Care Home: The Manor House Barnard Castle

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What the care home does well People are provided with good information about the home and they are invited to look around before they move in. This helps people with their decision making when looking for a care home. The home makes sure that it can meet peoples` needs before they move in by receiving important information from health and social care services who have carried out an assessment of need. Care plans generally give staff clear information about what they need to do to meet the service users health and personal care needs. Staff have had lots of training to make sure that they know how to write these in a person centred way, so that service users receive care and support in the way that they prefer. There are good arrangements in the home for meeting service users` health care needs. Service users are supported to see their GP`s, dentists, chiropodists, etc. There are plenty of activities available for people to take part in and relatives can visit the home any time they wish. The meals are good with plenty of choices available. There is a good complaints procedure and everyone said they were confident in talking to staff if they were unhappy. Staff have had training so that they know what to do should they suspect or witness abuse. The home is clean and comfortable and everyone has their own bedroom with Internet access. The quality of fixtures and fittings is excellent and the environment has been adapted to meet the needs of people with dementia. For example: memory boxes are placed next to the service users bedroom to act as a prompt, reminding people of where their room is so that they can go there independently. Staff training is good and includes the different needs of people who live in the home. This means that staff have the right knowledge and skills. Service users and relatives said: "its a beautiful, lovely home, the best thing that has happened in Barnard Castle", "Beryl, (the manager), is very nice indeed, all of the staff are", "its buzzing", "its the nicest home", "the bedrooms are lovely and clean" "staff sit and talk to residents" and "friendly and pleasant atmosphere". What has improved since the last inspection? This was the home`s first inspection. What the care home could do better: Medication administration records need to be better. For example: there should be a brought forward figure on the medication administration charts, so staff know how much medication should be in stock. This will also help staff to check that service users have been given their medication as prescribed. Accurate records need to be kept of the amount of controlled drugs held in stock. (A director, the responsible individual and the manager of the home told us in a meeting after the inspection that all of the issues relating to medication had been addressed). The manager is starting to find out about the service users` life history. This needs work needs to continue as it will help to make sure person centred care is provided. Before a new member of staff is able to work in the home the manager must make sure that they have an Independent Safeguarding Authority check for them. This is to make sure that they are suitable to work with vulnerable adults. The manager must register with us. This is important as it is a legal requirement to make sure that the manager has the right skills and experience to manage a care home. Key inspection report Care homes for older people Name: Address: The Manor House Barnard Castle John Street The Manor House Barnard Castle County Durham DL12 8ET     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Nicola Shaw     Date: 2 8 0 5 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: The Manor House Barnard Castle John Street The Manor House Barnard Castle County Durham DL12 8ET 01914605219 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Hadrian Healthcare (NE) Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 75 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability sensory impairment Additional conditions: The maximum number of service users who can be accommodated is : 75 The registered person may provide the following category of service only : Care home with nursing - Code N, to service users if 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: 75, Dementia - Code DE, maximum number of places: 75, Physical disability - Code PD, maximum number of places: 10, Sensory Impairment - Code SI, maximum number of places: 5. Date of last inspection 75 0 10 5 Over 65 0 75 0 0 Care Homes for Older People Page 4 of 27 Brief description of the care home The Manor house is a purpose built 75 bed home located in the centre of Barnard Castle, near to a range of local facilities. The home is divided into four units, Bowes, which provides nursing care, Chesters, which provides a service to people with dementia, Starling and Teesdale, both of which provide residential care. Each unit is staffed and operates independently of each other. Facilities available to service users include shopping areas and a coffee shop, a hairdressing and beauty salon, a library, and a a range of dining and lounge areas. There are also beautiful landscaped gardens which can be easily used by service users. All bedrooms are single with en-suite facilities and all benefit from wireless internet access. The weekly fees at the time of this inspection range from 449.71 pounds to 734 pounds. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection took place over two days, the 25th and 28th May 2010. Before the visit we looked at, information we have received since the home first opened, how the service has dealt with any complaints and concerns, the providers view of how well they care for people and the views of people who use the service, their relatives and staff. During the visit we, talked to people who use the service, relatives, staff and the manager. We 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 had the knowledge, skills and training to meet the needs of the people they care for. We also looked around parts of the building to make sure it was clean, safe and comfortable. Care Homes for Older People Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: Medication administration records need to be better. For example: there should be a brought forward figure on the medication administration charts, so staff know how much medication should be in stock. This will also help staff to check that service users have been given their medication as prescribed. Care Homes for Older People Page 7 of 27 Accurate records need to be kept of the amount of controlled drugs held in stock. (A director, the responsible individual and the manager of the home told us in a meeting after the inspection that all of the issues relating to medication had been addressed). The manager is starting to find out about the service users life history. This needs work needs to continue as it will help to make sure person centred care is provided. Before a new member of staff is able to work in the home the manager must make sure that they have an Independent Safeguarding Authority check for them. This is to make sure that they are suitable to work with vulnerable adults. The manager must register with us. This is important as it is a legal requirement to make sure that the manager has the right skills and experience to manage a care home. 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 8 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 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 are currently being up-dated to contain information about the new manager. They contain useful information, for example, about the type of facilities available and a promise to respect the dignity of individuals as well as helping people to be as independent as possible. Care Homes for Older People Page 10 of 27 Evidence: 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 so that she can decide whether The Manor House is able to meet their needs. For potential service users who are not funded by the local authority the manager will carry out an assessment of need. The home also provides service users with the opportunity of visiting the home, have a meal and/or move in on a trial basis. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care needs of the service users is met, and developments in the quality of information that is available in the care plans support this. Staff care practices fully preserve the dignity of the people who live here. And medication procedures protect the service users. Evidence: A range of standard 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 and nutrition. One care plan we looked at for a person at risk of developing a pressure sore provided conflicting information. For example: one intervention provided guidance to staff to alternate this persons position regularly, however, other guidance for staff indicated that this person could alternate their own position. It was also recorded in this care plan that the appropriateness of their mattress be assessed weekly but there was no Care Homes for Older People Page 12 of 27 Evidence: evidence that this had taken place. In this persons file there were also 2 care plans for eating. One stated offer small appetising meals 4 times daily and that this person had a reduced appetite and was at risk of malnutrition. However, the second care plan said that the person had a good appetite and ate a normal diet. The responsible individual, in a meeting after the inspection, told that she had reviewed the care plans, and that this person did need two care plans in relation to nutrition. However, she agreed to look at ways of how this and other information could be communicated more clearly to staff. The aim of another care plan was to ensure that a service user was provided with an adequate fluid intake of 1500 to 2000 mls per day. There was no evidence that this care plan had been implemented. There were significant gaps on one persons food monitoring sheet. There was no evidence that service users, their relatives or advocates had been involved in writing the care plans. In a meeting after the inspection the director, responsible individual and the manager confirmed that all of the above issues have been fully addressed. This has included providing intensive training to all staff about how to write a care plan. We looked at a care plan for a service user who has dementia. The information in here was much clearer and person centred with details of their personal preferences, likes and dislikes. There was also a plan in place providing staff with guidance about how to support this person should they become agitated, and what might trigger this, for example a noisy environment. This demonstrated that staff had a good understanding of dementia and how noise can affect a persons well being. However, these care plans were dated March 2010, yet the person was admitted in December 2009, some 3 months earlier. Service users have access to a range of health care professionals, including GPs, chiropodists, dentists, etc. It was good to note how the staff identified that a person with dementia was agitated because they were in pain and made sure that they quickly saw the appropriate health care professional. Medication is stored in a locked, secure room in each unit. We looked at how the Care Homes for Older People Page 13 of 27 Evidence: medication was looked after in Bowes, where nursing care is provided. The medication trolley were clean and well organised. Staff monitor the temperature of the medication room and the medication fridge to make sure that medicines are stored correctly. The nurses order the medication from the prescriptions to ensure that service users are provided with the correct medication. There were no gaps on the Medication Administration Records, (MAR), we looked at which demonstrates that service users are receiving