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(6)Tj ET /F1 12 Tf BT 1 0 0 1 392.28 122.79 Tm (1)Tj ET /F1 12 Tf BT 1 0 0 1 423.61 122.79 Tm (1)Tj ET /F1 12 Tf BT 1 0 0 1 454.95 122.79 Tm (2)Tj ET /F1 12 Tf BT 1 0 0 1 486.28 122.79 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 517.6 122.79 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 548.96 122.79 Tm (9)Tj ET endstream endobj 6 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]/XObject<>>>/MediaBox[0 0 612 792]>> endobj 7 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (2)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 768.28 Tm (Information about the care home)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 20.58 w 31.2 746.8 m 274.61 746.8 l S 0.001 w 1 1 1 RG 20.58 w 276.86 746.8 m 580.25 746.8 l S 0.001 w 0.95294 0.95294 0.95294 RG 90.9 w 31.2 688.81 m 274.61 688.81 l S 0.001 w 1 1 1 RG 90.9 w 276.86 688.81 m 580.25 688.81 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 630.82 m 274.61 630.82 l S 0.001 w 1 1 1 RG 20.58 w 276.86 630.82 m 580.25 630.82 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 607.99 m 274.61 607.99 l S 0.001 w 1 1 1 RG 20.58 w 276.86 607.99 m 580.25 607.99 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 585.16 m 274.61 585.16 l S 0.001 w 1 1 1 RG 20.58 w 276.86 585.16 m 580.25 585.16 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 562.33 m 274.61 562.33 l S 0.001 w 1 1 1 RG 20.58 w 276.86 562.33 m 580.25 562.33 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 735.39 m 582.46 735.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 642.23 m 582.46 642.23 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 619.41 m 582.46 619.41 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 596.58 m 582.46 596.58 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 573.74 m 582.46 573.74 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 758.22 m 582.46 758.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 735.39 m 582.46 735.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 642.23 m 582.46 642.23 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 619.41 m 582.46 619.41 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 596.58 m 582.46 596.58 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 573.74 m 582.46 573.74 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 550.91 m 582.46 550.91 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 759.29 m 30.07 549.84 l S 0.001 w [] 0 d [] 0 d 2.25 w 275.73 759.29 m 275.73 549.84 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 759.29 m 581.38 549.84 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 742.03 Tm (Name of care home:)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 742.03 Tm (Waterside Care Centre)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 719.2 Tm (Address:)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 719.2 Tm (Waterside Care Centre )Tj ET /F1 12 Tf BT 1 0 0 1 279.71 701.62 Tm (Leigh Sinton)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 684.04 Tm (Malvern)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 666.46 Tm (Worcestershire)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 648.88 Tm (WR13 5EQ)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 626.05 Tm (Telephone number:)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 626.05 Tm (01886833706)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 603.22 Tm (Fax number:)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 603.22 Tm (01886832882)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 580.39 Tm (Email address:)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 557.56 Tm (Provider web address:)Tj ET /F1 10 Tf BT 1 0 0 1 28.35 521.61 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 31.2 502.13 m 353.25 502.13 l S 0.001 w 1 1 1 RG 20.58 w 355.5 502.13 m 565.9 502.13 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 433.64 m 353.25 433.64 l S 0.001 w 1 1 1 RG 20.58 w 355.5 433.64 m 565.9 433.64 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 410.8 m 353.25 410.8 l S 0.001 w 1 1 1 RG 20.58 w 355.5 410.8 m 565.9 410.8 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 490.71 m 568.1 490.71 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 467.88 m 567.8 467.88 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 445.05 m 568.1 445.05 l S 0.001 w [] 0 d [] 0 d 2.25 w 354.37 514.62 m 354.37 489.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 422.22 m 568.1 422.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 513.54 m 568.1 513.54 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 490.71 m 567.8 490.71 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 467.88 m 568.1 467.88 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 445.05 m 568.1 445.05 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 422.22 m 568.1 422.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 399.39 m 568.1 399.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 514.62 m 30.07 398.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 354.37 446.13 m 354.37 398.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 514.62 m 567.02 398.31 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 497.36 Tm (Name of registered provider\(s\):)Tj ET /F1 12 Tf BT 1 0 0 1 358.35 497.36 Tm (Minster Care Management Limited)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 474.52 Tm (Name of registered manager \(if applicable\))Tj ET /F1 12 Tf BT 1 0 0 1 34.05 451.7 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 428.86 Tm (Type of registration:)Tj ET /F1 12 Tf BT 1 0 0 1 358.35 428.86 Tm (care home)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 406.04 Tm (Number of places registered:)Tj ET /F1 12 Tf BT 1 0 0 1 358.35 406.04 Tm (46)Tj ET /F1 10 Tf BT 1 0 0 1 28.35 387.09 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 66.24 w 32.32 343.64 m 564.47 343.64 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 356.18 m 567.8 356.18 l S 0.001 w [] 0 d [] 0 d 2.25 w 297.24 333.36 m 567.8 333.36 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 379.02 m 567.8 379.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 356.18 m 567.8 356.18 l S 0.001 w [] 0 d [] 0 d 2.25 w 297.24 333.36 m 567.8 333.36 l S 0.001 w [] 0 d [] 0 d 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298.37 308.23 m 298.37 283.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 430.37 308.23 m 430.37 283.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 308.23 m 567.02 283.24 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 290.96 Tm (dementia)Tj ET /F1 12 Tf BT 1 0 0 1 302.35 290.96 Tm (46)Tj ET /F1 12 Tf BT 1 0 0 1 434.35 290.96 Tm (0)Tj ET 0.95294 0.95294 0.95294 RG 109.98 w 32.32 206.71 m 564.77 206.71 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 241.12 m 567.8 241.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 218.29 m 568.1 218.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 263.95 m 567.8 263.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 241.12 m 568.1 241.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 218.29 m 568.1 218.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 151.71 m 568.1 151.71 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 265.02 m 30.07 150.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.72 265.02 m 566.72 150.64 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 247.76 Tm (Conditions of registration:)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 224.93 Tm (The maximum number of service users to be accommodated is 46)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 202.1 Tm (The registered person may provide the following category of service only: Care Home )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 187.52 Tm (with Nursing \(Code N\) To service users of the following gender: Either Whose primary )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 172.94 Tm (care needs on admission to the home are within the following categories: Dementia )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 158.36 Tm (\(DE\) 46)Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 31.2 136.93 m 315.25 136.93 l S 0.001 w 1 1 1 RG 20.58 w 317.5 136.93 m 346.55 136.93 l S 0.001 w 20.58 w 348.8 136.93 m 377.9 136.93 l S 0.001 w 20.58 w 380.15 136.93 m 409.2 136.93 l S 0.001 w 20.58 w 411.45 136.93 m 440.55 136.93 l S 0.001 w 20.58 w 442.8 136.93 m 471.9 136.93 l S 0.001 w 20.58 w 474.15 136.93 m 503.2 136.93 l S 0.001 w 20.58 w 505.45 136.93 m 534.55 136.93 l S 0.001 w 20.58 w 536.8 136.93 m 565.9 136.93 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 148.34 m 568.1 148.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 125.51 m 568.1 125.51 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 149.42 m 30.07 124.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 316.37 149.42 m 316.37 124.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 347.67 149.42 m 347.67 124.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 379.02 149.42 m 379.02 124.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 410.32 149.42 m 410.32 124.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 441.67 149.42 m 441.67 124.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 473.02 149.42 m 473.02 124.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 504.32 149.42 m 504.32 124.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 535.67 149.42 m 535.67 124.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 149.42 m 567.02 124.43 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 132.15 Tm (Date of last inspection)Tj ET /F1 12 Tf BT 1 0 0 1 328.2 132.15 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 359.53 132.15 Tm (2)Tj ET /F1 12 Tf BT 1 0 0 1 390.86 132.15 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 422.18 132.15 Tm (3)Tj ET /F1 12 Tf BT 1 0 0 1 453.53 132.15 Tm (2)Tj ET /F1 12 Tf BT 1 0 0 1 484.86 132.15 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 516.18 132.15 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 547.53 132.15 Tm (9)Tj ET 0.95294 0.95294 0.95294 RG 17 w 31.2 113.64 m 565.9 113.64 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 104.01 m 568.1 104.01 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 105.09 m 30.07 34.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 105.09 m 567.02 34.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 123.26 m 568.1 123.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 104.01 m 568.1 104.01 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 35.8 m 568.1 35.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 124.34 m 30.07 102.93 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 124.34 m 567.02 102.93 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 35.5 110.07 Tm (Brief description of the )Tj ET /F1 12 Tf BT 1 0 0 1 177.31 110.07 Tm (care home)Tj ET /F1 12 Tf BT 1 0 0 1 35.5 90.82 Tm (This is a purpose built two storey home situated in the village of Leigh Sinton, near )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 73.82 Tm (Malvern. It provides nursing care on a permanent and respite basis for up to 46 older )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 56.83 Tm (adults who have dementia and may also have some physical disabilities. All bedrooms )Tj ET endstream endobj 8 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 9 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (3)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 17 w 31.2 776.72 m 565.9 776.72 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 767.1 m 568.1 767.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 768.18 m 30.07 559.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 768.18 m 567.02 559.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 786.35 m 568.1 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 767.1 m 568.1 767.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 560.85 m 568.1 560.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 766.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 787.43 m 567.02 766.02 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 35.5 773.16 Tm (Brief description of the )Tj ET /F1 12 Tf BT 1 0 0 1 177.31 773.16 Tm (care home)Tj ET /F1 12 Tf BT 1 0 0 1 33.25 756.16 Tm (are single occupancy and have ensuite facilities. There is a choice of well furnished )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 739.16 Tm (seating areas. Bathing facilities are available on each floor offering a choice of a bath )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 722.16 Tm (or shower. Aids and adaptations are available so that people requiring assistance can )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 705.16 Tm (receive it safely. There is a passenger lift so that people can access all parts of the )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 688.16 Tm (home and there is a secure garden to the rear of the premises that is accessible to )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 671.16 Tm (people with limited mobility. At the front of the building is a car park providing off road )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 654.16 Tm (parking for staff and visitors. The home has a no smoking policy. There is a bus route )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 637.16 Tm (to Leigh Sinton and the home is within walking distance of the local shops. In the )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 620.16 Tm (reception area there is a range of information for people living in the home and their )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 603.16 Tm (visitors to access about the home . A copy of the inspection report should now be )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 586.16 Tm (added to that information.The home has a range of fees and the manager should be )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 569.16 Tm (contacted for up to date information about what these are. )Tj ET endstream endobj 10 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 11 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (4)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 745.27 Tm (What we found:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 691.53 w 31.2 389.44 m 580.26 389.44 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 736.33 m 582.46 736.