Care Home: Well Springs Nursing Home

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What the care home does well The home is well managed and run in the best interests of the people who live there. The people who live at Well Springs said they are happy and the home has a welcoming atmosphere. We were told that the staff do what people want in the way people prefer. Everyone we spoke to said they are satisfied with the care and support they receive. one person said `They look after me very well. I am very happy here`. One member of staff said `I have worked in a few nursing homes. I feel Well Springs gives the best care towards the residents I have ever come across.` Another said the home `Supports clients individual needs with dignity and provides a happy home from home atmosphere.` Before moving into Well Springs, people`s needs are thoroughly assessed to make sure that the home is able to meet their needs. One staff member said that `...if there is any equipment we need to make the job easier and safer for the residents if we go to the management we do receive it.` Everyone said that staff listen to them, and act on what they say and people said they like the meals and enjoy the activities. The staff understand the needs and preferences of all the people who live at the home. People`s health is looked after and the staff have the skills and experience they need to do this. There is good and friendly interaction between the people who live at the home and the staff. There seemed to be enough staff on duty to make sure they have time to spend with people in conversation as well as supporting people to take part in individual and group activities. The home`s recruitment procedures are thorough, making sure that staff are safe to work with the people who live at the home. One member of staff said `the management have selected good staff...and we have a good team that works well together.` All the staff said they enjoy working at the home and felt they were well supported by their manager. They said the training is good and helps them to do their job well. One member of staff said `We have regular staff meetings...` and said they can always talk to the manager if they have any concerns. The complaints and adult protection systems work well and people said they know and understand what to do if they have a concern. The home is clean and well maintained and everyone we spoke to said the home is always kept fresh and clean. One person said `Well Springs is always clean and tidy.` What has improved since the last inspection? During the past year the home has invested in more pressure relieving mattresses and cushions, specialist beds and other adaptations to support people to maintain their health and independence. The nurse call system has been upgraded and the entry to the grounds from outside has been made more secure. There are now drinks making facilities in one of the conservatories, so that people who live at the home, and their visitors, can make their own drinks if they choose. What the care home could do better: People`s care plans are working documents and must always be kept up to date, in order to guide staff in how to provide the support and care the person needs. The plans include risk assessments where someone is assessed as being at risk. These need to be kept up to date in order that staff are aware of any risks and can make sure they are minimised and people are kept safe. The medicines administration procedures need to be improved, to make sure they are always accurate and to confirm that people are receiving their medicines in the way their doctor has prescribed. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Well Springs Nursing Home 122 Leylands Lane Heaton Bradford West Yorkshire BD9 5QU     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Liz Cuddington     Date: 1 7 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 30 Information about the care home Name of care home: Address: Well Springs Nursing Home 122 Leylands Lane Heaton Bradford West Yorkshire BD9 5QU 01274488855 01274544801 sueseal@btconnect.com 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) : Rossefield Nursing Homes Limited care home 52 Number of places (if applicable): Under 65 Over 65 0 52 0 dementia old age, not falling within any other category physical disability Additional conditions: 52 0 52 The maximum number of service users who can be accommodated is: 52 The registered person may provide the following category of service only: Care Home with Nursing - Code N, To service users of the following gender: Either, Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places 52, Dementia - Code DE, maximum number of places 52, Physical Disability - Code PD, maximum number of places 52 Date of last inspection Brief description of the care home Well Springs provides nursing care for 52 men and women, predominately over the age of 65 years. Accommodation is provided in both single and shared rooms on the ground and first floors. There is a large lounge and two conservatories on the ground floor. Care Homes for Older People Page 4 of 30 Brief description of the care home The home is situated in the Heaton area of Bradford approximately 2 miles from the city centre. Local shops and amenities are situated close to the home. The detached property is set in extensive private gardens with parking space provided within the grounds. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is two stars. This means the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services 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. The weekly fees the home charges are between four hundred and seven pounds and ninety six pence for residential care and seven hundred and fifty five pounds for Care Homes for Older People Page 6 of 30 nursing care. The purpose of this inspection was to assess the quality of the care and support received by the people who live at Well Springs. The visit to the home was carried out over one day by one inspector. The last key inspection was in June 2007. The methods used to gather information included conversations with the people living at the home, the staff and visiting healthcare professionals as well as looking at care plans and examining other records. We received the homes self-assessment questionnaire before the inspection visit. We also received surveys from people who live at the home, the staff and healthcare professionals. These all gave us a lot of useful information about the home and helped us plan the visit. We would like to thank the people who live at the home, their relatives and the staff, for their welcome and hospitality and for taking the time to talk and share their views during the visit. What the care home does well: What has improved since the last inspection? Care Homes for Older People Page 8 of 30 During the past year the home has invested in more pressure relieving mattresses and cushions, specialist beds and other adaptations to support people to maintain their health and independence. The nurse call system has been upgraded and the entry to the grounds from outside has been made more secure. There are now drinks making facilities in one of the conservatories, so that people who live at the home, and their visitors, can make their own drinks if they choose. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out 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 30 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 30 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 assessed before they are admitted to the home, to make sure their needs can be met. Evidence: People said that they were given enough information about the home before deciding to move in, and they had also received a contract. Where possible the home encourages people and their families to visit the home and talk to the people who already live at the home, their relatives and the staff. The home invites them to come and spend time at the home, share a meal and maybe take part in the days activities. This means that the home can get to know the persons needs and the individual has the information he or she needs to make a decision. Before moving into Well Springs, peoples needs are assessed to make sure that the Care Homes for Older People Page 11 of 30 Evidence: home is able to meet their needs. This assessment, as well as Social Services needs assessments when available, forms the basis for the individual plan of care and support. Care Homes for Older People Page 12 of 30 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. Peoples personal and healthcare needs are met, but the care plans do not accurately reflect peoples care and support needs. People are not fully protected by the medication administration systems. Staff treat people with respect, care and consideration at all times. Evidence: From observation and discussions with staff and people living at the home, it was clear that the staff are aware of each persons needs and preferences. The staff make sure they provide the help people need in the way they prefer. One member of staff said that when someone is moving into the home, especially of they have very particular care and support needs, ...we receive all the information before the person arrives at the home. Staff also said they are always kept up to date with peoples changing needs. Care Homes for Older People Page 13 of 30 Evidence: Four care and support plans were looked at, to make sure that peoples health and personal care needs are being met in the way the person prefers. The plans cover each area of the individuals care needs, emphasising any special needs the individual may have. The manager said that each year people who live at the home and their families are invited to go through the plan and agree any changes. Also, the staff review each part of the plan every month, to make sure the plan reflects peoples current care and support needs. These reviews confirmed our observations that the staff are fully aware of everyones needs and are offering the level of care and support each individual needs. However, the plans we looked at had not been updated to reflect peoples changing needs. For example, one persons plan shows how staff should assist the person to walk and use the toilet, yet the reviews showed that this person is now permanently nursed in bed. Another persons oral care plan did not reflect the situation as shown in recent reviews. The plans include risk assessments and management plans where someone is at risk of falling, becoming malnourished, injuring themselves or any other area the staff feel may put the individual at any risk. Although where someone uses oxygen there was no risk assessment in the plan. Peoples care plans are working documents and should always be kept up to date, in order to guide staff in how to provide the support and care the person needs. At present the nurses are responsible for updating the plans. They need to make sure this is done whenever someones needs change. If they are not currently involved in developing the plans, it may be valuable to include the rest of the staff team in this. For example, if someones nutritional intake is at risk the catering staff could be involved in looking at how their nutrition can be improved by adjusting their diet. The housekeeping staff often spend a lot of time with people who stay in their bedrooms for most of the day. They will be able to offer a view on the persons well-being and how this can be supported. The care staff also need to be involved,as they provide the majority of peoples day to day care and therefore have a wide knowledge of peoples care and support needs. Health care visits and treatments are recorded in detail and everyone who commented said they always receive the healthcare they need. One visiting healthcare professional said the staff ...work in a proactive collaborative manner with me in an effort to Care Homes for Older People Page 14 of 30 Evidence: prevent hospital admission. Another healthcare professional said the home provides Holistic care tailored to individual needs. One healthcare professional confirmed that the home always seeks advice and acts upon it, to improve the health of the people who live there. The people we spoke with said they are satisfied with the care they receive and everyone who commented said they are looked after well. The medicines are kept safe and secure in locked cabinets and the medicine trolleys were locked when unattended. Most of the medicines are supplied by the pharmacy in a monitored dosage system, but some remain in the original packaging. The Medicines Administration Record (MAR) charts, which must show clearly the quantities of medicines received and in stock for each person, were examined. The medicines supplied in the monitored dosage system appeared to be recorded accurately. We checked some of the medicines that were supplied in their original packaging, to make sure the numbers that had been signed as administered tallied with the