Care Home: The Rowans Care Home

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What the care home does well We observed staff and management being very friendly and respectful to people who live in the service. Residents and relatives said that staff were friendly and attentive and welcomed visitors. Residents and relatives can be involved in setting up and reviewing care plans so that residents get the care they want. There are systems in place to review care to improve the welfare needs of people, e.g. accident and medication reviews. Activities are provided by positive and enthusiastic staff. Independence is encouraged as much as possible, e.g. in personal care, gardening, going out etc. Staff were seen to be informally chatting and reminiscing with people. Food is seen as of a high standard and management have an oversight as to how much people eat and drink and take action as needed. Health and safety systems are in place to protect the health of people. The Manager is setting up `Champions` for important issues such as dignity, pressure sore prevention etc to improve care to people. What has improved since the last inspection? A lot of staff training has taken place so as to equip staff with the skills to improve care to people who live in the home. What the care home could do better: Residents welfare could be more effectively met by ensuring that: All aspects of care e.g. proper toileting programmes, moving and handling details, personal history, daily living wishes etc need to be detailed in Care Plans and staff to read all Care Plans to assist staff to meet all residents needs. Medication recording always needs to be in place to protect peoples health needs. More outings and activities, based on residents wishes, are needed. Staff must be aware of which Agencies to contact if the in house process fails. Proper staff references should always be taken up to fully protect people from unsuitable staff.The staff training programme needs to become more comprehensive through training on all peoples conditions, ensuring all staff receive thorough training to increase their skills in delivering good quality care for residents. Key inspection report Care homes for older people Name: Address: The Rowans Care Home Owen Street Coalville Leicestershire LE67 3DA     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: Keith Charlton     Date: 1 2 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 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) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: The Rowans Care Home Owen Street Coalville Leicestershire LE67 3DA 01530814466 01530814455 rowans@schealthcare.co.uk www.southerncrosshealthcare.co.uk Southern Cross Care Homes No 2 Ltd care home 54 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: 1. The registered person may provide the following category/ies of service only: Care home only Code PC 2. The maximum number of service users who can be accommodated is: 54 First Floor The service users admitted to the home who fall within category DE, DE(E) or dual disability DE/PD, DE(E)/PD(E) may only be accommodated on the first floor. Maximum number of service users accommodated on the first floor shall not exceed 30. Maximum number of service users accommodated on the ground floor shall not exceed 24. No one under the age of 50 years of category PD to be admitted into the home No person under 55 years of age who falls within category DE may be admitted to the home Care Homes for Older People Page 4 of 27 Over 65 30 24 54 30 0 54 The service users admitted to the home who fall within category OP may only be accommodated on the ground floor The service users admitted to the home who fall within the sole category of PD or PD(E) may only be accommodated on the ground floor. To be able to admit the person of Category LD(E) identified in correspondence with the previous registration authority dated 27th March 1998 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 Physical disability Code PD Dementia Code DE Date of last inspection Brief description of the care home The last key inspection of the service was on the 14th November 2007. The fees for 2009 are #400-#650 per week. The most recent inspection report can be found in the reception area. The Rowans is a care home providing personal care and accommodation for up to fiftyfour older people, which includes older people who have a physical disability and dementia. The home is owned by the Southern Cross group of care homes, who own other care homes in Leicestershire. The home is located close to the town centre of Coalville, close to shops, pubs, the post office and other amenities. The home is easily accessible by private or public transport. The home is a purpose built two-storey building with level entry access and access to both floors is accessible by use of the passenger lift or stairs. An adequate number of facilities are situated throughout the premise, namely washing, bathing and toilet facilities. The home has fifty-two single bedrooms, two with ensuite facilities and one double bedroom without ensuite facility. The home has a garden to the side and rear of the building which is well maintained and which is accessible to all residents. 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: The quality rating for this service is Two Stars. This means the people who use this service experience good quality outcomes. We, as it appears throughout the Inspection Report, refers to The Care Quality Commission (CQC). The inspection process consisted of pre-planning the inspection, which included reviewing the Annual Quality Assurance Assessment (AQAA), which is self assessment tool completed by a representative of the service. We have sent surveys to people who use the service along with staff and their comments will be in this Report if received before publication. The unannounced site visit commenced on the 13th October 2009 and was carried out by Keith Charlton. Care Homes for Older People Page 6 of 27 The focus of the inspection is based upon the outcomes for people who use the service. The method of inspection was case tracking. This involved identifying people with varying levels of care needs and looking at how these are being met by the staff at The Rowans. Four residents were selected. Discussions were held with six residents, though this was limited as most residents had difficulties with communication due to their dementia, three relatives, the Manager, the Area Manager, and two members of staff. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: Residents welfare could be more effectively met by ensuring that: All aspects of care e.g. proper toileting programmes, moving and handling details, personal history, daily living wishes etc need to be detailed in Care Plans and staff to read all Care Plans to assist staff to meet all residents needs. Medication recording always needs to be in place to protect peoples health needs. More outings and activities, based on residents wishes, are needed. Staff must be aware of which Agencies to contact if the in house process fails. Proper staff references should always be taken up to fully protect people from unsuitable staff. Care Homes for Older People Page 8 of 27 The staff training programme needs to become more comprehensive through training on all peoples conditions, ensuring all staff receive thorough training to increase their skills in delivering good quality care for residents. 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 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 10 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. People living at The Rowans have had their needs properly assessed before moving into the home. Evidence: Yes I got all the relevant information from the home when I came to look at the home, one person who lives in the home said. The AQAA stated that prospective residents are invited to the home and can stay for the day, relevant information is provided and assessments are carried out by the management. Most people were not able to confirm that they had been provided with sufficient written information about the home due to their dementia conditions but a person who lives at the service and relatives spoken with said they had enough information at the time of admission in order to be able to make up their minds about the home. Care Homes for Older People Page 11 of 27 Evidence: We case tracked a person living in the home who had moved into The Rowans in the past. We checked that the family had received information to help with the choice of home, and the relative said she had received enough information. We also checked that this person had her needs properly assessed prior to moving in, to ensure that the staff at the home could meet their needs and we found that the assessment system was detailed regarding residents needs, though past health checks had not been included, which is useful to prompt these checks and improve the health and daily quality of life for people. The Manager said this would be followed up. Care Homes for Older People Page 12 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. People at The Rowans receive good health and social care practice. Evidence: Residents and relatives said that staff provided excellent personal care: Staff are always helpful and are nice and friendly, and My mother has had no problems here. Staff are good and we cant fault them in any way, were some of the many very positive comments that people and relatives made. The AQAA stated that the home has a person centered approach, based on individual needs, (i.e. not treating everyone the same but making sure care is provided to the known wishes and preferences of the person), that there are six monthly medication reviews and that most staff have received dementia training to equip them with the skills they need to properly care for people with dementia. A person who uses the service could recall having a care plan and relatives thought staff knew the care needs of their relative. We checked the care plans of four people living at the home who were case tracked. Plans showed detail regarding the support Care Homes for Older People Page 13 of 27 Evidence: required by staff to ensure the physical health of people living at the home, and there was some information to inform staff of the residents personal history though not very much information of the preferred daily living routines of residents to ensure their social and emotional well being is fully supported. The Manager said that she had identified that there needs to be more information as to the individual history of people so that staff can appreciate peoples personalities and experiences. Continence information was recorded though this assessment needed more detail to work out the individual needs of a resident so staff could prompt before they needed to go to the toilet. There were gaps on health check recording insofar as there was no moving chart for one person and the type of sling needed was not specified in the plan so that people may not have had their full needs met. The Manager said that these issues would be followed up. Staff said they had not read all Care Plans - this is needed so that they can fully understand residents needs. The Manager said this would be also followed up. People and relatives said that staff were quick to alert the GP if there was sickness. Accident records were checked and medical services were contacted when a resident had a potentially serious injury except in one instance. The Manager and Line Manager said that this is being followed up with the staff member concerned.There was also a monthly audit in place to review why accidents happened so that preventative steps can be put in place, thus protecting residents health. We checked the medication records, and found that there was generally good recording of the administration of the medicines in the home, though there were some gaps that the Manager said she would follow up. There is a system in place so this is checked on a daily basis. There was good information on medication sheets regarding photos of people and allergies, so that residents health is protected by staff having awareness of this information. It was found that staff issuing medication did not record after issuing it to people though she then realised that she should be doing this when asked. Controlled medicines storage was in a secured cabinet. The Manager said this storage conformed to the latest legal requirements. We spent time watching staff interaction with people living at The Rowans. We saw staff being friendly and caring to people throughout the day doing their best to meet the needs of people living at the home and relatives confirmed that staff respected privacy and addressed people by their preferred names, which respected their dignity. Staff were seen to assist residents in various ways - giving choices for meals, encouraging residents in activities and to take their medication etc. 