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.55 m 582.46 42.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 737.41 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 737.41 m 581.38 41.47 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 720.15 Tm (The reason for this inspection was to check the homes compliance with the requirements )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 705.57 Tm (made under Regulations 12, 13\(2\), 15, 18, 26 and 37, of the Care Homes Regulations )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 690.98 Tm (2001 at the key inspection which took place over a three day period on the 10th )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 676.41 Tm (September 2009, and the outcome is as follows:)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 661.83 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 647.24 Tm (The visit to the home was undertaken over a period of one day when there were 28 )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 632.66 Tm (people living there, two of these people were in hospital. The home did not know that we )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 618.09 Tm (were visiting on that day. We looked at care files for three people living in the home, )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 603.51 Tm (spoke with staff, relatives who were visiting the home, completed a partial tour of the )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 588.92 Tm (building and observed staff performing their duties. We also reviewed the medication )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 574.34 Tm (system, saw staffing rotas and staff training matrix and some other records about the )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 559.77 Tm (running of the home. The acting manager and project manager were present at the )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 545.18 Tm (home.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 530.6 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 516.03 Tm (Management and staff assisted us to complete our inspection and we were made to feel )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 501.45 Tm (welcome.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 486.86 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 472.29 Tm (Choice of Home.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 457.7 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 443.13 Tm (We were told that there have been no new admissions into the home since we last )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 428.55 Tm (inspected.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 413.96 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 399.39 Tm (Health and Personal Care)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 384.8 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 370.23 Tm (We looked at the care files for three people who live at the home and it was positive to )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 355.64 Tm (see that improvements had been made in relation to care plans. The care plans that we )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 341.07 Tm (saw were now written in the 'first person' as a reminder to staff that people and or their )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 326.48 Tm (representatives should be encouraged to be part of the care planning process. The care )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 311.9 Tm (plans provided staff with sufficient information about how they should assist people to )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 297.33 Tm (meet their individual needs in a way that they prefer. We found specific instructions in )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 282.74 Tm (one care plan for staff to follow and be mindful of when assisting the person with their )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 268.17 Tm (personal care and recognising when a person is resistant to care. For example, 'Resistant )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 253.59 Tm (to assistance, explain clearly all your planned actions and using short sentences. To do as )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 239.01 Tm (much as I can myself to encourage independence. Space to calm down if I become )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 224.43 Tm (aggressive or agitated whilst washing and dressing. Choice of clothing'.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 209.85 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 195.26 Tm (One are that continues to need some improvement is to make sure all staff are recording )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 180.68 Tm (in the separate records available when a person is assisted with their personal care tasks, )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 166.1 Tm (such as, washing, bathing and or showering. We spoke with two members of staff about )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 151.52 Tm (the importance of staff recording in this area and it was recognised that some staff are )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 136.95 Tm (forgetting to record these tasks at times. From our observations no individuals looked )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 122.36 Tm (unkempt and or unclean so we could not clearly state there are poor outcomes in this )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 107.79 Tm (area for people. However, we shall continue to monitor staff recordings and observations )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 93.21 Tm (of how people are supported and assisted with their personal care tasks as part of our )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 78.63 Tm (regulatory activity,)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 64.04 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 49.47 Tm (There were some good details recorded about how staff could assist people to maintain )Tj ET endstream endobj 12 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 13 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (5)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 741.55 w 31.2 414.45 m 580.26 414.45 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.55 m 582.46 42.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 41.47 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (their independence. One care record referred to someone needing to wear comfortable )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (shoes and environment to be clutter free. We observed this person wearing appropriate )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (foot wear and enjoying their conversations' with staff. Individual risk assessments had )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (been written on the care records we sampled and these identified where people were at )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (risk from falls, moving and handling guidance, nutrition, bowel and urinary incontinence.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (We shall be continuing to monitor people's risk assessments and the review of care plans )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (as part of our regulatory activity, but we consider that the requirements under Regulation )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (15 have been met.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (It was positive to see that in the care plans we sampled we found that staff are )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (identifying individuals short term needs and risks to their health and wellbeing. In one )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (care record we saw that the person had a pressure ulcer. Staff should be commended for )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (their work in drawing up this care plan as it provides staff with precise guidance in )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (dressing the pressure ulcer. For example we saw, signs to observe for any infection, )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm (maintaining a nutritious diet and encouraging the person to change position in bed to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm (alleviate their pressure area. It was also noted that a referral had been made to a Tissue )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (Viability Nurse \(TVN\) suggesting a proactive approach to pressure ulcer treatment. We )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (found that staff had fully complied with the instructions for treatment supplied by the TVN )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm (apart from one occasion when the dressing had not been changed for a period of eight )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm (days from the 17th November until the 25th November 2009. When it was changed it )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (was noted, 'Area red swab taken and sent'. We were told that it must have been changed )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (but we could not find any recordings that would confirm this. Also there were some )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (occasions when wound sizes had not been recorded, these shortfalls need addressing. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (Staff recordings will require monitoring to ensure that all are of an acceptable standard.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm (We established with staff that we spoke to, which people who lived in the home had been )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (identified as losing weight. It was positive that staff spoken with about this subject area )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm (were able to tell us the names of people who were experiencing weight loss. We looked at )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 352.6 Tm (the daily recordings for these people and established that there is not a consistent in the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm (methods used to adequately report what individuals have eaten and or drank during the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm (day. For example, we saw documented for one person, 22.11.09 quarter of pudding and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm (100ml drink. 23.11.09 2 biscuits, 4 drinks but does not show volume. 24.11.09 1 )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 294.27 Tm (breakfast, 3 drinks and 200ml. 3 biscuits. All main meal. Half of pudding. 25.11.09 All )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 279.7 Tm (main meal. 6 drinks but does not show volume. 3 biscuits. This is one example but )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 265.11 Tm (highlights others that we saw and reflects that staff are being inconsistent in their )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 250.54 Tm (recording methods in relation to individual's food and fluid intake. We also spoke with )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 235.96 Tm (some staff about appropriately recording meals and fluids. One member of staff said that )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 221.38 Tm (they had not received any nutrition training but the acting manager showed us this staff )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 206.79 Tm (members training certificate in this subject area. Therefore staff competencies' must be )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 192.21 Tm (monitored and reviewed accordingly so that dietary recordings for all people are )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 177.63 Tm (completed using robust methods so that individual's health and wellbeing are not placed )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 163.05 Tm (at risk.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 148.48 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 133.9 Tm (We found that one care plan that we looked at in relation to supporting a persons anxiety )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 119.32 Tm (had been reviewed since we last inspected the home. It was positive to see that it now )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 104.74 Tm (stated, 'Encourage and participate appropriately diversion activities with or without )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 90.15 Tm (activity coordinator. Observe to establish if there are any triggers that activate anxiety'. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 75.57 Tm (Staff using diversion activities with people who required support with their behaviour was )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 60.99 Tm (not being put into practice when we last inspected the home. Therefore this shows that )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 46.42 Tm (staff are being supported to move in the direction in identifying likely triggers to the type )Tj ET endstream endobj 14 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 15 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (6)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 741.55 w 31.2 414.45 m 580.26 414.45 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.55 m 582.46 42.