amounts received and the quantities remaining. We looked at eight different medications and found that most of them did not appear to be accurately recorded. For example, one person had received 28 Lansoprazole tablets from the pharmacy. There were signatures on the MAR chart showing that three tablets had been administered, yet there were 27 tablets still in the packet when there should have been 25. The nurses are responsible for all of the administration of medicines. At the time we looked this seems to be done without taking account of the need for accuracy. It may be that some tablets from the previous four week recording period were brought forward to the new MAR chart, or someone has not taken their medication when it was offered, and this has not been shown on the chart. It is essential that all medication received, brought forward and administered is recorded accurately on each occasion. In order to keep an accurate record of the medicines that are supplied in their original packaging, a brought forward system needs to be in place for medicines that are carried forward from one MAR chart to the new chart. This will make sure that audit checks can be carried out accurately, to check that medicines have been administered accurately on each occasion. During the visit, all the staff were seen to treat people with respect and maintain their dignity. The people who commented said that they receive the care they need and are Care Homes for Older People Page 15 of 30 Evidence: supported to maintain their independence for as long as they are able. Everyone said the staff listen and act on what they say. One person confirmed this and said ...the staff are very good. Care Homes for Older People Page 16 of 30 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 take part in a range of activities. People are offered a good choice of meals to make sure their dietary needs and preferences are met. Evidence: The activities are organised by the activities co-ordinator with support from the care staff, and people take part or not as they wish. One person said I love the concerts we have here and another said they had learnt a new skill that they did not think they could do. One person said that ...the staff help me by taking me out on their days off. The staff spend time with people on one to one activities, as well as doing things people can enjoy together. The activities co-ordinator said she is gradually widening the range of activities that are available. There is a four week plan which includes painting, model making and other crafts as well as quizzes, trips to the pub and the shops. The home is hosting a Marie Curie tea, to raise funds for the charity, and they also celebrate special events. Care Homes for Older People Page 17 of 30 Evidence: The co-ordinator said she makes sure that every day she spends time with the people who stay in their own rooms, either just to talk or to do an activity they choose. There were some life histories in the activities records and we discussed how these could be further developed, perhaps involving peoples families as well, and maybe making them as much a reminiscence book as a history of the individuals life. This would help staff get to know people even better and plan activities and have conversations that remind people of the things they have enjoyed during their lives. At mealtimes there are always alternatives available if people do not want the choices on the menu. As well as a cooked meal at lunchtime, there is a choice of hot and cold dishes at teatime. The fresh fruit salad at lunchtime looked particularly delicious. People said that they enjoy the meals, the portions are generous and the food is always hot when it is served. People are offered hot and cold drinks and snacks throughout the day. The people who live at Well Springs said they can do what they want, when they want. This confirmed our observations that the staff support people to live their life in the way they choose. Care Homes for Older People Page 18 of 30 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 are aware of how to raise a concern or make a complaint if they are dissatisfied with the service. The staff have received suitable training and understand the adult protection policies and procedures, which makes sure that people at the home are safe. Evidence: Any complaints or concerns are recorded in a complaints file. The actions taken and the outcomes are recorded. The responses to complaints dealt with all the issues raised and answered the persons concerns thoroughly. Where they are needed, improvements are made as a result of complaints investigations. Staff said they know what to do if anyone has concerns. The people who live at the home said they know what to do if they have a concern or complaint. Newly employed staff are made aware of the homes whistle blowing policies and procedures, to be used if they suspect abuse or see examples of poor practice. All the new staff take adult protection and whistle blowing training as part of their induction training. All the appropriate policies and procedures are in place to guide staff. Care Homes for Older People Page 19 of 30 Care Homes for Older People Page 20 of 30 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 provides a comfortable and well-maintained environment. Evidence: The home is clean and well maintained and everyone we spoke to said the home is always kept fresh and clean. The home is attractively decorated and the furniture is comfortable with special pressure relieving seat cushions on the chairs and sofas. The rooms are comfortably furnished and have a welcoming feel. There are sufficient, accessible toilets and bathrooms on all floors of the house. One of the bathrooms is in the process of being upgraded with a specialist, therapeutic bath. Many of the bedrooms have an en suite toilet and wash basin and some of the ground floor rooms have patio doors leading into the gardens. During the past year the home has invested in more pressure relieving mattresses and cushions, specialist beds and other adaptations to support people to maintain their health and independence. The gardens are attractive and well kept and are a very pleasant place for people to sit out in. There are two conservatories, leading onto a paved walkway around the house Care Homes for Older People Page 21 of 30 Evidence: and gardens. Staff are employed to help look after the maintenance of the house and grounds as well as keeping the gardens tidy. Over the