Care Home: Walldene Court

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What the care home does well People were properly accessed before they entered the care home. This assessment was documented and formed part of the initial care plan. Care needs were clearly recorded, this included health care provided by other professionals and details of residents personal preferences and needs. All residents looked clean and well cared for. We spoke to a number of residents who all told us that the staff treated them well and they felt happy at the home. Residents said that staff helped them with personal care tasks in a sympathetic manner. Residents told us that they could go to bed, wash or bathe, get up in the morning and spend their day as they wished. We examined the ordering, storage, administration and disposal of medication. The ordering and storage of medicines was generally well-managed and there were robust controls in place for the security and stock control of controlled drugs. Records suggest that people generally receive their prescribed medication correctly. Residents told us that they enjoyed the food in the home. They said that they had a choice of meal at each meal time, if they did not like either choice there were also other options available. The kitchen was clean and tidy and dining rooms were attractively set. Staff helped residents to eat and drink when needed. There is a staff member in charge of activities. An activities programme was available which showed a varied range of social events and activities. The home was clean and warm. Residents bedrooms were well personalised and decorated very individually to suit the taste of the resident. There are a number of small lounges within the home, these gave a homely appearance and seemed to be appreciated by residents. There were sufficient numbers of staff on duty. Staff confirmed that there were usually the same numbers of staff on other days. Records showed that staff had been properly screened before employment and receive adequate training to carry out their job. The management of the home was good. There were clear lines of accountability within the staff team. The systems of management included auditing of care practices as well as health and safety. Money held on behalf of residents was well accounted for and securely stored. Health and safety checks and tests were up-to-date. Servicing and maintenance agreements were in place for lifts, hoists and electrical systems. What has improved since the last inspection? Since the last inspection staff have received formal supervision. However, this is still not happening regularly enough. What the care home could do better: When managing medication, record keeping could be improved to make sure that all hand written entries on administration records are complete, and the allergy status recorded. Regular audit of the medication system should take place to confirm that staff follow the medicines policy. There are several areas of the home requiring refurbishment and the standard of the accommodation did not always reflect the good care taking place there. Several curtains were hanging from their fittings, some walls required redecoration and there was damage to telephone points and wiring in the main corridors. There had been a leak resulting in damage to a ceiling in a lounge. The dining room carpets looked worn and stained and the surfaces of the benches within these rooms were damaged. To promote the control of infection some waste bins should be replaced with foot operated ones. Health and safety training for staff was not up to date. Quality assurance systems did not include consultation with any users of the service. The manager confirmed that quality questionnaires had not been issued within the past year. Staff had not been formally supervised often enough. This is important to allow staff to contribute to the development of the service and review their own practice. Key inspection report Care homes for older people Name: Address: Walldene Court Threap Gardens Off Simonside Avenue Howdon Wallsend NE28 7HT     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: Janet Thompson     Date: 1 3 0 1 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 28 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 28 Information about the care home Name of care home: Address: Walldene Court Threap Gardens Off Simonside Avenue Howdon Wallsend NE28 7HT 01912633791 01912343313 tracey.clayton@anchor.org.uk www.anchor.org.uk Anchor Trust care home 42 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 old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Walldene Court is a purpose built care home in Howden. The home is divided into four units arranged over two floors. Some local amenities are within walking distance and access in and out of the home is good. There are forty-two single rooms, all with ensuite facilities. There are communal sitting rooms and dining areas on each floor. Assisted bathing and toilet facilities are located around the home. There is a passenger lift in the centre of the building. Walldene Court provides nursing and residential care. The costs of the service varies according to need. All fees are subject to an additional nursing fee element where appropriate. Information, including inspection reports, is provided for people who live in the home, people interested in moving to Walldene Court, their relatives and friends, to help them decide if their care and nursing needs can be met. Care Homes for Older People Page 4 of 28 Over 65 41 0 0 1 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This is an overview of what the inspector found during the inspection. The quality rating