Care Home: Whorlton Grange Residential Home

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What the care home does well The home was clean, tidy, warm, well ventilated and odour free. The domestic team work hard to keep the building looking good and people said that they are very happy with the cleanliness of their bedrooms. The home is nicely furnished, well maintained and attractively decorated. It is safe and free from potential hazards. The home has access to a handyman two days a week which enables repairs to be carried out quickly. The premises are set in attractive landscaped grounds and the home has its own gardener. There are a range of communal areas that can be used by people wanting to socialise or have private time to themselves. There is a pleasant atmosphere at the home and visitors receive a warm welcome. People wishing to live at the home are invited to spend a day at Whorlton Grange getting to know its routines, the staff and other people living there. They are also invited to participate in the lunch and teatime meals. The home`s records are generally up to date, accurate and well maintained. Staff are kind, respectful, considerate and have developed warm and caring relationships with the people in their care. People living at the home are satisfied with the care and support they receive. Staff communicate with people in a positive manner. Staff are very proud of the quality of care provided at the home. There is a pleasant atmosphere at the home and visitors receive a warm welcome. People living at the home said that the quality of meals served is good. The inspector attended the lunchtime meal and found it to be appetising, tasty and nutritious. It was also nicely served by the staff on duty. People received the support they needed to eat their meals. Over 90 per cent of the staff team have obtained a relevant qualification in care. Some members of the senior team have completed extra qualifications enabling them to assess and verify the training undertaken by other staff working at the home. All the care staff have completed training in how to work with people who have dementia. There is a strong commitment within Whorlton Grange to ensuring that people living at the home have access to a wide range of social activities. A forward planner setting out the activities to be provided each month is in place. Two staff are responsible for overseeing the delivery of activities within Whorlton Grange. People are satisfied with the level of activities provided. What has improved since the last inspection? Medication audits are carried out on a regular basis. This helps to ensure that people are protected from harm and receive the medication they need to keep them healthy. New policies and procedures have been devised and are being implemented at the home.A wider range of social activities are now provided. Reminiscence scrapbooks have been introduced to facilitate discussions with service users. Improvements have been made to the premises. A ramp has been built leading out into the courtyard. A new roof has been fitted in the conservatory. New furniture has been provided in the lounge. The home has been redecorated. IT equipment has been provided in the office. What the care home could do better: No requirements have been set following this inspection. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Whorlton Grange Residential Home Whorlton Grange Cottages (opp. Golf Club House) Westerhope Newcastle Upon Tyne Tyne & Wear NE5 1ND     The quality rating for this care home is:   three star excellent 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: Elizabeth Gaffney     Date: 1 8 0 5 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 27 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 27 Information about the care home Name of care home: Address: Whorlton Grange Residential Home (opp. Golf Club House) Whorlton Grange Cottages Westerhope Newcastle Upon Tyne Tyne & Wear NE5 1ND 01912140120 01912140261 noemail 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) : Wellburn Care Homes Limited care home 45 Number of places (if applicable): Under 65 Over 65 12 33 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 0 Whorlton Grange provides personal care for up to 45 older people, including older people with dementia. The home is located within Westerhope and has extensive wellkept grounds. The property was converted to a care home and has been extended. Accommodation is over two floors with a passenger lift. A further extension and improvements to the building were completed in July 2005. Additional bedrooms, extra communal space, a bathroom and a patio area were added at this time. The home has 39 single and 3 double bedrooms, 38 of which have en-suite facilities. There is easy access by public transport. Local amenities and shops are available in Westerhope. The current charge for a place ranges from 399 to 480 pounds. Extra charges are made for hairdressing, private chiropody services, newspapers, toiletries. The most recent inspection report was available on request to residents, visitors and staff. Care Homes for Older People Page 4 of 27 Brief description of the care home Information about fees charged was included in the homes service user guide. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent 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 2 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. Before the visit, we looked at: information we have received since the last visit on 24 April 2007; how the service dealt with any complaints and concerns since the last visit; Care Homes for Older People Page 6 of 27 any changes to how the home is run; the acting managers view of how well they care for people and the views of people who use the service and their relatives, staff and other professionals. An unannounced visit was made on the 15 May 2009. During the visit we: talked with people who use the service, staff and the acting manager; looked at information about the people who use the service and how well their needs are met; looked at other records which must be kept; checked that staff had the knowledge, skills and training to meet the needs of the people they care for; looked around the building to make sure it was clean, safe and comfortable and checked what improvements had been made since the last visit. We told the acting manager what we found. What the care home does well: What has improved since the last inspection? Medication audits are carried out on a regular basis. This helps to ensure that people are protected from harm and receive the medication they need to keep them healthy. New policies and procedures have been devised and are being implemented at the home. Care Homes for Older People Page 8 of 27 A wider range of social activities are now provided. Reminiscence scrapbooks have been introduced to facilitate discussions with service users. Improvements have been made to the premises. A ramp has been built leading out into the courtyard. A new roof has been fitted in the conservatory. New furniture has been provided in the lounge. The home has been redecorated. IT equipment has been provided in the office. 