Care Home: Victoria Care Home

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What the care home does well There is a very good pre admission assessment process in place, giving the assurance that peoples` needs are satisfactorily identified, in order to determine if they can be provided for at the Victoria Care Home. The care planning documentation is good, with the emphasis being that a person centered service is provided. The provision of activities is of a very good standard, helping to give assurance that people are receiving appropriate motivation and stimulation. The decor and maintenance is kept up to date, helping to ensure that the home is a safe and pleasant place to live and work. The standard of care and support throughout the home is good. However, it was evident that the support of people with dementia is of a very good standard. The provision of training is satisfactorily provided and it is evident that training is kept up to date and appropriate. It was observed that good and trusting relationships exist between service users and members of staff. There was a calm and relaxed atmosphere in the home, with a number of people commenting about the homely and family atmosphere. There is a well established staff team, which helps to give the assurance that people are familiar, comfortable and trusting of the people who support and care for them. It was evident that the Victoria is well managed, with service user`s, relatives and members of staff clearly indicating that they have full confidence in the organisation and the running of the home. What has improved since the last inspection? The fluid balance charts are now fully recorded and up to date. It was apparent that appropriate action is taken, in order to ensure that peoples` fluid intake is sufficient to maintain their health. The procedures around mealtimes have improved and during the inspection visits it was observed that the dining room tables were appropriately laid. It was also observed during lunchtime on the Edward unit that six members of staff were respectfully supporting eight people in a dignified manner. The recruitment process is much more robust. This helps to give the assurance that only suitable employees are recruited to support vulnerable people. What the care home could do better: The medication procedures need to be more thorough (see Health and Personal Care). It is strongly recommended that when a person is administering medicines, that this should be the only task they are performing. This will help prevent any mistakes, errors or incidents happening. It is recommend that some consideration be given to relocating the main entrance to the home. This would give more privacy to the people who use the lounge, which is adjacent to the entrance. Key inspection report Care homes for older people Name: Address: Victoria Care Home Victoria Street Rainford St Helens Merseyside WA11 8DA     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Phil McConnell     Date: 2 3 0 2 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: Victoria Care Home Victoria Street Rainford St Helens Merseyside WA11 8DA 01744886225 01744886193 victoria@fshc.co.uk None Four Seasons Healthcare (England) Limited (Wholly owned subsidiary of Four Seasons Health Care Ltd) Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Siobhan Dean Type of registration: Number of places registered: care home 53 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Service users to include up to 23 OP and up to 30 DE(E) Service users to include up to 3 DE (out of 30 DE(E) category) Date of last inspection Brief description of the care home Victoria Care Home is owned and managed by Four Seasons Health Care, a large organisation who provide care services nationwide. The building is a purpose built care home, providing single bedrooms, shared lounges Care Homes for Older People Page 4 of 27 Over 65 30 23 3 0 1 9 0 3 2 0 0 9 Brief description of the care home and bathrooms over two storeys. There is an enclosed rear garden with some parking to the front of the building. The home is situated in a residential area of Rainford, with good transport links. Two different services are provided within the home. Edward Unit is located on the top floor and provides care with nursing for people who have dementia. Alexandra Unit is located on the ground floor and provides care with nursing for older people. Both services provide staff, including registered nurses, 24 hours a day. The present rate of fees is between £367.52 - £750.00 depending on individual assessed needs. 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: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Various information was gathered in order to be able to assess the National Minimum Standards for Care Homes for Older People, including: The Annual Quality Assurance Assessment, this is a document which the registered manager completes every year and it contains information about the service being provided. We use this information, in part to focus on our inspection activity. An unannounced Key Inspection, was carried out on the 19th of February 2010 with a further second inspection visit on the 23rd February 2010 by the Care Quality Commission (CQC). The registered manager (Siobhan Dean) was present at both visits. There was the opportunity to speak to some of the people who use the service in private, speak to some visitors and discussions also took place with some of the staff team. Peoples files were examined, with all relevant documentation being in place including, initial assessment documentation and care plans. Care Homes for Older People Page 6 of 27 A number of the staff files were examined and they also contained all of the necessary documentation needed for inspection purposes including, recruitment information and evidence of relevant training that has been provided. Throughout the site visits there was the chance to observe the support and care that was being provided to individuals, which was done in a caring, appropriate and professional manner. The organisations policies, procedures and the health and safety documentation were examined and they were found to be up to date and satisfactory. A tour of the premises was carried out and it was found to be clean, safe, hygienic, comfortable and very well decorated throughout. One requirement and one recommendation were issued by the CSCI following the previous inspection (19/03/09). It was evident at this inspection, that the requirement and the recommendation have been satisfactorily addressed. 