Care Home: Willowdene Care Home

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What the care home does well The home provides a good range of information to people thinking of coming to the home, so they can make an informed decision. The home makes a full assessment of a person`s needs before deciding if it can meet all those needs. The home draws up detailed plans to meet the care needs of its service users. Service users health care needs are also fully assessed and properly met. The home stores medicines safely, and administers them correctly and safely. Service users say that staff treat them well and treat them with respect. The home is working hard to provide a stimulating atmosphere in the home, with appropriate social activities for service users. Service users are encouraged to keep in regular contact with family and friends, who say they are always made welcome in the home. Service users are also encouraged to take as much control over their own lives as they are able, and make their own decisions. Service users are very complimentary about the food, and there is a balanced diet, with a choice included. Complaints and concerns are taken very seriously and are responded to properly. The home is kept exceptionally clean, hygienic and free from odours. The home has enough staff to meet the needs of service users. (But must keep staffing levels under review). The home is very careful as to how it recruits new staff, and runs all the necessary checks on them to protect its service users. The manager is experienced and is providing very positive leadership to the home. The home is being run in the best interests of the service users, and there is now an established nursing team. Service users finances are protected by the home`s policies and accounting systems. The health and safety of the service users and of the staff are protected by the home`s policies and systems. What has improved since the last inspection? The home has recruited an established qualified nursing team, and no longer uses agency nurses. This has resulted in continuity of care for service users, and vastly improved staff relations within the home. There is is no longer a staff divide, and morale is high. All the requirements and recommendations identified at the last inspection visit have been met. During the last 12 months, Durham County council`s safeguarding Team have provided the service with care plan training, mental capacity training and deprivation of liberty training. The management team said that the training provided was excellent. What the care home could do better: The home maintains good medication procedures and records, they were reminded to always use the correct code when a PRN medication (As Required) is not administered: Code N should be entered on the medication chart. The service is good at identifying each persons social needs, and completing life story books. This information should be collated to implement detailed social care plans, this will ensure that each persons holistic needs are fully met. Currently there are enough staff to meet the needs of the service users. The home is good at assessing the dependency needs of the service users. The results of these assessments should continue to be used to identify the number of staff required. (as the home fills up) This will ensure that enough staff are employed to meet the assessed needs of the service users. To ensure that the service users nutritional needs are fully met, additional staff must be made available at mealtimes, to assist service users to eat on the Maple Unit. (The manager agreed to address this issue immediately) To enhance the environment for service users, the lounge carpet on the first floor nursing unit should be replaced. Key inspection report Care homes for older people Name: Address: Willowdene Care Home Lizard Lane Sedgefield Stockton On Tees TS21 3ET     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: Jim Lamb     Date: 2 6 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) 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 28 Information about the care home Name of care home: Address: Willowdene Care Home Lizard Lane Sedgefield Stockton On Tees TS21 3ET 01740623644 01740623645 willowdene@gmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Maria Mallaband Care Homes Ltd care home 48 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: 48 The registered person may provide the following category of service only: Care Home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category - Code OP, maximum number of places 36 (Nursing) Dementia, Code DE - maximum number of places 12 (personal care only) Date of last inspection Brief description of the care home Willowdene provides residential care services for up to 36 persons in the category of OP older persons and for up to 12 persons in the category of DEE Dementia Elderly residing in the Maple Suite. The home is also registered to provide nursing care for people. The nursing care unit is based on the first floor of the building. The Home is a modern two story building with the benefit of a lift between the floors along with a single floor annex known as the Maple Suite. The home is situated on the B 1278, about half way between Sedgefield and Fishburn, and lies within its own grounds. Care Homes for Older People Page 4 of 28 Over 65 0 36 12 0 Brief description of the care home Although situated in a rather isolated position, with no shops or other amenities close to the home, there are frequent buses to local villages and major towns and cities in the area eg Durham, Sunderland with a bus stop immediately outside the home. 