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 41.47 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (of behaviour individuals may potentially display and what staff should do to diffuse the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (situation.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (We spoke with some staff about the likes and dislikes of people who live in the home and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (how staff support individuals who have some behaviour difficulties. Staff showed they )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (had some knowledge of what to do in practice but we also recognised that staff would )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (value some further training in dementia to help them in their roles. We were told by the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (activity coordinator on the ground floor that she still has not received any training in )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (dementia. However, the acting manager told us that she has put the activity coordinators )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (on dementia training twice but they did not attend. The acting manager said that it is )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (their intention that all staff have dementia training including the housekeepers. We did )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (look at the training matrix which should have a clear date of when this was devised for )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (monitoring and reviewing purposes so that staff training is planned effectively. Seven )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (people have had dementia awareness training in 2008.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm (We shall be continuing to monitor staff members knowledge and skills in relation to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm (meeting and understanding individuals needs but we consider that the requirements )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (under Regulation 12 have been met.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm (Medications.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (The pharmacist inspector checked the management and control of medicines within the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (service. We looked at medicine storage, some care records and medicine administration )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (records. We spoke to staff and the acting manager.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm (Medicine procedures for the control and handling of medication were not immediately )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm (available. We were informed by a member of staff that the policy was kept in the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (downstairs office and not in either of the two medicine storage rooms. This means that )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm (staff did not have quick access to medicine procedures to ensure medication was handled )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 352.6 Tm (safely.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm (We saw that medicine was stored in two locked and dedicated medicine storage rooms, )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm (which included a sink and worktops. We saw one room upstairs and one room downstairs. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 294.27 Tm (All medication seen was secure and locked, which means that medicine is safe.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 279.7 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 265.11 Tm (The temperature of all medication storage was checked and recorded daily. We saw )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 250.54 Tm (records for the temperatures for the two refrigerators and the two locked medicine )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 235.96 Tm (storage rooms were within the recommended safe storage temperature ranges for )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 221.38 Tm (medication.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 206.79 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 192.21 Tm (We saw that some medication was not stored correctly. For example, we saw in the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 177.63 Tm (upstairs medication trolley a prescribed ointment, which was to be used externally, was )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 163.05 Tm (stored on the same shelf as medication to be taken by mouth and also next to an insulin )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 148.48 Tm (vial. This means that there was an increased risk of contamination between medication )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 133.9 Tm (for external use and medication to be taken by mouth.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 119.32 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 104.74 Tm (We found it difficult to easily locate people's medication in the medicine trolleys. We )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 90.15 Tm (found that medication provided by the pharmacy in individual named blister packs were )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 75.57 Tm (easy to locate, however we found it more difficult to locate medication that was available )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 60.99 Tm (in boxes or bottles. We found these on shelves in the door of both trolleys but it took )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 46.42 Tm (some time to find a person's named medication. For example, we found that one person )Tj ET endstream endobj 16 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 17 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (7)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 741.55 w 31.2 414.45 m 580.26 414.45 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.55 m 582.46 42.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 41.47 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (had two opened boxes of the same tablet and was located in two different doors of the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (trolley. We also found medication for the same person located on different shelves in the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (medicine trolley. This means that due to a lack of organisation within the medicine )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (trolleys there was an increased risk of a medication error.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (We found a lack of stock control and rotation of medication. For example, we saw that )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (there were four boxes of the same medication for an identified person stored in a )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (cupboard. The medication was prescribed for Parkinson's Disease. We saw that one box )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (was dated 9th September 2009, two boxes were dated 13th October 2009 and one box )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (was dated 9th November 2009. We also found two open boxes of the medication in the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (medicine trolley dated 9th November 2009. Both of these boxes had been opened with )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (tablets removed, however there was no date of opening recorded on one of the boxes. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (There was a lack of stock rotation and control of people's medication. This means that it )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (was not possible to accurately check the amount of medication that had been given to the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (person and there was an increased risk of a medication error.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm (Controlled drug medication, which requires special storage, was stored according to legal )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (requirements. We saw that the medication cabinet available for storing these medicines )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (met the requirements of the Misuse of Drugs Act 1971, the Misuse of Drugs \(Safe )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm (Custody\) Regulations 1973. We looked at the medication records and found that they )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm (were accurate. This means that there were safe arrangements in the home to meet legal )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (requirements and ensure secure storage of people's medication.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (Medication administration records \(MAR\) were not always documented with a signature )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (for administration or an appropriate code documented with a reason why the medication )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm (was not given. For example, we looked at the MAR charts for an identified person and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm (found gaps where there were no signatures for administration of one prescribed medicine )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (for Parkinson's Disease. The medication was prescribed to be given six times a day. We )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm (saw that there was no record of the medication being given at 7.30pm on 16th, 20th and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 352.6 Tm (24th November 2009. We checked the amount of tablets available in the home in order to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm (determine whether medication had been given as prescribed. We found that the amount )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm (of tablets that had been removed from the container did not match with the record of )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm (receipt or the medication records for administration. We asked the unit manager what )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 294.27 Tm (system was in place to ensure the person was given their medication six times a day. We )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 279.7 Tm (were told that staff would hand over to the next person and they would know to give the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 265.11 Tm (medication. We asked what audits and checks were made to ensure that medication was )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 250.54 Tm (given. We were told that there were no audits and we were not shown any audits. This )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 235.96 Tm (means that due to poor records it was not clear if the person had been given their )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 221.38 Tm (medicines as prescribed, which means that their Parkinson's Disease could become )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 206.79 Tm (worse.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 192.21 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 177.63 Tm (Medication was not always given to the person as prescribed and records were not )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 163.05 Tm (correct. For example, we looked at a blister pack, which was supplied by the pharmacy, )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 148.48 Tm (for an identified person. The medication was prescribed for Parkinson's Disease and was )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 133.9 Tm (to be given two tablets three times a day. We saw that two tablets were still in the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 119.32 Tm (container for Wednesday 18th November 2009.We looked at the MAR chart and saw that )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 104.74 Tm (there was a signature for administration documented on the 18th November 2009. We )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 90.15 Tm (showed this to the Unit Manager who was unable to explain why this had happened. We )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 75.57 Tm (looked at the person's daily notes and found that the person had falls recorded and their )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 60.99 Tm (mobility was very poor due to their Parkinson's Disease. It was therefore a concern that )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 46.42 Tm (the person had not been given their prescribed medication for Parkinson's Disease but )Tj ET endstream endobj 18 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 19 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (8)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 741.55 w 31.2 414.45 m 580.26 414.45 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.55 m 582.46 42.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 41.47 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (the records documented that it had been given. This means that the person's Parkinson's )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (Disease was not treated according to a doctors instructions.