Care Home: Wren Park Nursing And Residential Home

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What the care home does well The manager understood the need to ensure that people could be cared for appropriately at the Wren Park, before they moved in. Therefore an assessment of needs was undertaken before people went to live at the home to make sure staff the staff team were able to care for them. Staff were polite and respectful to people living at the home. They took their time and didn`t hurry people. The home was in a beautiful location overlooking countryside and was nicely decorated. There were no offensive smells. There were sufficient staff on duty at all times and staff appeared to enjoy working at the home. Care plans were well written and staff followed them to provide a good level of care. Other health care professionals, such as specialist nurses, opticians and chiropodists, were contacted for advice and treatment. Most of the people using the service were given the opportunity to take part in a variety of activities, provided by the activity co-ordinator, within the home. What has improved since the last inspection? Since the last inspection the service ensured that there were care plans in place for all of a residents assessed needs. Medication systems ensured that people received the correct medication at the prescribed times. Permanent staff did not commence work until checks and references had been sought. Staff received more training specific to the individual needs of a person and training did not only cover the mandatory core areas of need. What the care home could do better: Requirements and recommendations made as a result of this inspection included:The need to record the quantity of any unused medication carried over to the next month. This ensures accurate reconciliation and provides a robust audit trail. The need to consider how meals are spaced throughout the day. The need to ensure that any complaints and concerns are correctly documented and thoroughly investigated, and unexplained injury is investigated using the safeguarding process. The practices around the use of equipment such as bed rails, recliner chairs, lap belts and keypads must consider the effect on the individual.Staff, particularly the manager would benefit from having access to the Internet to keep updated. Key inspection report Care homes for older people Name: Address: Wren Park Nursing And Residential Home Hitchin Road Shefford Bedfordshire SG17 5JD     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: Sally Snelson     Date: 1 0 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 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: Wren Park Nursing And Residential Home Hitchin Road Shefford Bedfordshire SG17 5JD 01462851548 01462850667 gagroup@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: GA Projects Limited care home 46 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: No one falling into the category of DE(E) may be admitted into the home where there are already 15 persons of category DE(E) accommodated in the home. No other person under the age of 65 years of age may be admitted to the home. The maximum number of service users must not exceed 46. To continue to accommodate the person aged 62 accommodated under category OP and who was named in the proposal to vary the conditions of registration. Date of last inspection Brief description of the care home Wren Park is a privately run care home for people over 65 years with nursing. There are forty six places, and fifteen of these can be for people with dementia. The home is situated at a short distance from the market town of Shefford. The premises comprise the original old house that has been adapted, and a large extension has been added to provide residential care. There is a garden with hard area and paths, and parking to the front of the building. Information about this home can be obtained by Care Homes for Older People Page 4 of 28 Over 65 15 46 0 0 2 1 1 1 2 0 0 8 Brief description of the care home phoning or visiting the home, and there is also an email address. home vary between £536 and £645 per week. The fees for this 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 inspection was carried out in accordance with the Care Quality Commissions (CQC) policy and methodologies, which requires review of the key standards for the provision of a care home for older people that takes account of residents views and information received about the service since the last inspection. Information from the home, through written evidence in the form of an Annual Quality Assurance Assessment (AQAA) has also been used to assess the outcomes within each standard. Evidence used and judgements made within the main body of the report include information from this visit. This inspection was carried out on the 10th December 2009 from 08:15 hours. The registered manager Elizabeth Mazhar was on leave so the inspection process was assisted by the deputy manager Jenny Spikings. Verbal feedback was given periodically throughout the inspection and at the end of the visit. The manager was spoken to on Care Homes for Older People Page 6 of 28 her return from leave. During the inspection the care of three people, including the most recent admission to the home, were case tracked. This involved reading their records and comparing what was documented to the care that was being provided. Documentation relating to:- staff recruitment, training and supervision, medication administration, complaints, quality assurance and health and safety in the home were also examined. We also had a tour of the premises and spent some time in the communal areas of the home, talking to the residents and visitors and observing the care practises and interventions that were carried out during this inspection. Prior to the inspection six residents and four members of staff completed questionnaires about their perception of the service for us. We would like to thank everyone involved for their support and assistance during this visit to the home. 