Care Home: Walton Manor

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What the care home does well On the day of the visit there was plenty of staff available. People living in the home were not rushed during the day and were given time that they need to maintain their independence. They told us that "staff are very nice" and "I like living here as much as you can". The home has a stable staff team, this means the people who live in the home know the care staff well. Staff demonstrated a genuinely kind and compassionate attitude and belief that they meet people`s needs fully. The majority of people living in the home spoken with enjoyed the food that was available and said they were offered choice. The people who live in the home had personalised their bedrooms as they chose. Some individuals had fridges and kettles in their bedrooms to maintain their independence. All people who wish to live in Walton Manor are given the opportunity to look around before they move in. This is done to make sure that the service can meet peoples individual needs. All people have their needs looked at before they move in order to make sure that the staff can be aware of how to meet people`s individual wishes and preferences. What has improved since the last inspection? The manager and her staff team continue to improve the quality of the service provided by Walton Manor. We noticed that in general people living in the service now received their medications in a manner that met their health and welfare needs. We observed a number of good practice instances including good checking of medications available and arrangements in place to make sure that people always had the medications in place that they needed. Records in the service have also improved. Care plans that guide staff in the support that they give were generally clearer, up to date and showed how staff were to meet people`s individual needs. The management of people`s personal allowance is clearer and it is easier for people living in the service to know how much money they have available. They are also supported to access this as needed. All the requirements on the last report were met. What the care home could do better: Despite the improvement in the safe management of medications staff need to still make sure that they give the medications that they sign for, follow prescription instructions and store items safely. There were people living in the home who were identified as needing supplementary food such as high protein drinks in order to maintain their nutrition. We noticed that these people were not receiving this supplements as they should and on occasions had lost significant weight or not gained weight as they should. There is some equipment in the environment that is not working. The service intends to redecorate and expand the service in the future and intend to repair these areas at this time. At present the amount of people living in the service means that the failed equipment does not have too much impact. This would become a bigger issue if Walton Manor had more people move in. Key inspection report Care homes for older people Name: Address: Walton Manor 23 Luton Grove Walton Road Liverpool Merseyside L4 4LG     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: Julie Garrity     Date: 0 1 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Walton Manor 23 Luton Grove Walton Road Liverpool Merseyside L4 4LG 01512981605 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: waltonmanor@europeanwellcare.com European Wellcare Homes Ltd care home 49 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home with nusing - Code , to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP. The maximum number of service users who can be accommodated is: 49 Date of last inspection Brief description of the care home Walton Manor Care Home provides care services for older people with personal care and nursing needs. The home is a modern building and was built with the purpose of providing a care to older people. There are 45 bedrooms in total. The bedrooms are on two floors and are accessible by a passenger lift. The ground floor is spacious with a large lounge and conservatory. There are designated smoking areas within the home. Each floor has its own dining area. The home is situated in a residential area of Walton in Liverpool, close to local Care Homes for Older People Page 4 of 27 Over 65 49 0 0 4 1 1 2 0 0 8 Brief description of the care home amenities and shops. The area is well served by public transport. Liverpool city centre is approximately a fifteen minute drive away. The building is centrally heated and has an enclosed private garden. There is a car park to the side of the building. Information about the service is availiable in the main foyer of the home and a copy given to people when they move in. This includes information about the fees in the home which details that they set at the rate that the local authority pays with a top up fee of fifteen pounds and three pence. European Wellcare Homes Ltd home owns the care home. They own a number of homes that provide a wide variety of care provision. The manager has been in post for several years and is registered with the comission to be the manager. The home charges fees from 322 to 566 pounds and additional fee known as a top up. Fees for private individuals are dependent on their 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The visit was carried out over a period of one day. We, the commission, arrived at the home at 09.30 and left at 18:30. The visit involved a specialist pharmacist inspector to look at medications, a lead inspector and a second inspector. The second inspector spent time observing staff contacts with people living in the home. We spoke with 14 people who live in the home, 2 visitors, 6 staff and the manager. A review took place of many of the records available in the home and CQC offices. These included individuals care plans, assessments, accident records, staff rota, staff files, maintenance records, menus, staff training, medications, activities records, information sent to us by Walton Manor and a self audit completed by the home known as an AQAA. Feedback was given to the manager during and at the end of the visit. The arrangements for equality and diversity were discussed during the visit and are Care Homes for Older People Page 6 of 27 detailed throughout this report. Particular emphasis was placed on the methods that the home used to determine individual needs, promote independence and support to make informed decisions in line with individual choices. 