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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 (Alexandra House)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 (143 High Street )Tj ET /F1 12 Tf BT 1 0 0 1 279.71 701.62 Tm (Pensnett)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 684.04 Tm (Brierley Hill)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 666.46 Tm (West Midlands)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 648.88 Tm (DY5 4EA)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 (01214343996)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 34.05 580.39 Tm (Email address:)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 580.39 Tm (suebastable@alexhouse1.fslife.co.uk)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 35.16 w 31.2 494.83 m 353.25 494.83 l S 0.001 w 1 1 1 RG 35.16 w 355.5 494.83 m 565.9 494.83 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 419.05 m 353.25 419.05 l S 0.001 w 1 1 1 RG 20.58 w 355.5 419.05 m 565.9 419.05 l S 0.001 w 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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 (Mr Jayantilal James Bhikhabhai )Tj ET /F1 12 Tf BT 1 0 0 1 358.35 482.77 Tm (Patel)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 459.95 Tm (Name of registered manager \(if applicable\))Tj ET /F1 12 Tf BT 1 0 0 1 34.05 437.11 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 414.29 Tm (Type of registration:)Tj ET /F1 12 Tf BT 1 0 0 1 358.35 414.29 Tm (care home)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 391.45 Tm (Number of places registered:)Tj ET /F1 12 Tf BT 1 0 0 1 358.35 391.45 Tm (50)Tj ET /F1 10 Tf BT 1 0 0 1 28.35 372.51 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 66.24 w 32.32 329.07 m 564.47 329.07 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 341.61 m 567.8 341.61 l S 0.001 w [] 0 d [] 0 d 2.25 w 297.24 318.77 m 567.8 318.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 364.43 m 567.8 364.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 341.61 m 567.8 341.61 l S 0.001 w [] 0 d [] 0 d 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220.91 m 297.25 220.91 l S 0.001 w 20.58 w 299.5 220.91 m 429.25 220.91 l S 0.001 w 20.58 w 431.5 220.91 m 565.9 220.91 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 269.74 m 568.1 269.74 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 232.33 m 568.1 232.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 292.57 m 568.1 292.57 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 269.74 m 568.1 269.74 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 232.33 m 568.1 232.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 209.5 m 568.1 209.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 293.65 m 30.07 208.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 298.37 293.65 m 298.37 208.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 430.37 293.65 m 430.37 208.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 293.65 m 567.02 208.42 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 276.39 Tm (dementia)Tj ET /F1 12 Tf BT 1 0 0 1 302.35 276.39 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 434.35 276.39 Tm (20)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 253.55 Tm (old age, not falling within any other )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 238.98 Tm (category)Tj ET /F1 12 Tf BT 1 0 0 1 302.35 253.55 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 434.35 253.55 Tm (30)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 216.15 Tm (physical disability)Tj ET /F1 12 Tf BT 1 0 0 1 302.35 216.15 Tm (10)Tj ET /F1 12 Tf BT 1 0 0 1 434.35 216.15 Tm (0)Tj ET 0.95294 0.95294 0.95294 RG 124.56 w 32.32 124.6 m 564.77 124.6 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 166.29 m 567.8 166.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 143.46 m 568.1 143.46 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 189.13 m 567.8 189.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 166.29 m 568.1 166.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 143.46 m 568.1 143.46 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 62.31 m 568.1 62.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 190.2 m 30.07 61.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.72 190.2 m 566.72 61.24 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 172.94 Tm (Conditions of registration:)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 150.11 Tm (The maximum number of service users to be accommodated is 50.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 127.28 Tm (The registered person may provide personal care with nursing, and accommodation for )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 112.7 Tm (service users of both sexes whose primary care needs on admission to the home are )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 98.12 Tm (within the following categories: - Old age not falling within any other category \(OP 30\) )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 83.54 Tm (- Dementia over the age of 65 \(DE \(E\) 20\) - Physical Disability over the age of 50 \(PD )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 68.96 Tm (10\))Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 31.2 48.65 m 315.25 48.65 l S 0.001 w 1 1 1 RG 20.58 w 317.5 48.65 m 346.55 48.65 l S 0.001 w 20.58 w 348.8 48.65 m 377.9 48.65 l S 0.001 w 20.58 w 380.15 48.65 m 409.2 48.65 l S 0.001 w 20.58 w 411.45 48.65 m 440.55 48.65 l S 0.001 w 20.58 w 442.8 48.65 m 471.9 48.65 l S 0.001 w 20.58 w 474.15 48.65 m 503.2 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359.53 43.88 Tm (1)Tj ET /F1 12 Tf BT 1 0 0 1 390.86 43.88 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 422.18 43.88 Tm (1)Tj ET /F1 12 Tf BT 1 0 0 1 453.53 43.88 Tm (2)Tj ET /F1 12 Tf BT 1 0 0 1 484.86 43.88 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 516.18 43.88 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 547.53 43.88 Tm (9)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 (15)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 30.07 576.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 768.18 m 567.02 576.77 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 28.99 577.85 m 568.1 577.85 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 35.5 753.91 Tm (Alexandra House is an extended and converted house, which is registered to provide )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 736.91 Tm (nursing care for 30 older people of which up to 10 beds may accommodate people )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 719.91 Tm (requiring terminal illness care and 20 older people with dementia. The home is divided )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 702.91 Tm (into two units: "Rose" accommodates persons requiring nursing care, including )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 685.91 Tm (palliative care and "Briony" which provides dementia care. The home also provides )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 668.91 Tm (Accident and Emergency Diversion beds, Intermediate care and GP Respite beds when )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 651.91 Tm (required. The home is situated on an easily accessible public transport route, is close )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 634.91 Tm (to Merry Hill and Dudley shopping centres and other local shops and amenities. There )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 617.91 Tm (is a car-parking facility to the side of the building and a garden, which is mainly laid )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 600.91 Tm (with grass and secluded areas. The home also has a memory )Tj ET /F1 12 Tf BT 1 0 0 1 410.12 600.91 Tm (garden.)Tj ET /F1 12 Tf BT 1 0 0 1 456.53 600.91 Tm ( )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 583.91 Tm ()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 (15)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 (We, the Care Quality Commission, undertook this random inspection visit to monitor )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 705.57 Tm (compliance with Statutory Regulation Notices issued to the registered persons, following )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 690.98 Tm (the key inspection on 21 and 22 January 2009. The Statutory Regulation Notices related )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 676.41 Tm (to failures to put in place care plans and risk assessments and failures to put in place safe )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 661.83 Tm (systems for the use of bedrails, which meant that people living at the home could not be )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 647.24 Tm (assured that their needs would be understood or met or that risks to their health safety )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 632.66 Tm (and well being would be minimised. We also monitored compliance with requirements )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 618.09 Tm (issued at the last inspection relating to the management and administration of )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 603.51 Tm (medication, where we had identified serious concerns.