Care Home: Urmston Cottage

What the care home does well The activity programme in the home provided interest and stimulation to the people accommodated. The activity co-ordinator who ran the programme was good at talking to people and finding out the kind of things that they enjoyed doing. The people we spoke to praised the quality of the meals provided in the home. One person told us that she looked forward to mealtimes. A visiting district nurse told us that staff were helpful and supportive to her in carrying our interventions with her patients living in the home. Policies and procedures were in place for investigating peoples concerns and complaints. We found the home clean and did not detect any unpleasant odours. The home and its equipment had been maintained in good order. Clear and accurate records were held in relation to health and safety maintenance and records of individuals personal spending money were accurate and up to date. What has improved since the last inspection? The information that people who enquire about this service are given had been reviewed and updated satisfactorily. Further improvements had been made to fire safety in the home, by ensuring that combustible materials were not stored in the cellar. Additionally, fire doors were now being kept shut at all times. Training in moving and handling had been undertaken by the majority of staff and they had been tested to make sure they understood how to use their learning safely. What the care home could do better: The quality of care planning and risk assessment in this home had shown no significant improvements since our last inspection. This continued to place the health, welfare and safety of people at serious risk. Management systems continued to be poor in relation to the auditing of care plans, infection control and staff deployment. Medicines record keeping needs to improve particularly for prescribed external preparations e.g. creams and for nutritional supplements to better support and evidence their correct use as prescribed. Care needs to be taken to ensure that it is promptly and accurately acted upon. Key inspection report Care homes for older people Name: Address: Urmston Cottage Greenfield Avenue Urmston Manchester M41 0XN     The quality rating for this care home is:   zero star poor service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Val Bell     Date: 1 7 0 6 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: Urmston Cottage Greenfield Avenue Urmston Manchester M41 0XN 01617473738 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Urmston Cottage (Mcr) Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 45 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 45 The registered person may provide the following category 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 anyother category - Code OP Physical disability - Code PD Date of last inspection Brief description of the care home Urmston Cottage is an extended Victorian property offering care and accommodation with nursing support to 45 service users. There are several lounges and a dining area for service users communal use. Bedroom accommodation is on two floors and is for single and double occupancy. Some bedrooms have en-suite facilities. A passenger lift supports service users to reach all parts of the home. There are gardens to the rear of Care Homes for Older People Page 4 of 29 Over 65 45 0 0 45 2 5 0 3 2 0 1 0 Brief description of the care home the property, which are well used in fine weather and parking space is available to the side of the home. The home is near the centre of Urmston, close to a number of shops and market place. It is close to local bus routes and the Metrolink. Fees are dependant on assessed care needs and individual funding arrangements and details of these can be obtained by contacting the manager at 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: zero star poor service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was a key inspection, which included a site visit to the home by two inspectors. The visit was unannounced, which means that the manager was not informed beforehand that we were coming to inspect the home. We last inspected this home in March 2010 and this visit was conducted to assess the improvements we required to be made following our visit in March. During this visit we spent time talking to people living in the home, the manager, directors and a range of staff working for the service. We looked at records including care plans and documents and procedures that told us how the home was being managed. Care Homes for Older People Page 6 of 29 What the care home does well: What has improved since the last inspection? What they could do better: 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. Care Homes for Older People Page 7 of 29 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 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 9 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The assessment and monitoring procedures used in Urmston Cottage do not safeguard the health and welfare of people using the service. Evidence: Written information given to people using this service had been produced in two documents called the Service User Guide and Statement of Purpose. When we examined these documents in March 2010 we found that they needed to be brought up to date. By the time of this visit both documents had been reviewed and updated as required. Copies of the updated documents had been issued to all service users and a copy left for reference in the homes reception area. We looked at the care records belonging to three people living in the home to assess if their changing needs had been regularly written down and incorporated into their care plans. It was of concern that we found several examples where peoples needs had changed, yet their assessments and care plans had not been updated with this Care Homes for Older People Page 10 of 29 Evidence: information. For example, one person had been confined to bed through ill-health when we visited three months previously. Her care plan