for this service is two stars. This means the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements. Some requirements from previous inspection reports may have been deleted or carried forward to this report as recommendations. This will only happen when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Before the visit we looked at information we received since the last visit to the home. This includes how the service dealt with any complaints, changes to how the home is run, the views of people who use the service and the managers views of how well they Care Homes for Older People Page 5 of 28 care for people. An unannounced visit was made on 13 January 2010 by three inspectors, one of which was a pharmacy inspector. The inspection took a combined time of 17 hours. During the visit we talked with people who use the service, some staff and the manager. We looked at information about people who use the service and other records which must be kept. We checked that staff had the knowledge, skills and training to meet the needs of the people they care for and we looked around the building to make sure it was clean, safe and comfortable. Following the inspection feedback was given to the manager. Care Homes for Older People Page 6 of 28 What the care home does well: What has improved since the last inspection? What they could do better: When managing medication, record keeping could be improved to make sure that all Care Homes for Older People Page 7 of 28 hand written entries on administration records are complete, and the allergy status recorded. Regular audit of the medication system should take place to confirm that staff follow the medicines policy. There are several areas of the home requiring refurbishment and the standard of the accommodation did not always reflect the good care taking place there. Several curtains were hanging from their fittings, some walls required redecoration and there was damage to telephone points and wiring in the main corridors. There had been a leak resulting in damage to a ceiling in a lounge. The dining room carpets looked worn and stained and the surfaces of the benches within these rooms were damaged. To promote the control of infection some waste bins should be replaced with foot operated ones. Health and safety training for staff was not up to date. Quality assurance systems did not include consultation with any users of the service. The manager confirmed that quality questionnaires had not been issued within the past year. Staff had not been formally supervised often enough. This is important to allow staff to contribute to the development of the service and review their own practice. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 28 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 28 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 are properly assessed, taking account of their needs and wishes, so that they may be assured that this is a suitable care service. Evidence: Three pre-admission assessments were seen. They contained enough information for staff to assess if they could meet the needs of people before admission. All assessments were clear and contained good information. The assessments were based on activities of living, information from other health professionals and carers was used to form judgements and action plans. Care Homes for Older People Page 10 of 28 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 receive personal care that is well planned and takes account of their diverse needs. Evidence: Three care plans were examined and two were case tracked. This means that we spoke to the individual residents or observed their care then matched our observations to what was written in the care plan. Both case tracked care plans did reflect the actual care needed by the residents. Care plans took account of peoples diverse and differing needs. People were supported to achieve independence and meet individual goals. Other health professionals contributed to the planning of care. These contributions were clearly recorded. One care plan did not have the initial assessment documentation fully filled in. However, the remainder of the care plan was up-to-date and fully completed. The actual care people received appeared to be good. We spoke to residents who told us that they were well cared for. They said staff responded quickly if they rang the call bell and were attentive to their needs. We noted that everyone was well dressed and Care Homes for Older People Page 11 of 28 Evidence: looked clean and cared for. We observed staff supporting residents to wash their hands, clean spectacles and hearing aids. Staff were knowledgeable about individual needs. Medication records examined and practices observed during the visit suggest that people living in the home can expect to receive their prescribed medicines correctly. Medicines were securely stored and records of prescriptions ordered, medication received and medication disposed of are maintained. Additional controls had been introduced to enhance the security and stock control of controlled drugs and specific at risk of misuse medicines. Staff were uniformly adhering to these additional controls though the signing over of the medicine keys between shifts is not always recorded. There were a number of handwritten entries on medication administration records which were incomplete and lacked the date of entry, the quantity of medication received or a witness signature to confirm accuracy of the entry. The quantity of medication carried over from the previous month was not always recorded on the medication administration record. This means it is difficult to maintain a complete record of medicines in the