Care Home: The Firs Residential Care Home

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What the care home does well Residents who completed our survey told us they received the care and support they needed, that staff were easily available and that they liked the meals at the home. Comments included: `staff work fast and well` another reported: `I am very happy with all my care`. Relatives told us that they were kept up to date with important issues affecting residents and that the care was good. One told us: `I was very worried about a care home for my mother but not now. She is very well looked after and very happy`. What has improved since the last inspection? This is the home`s first inspection since it became registered with us. What the care home could do better: There is much this home needs to do to improve its service to residents. Residents` contracts must set out in detail the fees payable and by whom so that people know the actual cost of their care. Only residents who have mental capacity and can understand their contracts, must sign them. Residents` care plans must be much more detailed to ensure that staff have the information they need to deliver comprehensive and consistent care. Weight charts and skin integrity charts must also be completed thoroughly and consistently to help monitor people`s health. Care plans should also clearly evidence that residents have been actively involved in decisions about their care. Residents need to be given the opportunity to express their wishes about what they want to happen when death approaches and to provide instructions about the formalities to be observed after they have died. Records made when medication is given to residents must improve so there is a clear and accurate record of what they have received. Medication must only be given in line with the prescriber`s instructions to ensure that people get their medication as intended. Staff must also have their competency assessed to administer medication so that they do it safely and correctly. Two main meals should be advertised and actively offered to residents so that they have a real choice in what they eat. The home`s recruitment practices are poor and must improve to ensure that proper checks are undertaken before someone starts working with vulnerable adults. All new staff must receive a full induction in line with Skills for Care so they have the knowledge to do their job. The home`s adult protection policy must be reviewed and updated to ensure it is in line with the Department of Health`s `No Secrets` Guidance and also local reporting procedures. Information about how to complain and how to report adult protection concerns must be made much more widely available around the home so that residents and their relatives know what to do if they wish to report concerns. Covers need to be placed on any radiators in areas where residents frequent to minimise the risk of them scalding themselves. Locks must be put on all toilets and bathrooms to maintain residents` privacy and dignity when using them. Names and orientation aids should be placed on bedroom doors to help residents find them. Headboards on beds stating `The Firs Residential Care Home` should be removed. Exterior woodwork around window frames needs to be repainted to prevent them rotting. Unlocked cupboards containing potentially harmful substances and items to residents must be kept locked at all times. The manager must implement robust and effective quality assurance and monitoring systems at the home so that shortfalls and poor practices are picked up quickly. Night staff must practice fire drills regularly so they know what to do in the event of the alarm sounding in the night. 14 requirements and 5 recommendations have been made as a result of this inspection indicating much has to be done to improve the quality of this service for the people who use it. Key inspection report Care homes for older people Name: Address: The Firs Residential Care Home Tower Farm Tower Road Little Downham Ely Cambridgeshire CB6 2TD     The quality rating for this care home is:   zero star poor 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: Janie Buchanan     Date: 1 7 0 8 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 26 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 26 Information about the care home Name of care home: Address: The Firs Residential Care Home Tower Farm Tower Road Little Downham Ely Cambridgeshire CB6 2TD 01353699966 01353699990 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Only Care Plc Name of registered manager (if applicable) Mrs Jennifer Ann Taylor Type of registration: Number of places registered: care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 27 The registered person may provide the following categories of service 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 Dementia Code DE Date of last inspection Brief description of the care home The Firs Residential Care Home is registered to provide accommodation and personal care for up to 27 older people, some of whom may have dementia. Current fees vary between £354 and £500 per week depending on peoples needs. Care Homes for Older People Page 4 of 26 Over 65 0 27 27 0 0 2 0 3 2 0 1 0 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: zero star poor 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: For this inspection we, (The Care Quality Commission), visited the home and talked with residents, staff ,the manager and a visiting relative. We also received a number of completed surveys from residents and their relatives asking them about the quality of the care they received. We had lunch at the home so we could talk with residents, assess the quality of the food and observe how staff assisted residents. We undertook a tour of the premises to check on health and safety matters, and checked medication records and storage. We also viewed some of the homes policies and procedures. Care Homes for Older People Page 5 of 26 What the care home does well: What has improved since the last inspection? What they could do better: There is much this home needs to do to improve its service to residents. Residents contracts must set out in detail the fees payable and by whom so that people know the actual cost of their care. Only residents who have mental capacity and can understand their contracts, must sign them. Residents care plans must be much more detailed to ensure that staff have the information they need to deliver comprehensive and consistent care. Weight