stated that this was the current situation, although we observed this person to be sitting on a sofa for the duration of the morning of this visit. The two remaining care records showed poor updating of information in relation to risk assessments and care plans for nutritional care. One example involved the frequency at which the persons risk assessment stated she needed weighing to monitor weight loss. This should have been weekly, but because the care plan had not been updated with this information timely identification of significant weight loss had not been made. These examples of poor record keeping have the potential to seriously compromise the health and welfare of people using this service. Urmston Cottage does not offer an intermediate care service. Care Homes for Older People Page 11 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal and health care needs of people living in Urmston Cottage are not documented accurately and this places their health, safety and welfare at serious risk. Evidence: We looked at three care plans to assess the progress made since our last visit in March 2010 when we found the standard of monitoring and review of care plans and risk assessments to be poor. The provider had given us assurances in their improvement plan that these issues would be addressed by 7th May 2010. We were told this would be achieved by introducing new care plan formats, which would be audited by senior staff and the manager at regular intervals. The three care plans that we examined had not been transferred to new formats and there was no written evidence that they had been subjected to regular auditing procedures. We did not find any evidence that assessments or oral health care plans had been included in the records we examined. Although there had been some progress in reviewing care plans each month, the three care plans we looked at should have been re-written as they had not been updated with each persons assessed Care Homes for Older People Page 12 of 29 Evidence: needs that had significantly changed over time. This meant that there was no accurate audit trail in place for these three people. For example, one of the care plans stated that the person was being cared for in bed, yet we observed the person sitting on a sofa for at least three hours on the morning of our visit. We brought to staffs attention the fact that she was not sitting on a pressure relieving cushion as detailed in the care plan risk assessment. Although this was rectified immediately we asked that she be repositioned as she had been left to sit awkwardly on the hard edge of the cushion. This person was anxious and distressed throughout the morning. Her care plan did not provide staff with any guidance on what to do to relieve her distress or provide reassurance. Two staff had not turned in for work on the morning of our visit and the manager had to work with nursing and care staff to provide the extra cover. This overstretched the staff team who appeared to be too busy to spend significant amounts of time to sit and talk to any of the service users. A pharmacist inspector looked at medicines administration. Since our previous visit further night staff had completed medication training, allowing some flexibility in the times that medicines are administered. But, further monitoring of the times daytime medicines are administered is needed to reduce the risk that where doses of the same medicines are repeated throughout the day, they may be given too closely together. As seen at our previous visit, records showing the administration of medication were generally clearly completed. However, there were still weaknesses in the arrangements for handling and administering prescribed external preparations e.g. creams and prescribed nutritional supplements. External preparations were now securely stored but a new recording system had been less successful. We saw that where cream charts were being used there were some gaps in the record keeping, and in other cases the cream charts were missing. We looked at the records for one person who was prescribed three external preparations and a tablet for itching. There was no supporting information within their care plan about looking after their skin, or the use of these preparations. Similarly, there were weaknesses in the handling of peoples nutritional supplements. One persons care plan said that a supplement was needed four times a day, but administration records showed a different supplement was being given, and only twice a day. Record keeping needs to improve to support and evidence the safe and correct use of peoples prescribed nutritional supplements and external preparations. We looked at medicines stocks. The ordering of the main monthly medicines delivery was better monitored by the home and had improved. But, further improvement is needed to the procedures for ordering medicines outside the main monthly order, to reduce the risk that doses may be missed because the are Care Homes for Older People Page 13 of 29 Evidence: none left to give. We saw that medicines with a limited life on opening were now dated on first opening, helping to ensure they are replaced on time. We found that medicines including controlled drugs were stored securely. This helps to reduce the risk of miss-handling or miss-use. Since our previous visit the homes medication policy has been reviewed, providing clearer guidance to staff in the handling of medicines at the home. The manager has continued to complete regular medication audits (checks) but these have not identified weaknesses in the homes arrangements for handling external preparations and nutritional supplements. Consideration needs to be given to carrying out a wider audit to help ensure that any new procedures are effective. Staff continued to talk to people in a respectful manner and all health and personal care was delivered to people in private. However, staff need to consider the effects on a persons dignity if they are left unsupervised when anxious and distressed. 