10 Questionnaires were sent to the home to give to people living there. None were returned. 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: Despite the improvement in the safe management of medications staff need to still make sure that they give the medications that they sign for, follow prescription instructions and store items safely. There were people living in the home who were identified as needing supplementary food such as high protein drinks in order to maintain their nutrition. We noticed that these people were not receiving this supplements as they should and on occasions had lost significant weight or not gained weight as they should. There is some equipment in the environment that is not working. The service intends to redecorate and expand the service in the future and intend to repair these areas at Care Homes for Older People Page 8 of 27 this time. At present the amount of people living in the service means that the failed equipment does not have too much impact. This would become a bigger issue if Walton Manor had more people move in. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People wishing to move into Walton Manor have the opportunity to decide if the service can meet their needs before they move in. Evidence: the lady that came to chat was very nice, asked A lot of questions I think she was plain nosey. But she was waiting here when I came and it was nice to see a face I knew. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The majority of the time peoples health and welfare needs are recognised and addressed.. Evidence: The AQAA for the home stated, We have a person centred approach with personal care. Comprehensive care plans and risk assessments are written in conjunction with residents and or families. Medications are reviewed by residents own GP. PCT pharmacist has also reviewed all residents medications. 6 residents care plans and medications are audited weekly. We looked at the care records including care plans for six people living in the service. In five of the care plans assessed medical and health needs had been recognised and plan was in place to guide staff how to meet peoples needs. One persons plan had failed to identify and action the risks that were in place such as a high risk of developing pressure ulcers. We also noticed that guidance for staff to deal with a persons diabetes was not sufficient to maintain their health and welfare needs fully. We saw that for some people directions about where to apply creams were not consistent and there was not the same level of information for all people who need to have creams applied. When people did not have their Care Homes for Older People Page 12 of 27 Evidence: treatment given as prescribed the staff recorded the reason. In the majority of cases were staff needed to monitor or action a health care need this had occurred. Where a person had a wound there was records that showed whether the treatment in place was effective enough. Records of external professionals visits such as dieticians were not always clearly recorded. This had resulted in information about dietary supplements that was unclear and did not give staff the guidance they needed to make sure that some people had their nutritional needs recognised and actioned correctly. We looked at how the service accessed external professionals and noticed that this was done appropriately. People living in the home told us if I have an appointment I am always able to get there and if Im not well the doctor comes to see me. Relatives spoken with told us that they thought people living in the homes health and welfare needs were very well recognised and actioned. We looked at records about medication together with the medicines available in the home for nine people. We found that most people were given most of their medication properly and their health was not at risk from harm. This was not always consistent and we noticed that for eight out of the nine peoples medicines there were small issues with one or more of their medicines. Most medication was stored safely and securely in the home. However we found that some prescribed creams were still stored in peoples bedrooms and there was no record available in their care records to show it was safe to store medication this way. If medicines are stored in the wrong place peoples health could be at risk. We also found that medication were not always stored in the right temperature. It is important to keep medication at the correct temperature to make sure it works properly. Medication which had a limited life once opened was dated on opening, which was an example of good practice as it means that people are not at risk of being given medication which was out of date. We noticed that staff failed to pay careful attention to special instructions on medication, for example we found that a medicine which should be given an hour before food was given after food. If special instructions are ignored the medication may not work properly and peoples health will be placed at risk. The records about how much medication arrived in the home were clear as were the records about the disposal of medication. The records about medicines showed that most medicines had been given to people as prescribed and that medicines could be accounted for. When we looked at the records together with the medicines held in the Care Homes for Older People Page 13 of 27 Evidence: home for four people we found that on some doses of medications had been signed for but had not been given. If people are not given their medicines as prescribed their health and wellbeing could be at risk. We found that in most instances people were given their medicines as prescribed for them. There were some practice areas that were in needed of improvement in order to fully support peoples health and Welfare needs. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who need extra support with their nutrition are not receiving support to meet their needs. The service supports people to live a lifestyle of their choosing. Evidence: We spoke to people living in the home who told us, happy in the home. They told us that they generally had their own routine and were able to mostly live a life of their own choosing. Observations of interactions between staff and people living in the home were generally positive with a lot of chatting and joking in place. There is information in individual activities plans such as, likes reading, watching television and listening to music. This is not always or generally looking at their daily routines. The majority of activities are undertaken by the activities co-ordinator. Some activities take place on a one to one basis or within groups and days out are available. Records are kept of the activities that people have completed to help determine what they like to do. Social historys for people were well developed for some people and brief for others. Social histories are useful for staff to help them determine the lifestyle, personal choices and people who are important to people who live in the home. People who live in the home said that, plenty of food and I like the food. The chef is keen to develop the menus and would like to receive training in developing specialised Care Homes for Older People Page 15 of 27 Evidence: diets and include these on the menu choices. Menus are available on each table these are in a format that does not meet the needs of all of the people living in the home. The cook changed the menu on the day of the visit to follow choices made by the people living in the home. The service users a risk assessment to determine peoples nutritional needs know as MUST. These were not always completed. We noticed that instructions to staff regarding food thicken supplements were confusing. When we looked at the records for people on food supplements we noticed that staff were not giving these as prescribed. In some cases people had continued to lose some weight despite having supplements designed to prevent this. Medication records showed that they were being given but daily fluid balance charts recorded that in most cases people who had been prescribed supplementary feeds were receiving significantly less than they were meant to. The staff had failed to provided the supplementary feeds necessary and placed people at risk of poor nutrition. We spoke to three visitors during the day. They told us that they are made to feel welcome and able to visit when I want People living in the home told us, I have lots of visitors, they come and sit in my room, the kids bounce all over the bed. Its very nice to have them here. We spoke to people living in the home who told us, happy in the home. They told us that they generally had their own routine and were able to mostly live a life of their own choosing. Observations of interactions between staff and people living in the home were generally positive with a lot of chatting and joking in place. There is information in individual activities plans such as, likes reading, watching television and listening to music. This is not always or generally looking at their daily routines. The majority of activities are undertaken by the activities co-ordinator. Some activities take place on a one to one basis or within groups and days out are available. Records are kept of the activities that people have completed to help determine what they like to do. Social historys for people were well developed for some people and brief for others. Social histories are useful for staff to help them determine the lifestyle, personal choices and people who are important to people who live in the home. People who live in the home said that, plenty of food and I like the food. The chef is keen to develop the menus and would like to receive training in developing specialised diets and include these on the menu choices. Menus are available on each table these are in a format that does not meet the needs of all of the people living in the home. The cook changed the menu on the day of the visit to follow choices made by the people living in the home. 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. People living in the home can be confident that their concerns will be dealt with. Evidence: The AQAA from the home told us that, records are kept about complaints received both at head office and at the home. There is a complaints procedure, which is displayed on the entrance hall wall. We have Let Us Know leaflets detailing complaints procedure and a complaints suggestions book available. A copy of how to raise concerns is available in the main entrance and a complaints and concerns book is placed in this area so relatives can write down any concerns they may have. We looked at concerns raised with the home and noted that three concerns had been investigated by the manager and action taken place to resolve the situation. People living in the home told us, they were happy but if they had a problem they would talk to the staff,. There is information in each bedroom that tells people who live in the home to raise their concerns with. We have not received and concerns or complaints about the home in the last six months. Staff have received training in recognising and reporting any concerns. They are supported by up to date policies and procedures that give them clear guidance. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. In general the home is clean and well presented. Evidence: A review of the home showed that the main areas such as dining area, lounge, bathrooms and corridors maintained to a reasonable standard. There is some equipment in the laundry that needs replacing and has needed replacing for several months. The manager has requested that this be replaced but this has not occurred. The intention at that owners to look at registering part of the home for people with dementia and at that time they will redecorate the second floor and some of the downstairs bedrooms. There is a large lounge/dining area, the lounge area is very large and not in proportion with the dining area. These means that people sit spread out around the edges of the room and this gives it an institutional appearance. The manager stated that there were also plans to utilise this room better and give it a more informal appearance. There is a conservatory that