charts and skin integrity charts must also be completed thoroughly and consistently to help monitor peoples health. Care plans should also clearly evidence that residents have been actively involved in decisions about their care. Residents need to be given the opportunity to express their wishes about what they want to happen when death approaches and to provide instructions about the formalities to be observed after they have died. Records made when medication is given to residents must improve so there is a clear and accurate record of what they have received. Medication must only be given in line with the prescribers instructions to ensure that people get their medication as intended. Staff must also have their competency assessed to administer medication so that they do it safely and correctly. Two main meals should be advertised and actively offered to residents so that they have a real choice in what they eat. The homes recruitment practices are poor and must improve to ensure that proper checks are undertaken before someone starts working with vulnerable adults. All new staff must receive a full induction in line with Skills for Care so they have the knowledge to do their job. The homes adult protection policy must be reviewed and updated to ensure it is in line with the Department of Healths No Secrets Guidance and also local reporting procedures. Information about how to complain and how to report adult protection concerns must be made much more widely available around the home so that residents and their Care Homes for Older People Page 6 of 26 relatives know what to do if they wish to report concerns. Covers need to be placed on any radiators in areas where residents frequent to minimise the risk of them scalding themselves. Locks must be put on all toilets and bathrooms to maintain residents privacy and dignity when using them. Names and orientation aids should be placed on bedroom doors to help residents find them. Headboards on beds stating The Firs Residential Care Home should be removed. Exterior woodwork around window frames needs to be repainted to prevent them rotting. Unlocked cupboards containing potentially harmful substances and items to residents must be kept locked at all times. The manager must implement robust and effective quality assurance and monitoring systems at the home so that shortfalls and poor practices are picked up quickly. Night staff must practice fire drills regularly so they know what to do in the event of the alarm sounding in the night. 14 requirements and 5 recommendations have been made as a result of this inspection indicating much has to be done to improve the quality of this service for the people who use it. 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 26 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 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their needs assessed before moving into the home, however they are not given information about the actual cost of their care. Evidence: There is a statement of purpose and service user guide that give information about the home and the services it offers. Each resident is also issued with a contract, a copy of which we viewed. However this contract does not give any details about the fees payable and by whom and so people are signing them without knowing the actual cost of their care. It also stated that the care provided would be the standard required by the National Care Standards Commission- an organisation no longer in existence. It was also concerning to note that one resident with, a diagnosis of dementia, had signed their contract, even though they could not have possibly understood its contents. We viewed the files of three recently admitted residents which showed that a basic Care Homes for Older People Page 9 of 26 Evidence: assessment of their needs had been completed before they moved into the home to ensure they could be met there. However, not many prospective residents actually visit the home and we discussed the importance of encouraging this with the deputy manager so that people get a chance to see themselves if it is where they want to live and to give them the opportunity to assess its facilities. Care Homes for Older People Page 10 of 26 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents care plans do not set out in detail the action which needs to be taken by care staff to ensure that all aspects of their health and personal care are met. The homes medication administration practices do not ensure that residents receive their medication safely. Evidence: The quality of information in the plans about residents needs was poor and not at all person centred. For example all that it stated in one plan under night care was that the resident requires help to bed. It did not give any information about what actual help was needed (e.g. undressing, washing, legs lifted to bed) and what the resident can actually manage themselves. Under the continence plan it only stated provide all needs and assistance without specifying what they were. Another resident was recorded as sometimes being quite aggressive due to their dementia: all that was stated in their plan was keep her safe. Some information in the plans was contradictory: in one part the plan stated that the resident is able to do all personal care needs in another part of the plan it stated needs assistance in all daily life. Without detailed information about residents specific needs it is unlikely that staff will Care Homes for Older People Page 11 of 26 Evidence: be able to offer comprehensive, consistent and personalised care to them. None of the plans we viewed showed that residents had actively been involved in their review and none of them had signed their plans to show they agreed with its contents. Residents end of life plans had not been completed in any of the files we viewed, thereby denying them the opportunity to discuss their preferences about end of life issues and care and so they could be recorded and respected. Weight charts were confusing with some weights entered as kilos and others entered as stones and pounds, making monitoring residents weights difficult. Skin integrity charts had been filled in erratically with long gaps between checks. This was particularly concerning for one resident who was observed to be very red and sore on her bottom. No further checks were recorded as having been made despite this. We checked a sample of residents medication administration records. There were a number of shortfalls: there was