel welcome. The meals are ample and tasty, the staff are friendly and helpful", "looks after the residents well" and "staff do their job well". A relative commented: "the home gives good care and my family member`s personal needs are attended to well. They are assisted with their meals, which are very good. The staff in the home are helpful and friendly". What has improved since the last inspection? At the last inspection there were 3 requirements for improvement made for the home to address. These involved fire training for staff, to review the smoking arrangements for service users and to address the standard of cleanliness in the kitchen. All of these requirements have been addressed by the manager. What the care home could do better: The care plans are not person centered and lack details for staff to follow. Information in the evaluations is not always used to up-date the care plans. Some of the staff need further training to make sure service users are treated with dignity at all times. And improvements need to be made to medication storage and administration procedures. Although everyone said they knew how to make a complaint the complaints procedure should be provided in large print and tell service users that they can complain to the local authority. The environment should be further adapted to help people with dementia find their way around and bathrooms should be age appropriate and homely. The manager should look at how accidents have happened and show that she has put in place measures to prevent them from happening again. A representative of the company must visit the home every month to make sure that good care standards are maintained. This is a legal requirement. The owner should consider providing the manager with administration support because currently she is responsible for all of this, including collection of service users fees, as well as working on the floor. A relative commented "some upgrading in the facilities of the home and toilets etc, would improve the home and the service users well-being". Key inspection report Care homes for older people Name: Address: Stockton Lodge Care Home Stockton Road Seaham Durham SR7 0HJ     The quality rating for this care home is:   one star adequate 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: Nicola Shaw     Date: 2 3 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Stockton Lodge Care Home Stockton Road Seaham Durham SR7 0HJ 01915130286 01915813735 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Doson Limited care home 39 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 39 The registered person may provide the following category of service only: Care Home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP - maximum number of places 23 Dementia Code DE, maximum number of places 16 Physical Disability, Code PD, maximum number of places 5 Date of last inspection Brief description of the care home Stockton Lodge is a purpose built care home that provide personal care for up to 39 older people. The home is divided into two units, the Mews provides accomodation for up to 23 people who suffer from dementia. The home also provides for people with physical disabilities. Care Homes for Older People Page 4 of 30 Over 65 0 23 0 16 0 5 0 7 1 1 2 0 0 8 Brief description of the care home Stockton Lodge is located on the outskirts of Seaham, and it is on a bus route and close to private housing estate, shops and local amenities. The home is situated in pleasant surroundings and within its own grounds. All bedrooms are single occupancy. 19 bedrooms have en-suite toilet facilities. The main home has separate lounges and dinning facilities. There is also a small conservatory area that leads into the enclosed courtyard. The Mews has its own lounge and dining facility. The rate of charges for the home range from 431.50 to 435.50 pounds per week. Care Homes for Older People Page 5 of 30 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: one star adequate 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: Before the visit we looked at: Information we have received since the last inspection visit on 7 November 2008. How the service dealt with any complaints and concerns since the last inspection. Any changes to how the home is run. The providers view of how well they care for people, as highlighted in the details provided in the Annual Quality Assurance Assessment (AQAA). Looked at information in surveys. We received 4 completed surveys from service users and 3 from care staff. During the visit we did the following: Talked to the people who use the service, the manager and the care staff. Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff have the knowledge, skills and training to meet the needs of the people they care for. Looked around the home to make sure it is safe and secure. Checked what improvements have been made since the last inspection. Care Homes for Older People Page 6 of 30 We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations- but only when it is considered that people who use the services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: The care plans are not person centered and lack details for staff to follow. Information in the evaluations is not always used to up-date the care plans. Some of the staff need further training to make sure service users are treated with dignity at all times. And improvements need to be made to medication storage and administration procedures. Although everyone said they knew how to make a complaint the complaints procedure should be provided in large print and tell service users that they can complain to the local authority. The environment should be further adapted to help people with dementia find their way around and bathrooms should be age appropriate and homely. The manager should look at how accidents have happened and show that she has put in place measures to prevent them from happening again. Care Homes for Older People Page 8 of 30 A representative of the company must visit the home every month to make sure that good care standards are maintained. This is a legal requirement. The owner should consider providing the manager with administration support because currently she is responsible for all of this, including collection of service users fees, as well as working on the floor. A relative commented some upgrading in the facilities of the home and toilets etc, would improve the home and the service users well-being. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 30 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 30 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. Good information is available to help prospective service users make an informed choice about where to live. The admissions process ensures that people are adequately assessed prior to care being offered. This means that service users are offered the right type of care at the home. Evidence: There is a Statement of Purpose and Service User Guide. These have been up-dated to provide details of the new provider. Three out of four service users who responded to surveys said that they received enough information about Stockton Lodge to help them decide that it was the right place for them to live. The manager told us that prior to admission, prospective service users and their Care Homes for Older People Page 11 of 30 Evidence: families are encouraged to visit the home in order to familiarise themselves with the services and facilities available. For prospective service users, funded by the local authority, the manager obtains a copy of the needs assessment and care plan from the care manager. This is so that she can decide whether Stockton Lodge is able to meet their needs. The manager also completes her own assessment of the service users needs to ensure that any specialist facilities required are in place before they move in. Care Homes for Older People Page 12 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is adequate information in the care plans about the health and personal care needs of the service users. However, these are not person centered and could be developed further to ensure that everyone receives care and support in a way that they prefer. Staff care practices do not fully always preserve the dignity of the people who live here. And medication administration procedures do not fully protect the service users. Evidence: A range of standardized assessments are in place that lead to the care plans being developed. These cover a number of areas such as risk of developing a pressure sore, mobility, eating, drinking and nutrition, communication, and how a person expresses whether or not they are in pain. However, the care plans we looked were not person centered and did not describe in enough detail the care to be provided in a way that each person prefers. For example, Care Homes for Older People Page 13 of 30 Evidence: in one persons personal hygiene care plan all it said was wash and dress on bed due to pressure sore with no further information about how this is to be achieved in a way that respects the service users personal preferences. In another there was a care plan in place about a person becoming anxious. Again information was brief with the intervention being needs re-assurance when anxious with no further detail about how this person expresses anxiety and the best way to support them when this happens. In some instances care plans were not available. For example: in one persons assessment it stated that there was no need for a care plan about eating and drinking because this person needs full support from staff. In such a situation a care plan is important to guide staff and should include information about the persons dietary preferences, how the food should be prepared, for example blended, cut into bite sizes pieces, etc, and any special equipment required. There was no care plan in place for a service user who, as a result of their dementia can at times become agitated. Monthly evaluations are carried out of the care plans. Sometimes, the evaluation indicated that a persons needs had changed, however, the care plan had not been updated to reflect this. For example: in one persons evaluation it said that they needed to be fastened in their wheelchair as they were at risk of falling. There was no risk assessment in place in relation to this nor had the care plan been up-dated. Service users weights are monitored each month. Service users have access to all NHS facilities. There are regular visits from GPs and other health professionals, including opticians and chiropody services. During our visit a dementia nurse was visiting a number of the service users in order to carry out an annual dementia assessment. All of the service users who completed a survey said that they received the medical care they needed. Medication is stored in a locked, secure room. Senior staff order the medication from the prescriptions to ensure that service users are provided with the correct medication. Staff confirmed that they had completed training in the safe handling of medication. Medication is transported around the home in a locked trolley. However, a number of medicines were not stored securely as they had been placed on top of the trolley. Care Homes for Older People Page 14 of 30 Evidence: Medication Administration (MAR) records did not always reflect what was happening in practice. For example: the MAR chart said that a prescribed eye ointment should be given 2 x daily. However, the staff told us that they only administer this as and when required. The date the eye ointment was opened had not been recorded, which is important as this ensures that it is not used beyond its expiry date. Another prescribed cream being administered to a service user was not on the MAR chart at all. We carried out a random audit of loose medication held in stock against records. The amount that had been given according to the MAR sheets did not balance with the amount held in stock. There were no gaps on the MAR, which we looked at which indicates that service users are receiving their prescribed medication. There is a small stock of controlled drugs. These are stored securely and an appropriate record is kept of when these have been administered. During our visit time was spent with the service users whilst they were having a meal and later relaxing in the lounge. Staff were not always respectful in their approach towards the service users. For example, during the meal one member of staff stood over a service user whilst assisting them with their meal asking them to open mouth. This is known as infantalization, that is treating the service user as a child, and is not good practice. In another situation staff talked about people with dementia as if they were not there, again, not good practice. A person who used a wheelchair, is dependent upon staff to leave the dining area, was left on their own in the dining area for some time after the meal whilst staff attended to other duties. These practice issues were discussed with the manager at the end of the inspection who agreed it would be beneficial for further training for staff. Personal and intimate care tasks were carried out in the privacy of the service users own bedrooms. Staff referred to the service users by their preferred name and it was clear there was generally a good rapport between the staff and service users. Service users said I feel staff treat me with respect, they always knock on doors and the staff are patient. Care Homes for Older People Page 15 of 30 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. Service users enjoy a variety of activities, and are able to maintain family and other contacts if they want to. This ensures service users have opportunities to lead a fulfilling lifestyle and do not become socially isolated. Evidence: There is an activities co-ordinator who works 16 hours per