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 588.92 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 574.34 Tm (The registered provider had informed the CSCI that the registered manager had resigned )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 559.77 Tm (from her post and left the home the home on 19 February without working the period of )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 545.18 Tm (notice. The new acting manager Mandy Coyne, the registered manager from another )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 530.6 Tm (home within the organisation was transferred to Alexandra House Nursing Home on a )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 516.03 Tm (permanent basis and had been in post for four weeks when we undertook this random )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 501.45 Tm (inspection. The new acting manager was a Registered General Nurse with 27 years )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 486.86 Tm (experience, she had been a registered manager for two years and five years experience )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 472.29 Tm (as deputy manager. She holds RGN, RMA, City and Guilds Teaching Certificate in Further )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 457.7 Tm (Education and Edexcel IT qualifications. An Operations Manager from the organisation )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 443.13 Tm (was also present at this inspection.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 428.55 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 413.96 Tm (We immediately noted that there was a much calmer and more relaxed environment at )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 399.39 Tm (the home. We were told that there were 20 people accommodated, 12 people with )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 384.8 Tm (dementia on Briony Unit and 8 people on Rose Unit, including 3 people admitted into GP )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 370.23 Tm (respite beds for short rehabilitation stays at the home. The acting manager had made )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 355.64 Tm (commendable improvements in the short time she had been in post at the home. We )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 341.07 Tm (noted that she had reorganised the staff teams so that they were allocated to work on )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 326.48 Tm (specified units, which had created improved continuity and consistency for people living )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 311.9 Tm (at the home. She had also introduced a named nurse and key worker system, which )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 297.33 Tm (included the people admitted for short stays and appeared to be working well. There was )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 282.74 Tm (a planned staff meeting held during the inspection visit and we spoke to a number of staff )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 268.17 Tm (who told us that they liked the new way of working and felt less pressurised and spoke of )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 253.59 Tm (the benefits to people living at the home. The acting manager acknowledged that it was )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 239.01 Tm ('early days, with lots more improvements to introduce'. She also told us that there were )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 224.43 Tm (currently no admissions to the home's palliative care or accident/emergency diversion )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 209.85 Tm (beds, which meant that there were few people with complex needs at the present time )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 195.26 Tm (and felt the real test would be when new admissions resumed.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 180.68 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 166.1 Tm (We monitored compliance with Statutory Regulation Notice Regulation 15\(1\), which )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 151.52 Tm (stated, "the registered person, shall after consultation with the service users, or )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 136.95 Tm (representative, prepare a written plan how the person's needs in respect of their health )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 122.36 Tm (and welfare are to be met". The registered persons were given until 31 March 2009 to )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 107.79 Tm ("ensure that all people using the service have a written plan as to how their individual )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 93.21 Tm (needs in respect of their health and welfare are to be met." The plans had also to be kept )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 78.63 Tm (under review, with the person and amended to reflect any changes to their health and )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 64.04 Tm (welfare.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 49.47 Tm ()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 (15)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 (We looked at the care records of 3 people permanently accommodated at the home and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (care records of 2 people admitted for short respite stays, since the last inspection. We )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (also looked at how people were supported and given assistance to meet their daily needs.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (The acting manager had introduced new comprehensive formats for pre-admission )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (assessments, healthcare screening tools, risk assessments and care plans and the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (monthly evaluations. We noted that a considerable amount of work had been completed )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (in just a few weeks and each person on Rose Unit had all of the new documentation in )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (place, with good progress made on Briony unit to transfer the existing information into )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (the new formats.)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 (One of the people living on Rose Unit had comprehensive risk assessments and health )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (screening tools all completed on 26/2/09, for example the moving and handling risk )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (assessment indicated needed the assistance of 1 member of staff for supervision and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (referred to previous falls recorded, which was positive, it was also recorded this person )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm (preferred a shower. However some of the records such as the weight records, nutritional )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm (assessment and Waterlow score, were initially not accurate because the assessments had )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (not included all areas of risk such as the skin condition, level of incontinence, poor )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (appetite, which meant that the risks would not be properly assessed or appropriate )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm (control measures put in place to minimise the risks. It was positive to see that the acting )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm (manager had reviewed the care records, completing the care plan review sheet, )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (identifying areas which were not accurate and needed to be improved, and had allocated )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (another RGN and on 31/3/09 the records had been accurately updated. We spoke to the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (nurse during the inspection and commended her thorough approach. We also noted the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (acting manager's proactive approach to monitoring the nurses competence and dealing )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm (with areas of weak practice.)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 noted that new risk assessments relating to risks of choking at night, had been put in )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm (place following incident with sweet found in a person's mouth, after relatives brought )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 352.6 Tm (sweets into the home. There was evidence that family had been involved and were in )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm (agreement with monitoring arrangements, which demonstrated good practice. This )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm (person had a new risk assessment and care plan following incidents of spilled drinks due )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm (to deterioration in physical health, with monitoring arrangements well documented which )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 294.27 Tm (demonstrated good practice. There was also a risk assessment and care plan put in place )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 279.7 Tm (on 3/4/09 related to the administration of prescribed Aspirin, following observations )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 265.11 Tm (relating to bruising, which may have been attributable to aspirin. There were instructions )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 250.54 Tm (for further observations and control measures to minimise bruising, which demonstrated )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 235.96 Tm (good practice.)