no staff signature tally in place, making it impossible to tell which staff had signed the records; hand written additions to the MAR sheets did not give enough instruction as to where topical medication had to be applied; there were a number of gaps in the MAR sheets where it was not possible to tell if someone had actually received their medication that day; one medication was prescribed to be given an hour before food, however the staff had consistently recorded they had administered the medication with the persons food; we noted several occasions where staff had signed to say they had given the tablets but the tablets remained in the blister pack; the recording of dates on the MAR sheet did not correspond to dates on the blister packs, and the date on which liquid bottles of medication had been opened had not been recorded. The manager stated that staff had received training in medication. However no one had actually assessed their competency to administer medicines following this training. These shortfalls put residents at serious risk of not receiving their medication safely and correctly. Care Homes for Older People Page 12 of 26 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. Residents have access to activities to keep them stimulated, and enjoy good food. Evidence: Staff told us they provide regular activities for residents such as quizzes, bingo, card games and a Nintendo Wii. During our inspection we observed one staff member playing cards and a memory game with one resident. We noted chalk boards in the main lounge advertising a forthcoming church service and hairdressers visit. The manager stated that a specific activities co-ordinator had just been employed and will start at the beginning of September. One resident we spoke to told us he enjoyed gardening and was currently growing tomato plants in the home. However, this same resident told us he really enjoyed the news and current affairs but that the television in the main lounge was not turned up loud enough for him to hear the news, so instead he just watched the pictures and tried to guess what was happening in the world. We took lunch with the residents which consisted of minced beef cobbler with mashed potatoes, runner beans and cauliflower, followed by chocolate whip or blackberry crumble. There was no choice advertised for the main course and residents we spoke to were not aware of an alternative if they didnt want minced beef. The food itself Care Homes for Older People Page 13 of 26 Evidence: was tasty and nutritious and residents we spoke to told us they really enjoyed meals at the home. However, the main course was served fully plated up thereby denying residents a good choice of what and how much they could have. This practice is a little institutionalised and should be reviewed. On the whole lunch was a pleasant and relaxed affair with residents being given plenty time to eat and staff assisting them respectfully and sensitively. Care Homes for Older People Page 14 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents feel able to raise their concerns, however the homes adult protection policy does not fully protect residents. Evidence: There is no information around the home for residents to see about how to raise complaints or concerns. However those we spoke to stated they felt able to complain if they were unhappy with any aspect of their care, identifying the manager as someone they would talk to. We received one complaint about the homes recruitment practices which the provider and manager dealt with swiftly and appropriately. Staff showed a satisfactory knowledge about the different types of abuse an older person could face but their knowledge about agencies involved in adult protection, or where they would report an incident to, was limited. We viewed a copy of the homes adult protection policy: it was dated July 2008 and there was no evidence that it had been reviewed or updated. It gave no information about who to contact to report concerns and the advice it gave was actually contradictory to local adult protection guidance. There was also no information about the home for residents or their relatives of what they should do, or who they should contact, if they wanted to report a concern. Care Homes for Older People Page 15 of 26 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. Residents have access to a variety of communal spaces, however the home needs better maintenance. Evidence: The home was clean, with no strong smells on the day we visited. Furnishings and fittings were comfortable and of good quality. There is a large dining room, lounge, TV area and conservatory, giving residents a good choice of space to use. Garden furniture had been placed outside for residents and the back of the home overlooks a field with horses in it. We checked the kitchen which was hygienic and all foodstuffs were stored neatly and safely. However we came across the following shortfalls: there was no lock on the downstairs toilet, thereby denying residents privacy and dignity when they used it; there were two uncovered radiators in the communal dining area putting residents at risk of scalding themselves should they fall against them; each bed headboard in residents bedrooms had the words The Firs Residential Home engraved onto them in large letters, making the bedrooms unhomely and very institutionalised; we came across an unlocked cupboard in the corridor which contained a razor, a bottle of talc and deodorant, apart from this storage being very unsafe for confused residents, it was not clear to whom these items belonged or if they were used communally by all residents; exterior window frames outside bedrooms 12 and 13 were in poor condition Care Homes for Older People Page 16 of 26 Evidence: and needed repainting; there were two patches of bare plaster on the wall outside room 15; upstairs corridors were bare and clinical with linoleum on the floor and few items of interest or stimulation on the walls; bedroom 22 overlooked a dilapidated shed with a rotting roof. This room was also very noisy on the day we visited as farm machinery was being used very close by. A number of bedrooms, although occupied by residents, had no names on them or any orientation aids attached to help residents find where they were. We checked outside the building and noted piles of rubbish and discarded paving slabs outside the kitchen. Some areas of the garden overlooked by residents were in poor condition with weeds and a large compost heap that could be easily