home and to check if people are receiving their medication as prescribed. We noticed gaps on two service users medication administration records where medicine administration had not been recorded but the medication was no longer in the monitored dose pack, suggesting that it had, in fact been given. Another service user had not received a daily dose of Docusate for three days because no supply was available. The administration record for another service user indicated that six morning medicines have not been given on two days because the person was asleep at the time of the administration round. It would be appropriate to discuss retiming of medicine administration with the GP if medication is regularly been omitted for this reason. Application of some skin products was not always regularly recorded. We were informed that some prescribed creams and ointments are applied by trained carers, but the nurse in charge subsequently signs the administration record to confirm treatment has been given. This practice goes against current professional guidance and should be changed to make sure that an accurate and timely record of the application of skin medication is made by the person responsible for carrying this out. The box on the administration record, which is used to record any allergies to medicines, was frequently left blank. Any known allergies should be recorded on the administration record or non-known entered to help inform staff administering medication. Care Homes for Older People Page 12 of 28 Evidence: One person was prescribed warfarin, but there was no written clinical guidance attached to the administration record to confirm the current dose to be administered. The dose printed on the administration record was no longer the correct dose and a handwritten entry, not countersigned, had been made to amend the dose. The dose change had occurred more than four months earlier but the pharmacy had not updated their medication record to reflect this. The controlled drug cupboards appear to meet safe custody regulations and records in the controlled drug register were accurate and well maintained. Regular audit of the medication system is not carried out. Audit helps to identify any medication problems promptly and helps to confirm that staff are closely following the providers medicines policy. We spoke to one resident who confirmed that he was able to choose his routines of the day, this included how he preferred his personal care to be met. Another resident confirmed that she could go to bed at whatever time she liked, she also confirmed that she was able to lie in bed late in the morning if she preferred. Care Homes for Older People Page 13 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to lead a healthy and fulfilling personal lifestyle. This takes account of their different needs and abilities. Evidence: Daily living routines are flexible and organised to suit peoples individual needs. Good information about social care needs is recorded in their records. Peoples preferences about activities and routines are identified. There are opportunities provided for people to take part in planned activities and outings that meet the social needs of the people living in the home. The activity organiser is available for twenty hours each week and divides her time between group and individual activities. A quiz was happening on the morning of this inspection and this was enjoyed by the people taking part. The activity organiser spends time with people when they are first admitted identifying their preferences and takes this into account when planning the programme of activities. Examples were given of how people are encouraged to take part and to continue with interests they had before coming to live in the home. There is one group activity available each day and there is a copy of the programme on the notice board. Two people said that sometimes activities do not happen if there is a shortage of staff. Care staff remind individuals of what is happening on a daily basis. Two people living in the home said that they enjoyed the opportunities to join in arranged activities. Care Homes for Older People Page 14 of 28 Evidence: They said that they could make choices about their routines and lifestyle. The residents said the food was very good and alternatives were available at each meal time. The menus provide a good variety of food that takes account of healthy eating principles, while still offering a choice. In addition to two choices there is another menu available at each mealtime providing sandwiches, omelettes and other alternatives. The food served was well cooked and presented and people said that they enjoyed the food. Pictorial menus are available for people with dementia. People were provided with appropriate support during the meal served during the inspection. The kitchen is well organised and stocks of food and storage arrangements are satisfactory. All kitchen staff have undertaken appropriate Food Handling training. Drinks are provided regularly through the day and there is a varied selection available and smoothies are made daily and offered to people. People have visitors at any time and are able to use their own rooms, or the lounges to see them. One relative said that she is very happy with the care and support provided by the staff. People said they were happy with the arrangements for visitors. There was evidence that the staff welcome visitors making available meals or drinks and it was observed that a good rapport existed between visitors and staff. Care Homes for Older People Page 15 of 28 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. People who use the service are protected from harm through