Care Home: Whitchurch House

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What the care home does well The home provides a range of written information to help people decide if Whitchurch House is the right place for them, and people have the opportunity to visit the home to help them make up their minds. People can be confident that their needs will be fully assessed before they move into the home. The home makes sure that people are involved in planning their own care, if they wish. People can be confident that their health and personal care needs will be met, and that the home manages medication safely. The home provides social and leisure activities for people to take part in. Food is of a high standard and provides a balanced and nutritious diet. People can be confident that the home will listen and take action about any concerns or complaints. Staff know how to protect people from the risk of abuse or neglect. The home provides a comfortable and homely environment for people to live. The home is kept very clean, and infection control is well managed. Staff at the home are kind and caring. Staff receive a range of training to help them gain the skills and knowledge they need. The home is managed in the best interests of the people who live there, by an effective team of senior staff. What has improved since the last inspection? Care plans are reviewed on a regular basis and are updated whenever people`s circumstances change. Care plans give clear instructions for staff on how to manage people`s needs, including their mobility needs. Risk assessments are reviewed and amended following any falls. People are weighed regularly and there is an effective system in place for referring anyone whose weight changes significantly. The home has ensured that medication is accounted for using an effective stock control system. Medication management has improved overall, and there are clear directions for staff for the use of "as required" medication. Staff who handle food as part of their duties have been trained in food hygiene. What the care home could do better: The home could provide a broader range of activities for people to take part in. The home`s recruitment procedures do not always ensure that the required checks are carried out before staff begin working at the home. New staff do not receive an induction programme which prepares them adequately for care work.There are some shortfalls in health and safety management, which could put people at risk of harm. Key inspection report Care homes for older people Name: Address: Whitchurch House Whitchurch House Whitchurch Ross-on-Wye Herefordshire HR9 6BZ     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: Sarah Blake     Date: 0 7 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 30 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 30 Information about the care home Name of care home: Address: Whitchurch House Whitchurch House Whitchurch Ross-on-Wye Herefordshire HR9 6BZ 01600890655 01600890655 whitchurchhouse@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Keith Arnold Brown care home 29 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 29 The registered person may provide the following category of service only: Care Home Only (Code PC); 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 (OP) 29 Date of last inspection Brief description of the care home The Provider is registered in respect of Whitchurch House to offer residential services to older people who may be too frail to continue to live in their own homes. Some may have developed some level of physical disability and some may experience confusion associated with memory loss. Whitchurch House is a period property which has been extended and is registered to provide accommodation for up to 29 people. There are bedrooms on both the ground floor and first floor level. The first floor is in two separate areas, one served by a Care Homes for Older People Page 4 of 30 Over 65 29 0 2 7 0 5 2 0 0 9 Brief description of the care home staircase and lift, the other by another staircase and chair lift. The home is situated in attractive gardens in a rural situation within walking distance of a church and nearby park attractions. It is within the flood plain of the River Wye and in 2000 a floodwall protection system was installed around the home. There are folders of information about the service that are available in each bedroom. A supply of brochures describing the service is also displayed in the front entrance. Each resident is charged individually according to their needs and the service should be approached for guidance regarding this. Additional charges are made for hairdressing, chiropody, magazines and newspapers. A copy of this report can be viewed at the home. 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: This was an unannounced inspection. One inspector spent a day at the home, talking to the people who use the service and the staff, and looking at the records, which must be kept by the home to show that it is being run properly. These include records relating to the care of people who use the service. We looked in detail at the records for three people living at the home. The inspector returned on another occasion to check the management of medication. The service had previously completed an Annual Quality Assurance Assessment (AQAA). The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the service. Some of the comments from the AQAA have been included within this inspection report. We also received completed survey forms from people who use the service, their Care Homes for Older People Page 6 of 30 relatives and health professionals who work with the home. The information from these sources helps us understand how well the home is meeting the needs of the people using the service. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: The home could provide a broader range of activities for people to take part in. The homes recruitment procedures do not always ensure that the required checks are carried out before staff begin working at the home. New staff do not receive an induction programme which prepares them adequately for care work. Care Homes for Older People Page 8 of 30 There are some shortfalls in health and safety management, which could put people at risk of harm. 