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. Social activities and mealtimes provide daily variation and interest for people living in Urmston Cottage. Evidence: There were no outstanding concerns in the area of activities provided in Urmston Cottage. The activities programme was assessed as good at our last visit in March and we observed that the activities co-ordinator was busy providing people with interesting and stimulating things to do during this visit. We observed that several people living in the home received visitors during the time we spent there. People can receive their visitors in private or use one of several communal areas for this purpose. We asked a visiting district nurse her views on the quality of the care provided in Urmston Cottage. She told us that she does not usually have patients in the home and that she was only filling in for a colleague who was on holiday. She told us that she had not heard any negative comments about the home and that staff were being helpful and supportive to her on this visit. The quality of the food provided in the home was rated as good on our last visit in March. Current menus provided evidence that people continue to be provided with Care Homes for Older People Page 15 of 29 Evidence: choice and variety in what they like to eat. We asked three people sitting at a dining table about the meal they had just eaten. They all confirmed that they had enjoyed it. One person commented, The food is always good here and I look forward to mealtimes. 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems in place for auditing care and support provided in the home do not safeguard the health, welfare and safety of people using the service. Evidence: There had been one complaint recorded by the home since our last visit. Records provided evidence that this had been investigated and responded to appropriately. We received an anonymous complaint about reduced staffing levels the week before our visit. We wrote to the provider and asked for a written response to the concerns by 16th June 2010. We did not receive a response by the time of our visit. We examined staff rotas to assess the staffing levels deployed during the 3 previous weeks. According to the managers assessment of dependency needs of the 35 people currently receiving support in the home, there should be a minimum of 7 nursing and care staff on duty during the day. The rotas provided evidence that this level of staffing had generally been provided. However, we found evidence that staff numbers had fallen below this level on several occasions. This means that there was a risk that peoples assessed needs may not have been fully met on days when the home had less than 7 nursing and care staff on duty. Following our last visit the provider sent us an improvement plan that detailed how the requirement to implement a system for reviewing and monitoring all aspects of the service would be met by 31st March 2010. Serious shortfalls found during this visit Care Homes for Older People Page 17 of 29 Evidence: in relation to care planning and risk assessment, medication administration and the levels of staffing provided demonstrated that the target date for improvement had not been met. The provider notified us about two safeguarding incidents that had been referred to the local authority for investigation since we last visited the home. Both allegations had been upheld and had resulted in two members of staff being dismissed from the home and referrals made to the Independent Safeguarding Authority. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Urmston Cottage have benefitted from improved fire safety, although failure to store soiled linen appropriately, potentially places their health and safety at risk. Evidence: We walked round the home on the afternoon of our visit to assess cleanliness, hygiene, maintenance and health and safety. The required improvements had been made since our last visit. The cellar had been emptied of all combustible materials and there was no evidence that fire doors were being propped open. A planned programme of maintenance was ongoing at the home. We found the home to be clean with no offensive odours present. However, we were concerned to find that the domestic team were short staffed because two assistants had been given holidays at the same time. Although they were working extremely hard to keep on top of the laundry needing attention they were compromised by a washing machine awaiting repair. Although this had been reported to the contractor the remaining machine could not cope with the volume of soiled linen needing to be laundered. This had resulted in a backlog of approximately 8 full bags of dirty laundry. The majority of bags had been stored outside the laundry entrance on what was an extremely hot and sunny day. This area was bordered by a garden provided for use by Care Homes for Older People Page 19 of 29 Evidence: people living in the home. One of the directors told us that he had offered to take some of the linen to a launderette, although it was not clear why his offer had been refused. The manager had not been made aware of the situation until we shared our concerns with her. 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Failure to deploy consistent and sufficient numbers of staff places the health, welfare and safety of people living in the home at risk. Evidence: We received an anonymous complaint, prior to our visit, alleging that staffing levels were not always sufficient to safely meet the assessed needs of people living in the home. We wrote to the provider about this and asked them to reply in writing by 16th June 2010. We had not received the providers response by the time of our visit on 17th June. We looked at staff rotas for the three weeks prior to our visit. We noted that staffing during the night appeared to be consistent and relevant to the number of people being cared for. However, we found that staff numbers between the hours of 08:00 and 20:00 lacked consistency in numbers. According to the managers assessment of the support needed by people living in the home there should be a minimum of 7 nursing and care staff deployed