Care Home: White Plains Residential Care Home

What the care home does well Prospective resident`s needs and wishes are assessed before they move to the home, to help them decide whether the home is the right place for them and whether they wish to live there. The manager or her deputy visit all prospective residents to undertake an assessment of their needs to ensure that both parties are confident that their needs can be met and they have the opportunity to visit the home before moving. The assessment documentation in use prompts staff to consider peoples` cultural and faith wishes. People living in the home have a choice as to how they spend their day and there is a programme of activities to provide for their social care needs and stimulation. The meals are freshly cooked on the premises and residents have a choice of food to meet their tastes and their health and cultural wishes. What has improved since the last inspection? Since the last inspection, undertaken in January 2009, the residents have moved into a newly built care home that has been built within the grounds of the former White Plains Residential Care Home since it could no longer meet the needs adequately of the people living there. The home has been decorated and furnished to a very high standard and is equipped with appropriate aids and equipment required to care for those living in the home. Information provided to current and prospective users of the service has been updated. Service users files viewed during this visit evidenced that people`s weights are now being monitored consistently on a monthly basis. Improvements to the care plan format have been made to ensure that they are individualised and provide a good `all round` picture of people`s individual care and support needs, their wishes, likes and dislikes. The home has concentrated upon working on a person centred dementia care approach to enable greater interraction and understanding between the dementia client group and staff. The manager, her deputy and four senior carers have completed a dementia training course with a further six staff enrolled to take it, to ensure that they have the skills and knowledge to care for people with dementia. The manager is also completing a three day leadership in person centred dementia care course What the care home could do better: The home must improve the way in which medication is managed for residents to receive their medication safely and reliably. They must ensure that they are aware of all current prescriptions for residents and staff follow the policy and procedure at all times. Risk assessments must be undertaken with regard to both the use of and storage of steradent tablets to ensure the health safety and wefare of those using the service. Key inspection report Care homes for older people Name: Address: White Plains Residential Care Home White Plains Residential Home Tilehouse Lane Denham Uxbridge Middx UB9 5DE     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Jane Handscombe     Date: 1 9 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: White Plains Residential Care Home White Plains Residential Home Tilehouse Lane Denham Uxbridge Middx UB9 5DE 01895832190 01895835966 whiteplains@bmcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): B & M Investments Ltd t/a B & M Care Name of registered manager (if applicable) Mrs Yvonne O`Connor Type of registration: Number of places registered: care home 38 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 38 The registered person may provide the following categories of service: Care home only (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) Dementia (DE) Date of last inspection Brief description of the care home White Plains Residential Care Home is a newly built home home providing personal care and accommodation for 38 older people. It is owned by B & M Care Services, Care Homes for Older People Page 4 of 28 Over 65 0 38 38 0 Brief description of the care home which is a public limited company. The home is located in Tilehouse Lane Denham next to a small airfield and not far from Denham village and is a three storey building accommodating up to thirty eight older people and some who have dementia. The home offers accommodation in two separate environments, all of which have en suite facilities, to suit the needs of the service users. Each environment has its own lounge and dining areas and has easily accessible and attractive gardens. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection which was conducted over the course of one day on 19th January 2010. The key standards for older peoples services were covered. Information received about the home since the last inspection was taken into account in the planning of the visit. Prior to the visit, the manager completed an annual quality assurance self-assessment and surveys were distributed to service users, relatives, visiting health and social care professionals and staff. However, the manager did inform us that the surveys were not received until the 18th December with a request for return by 29th December and therefore those that have not yet been received at the time of writing this report will however be considered as part of our ongoing regulatory responsibilities for registered services. Five service users, nine relatives, six members of staff and two health and social care professionals returned the questionnaires. Residents and visitors were also spoken to on the day of the unannounced visit. Discussions took place with the manager, care staff and chef. Care practice was observed. A tour of the premises and examination of some of the required Care Homes for Older People Page 6 of 28 records was also undertaken. The homes approach to equality and diversity was considered throughout. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 8 of 28 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 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information about the service is contained within the homes statement of purpose and service users guide to provide prospective service users and their families with necessary information to help them make an informed choice about moving into the home. Contracts are in place, setting out the terms and conditions of residency so that service users know their rights and what to expect.. All prospective users of the service are provided with an assessment of their needs, prior to moving into the home, to ensure that both parties are confident that their needs can be met appropriately. Evidence: The home has a statement of purpose and service users guide to provide prospective service users with sufficient information about the home and services that it can offer. Both the documents can be provided in large print and alternative formats to suit peoples individual needs. Care Homes for Older People Page 11 of 28 Evidence: Most of the service users who completed comment cards said that they had received enough information prior to moving in and one relative spoken to during the visit explained that they had made the arrangements on behalf of their family member with sufficient information being provided to assist them when deciding if White Plains Residential Home was the appropriate place for their relative. Information provided to us in the completed AQAA informed us that the service encourages prospective users of the service to visit the home to meet with staff, fellow users of the service and to gain a feel of the home to enable them in deciding if the home is suitable for their individual needs and this was verified by a relative who spoke to us during the inspection. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individual care plans are person-centred to include peoples preferences in how they wish the care to be provided and promote their overall well-being. Poor procedures around the recording and administration of medication are evident which could compromise the service users health and well being. Evidence: Each user of the service has an individual personalised care plan in which they and/or their relatives have been consulted with, which is regularly reviewed and updated. As part of the inspection process we chose to view three service users files, all of which gave a good all round picture of the individuals needs and contained detailed instructions for staff to follow to ensure that their needs are fully met. The care plans inspected focused on peoples individual strengths and preferences covering areas such as medical needs, personal care, social skills and leisure, personal hygiene, mobility, food and diet, communication and any special care needs. Each file Care Homes for Older People Page 13 of 28 Evidence: viewed contained evidence of regular reviews being undertaken and care plans updated where their needs change. Suitable arrangements are in place for meeting the healthcare needs of those using the service. Records of contact with healthcare professionals, including GPs, District Nurses, Community Psychiatrist Nurses, Chiropodist and other healthcare services are maintained and detailed in the service users care plans. Whilst the home has policies and procedures in place around the administration of medication there are some poor procedures taking place which could compromise the health and welfare of those using the service. Two of which the Commission had been notified about prior to the inspection, one of which had been investigated appropriately and another which is being dealt with at the time of writing this report. As part of the inspection process we looked at the medication systems within the home. All medication was found to be stored safely and securely in appropriate medication storage facilities. Any controlled drugs were stored in a seperate medication cabinet designed for such medication and records were kept in an appropriate controlled drugs register. We chose to undertake an audit of the controlled drugs and found those held within the home tallied with that documented in the register. Whilst viewing the medication administration records (MAR) evidence highlighted that medication is not always documented appropriately on the users Medication Administration Records (MAR). There were instances in which there were gaps where administered medication had not been signed for appropriately. One service user was prescribed eye drops to be administered twice a day however the MAR contained gaps between 31/12/09 and 19/01/10 and the coding system had not been used to determin why the medication had not been administered as prescribed by the GP. Another service users MAR indicated that he/she was prescribed a medication to be taken twice a day, although the MAR indicated that this too had not been administered as prescribed; upon enquiry we were informed that the medication was a medication to be administered as required and the service user was being offered them but refused however the MAR did not indicate the medication as a PRN and the coding system was not being used to evidence the service user had chosen not to take them. The same service user was prescribed another medication to be administered twice a day although the MAR indicated this had not been administered as required; upon enquiry we were informed that the GP had stopped the medication yet there was no signed documentation available to evidence this. The registered manager acted upon the shortcomings and informed us the day following this inspection that an appointment had been made for the GP to visit the home and review all MAR sheets and where medication was to be administered as required detail this on the relevant MAR and prescriptions. The manager also informed us that Care Homes for Older People Page 14 of 28 Evidence: all medication profiles had been updated that day and that she was booking a refresher training date for all those staff who dispense medication. A requirement has been made within this report to ensure that all staff handling medication follow the policies and procedures at all times and use the coding system to explain any medication that has not been administered as prescribed. Feedback from five people who completed surveys for us was generally positive, four told us that they always receive the medical care they need, whilst one answered usually, all told us that they receive the care and support that they need and that the staff are available when they need them. One social care professional responded to our survey and gave positive feedback on the care and support given at White Plains, informing us that peoples health care needs are properly monitored, reviewed and met by the service, that they seek and act on advice to meet peoples social and health care needs and improve their well being and that they support people to live the life they choose wherever possible. They further told us that peoples privacy and dinity is always respected and that the the manager and staff have the right skills and experience those that are living in the home. Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home employs an activities co-coordinator who ensures there is a varied program of activities providing a range of stimulating, therapeutic, interesting activities for those who wish to partake. Evidence: People using the service are able to take part in activities suited to their needs and abilities, which include; cooking sessions, movement and music, art and craft and quizzes. One to one sessions are provided for those unable to join in group activities. Regular outings are arranged for those who wish to partake and a PAT dog (pets as therapy) visits the service users regularly. There is a visiting hairdresser who provides a hairdressing service for those who require and two volunteers visit regularly to interact and chat with those living in the home. The home welcomes visitors and encourages people to maintain contact with families, friends and the wider community. The food provided in the home is of good quality, freshly prepared and cooked on the premises, offers choice and meets the dietary needs of those using the service. All those people living in the home who completed Care Homes for Older People Page 16 of 28 Evidence: surveys said that they generally like the meals that they were provided with, although one did say that the home could do better in ensuring that the meals provided to them were hot, that the plate is hot, not the food. In discussion with the manager, we were informed that she was aware of concerns over the tempreature of the food and informed us that whilst food had been taken to the dining area in hot food trolleys, it became cooler when serving up from the trolley and therefore, the food is now dished up on plates and taken to the dining area in the trolley and served directly from there, which has resulted in people receiving their food at appropriate temperatures. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a satisfactory complaints procedure with evidence that residents feel their views are listened to and acted upon. Evidence: Discussions with service users and the feedback gained through surveys sent out to other users of the service, family members and visitors to the home, informed us that the vast majority of people knew how to make a formal complaint, although there was one service user and one relative who informed us that they did not know, however all the service users who responded did tell us that there was somebody they could speak to informally if they were not happy. They described the management and staff as being very approachable, helpful and friendly. The complaints procedure was available at the home and is included in the service users guide. The home encourages people to raise any concerns, complaint and suggestions, which it records along with any necessary actions taken to investigate and address issues. The complaints book was viewed during this visit and it was noted that the service have received five complaints, all of which were logged and dealt with appropriately and in line with the services complaints procedure. The home has in place procedures to follow in circumstances where there are any suspicions concerning possible abuse. There are policies and procedures in place to guide the manager and staff on how to respond to any suspicion or incidences of abuse. Training is provided to all members of staff to assist them in becoming aware Care Homes for Older People Page 18 of 28 Evidence: of their own care practices, to recognise signs and symptoms of abuse and to emphasise each staff members responsibility to whistle blow on any poor practice or concerns that come to their attention. Each member of staff spoken to during this visit assured us that they would have no hesitation in approaching the manager should the need arise. Information provided to us in the AQAA informed us that at the time of completing the AQAA the service had not had any safeguarding incidents during the period under review, however at the time of writing this report, the service have notified us of one incident which is presently being investigated and which the manager has been advised to referr to the local safeguarding team in line with the local interagency policy and procedure. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was purpose built and offers all the essential facilities required of a care home. The decor and furnishings are of a high standard and afford a comfortable pleasant home for the residents. Evidence: The accommodation consists of three floors with additional facilities on the lower ground floor. Each of these floors is served by a passenger lift. The kitchen is a very good size and has all the relevant equipment needed. The laundry facilities have all the relevant equipment including two washing machines, two tumble driers and ironing facilities. The home offers accommodation in two separate environments to suit the needs of the service users. Each environment has its own lounge and dining areas and has easily accessible and attractive gardens. There is also a kitchenette on each floor and a quiet room. Each floor has an assisted bathroom, plenty of additional toilets and a sluice. There is also a treatment room which is also used by the visiting GP who provides a weekly surgery for those using the service. The corridors are bright and spacious with pictures reflective of the service users who live there. There are plenty of areas to wander and sit down for a chat. Bedrooms are of a good size and meet all the necessary requirements. Each bedroom has an en suite, under floor heating that can be controlled by the individual, lockable Care Homes for Older People Page 20 of 28 Evidence: storage facilities, a telephone and television point. The lower ground floor has staff facilities, a chapel cum training room and an activities room and externally there is parking for some cars to the front of the building and a nice spacious garden for the service users and their relatives to enjoy during the warmer months. The standard of environment