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: 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: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. How the inspection was carried out. Before the visit we looked at information we have received since the last visit, how the service dealt with any complaints and concerns since the last visit, any changes to how the home is run, the providers view of how well they care for people, and the views of Care Homes for Older People Page 6 of 28 people who use the service and their relatives, staff and other professionals. During the visit we talked with people who use the service, relatives, staff, the manager, and visitors, 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/parts of 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 manager/provider what we found. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? The home has recruited an established qualified nursing team, and no longer uses Care Homes for Older People Page 8 of 28 agency nurses. This has resulted in continuity of care for service users, and vastly improved staff relations within the home. There is is no longer a staff divide, and morale is high. All the requirements and recommendations identified at the last inspection visit have been met. During the last 12 months, Durham County councils safeguarding Team have provided the service with care plan training, mental capacity training and deprivation of liberty training. The management team said that the training provided was excellent. 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 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. Prospective service users are provided with enough information about the service to enable them to make an informed choice about whether this is where they want to live. Evidence: People who come to stay here are given an information pack, called a Service Users Guide, which includes useful information about what they can expect from the service. Everyone is encouraged to come and have a look around the home before making a decision. In this way people have good information to make a decision about whether to move to this home. There are clear records to show that the needs of the service users were assessed before they moved in so that the home knows whether those needs can be met here. Care managers of the Social Services Department carry out most assessments and Care Homes for Older People Page 11 of 28 Evidence: these are provided to the home. The manager also carries out assessments of prospective new service users, to make sure that the home can meet their individual needs. The assessments are holistic and also include details of peoples spiritual and social care needs so that the home can plan to support them in these areas. All are provided with a detailed contract that fully explains the terms and conditions of the service, and the fees to be paid. Intermediate care is not provided. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care planning system is clear enough to ensure that staff have the information they need to meet the assessed needs of the service users. Evidence: People using the service are given sensitive personal support by the staff to promote each individuals independence, dignity, privacy and choice. Each person has an individual assessment of his or her personal needs, and has a care/goal plan in place to meet those needs. Plans are person-centred, sensitive and thoughtful. They stress the strengths of the individual, and are positive in terms of seeking to develop the skills and abilities of the person. Privacy is given a high priority. Plans are reviewed every month, and amended as necessary, to reflect the progress made by the individual. It was agreed by the senior nurse/manager to implement more detailed social care plans for each service user. This will ensure that each persons holistic needs are fully met. Each person has his or her own Personal Health Information file. This contains Care Homes for Older People Page 13 of 28 Evidence: professional health assessments, correspondence, records of contacts with health professionals. It demonstrated that all aspects of a persons physical and mental health are taken seriously and are properly met. Medicines are ordered monthly, and these are delivered in blister packs. This is working well, and there are policies and procedures in place to minimise any risk of a medication error. The Medication Administration Records (MAR) was checked. This was found to completed properly, with no gaps. Staff were reminded to always use the correct codes, for example code N for PRN drugs not given. Senior staff do a weekly audit of the prescribed and non-prescribed (homely medicines) medications. Medicines are safely stored. All staff have had training on how to use the medication system. They have also had external Safe Handling of Medicines training. Care Homes for Older People Page 14 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users are offered a good quality lifestyle, which includes varied social contact and activities. Additional staff are needed to assist service users during mealtimes the Maple unit. Evidence: Each person has an assessment of their social needs that gives details of his/her background, lifestyle, routines and interests. Life story books are also completed for each person. This information should be used to implement individual social care plans. The manager agreed to implement detailed social care plans immediately. Wherever possible staff and the activities coordinator support individual needs and requests for one-to-one activities and outings. The home has a well thought out activities programme, and service users are supported and encouraged to participate. During the summer months there are regular outings. The usual range of festivals and other significant days are celebrated. These include Valentines Day, Shrove Tuesday (pancake tossing), Burns night, Halloween etc. with photos taken and displayed in the home. The home has an open visiting policy. Visitors are welcomed and can take refreshments and meals. Service users choose whom they wish to see and where to receive visitors. Contact with friends and family Care Homes for Older People Page 15 of 28 Evidence: is supported through visits, telephone calls and letters/cards. Two visitors said they