week. A social profile has been completed for each service user. These include information about their social history, likes and dislikes. This information is used by the activities co-ordinator to help her develop the activities programme. The activities available to service users include film and games days, sing alongs, arts and crafts, cookery, reminiscence and during the warmer weather trips down to the beach. Service users said a girl comes in and does activity work. We do exercises. Three out of four service users said in surveys that there are always activities that they can take part in if they want to. On the day of our visit a hairdresser was visiting. And friends and relatives were seen to freely come and go. We spent time with people during lunch and when the evening meal was served. Care Homes for Older People Page 16 of 30 Evidence: Tables were nicely presented with festive napkins and table cloths. Service users were offered a choice of drink with their meal and those service users who needed support were offered this by staff. However, as previously mentioned this was not always carried out in a dignified manner. Although some staff did make sure they sat next to the person they were assisting, offering support in a sensitive way. There is a choice of main meal and pudding. And the manager has purchased a menu board so that the choice of meal available can be displayed each day. Three out of four service users said in surveys that they always liked the meals in the home. Service users said: the foods good, the meals are ample and tasty, the foods very good, there is plenty of it and the foods nice, very nice. Care Homes for Older People Page 17 of 30 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 home has a good complaints procedure so people know that their views will be listened to and acted upon. And staff training helps to ensure that the service users are protected from abuse. Evidence: The home has a complaints procedure, which is displayed in the home. However, this is in small print and may be difficult for some people to read. The complaints procedure does not inform service users that they can complain to the Local Authority if they have any concerns. The manager told us that she has not received any complaints in the last year. Service users told us I would complain, I feel that the staff listen. Everyone who completed a survey said that there was someone they could speak to informally if they were unhappy and knew how to make a formal complaint. There has been one safeguarding referral made in the last year, which has been dealt with by the Local Authority. All staff receive training in safeguarding adults and staff told us in surveys that they knew what to do if someone had concerns about the home. Service users told us they felt safe in the home. Care Homes for Older People Page 18 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from a clean and well maintained place to live, although some areas of the home could be developed further to meet the needs of people with dementia. Evidence: Improvements to the environment since the last inspection include the re carpeting of the reception area, both dining rooms and some of the service users bedrooms. Service users told us they liked their bedrooms. Those we looked at were clean and personalised. Service users told us that staff kept their bedrooms clean. And all of the service users who completed a survey said that the home was always clean and fresh. They said theyve always got the Hoover out, its very clean and thats what I like about it. The home is registered to provide a service for people with dementia. However, although there are some signs to help to orientate people, for example, names on bathroom doors, these are placed high up on the door and may be difficult for people to see. In addition, although in some instances the service users name was placed on their bedroom door, again this was high up and therefore difficult for people to see. There were also in some instances a photograph of some people on their door, as they are now. For people with dementia, with short term memory loss, this may not be an Care Homes for Older People Page 19 of 30 Evidence: appropriate way to help them find their bedroom, as they may not recognise themselves as they are now. We looked at the bathrooms on the first floor of the home. In one of these there were large pictures of fish painted on the walls. For people with problems with their perception this might cause difficulties for them. Consideration needs to be given to making bathrooms and shower rooms homely and age appropriate. The manager told us that the bathrooms on the first floor of the home are not used. The lounges benefited from Christmas decorations in preparation for the festive season, One particular corridor was very cool on this cold winters day. Also service users said that the lounge was very cold first thing in the morning. The manager told us that the heating in certain parts of the home has always been an issue and is a consequence of the position of the home. Additional heating devices are used in the lounge to make sure that a warm comfortable temperature is maintained for service users. There is a snoezelen room. This is where there is a range of multi sensory equipment, such as fiber optic lights, where people with dementia can sit and relax. However, this room is kept locked and therefore is only available to use as a designated activity. Consideration should be given, following a risk assessment, of keeping this room open so that people can independently choose to use it. There are adequate laundry facilities and 12 staff have completed training in infection control. Care Homes for Older People Page 20 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels are sufficient, which ensures staff are able to meet the care needs of the service users. Staff training is satisfactory and includes specialist training in order to meet the diverse needs of the service users. This ensures staff can effectively meet the care needs of people with dementia. Staff recruitment procedures fully protect the service users. Evidence: On duty when we visited was the manager and 4 senior staff. The manager told us that there are always 5 staff on duty in the morning and evening and if necessary during the afternoon to accompany service users to medical appointments. There are currently 31 people living in the home and therefore these staffing levels are adequate. Service users said I think theres enough staff on duty. I dont have to wait if I need help. Two service users who completed a survey said that the staff were always available when they needed them, two said usually. There has been a low turnover of staff, which is good for continuity of care. Care Homes for Older People Page 21 of 30 Evidence: All of the service users spoke positively about the staff and there was clearly a good rapport between the