their prescribed medication. There is a small stock of controlled drugs. These are stored securely, however, accurate records had not been kept of the amount in stock of one of these. There is no brought forward figure recorded on MAR sheets for medication which is not dispensed in a monitored dosage system. This makes it difficult to carry out a stock check of this medication. We did a brief audit of one service users loose medication and found that the amount in stock did not corresponded to the amount that had been administered according to the MAR charts. A record is not maintained of when prescribed creams are administered. We have received written confirmation from a co director of the company stating that immediate action has been taken to address the issues in relation to medication. Staff referred to the service users by their preferred name and it was clear there was a good rapport between the staff and service users. Staff were always observed to be respectful in their approach towards service users. For example staff did not rush service users when supporting them to walk but made sure that they assisted them at a pace comfortable for them. And when talking with service users made sure that they knelt down beside them so that they were were at their level. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience 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. Service users health and welfare is promoted by the provision of a varied menu. Evidence: There are 2 designated activities co-ordinators. It is the role of the activity coordinators to plan the weekly activities based upon information from service users in relation to their individual choices. Examples of recent activities include a barbecue, picnic and cheese and wine evening. Facilities within the home include access for service users to a wireless network for those who own their own computers, refreshment hubs on both floors, hairdressing salon with nail bar, TV rooms, shop, music room as well as two beautiful well maintained gardens. Volunteers form the local community provide additional entertainment for the service users. An example of this is the local school who recently were involved in a game of Care Homes for Older People Page 15 of 27 Evidence: guess the role of staff. There is also a gentlemans club where guest speakers are invited to attend. One service user uses the Internet facility to e mail and invite their friends along to this. There is also a weekly newsletter called sparkle and and service users are supported to write and contribute to this. However, there is very little information in the care plans about the service users social history. The manager told us that she is beginning to involve service users and their family members in life story work. Relatives said that they can visit the home any time and are always made to feel welcome by staff. Relatives are also encouraged to take part in the care of their family member if they want to, for example, helping them with their meal. We spent time with people with dementia who live in Bowes whilst lunch was served. Dining tables were beautifully presented with tables cloths, condiments, etc. Service users were offered a choice of main meal at the time that it was served ( which is good practice in dementia care as people with short term memory loss may not remember if they had been asked to choose form a menu some time before the meal). It was excellent that, once staff had served the food, they sat with service users to have their meal. Again this is good practice in dementia care as not only does this provide the opportunity for staff to closely monitor what service users have eaten, but they can act as a visual cue to some people helping them to retain their independent eating skills. Service users and relatives we spoke to commented positively about the food. One relative commented that since living at this home their family member had put on a considerable amount of weight. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a good complaints procedure so people know that their views will be listened to and acted upon. Service users are protected from abuse through the homes safeguarding policies and staff training. Evidence: The home has a complaints procedure. This is on display in the home and in the Service User Guide. There has been one complaint in the last year. We looked at the complaints record, which showed that this had been thoroughly investigated by the company. We spoke to 4 staff who confirmed that they knew what to do if someone came to them with a complaint. Service users who completed a survey said that they could speak to someone informally if they were not happy. They also said that they knew how to make a complaint. Relatives we spoke to said that they would have no hesitation in making a complaint but that they had no cause to. Staff confirmed that they had had training about safeguarding adults. The home has a copy of the Local Authority Safeguarding Adults policy and procedure Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from excellent accommodation that meets their needs. Evidence: Manor House is a purpose built care home situated in Barnard Castle. All bedrooms are single with en-suite facilities, all of which benefit from wireless Internet access and some, private fitted fridges. There are dining rooms and Bistros, a library and hairdressing facility. There are also beautiful landscaped gardens with private seating areas, water features and raised planting areas for service users to use and enjoy. In Chesters, where people with dementia live, the environment has been adapted specifically to meet the needs of people with short term memory loss. For example: there are memory boxes on the service users bedroom door to help them find their own rooms. There are no long corridors with a locked door at the end which may cause some people with dementia to become agitated. And sensory items have been placed along corridors to provide stimulation for people. One service user invited us to view their bedroom. This was bright, airy and personalised with photographs and ornaments. Service users who completed surveys said that the home was always clean and fresh. One person commented that there were good facilities for visitors and tenants. Care Homes for Older People Page 18 of 27 Evidence: Some staff are in the process of completing infection control training. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels and staff training is satisfactory and includes specialist training in order to meet the diverse needs of the service users. This helps to ensure staff can effectively meet the care needs of people who live here. Staff recruitment procedures generally protect the service users. Evidence: There are 4 units in the home, Teesdale for people who need residential care (currently 18 service users), Chesters for people with dementia, (currently 15 service users), Bowes for people who need nursing care,(currently 6 service users) and Starling, for people who require residential care, (currently 2 service users). At the time of our inspection on duty were the following: Bowes- a nurse manager, a registered general nurse and 3 care assistants,(Bowes staff are currently supporting the 2 service users living in Starling), Teesdale-1 senior and 1 care assistant, Chesters- 2 senior and 1 agency staff. There were also 2 additional staff in the process of completing their induction training, 2 cooks and a kitchen assistant, 4 domestic staff, the manager an administrator and an activities co-ordinator. Care Homes for Older People Page 20 of 27 Evidence: The above staffing levels are appropriate for the current number of people living in the home. Service users who completed surveys said that there were always enough staff available when they needed them. We talked to staff about their induction training. They commented that they felt it provided them with the knowledge and skills they needed to meet the needs of the service users. Other training recently provided includes focus on under nutrition, and training in health and safety issues, including moving and handling and fire safety. The manager has recently purchased some information about the needs of people with dementia and is arranging for staff to receive training about this All of the service users spoke positively about the staff and there was clearly a good rapport between the service users and staff. Service users said: helpful and caring staff, always on hand when needed, taking time to listen. Staff files showed that the companys recruitment procedures are generally followed. This includes obtaining two written references an Enhanced Criminal Records Bureau (CRB) check and an Independent Safeguarding Authority (ISA) Check, before prospective staff work in the home, to ensure that they are suitable. However, in one staff file we looked at their CRB and ISA checks had been received after their start date on the staff rota. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although the home does not have a registered manager, service users have benefited from a consistent management approach. Evidence: The first registered manager of this home left soon after the home opened. Whilst awaiting for the current manager to take up her position in this home the responsible individual has been responsible for the day to day management of the home, with the support of the directors of the company. The current manager has been in post for a short time. She has many years experience of managing care services and confirmed that she as in the process of applying to be the registered manager. Relatives commented that Beryl (the manager) is visible, she is out on the floor so she can see what goes on. She has recently invited relatives and friends to a cheese and wine night so that she could introduce herself to them. Care Homes for Older People Page 22 of 27 Evidence: Regular reports on the conduct of the home are completed by the responsible individual and directors of the company. All sections of the Annual Quality Assurance Assessment were completed and the information gave a reasonable picture of the current situation within the home. The home employs a full time administrator who is responsible for the service users finances on a day to day basis. Service user monetary transactions are recorded appropriately. The manager carries out an audit of these each month. Staff confirmed that they had supervisions. On the day of our visit staff were receiving training in fire safety. A record of all accidents is maintained. And there is a system in place for monitoring the number of falls that have taken place so that preventative measures can be introduced if necessary. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 29 19 An Independent Safeguarding check must be obtained before prospective staff are able to work supervised within the home. 21/07/2010 This is to ensure service users are fully protected. 2 31 9 The manager must register with the CQC. This is to ensure that service users are protected by a manager who is considered fit to manage a care 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 30/06/2010 1 7 The development of the care plans should continue as discussed in the meeting following the inspection. Accurate records should be kept of food and fluid intake, where this has been identified as a need. Service users or their representatives should be involved in Page 25 of 27 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 developing the care plans. 2 9 There should be a brought forward figure recorded on the Medication Administration Record for loose medicines to assist with the auditing process. Life story work should continue as planned. 3 12 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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 27 of 27 - 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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