Care Home: The Laurels Nursing Home

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What the care home does well The home provides prospective residents with whatever length of time they need to decide if they wish to live at the home. Detailed information is collected about a new person coming to live at the home to help ensure staff can provide the necessary levels of care and support to the person. There are good arrangements for people to maintain contact with their family and friends. People have the opportunity to follow their religion if they wish to. There is a varied programme of activities for people to take part in if they wish. People enjoy a varied and nutritious diet and home baking. There is a good level of staff training to help staff provide more individual care to people living at the home. What has improved since the last inspection? The manager has become registered with the regulatory authority for the day to day running of the home. There is an on going programme of decoration and refurbishment around the home. A mini bus is available for the use of people living in the home and the day service. Some profiling beds have been bought for the use of people in the home. The complaints procedure has been updated. Pictorial menus have been made for people who may not know the written word. Systems are in place to help involve people in decision making in their daily living requirements. An activities organizer is employed to work at the home. The level of staff training is continuing to improve. Over 75% of carers have achieved National Vocational Qualifications (NVQ) at level 2. The standard of record keeping continues to improve to help ensure individualized care is provided to people living at the home. What the care home could do better: The Statement of Purpose and service user guide should be up dated to people who may wish to come to live at the home may receive accurate information. Care plans must include guidelines about the care and support provided to people that may be difficult to work with. A deprivation of liberty assessment should be carried out for the identified person. Risk assessments must be up to date on all care files to ensure any identified risks are managed appropriately. Care files of people living at the home should be indexed to help find information as required. Menus should be displayed in an accessible format so people are reminded of the food that is being served to them. All staff must receive the local authority safeguarding training. Staff should receive training about behaviour that is difficult to work with. Sufficient working equipment should be provided in the laundry to ensure all the laundry can be carried out in a timely way. The identified bathroom should be decorated for the comfort of people living in the home. The garden should be made attractive and suitable seating provided in the sitting area for the benefit of people living in the home. Staffing levels should be kept under review and vacancies filled to ensure the smooth running of the home with staff carrying out their defined job role. Key inspection report Care homes for older people Name: Address: The Laurels Nursing Home Francis Way Hetton Le Hole Houghton Le Spring Tyne & Wear DH5 9EQ     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: Karena Reed     Date: 2 2 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 29 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 29 Information about the care home Name of care home: Address: The Laurels Nursing Home Francis Way Hetton Le Hole Houghton Le Spring Tyne & Wear DH5 9EQ 01915173763 01915260837 The.Laurels@FSHC.Co.uk www.fshc.co.uk Tamaris Healthcare (England) Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Type of registration: Number of places registered: care home 55 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: 55 The registered person may provide the following categories of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places: 55 Dementia - Code DE, maximum number of places : 3 Date of last inspection Brief description of the care home The Laurels is a privately owned care home, which is located in the village of Hettonle-Hole. It is within walking distance of a range of local facilities including shops, public houses, a health centre, library and a Church, and is also near to a bus stop. Care Homes for Older People Page 4 of 29 Over 65 0 55 3 0 2 3 0 9 2 0 0 9 Brief description of the care home The home may provide permanent accommodation with personal care support and nursing for up to fifty-five older people, some of whom may have a physical disability or sensory impairment. A limited number of physically disabled adults under the age of sixty-five may also be accommodated within this total number. The homes entrance is level, and a shaft lift provides access between floors. Accommodation is laid out over both the ground and first floors. Each has selfcontained lounges, dining areas and adequately equipped bathrooms.All bedrooms have en-suite toilet facilities. The building shares it grounds with another care home owned by the same company. The grounds are well kept, there are accessible paved areas for residents and car parking is available. The weekly fees range from 407 pounds to 422 pounds per week. The nursing care element is 106:30 pounds and is set nationally. There are extra charges for hairdressing, toiletries, newspapers and chiropody services. Information about the home,services,contracts and fee rates are included in the Statement of Purpose and Service User Guide.These are readily available in the home. Care Homes for Older People Page 5 of 29 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: The quality rating for this service is 1 star. This means that the people who use the service experience adequate quality outcomes. 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 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. How the inspection was carried out. Before the visit: We looked at information we have received since the last inspection, how the service Care Homes for Older People Page 6 of 29 dealt with any complaints and concerns since the last visit, any changes to how the home is run, the provider view of how well they care for people and the views of people who use the service and their relatives, staff and other professionals. The Visit: An unannounced visit was made on April 22nd 2010. During the visit we talked with people who use the service and staff. We looked at information about the people who use the service and how well their needs are met.We looked at other records which must be kept, checked that staff had the knowledge, skills and training to meet the needs of the people they care for,looked around the building to make sure it was clean, safe and comfortable and checked what improvements had been made since the last visit. We told the manager what we found. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: The Statement of Purpose and service user guide should be up dated to people who may wish to come to live at the home may receive accurate information. Care plans must include guidelines about the care and support provided to people that Care Homes for Older People Page 8 of 29 may be difficult to work with. A deprivation of liberty assessment should be carried out for the identified person. Risk assessments must be up to date on all care files to ensure any identified risks are managed appropriately. Care files of people living at the home should be indexed to help find information as required. Menus should be displayed in an accessible format so people are reminded of the food that is being served to them. All staff must receive the local authority safeguarding training. Staff should receive training about behaviour that is difficult to work with. Sufficient working equipment should be provided in the laundry to ensure all the laundry can be carried out in a timely way. The identified bathroom should be decorated for the comfort of people living in the home. The garden should be made attractive and suitable seating provided in the sitting area for the benefit of people living in the home. Staffing levels should be kept under review and vacancies filled to ensure the smooth running of the home with staff carrying out their defined job role. 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 29 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 29 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. Detailed assessments of people who are to use the service are carried out before they move into the home to ensure all their needs can be met. Evidence: The Statement of Purpose and service user guide were examined. The Statement of Purpose is a pre-printed document which requires the provider to input individual information about the service. It contained the necessary information as required by the Care Homes Regulations 2001,however it required updating. A service user guide is sent out to anyone who may be interested in coming to live at the home after they have made an inquiry. Records for four people who live at the home showed that when they were admitted to The Laurels an assessment of their care needs had been carried out before their admission by a social worker or health professional. This assessment is forwarded to the home for the manager to look at to determine if the needs of the person can be Care Homes for Older People Page 11 of 29 Evidence: met. The manager or senior staff carry out a comprehensive pre-admission assessment to ensure that the staff can meet each individuals needs. The person living at the home and relevant people are involved in the assessment. These initial assessments are used to create care plans. The manager said that any person interested or needing to use the service or relatives are encouraged to visit the home to have a look around and meet the staff. People have the opportunity to visit the home as often as they need in order to decide if they want to live there. A prospective resident may come for meals, have overnight stays and be introduced to other people who live at the home at a pace suitable to the individual. Care Homes for Older People Page 12 of 29 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 are adequate arrangements in place to ensure the health and personal care needs of people living at the home are met by staff. Evidence: The care files of four people that use the service were looked at during the visit. Care plans were being rewritten to ensure they were jargon free and more easy to understand. Training was planned for the relevant staff about care planning. A key worker system was in place and nurses and carers were involved in contributing to the care plans. There is a system for the monthly evaluation of care plans but one person with challenging needs had not had their risk assessment and care plan evaluated since January. Conversation with some visitors and records maintained the home did not have consistent strategies in place to work with people who may display behaviours that may be challenging to work with. The files looked at contained comprehensive and completed documentation to help staff meet the needs of the person. Detailed assessment of needs for each person were in place. A care plan was not in place to provide the necessary interventions for a person who would try to abscond from the building. A capacity and consent from was not available on this Care Homes for Older People Page 13 of 29 Evidence: persons file recording capacity to make decisions and a deprivation of liberty assessment had not been carried out with regard to the desire to leave the building without permission and unescorted when it was not safe for the person to do so. Files showed clear evidence of nutritional and continence screening, moving and handling assessments,risk assessments for falls and pressure care,well being indicator, a pain assessment tool, a history of the person including interests, family details and other important and useful information. Care files were not indexed to make information more easily accessible. There was clear evidence of the involvement of GPs, District Nurses and other health care professionals, such as chiropodists.People living at the home confirmed that if they were feeling unwell, the GP would be called. People who use the service are assessed on a regular basis by nurses working at the home to determine if they are at risk of developing pressure sores. Pressure relieving mattresses are available for those people assessed at risk or who have developed a sore. People who use the service looked cared for and staff showed respect in their actions and in the way they spoke to people they were attending to. A dignity champion has been appointed from the staff team to help ensure the dignity of people living at the home is respected and maintained. Care Homes for Older People Page 14 of 29 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. People living at the home have opportunities to make choices about activities,daily routines and menus so that they may lead a lifestyle that matches their social care needs. Evidence: The care plans of people living at the home recorded information about their social and leisure needs, their likes, dislikes,personal history, things that are meaningful and