seen. This gave the approach to the home a rather shabby and neglected feel. Care Homes for Older People Page 17 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive their care from trained staff in sufficient numbers to meet their needs, however the homes recruitment procedures do not protect them. Evidence: There is a minimum of two staff on duty throughout the day and night to meet the needs of nine residents currently. This is a good ratio of staff to residents and will ensure that residents needs are met quickly. Residents we spoke to told us there were plenty staff around and they rarely waited long for help. One told us: there are buzzers all around and staff are there in seconds. We checked the training files for 3 members of staff which showed they had received a range of training relevant to their role, however one staff members moving and handling training needed to be updated. We checked the personnel files for three recently employed staff. There were shortfalls in their recruitment. One staff member had started working at the home before a CRB or two references had been obtained; another staff member had started employment before the home had received their ISA first check and one reference for this person was also unsuitable, having been obtained from a colleague at a previous care home rather than the manager. One member of staff had not signed their employment contract and another had not received an induction to the job. Care Homes for Older People Page 18 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in home which needs better management to ensure they receive a good service. Evidence: The manager has previous experience of working with older people in a residential care setting and has achieved her registered managers award. Staff told us they felt supported by her and one reported:shes easy to talk to and gives good advice. These staff also confirmed they had received supervision. However this report has highlighted that the manager has failed to implement robust quality assurance and monitoring tools to ensure that care plans are detailed, that regular medication checks are done, that staff are only employed after full checks, and that the environment is made safe for residents. There is much she has to do to raise the standards in the home and to ensure residents receive a good, safe service. The home holds money for one resident. We checked the cash sheets for this resident which showed that a written record of all financial transactions undertaken on their Care Homes for Older People Page 19 of 26 Evidence: behalf was kept along with satisfactory receipts to show how their money had been spent. We checked a number of records in relation to health and safety (including legionella testing, lifts service, portable appliance testing and electrical installation) which showed us the home regularly maintains and services its equipment to ensure its safety. However there was no evidence to show that night staff regularly practised fire drills so that they would know what to do in the event of a fire. Care Homes for Older People Page 20 of 26 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 21 of 26 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 2 5 Residents contracts must set out in detail the fees to be paid and by whom. You must do this to ensure residents have a clear understanding of the cost of their care 28/09/2010 2 7 15 Residents care plans must be much more detailed and informative. You must do this to ensure that staff have the guidance they need to provide comprehensive, consistent and personalised care. 28/09/2010 3 8 12 Residents weight and skin integrity charts must be completed consistently and thoroughly You must do this to ensure their health is monitored closely. 28/09/2010 Care Homes for Older People Page 22 of 26 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 4 9 13 Medication must only be given in line with prescribed instructions. You must do this to ensure that people get their medication as intended 31/08/2010 5 9 18 Staff must have their competency to administer medication assessed. You must do this to ensure they do it safely and correctly. 30/09/2010 6 9 13 Records made when medication is given to residents must be accurate and complete. You must do this to demonstrate that people receive their medication as prescribed 31/08/2010 7 16 22 Information about how to raise concerns and complaints must be made easily available to residents You must do this to ensure they know how to raise any concerns they have. 28/09/2010 8 18 13 The homes adult protection 28/09/2010 policy must be reviewed and updated. Care Homes for Older People Page 23 of 26 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 You must do this to ensure proper procedures are followed and residents are protected 9 19 23 Cupboards containing potentially harmful items to residents must be kept locked You must do this to protect residents. 10 19 23 Unguarded radiators must 28/09/2010 have covers placed on them. You must do this to prevent the risk of residents scalding themselves 11 19 12 A lock must be installed in the downstairs toilet. You must do this so that residents dignity and privacy is maintained. 12 27 19 Proper recruitment checks must be undertaken before someone starts working at the home. You must do this to ensure that only the right people are employed and residents are protected. 13 32 24 Effective quality assurance 28/09/2010 an monitoring systems must be implemented. 28/09/2010 28/09/2010 30/08/2010 Care Homes for Older People Page 24 of 26 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 You must do this to ensure that residents receive a good service 14 38 23 Night staff must practise fire 28/09/2010 drills You must do this to ensure they know what action to take in the event of a fire 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 9 Residents need to be given opportunities to discuss their end of life preferences and to have these recorded so they can be respected. A choice of two main dishes should be advertised and actively offered to residents at lunch. Exterior woodwork around window frames should be repainted to prevent them rotting. Headboards stating The Firs Residential Home should be removed. Names and orientation aids should be placed on residents bedroom doors to help them find them. 2 3 4 5 15 19 19 19 Care Homes for Older People Page 25 of 26 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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