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (Prescribed medication was not available to administer according to the directions of a )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (doctor. For example, we saw a MAR chart for an identified person for a capsule to be )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (given once a day to reduce acid in the stomach. We saw that the MAR chart had been )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (documented with a code 'os' from 10th November 2009 to 13th November 2009. A total )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (of four days had been recorded as 'os'. The code 'os' was defined on the MAR chart as )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm ('out of stock'. We were informed by the unit manager that this can happen because it )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (takes time to fax the order through to the surgery and then get the medication from the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (pharmacy. We were told that all trained staff should know how to order medication. We )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (were shown some printed notes, which were not dated, that informed staff to order )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (medication. We were told that nobody had informed a doctor that the person was without )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (their prescribed medication. This means that due to the person not being given their )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (medication they were at risk of increased acid in the stomach and therefore at risk of )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm (harm.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (Information relating to medication to be given 'when required' was not always available. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (For example, we looked at two care plans for people who were prescribed medication )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm (used to treat anxiety and agitation when required. The tablet can cause drowsiness and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm (sedation. The first care plan we looked at included a detailed and informative protocol )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (which informed staff what calming measures should be used to help the person before )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (administering a tablet. The tablet was prescribed as take one or two up to four times a )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (day. The protocol also informed staff under what circumstances the tablet should be )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (given. This means that there were clear written directions for nursing staff to follow. The )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm (second care plan we looked at did not include a protocol for the administration of the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm ('when required' tablets. The tablet was prescribed as one to be taken when required up to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (twice a day. We looked at the MAR chart for the person and saw that the tablet was being )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm (given frequently and in particular during the morning. We also saw the person was not )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 352.6 Tm (always given their other medicines because they were sleepy. We looked at the daily )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm (notes and saw that there was a pattern of the person sleeping in the morning. An entry )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm (dated 2nd November stated 'slept in this morning on waking lots of calling out and quite )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm (unsettled. 2mg diazepam administered as prescribed'. We were concerned that )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 294.27 Tm (medication was being given to sedate the person with no agreed protocol available. We )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 279.7 Tm (spoke to the acting manager who informed us that they had asked for a doctor to review )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 265.11 Tm (the person and their medication. This was not documented in the persons care plan. This )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 250.54 Tm (means that due to a lack of protocols with regard to when required medication people )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 235.96 Tm (were at increased risk of harm.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 221.38 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 206.79 Tm (When we arrived for the inspection we saw that staff were receiving training from a )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 192.21 Tm (pharmacist on the safe handling of medicines. This means that medication was being )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 177.63 Tm (given to people by nursing staff that were kept up to date with good practice in medicine )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 163.05 Tm (management.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 148.48 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 133.9 Tm (Requirement 13\(2\) made at the last inspection has not been met and therefore this )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 119.32 Tm (service has now been referred to the Regional Enforcement Team to consider what )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 104.74 Tm (further action may be undertaken.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 90.15 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 75.57 Tm (Environment)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 60.99 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 46.42 Tm (At the key inspection on the 10th September 2009 we found that two free standing fans )Tj ET endstream endobj 20 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 21 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (9)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 741.55 w 31.2 414.45 m 580.26 414.45 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.55 m 582.46 42.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 41.47 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (were situated, one on each floor of the home, in the corridor area which were potentially )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (hazardous to individuals who wandered around the home unsupervised. We found that )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (these fans were not in operation on this random inspection and the acting manager )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (confirmed that they were no longer in use at the home.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (We consider Regulation 13 has been met in relation to the hazards of free standing fans )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (in relation to protecting people's safety within the home.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (Staffing)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (During our visit we spent some time sitting in the lounge/dining area on the ground floor )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (and sitting by the lounge and dining areas on the first floor. We observed staff practices )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (and found there was more engagement in terms of staff conversing with people who live )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (in the home. There was a less chaotic and rushed atmosphere and we did not see )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (individuals left unsupervised which ensures the safety of the people living in the home. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm (We observed staff taking people from the lounge, to the toilet and then to the dining )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm (table whilst conversing with people. This meant that people were being told what was )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (happening and where they were going. We also saw staff telling people what is on offer )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (for lunch and lunchtime was at 12:50 am.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm (All of the staff spoken to were able to tell us about individual people and knew what their )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (needs, likes and dislikes were. As stated previously in this report staff must now )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (remember to complete all of their recordings to mirror the assistance and support they )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (provide to people who live in the home. These recordings are important to assist with the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (monitoring and reviewing of individuals needs ensuring that any difficulties are 'picked )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm (up' in a timely manner and any external professional guidance is sought.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (We were told that staff levels have improved since we last inspected the home and all )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm (shifts are covered appropriately. On occasions there is sickness but we were told that if )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 352.6 Tm (this happens shifts are covered so that there is always six care assistants on duty )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm (together with two nursing staff on the early shifts. We were advised by the acting )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm (manager that bank and agency staff together with staff from the providers other homes )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm (when the necessity arises.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 294.27 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 279.7 Tm (We shall be continuing to monitor staffing levels at the home as part of our regulatory )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 265.11 Tm (activity, but we consider that the requirements under Regulation 18 have been met. Staff )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 250.54 Tm (training is now being proactively booked so that any identified areas of gaps where staff )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 235.96 Tm (require training are being sought. We saw on the notice board that POVA training was )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 221.38 Tm (booked for the 17th November 2009 and challenging behaviour was booked for the 2nd )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 206.79 Tm (December 2009. It also stated, 'staff must make every effort to attend'. Staff have )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 192.21 Tm (appropriately received food hygiene training and manual handling training was noted on )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 177.63 Tm (the notice board and training matrix. This practice should make certain that staff have )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 163.05 Tm (received the appropriate training to ensure that they have the knowledge and skills to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 148.48 Tm (meet the individual and collective needs of people living at the home.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 133.9 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 119.32 Tm (We shall be continuing to monitor staff training in relation to food hygiene and manual )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 104.74 Tm (handling as part of our regulatory activity, but we consider that the requirements under )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 90.15 Tm (Regulation 13 in relation to training have been met.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 75.57 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 60.99 Tm (Management and Administration.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 46.42 Tm ()Tj ET endstream endobj 22 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 23 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (10)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 536.06 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 554.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 250.86 w 31.2 659.79 m 580.26 659.79 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 533.24 m 582.46 533.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 532.16 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 532.16 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (From our findings we note that action has been taken in some areas since our last key )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (inspection and this has been briefly highlighted in this random report.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (We were shown records that reflected that the project manager has been completing )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (Regulation 26 visits since we last inspected the home. This contains more detail than )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (some of the previous reports that we have seen about the quality of service being )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (provided.