of interest to the person. An activities organizer works full time at the home but she becomes involved in care duties if there is a shortage of staff e.g at lunch times and if the handyman is not available as was observed on the day of inspection she went to the chemist. The activities organizer was very enthusiastic and had many ideas to promote social activities and make sure they were meaningful and person centred. The person works with people on an individual basis as well as organizing group activities. A weekly activities plan is available for people around the home and these include: bowling,baking,table games,gardening, memory skills, pamper sessions, armchair exercises, WII 1:1 interactive games, washing up, quizzes, exercise, movies,family visits,arts and crafts and sing along. The home also has a mini bus to take people for Care Homes for Older People Page 15 of 29 Evidence: trips every week. People have been for a lakes outing, to a World War 2 exhibition and meal. A monthly church service also takes place for people living in the home to attend. Entertainment is also arranged for people in the home such as musical entertainers and talks. Monthly coffee mornings also take place, buffet teas,choir and dvd afternoons. People living at the home are also supported and encouraged to follow their own hobbies and interests, one person told me he visits his local social club when he wants. Staff ask each person about their wishes,interests and choices.Staff have had some training about memory loss and dementia care. This training should help ensure people are given some choice in order to keep some control in their lives. Staff support people to keep in touch with relatives. There were some relatives visiting at the time of inspection who had mostly positive comments to make about the service. People living at the home are asked daily what they wish to eat from the menu selection. Pictorial menus are available for people to help them make a choice about what they may wish to eat. A menu was not available to display the daily choices available. Special diets are provided for. Menus are made up at the home with suggestions from people living there. Lunch on the day of inspection was lamb burger or diced steak, potatoes,cabbage and cauliflower followed by sponge and custard or ice cream. People living at the home also enjoy home baking. People were very positive about the food provided. Care Homes for Older People Page 16 of 29 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. The home has a complaints and protection system but it is not robust to safeguard vulnerable people. Evidence: Information about how to make a complaint is provided in the Service Users Guide. There is a complaints procedure on display within the home. The home keeps a record of complaints. There have been two complaints received and investigated since the last inspection and any necessary action taken. One safeguarding incident has also been reported under the local councils safeguarding procedures. The home has a copy of the Local Authorities Vulnerable Adults procedures. Staff have received some internal training about safeguarding of vulnerable adults,they receive a booklet as part of their induction about abuse.They have not yet received the local authoritys safeguarding training which shows the action required by the home when there is an allegation of suspected abuse and the role of the local authority in the multi-disciplinary safeguarding strategy. Staff have not received training about behaviour that is difficult to work with. Care plans also did not show any interventions required due to behavioural problems. Staff have received some training about dementia care which should give them more insight into the care and Care Homes for Older People Page 17 of 29 Evidence: support needs of people with memory loss. Care Homes for Older People Page 18 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a comfortable and safe environment for those living there. Evidence: There is an ongoing programme of decoration and refurbishment around the home. Since the last inspection 5 bedrooms have been decorated and new furniture, carpets and bedding replaced in the rooms. The dining room has been redecorated and the flooring replaced. New china, cutlery and other kitchen equipment have been obtained. A random inspection of the premises took place which showed the bathroom by bedroom 29 required decorating, bedroom 33 had broken drawers and a worn headboard,I was informed new furniture had been ordered for this bedroom. The home is accessible and placed in the centre of a local community. A maintenance person works at the home, however systems need to be put in place to ensure his duties for the maintenance of the home are carried out when he is not available due to holidays or sickness. The home has an appropriate amount of sitting,recreational and dining space. Furnishings and fittings were domestic in design. Room sizes meet the minimum required . People all enjoy their own bedrooms. Care Homes for Older People Page 19 of 29 Evidence: There was emergency lighting around the home. The washing machine has the specified programme to meet disinfection standards,however one washing machine was out of order and a new one had been purchased. A tumble drier was still out of action as parts were on order but a new one was being purchased. The laundry assistant was working hard to deal with the mass of laundry that required drying. The home was observed to be clean and odour free. This is a commendation to the housekeeping staff on duty as there are vacancies in this department. At the time of inspection one of the domestics was carrying out care duties. There is a large garden at the home for the use of people but the seating area required some work when the weather improved to make it more attractive for people to sit out. Some picnic benches were available in the area but they are not appropriate and could pose a safety risk to less mobile people. I was informed other garden furniture was available for the use of people living at the home. Care Homes for Older People Page 20 of 29 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. There are adequate staffing levels for the current occupancy levels of the home, but their care needs are not all met by carers.Staff are appropriately recruited but staffing levels need to be kept under review to ensure all the needs of people living at the home can be met by qualified staff or carers. Evidence: At the time of inspection there were 39 people using the service. The homes duty roster and discussion with the manager showed that there were two nurses on duty during