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 (We noted on another person's weight records fluctuating weights for example 30/1/09 )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 192.21 Tm (77.9 kg, 23/2/09 74 kg, 1/3/09 76.1 kg and 1/4/09 74.6 kg. We recommended that )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 177.63 Tm (weight records should show that fluctuations in weight have been investigated, for )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 163.05 Tm (example whether the person was weighed at same time of day, on the same scales, and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 148.48 Tm (accuracy of the calibration of scales.)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 looked at the care records for a person admitted to the home for rehabilitation )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 104.74 Tm (following surgery and noted that all required risk assessments, healthcare screening and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 90.15 Tm (care plans were in place and diligently completed. For example it was recorded that this )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 75.57 Tm (person was unable to bathe or shower for two weeks postoperatively, and included )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 60.99 Tm (instructions that 'Ted' socks in place were to be removed daily, that the person was )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 46.42 Tm (mobile with crutches, and would like a walking frame in the bedroom. The exercise )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 (15)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 (programme prescribed by the orthopaedic nurse specialist and occupation therapist was )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (recorded and was being followed. This person also had care plans, additional medication )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (and monitoring for postoperative nausea and oral thrush. This person had chosen to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (administer their own subcutaneous injections for 25 days post operatively and was being )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (supported to do so by the nursing staff. This demonstrated that people were encouraged )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (and supported to remain as independent as possible, which was very good practice.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (Another person admitted for a respite stay had a pre-admission assessment recorded )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (using the new format, which was very comprehensive and well completed. This included )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (important details about the involvement of the community network of family, friends, and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (carers. The care records also included a, new sheet, identifying the type of admission and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (information about other agencies involved, such as social worker, district nurse. This )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (meant that the person was clearly identified as "GP respite, short stay", which was a )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (positive development and provided all staff with information about the reasons for this )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (person's stay at the home. This person also had a comprehensive and clearly documented )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm (plan for discharge, including information to be passed to other agencies.)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 (We concluded that there was satisfactory evidence of compliance with the Statutory )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (Regulation Notice 15\(1\) relating to care planning.)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 (The CQC Pharmacist Inspector undertook inspection of the control and management of )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (medication within the service on 7th April 2009. We spoke with two members of staff. All )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (feedback was given to the Acting Manager.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (We were shown a new medication policy dated 6th April 2009, which had not been shown )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm (to staff at the time of the inspection. The manager informed us that all staff had signed a )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm (document to say they had seen a copy of the Royal Pharmaceutical Society of Great )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (Britain guidance document on safe administration of medication in Care Homes. The )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm (service had also recently changed to a new pharmacy to obtain medication. A member of )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 352.6 Tm (staff informed us that the new system appeared to be working well with no major )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm (problems. This means that safe medication procedures were in the process of being )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm (implemented and agreed with staff to ensure that the residents were safeguarded.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 294.27 Tm (We saw that medication was stored neatly and tidily in locked medicine trolleys in each )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 279.7 Tm (unit. The person in charge of the unit held the key. This means that it was easy to locate )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 265.11 Tm (residents' medication and it was stored safely.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 250.54 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 235.96 Tm (The treatment room downstairs felt very warm. Daily temperature records were available )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 221.38 Tm (which documented that the temperature of the room varied between 24 -26 degrees C. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 206.79 Tm (Manufacturers recommend that medication should be stored below 25 degrees C and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 192.21 Tm (therefore medication was sometimes stored at higher temperatures which may cause )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 177.63 Tm (deterioration. We saw that a window was open in order to allow some cool air into the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 163.05 Tm (room, however it was not secure and increased the risk of unauthorised access to the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 148.48 Tm (treatment room. Medication was also stored in Briony unit, however there were no )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 133.9 Tm (temperature records available for the room or for the refrigerator, which means that the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 119.32 Tm (service could not demonstrate that medication was stored within a safe temperature )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 104.74 Tm (range.)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 (The majority of the medicine records seen were documented with staff signatures to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 60.99 Tm (record that medication had been administered to a resident or a code was recorded to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 46.42 Tm (explain why medication had not been administered. We also saw records for the receipt )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 (15)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 (and disposal of medication, which were double checked by two members of staff. We )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (looked in detail at three residents medication records. We were able to follow an audit )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (trail to ensure that medication was being administered safely and correctly. The records )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (were clear and up to date which demonstrated that the service was recording and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (documenting medication accurately.)