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (We are now receiving notifications \(Regulation 37\) about any incidents that may affect )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (the wellbeing of people who live in the home. We were told by staff who we spoke with )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (that there have been no incidents where individuals have left the home unescorted since )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (we last inspected the home. The acting manager also told us that they are educating staff )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (in relation to completing Regulation 37 notifications and this work is ongoing.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (We shall be continuing to monitor these reports as part of our regulatory activity, but we )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm (consider that the requirements under Regulation 26 and 37 have been met.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm ()Tj ET /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 515.17 Tm (What the care home)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 175.95 515.17 Tm (does well:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 355.92 w 31.2 326.02 m 580.26 326.02 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 505.11 m 582.46 505.11 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 146.93 m 582.46 146.93 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 506.18 m 30.07 145.86 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 506.18 m 581.38 145.86 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 488.92 Tm (The focus of the inspection was to check if requirements had been met. Therefore, we did )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 474.34 Tm (not look at many aspects of the service and may not, therefore, have identified some )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 459.76 Tm (positive things about the home. The next key inspection will provide us with the chance )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 445.18 Tm (to look at the broader picture of the service at the home and what it is like for the people )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 430.6 Tm (who live there. However, we did note the following improvements:-)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 416.02 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 401.44 Tm (Staff we spoke with told us that there are now reading care plans so that they are )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 386.86 Tm (implemented as working documents to guide all staff so that the overall care delivery can )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 372.28 Tm (be improved to make sure all of peoples needs are met.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 357.7 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 343.12 Tm (Some brief observations of lunch time highlighted that it was less chaotic and a much )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 328.54 Tm (more relaxed informal experience.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 313.96 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 299.38 Tm (We noticed that people who live in the home were using a newly created sensory room )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 284.8 Tm (which they seemed to be enjoying.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 270.22 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 255.64 Tm (There is also an increase in appropriate picture and photographs now displayed on the )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 241.06 Tm (walls. Some of the photographs displayed are of people who live in the home enjoying )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 226.48 Tm (activities. We also found that a notice board has been placed on the wall on the first floor )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 211.9 Tm (which is now used for information notices for people to read as they choose.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 197.32 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 182.74 Tm (We also saw a note from the acting manager which confirmed that she has an 'open door' )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 168.16 Tm (policy and is the acting manager. At the previous inspection staff and relatives told us )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 153.58 Tm (that they were uncertain who was managing the home.)Tj ET /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 126.61 Tm (What they could do better:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 74 w 31.2 79.55 m 580.26 79.55 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 117.68 m 582.46 117.68 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 41.42 m 582.46 41.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 118.75 m 30.07 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 118.75 m 581.38 40.35 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 101.49 Tm (When a person is admitted into hospital a reassessment must be done by the manager )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 86.91 Tm (and or staff who have the designated responsibility to do this. This will make certain that )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 72.33 Tm (the home is able to meet the individual's needs if and when they are discharged from )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 57.75 Tm (hospital.)Tj ET endstream endobj 24 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 25 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (11)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 536.06 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 554.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 557.04 w 31.2 506.7 m 580.26 506.7 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 227.06 m 582.46 227.06 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 225.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 225.98 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (When staff are assisting people with their personal care tasks they must remember to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (record these so that we can be confident that people are receiving the support and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (assistance required to maintain their personal hygiene needs in the way they prefer.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (It is important that when a person is identified as losing weight and or nutritionally )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (compromised due to a medical/health needs then staff practices must be improved in the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (area of recording each person's nutritional intake in a precise and adequate manner. This )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (will make certain that individuals are not left at risk from their health and or wellbeing )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (deteriorating due to inappropriate monitoring and reviewing tools.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (Staff must be trained in meeting individuals nutritional needs and staff practices must be )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (monitored and reviewed to show any deficits in staff competencies in this area where )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (further knowledge may be required. This will ensure that individuals are receiving the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (care and support they need in relation to meeting their nutritional needs so therefore )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm (remaining healthy and well.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (Staff recordings must reflect what is happening in practice specifically in the area of staff )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (practices when attending to individuals pressure areas. This will demonstrate that people )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm (are receiving the care that is required to meet their health needs and act as a )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm (monitoring/reviewing tool to promote individuals healiing processes.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (Staff competencies in the area of administering medication must be assessed, monitored )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (and reviewed on a regular basis by the manager or the person who is designated to be )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (responsible for this. This will make certain that people are protected by robust medication )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm (processes.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (There must be regular auditing of medications by the manager or the person who is )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm (designated to be responsible for this. This practice will highlight any medication )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 352.6 Tm (discrepancies, errors and or oversights to make sure that people are protected from )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm (harm.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm (All staff must have received dementia training and for staff competencies in this subject )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 294.27 Tm (matter to be regularly assessed to ensure that people are in 'safe hands' at all times.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 279.7 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 265.11 Tm (Please see the report of the key inspection of 10th Septmber 2009 for other information )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 250.54 Tm (about areas where the home need to make improvements.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 235.96 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 211 Tm (If you want to know what action the person responsible for this care home)Tj ET /F1 12 Tf BT 1 0 0 1 483.55 211 Tm (is taking )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 195 Tm (following this report, you can contact them using the details set out on page 2.)Tj ET endstream endobj 27 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 29 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (12)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 536.06 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 554.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 36.25 w 29.47 752.7 m 564.97 752.7 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 26.14 753.83 m 568.3 753.83 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 773.08 m 568.3 773.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 753.83 m 568.3 753.83 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 734.58 m 568.3 734.58 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.22 774.15 m 27.22 733.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 423.22 754.9 m 423.22 733.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 468.22 754.9 m 468.22 733.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 495.22 754.9 m 495.22 733.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 540.22 754.9 m 540.22 733.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 774.15 m 567.22 733.5 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 33.75 759.89 Tm (Are there any outstanding requirements from the last inspection?)Tj ET /F1 12 Tf BT 1 0 0 1 429.75 740.64 Tm (Yes)Tj ET /F2 12 Tf BT 1 0 0 1 476.37 742.58 Tm (5)Tj ET /F1 12 Tf BT 1 0 0 1 501.75 740.64 Tm (No)Tj ET /F2 12 Tf BT 1 0 0 1 546.75 742.58 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 635.4 w 32.32 361.38 m 564.97 361.38 l S 0.001 w 1 1 1 RG 242.28 w 31.2 455.08 m 91.05 455.08 l S 0.001 w 242.28 w 93.3 455.08 m 197.4 455.08 l S 0.001 w 242.28 w 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577.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 578.42 m 92.17 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 578.42 m 198.52 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 578.42 m 290.57 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 578.42 m 474.92 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 681.33 m 568.4 681.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 609.9 m 568.4 609.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 577.34 m 568.4 577.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 332.82 m 568.3 332.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 190.35 m 568.3 190.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 41.42 m 568.3 41.