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 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. The home provides a range of information to help people decide if Whitchurch House is the right place for them. People can be confident that their needs will be fully assessed before they move into the home. Evidence: The home provides a range of written information to help people decide if they wish to move into Whitchurch House. This is in the form of a Service User Guide. The Service User Guide is detailed and tells people what life is like at the home. It would be helpful if the Service User Guide could be made available in alternative formats, such as large print, to meet peoples individual communication needs. The home also has a website at www.whitchurchhouse.co.uk, which contains useful information about the home. In our surveys, people told us that they had been given sufficient information before they moved in, so that they could make an informed decision about whether Whitchurch House was the right place for them. Care Homes for Older People Page 11 of 30 Evidence: We spoke to relatives of people living at the home, and they told us that they had visited the home before their relatives moved in, and had been made very welcome. One person said I dont think we could have chosen a better home. We looked at the records for one person who had recently moved into the home. The records showed that an assessment of the persons needs had been carried out before they moved in. This assessment was thorough and clearly identified the support that they would need from staff. Information from other sources such as Social Services was included in the assessment, and therefore the home was able to ensure that it could meet the persons needs, and staff had the information they needed to care for the person. 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. The home makes sure that people are involved in planning their own care, if they wish. People can be confident that their health and personal care needs will be met, and that the home manages medication safely. Evidence: We looked at the records for three people who live at the home, and talked to staff who care for them. Where possible, we spoke to the people themselves and to their relatives. This helps to give us a good picture of how the home supports the people who live there. We saw that peoples needs had been clearly identified, and there were detailed instructions for staff about how to meet peoples needs, whilst allowing them to make choices and maintain their independence as far as possible. For example, one person needed help to get dressed in the mornings. The care plan stated please ask B (name of person) what she would like to wear, and when we spoke to the person, they told us that they enjoyed choosing their clothes each day. In the AQAA, the managers stated we recognise people as individuals and respect any wishes/ preferences Care Homes for Older People Page 13 of 30 Evidence: expressed when providing health or personal care. We saw that risks relating to peoples personal care were managed safely. One person had had several falls recently. We saw that the home had contacted the falls prevention service for advice, and had updated the care plan to show that the times of the persons evening medication had been changed to reduce the risk of falls. One person needed assistance with their mobility, and the care plan clearly stated how this was to be carried out. We saw staff assisting the person to walk from one part of the home to another, and they were following the instructions in the care plan. Records showed that care plans are reviewed monthly and amended as necessary. We spoke to a relative of someone who lives at the home, and they told us that they had been involved in the most recent care plan review, and had appreciated the opportunity to become more involved in their relatives care. At the previous inspection, we had made several requirements about care planning and the management of the risk of falls and mobility issues. It was very encouraging to see that the home has made improvements in all these areas. Records showed that the home carries out regular nutritional assessments, and people are weighed monthly, with a clear system to ensure that any significant weight gain or loss is reported and managed by working with health care professionals such as the GP or District Nurse. Relatives told us that the home keeps them informed of any health problems, and that the home requests medical help promptly. We saw from the records that one person had been suffering from a cough, and the home had asked the GP to visit the next day. The records showed clearly how often the GP had visited and the outcome of each visit. At the previous inspection, we had identified some areas of concern in the management of medication. We visited the home on a separate occasion specifically to check how medication is managed. We saw that medication is stored securely in a locked trolley and locked cupboards. The Medication Administration Record (MAR) charts were fully completed with no gaps, and provided an accurate record of the administration of medication. The home has put in place a new system for making sure that there is accurate stock control of all medication received into the home. We sampled two medications which Care Homes for Older People Page 14 of 30 Evidence: had been prescribed on an as required basis, to see if the homes stock control system was accurate. All the records were accurate and up to date, showing that the home is able to account for all the medication for which it is responsible. We saw that one person had been prescribed some eye preparations. There was no record of which eye the treatment was for, and there was no record of when the container had been opened. This is important, as these eye preparations must be discarded twenty-eight days after opening. One person who lives at the home takes responsibility for some of their own medication, and we saw that this had been assessed to make sure that it did not place the person or anyone else at risk. It is good practice to support people who wish to take responsibility for their own medication where possible, as this helps to promote independence. During the inspection, we saw staff supporting people in a caring manner, and making sure that their privacy and dignity was respected. For example, staff always knocked before entering a bedroom or a bathroom, and waited for a reply before entering. Care Homes for Older People Page 15 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. The home provides some activities for people to take part in, but this could be improved to include a wider range of social and leisure opportunities. Food is of a high standard and provides a balanced and nutritious diet. Evidence: People who live at the home told us in our surveys that there are usually enough social activities for them to take part in. The home has recently appointed a part-time activities co-ordinator, who explained her plans for a more varied range of activities. In the AQAA, the home recognised that the range of activities could be improved: we would like to offer a more extensive and varied range of activities for individuals and groups. Records showed that recent activities had included a Halloween party, flower arranging and making calendars. Entertainers visit the home regularly and the mobile library visits fortnightly. In the AQAA, the home