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 (Two residents care plans were looked at because they had been prescribed medication for )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (behaviour control to be administered 'when required'. The medication records for both )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (residents documented that the medication for behaviour control had been administered )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (and a reason for giving it was recorded on the medication record charts. However, there )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (was no protocol in place to inform staff under what circumstances the medication should )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (be administered. We discussed this with the manager who agreed that a protocol should )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (be available. This means that the residents' healthcare and medication care records were )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (not always person specific and did not document a plan for staff to follow to ensure the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (well being of the residents.)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 (We monitored compliance with Statutory Regulation Notice Regulation 13\(4\), which )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (stated, the registered persons were required by 31 March 2009 to carry our risk )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (assessments for people living at the home, including risks associated with bedrails and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm (bed bumpers, which are to be fitted to a person's bed, carry out comprehensive risk )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm (assessments for any activities, which may affect the person's health and safety, and put )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (systems in place to ensure any unnecessary risks to people's health and safety are )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (identified and so far as possible eliminated.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (We toured the home to look at all the bedrails currently in place. There were two people )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm (on Briony Unit assessed as requiring bedrails fitted to their bed. We saw that both people )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm (had 'Third Party bedrails' in place, this meant they were not integral to the bed. We saw )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (that they were extended to full length of bed, with a bar under the mattress, which was )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm (tight fitting and had limited movement. The acting manager had purchased new full )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 352.6 Tm (length bedrail bumpers for all beds with bedrails in use. The first bed we observed had a )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm (high foam mattress in place and the measured height from uncompressed mattress to the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm (top of the bedrails was 300mm, well within the 220 mm required and there were no )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm (excessive gaps. The second bed we observed had a pressure relieving mattress in place )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 294.27 Tm (and the measured height from the uncompressed mattress to the top of the bedrails was )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 279.7 Tm (280mm, well within the 220 mm required dimensions and there were no excessive gaps.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 265.11 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 250.54 Tm (There were integral bedrails on nursing profile beds on Rose Unit but they were only in )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 235.96 Tm (use for one person. We observed this persons bed, which had full size bumpers in place )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 221.38 Tm (and there were no excessive gaps of more than 60mm between the bed and mattress. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 206.79 Tm (The measured height from uncompressed mattress to top of bedrails was 300mm, well )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 192.21 Tm (within the 220 mm dimension required.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 177.63 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 163.05 Tm (We also looked at the revised and updated bedrails risk assessment on these persons )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 148.48 Tm (care records, which accurately reflected the persons care needs and associated risks.)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 spoke to a care assistant, who accompanied us on the review of beds with bedrails. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 104.74 Tm (She confirmed that the acting manager, Mandy Coyne had delivered a training session )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 90.15 Tm (relating to the use of bedrails for all staff two weeks prior to this random inspection visit. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 75.57 Tm (The member of staff was very knowledgeable about the use of bedrails, associated risks )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 60.99 Tm (and control measures needed to minimise any risks of harm to the person requiring their )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 46.42 Tm (use.)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 (15)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 717.42 w 31.2 426.52 m 580.26 426.52 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 66.68 m 582.46 66.68 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 65.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 65.6 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 (The acting manager acknowledged that she had not recorded the training session. We )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (recommended that all awareness and training sessions delivered 'in house' should be )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (documented, together with staff signatures to demonstrate improved knowledge and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (skills have been provided for the benefit of the welfare and safety of people living at the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (home.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (The acting manager held planned meeting with the handyman during this random )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (inspection visit to discuss the responsibilities of the newly revised and updated job )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (description. We witnessed her one to one session to raise awareness of this person's )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (responsibilities, including a practical session to check that all bedrails that were currently )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (in use at the home were fitted correctly, were within the permitted dimensions, were )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (compatible with the mattresses, to ensure that there were no excessive gaps and that )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (there were the correct size of bedrail bumpers in place.)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 looked at the accident records and noted that there had been 29 recorded accidents )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm (between January 2009 and March 2009. We saw that the acting manager had introduced )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (rigorous accident analysis, evaluation and control measures.)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 (Prior to this random inspection we noted evidence that Regulation 37 Notifications had )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm (been made proactively to the Commission since February 2009. We assessed records at )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (the home, which corresponded to the Accidents records and notifications. This )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (demonstrated good practice and compliance with the Requirement relation to Regulation )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (37 issued at the key inspection on 21 January 2009.)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 (We concluded that there was satisfactory evidence of compliance with the Statutory )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm (Regulation Notice 13\(4\) relating to the assessment and management of risks, especially )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (related to bedrails.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 352.6 Tm (We looked at how complaints were being managed and noted the homes complaints )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm (procedure was in place and displayed, together with contact details of external agencies. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm (We looked at the homes complaints log for any complaints received since the last )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm (inspection. We noted that the acting manager had recorded details of complaint from a )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 294.27 Tm (relative of a person living at the home and had conducted a thorough investigation and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 279.7 Tm (offered a resolution.