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: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 8 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is an excellent comprehensive pre admission assessment process in place, giving the assurance that new or prospective service users are appropriately assessed. Evidence: The admission policy and procedures for Victoria Care Home were checked and they were observed to be up to date and thorough. Six service users files (Three from each unit) were examined, including the last person to go and live at the Home. Each file contained a photograph of the person (signed consent). This is particularly beneficial to new members of staff and generally helps to avoid any errors or mistakes occurring. The front page of the files contained specific detailed information including, persons GP, NOK, key worker, named nurse and any known allergies. Peoples files were very well organised, containing all of the relevant assessment Care Homes for Older People Page 11 of 27 Evidence: documentation including: admission assessments, recently completed Social Services assessment reviews, nursing assessments, contracts, detailed care plans with informative personal profiles for each person, up to date and relevant daily record documentation, appropriate risk assessments and progress charts for each person. Overall peoples files were very well maintained, organised and containing appropriate information. This helps to give the assurance that the care and nursing staff have the necessary guidance to help enable them to support, care and nurse for the new or prospective service user. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The medication procedures need to be more robust. This will help give the assurance that any mistakes, medication errors or incidents are reduced. Evidence: Six individual service users care plans were examined and they were observed to be of a very good standard, being well maintained, detailed and with expected outcomes for each person. The plans were written in the first person, as though the person was writing the plan themselves. It was evident that peoples plans are person centered and are focused on the person and their individual specific needs. Files contained evidence that peoples health care needs are being provided,with records of GP visits, hospital appointments and all other appointments and consultations with health professionals. The feedback received from service users and relatives was positive about individuals health care needs. Some of the comments were, The care my relative receives is outstanding my relative is happy, contented and well looked after and the staff are Care Homes for Older People Page 13 of 27 Evidence: excellent in the care of my relative. There was a policy, with clear procedures for the administration of medication. However, during the first inspection visit it was discovered that the correct procedures on the Edward unit were not being followed. It was observed that medicines were left unattended. The nurse on duty was performing other tasks and had left the medication trolley and the clinic room unlocked. The management were made aware that this poor practice is totally unacceptable. It was immediately addressed, with a plan initiated to ensure that everyone is fully aware of the correct procedures to follow. This is needed to ensure that people are protected. The individual medication administration records (MAR) had a photograph attached of the person, which helps eliminate potential identity mistakes. There was up to date information available regarding, what medication had been prescribed for, with detailed information available about any possible side affects. The members of staff on duty during the inspection visits were observed demonstrating a caring and respectful approach to service users, and the feedback received from people was that respect and dignity is demonstrated at all times. 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. Relevant, appropriate, recreational, leisure activities and interests are provided, demonstrating that people are positively motivated and stimulated. This helps give people a sense of wellbeing and of being valued. Evidence: The activities programme for the Victoria Care Home was examined and it was evident that careful consideration is given to ensuring that appropriate, meaningful and stimulating activities are regularly provided. The planned activities and events are advertised and displayed on the notice boards in prominent places throughout the home. Information is gathered during the initial assessment period regarding, a persons life history, past employment, religious beliefs, lifestyle, hobbies, interests and likes and dislikes. Some of the activities available were, gentle chair exercises, Reminiscence sessions (down memory lane), Pet therapy, bingo, DVDs / films, singalongs, and art and crafts. There was also evidence that regular entertainment is provided in the home, with regular outings to places of interest. Some comments from service users and relatives were, They encourage social activities with music and fun the staff care for the residents well and there are a lot of activities for the residents and there are plenty of organised activities. Other events taking place include, hairdressing and manicure sessions. All service users birthdays are celebrated. The Care Homes for Older People Page 15 of 27 Evidence: home have recently obtained a lap top, which is used by service users and their relatives. It was commented that one service user had spoken to a relative in Australia, using the lap top with Skype. There is a Loop system in place in some areas of the home. This system is used by people who use hearing aids, which helps to promote inclusion for people who have an hearing impairment. During