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 682.4 m 30.07 576.27 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 610.97 m 92.12 576.27 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 610.97 m 198.52 576.27 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 610.97 m 290.62 576.27 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 610.97 m 475.02 576.27 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 682.4 m 567.32 576.27 l S 0.001 w [] 0 d /F1 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 664.12 Tm (Outstanding statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 34.05 645.7 Tm (These are requirements that were set at the previous inspection, but have still not )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 631.12 Tm (been met.)Tj ET /F1 12 Tf BT 1 0 0 1 95.57 631.12 Tm ( )Tj ET /F1 12 Tf BT 1 0 0 1 104.02 631.12 Tm (They say what the registered person had to do to meet the Care Standards )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 616.54 Tm (Act 2000, )Tj ET /F1 12 Tf BT 1 0 0 1 96.58 616.54 Tm ( Regulations 2001 and the National Minimum Standards.)Tj ET /F1 10 Tf BT 1 0 0 1 31.2 598.72 Tm (No.)Tj ET /F1 10 Tf BT 1 0 0 1 96.1 595.72 Tm (Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.5 595.72 Tm (Regulation)Tj ET /F1 10 Tf BT 1 0 0 1 294.6 595.72 Tm (Requirement)Tj ET /F1 10 Tf BT 1 0 0 1 479 595.72 Tm (Timescale for )Tj ET /F1 10 Tf BT 1 0 0 1 479 583.57 Tm (action)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 561.16 Tm (1)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 561.16 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 561.16 Tm (13)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 561.16 Tm (Appropriate information )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 546.58 Tm (relating to medication must )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 532 Tm (be kept, for example, in risk )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 517.42 Tm (assessments and care plans )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 502.84 Tm (to ensure that staff know )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 488.26 Tm (how to use and monitor all )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 473.68 Tm (medication including 'when )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 459.1 Tm (required', as directed and )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 444.52 Tm (self administered )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 429.94 Tm (medications.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 412.36 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 397.78 Tm (This will make certain that all )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 383.2 Tm (medication is administered )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 368.62 Tm (safely, correctly and as )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 354.04 Tm (intended by the prescriber to )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 339.46 Tm (meet individual health needs.)Tj ET /F1 12 Tf BT 1 0 0 1 478.9 561.16 Tm (26/11/2009)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 316.63 Tm (2)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 316.63 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 316.63 Tm (13)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 316.63 Tm (The quantity of any balances )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 302.05 Tm (carried over from the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 287.47 Tm (previous cycles must be )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 272.89 Tm (recorded.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 255.31 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 240.73 Tm (This will enable audits to )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 226.15 Tm (take place to demonstrate )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 211.57 Tm (the medicines are )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 196.99 Tm (administered as prescribed. )Tj ET /F1 12 Tf BT 1 0 0 1 478.9 316.63 Tm (26/11/2009)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 174.16 Tm (3)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 174.16 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 174.16 Tm (13)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 174.16 Tm (The medicine chart must )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 159.58 Tm (record the current drug )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 145 Tm (regime as prescribed by the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 130.42 Tm (clinician. It must be referred )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 115.84 Tm (to before the preparation of )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 101.26 Tm (the residents medicines and )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 86.68 Tm (be signed directly after the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 72.1 Tm (transaction and accurately )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 57.52 Tm (record what has occurred as )Tj ET /F1 12 Tf BT 1 0 0 1 478.9 174.16 Tm (26/11/2009)Tj ET endstream endobj 30 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 31 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (13)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 536.06 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 554.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 739.3 w 32.32 414.45 m 564.97 414.45 l S 0.001 w 1 1 1 RG 154.8 w 31.2 603.84 m 91.05 603.84 l S 0.001 w 154.8 w 93.3 603.84 m 197.4 603.84 l S 0.001 w 154.8 w 199.65 603.84 m 289.45 603.84 l S 0.001 w 154.8 w 291.7 603.84 m 473.8 603.84 l S 0.001 w 154.8 w 476.05 603.84 m 566.1 603.84 l S 0.001 w 286.02 w 31.2 381.18 m 91.05 381.18 l S 0.001 w 286.02 w 93.3 381.18 m 197.4 381.18 l S 0.001 w 286.02 w 199.65 381.18 m 289.45 381.18 l S 0.001 w 286.02 w 291.7 381.18 m 473.8 381.18 l S 0.001 w 286.02 w 476.05 381.18 m 566.1 381.18 l S 0.001 w 192.25 w 31.2 139.8 m 91.05 139.8 l S 0.001 w 192.25 w 93.3 139.8 m 197.4 139.8 l S 0.001 w 192.25 w 199.65 139.8 m 289.45 139.8 l S 0.001 w 192.25 w 291.7 139.8 m 473.8 139.8 l S 0.001 w 192.25 w 476.05 139.8 m 566.1 139.8 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 525.32 m 568.3 525.32 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 237.05 m 568.3 237.05 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 683.45 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 683.45 m 567.22 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 714.92 m 568.4 714.92 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 682.37 m 568.3 682.37 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 683.45 m 92.17 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 683.45 m 198.52 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 683.45 m 290.57 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 683.45 m 474.92 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 786.35 m 568.4 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 714.92 m 568.4 714.92 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 682.37 m 568.4 682.37 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 525.32 m 568.3 525.32 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 237.05 m 568.3 237.05 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.55 m 568.3 42.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 681.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 716 m 92.12 681.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 716 m 198.52 681.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 716 m 290.62 681.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 716 m 475.02 681.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 787.43 m 567.32 681.29 l S 0.001 w [] 0 d /F1 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 769.15 Tm (Outstanding statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 34.05 750.72 Tm (These are requirements that were set at the previous inspection, but have still not )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 736.15 Tm (been met.)Tj ET /F1 12 Tf BT 1 0 0 1 95.57 736.15 Tm ( )Tj ET /F1 12 Tf BT 1 0 0 1 104.02 736.15 Tm (They say what the registered person had to do to meet the Care Standards )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 721.57 Tm (Act 2000, )Tj ET /F1 12 Tf BT 1 0 0 1 96.58 721.57 Tm ( Regulations 2001 and the National Minimum Standards.)Tj ET /F1 10 Tf BT 1 0 0 1 31.2 703.74 Tm (No.)Tj ET /F1 10 Tf BT 1 0 0 1 96.1 700.74 Tm (Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.5 700.74 Tm (Regulation)Tj ET /F1 10 Tf BT 1 0 0 1 294.6 700.74 Tm (Requirement)Tj ET /F1 10 Tf BT 1 0 0 1 479 700.74 Tm (Timescale for )Tj ET /F1 10 Tf BT 1 0 0 1 479 688.59 Tm (action)Tj ET /F1 12 Tf BT 1 0 0 1 292.3 671.43 Tm (some gaps were found on )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 656.85 Tm (the MARS. )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 636.28 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 292.3 621.7 Tm (This is to ensure that the )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 607.11 Tm (right medicine is )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 592.53 Tm (administered to the right )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 577.96 Tm (resident at the right time and )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 563.38 Tm (at the right dose as )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 548.79 Tm (prescribed and records )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 534.22 Tm (reflect practice.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 509.14 Tm (4)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 509.14 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 509.14 Tm (13)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 509.14 Tm (The receipt, administration )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 494.55 Tm (and disposal of controlled )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 479.98 Tm (drugs must be recorded in a )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 465.39 Tm (controlled drugs register. )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 450.82 Tm (This must be referred to )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 436.23 Tm (before the preparation of the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 421.65 Tm (residents medicines and be )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 407.08 Tm (signed directly after the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 392.49 Tm (transaction by two members )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 377.92 Tm (of staff and accurately record )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 363.33 Tm (what has occurred as some )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 348.76 Tm (controlled drugs were )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 334.17 Tm (unaccounted for.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 316.6 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 302.02 Tm (This will make sure that )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 287.43 Tm (individuals are receiving their )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 272.86 Tm (medications as prescribed by )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 258.27 Tm (their clinicians to promote )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 243.7 Tm (their health and wellbeing.)Tj ET /F1 12 Tf BT 1 0 0 1 478.9 509.14 Tm (26/11/2009)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 220.87 Tm (5)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 220.87 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 220.87 Tm (13)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 220.87 Tm (A quality assurance system )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 206.29 Tm (must be installed to assess )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 191.71 Tm (staff competence in their )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 177.13 Tm (handling of medicines. )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 162.54 Tm (Appropriate action must be )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 147.96 Tm (taken when these indicate )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 133.38 Tm (that medicines are not )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 118.81 Tm (administered as prescribe )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 104.22 Tm (and records do not reflect )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 89.64 Tm (practice.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 72.07 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 57.49 Tm (This is to ensure that all )Tj ET /F1 12 Tf BT 1 0 0 1 478.9 220.87 Tm (26/11/2009)Tj ET endstream endobj 32 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 33 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (14)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 536.06 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 554.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 320.1 w 32.32 624.05 m 564.97 624.05 l S 0.001 w 1 1 1 RG 46.74 w 31.2 657.88 m 91.05 657.88 l S 0.001 w 46.74 w 93.3 657.88 m 197.4 657.88 l S 0.001 w 46.74 w 199.65 657.88 m 289.45 657.88 l S 0.001 w 46.74 w 291.7 657.88 m 473.8 657.88 l S 0.001 w 46.74 w 476.05 657.88 m 566.1 657.88 l S 0.001 w 169.38 w 31.2 547.57 m 91.05 547.57 l S 0.001 w 169.38 w 93.3 547.57 m 197.4 547.57 l S 0.001 w 169.38 w 199.65 547.57 m 289.45 547.57 l S 0.001 w 169.38 w 291.7 547.57 m 473.8 547.57 l S 0.001 w 169.38 w 476.05 547.57 m 566.1 547.57 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 633.38 m 568.3 633.38 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 683.45 m 30.07 460.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 683.45 m 567.22 460.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 714.92 m 568.4 714.92 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 682.37 m 568.3 682.37 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 683.45 m 92.17 460.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 683.45 m 198.52 460.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 683.45 m 290.57 460.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 683.45 m 474.92 460.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 786.35 m 568.4 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 714.92 m 568.4 714.92 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 682.37 m 568.4 682.37 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 633.38 m 568.3 633.38 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 461.75 m 568.3 461.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 681.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 716 m 92.12 681.