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 265.11 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 250.54 Tm (The acting manager had made appropriate safeguarding referrals as incidents have come )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 235.96 Tm (to her notice and responded proactively, fully co operating with external agencies to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 221.38 Tm (allegations of abusive behaviour towards people living at the home, which were recently )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 206.79 Tm (made at a training venue outside the home.)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 (We also noted the acting manager's positive and prompt action to diligently monitor the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 163.05 Tm (performance of the Registered Nurses in relation to care planning, risk assessments and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 148.48 Tm (medication. In the short time, four weeks, since she was transferred to this home, she )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 133.9 Tm (had commenced staff supervisions, performance appraisals and held staff meetings. We )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 119.32 Tm (saw evidence that she was taking action to support staff and also deal with areas of weak )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 104.74 Tm (practice. She had evaluated and reorganised the staff team, and care staff had been )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 90.15 Tm (allocated to work on either Rose Unit or Briony Unit, improving the continuity and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 75.57 Tm (consistency of care for people living on those units.)Tj ET /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 48.61 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 48.61 Tm (does well:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 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 (15)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 370.5 w 31.2 599.97 m 580.26 599.97 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 28.99 413.6 m 582.46 413.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 412.52 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 412.52 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 770.16 Tm (This random inspection was conducted with full co-operation of the recently appointed )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 755.59 Tm (acting manager and operations manager. There was satisfactory evidence of compliance )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 741.01 Tm (with two Statutory Regulation Notices issued following the last key inspection. )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 726.42 Tm (Considerable improvements had been made in a very short space of time, which was )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 711.84 Tm (commendable.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 697.27 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 682.68 Tm (The staff were friendly, caring and made efforts to communicate and offer assurances to )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 668.1 Tm (people living at the home. For example staff were seen talking to people in a reassuring )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 653.53 Tm (manner and at a level and pace that the person understood.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 638.95 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 624.36 Tm (Considerable improvements had been made to the systems for administering medication )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 609.78 Tm (to people living at the home, though a few additional improvements must be put in place )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 595.21 Tm (to make the system as safe as possible.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 580.63 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 566.04 Tm (The acting manager had made a proactive safeguarding referral to the Lead Agency, )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 551.47 Tm (Dudley DACHS, and had co-operated fully with ongoing investigations, which means )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 536.89 Tm (people feel assured they will be safeguarded from harm.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 522.3 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 507.73 Tm (We spoke to two people staying temporarily at the home in GP respite beds, following )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 493.14 Tm (surgery. They both told us they had enjoyed their stay at the home and had felt well care )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 478.57 Tm (for and supported with their programmes for rehabilitation. One person told us her )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 463.98 Tm (mother had stayed at Alexandra House some years ago and so she felt she knew what )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 449.4 Tm (she could expect, and she had not been disappointed. She told us that she had made a )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 434.83 Tm (friend of the other person and they said they intended to keep in touch with each other )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 420.24 Tm (when they returned to their own homes. This was a very positive outcome for them.)Tj ET /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 392.15 Tm (What they could do better:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 195.54 w 31.2 283.2 m 580.26 283.2 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 382.09 m 582.46 382.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 184.3 m 582.46 184.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 383.17 m 30.07 183.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 383.17 m 581.38 183.22 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 365.9 Tm (The registered manager had resigned since the last inspection and though a new )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 351.33 Tm (manager was recently appointed, an application for registration as the manager of the )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 336.74 Tm (home must be submitted to the CQC Regional Registration Team as a priority.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 322.17 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 307.58 Tm (The registered persons must make sure that the additional improvements required at this )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 293.01 Tm (inspection visit for the administration of peoples medication are put in placed and that )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 278.42 Tm (medication is stored at the correct temperature and everyone living at the home receives )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 263.85 Tm (their medication as prescribed by their doctor, with safeguards in place to maintain their )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 249.26 Tm (health and well being.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 234.68 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 220.1 Tm (The registered persons must continue the improvements to ensure full compliance with )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 205.52 Tm (requirements and recommendations issued at the key inspection in January 2009 and not )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 190.95 Tm (assessed at this random inspection.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 165.99 Tm (If you want to know what action the person responsible for this care home)Tj ET /F1 12 Tf BT 1 0 0 1 483.55 165.99 Tm (is taking )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 149.99 Tm (following this report, you can contact them using the details set out on page 2.)Tj ET endstream endobj 22 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 24 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 (15)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 169.38 w 31.2 491.53 m 91.05 491.53 l S 0.001 w 169.38 w 93.3 491.53 m 197.4 491.53 l S 0.001 w 169.38 w 199.65 491.53 m 289.45 491.53 l S 0.001 w 169.38 w 291.7 491.53 m 473.8 491.53 l S 0.001 w 169.38 w 476.05 491.53 m 566.1 491.53 l S 0.001 w 362.04 w 31.2 223.57 m 91.05 223.57 l S 0.001 w 362.04 w 93.3 223.57 m 197.4 223.57 l S 0.001 w 362.04 w 199.65 223.57 m 289.45 223.57 l S 0.001 w 362.04 w 291.7 223.57 m 473.8 223.57 l S 0.001 w 362.04 w 476.05 223.57 m 566.1 223.57 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 405.71 m 568.3 405.71 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 578.42 m 30.07 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 578.42 m 567.22 40.35 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 568.3 577.34 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 28.99 405.71 m 568.3 405.71 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 (8)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 561.16 Tm (12)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 561.16 Tm (The registered persons must )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 546.58 Tm (ensure that special care )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 532 Tm (records such as food, fluid )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 517.42 Tm (balance charts and turn )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 502.84 Tm (charts are in place, with care )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 488.26 Tm (provided appropriately )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 473.68 Tm (recorded and monitored. )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 456.1 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 441.52 Tm (This is to ensure residents )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 426.94 Tm (health and well being is )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 412.36 Tm (maintained )Tj ET /F1 12 Tf BT 1 0 0 1 478.9 561.16 Tm (02/03/2009)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 389.53 Tm (2)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 389.53 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 389.53 Tm (13)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 389.53 Tm (The registered persons must )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 374.95 Tm (provide a written protocol for )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 360.37 Tm (the administration of covert )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 345.79 Tm (medication, which )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 331.21 Tm (incorporates NMC and Royal )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 316.63 Tm (Pharmaceutical GB guidance )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 302.05 Tm (and maintains records )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 287.47 Tm (reflecting the reasons why )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 272.89 Tm (covert administration is )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 258.31 Tm (required, how the medicine is )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 243.73 Tm (given, the persons )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 229.15 Tm (agreement, or evidence of an )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 214.57 Tm (assessment in accordance )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 199.99 Tm (with the Mental Capacity Act, )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 185.41 Tm (with an Independent )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 170.83 Tm (Advocate as necessary to )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 156.25 Tm (indicate decisions are made )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 141.67 Tm (and reviewed in the persons )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 127.09 Tm (best interests. Documented )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 112.51 Tm (Pharmaceutical must also be )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 97.93 Tm (obtained to demonstrate )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 83.35 Tm (which medicines can be )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 68.77 Tm (given covertly and in which )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 54.19 Tm (food preparations. This is to )Tj ET /F1 12 Tf BT 1 0 0 1 478.9 389.53 Tm (02/03/2009)Tj ET endstream endobj 25 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 26 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 (15)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 585.21 w 32.32 491.49 m 564.97 491.49 l S 0.001 w 1 1 1 RG 111.06 w 31.2 625.72 m 91.05 625.72 l S 0.001 w 111.06 w 93.3 625.72 m 197.4 625.72 l S 0.001 w 111.06 w 199.65 625.72 m 289.45 625.72 l S 0.001 w 111.06 w 291.7 625.72 m 473.8 625.72 l S 0.001 w 111.06 w 476.05 625.72 m 566.1 625.72 l S 0.001 w 169.38 w 31.2 483.24 m 91.05 483.24 l S 0.001 w 169.38 w 93.3 483.24 m 197.4 483.24 l S 0.001 w 169.38 w 199.65 483.24 m 289.45 483.24 l S 0.001 w 169.38 w 291.7 483.24 m 473.8 483.24 l S 0.001 w 169.38 w 476.05 483.24 m 566.1 483.24 l S 0.001 w 198.54 w 31.2 297.04 m 91.05 297.04 l S 0.001 w 198.54 w 93.3 297.04 m 197.4 297.04 l S 0.001 w 198.54 w 199.65 297.04 m 289.45 297.04 l S 0.001 w 198.54 w 291.7 297.04 m 473.8 297.04 l S 0.001 w 198.54 w 476.05 297.04 m 566.1 297.04 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 569.06 m 568.3 569.06 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 397.43 m 568.3 397.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 683.45 m 30.07 195.56 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 683.45 m 567.22 195.56 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 92.17 195.56 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 683.45 m 198.52 195.56 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 683.45 m 290.57 195.56 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 683.45 m 474.92 195.56 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 28.99 569.06 m 568.3 569.06 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 397.43 m 568.3 397.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 196.64 m 568.3 196.64 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 (safeguard the health and )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 656.85 Tm (well being of people living at )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 642.28 Tm (the home. )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 621.7 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 292.3 607.11 Tm (This is to safeguard the )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 592.53 Tm (health and well being of )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 577.96 Tm (people living at the home. )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 552.88 Tm (3)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 552.88 Tm (33)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 552.88 Tm (24)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 552.88 Tm (The registered persons must )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 538.29 Tm (implement effective quality )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 523.72 Tm (monitoring systems, which )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 509.14 Tm (demonstrate that positive )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 494.55 Tm (quality outcomes are )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 479.98 Tm (consistently achieved for all )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 465.39 Tm (persons living at the home. )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 447.82 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 433.23 Tm (This is to safeguard the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 418.65 Tm (health, well being and safety )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 404.08 Tm (of people living at the home. )Tj ET /F1 12 Tf BT 1 0 0 1 478.9 552.88 Tm (31/03/2009)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 381.24 Tm (4)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 381.24 Tm (36)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 381.24 Tm (12)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 381.24 Tm (The registered persons must )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 366.67 Tm (implement a robust formal )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 352.08 Tm (staff supervision system for )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 337.51 Tm (staff support and )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 322.92 Tm (development to ensure that )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 308.35 Tm (they have the knowledge, )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 293.77 Tm (skills and training to met )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 279.18 Tm (each persons individual )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 264.61 Tm (needs. )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 247.02 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 232.45 Tm (This is to safeguard the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 217.87 Tm (health, well being and safety )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 203.29 Tm (of people living at the home. )Tj ET /F1 12 Tf BT 1 0 0 1 478.9 381.24 Tm (27/02/2009)Tj ET endstream endobj 28 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 (15)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 242.28 w 31.2 378.36 m 91.05 378.36 l S 0.001 w 242.28 w 93.3 378.36 m 197.4 378.36 l S 0.001 w 242.28 w 199.65 378.36 m 289.45 378.36 l S 0.001 w 242.28 w 291.7 378.36 m 473.8 378.36 l S 0.001 w 242.28 w 476.05 378.36 m 566.1 378.36 l S 0.001 w 169.38 w 31.2 170.28 m 91.05 170.28 l S 0.001 w 169.38 w 93.3 170.28 m 197.4 170.28 l S 0.001 w 169.38 w 199.65 170.28 m 289.45 170.28 l S 0.001 w 169.38 w 291.7 170.28 m 473.8 170.28 l S 0.001 w 169.38 w 476.05 170.28 m 566.1 170.28 l S 0.001 w 40.79 w 31.2 62.94 m 91.05 62.94 l S 0.001 w 40.79 w 93.3 62.94 m 197.4 62.94 l S 0.001 w 40.79 w 199.65 62.94 m 289.45 62.94 l S 0.001 w 40.79 w 291.7 62.94 m 473.8 62.94 l S 0.001 w 40.79 w 476.05 62.94 m 566.1 62.94 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 256.1 m 568.3 256.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 84.46 m 568.3 84.46 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 28.99 256.1 m 568.3 256.