the inspection visits it was evident that there was an happy atmosphere in the home, with people coming and going. There is an open door policy at the home and some of the comments from visitors were, I visit four times a week and I am always made welcome My mother is treated excellently, all of the staff are really good always welcome friends and family and the staff have always got time to speak to me. During both of the inspection visits, staff were observed supporting service users in a calm, relaxed atmosphere, with sensitivity. The menus for meals were examined and they were found to varied and nutritional, with the menus being on a four week rolling programme. The kitchen staff maintain good records of individuals specific dietary needs and it was evident that the cook endeavors to consistently provide nutritional wholesome meals and is fully aware of peoples dietary requirements. For example, the cook was able to immediately give information about some service users who have diabetes. The comments received about the meals were all commendable. The previous report highlighted that there needed to be an improvement around mealtimes. During the recent visits, it was observed that tables were very nicely laid in readiness for lunch. People were also observed being supported (where needed) to eat their meals. This was being done in a dignified manner, discreetly and respectfully. It was apparent that this issue has been satisfactorily addressed. 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. Victoria Care Home have satisfactory policies and procedures in place regarding complaints and safeguarding issues, with up to date safeguarding training being provided. This helps to show that people are protected from harm or abuse. Evidence: Victoria Care Home has a comprehensive complaints policy and procedure in place. In the last twelve months three complaints had been received by the home. However, the complaints had been dealt with appropriately and within the recognised acceptable timescale. The feedback received demonstrated that it was apparent that people knew who to raise any concerns or complaints with. There was a thorough policy in place to deal with a suspicion or allegation of abuse. Training records were examined and it was evident that all staff have received appropriate and satisfactory training in the safeguarding of adults. In discussion with some of the staff, they were able to confirm that they had received safeguarding training and were fully aware of what to do in the event of suspecting or being informed on any type of abuse. This helps to give the assurance that the provider is doing as much as possible to protect vulnerable people. The previous inspection carried out by the Commission for Social Care Inspection (CSCI) highlighted a shortfall in the process of dealing with the references for newly Care Homes for Older People Page 17 of 27 Evidence: appointed staff. This shortfall has been satisfactorily addressed, with all satisfactory references being in place. 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. The home is clean, hygienic and well maintained, helping to ensure that people live and work in a safe, comfortable and pleasant environment. Evidence: A full tour of the home was carried out and generally it was found to be of a very good standard. It was found to be clean and hygienic, with anti bacterial hand gels strategically situated around the home. This is regarded as good practice, helping with the management of cross infection. There are two units in the home, the Edward unit and the Alexandra unit. Both units are pleasantly decorated, safe and very well maintained. A number of people commented, that the maintenance man is very good. The Edward unit specifically provides care and support for people who have dementia. This unit was observed to be really well equipped to provide motivation and stimulation to the service users. Some of the different aspects of stimulation included, a sensory room (Snoozelen), pleasant piped music was being played, corridors had photographs of famous film stars and entertainers, copies of newspaper headlines, for example, First man landing on the moon, Berlin wall tumbles, President Kennedy assassinated and Edward the 7th abdicates. Some service users had brief records of their history/backgrounds situated outside their rooms. One other corridor had painted murals of local football clubs and rugby clubs. These paintings were really well done and it was apparent that they had Care Homes for Older People Page 19 of 27 Evidence: created a lot of interest amongst service users. Overall the provision of care for people with dementia, promoting stimulation is of a very good standard. Each unit had a treatment room where medication is stored, medical records maintained and some medical procedures carried out, for example the changing of dressings. Peoples bedrooms were found to be very well decorated and individualised with peoples own personal items. This helps people feel familiar and comfortable with their surroundings. The front entrance to the home leads straight on to one of the lounges for the Alexandra unit. It was suggested to the registered manager that some consideration needs to be given to possibly relocating the main entrance. At the present time the main thoroughfare for anyone entering the home is through this lounge, therefore this does not give the people who use this lounge total privacy. The lounges are also well decorated and comfortable. The dining rooms were airy, nicely decorated, with the tables being laid with clean fresh table clothes and napkins. The laundry was very well organised, with adequate machinery to cater for the needs of the people living at the Victoria Care Home. The feedback received was very positive about the cleanliness, comfort and decor of the home. For example, the home is really well decorated and well maintained. The kitchen was observed to be clean, hygienic, well organised, with stainless steel worktops. The cook stated , we only have to ask for new equipment and it is provided. There was appropriate specialist equipment observed around the home, such as lifting hoists, walking frames and wheelchairs, thereby helping to ensure that individual needs are catered for, whilst independence is promoted. As already mentioned the home employs a maintenance man, who carries out any minor repairs, in order to ensure that the home is safely maintained. The outside grounds are maintained to a good standard. Overall it was evident that the provider is committed to ensuring that the home is well decorated, safe, very well maintained, pleasant and a comfortable home for people to live and work in. 