told us we recognise, celebrate and enjoy important dates in peoples lives. We spoke to a relative of someone who lives at the home, and they told us that the home is very good at celebrating birthdays: cake and a glass of sherry for everyone. Care Homes for Older People Page 16 of 30 Evidence: Relatives told us that they are always made welcome at the home, and one relative described it as like walking into your own home. The home provides a varied menu of food which has been assessed for its nutritional value. The menu is rotated on a four-weekly basis, so that people have variety in their diets. On the day of the inspection, lunch was sausages with onion gravy, potatoes, and frozen mixed vegetables. There was no choice of main meal shown on the menu, but staff told us that they ask people for their lunch menu choices at breakfast, and it is made clear that the cook will make alternatives if requested. The cook told us that meat and greengroceries are sourced from local suppliers. We saw that one persons care plan stated will need food cutting up, and we saw that that this was done sensitively at lunch. The care plan also stated C (name of person) likes to wear a bib when eating to keep clothes clean, and we observed that the person was wearing a cloth bib at lunch, which was removed as soon as they had finished. Lunch was a sociable occasion, and staff generally supported people in a sensitive and respectful manner, although we saw two members of staff assisting people to eat by standing over them, rather than sitting beside them and taking time to make the occasion enjoyable for the person. Care Homes for Older People Page 17 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 can be confident that the home will listen and take action about any concerns or complaints. Staff know how to protect people from the risk of abuse or neglect. Evidence: In our surveys, people told us that they knew how to raise any concerns or complaints with the home. We spoke to two relatives of people living at the home, and they told us that they would feel comfortable raising any issues and felt confident that they would be listened to, and the situation resolved. Both told us that they had never had any reason to complain. Records showed that the home had received two complaints in the past year about minor issues. These had been resolved in a timely manner and the home had kept people informed throughout the process. We, the Commission, have not received any complaints about the home since the last inspection. One of the ways in which homes can ensure the safety of the people who live there is by ensuring that they carry out staff recruitment in such a way that only suitable staff are employed. We looked at records for two new members of staff. We saw that, although most of the required checks, such as Criminal Records Bureau (CRB) checks, had been carried out, the home had not received written references from one staff members previous employers. References are one way of making sure that staff are suitable to work with vulnerable people. Care Homes for Older People Page 18 of 30 Evidence: We spoke to staff, who showed a good understanding of how to protect vulnerable people from abuse or neglect. Records showed that all staff at the home will be attending training in the protection of vulnerable adults in January. Care Homes for Older People Page 19 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 excellent 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 homely environment for people to live. The home is kept very clean, and infection control is well managed. Evidence: Whitchurch House is a large country house, which has been extended and adapted to meet the needs of the people who live there. It stands in its own well-maintained grounds, and is situated in a rural area of South Herefordshire. The home is divided into the main house and the coach house, which are linked by the dining room. The dining room is a pleasant room, with small dining tables and chairs arranged so as to promote social interaction. The tables were laid with cloths and linen napkins, and there were fresh flowers on each table. The main lounge is a large room with armchairs placed around the edge of the room. This gives the room a somewhat institutional feel. The deputy manager has since told us that the home is trying out new ways of arranging the furniture in this room, to try to provide a more homely atmosphere. There are other smaller lounges where people can sit quietly or meet with their families, and these are all furnished with comfortable seating, and have a more homely atmosphere. We saw that people are encouraged to personalise their bedrooms with ornaments, Care Homes for Older People Page 20 of 30 Evidence: pictures and items of their own furniture if they wish. The bedrooms were clean and beds were made up with clean linen. People told us that the whole home is always kept very clean, and one person said you come through the front door and its always fresh and clean. We saw a staff member using sanitiser on door handles in the communal areas of the home. This shows a good understanding of ways to prevent the spread of infection. We saw that bathrooms and toilets had plentiful supplies of liquid hand wash and paper towels. There were hand sanitiser dispensers throughout the home, and we saw staff using them throughout the day. Staff were using protective equipment such as gloves and aprons appropriately, and the staff we spoke to had a good understanding of infection control. Care Homes for Older People Page 21 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. Staff at the home are kind and caring. New staff do not receive an induction programme which prepares them adequately for care work. Staff receive a range of training to help them gain the skills and knowledge they need. Evidence: The home does not have a high turnover of staff, and this means that staff get to know the people living at the home very well. People were very positive about the staff, and comments included theyre all so kind, nothing is too much trouble, nothing ever seems to be an inconvenience, the staff make the place and I cannot fault the care that they provide here. Rotas showed that there are always sufficient staff on duty to meet peoples needs, and people told us that staff always respond promptly when assistance is needed. The home operates a key worker system, whereby each person living at the home has a named member of staff who has clearly defined responsibilities for supporting them in areas such as ensuring that they attend any medical appointments, reminding them of significant dates, and by building a relationship of mutual trust. We have already mentioned in the Complaints and Protection section of the report that there were some shortfalls in staff recruitment procedures, and we will be making a requirement that the home makes