the day and evening with 6 carers until the afternoon and 5 carers until evening. On night duty there was 1 nurse and 3 carers. These numbers include the manager. Other staff members are employed for duties such as cleaning,food preparation,cooking, gardening,maintenance,laundry and social activities with people who live at the home. Some staff files were examined. The necessary checks are carried out before a person is appointed to work at the home. There are currently vacancies for a carer, kitchen assistant and laundry assistant. Care Homes for Older People Page 21 of 29 Evidence: There is a good level of staff training. Over 75 of the carers have achieved a national Vocational Qualification at level 2. As the home provides nursing care, nurses with nursing qualifications are employed. Staff have received the necessary statutory training and developmental training is carried out to help ensure that staff can meet the needs of people living at the home. Training carried out includes:palliative care, dementia care awareness, infection control,customer care,good hygiene awareness,continence,diabetes,health and safety,moving and handling and equality and diversity. Future training includes falls awareness and care planning. Care Homes for Older People Page 22 of 29 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 home is becoming better run to ensure that it promotes the interests and well being of the people who live there. Evidence: The manager is a nurse and has several years experience working with this service user group. She has become registered with the regulatory authority for the day to day running of the home since the last inspection. The manager has worked at the home for 2 years and has worked to try to raise staff morale and create a staff team. At times staff sickness and lateness in reporting absence can cause problems trying to find relief staff to ensure there are sufficient staff on duty to meet the needs of people living at the home therefore staff are deployed from other duties to help cover. The manager and Company is working to ensure requirements and recommendations from previous inspections are all carried out in a timely way,outstanding requirements include:all staff must receive local authority safeguarding training and some en-suite facilities still require upgrading in areas of redecoration. Care Homes for Older People Page 23 of 29 Evidence: Staff meetings take place and resident and relative meetings. The meetings enable the home to inform people of important information, discuss future events,discuss any concerns and talk openly about the home. There was a good standard of record keeping and statutory records were up to date apart from documents detailing fire safety were not up to date as no one had been assigned in the maintenance persons absence to carry out these duties. Lockable facilities are available for people to keep their own money if they wish. The home has a suitable system for accounting any monies on behalf of a person living at the home. Systems have been introduced to ensure regular auditing is carried out by the home and the Company to ensure that the home is run in the best interests of people who use the service. The home and the Company carry out their own quality assurance exercise in which they send questionnaires out to people who use the service to see if they are happy with the care provided. Care Homes for Older People Page 24 of 29 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 18 13 The registered persons must 26/02/2010 ensure that all grades of staff have training that follows the Local Authority Procedural Guidance. This will ensure that people living in the home ate protected from harm. 2 24 23 The registered persons must 29/03/2010 continue with the refurbishment of the bedrooms including the ensuite facility. This will make sure that people live in rooms which remain safe and equipped to assure comfort and meet individual need. Care Homes for Older People Page 25 of 29 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 8 17 A record must be kept of any limitations agreed with the service user e.g with regard to the person who wishes to leave the premises. This is to involve the service user in any decsions and provide evidence when there is adeprivation of liberty. 25/05/2010 2 8 13 Care records and risk assesments must contain the required up to date information to enable staff to deliver care and support to service users in a safe and consistent way. This is to ensure the health and safety of all people living at the home. 24/05/2010 3 18 13 All staff must receive the local authority safeguarding of adults training. THIS REQUIREMENT REMAINS OUTSTANDING. 17/07/2010 Care Homes for Older People Page 26 of 29 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 the protection of vulnerable people. 4 27 18 Staffing levels must be kept 17/06/2010 under review to ensure their are sufficient carers to meet the care and support needs of people living at the home. This is to ensure the correct deployment of staff around the home. 5 38 13 The fire checks must be carried out and the fire log completed within the prescribed timescales. completed This is to ensure the health and safety of people living 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 24/05/2010 1 1 The Statement of Purpose and service user guide should be updated to make sure it contains the most recent information to provide to people about the home. The care records of people living at the home should be indexed to make it more easy to find any necessary information in their files. Accessible menus should be displayed in the dining room or where people can easily see them to be reminded of the food and snacks available daily. 2 8 3 15 Care Homes for Older People Page 27 of 29 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 4 18 Staff should receive training about challenging behaviour in order to provide consistent care and support to vulnerable people. The identified bathroom should be decorated in the interests of the comfort of people living at the home. The paved area in the garden should be made comfortable and appropriate garden furniture provided for the benefit and safety of people living at the home. Staff should be assigned to routinely carry out their own job role as described in their job description. 5 6 19 19 7 27 Care Homes for Older People Page 28 of 29 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. © 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. Care Homes for Older People Page 29 of 29 - 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. 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