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 716 m 198.52 681.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 716 m 290.62 681.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 716 m 475.02 681.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 787.43 m 567.32 681.29 l S 0.001 w [] 0 d /F1 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 769.15 Tm (Outstanding statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 34.05 750.72 Tm (These are requirements that were set at the previous inspection, but have still not )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 736.15 Tm (been met.)Tj ET /F1 12 Tf BT 1 0 0 1 95.57 736.15 Tm ( )Tj ET /F1 12 Tf BT 1 0 0 1 104.02 736.15 Tm (They say what the registered person had to do to meet the Care Standards )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 721.57 Tm (Act 2000, )Tj ET /F1 12 Tf BT 1 0 0 1 96.58 721.57 Tm ( Regulations 2001 and the National Minimum Standards.)Tj ET /F1 10 Tf BT 1 0 0 1 31.2 703.74 Tm (No.)Tj ET /F1 10 Tf BT 1 0 0 1 96.1 700.74 Tm (Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.5 700.74 Tm (Regulation)Tj ET /F1 10 Tf BT 1 0 0 1 294.6 700.74 Tm (Requirement)Tj ET /F1 10 Tf BT 1 0 0 1 479 700.74 Tm (Timescale for )Tj ET /F1 10 Tf BT 1 0 0 1 479 688.59 Tm (action)Tj ET /F1 12 Tf BT 1 0 0 1 292.3 671.43 Tm (medicines are administered )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 656.85 Tm (as prescribed and this can be )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 642.28 Tm (demonstrated.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 617.2 Tm (6)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 617.2 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 617.2 Tm (13)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 617.2 Tm (Staff who administer )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 602.61 Tm (medication must be )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 588.03 Tm (competent and their practice )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 573.46 Tm (must ensure that residents )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 558.88 Tm (receive their medication )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 544.29 Tm (safely and correctly. )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 526.72 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 512.14 Tm (This will make sure )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 497.55 Tm (individuals receive their )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 482.98 Tm (medications as prescribed by )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 468.39 Tm (their clinicians.)Tj ET /F1 12 Tf BT 1 0 0 1 478.9 617.2 Tm (26/11/2009)Tj ET endstream endobj 34 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 35 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (15)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 536.06 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 554.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 770.27 Tm (Requirements and recommendations from this inspection:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 754.85 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 108.12 w 32.32 692.47 m 564.97 692.47 l S 0.001 w 1 1 1 RG 20.58 w 31.2 649.83 m 91.05 649.83 l S 0.001 w 20.58 w 93.3 649.83 m 197.4 649.83 l S 0.001 w 20.58 w 199.65 649.83 m 289.45 649.83 l S 0.001 w 20.58 w 291.7 649.83 m 473.8 649.83 l S 0.001 w 20.58 w 476.05 649.83 m 566.1 649.83 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 30.07 662.32 m 30.07 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 662.32 m 567.22 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 693.79 m 568.4 693.79 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 661.24 m 568.3 661.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 662.32 m 92.17 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 662.32 m 198.52 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 662.32 m 290.57 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 662.32 m 474.92 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 748.78 m 568.4 748.78 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 693.79 m 568.4 693.79 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 661.24 m 568.4 661.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 638.41 m 568.3 638.41 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 749.86 m 30.07 660.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 694.87 m 92.12 660.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 694.87 m 198.52 660.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 694.87 m 290.62 660.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 694.87 m 475.02 660.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 749.86 m 567.32 660.17 l S 0.001 w [] 0 d /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 732.6 Tm (Immediate requirements:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 34.05 715.02 Tm (These are immediate requirements that were set on the day we visited this care home. )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 700.44 Tm (The registered person had to meet these within 48 hours.)Tj ET /F1 10 Tf BT 1 0 0 1 31.2 682.62 Tm (No.)Tj ET /F1 10 Tf BT 1 0 0 1 96.1 679.62 Tm (Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.5 679.62 Tm (Regulation)Tj ET /F1 10 Tf BT 1 0 0 1 294.6 679.62 Tm (Requirement)Tj ET /F1 10 Tf BT 1 0 0 1 479 679.62 Tm (Timescale for )Tj ET /F1 10 Tf BT 1 0 0 1 479 667.47 Tm (action)Tj ET 0.95294 0.95294 0.95294 RG 556.24 w 32.32 321.8 m 564.97 321.8 l S 0.001 w 1 1 1 RG 300.6 w 31.2 349.2 m 91.05 349.2 l S 0.001 w 300.6 w 93.3 349.2 m 197.4 349.2 l S 0.001 w 300.6 w 199.65 349.2 m 289.45 349.2 l S 0.001 w 300.6 w 291.7 349.2 m 473.8 349.2 l S 0.001 w 300.6 w 476.05 349.2 m 566.1 349.2 l S 0.001 w 154.1 w 31.2 119.6 m 91.05 119.6 l S 0.001 w 154.1 w 93.3 119.6 m 197.4 119.6 l S 0.001 w 154.1 w 199.65 119.6 m 289.45 119.6 l S 0.001 w 154.1 w 291.7 119.6 m 473.8 119.6 l S 0.001 w 154.1 w 476.05 119.6 m 566.1 119.6 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 197.77 m 568.3 197.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 501.7 m 30.07 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 501.7 m 567.22 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 533.17 m 568.4 533.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 500.63 m 568.3 500.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 501.7 m 92.17 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 501.7 m 198.52 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 501.7 m 290.57 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 501.7 m 474.92 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 602.16 m 568.4 602.16 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 533.17 m 568.4 533.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 500.63 m 568.4 500.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 197.77 m 568.3 197.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 41.42 m 568.3 41.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 603.24 m 30.07 499.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 534.25 m 92.12 499.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 534.25 m 198.52 499.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 534.25 m 290.62 499.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 534.25 m 475.02 499.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 603.24 m 567.32 499.55 l S 0.001 w [] 0 d /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 588.98 Tm (Statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 34.05 568.98 Tm (These requirements set out what the registered person must do to meet the Care )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 554.4 Tm (Standards Act 2000, )Tj ET /F1 12 Tf BT 1 0 0 1 166.31 554.4 Tm (Regulations 2001 and the National Minimum Standards. The )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 539.82 Tm (registered person\(s\) must do this within the timescales we have set.)Tj ET /F1 10 Tf BT 1 0 0 1 31.2 522 Tm (No.)Tj ET /F1 10 Tf BT 1 0 0 1 96.1 519 Tm (Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.5 519 Tm (Regulation)Tj ET /F1 10 Tf BT 1 0 0 1 294.6 519 Tm (Requirement)Tj ET /F1 10 Tf BT 1 0 0 1 479 519 Tm (Timescale for )Tj ET /F1 10 Tf BT 1 0 0 1 479 506.85 Tm (action)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 484.44 Tm (1)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 484.44 Tm (3)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 484.44 Tm (12)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 484.44 Tm (When a person is discharged )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 469.86 Tm (from hospital the manager of )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 455.28 Tm (the home and or the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 440.7 Tm (deisgnated person must )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 426.12 Tm (ensure that a reassessment )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 411.54 Tm (of the persons identified )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 396.96 Tm (needs are completed prior to )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 382.38 Tm (them returning to the home. )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 367.8 Tm (This will ensure that staff are )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 353.22 Tm (confident in meeting peoples )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 338.64 Tm (needs so that their health )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 324.06 Tm (and safety is not placed at )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 309.48 Tm (risk.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 294.9 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 277.32 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 262.74 Tm (This will ensure that staff are )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 248.16 Tm (able to meet a persons )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 233.58 Tm (health needs with confidence )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 219 Tm (so that people are not at )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 204.42 Tm (risk.)Tj ET /F1 12 Tf BT 1 0 0 1 478.9 484.44 Tm (27/11/2009)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 181.59 Tm (2)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 181.59 Tm (7)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 181.59 Tm (12)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 181.59 Tm (Staff must clearly record )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 167.01 Tm (individuals nutritional intake )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 152.43 Tm (on a daily basis by )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 137.85 Tm (documenting portions of food )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 123.27 Tm (with quantity eaten and )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 108.69 Tm (volumes of fluids that have )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 94.11 Tm (been drank. This is important )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 79.53 Tm (for people who have been )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 64.95 Tm (identified as losing weight )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 50.37 Tm (and or nutritionally )Tj ET /F1 12 Tf BT 1 0 0 1 478.9 181.59 Tm (27/11/2009)Tj ET endstream endobj 36 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 37 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (16)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 536.06 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 554.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 739.3 w 32.32 414.45 m 564.97 414.45 l S 0.001 w 1 1 1 RG 125.64 w 31.2 620.86 m 91.05 620.86 l S 0.001 w 125.64 w 93.3 620.86 m 197.4 620.86 l S 0.001 w 125.64 w 199.65 620.86 m 289.45 620.86 l S 0.001 w 125.64 w 291.7 620.86 m 473.8 620.86 l S 0.001 w 125.64 w 476.05 620.86 m 566.1 620.86 l S 0.001 w 198.54 w 31.2 456.52 m 91.05 456.52 l S 0.001 w 198.54 w 93.3 456.52 m 197.4 456.52 l S 0.001 w 198.54 w 199.65 456.52 m 289.45 456.52 l S 0.001 w 198.54 w 291.7 456.52 m 473.8 456.52 l S 0.001 w 198.54 w 476.05 456.52 m 566.1 456.52 l S 0.001 w 227.7 w 31.2 241.15 m 91.05 241.15 l S 0.001 w 227.7 w 93.3 241.15 m 197.4 241.15 l S 0.001 w 227.7 w 199.65 241.15 m 289.45 241.15 l S 0.001 w 227.7 w 291.7 241.15 m 473.8 241.15 l S 0.001 w 227.7 w 476.05 241.15 m 566.1 241.15 l S 0.001 w 81.38 w 31.2 84.36 m 91.05 84.36 l S 0.001 w 81.38 w 93.3 84.36 m 197.4 84.36 l S 0.001 w 81.38 w 199.65 84.36 m 289.45 84.36 l S 0.001 w 81.38 w 291.7 84.36 m 473.8 84.36 l S 0.001 w 81.38 w 476.05 84.36 m 566.1 84.36 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 556.92 m 568.3 556.92 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 356.13 m 568.3 356.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 126.18 m 568.3 126.18 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 685.89 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 685.89 m 567.22 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 717.36 m 568.4 717.36 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 684.81 m 568.3 684.81 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 685.89 m 92.17 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 685.89 m 198.52 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 685.89 m 290.57 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 685.89 m 474.92 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 786.35 m 568.4 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 717.36 m 568.4 717.36 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 684.81 m 568.4 684.81 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 556.92 m 568.3 556.92 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 356.13 m 568.3 356.