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. There are opportunities for people at The Rowans to take part in activities and have a relaxed lifestyle. Evidence: People said that they were largely satisfied with the current activities. One person said: Yes, we have quite a lot of activities but it would be nice to have some more and more trips out, one person said. The AQAA stated that activities are varied and delivered in various ways by a full time activities organiser. There is also a voluntary activities person who was the former Activities Organiser. Both people were found to be very positive and enthusiastic and had good senses of humour and had a laugh with people, which people enjoyed. People have the opportunity to garden as there are raised beds and a vegetable patch. The Manager said she was looking into the arranging of holidays for people. We saw the full time Activities Organiser providing a quiz and bingo with people and we saw that a staff member went into a lounge and talked to people about their past lives. A person was taken out to the garden to watch the homes chickens in the Care Homes for Older People Page 15 of 27 Evidence: chicken coup and a person was seen to be doing some gardening - proof that peoples interests and independence is actively encouraged by the management of the service. People also watched TV, listened to music and staff said there are daily activities - also displayed on a noticeboard was an advert for people and staff to be involved in the homes choir.The Manager said that she is also to develop memory boxes of treasured items for people so that staff can use them for one to one reminiscence sessions with people. The Manager also said that she is to do a regular newsletter for people and ask them if there were any stories etc they wanted to have in it. The relations between staff and residents were observed to be relaxed, positive and friendly. Staff said there were no rules. People can get up when they like, choose their clothes and food etc.The home supports residents with dementia with staff training on this having taken place and there was displayed information for the menu, though not for day, weather, place etc.The only suggestions made were for regular outings and more in house activities, which the Manager said were being followed up. Visitors are welcomed at The Rowans and we were informed by visiting relatives that they could come at any reasonable time and they were always greeted in a friendly way by staff. People said that they enjoyed the food: The food is very good. We have a good cook, one person said. We observed lunch being served. There was a choice of a hot dinner or alternative. Food was well presented and looked appetising, with good portions being served to each person, followed by a choice of dessert. Food records showed a good variety of traditional food served. There was evidence that the cook takes part in Residents Meetings so as to hear suggestions and comments about the food and adjust the menu accordingly to meet peoples preferences. Information regarding peoples weight is also supplied to her so she can adjust the diets accordingly. We observed staff assisting a person to eat to ensure that proper nutrition was supplied. 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. Complaints are taken seriously and residents protected from abuse. Evidence: The AQAA stated that there is a communication and suggestion book, the Manager has a weekly Surgery for people and their relatives to come and speak about anything that concerns them, that there is to be a residents and relatives committee being set up and staff have received deprivation of liberty training. No one said that they had had a complaint though were confident if they took to management it would be quickly dealt with. A person said, Caroline (the Manager) would make sure it was sorted out if I was bothered about anything, one person said. We saw that there have been complaints since the last inspection in the complaints book. All were properly detailed to clearly show what the complaint was and how it was dealt with. We talked to staff to find out how much they knew about protecting people in the home from abuse. Records showed they had received training about safeguarding adults from abuse, and they knew the in house procedure, but struggled with Agencies to whistle blow to if the in house procedure failed. We looked at the staff recruitment records to see whether all the proper checks had Care Homes for Older People Page 17 of 27 Evidence: been made on staff before they started employment at The Rowans. We found records which showed staff had started work with legal checks in place to help management reach the judgement that people were safe to start employment. Care Homes for Older People Page 18 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 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 Rowans live in a homely and well maintained environment. Evidence: My bedroom is comfortable and I can have it the way I like, one person said. All people and their relatives spoken with said that bedrooms were clean and tidy: My mothers bedroom is always kept clean, one relative said. The AQAA stated that there is a bright and welcoming entrance, that bedrooms are decorated following peoples individual wishes, that equipment is regularly serviced, staff have received training as to how to use all aids, there is quality furniture and furnishings which have been chosen by the people living in the home, that furniture appropriate for people with dementia is to be installed, and that lounges have been refurbished. We saw people at The Rowans living in a clean and well maintained environment. The furnishings in communal areas are of good quality and homely, and people are encouraged to bring their personal possessions into their bedrooms. The Manager talked about buying