last year the nurse call system has been upgraded and the entry to the grounds from outside has been made more secure. There are drinks making facilities in one of the conservatories, so that people who live at the home, and their visitors, can make their own drinks if they choose. Protective gloves, aprons and disinfecting hand rub are available for staff to use when necessary, to support the homes infection control measures. Care Homes for Older People Page 22 of 30 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. Sufficient staff are employed to meet peoples needs. People are protected by thorough recruitment procedures, which ensure that staff are suitable to work with people who live at the home. Suitable training is provided to make sure staff have the skills and knowledge they require to be able to meet peoples needs. Evidence: The staff rotas, and peoples comments, confirmed our observations that there are enough staff on duty to meet peoples care, social and leisure needs. In addition to the manager, there are two nurses and five support staff on duty during the day and evening, plus one extra in the morning, and four waking staff at night, including a nurse. There are also plenty of housekeeping and catering staff on duty each day. These staffing levels seem to be sufficient to provide care and support for the people who currently live at Well Springs. The staff confirmed that staffing levels are adjusted to meet peoples needs. People who live at the home said there are enough staff around and our observations confirmed this. One person said there are always staff around, making sure that everyone is all right. Care Homes for Older People Page 23 of 30 Evidence: The homes recruitment procedures are thorough, making sure that staff are safe to work with the people who live at the home. All new staff complete an application form and provide two written references. Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) register checks are obtained and no new staff begin work until these checks have been completed satisfactorily. There is plenty of training available for staff and they said the training is good and keeps them up to date. The home keeps good records of staff training, which also shows when updates are needed. Staff have attended training courses on moving and handling, fire safety and other health and safety training. Courses are arranged for the nurses, to keep their clinical skills and knowledge up to date. Other training is also provided in subjects such as dementia care, palliative care and infection control. All new staff complete induction training which meets the Skills for Care criteria. This gives them good basic training to help them do their job effectively, and provides a sound basis for taking a National Vocational Qualification (NVQ) course. Twelve of the twentyfour care and support staff have achieved an NVQ in care at level 2 or 3, or the eqivalent, and nine are enrolled to start the level 2 or 3 award. The housekeeping staff are being encouraged to take a relevant NVQ course and one has already achieved the level 2 award. The activities co-ordinator also has an NVQ award. We spoke with some staff who were returning to work after a period of absence and they said they have been very well supported to plan their return and find their way back into their jobs. Care Homes for Older People Page 24 of 30 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 home is safe and well managed, in the best interests of the people who live there. Evidence: The manager has the necessary experience and qualifications to manage the home, in the best interests of the people who live there. The manager attends training to keep up her professional development. The records and the staff confirmed that all staff have one to one supervision meetings with their line manager. Supervision meetings support staff to plan their personal and professional development and give them the opportunity to discuss any areas of concern in a confidential setting. The staff said that they are well supported and they work well together as a team. Regular staff meetings are held and staff are encouraged to make their views known and contribute to the running of the home. Care Homes for Older People Page 25 of 30 Evidence: Peoples personal information is stored securely when it is not being used. The homes policies and procedures are up to date, which makes sure they provide relevant information to guide staff on how to act in every situation. All the regular health and safety checks for the home are carried out in a timely manner. These measures make sure that the health, safety and welfare of the people at the home is promoted and safeguarded. Following their most recent inspection, the Environmental Health Officer has awarded the homes kitchen a score of four stars out of a maximum of five, for hygiene and good kitchen practice. The requirements of the report have been dealt with. The home has a range of quality assurance systems in place, to help determine the quality of service the home offers. These include surveys for the people who live at the home, their relatives and visitors and regular meetings with the people who live at Well Springs and their relatives. The information and commnents are used to improve the quality of the service offered. Care Homes for Older People Page 26 of 30 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 27 of 30 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 7 15 Peoples care plans are working documents and must always be kept up to date. This is in order to guide staff in how to provide the support and care the person needs. 30/09/2009 2 9 13 The medicines administration record keeping procedures must be improved. The records must show exactly what medicines have been received and administered; allowing the amounts remaining in stock to be correctly calculated. This is to make sure the records are always accurate and to confirm that people are receiving their medicines in the way their doctor has prescribed. 31/07/2009 Care Homes for Older People Page 28 of 30 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 The risk assessments, where someone is assessed as being at risk, need to be kept up to date in order that staff are aware of any risks and can make sure they are minimised and people are kept safe. Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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. 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