during daytime hours. It was of concern that we found staffing levels to have fallen below this number on several occasions. This raised serious concerns about the level of care and supervision that reduced numbers of staff can provide in supporting people safely. An attempt had been made to rectify this by reorganising the current weeks rota. However, on the day of our visit, two members of staff had failed to turn in for work, leaving the home short-staffed once again. This Care Homes for Older People Page 21 of 29 Evidence: meant that the manager had to cover for their absence by providing assistance with nursing and personal care. At our last visit we made a requirement for all staff to receive refresher training in moving and handling, because we were concerned that people were not being supported with their mobility in a safe manner. It was encouraging to find that this training had been provided to the majority of staff. Each member of staff had undergone competency assessments following their training, to ensure that they were confident in applying their knowledge of moving and handling techniques in a safe manner. At the time of our visit a process was underway to recruit new staff to work in the home. The provider was awaiting copies of various pre-employment documents to ensure that the candidates selected would be suitable to work with older people. 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The current management systems do not ensure the efficient running of the home or the ongoing improvement of the service. Evidence: A new manager was appointed following our last visit to this home. She had the relevant qualifications and experience to manage a care home for older people. Following our last visit we issued an improvement plan to the home, detailing the required improvements and the timescales in which these must be achieved. During this visit we assessed the progress that had been made to meet the requirements outstanding. It was of concern to find that only four of the eleven outstanding requirements had been met. Issues relating to risk assessment, care planning, the administration of medication and staff complement still presented serious risks to the health, safety and welfare of people using the service. One area of the improvement plan that has been ineffective was the need to have Care Homes for Older People Page 23 of 29 Evidence: systems for monitoring and reviewing the way the home was being managed. Although we were told that additional resources were to be made available, such as regular audits by head office and senior staff, this had not been effective in improving outcomes for people living in the home. The managers ability to drive forward these improvements had been compromised on several occasions by having to provide cover on the rota when staff shortages had occurred. This reduced her capacity to monitor and supervise staff practice and carry out the audits that she had been given responsibility for. The manager has not submitted an application to register with the Commission. The required improvements had been made to fire safety practice and monitoring in the home as required at our last visit in March 2010. 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 8 18 There must be a system in 25/05/2010 place to monitor and supervise staff practice in the quality of care provided to people living in the home. To provide evidence that individuals personal and healthcare needs are being met. 2 8 12 Care plans must contain sufficient detail to demonstrate that peoples needs are being met appropriately and in accordance with their stated preferences. To ensure that people are receiving care and support that promotes their wellbeing. 19/02/2010 3 8 12 Staff must ensure that people living in the home receive the right care and appropriate treatment. To ensure that peoples personal, health and safety needs are met. 25/04/2010 4 9 13 All medication including prescribed nutritional supplements and external preparations e.g. creams must be safely administered 30/04/2010 Care Homes for Older People Page 25 of 29 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 as prescribed and supported by clear and accurate record keeping to evidence their correct use to support peoples health and wellbeing. 5 18 24 Systems must be in place for 25/04/2010 reviewing and auditing all aspects of the service being provided. To ensure that standards are being met and that people using the service are safeguarded from harm. 6 31 9 The manager of Urmston Cottage must apply for registration with the Care Quality Commission. To ensure that the manager is a fit person to manage a home for older people. 7 31 24 The registered provider must 25/06/2010 ensure that appropriate systems are in place for the efficient management of the home. To provide evidence that the home is being managed in the best interests of the people accommodated. 05/03/2010 Care Homes for Older People Page 26 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 1 26 13 Soiled laundry must be stored safely prior to washing. To minimise the risk of the spread of infection to people using the service via substances hazardous to health. 17/07/2010 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 3 14 Changes to the assessed needs of people using this service must be identified in a timely manner and incorporated into an up to date plan of care. To ensure that people receive continuity in the provision of appropriate care and attention to meet their changing needs. 17/07/2010 2 27 18 The registered person must ensure that sufficient numbers of staff are provided at all times To ensure that the assessed needs of people living in the home are being met. 17/07/2010 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 1 10 Strategies should be in place at all times to ensure that people receive the care and support they need to relieve anxiety and distress. To safeguard the dignity and wellbeing of people using the service. 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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