specialist furniture that is more robust so as to cater for the needs of people with dementia. The service has improved the environment to further to help residents with dementia, Care Homes for Older People Page 19 of 27 Evidence: e.g. colour coding bedroom and toilet doors, to make facilities clearer, and try to orientate people to go to their own bedrooms etc. Records show that the home is well maintained, and good measures are in place to keep the home hygienic. There were no odours in general apart from a low level odour on the first floor on day two of the inspection. First floor corridors are to be redecorated according to the Manager to benefit the people on this floor with dementia. The garden is attractive and well maintained. There is a chicken coup where people can go and look at the chickens and this helps brings back memories of past times. Care Homes for Older People Page 20 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. Residents needs are met by a competent staff group though staff training needs to be extended to ensure staff have the skills to meet all residents needs. Evidence: There were no comments that staff were too busy: Staff come to you as quickly as possible, one person said. The staff rota showed eight care staff during the day/evening (five on the dementia unit on the first floor and three for twenty people on the ground floor) plus the Manager, with five awake staff at night. Domestic staff work seven days per week and there is a cook every day. We spoke with the Manager about the staffing and she said that current arrangements worked well. A staff member said that although he had only been working at the home for a short time he had been encouraged by management to do further training and was looking forward to doing a NVQ 2 course in the future and had already completed a number of training courses and a thorough induction. From information obtained from the AQAA we saw that there are over 50 of staff with NVQ training, needed to ensure a good range of knowledge to meet residents needs. We found that staff have been on a number of training events to help update Care Homes for Older People Page 21 of 27 Evidence: their practice on areas such as Moving and Handling, Fire Safety, Infection Control etc and more training - first aid, dementia, protection from abuse and challenging behavior, was planned though some staff had not received training on peoples conditions as shown by the Training Matrix we saw - e.g. Sight and Hearing Impairment, Stroke, Mental Health conditions, Parkinsons Disease, Diabetes etc. The Manager said this would be followed up. Staff records showed that checks had been carried out to protect residents from unsuitable staff though there was evidence that not all references came from the management of their previous employment, which does not pick up relevant information on staff competency, honesty etc. Care Homes for Older People Page 22 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. There are management systems in place to protect the health and safety of residents. Evidence: Caroline Harrison is the Manager of the home. She said that she is on the point of applying to the Commission to become the Registered Manager. Caroline will sort out anything that you brought to her, one resident said. Caroline explained her intention to set up Champions for important issues on the running of the service - Dignity, Fire, First Aid, Pressure sore prevention etc, which will promote these important issues and ensure better care for people who live in the home. People, relatives and staff were very positive about Caroline and her management skills. Caroline has an awareness of the Mental Capacity Act and the need to make referrals to the relevant Agency regarding deprivation of liberty issues, which means that residents are protected from inappropriate deprivations of liberty. We saw that appropriate referrals had been made to the right agency to see whether proper safeguards are in place. Care Homes for Older People Page 23 of 27 Evidence: Satisfaction questionnaires were sent around the home last year, which were seen to be very positive. Caroline said that they had also been sent to relatives and she will in future send them to other relevant people such as GPs, District Nurses, Social Workers etc. Caroline said that an analysis of the results to see if improvements in the service were needed would be in place in future. Written records regarding finances for residents are properly in place. There was evidence of a Residents Meetings discussing relevant issues - activities, food, staff, complaints etc, which showed their involvement in the running of the home. Caroline said that this meeting would be extended to relatives as well to attend to put their views forward. Staff informed us that they were able to tell management of the problems they were facing and there were regular meetings and supervision to support them. There are proper Health and Safety systems in place in the home. We saw risk assessments for safe working practices and COSHH assessments to keep residents and staff safe. Proper fire records were in place with regular fire drills. Staff were asked about the fire drill procedure and they all knew what to do. Care Homes for Older People Page 24 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 25 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 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 Care Plans need to be more detailed to record issues such as individual continence needs, daily living wishes, personal history, and detailed moving and handling information, with care staff reading all the Plans so as to always be aware of how to meet peoples needs. Medication needs to be signed after it is given to people, so that mistakes are avoided and peoples health needs are protected. Staff need to be aware of all the Agencies they can contact if abuse is suspected if the in house procedure does not work. References from the management of the last employer of staff needs to be obtained to get a better picture of staff competence etc. Staff training needs to be extended to include all residents conditions. 2 9 3 18 4 29 5 30 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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