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 126.18 m 568.3 126.18 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.55 m 568.3 42.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 683.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 718.44 m 92.12 683.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 718.44 m 198.52 683.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 718.44 m 290.62 683.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 718.44 m 475.02 683.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 787.43 m 567.32 683.73 l S 0.001 w [] 0 d /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 773.16 Tm (Statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 34.05 753.16 Tm (These requirements set out what the registered person must do to meet the Care )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 738.59 Tm (Standards Act 2000, )Tj ET /F1 12 Tf BT 1 0 0 1 166.31 738.59 Tm (Regulations 2001 and the National Minimum Standards. The )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 724.01 Tm (registered person\(s\) must do this within the timescales we have set.)Tj ET /F1 10 Tf BT 1 0 0 1 31.2 706.18 Tm (No.)Tj ET /F1 10 Tf BT 1 0 0 1 96.1 703.18 Tm (Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.5 703.18 Tm (Regulation)Tj ET /F1 10 Tf BT 1 0 0 1 294.6 703.18 Tm (Requirement)Tj ET /F1 10 Tf BT 1 0 0 1 479 703.18 Tm (Timescale for )Tj ET /F1 10 Tf BT 1 0 0 1 479 691.03 Tm (action)Tj ET /F1 12 Tf BT 1 0 0 1 292.3 673.88 Tm (compromised due to their )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 659.29 Tm (health needs. )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 638.72 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 292.3 624.14 Tm (This will make certain that )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 609.55 Tm (individuals health and )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 594.97 Tm (wellbeing are not placed at )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 580.4 Tm (risk due to being nutritionally )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 565.82 Tm (compromised.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 540.73 Tm (3)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 540.73 Tm (7)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 540.73 Tm (12)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 540.73 Tm (Staff must be able to )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 526.16 Tm (demonstrate they are )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 511.58 Tm (monitoring and )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 496.99 Tm (communicating health )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 482.42 Tm (concerns such as individuals )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 467.83 Tm (pressure areas by recording )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 453.26 Tm (all relevant assessments )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 438.67 Tm (changes in needs and )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 424.1 Tm (decisions made. )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 406.52 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 391.93 Tm (This will ensure that peoples )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 377.36 Tm (heath concerns are managed )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 362.77 Tm (in a timely way.)Tj ET /F1 12 Tf BT 1 0 0 1 478.9 540.73 Tm (27/11/2009)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 339.95 Tm (4)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 339.95 Tm (18)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 339.95 Tm (12)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 339.95 Tm (Staff must show that they )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 325.36 Tm (have received training in )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 310.79 Tm (nutrition and can indicate )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 296.2 Tm (their knowledge around )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 281.63 Tm (nutrition both in practice and )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 267.05 Tm (when asked to reflect staff )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 252.46 Tm (competency in this subject )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 237.88 Tm (matter. )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 220.3 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 205.73 Tm (This will make certain all )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 191.15 Tm (individuals can be confident )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 176.57 Tm (that staff skills and )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 161.99 Tm (knowledge in nutrition is )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 147.4 Tm (promoting their health and )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 132.82 Tm (wellbeing.)Tj ET /F1 12 Tf BT 1 0 0 1 478.9 339.95 Tm (27/11/2009)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 110 Tm (5)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 110 Tm (18)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 110 Tm (12)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 110 Tm (Staff who work with people )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 95.42 Tm (with specialist needs such as )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 80.83 Tm (dementia must have the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 66.25 Tm (appropriate training and be )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 51.67 Tm (able to demonstrate their )Tj ET /F1 12 Tf BT 1 0 0 1 478.9 110 Tm (27/11/2009)Tj ET endstream endobj 38 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 39 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (17)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 536.06 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 554.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 239.51 w 32.32 664.34 m 564.97 664.34 l S 0.001 w 1 1 1 RG 140.22 w 31.2 613.58 m 91.05 613.58 l S 0.001 w 140.22 w 93.3 613.58 m 197.4 613.58 l S 0.001 w 140.22 w 199.65 613.58 m 289.45 613.58 l S 0.001 w 140.22 w 291.7 613.58 m 473.8 613.58 l S 0.001 w 140.22 w 476.05 613.58 m 566.1 613.58 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 30.07 685.89 m 30.07 541.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 685.89 m 567.22 541.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 717.36 m 568.4 717.36 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 684.81 m 568.3 684.81 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 685.89 m 92.17 541.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 685.89 m 198.52 541.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 685.89 m 290.57 541.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 685.89 m 474.92 541.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 786.35 m 568.4 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 717.36 m 568.4 717.36 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 684.81 m 568.4 684.81 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 542.34 m 568.3 542.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 683.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 718.44 m 92.12 683.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 718.44 m 198.52 683.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 718.44 m 290.62 683.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 718.44 m 475.02 683.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 787.43 m 567.32 683.73 l S 0.001 w [] 0 d /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 773.16 Tm (Statutory requirements)Tj ET 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The )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 724.01 Tm (registered person\(s\) must do this within the timescales we have set.)Tj ET /F1 10 Tf BT 1 0 0 1 31.2 706.18 Tm (No.)Tj ET /F1 10 Tf BT 1 0 0 1 96.1 703.18 Tm (Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.5 703.18 Tm (Regulation)Tj ET /F1 10 Tf BT 1 0 0 1 294.6 703.18 Tm (Requirement)Tj ET /F1 10 Tf BT 1 0 0 1 479 703.18 Tm (Timescale for )Tj ET /F1 10 Tf BT 1 0 0 1 479 691.03 Tm (action)Tj ET /F1 12 Tf BT 1 0 0 1 292.3 673.88 Tm (competence both in practice )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 659.29 Tm (and through discussions.)Tj ET /F1 12 Tf BT 1 0 0 1 292.3 638.72 Tm (This will ensure that people )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 624.14 Tm (receive specialist care that is )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 609.55 Tm (based on current good )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 594.97 Tm (practice and reflect relevant )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 580.4 Tm (specialist and clinical )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 565.82 Tm (guidance.)Tj ET 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455.72 m 92.17 433.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.47 455.72 m 198.47 433.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 525.29 m 567.32 433.17 l S 0.001 w [] 0 d /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 508.03 Tm (Recommendations)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 34.05 490.45 Tm (These recommendations are taken from the best practice described in the National )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 475.87 Tm (Minimum Standards and the registered person\(s\) should consider them as a way of )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 461.29 Tm (improving their service.)Tj ET /F1 10 Tf BT 1 0 0 1 34.05 440.47 Tm (No)Tj ET /F1 10 Tf BT 1 0 0 1 96.15 440.47 Tm (Refer to Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.45 440.47 Tm (Good Practice Recommendations)Tj ET endstream endobj 40 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 41 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 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BT 1 0 0 1 234.56 719.2 Tm (Care Quality Commission)Tj ET /F1 12 Tf BT 1 0 0 1 31.2 696.37 Tm (Audience:)Tj ET /F1 12 Tf BT 1 0 0 1 234.56 696.37 Tm (General Public)Tj ET /F1 12 Tf BT 1 0 0 1 31.2 673.54 Tm (Further copies from:)Tj ET /F1 12 Tf BT 1 0 0 1 234.56 673.54 Tm (0870 240 7535)Tj ET /F1 12 Tf BT 1 0 0 1 335.41 673.54 Tm (\(telephone order line\))Tj ET /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 652.59 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 638.01 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 623.42 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 78.9 w 25.8 581.46 m 563.3 581.46 l S 0.001 w /F1 12 Tf BT 1 0 0 1 34.05 605.84 Tm (Our duty to regulate social care services is set out in the Care Standards Act 2000.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 591.27 Tm (Copies of the National Minimum Standards )Tj ET /F1 12 Tf BT 1 0 0 1 303.94 591.27 Tm (Care Homes for Older People can be )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 576.68 Tm (found at www.dh.gov.uk or got from The Stationery Office \(TSO\) PO Box 29, St )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 562.1 Tm (Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 547.53 Tm (the Stationery Office is also available: www.tso.co.uk/bookshop)Tj ET /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 526.95 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 509.36 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 494.79 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 480.2 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 34.16 w 25.8 460.61 m 563.3 460.61 l S 0.001 w /F1 20 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 455.08 Tm (Helpline:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 20 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 420.92 Tm (Telephone:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 20 Tf BT 1 0 0 1 147.95 420.92 Tm (03000 616161)Tj ET /F1 20 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 389.27 Tm (Email:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 20 Tf BT 1 0 0 1 99.55 389.27 Tm (enquiries@cqc.org.uk)Tj ET /F1 20 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 357.61 Tm (Web: )Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 20 Tf BT 1 0 0 1 88.63 357.61 Tm (www.cqc.org.uk)Tj ET /F1 18 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 327.95 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 18 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 299.21 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 28.35 276.5 Tm (We want people to be able to access this information. If you would like a summary in a )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 259 Tm (different format or language please contact our helpline or go to our website.)Tj ET /F1 18 Tf BT 1 0 0 1 28.35 232.98 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 210.26 Tm (Copyright \(2009\) Care Quality Commission \(CQC\). This publication may be reproduced )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 192.76 Tm (in whole or in part, free of charge, in any format or medium provided that it is not used for )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 175.27 Tm (commercial gain. This consent is subject to the material being reproduced accurately and )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 157.77 Tm (on proviso that it is not used in a derogatory manner or misleading context. 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