are always kept up to date with important issues affecting their relative. Some service users continue to manage their financial affairs. Where this is not possible they are assisted by relatives/representatives. The homes management does not take responsibility for finances, other than holding cash for personal spending in the safe. Service users nutritional needs are assessed and care planned where necessary, and weights are monitored. Special diets are catered for. These currently include low fat, diabetic and soft diets. Blended food is served separately. Independent eating is encouraged, with use of aids if needed. The inspector observed the lunchtime meal being served on the EMI Maple unit. Two staff work on this unit, however, five service users require full assistance to eat. On the day of the inspection, two visitors were assisting their relatives to eat, and staff were assisting the other three service users. Because of the dependency levels of the service users, it is not acceptable for 2 staff to try to assist five people with their meals, and this compromises their dignity. This matter was discussed with the manager, she agreed to immediately rota other staff (possibly Domestic staff, who have had food hygiene training) to assist during meal times on this unit. One of the relatives spoken to said, she also had concerns about the lack of staff support during meal times. However, she also said that the care her Mother received was excellent, and that the staff on this unit were extremely caring and supportive, and that she was always made to feel welcome. The current menus showed that there is a choice of meals available. Menus are displayed. The inspector also observed lunch on the first floor nursing unit. The tables were nicely set with cloths, placemats and full range of condiments. Hot and cold drinks were available. The meal was served at a leisurely pace, and staff were on hand to offer discreet help if needed. Service users told the inspector the food is good. They confirmed choice of meals is offered. Care Homes for Older People Page 16 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 complaints management is effective, and this results in the service users being protected from harm and abuse. Evidence: Information about complaints is displayed on notice boards around the home and in the homes Statement of Purpose and Service Users Guide. The people spoken to by the inspector confirmed they were aware of how to raise any concerns or complaints. Although nobody spoken to had any cause for complaint, all expressed confidence that any complaints they might have would be taken seriously. Service users and families views are obtained through regular contact and an open door policy. Service users / Family Meetings are held, which provide an additional forum to discuss any concerns or potential difficulties. Staff meetings are also held. One person spoken to said, I have never had to make a complaint, but if there is a problem I speak to the staff or the manager. Another person said, If anything did bother me, i would soon tell them, and they always listen to what i have to say. The organisations policy and procedure documents relating to adult protection provide information and guidance to staff. A copy of Durham & Darlington Adult Protection Committees Inter-Agency Adult Protection Policy & Procedures on abuse and the Care Homes for Older People Page 17 of 28 Evidence: protection of vulnerable adults is available in the home. The home also has a copy of the Department of Healths NO SECRETS. Additional staff training about abuse and the protection of vulnerable adults has taken place for all staff staff during the last 12 months. This is good practice. Care Homes for Older People Page 18 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 provides a very comfortable and safe environment for those living there. Evidence: The home was clean, well decorated and well maintained. The grounds were attractive, tidy, safe, and accessible. The home has an appropriate amount of sitting, recreational and dining space. There are enough rooms for a variety of activities to take place, including a large highly attractive conservatory overlooking woodland. During the last twelve months, there has been some significant improvements made to the environment, several profiling beds have been purchased, several bedrooms have new furniture and most have recently been decorated, and new crockery has been purchased. More improvements are planned for this year, these include: Plans to create a reminiscence lounge, and service users and their relatives will be involved in its design. The management team intend to implement orientation boards and improved signage throughout the home, the latter will help service users to find there way around the home more easily. The home is also considering memory lane boxs, these will be located outside each persons bedroom door and will be unique to each individual, and again, these will help Care Homes for Older People Page 19 of 28 Evidence: service users to identify their own bedrooms more easily. Service users can see visitors in private in their own rooms. Furnishings and fittings were domestic in design and in good condition. The majority of bedrooms have got en-suite facilities. The carpet in the first floor lounge needs to be replaced, despite regular cleaning the carpet is badly stained in several areas. The manager said that this will be addressed. All doors have privacy locks and room sizes exceed the required standards. There is space on either side of beds when necessary, to enable access for carers and specialist equipment. Service users bedrooms have opening windows and restrictors are in place. The rooms were centrally heated and the heating level could be controlled within each bedroom. There are several attractive garden areas that have been landscaped, and service users have easy access to these areas. There was emergency lighting throughout the home. The kitchen was