policies, procedures and staff training. Evidence: Staff follow the homes policies and procedures in relation to complaints and adult protection. Staff have received training in adult protection and appeared to have a good understanding of the procedures. Residents told us that they had no complaints to make, however, they would complain if they need to. One resident said he would complain to a nurse, another resident would complain to the manager. There have been some incidents that were referred to the adult safeguarding team. The incidents were well managed, the home provided clear information and worked well with all authorities. The provider has a tier of management to investigate all serious incidents or complaints. This level of management is independent of the home and takes a lead role in safeguarding procedures. Care Homes for Older People Page 16 of 28 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. Residents live in a home that is clean, warm and comfortable, but requires some decorating and updating to be carried out. Evidence: The home is in a quiet residential area near to the centre of Howden. The grounds were tidy, attractive and accessible. Walldene is a purpose built home on two floors. Accommodation is arranged in smaller units. The home was homely, clean and odour free at the time of this inspection. Some areas of the home would benefit from refurbishment as the decor is worn and becoming shabby. In particular the dining room decor and carpeting is worn and shabby. The kitchen units worktops are stained and present a poor appearance. Curtains are not hung properly and add to the poor standard of decor. The ceiling in one of the upstairs sitting areas has been damaged by a leak and there is a hole in it that requires repair. Some of the sitting areas are comfortable and very homely providing good accommodation for the people living in the home. There are good systems in place for day to day repairs and records showed that these are addressed quickly by the handyman. However there was evidence of damaged boxing to pipes, damage to walls where wiring has been moved, marked carpets, telephone plugs at floor level damaged, damage to wallpaper and paintwork that is impacting on the quality of the environment. There was no evidence that a planned programme of refurbishment is in place, although the manager said that it is planned to replace the call system and improve the lighting in the home. Care Homes for Older People Page 17 of 28 Evidence: The home is accessible and has a range of equipment and aids to suit the needs of the people living there. Bathrooms and toilets are equipped with appropriate aids and adaptations to suit the needs of the people using the service. One assisted bath is to be replaced as the existing one is not working properly. The laundry was clean, organised and well equipped. There is sufficient laundry equipment available. Infection control procedures are in place and staff training is organised. Not all bins in use were foot operated to ensure that good infection control is maintained. Care Homes for Older People Page 18 of 28 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. People using the service are supported and protected through staff numbers, skill and ability. Evidence: The home was adequately staffed on the day of the inspection and enough staff were scheduled to be on duty in the future. Staff confirmed that the staffing levels on the day were the levels they usually worked with. There were two registered nurses on duty and seven care assistants. They were supported by four members of the domestic cleaning staff, two kitchen staff and administrative staff. The manager stated, and records confirmed, that 18/33 care staff have been trained to NVQ level II or above. This is just above that required 50 minimum. Staff training files were examined which showed that staff were up to date with most of the required training. Not all staff were up-to-date with health and safety training. The manager holds a training file which shows her which staff need refresher training in certain subjects. The provider has issued a better electronic training plan, this has not yet been implemented. Four staff recruitment files were examined. These were for one registered nurse and three care assistants. All contained good information about pre-employment checks. All staff had completed an application form, two references were obtained and there Care Homes for Older People Page 19 of 28 Evidence: was evidence that identity checks and criminal records checks had been undertaken. All staff had very comprehensive induction training following their employment. We spoke to several staff who had worked at the home for a number of years. They confirmed that they received the training they needed to fulfil their role. The staff team appeared to be well-established, this provides a good level of stability for residents. Care Homes for Older People Page 20 of 28 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. People using the service are protected through effective management that takes account of the differing needs of the service. Evidence: The home has an experienced registered manager. She has been assessed as having the competency and skills to run the home. The manager is supported by a deputy manager and there are clear lines of accountability within the staff team. Residents told us that the home seems to run well. The manager is leaving the home in the next few weeks, the deputy manager will run the home in her absence and recruitment is underway to find a new manager. Staff receive formal supervision but not on a regular basis. This should give them an opportunity to contribute