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: Requirements and recommendations made as a result of this inspection included:The need to record the quantity of any unused medication carried over to the next month. This ensures accurate reconciliation and provides a robust audit trail. The need to consider how meals are spaced throughout the day. The need to ensure that any complaints and concerns are correctly documented and thoroughly investigated, and unexplained injury is investigated using the safeguarding process. The practices around the use of equipment such as bed rails, recliner chairs, lap belts and keypads must consider the effect on the individual. Care Homes for Older People Page 8 of 28 Staff, particularly the manager would benefit from having access to the Internet to keep updated. 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. The manager understood the need to ensure that people could be cared for appropriately at this home, before they moved in. To this end she and/or the deputy carried out a comprehensive assessment on all prospective residents. Evidence: The home had a Statement of Purpose and Service User Guide. These documents were kept updated and held as part of a brochure that could be given to prospective residents when they visited or to anyone making an enquiry. In this format they provided a clear description of the home with the use of photographs enhancing the descriptions. Contracts were checked and were all signed and dated appropriately, the contracts set out what the home provided and what the fee included, but did not clearly define the bedroom that was occupied. During the inspection we looked at the files of three residents; two had been admitted Care Homes for Older People Page 11 of 28 Evidence: since our last inspection. Pre-admission assessments had been carried out in advance of the admission. These documents contained sufficient detail to ensure that the staff team had the relevant experience and qualifications to meet the residents needs. The information from the assessment was used to produce an admission report. The staff undertaking the assessments were signing and dating documentation and we had a clear picture as to how decisions had been made. This home did not provide intermediate care. 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. Care plans were well written and staff followed them to provide a good level of care. On the whole medication records and procedures were good. Evidence: We looked at the plans of care for three of the people using the service. We chose at random a person living on the ground and the first floor of the nursing unit, and a person cared for in the residential unit. The plans covered all the activities of daily living. For example in one file there were plans for confusion, depression, mobility, hygiene, elimination and food. As the resident was diabetic there was also additional information about hyper and hypoglycemia. The plans were all clearly written and included the problem, the goal, and the action staff needed to take. The plans were reviewed at least monthly and we saw evidence that as care needs altered the plans were changed to reflect this. For example a person who needed antibiotics for a urinary tract infection had this clearly recorded as part of a short term plan. Risk assessments were completed for moving and handling, falls, nutrition and Care Homes for Older People Page 13 of 28 Evidence: continence. It was clear that staff assessed and acted on the assessment. For example pressure relieving equipment was appropriately used and weight decreases were acted upon in a timely fashion. We saw evidence that staff had recognised a potential pressure ulcer and acted appropriately and either prevented or quickly healed one. Where people had developed a sore the GP and the tissue viability nurse had been involved in the plan of care. There was also information in care records to show that other health care professionals, such as specialist nurses, opticians and chiropodists, were contacted for advice and treatment. Since the last inspection white boards had been put in each bedroom. These advised staff about moving and handling needs. These had been kept up-to-date. Residents in this home were relaxed, happy and well presented. Observations of care, identified people being treated with respect, and addressed in a way that was their preference. Two residents and one staff member had written in their questionnaires that call bells were not always answered immediately. Although we did not see any evidence of this we did bring it to the attention of the nurse in charge to look into. During this inspection we examined the Medication Administration Record (MAR) sheets for the three residents whose care we tracked. These were tidy and well completed with signatures and omission codes where necessary. There was some confusion as to which of the omission codes should be used for a medication that was prescribed to be given as required but not required during a routine medication round. The coding needs to be agreed amongst the staff team to ensure consistency. All the medication dispensed in blister packs, and the medication prescribed on a regular basis and dispensed in boxes reconciled correctly. However for some of the as required medication such as paracetamol, it was not always clear how many tablets had been carried forward from month to month, and therefore it was difficult to reconcile. We discussed this matter with the nurses responsible for medication on the unit and the deputy manager as part of out feed back. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Most of the people using the service were given the opportunity to take part in a variety of activities, provided by the activity co-ordinator, within the home. Care staff were sensitive to the needs of those residents who found it difficult to eat and gave assistance with feeding, at an acceptable pace for the resident. Evidence: The home had a formal activity plan that was displayed throughout the home each week. During the inspection we spoke to one of the two part-time activity coordinators who told us about the variety of activities she provided for the residents, and how she altered and adapted sessions according to the needs and abilities of the residents. On the day of the inspection she was providing hand massage and manicure for the ladies and gentleman who wanted it. She used the time to talk to them about their families and previous interests. She told us that she recorded any interactions she had with residents and how the activity had been received. The activity plan included group activities, trips out and one to one time in each of the areas of the home. We spent some time in three lounges during the morning. Music was playing and the Care Homes for Older People Page 15 of 28 Evidence: television was on in some areas, but only where residents wanted it and were engaged with the programme that was showing. We were told that friends and family were encouraged to visit at any time and that events were planned that involved residents and their families. At lunch time the meal was served from a hot lock. Residents had chosen from an option of two the day before but could alter their minds on the day. The cook told us she had worked at the home for a number of years and knew the residents likes and dislikes. The meals looked appetising and contained a good variety of food groups. The main meal was braised beef, cabbage, potatoes and mixed vegetables, but we saw people having a variety of alternatives including sausages and salads. The cook had a good knowledge of how to improve the calorific content of small portions of food. People living at the home told us that on the whole they enjoyed the food and looked forward to mealtimes, one resident told us that she always forgot what she had ordered so it was a surprise each day when dinner arrived. We were concerned that the meals were not well spaced. For example breakfast was 8-9am and lunch at 12.15 followed by afternoon tea at 3pm and supper at 4.30pm. Although residents were offered a milky drink and a snack before bedtime, we knew that some frail elderly people would be asleep and therefore have 15 plus hours without eating. Although we were told breakfast was served between 8am and 9am we saw people getting up later than this and having their breakfast when they were ready. Everyone who was served was offered a clear choice of food and drink. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home had links with external agencies but there was a lack of understanding of safeguarding procedures and how they work. Staff had training around safeguarding adults but did not always put theory into practice. Practice around the use of equipment such as bed rails, recliner chairs, lap belts and keypads only focused on keeping people safe and not the individual. Evidence: The home had a robust complaints procedure that was included in the Service Users Guide and displayed in the entrance of the home. It was therefore easily accessible to residents and visitors to the home. It confirmed the expected timescales for responses, and advised people of the process if they were dissatisfied with the outcome. The home had received one complaint since the previous inspection which had been upheld. We were told that the manager was available for residents or relatives if they had a concern and often this prevented concerns becoming complaints. However we were aware that a relative believed a piece of jewellery might have gone missing, and although this had been investigated it did not appear to have a closure and was not recorded anywhere other than the care notes. The deputy told us this had been raised as a concern not a complaint, but as the jewellery had not been found we would have Care Homes for Older People Page 17 of 28 Evidence: expected the manager to have taken this forward. Some incidents that should have been reported to us, such as the development of grade two or above pressure sores and unexplained bruising had not always been reported and we were therefore not sure that the appropriate action to keep people safe was always taken. We were also concerned that two residents who wore lap belts while in their recliner chairs had not consented to this form of restraint, and neither was there any documentation to support the use of the restraint. Staff received SOVA training as part of the induction process and the training was updated appropriately. 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 provided an appropriate homely environment for the people who lived there. It was well lit, clean and tidy and smelt fresh. Evidence: There had been no major changes to the environment since our last inspection and the comments made at that time remain current. Peoples rooms that were seen contained personal items for example photographs and pictures. Assisted bathrooms are in place and grab rails were also in place to assist people with their mobility. The large ground floor sitting areas to both sides of the home were decorated satisfactorily, people spoken with all said that they were satisfied with the accommodation and the views from the windows onto the grounds. Communal spaces provide a good amount of natural light and ventilation. People spoken to felt very satisfied with their individual rooms. Cleaning schedules were seen to be in place alongside clinical and domestic type waste contracts. Protective clothing such as gloves and aprons were seen to be used by staff and hand washing facilities were situated throughout the home. No odours were detected at this visit. At this visit the home was decorated in preparation for Christmas and was clean and tidy. One resident told us that she had a small bedroom but then went on to tell us Care Homes for Older People Page 19 of 28 Evidence: that the management had offered her the chance to move into a larger one on more than one occasion but said she had declined as she was settled in the room. 