spotlessly clean and very well organised. Water is stored at over 60c Valves at water outlets ensure water is provided close to 43C to prevent scalding. The home was exceptionally clean throughout and free from offensive odours. The laundry facilities are very well organised. The washing machines have the specified programme to meet disinfection standards. Care Homes for Older People Page 20 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. There is a good match of well-qualified staff, who are appropriately recruited and supervised. Evidence: In addition to the manager, there is 1 qualified nurse and 2 care staff from 8am to 8pm on the nursing unit. The residential unit has 1 senior carer and 1 care staff. The Maple unit has 1 senior and 1 care staff. From 8pm to 8am there is 1 qualified nurse and 5 care staff on duty. The manager was made aware that if the number of service users increase, particularly on the nursing and Maple unit, then the staffing levels will also need to be increased. The personnel records of four staff were examined. All four had completed application forms, the dates of employment were clear, making it easy to follow a clear employment audit trail. The manager also completes an audit check list and this ensures that all the necessary checks have been completed prior to commencing employment. All had the required two work references, (crb) criminal record bureau check, Care Homes for Older People Page 21 of 28 Evidence: documentary evidence of identity, induction and training and development information. The organisation employs a training and development officer, and all staff have an annual training matrix drawn up, this covers all mandatory training needs, and other core training needs, such as control of infection and Adult Protection. Individual staff members have his or her individual training needs analysis on their personal file. All staff receive regular supervision sessions. The manager said that, mental capacity and deprivation of liberty training has also taken place during the last 12 months. NVQ training: 97 of staff have achieved Level 2/3, this is good practice. During the tour of the building staff were observed to treat service users with respect. The home now has an established nursing staff team, and this is working well. Agency nursing staff are no longer used. Care Homes for Older People Page 22 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. The manager is supported by the organisation in providing good leadership throughout the home, with staff demonstrating an awareness of their roles and responsibilities. Evidence: The manager had obtained relevant qualifications, including the Registered Managers Award. She had extensive experience and displayed the professional competence required to manage the home. There was evidence that the staff team worked hard to improve the lives of the people living at the home. Staff and service users felt that the managers style of leadership was fair, supportive and understanding. The majority of service users had requested that the home take on day-to-day responsibility for overseeing their pocket money. A safe was available to ensure that their money could be kept secure. Staff signatures had been obtained for all money spent on behalf of service users and receipts had been obtained and attached to their Care Homes for Older People Page 23 of 28 Evidence: financial balance sheets. Financial records showed evidence of regular audits. The home does not acting as an appointee for any of the service users. A quality assurance system had been developed to monitor the quality of care provided in the home. For example, quality surveys had been sent to people living at that the home and their relatives. The home has a detailed annual development/business plan in place. All staff working at the home had received supervision at least six times during the last 12 months. Supervision sessions were used to provide staff with feedback on their performance, and training needs. A range of health and safety records were examined and found to be up to date. A tour of the premises identified no health and safety concerns. An audit of the homes fire records confirmed that the required fire prevention checks had been completed. For example, the homes emergency lighting and fire extinguishers had received monthly visual checks. An up to date fire risk assessment was in place. The homes accident records contained the required details. The homes lift and hoisting equipment had been serviced. All gas and electrical appliances had been subject to the required safety checks. A range of workplace risk assessments had been completed. Care Homes for Older People Page 24 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 25 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 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 12 To ensure service users holistic needs are being addressed, detailed social care plans should be implemented. Again, the manager agreed to implement social care plans immediately. 2 15 There are not enough staff available during mealtimes to assist service users to eat their meals on the Maple Unit. This potentially results in cold and unappetizing food being served, and compromises the service users dignity. On the day of the inspection, the manager made immediate plans to rectify this situation. She arranged additional staff cover during mealtimes. 3 19 To improve the comfort of the service users and the appearance of the unit, the first floor lounge carpet should be replaced. Despite regular cleaning, the carpet is badly stained in several areas. As the home fills up, staffing levels must be kept under review. Page 26 of 28 4 27 Care Homes for Older People 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 This will ensure that the service is confident that it can meet the assessed needs of all the service users. 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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