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 84.46 m 568.3 84.46 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 (8)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 484.44 Tm (13)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 484.44 Tm (The registered persons must )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 469.86 Tm (make arrangements to )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 455.28 Tm (ensure that care plans )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 440.7 Tm (include detailed information )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 426.12 Tm (and instructions for staff in )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 411.54 Tm (respect of the administration )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 396.96 Tm (and management of )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 382.38 Tm (medicines, including the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 367.8 Tm (reasons to give medicines on )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 353.22 Tm (an as and when basis and )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 338.64 Tm (what constitutes 'needed' for )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 324.06 Tm (the named person.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 306.48 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 291.9 Tm (This is to safeguard the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 277.32 Tm (health and well being of )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 262.74 Tm (people living at the home.)Tj ET /F1 12 Tf BT 1 0 0 1 478.9 484.44 Tm (01/06/2009)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 239.91 Tm (2)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 239.91 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 239.91 Tm (13)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 239.91 Tm (The registered persons must )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 225.33 Tm (make arrangements to )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 210.75 Tm (ensure that medication is )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 196.17 Tm (stored securely and at the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 181.59 Tm (correct temperature )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 167.01 Tm (recommended by the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 152.43 Tm (manufacturer.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 134.85 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 120.27 Tm (This is to safeguard the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 105.69 Tm (health and well being of )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 91.11 Tm (people living at the home.)Tj ET /F1 12 Tf BT 1 0 0 1 478.9 239.91 Tm (01/06/2009)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 68.28 Tm (3)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 68.28 Tm (31)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 68.28 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 68.28 Tm (An application must be )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 53.7 Tm (submitted to the CSCI for the )Tj ET /F1 12 Tf BT 1 0 0 1 478.9 68.28 Tm (06/07/2009)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 (15)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 297.83 w 32.32 635.18 m 564.97 635.18 l S 0.001 w 1 1 1 RG 198.54 w 31.2 584.41 m 91.05 584.41 l S 0.001 w 198.54 w 93.3 584.41 m 197.4 584.41 l S 0.001 w 198.54 w 199.65 584.41 m 289.45 584.41 l S 0.001 w 198.54 w 291.7 584.41 m 473.8 584.41 l S 0.001 w 198.54 w 476.05 584.41 m 566.1 584.41 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 30.07 685.89 m 30.07 482.94 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 685.89 m 567.22 482.94 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 92.17 482.94 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 685.89 m 198.52 482.94 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 685.89 m 290.57 482.94 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 685.89 m 474.92 482.94 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 28.99 484.02 m 568.3 484.02 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 (Registration of the manager )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 659.29 Tm (within 3 months.)Tj ET /F1 12 Tf BT 1 0 0 1 292.3 644.72 Tm (This to ensure the home is )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 630.14 Tm (managed and run to assure )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 615.55 Tm (the health well being and )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 600.97 Tm (safety of the people living )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 586.4 Tm (there. )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 565.82 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 292.3 551.23 Tm (This to ensure the home is )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 536.66 Tm (managed and run to assure )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 522.08 Tm (the health well being and )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 507.49 Tm (safety of the people living )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 492.92 Tm (there. )Tj ET 0.95294 0.95294 0.95294 RG 419.97 w 32.32 254.79 m 564.97 254.79 l S 0.001 w 1 1 1 RG 108.06 w 31.2 321.89 m 91.05 321.89 l S 0.001 w 108.06 w 93.3 321.89 m 197.4 321.89 l S 0.001 w 108.06 w 199.65 321.89 m 566.1 321.89 l S 0.001 w 93.48 w 31.2 218.88 m 91.05 218.88 l S 0.001 w 93.48 w 93.3 218.88 m 197.4 218.88 l S 0.001 w 93.48 w 199.65 218.88 m 566.1 218.88 l S 0.001 w 64.32 w 31.2 137.73 m 91.05 137.73 l S 0.001 w 64.32 w 93.3 137.73 m 197.4 137.73 l S 0.001 w 64.32 w 199.65 137.73 m 566.1 137.73 l S 0.001 w 59.64 w 31.2 73.5 m 91.05 73.5 l S 0.001 w 59.64 w 93.3 73.5 m 197.4 73.5 l S 0.001 w 59.64 w 199.65 73.5 m 566.1 73.5 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 266.74 m 568.3 266.74 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 171.01 m 568.3 171.01 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 104.44 m 568.3 104.44 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 378.13 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 378.13 m 567.22 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 397.45 m 568.4 397.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 377.05 m 568.3 377.05 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 378.13 m 92.17 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 378.13 m 198.52 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 467.02 m 568.4 467.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 397.45 m 568.4 397.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 377.05 m 568.4 377.05 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 266.74 m 568.3 266.74 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 171.01 m 568.3 171.01 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 104.44 m 568.3 104.44 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 30.07 468.1 m 30.07 375.97 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 398.53 m 92.17 375.97 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.47 398.53 m 198.47 375.97 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 468.1 m 567.32 375.97 l S 0.001 w [] 0 d /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 450.83 Tm (Recommendations)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 34.05 433.26 Tm (These recommendations are taken from the best practice described in the National )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 418.67 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 34.05 404.1 Tm (improving their service.)Tj ET /F1 10 Tf BT 1 0 0 1 34.05 383.27 Tm (No)Tj ET /F1 10 Tf BT 1 0 0 1 96.15 383.27 Tm (Refer to Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.45 383.27 Tm (Good Practice Recommendations)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 360.86 Tm (1)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 360.86 Tm (1)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 360.86 Tm (It is strongly recommended that the homes statement of )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 346.29 Tm (purpose and service user guide include specific information )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 331.7 Tm (about the diverse range of services offered and how the )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 317.13 Tm (needs of people living permanently at the home will be )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 302.55 Tm (met.)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 287.96 Tm (This was a previous good practice recommendation. Not )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 273.39 Tm (assessed at this Random Inspection. )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 250.55 Tm (2)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 250.55 Tm (2)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 250.55 Tm (That each person living at the home is given an up to date, )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 235.98 Tm (accurate contract of residence with details of their )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 221.4 Tm (individual fees and RNCC reimbursement where applicable, )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 206.82 Tm (signed date and witnessed.)