service users and staff. The manager has identified where there are gaps in staff training and has developed a training programme to address this. As well as the NVQ level 2 , 3 and 4 qualification in care staff have completed training about dementia and training about the nutritional needs of older people called focus on food. All new staff undertake the Skills for Care induction progamme. Staff told us that training is on going and a senior member of staff said that staff are keen to get knowledge. They told us that the induction covered everything they needed to know to do their job well. Staff files showed that the companys recruitment procedures are followed. This includes obtaining two written references and an Enhanced Criminal Records Bureau check to ensure that the prospective staff member is suitable. Care Homes for Older People Page 22 of 30 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. Good management systems generally ensure the health, safety and welfare of service users. There is an adequate quality assurance system. This is based on the views of service users, where they are able to communicate their wishes, so that they know their rights and views will be listened to. However, does not include a monthly visit from the provider to ensure that care standards are being met. Evidence: It was evident that the manager has worked hard to improve the service for service users. For example: this has included developing up-to-date policies and procedures, She provided us with information, before we visited, about what has improved in the home in the last year and it is clear she knows what needs to be done to improve things further. Care Homes for Older People Page 23 of 30 Evidence: The manager has managed this care home for 13 years. She undertakes training alongside her staff to keep her knowledge and skills up-to-date. This has included training about the needs of people with dementia, food hygiene, infection control and focus on food. An issue raised during the last inspection relates to the manager being left to do all of the administrative work, including the handling of the invoicing of service users or their representatives for their charges for residential care. The manager is also counted in as a member of staff on the floor between 8.00am and 10.00am when she helps with breakfast. Although the manager said she could cope consideration should be given to the provision of administrative staff to assist her in the day to day running of the home. Questionnaires are used to obtain feedback about the service. These are sent out annually to relatives and other health and social care professionals and information from these used to improve the service. However, there has only been one visit from a representative acting on behalf of the provider, to assess the quality of care provided in this home. This is a legal requirement. All staff receive regular supervisions. Staff told us in surveys that the manager meets with them regularly to discuss how they are working. There are also regular team meetings. We looked at how the home manages the service users personal allowance. Adequate records of this are maintained and receipts are obtained for any money deposited or withdrawn. The home has contractors to service equipment. A maintenance log is available with certificates of equipment and appliance checks. Records are maintained of all accidents, however, these do not include follow action taken by the manager to prevent the accident from happening again. Care Homes for Older People Page 24 of 30 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 14 12 Safety and welfare of the 31/12/2009 residents must be promoted. The current arrangements for residents who smoke must be reviewed as this is at odds with the companys own policy on smoking. Furthermore, the current practice is unsafe, and infringes on the rights of those residents who smoke. 2 19 13 Health and Welfare of the residents. All harmful substances must be properly stored in line with COSHH regulations and guidelines. 12/12/2008 3 26 12 Health and Welfare of the residents Standard of cleanliness in the kitchen must be improved. These inlude the general cleanliness of the kitchen, containers, and some of the equipments. 12/12/2008 4 28 12 Health and Welfare of the service users. Staff must recieve fire safety training and regular fire drills as recommended by the Fire Authority. 19/12/2008 Care Homes for Older People Page 25 of 30 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 30 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 1 9 13 All medication must be stored securely. This is to protect the health and welfare of service users. 21/01/2010 2 9 13 The Medication Administration Record must have accurate information about when prescribed medication is to be administered. All prescribed medication should be entered onto the Medication Administration Record. All medication should be stored securely. This is to ensure service users receive their prescribed medication when they need it. 21/01/2010 3 10 12 Service users must be treated with dignity and respect at all times. This is to preserve the well being of service users. 14/01/2010 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 33 26 The registered provider must ensure that the care 31/01/2010 Care Homes for Older People Page 27 of 30 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 home is visited by an employee of the organisation, who is not directly concerned with the conduct of the care home, and prepare a written report on the conduct of the home. This is to ensure that good standards of care are provided in the home. 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 Care plans should be kept up to up-to date. They should be person centered with more detail so that service users receive the care and support they need in a way that they prefer. There should be a stock control system in place for all loose medication to ensure that this this has been given as prescribed and to assist with medication audits. The complaints procedure should be in large print to help people to read the information. It should also inform service users that they can complain to the Local Authority. The environment, including the bathrooms, by use of colours and signs, should be improved, based upon current good practice in dementia care, to help people with dementia find their way around. The snoezelen room should be available for service users to independently use. Consideration should be given to the provision of an administrator in order to assist the manager in the day to day running of the home. The manager should demonstrate that she has looked at Page 28 of 30 2 9 3 16 4 19 5 6 19 31 7 38 Care Homes for Older People Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations the occurrence of accidents and implemented any follow up action as necessary. Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!