is used mainly by people who smoke. Staff who smoke do so in the garden at the rear and this has lead to a large amount of cigarette ends around the conservatory door. Staff have received training in infection control. We noticed that there was equipment around the home to help reduce the spread of infection such as gloves and aprons. There was disposable hand towels and liquid soap in most of the main bathrooms. Although in some bathrooms there was hard soap that is not useful in preventing the Care Homes for Older People Page 18 of 27 Evidence: spread of infection. We noticed that the service did not have enough overnight continence aids we spoke to manager who said that she would arrange for more to be ordered. Other incontinence aids known as net pants were not kept for each person. They were properly washed but this did not support peoples privacy and dignity. All of the bedrooms in the home are single occupancy, and most of the people who live in the home have personalized their bedrooms with pictures and ornaments. Individuals spoken with said, their room was very comfortable, they had all their things with them and they liked my room, comfortable, clean and staff keep it tidy. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Walton Manor have skilled staff available in sufficient numbers to support their needs. Evidence: Staff were observed during the day not to rush the people who live in the home and to have enough time to meet their needs. The AQAA for the home told us, All staff receive a full induction through our training department. Regular supervisions are held to allow staff to give feedback regarding training. Staff spoken with all said that they have received training in lots of areas such as eating disorders, challenging behaviour, basic food hygiene, moving and handling, dementia, first aid and food safety. Each member of staff has a file in place that identifies the training that they are too receive or have done. These had all been updated and included certificates of training. A training plan is also in place that shows what training people have had and when update training is due. Staff recruitment files were looked at. All but one staff file showed that staff had had all the necessary checks in place that they needed to start work. We noticed that an induction programme was available that helped staff develop the skills they needed when they started working in Walton Manor. People living in the home made positive comments about the staff including I am as I Care Homes for Older People Page 20 of 27 Evidence: can be, the staff are very nice and there is plenty of staff. During the visit we observed that there was sufficient care staff available who were supported by a team including a qualified nurse, kitchen staff, laundry, cleaning staff and an activities coordinator. Staff spoken with reported that they felt that there was enough staff available. This was supported by the people who live in the home and their families who also felt that there was plenty of staff available. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager and staff team continue to increase the quality of the service provided to people living in Walton Manor. Evidence: The manager has worked in the home for several years, the AQAA completed by the manager told us that, she has over 20 years experience at a senior level. Staff expressed confidence in the manager. The organisation that owns the home has a number of quality assurance systems in place designed to identify strengths and areas of improvement. The AQAA told us, there are Annual self audits, completed along with health and safety audit. We do weekly care plan and medication audits. Monthly visits by the programme manager are held. Support from senior management is given. We noted during our visit the service has made improvements in many areas such as medications, care planning and staff recruitment. This has helped to improve the quality of the service. The manager is continuing to develop the quality of the service and is putting into place ideas such as new assessments to help make sure that they can recognise and support peoples different needs. Care Homes for Older People Page 22 of 27 Evidence: The certificates of insurance and maintenance of machinery, gas, electricity, fire equipments, lifts were in date and valid, including the home certificate of Employers Liability Insurance Certificate. The maintenance team regularly looks at the emergency lighting, the call system and the fire alarms monthly. There are statements available for individual personal funds. These were recent and easy to read clearly showing the funds available for people to spend. Receipts of individual spending were not available, but were detailed on the fund statements available. Risk assessments in the home for individuals were completed by the staff. Risk assessments included, pressure ulcers and poor nutrition these influenced the support received by people living in the service. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 Effective systems need to be 17/02/2010 in in place for the accurate recording and safeadministration of all medication. These systems must also include arrangements to ensure that all medicines are stored properly and individual risk assessments regarding the storage of creams in peoples bedrooms medicines is fully documented. To ensure that residents health is not at risk. 2 15 12 Were supplementary feeds 31/12/2009 have been put into place. Staff need to make sure that people receive this as they should. In order to maintain a good nutritional state for people who need it Care Homes for Older People Page 25 of 27 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 Clear details in care plans needed to be available for all assessed needs. Care plans need to be of the same standard in order to make sure that staff deliver a consistent level of care that meets peoples needs. Look at ways to make activities part of peoples everyday experience. The service needs to review the dining and lounge arrangements in order to provide a less formal environment All equipment that is need of replacing needs to be done as soon as possible. 2 3 12 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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