within this home is good, providing residents with an attractive and comfortable place to live and offers all the essential facilities required of a care home. All parts of the home are accessible to the service users, with the use of grab rails and a lift to facilitate mobility around the home. The inspector noted the cleanliness was generally very good, which residents confirmed was always the case. The home encourages residents to bring small items of furniture and memorabilia to personalise their rooms to their own liking, which was evident on touring the home. Residents bedrooms viewed on the day of inspection were all wheelchair accessible and contained en suite facilities which included a wash basin, shower and WC. Grab rails were seen to be fitted in both the bedroom and en suite to aid mobility where needed. All residents rooms are provided with a call system with an accessible alarm facility to call staff in the case of an emergency. Residents spoken to were very happy with their rooms and found them to be spacious, furnished to a good standard and meeting their needs appropriately. However, whilst viewing service users bedrooms it was noted that steradent tablets were not being stored securely and appropriately thereby compromising the health and safety of those using the service. We advised the manager that risk assessments must be undertaken with regard to the use of and storage of steradent tablets and we received confirmation the following day that risk assessments had been undertaken in relation to people using such tablets. A requirement has been made within this report to ensure risk assessments be undertaken with regard to both the use of and storage of steradent tablets. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff team are provided with a good range of training, ongoing support and supervision to ensure they have the relevant skills and knowledge to enable them to deliver the care safely and competently Evidence: The staff members are an enthusiastic team who have worked positively with the residents during their first few months at their new home. They have offered a consistency of care to those using the service and worked very well as a team, ensuring that the needs of the residents are met. We chose to look at three staff personnel files at random, one of who had been recently recruited and two longernstanding member of staff, to ensure that robust recruitment procedures are in place and to ensure that staff are provided with appropriate training to ensure that those using the service are protected by the homes recruitment procedures and that staff have the skills, support and knowledge to undertake their roles competently. Recruitment procedures at the home were robust with clear monitoring systems in place to promote the protection of service users including application form; interview notes, two written references and Criminal Records Bureau (CRB) check being sought prior to employment. Care Homes for Older People Page 22 of 28 Evidence: All new members of staff undergo induction training, upon appointment to their posts, and are offered ongoing training and encouraged to undertake the National Vocational Qualification (NVQ) in care, which equips them to meet the assessed needs of the residents within the home and allow for personal development. Presently there are twenty four permanent care workers, of which nineteens hold NVQ level 2 in care or above, which is commendable. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. White Plains is a well managed home, run in the best interests of those using the service, with safeguards in place to protect their health, safety and welfare. Evidence: The registered manager is experienced, knowledgeable, has the required qualifications and competence to manage the home. She displays a good sound knowledge of matters related to the management and running of the care home. Both residents and staff informed us that the manager is very approachable and supportive and values their opinions and suggestions. It was felt that she runs the home in an open, transparent manner and always in the best interests of those using the service. The home has a health and safety policy statement and provides training for staff on safety topics such as moving and handling residents and fire safety training. As part of the inspection process we discussed health and safety issues and saw appropriate maintenance records relating to maintaining a safe environment for residents. Regular safety checks are undertaken relating to fire safety and infectious diseases and regular Care Homes for Older People Page 24 of 28 Evidence: servicing and maintenance of equipment, all of which were seen to be documented appropriately. Evidence was held within staff personnel files to inform us that care staff receive formal supervision regualrly and this was also verified whilst speaking to staff during this visit. We are informed that they also receive an annual appraisal of their work in which they can discuss their performance, any areas of concern and plan for any future training and development needs. It was noted that some staff members appraisals were due and the manager informed us that these were in hand to be attended to. The home deals with a number of diverse care needs and there is a commitment to ensure that all clients, however diverse their needs may be, receive a person-centred package of care which meets their needs appropriately. The manager has concentrated upon working on a person centred dementia care approach to enable greater interraction and understanding between the dementia client group and staff. The manager, her deputy and four senior carers have completed a dementia training course with a further six staff enrolled to take it, to ensure that they have the skills and knowledge to care for people with dementia. The manager is also completing a three day leadership in person centred dementia care course. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 24 13 Risk assessments must be undertaken with regard to the use of and storage of steradent tablets. To ensure the health, safety and welfare of all those using the service. 28/02/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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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