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 192.24 Tm (This was a previous good practice recommendation. Not )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 177.65 Tm (assessed at this Random Inspection. )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 154.82 Tm (3)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 154.82 Tm (8)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 154.82 Tm (It was recommended that weight records should show that )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 140.24 Tm (fluctuations in weight have been investigated, for example )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 125.67 Tm (whether the person was weighed at same time of day, on )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 111.08 Tm (the same scales, and accuracy of the calibration of scales.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 88.25 Tm (4)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 88.25 Tm (15)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 88.25 Tm (That there should be daily menus produced in appropriate )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 73.68 Tm (formats, such as large print or pictorial, suitable for people )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 59.1 Tm (with dementia or sensory impairments to assist their )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 (15)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 502.8 w 32.32 532.7 m 564.97 532.7 l S 0.001 w 1 1 1 RG 46.74 w 31.2 671.89 m 91.05 671.89 l S 0.001 w 46.74 w 93.3 671.89 m 197.4 671.89 l S 0.001 w 46.74 w 199.65 671.89 m 566.1 671.89 l S 0.001 w 49.74 w 31.2 621.4 m 91.05 621.4 l S 0.001 w 49.74 w 93.3 621.4 m 197.4 621.4 l S 0.001 w 49.74 w 199.65 621.4 m 566.1 621.4 l S 0.001 w 122.64 w 31.2 532.96 m 91.05 532.96 l S 0.001 w 122.64 w 93.3 532.96 m 197.4 532.96 l S 0.001 w 122.64 w 199.65 532.96 m 566.1 532.96 l S 0.001 w 93.48 w 31.2 422.64 m 91.05 422.64 l S 0.001 w 93.48 w 93.3 422.64 m 197.4 422.64 l S 0.001 w 93.48 w 199.65 422.64 m 566.1 422.64 l S 0.001 w 93.48 w 31.2 326.92 m 91.05 326.92 l S 0.001 w 93.48 w 93.3 326.92 m 197.4 326.92 l S 0.001 w 93.48 w 199.65 326.92 m 566.1 326.92 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 647.39 m 568.3 647.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 595.4 m 568.3 595.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 470.51 m 568.3 470.51 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 374.78 m 568.3 374.78 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 697.46 m 30.07 277.97 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 697.46 m 567.22 277.97 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 716.78 m 568.4 716.78 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 696.38 m 568.3 696.38 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 697.46 m 92.17 277.97 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 697.46 m 198.52 277.97 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 28.99 716.78 m 568.4 716.78 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 696.38 m 568.4 696.38 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 647.39 m 568.3 647.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 595.4 m 568.3 595.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 470.51 m 568.3 470.51 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 374.78 m 568.3 374.78 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 279.05 m 568.3 279.05 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 695.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 717.86 m 92.17 695.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.47 717.86 m 198.47 695.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 787.43 m 567.32 695.3 l S 0.001 w [] 0 d /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 770.16 Tm (Recommendations)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 34.05 752.59 Tm (These recommendations are taken from the best practice described in the National )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 738.01 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 34.05 723.42 Tm (improving their service.)Tj ET /F1 10 Tf BT 1 0 0 1 34.05 702.6 Tm (No)Tj ET /F1 10 Tf BT 1 0 0 1 96.15 702.6 Tm (Refer to Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.45 702.6 Tm (Good Practice Recommendations)Tj ET /F1 12 Tf BT 1 0 0 1 200.25 685.45 Tm (understanding and help them make realistic choices.)Tj ET /F1 12 Tf BT 1 0 0 1 200.25 670.86 Tm (This was a previous good practice recommendation. Not )Tj ET /F1 12 Tf BT 1 0 0 1 200.25 656.28 Tm (assessed at this Random Inspection. )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 631.21 Tm (5)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 631.21 Tm (15)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 631.21 Tm (There should always be an equitable choice of meal )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 616.63 Tm (available. This was a previous good practice )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 602.04 Tm (recommendation. Not assessed at this Random Inspection.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 579.22 Tm (6)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 579.22 Tm (20)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 579.22 Tm (That serious consideration be given to providing separate )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 564.64 Tm (facilities for people admitted for short stays or intermediate )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 550.05 Tm (care, so that they do not intrude on people who live )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 535.47 Tm (permanently at the home, unless this is with their clear )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 520.9 Tm (documented agreement and consent and is regularly )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 506.32 Tm (reviewed.)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 491.73 Tm (This was a previous good practice recommendation. Not )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 477.15 Tm (assessed at this Random Inspection.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 454.33 Tm (7)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 454.33 Tm (20)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 454.33 Tm (That serious consideration be given to the internal )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 439.74 Tm (environments of each unit to provide more orientation and )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 425.17 Tm (stimulation, especially for people with dementia and )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 410.58 Tm (sensory disabilities.)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 396.01 Tm (This was a previous good practice recommendation. Not )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 381.42 Tm (assessed at this Random Inspection.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 358.6 Tm (8)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 358.6 Tm (21)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 358.6 Tm (That the action is taken to undertake minor repairs to )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 344.02 Tm (bathrooms and WCs , and bedrooms including securing )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 329.43 Tm (wardrobes, which could pose health and safety risks to )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 314.86 Tm (people living in the home.)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 300.27 Tm (This was a previous good practice recommendation. Not )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 285.7 Tm (assessed at this Random Inspection.)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 (15)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 (Reader Information)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 20.58 w 28.35 746.8 m 229.46 746.8 l S 0.001 w 1 1 1 RG 20.58 w 231.71 746.8 m 581.74 746.8 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 28.35 723.97 m 229.46 723.97 l S 0.001 w 1 1 1 RG 20.58 w 231.71 723.97 m 581.74 723.97 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 28.35 701.14 m 229.46 701.14 l S 0.001 w 1 1 1 RG 20.58 w 231.71 701.14 m 581.74 701.14 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 28.35 678.31 m 229.46 678.31 l S 0.001 w 1 1 1 RG 20.58 w 231.71 678.31 m 581.74 678.31 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 26.14 735.39 m 583.94 735.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 712.55 m 583.94 712.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 689.72 m 583.94 689.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 758.22 m 583.94 758.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 735.39 m 583.94 735.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 712.55 m 583.94 712.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 689.72 m 583.94 689.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 666.9 m 583.94 666.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.22 759.29 m 27.22 665.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 230.59 759.29 m 230.59 665.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 582.86 759.29 m 582.86 665.82 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.2 742.03 Tm (Document Purpose:)Tj ET /F1 12 Tf BT 1 0 0 1 234.56 742.03 Tm (Inspection Report)Tj ET /F1 12 Tf BT 1 0 0 1 31.2 719.2 Tm (Author:)Tj ET /F1 12 Tf 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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