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. The manager now encouraged staff to attend a variety of training, including mandatory training. There was a good recruitment procedure in place for permanent staff. Evidence: The staff were divided into three teams to provide care. On the day of the inspection there was a nurse and three carers supporting 18 residents with nursing needs on the first floor, a nurse and two carers supporting 13 residents with nursing needs on the ground floor and two carers for the 10 residents in the residential unit. In returned questionnaires three of the six residents who responded told us that they sometimes had to wait for care, especially help using the lavatory, and one of the four members of staff who completed a questionnaire also spoke of the need for more staff. On the day of the inspection sufficient staff were on duty but they were not always visible to the residents. This was particularly noticeable in the communal areas where residents could be left unattended for some time because staff were providing care in bedrooms or elsewhere within the home. We spoke to a number of staff who told us that they had worked at the home for several years. We also spoke to staff from abroad who were working as carers and nurses. The deputy told us that there was an expectation that staff from abroad had a reasonable command of the English language. One member of staff reported that staff Care Homes for Older People Page 21 of 28 Evidence: could sometimes speak in their own language which could be confusing for the residents. We did not see any evidence of this on the day. During the inspection we looked at the files of three staff including one that had been appointed since the previous inspection. Each file contained fully completed application forms, appropriate references, Criminal Record Bureau (CRB), including checks against the new barring criteria, interview notes, job descriptions and terms and conditions of employment. All documents were signed and dated appropriately. Following the inspection of a sister home earlier in the year we had been concerned that Wren Park were also employing nurses from an unregistered agency. We were particularly concerned that the manager told us that she did not request to see evidence of checks or training certificates for staff employed via an agency, as she believed that this was the responsibility of the agency. We were reassured to see that this agency were no longer supplying staff and the home had a record of the employment status of any agency staff they were using. Since the last inspection the manager had ensured that specialist training to provide information about conditions, for example diabetes had been included in the training plan. The induction programme for all new staff was robust and we saw that the mentor took time to work through the induction programme with the student. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager was qualified and had the necessary experience to run the home, but there were some areas where correct procedures were not always evident. Evidence: The registered manager had the relevant qualifications and experience to run a care home with nursing and had worked at the home since 1996. As already stated the manager was supernumerary and the deputy, who assisted with the inspection, told us that she had six office hours each week as she was responsible for the duty rota. Prior to, and during, the inspection we discovered some areas that had not been correctly managed: these have been referred to throughout this report. For example, the employing of agency staff without knowledge of their current criminal record or qualifications (including their right to practice as nurses), the reporting under regulation 37 and SOVA procedures of incidents of unexplained bruising pressure sores of grade 2 and above, and the failure to record methods of restraint being used in the home. We also noted that when the AQAA was completed the manager recorded Care Homes for Older People Page 23 of 28 Evidence: that 16 of the residents had a primary diagnosis of dementia. The home has a condition to its registration that no more than 15 people with this diagnosis should live at Wren park. We were not made aware of the need for this variation. All sections of the AQAA had been completed and the information gave a reasonable picture of the current situation, but more supporting evidence would have been useful to illustrate what the service had done in the last year, and how it was planning to improve. Some meetings for staff residents and relatives, had been carried out, ensuring that the opinions of everyone involved in the home were sought and opinions listened to. Staff files included supervision records and all the staff that we spoke to confirmed that they had regular supervision. Residents personal money that was held within the home was audited against any expenditures and the stored receipts and found to be correct. Health and safety checks including water temperatures, fire call bells, freezer and food temperatures were being recorded appropriately, and issues were addressed in a timely fashion. The last visit from the authority had been in 2007. 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 1 16 17 A record of all complaints made by a service user or any other people connected with the service user must be kept. This shows how the complaint was dealt with and the investigation process. 15/01/2010 2 18 12 The manager must ensure that all allegations of possible abuse are followed up. This ensures that people living in the ho,me are kept safe. 15/01/2010 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 1 2 Contracts provided to people using the service should include details about the room that they occupy. Care Homes for Older People Page 26 of 28 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 2 9 Care should be taken that the quantity of any unused medication carried over to the next month is recorded to ensure accurate reconciliation. Care should be taken that meals are spaced regularly throughout the day. The person in charge of the shift should consider how staff are deployed throughout the home. Consideration should be given to the staff at the home having access to a computer so as to keep updated with practice. The should be sufficient evidence in the AQAA to show that the manager has plans top continually improve the service. 3 4 5 15 27 31 6 32 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. 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. 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