to the running of the home and identify any training needs they might have. The manager confirmed that a programme of forthcoming supervisions is in place and that this has been delegated to the deputy manager to Care Homes for Older People Page 21 of 28 Evidence: carry out. The home does operate a quality assurance system. There are a number of audits carried out within the home, these include focused audits that look at areas such as moving and handling and accidents. The manager collates information on a monthly basis about the incidence of pressure sores and other health matters within the home. This information is sent to head office where the data is gathered to identify if there are any trends or areas of concern. There have not been any residents or relatives quality questionnaires issued by the service in the last year. The manager feels that residents are consulted on a daily basis, this may be sufficient for the day-to-day running of the home, however, people should be given the opportunity to comment on a more formalised and confidential system. Servicing and maintenance agreements are in place for facilities and equipment. Risks in the environment and tasks, including safe working practices are assessed and reviewed. The health and safety systems are audited annually by the provider. All fire safety checks, tests and instructions to staff are conducted at the required frequency and recorded. There were no obvious trip hazards in the home. Fire exits were clear of obstruction and all hazardous fluids locked away. Records are kept of all money held on behalf of people living in the home. There are clear records and receipts kept of for all transactions made. Care Homes for Older People Page 22 of 28 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 23 of 28 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 To make arrangements to ensure that medication administration records are accurately maintained. Ensure that the reasons for non-administration of medication are recorded by a timely entry of an appropriate code or entry on the medication administration record. Ensure that the meaning of any such codes are clearly explained on each record. Ensure that the person administering the medication completes the medication administration record in respect of each individual service user at the time of administration. 13/02/2010 Care Homes for Older People Page 24 of 28 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action This safeguards the health and welfare of people living in the home 2 19 23 Repair and repaint the ceiling in the first floor lounge. This ensures residents live in an attractive well kept environment. 3 19 23 Ensure all curtains in the 01/04/2010 home are hung correctly and fit the windows they are intended for. This helps to promote a homely feel to the home. 4 19 23 Redecorate dining rooms and replace the carpets. This will help to improve the dining experience for residents. 5 19 23 Redecorate communal areas and corridors, making good damaged walls. This ensures residents live in an attractive and well maintained environment. 6 21 23 Provide at least one assisted 01/04/2010 bath on each floor of the home. 01/02/2011 01/02/2011 01/06/2010 Care Homes for Older People Page 25 of 28 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 Residents do not have to be taken to a different floor to bathe. 7 26 13 Replace all bins with foot operated ones. Replace the bench surfaces in the small kitchens. This helps to control the incidence and spread of infection. 8 28 18 Ensure all staff are trained in health and safety. This helps to promote the safety of residents and other users of the building. 9 36 18 Ensure that staff recieve 01/04/2010 supervision at more frequent intervals. This gives an opportunity to involve staff in the running of the home and any issues to be addressed. 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 01/04/2010 01/03/2010 1 9 The written instructions provided by the anticoagulant clinic should be kept attached to the administration record of persons receiving anticoagulant treatment. This makes sure that staff have accurate and up to date guidance on the Care Homes for Older People Page 26 of 28 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 dose of anticoagulant to administer. 2 9 Staff should sign and date handwritten entries they make on the medication administration record. Each entry should be checked and countersigned by a second person to reduce the risk of error when copying information. A list of staff authorised to administer medication, together with their signatures, should be maintained in the medication administration record file. A system should be in place to record all medication kept in the home and carried over from the previous month. This helps to confirm that medication is being given as prescribed and assists in checking stock levels. Regular audit of the medication system should be undertaken to confirm that staff are following the homes medicines policy. Any known allergies or none known should be recorded in the appropriate section on all administration records. The ordering cycle of some medicines should be amended and synchronised with the monthly order saw that the supply does not run out and treatment can be maintained. The medicines policy should incorporate local medication practices in the home, such as the additional stock checks carried out on controlled drugs. Include consultation with service users within the quality control system. 3 9 4 9 5 9 6 7 9 9 8 9 9 33 Care Homes for Older People Page 27 of 28 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). 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