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. There is a robust recruitment process in place, helping to give the assurance that only suitable people are employed to nurse, care and support vulnerable people. Evidence: Victoria Care Home was observed to be satisfactorily staffed, with qualified nurses and care staff. It was evident that a number of the staff team have worked at the home for some time, which gives an assurance of continuity and familiarity for the people using the service. Seven of the staff files were examined including the most recent person to be employed at the home. The files were very well organised, with all of the necessary recruitment documentation being in place including, application forms, two written references for each person (previous requirement) and in some cases there were three references, Protection of Vulnerable Adults (POVA), Criminal Record Bureau (CRB) checks,contracts of employment and records of induction periods. This all helps to demonstrate that only suitable people are employed to support and care for vulnerable people. Some of the feedback received regarding the staff team was, The team leader upstairs(Edward unit) has made a big difference the staff are really good and All of the staff are good. There was available evidence to show that all members of staff have received Care Homes for Older People Page 21 of 27 Evidence: appropriate, relevant and satisfactory training. Some of the training provided included, completing specific workbooks during a twelve week induction period. These workbooks included, basic food hygiene, management of pain, diabetes, diversity and the safeguarding of adults. As previously mentioned the provision of safeguarding training is satisfactorily provided. Other training provided is: First aid, moving and handling, health and safety, infection control, skin and wound care and fire training. Over 50 of staff have obtained the National Vocational Qualification in care at level 2, with 3 of the staff having achieved level 3. The training provision is assessed to be very good and people using the service are supported and cared for by a well trained and skilled staff team. Some of the comments from the staff were, The safeguarding training was really good, it was a lengthy course I really like working here. At the moment its really good and a nice atmosphere Its a really nice place to work and I love the job, if the residents are happy, then I am happy. In the feedback received and in observation, it was apparent that the dedication and commitment of the staff team at the Victoria Care Home is of a very good standard. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and organised, ensuring as much as possible that service users are safe and receive a good quality service. Evidence: The Registered manager for the Victoria Care Home has a number years of experience in nursing and social care. She is a qualified Registered General Nurse (RGN) and is registered with the Care Quality Commission (CQC) as the registered manager for the home. She has been employed by the organisation (Four Seasons) for over 5 years. From the feedback received it appears that during her time at Victoria she has made some positive changes. Some comments regarding the management were, I can see the progress made, since the present manager came into post Many good changes have happened, we are going forward The manager doesnt hide anything, she is very approachable and the last twelve months have been really positive. There were procedures in place, regarding service users finances, with appropriate Care Homes for Older People Page 23 of 27 Evidence: and adequate records being maintained. This helps to ensure that peoples finances are safeguarded. There was documented evidence to show that regular staff supervisions take place. The minutes of recent staff meetings and relative meetings were also observed. This helps to demonstrate that the provider is committed to obtaining peoples views and values their opinions. During the inspection visits and in the information gathered it was evident that staff feel valued and their suggestions are taken seriously. The health and safety policy and procedures were examined and they were found to be up to date. All of the homes health and safety inspection certificates were also observed including, electricity, gas, fire extinguishers, portable appliance testing (PAT), hoists and the passenger lift inspection certificate. The inspection certificates were all up to date and correct. Also observed was a satisfactory environmental health report. There were Regulation 26 visit reports available for inspection, which are monthly inspection visits that are usually carried out by the regional manager. These reports were assessed to be informative and constructive. There was sufficient evidence to demonstrate that the health and safety of service users and staff is promoted as much as possible, to help ensure that people live and work in a safe and healthy environment. 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 1 9 13 The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home Medicines within the home should be correctly stored / locked away, when not being administered. 19/03/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 9 When a person is administering medication. It is recommended that this is the only task they perform. This will help avoid any errors or incidents occurring. It is suggested that some consideration should be afforded to redesigning or relocating the front entrance to the home. 2 19 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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