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 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are suitable arrangements for making sure that peoples needs are assessed before they are admitted into the home. This will help people to feel confident that staff will know how to meet their needs once they move into the home. Evidence: Admissions into the home do not take place until a full assessment of each persons needs has been carried out. In the sample of care records looked at, a copy of each persons social services assessment and care plan has been obtained. The home also carries out its own pre-admission needs assessment to ensure that Whorlton Grange is able to offer a suitable placement. These assessments are carried out by suitably qualified and experienced staff. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements for meeting peoples health and personal care needs are good. This means that people are able to benefit from living in a home where their health and well-being is promoted and treated seriously. Evidence: A sample of care records was looked at as part of the inspection. This showed that a range of care plans have been devised for each person covering such areas as personal hygiene and peoples health care needs. Care plans identify each persons strengths, assessed needs, what the home hopes to achieve by its involvement as well as a description of what action will be taken to meet peoples needs. Care plans are generally reviewed each month. Staff are knowledgeable about the content of peoples care plans. Of the four staff who returned surveys, all said they are given up to date information about peoples needs. However, the descriptions of some peoples needs are not clear enough and some of the actions to be carried out by staff do not contain sufficient detail. Care Homes for Older People Page 12 of 27 Evidence: Arrangements are in place to meet peoples healthcare needs. Service users said that they have been registered with a local GP and staff arrange for visits to take place if they become unwell. People using the service who were interviewed said that their healthcare needs are well met. Of the three service users that returned surveys, all said that they receive the care and support they need. Peoplesweight is checked every month, and where weight loss is identified as a potential problem, the manager consults with her staff to decide on a course of action. Where staff have identified that people have specific healthcare needs, support plans are put in place. For example, a support plan has been devised for one service user with Diabetes. The home has carried out preventative healthcare risk assessments to help keep people safe. For example, in the sample of care records checked, nutritional and falls risk assessments have been completed for each person. Although preventative pressure sore risk assessments have not been carried out, the manager reported that there are no service users with active pressure sores. Staff are very clear about the action they would take if a service user started to develop red areas or breaks in their skin. Also, peoples nutritional risk assessments do not contain a completed Body Mass Index. The home has a medication policy that staff are expected to follow. All medication is kept in a locked cupboard and cabinet. Staff administer medication in a safe and professional manner. Controlled drugs are administered when required and an appropriate record is kept. The homes medication records are generally well completed. All staff administering medication have received training. A written assessment of staffs continuing competency to administer medication has been carried out. No requirements or recommendations were made following the last pharmacy inspection of the homes medication arrangements. The Commission has not been notified of any mis-administrations of medication. Staff are clear about the steps they should take to respect peoples dignity and privacy. For example, staff consult service users about how to meet their needs in a quiet manner ensuring that personal matters are treated confidentially. During the inspection, staff supported one service user to go to their bedroom so that their GP could treat them in private. Another service user said that their mail is delivered unopened. People using the service said that staff are always respectful and treat them in a dignified manner. The home operates a key worker system that enables staff to work more closely with some people whilst also contributing to the care of all living at the home. The system enables staff to provide more person centred care. Care Homes for Older People Page 13 of 27 Evidence: The provider and manager demonstrated that they keep up to date with key developments taking place in the field of social care for older people. For example, the provider has recently provided the home with Mental Capacity Act (MCA) assessment forms to enable staff to assess peoples competency to make decisions about how they live their lives. The acting manager has already commenced this process. Care plans providing staff with guidance on how to meet peoples End of Life needs and wishes have not been devised. Also, one persons care records contain a statement that their family do not wish their relative to be resuscitated in the event of their death. The acting manager was provided with advice about Do Not Resuscitate certificates and End of Life advance plans. The manager agreed to carry out an appropriate MCA assessment in conjunction with the personns family, their GP and care manager. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People experience a lifestyle at Whorlton Grange that matches their expectations and preferences, and satisfies their social and recreational needs. This helps people to benefit from living in a home where they are supported to live stimulating and fulfilling lives. Evidence: People living at the home are able to lead stimulating and fulfilling lifestyles. For example, the activities co-ordinators prepare a forward planner detailing what activities are to be provided. A copy of the monthly activity planner is placed in each persons bedroom. The home has built up good information about resources available within the local community and surrounding area. A photographic diary is kept to provide people with memories of the events and activities they have participated in. Peoples social needs have been assessed and care plans devised. People interviewed during the inspection said that the home is good at meeting their social needs and provides them with a variety of social activities to choose from each month. Of the three service users who returned surveys, all said that the home usually provides appropriate activities for them to join in. Care Homes for Older People Page 15 of 27 Evidence: People spoken with said that the acting manager and her staff always make families and friends feel welcome. People living at the home said that they are able to see their visitors in private or meet with them in the communal areas. No-one spoken with could recall the home placing any restrictions upon their visitors. Day-to-day support with managing finances is provided where a need to do so is identified. People said that they had been supported to bring their own personal possessions with them when they moved into Whorlton Grange. Staff provide people with opportunities to make everyday decisions. For example, regular meetings are held with service users where they are supported to comment on the homes activity plans and menus. The home uses a four week rotating set of seasonal menus. These have been prepared by the chef taking account of suggestions made by people living at the home. Over reliance on tinned and pre-packaged food is avoided, with the emphasis being placed on regular deliveries of fresh meat, fish and vegetables. Regular drinks and snacks are available throughout the day. The inspector joined people for their lunch time meal. The food served was of a good quality, well-presented and met peoples dietary needs. For those individuals who needed support during the mealtime, this was carried out in a helpful and sensitive manner. The mealtime was relaxed and staff gave individuals the time they needed to finish their meal. The dining area is pleasant and has been nicely decorated. The tables are attractively set with matching crockery and crisp clean linen. People said that the meals served are always of a good standard offering both choice and variety. They also said that they receive enough to eat and drink and alternatives to the main menu meals are available. One person said that they had raised a concern about the quality of some of the meals served. They said that their comments were well received by the home and action was taken to address their concerns. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes management of complaints is satisfactory and the arrangements for keeping people safe are good. This will help people to feel confident that staff are clear about the action they would take to keep them free from harm or abuse. Evidence: The complaints procedure provides staff with guidance about how to handle complaints. People living at the home said that they would be happy to raise any concerns that they might have with the acting manager or a member of the staff team. Neither the home, nor the Commission, had received any complaints since the last inspection. The provider has devised a safeguarding policy to help keep people using its service safe. The policy has been updated to reflect the duties and responsibilities imposed upon the providers by the Mental Capacity Act and Deprivation of Liberty Regulations. The Commission has been notified of two safeguarding concerns. The acting manager handled the safeguarding concerns raised in a satisfactory manner and worked well with the local safeguarding team to address the concerns raised. All staff have received safeguarding training. People living at the home said that they feel safe and secure at Whorlton Grange. Staff are clear about the action they would take to protect people from potential harm or abuse. Care Homes for Older People Page 17 of 27 Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Satisfactory arrangements are in place to maintain, replace and improve the homes decoration, furnishings and fittings. This means that people living at the home are provided with comfortable accommodation that is well maintained and which satisfactorily meets their needs. Evidence: On the day of the inspection, Whorlton Grange was clean, safe, comfortable and well maintained. The home is situated in the village of Westerhope and provides easy access to local community facilities and services. The home is fully accessible to people with physical disabilities. For example, a lift has been provided to the first floor. A stair lift provides access to a separate first floor bedroom. People living at the home have access to a range of communal facilities such as lounge areas, a sunroom, a conservatory and a dining room. The homes physical environment meets the individual requirements of the people who lived there. A range of specialist equipment and adaptations are provided. For example, a fixed hoist has been fitted in each bathroom. Grab rails have been fitted in each en-suite toilet. Extra toilet aids are provided according to the needs of the person occupying the bedroom. The provider has devised an infection control policy which provides staff with good Care Homes for Older People Page 19 of 27 Evidence: advice and guidance. Anti-bacterial gel hand wash dispensers have been fitted in each bedroom, toilet and bathroom area. The home has established links with the local infection control nurse and staff have completed infection control training. The laundry was checked and found to be clean, tidy and well organised. Bedrooms are redecorated before the next occupant takes up residency. Mostly single room accommodation is provided and the majority of bedrooms have an en-suite facility. There are a small number of double rooms, one of which is occupied by a married couple. The bedrooms visited were clean, tidy, nicely decorated and attractively furnished. Each room has been personalised in line with the occupants preferences. Some of the bedrooms contain furniture that people have brought in with them. Assisted bathing facilities are available on both floors. The bathrooms are kept clean and are pleasantly decorated. Homely touches such as pictures have been added. A thermometer is available in each bathroom to enable staff to test hot water temperatures. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good arrangements for ensuring that sufficient numbers of suitably trained staff who have been subject to robust pre-employment checks work in the home. This means that people can be confident that they will be cared for by suitable staff who have been trained to do their job. Evidence: Six staff are rostered on duty throughout the working day and there are three night carers between 9pm and 8am. The manager has been provided with an extra 60 hours each weekto cover staff holidays and sickness. Staff said that there are always or usually sufficient staff on duty to meet peoples needs. People using the service said that staff are always available when needed. Staff are provided with opportunities to undertake training that is relevant to their job. All staff have completed training in food hygiene, infection control, first aid, health and safety and fire prevention. However, some staff have not updated their moving and handling training during the previous 12 months. Each member of the care staff team has obtained a nationally recognised qualification in care. New staff are provided with an opportunity to complete Skills for Care training where they do not have a National Vocational Qualification in Care. At the time of the Care Homes for Older People Page 21 of 27 Evidence: inspection, the acting manager was supporting a new member of staff to complete their Skills for Care induction workbook. She also confirmed that a completion certificate would be placed in this staff members training file. New staff are subject to a range of pre-employment checks before they can commence work at the home. For example, staff whose files were looked at had completed an application form and a statement confirming whether they had any convictions or cautions. The provider had obtained two written references, proof of peoples identities as well as a recent photograph, and a Criminal Records Bureau disclosure check. A concern about one staff members employment history dates was identified but this was immediately rectified during the inspection. Staff who returned surveys confirmed that pre-employment checks had been carried out before they could start work at the home. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements for running and managing the home are good. This means that people are able to benefit from living in a home where their health, safety and well being is promoted and protected. Evidence: The acting manager has obtained relevant qualifications, including the Registered Managers Award. She has extensive experience of working at Whorlton Grange and displays the professional competence required to manage the home. Staff are clear about the standards of care to which they are expected to work. The majority of people living at Whorlton Grange have requested that the home take on day-to-day responsibility for overseeing their money. Each person has their own separate purse in which their money is kept. Peoples money is kept secure at all times. Two staff signatures are obtained for all financial transactions involving peoples Care Homes for Older People Page 23 of 27 Evidence: money and receipts are obtained. Access to the safe is restricted to senior staff. The acting manager completed a check of peoples money as part of the inspection. The money held on peoples behalf matched the written records kept by staff. Internal systems have been developed to monitor the quality of care provided in the home. For example, quality surveys have been sent to people and their relatives. Regular monitoring visits are carried out by the provider. Although the acting manager submitted an Annual Quality Assurance Assessment when asked to do so by the Commission, some areas of the document contained limited information about how the service complies with the National Minimum Standards. Since the last inspection, the provider has updated key policies and procedures to make sure that they reflect developments in the field of social care. However, some have not been updated since 2004. Staff receive regular supervision in line with the National Minimum Standards. Supervision sessions are used to provide staff with feedback on their performance. Records are kept of all staff supervision sessions. There are good arrangements for keeping people safe. A tour of the premises identified no health and safety concerns. A sample of health and safety records was looked at during the inspection. This confirmed that regular fire prevention checks are carried out. For example, the last fire drill took place in March 2009 and involved 10 staff and visitors present within the building. However, a recent audit visit carried out by the local council identified that some staff needed to update their fire training. The manager confirmed that this has since taken place. An up to date fire risk assessment is in place. The homes lift and hoisting equipment were last serviced in February 2009. The home has a current gas safety certificate and all electrical appliances have been subject to the required safety checks. A range of workplace risk assessments have been completed. These are kept up to date. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 Ensure that peoples support plans clearly identify their assessed needs as well as the actions to be taken by staff to meet those needs. Complete a preventative pressure sort risk assessment for each person living at the home. Ensure that each person has an End of Life care plan. Wherever possible, this should be agreed with their family, GP and care manager. Use the MUST nutritional assessment tool to assess peoples risk of developing malnutrion. The homes policies and procedures should be reviewed and updated every 12 months. 2 8 3 8 4 5 8 37 Care Homes for Older People Page 26 of 27 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. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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