sure that all the required checks are made before Care Homes for Older People Page 22 of 30 Evidence: any new member of staff starts work at the home. We had previously had some concerns about the training provided for staff at the home. The deputy manager showed us a new training matrix, which clearly identified any training needs. We saw that staff were generally up to date with their mandatory training, and that training sessions had been booked for the near future where staff needed updates. In the AQAA, the home told us that care staff who handle food as part of their duties have undertaken food hygiene training. One area which still needs improvement is the induction of staff who are new to care work. There are national standards for this induction, and it is a requirement that homes provide induction that meets the Skills for Care Common Induction Standards. In the AQAA, the home told us that no staff have completed this induction, and we saw no evidence that a new member of staff who was not experienced in care work had completed the induction programme. It is very important that staff who care for vulnerable people have the skills and knowledge necessary to provide care of a high standard. Care Homes for Older People Page 23 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 generally managed in the best interests of the people who live there. There are some shortfalls in health and safety management, which could put people at risk of harm. Evidence: The home has two managers and a deputy manager. The two managers are in the process of applying to be registered with the Commission. Each of the managers works some shifts as a carer, and people commented positively on this arrangement. One person said it keeps them up to date with the caring side of things, and a staff member commented that its unusual but nice, as they know what we have to do. The managers told us that this arrangement helped them to ensure that by supervision of care staff, the homes high standards of care were maintained. Both managers were able to demonstrate good understanding of the principles of person-centred care, and showed awareness of equality and diversity issues. Care Homes for Older People Page 24 of 30 Evidence: The deputy manager has responsibility for training, medication and staffing records. Although he does not carry out any care duties routinely, he is very involved in the life of the home, and was very knowledgeable about the people who live there. The management system has been in place for eighteen months, and there is clearly good teamwork and respect for each others skills and knowledge. The home returned the AQAA when we asked for it. It contained detailed information about the home, and showed that the managers understand what the home needs to do in order to improve. The home keeps records of all accidents and incidents and we saw that these were recorded in detail in an accident book, and that care plans showed that measures to reduce the risks of accidents had been put in place where relevant. We saw that the home had written to peoples families, asking for their views on the service provided by the home. The managers showed us a new form which they would be using to gain peoples views. We saw that the home had sent out a quality assurance questionnaire in September 2009, and the results of this showed a high level of satisfaction. Some minor issues had been identified and the home was able to show how these had been addressed. The registered provider, Keith Brown, currently takes responsibility for health and safety matters in the home. Previously we had been concerned that a hoist used to assist people with mobility needs had not been serviced. At this inspection, we saw that the hoist had been serviced, but we found that other items of specialist equipment, such as bath hoists, had not been serviced since 2006. The Lifting Operations and Lifting Equipment Regulations 1998 state that any equipment used at work for lifting or lowering loads must be serviced every six months. Mr Brown arranged for the equipment to be serviced as soon as we pointed this out to him, but it concerns us that this had not been identified or addressed prior to the inspection, especially as a requirement had been made about this at the last inspection. We were concerned that there was no evidence that water management checks such as records of the hot water outlet temperature, shower head maintenance, and Legionella checks had been carried out. Mr Brown was not able to tell us if and when these checks had been done. It is very important that water management is carried out as required, so that people are not put at risk of harm or injury. We had previously been concerned about some aspects of fire safety at the home, and we were pleased to see that all fire safety checks were being carried out at the Care Homes for Older People Page 25 of 30 Evidence: required frequency and were being recorded. 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 29 19 (1)(b) You must obtain in 19/02/2010 respect of all persons employed at the home all of the relevant information and documents as required by Regulation 19(1)(b) and paragraphs 1 - 9 inclusive of Schedule 2 of the Care Homes Regulations 2001 prior to them commencing employment. This is so that people can be confident that only suitable staff are employed at the home. (1) You must ensure that staff who are new to care work undertake induction which meets the Skills for Care Common Induction Standards. This is so that people can be confident that staff have the skills and knowledge to 19/02/2010 2 30 18 Care Homes for Older People Page 28 of 30 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 provide a high standard of care. 3 38 23 (c) You must put an effective system in place to ensure that maintenance checks of all equipment and services are carried out at the appropriate intervals. This is to prevent the risk of harm or injury to people who live or work at the home. 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 19/02/2010 1 1 You should ensure that written information is made available in alternative formats to meet peoples communication needs. You should ensure that the date of opening is marked on medication containers. This is so that medication is managed safely. You should review medication and care records to ensure that there is always clear written direction for staff on how to administer medication. You should ensure that staff assist people who need support with eating and drinking in a manner which promotes dignity and respect. You should put an effective system in place to ensure that all recruitment checks are carried out before any new member of staff commences work at the home. 2 9 3 9 4 15 5 29 Care Homes for Older People Page 29 of 30 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. 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