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(8)Tj ET /F1 12 Tf BT 1 0 0 1 392.28 140.37 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 423.61 140.37 Tm (6)Tj ET /F1 12 Tf BT 1 0 0 1 454.95 140.37 Tm (2)Tj ET /F1 12 Tf BT 1 0 0 1 486.28 140.37 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 517.6 140.37 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 548.96 140.37 Tm (9)Tj ET endstream endobj 6 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]/XObject<>>>/MediaBox[0 0 612 792]>> endobj 7 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (2)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (17)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 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582.46 659.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 636.98 m 582.46 636.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 614.16 m 582.46 614.16 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 591.33 m 582.46 591.33 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 28.99 659.82 m 582.46 659.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 636.98 m 582.46 636.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 614.16 m 582.46 614.16 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 591.33 m 582.46 591.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 568.49 m 582.46 568.49 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 759.29 m 30.07 567.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 275.73 759.29 m 275.73 567.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 759.29 m 581.38 567.42 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 (Amberley)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 (481-483 Stourbridge Rd )Tj ET /F1 12 Tf BT 1 0 0 1 279.71 701.62 Tm (Brierley Hill)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 684.04 Tm (West Midlands)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 666.46 Tm (DY5 1LB)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 643.63 Tm (Telephone number:)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 643.63 Tm (01384482365)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 620.8 Tm (Fax number:)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 597.97 Tm (Email address:)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 597.97 Tm (paul.hughes@blueyonder.co.uk)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 575.14 Tm (Provider web address:)Tj ET /F1 10 Tf BT 1 0 0 1 28.35 539.2 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 31.2 519.71 m 353.25 519.71 l S 0.001 w 1 1 1 RG 20.58 w 355.5 519.71 m 565.9 519.71 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 496.88 m 353.25 496.88 l S 0.001 w 1 1 1 RG 20.58 w 355.5 496.88 m 565.9 496.88 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 474.05 m 353.25 474.05 l S 0.001 w 1 1 1 RG 20.58 w 355.5 474.05 m 565.9 474.05 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 508.29 m 568.1 508.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 485.46 m 568.1 485.46 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 531.12 m 568.1 531.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 508.29 m 568.1 508.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 485.46 m 568.1 485.46 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 462.63 m 568.1 462.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 532.2 m 30.07 461.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 354.37 532.2 m 354.37 461.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 532.2 m 567.02 461.55 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 514.93 Tm (Name of registered provider\(s\):)Tj ET /F1 12 Tf BT 1 0 0 1 358.35 514.93 Tm (Merron Care Ltd)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 492.11 Tm (Type of registration:)Tj ET /F1 12 Tf BT 1 0 0 1 358.35 492.11 Tm (care home)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 469.27 Tm (Number of places registered:)Tj ET /F1 12 Tf BT 1 0 0 1 358.35 469.27 Tm (25)Tj ET /F1 10 Tf BT 1 0 0 1 28.35 450.33 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 66.24 w 32.32 406.89 m 564.47 406.89 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 419.42 m 567.8 419.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 297.24 396.6 m 567.8 396.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 442.26 m 567.8 442.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 419.42 m 567.8 419.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 297.24 396.6 m 567.8 396.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 373.77 m 567.8 373.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 443.33 m 30.07 372.69 l S 0.001 w [] 0 d [] 0 d 2.25 w 298.32 420.5 m 298.32 372.69 l S 0.001 w [] 0 d [] 0 d 2.25 w 432.52 397.67 m 432.52 372.69 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.72 443.33 m 566.72 372.69 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 426.07 Tm (Conditions of registration:)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 403.24 Tm (Category\(ies\) :)Tj ET /F1 12 Tf BT 1 0 0 1 302.3 403.24 Tm (Number of places \(if applicable\):)Tj ET /F1 12 Tf BT 1 0 0 1 302.3 380.41 Tm (Under 65)Tj ET /F1 12 Tf BT 1 0 0 1 436.5 380.41 Tm (Over 65)Tj ET 1 1 1 RG 20.58 w 31.2 358.98 m 297.25 358.98 l S 0.001 w 20.58 w 299.5 358.98 m 429.25 358.98 l S 0.001 w 20.58 w 431.5 358.98 m 565.9 358.98 l S 0.001 w 35.16 w 31.2 328.86 m 297.25 328.86 l S 0.001 w 35.16 w 299.5 328.86 m 429.25 328.86 l S 0.001 w 35.16 w 431.5 328.86 m 565.9 328.86 l S 0.001 w 20.58 w 31.2 298.73 m 297.25 298.73 l S 0.001 w 20.58 w 299.5 298.73 m 429.25 298.73 l S 0.001 w 20.58 w 431.5 298.73 m 565.9 298.73 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 347.56 m 568.1 347.56 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 310.15 m 568.1 310.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 370.39 m 568.1 370.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 347.56 m 568.1 347.56 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 310.15 m 568.1 310.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 287.32 m 568.1 287.32 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 371.47 m 30.07 286.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 298.37 371.47 m 298.37 286.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 430.37 371.47 m 430.37 286.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 371.47 m 567.02 286.24 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 354.2 Tm (dementia)Tj ET /F1 12 Tf BT 1 0 0 1 302.35 354.2 Tm (6)Tj ET /F1 12 Tf BT 1 0 0 1 434.35 354.2 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 331.38 Tm (old age, not falling within any other )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 316.8 Tm (category)Tj ET /F1 12 Tf BT 1 0 0 1 302.35 331.38 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 434.35 331.38 Tm (25)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 293.96 Tm (physical disability)Tj ET /F1 12 Tf BT 1 0 0 1 302.35 293.96 Tm (5)Tj ET /F1 12 Tf BT 1 0 0 1 434.35 293.96 Tm (0)Tj ET 0.95294 0.95294 0.95294 RG 109.98 w 32.32 209.71 m 564.77 209.71 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 244.12 m 567.8 244.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 221.29 m 568.1 221.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 266.95 m 567.8 266.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 244.12 m 568.1 244.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 221.29 m 568.1 221.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 154.71 m 568.1 154.71 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 268.02 m 30.07 153.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.72 268.02 m 566.72 153.64 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 250.76 Tm (Conditions of registration:)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 227.93 Tm (The maximum number of service users who can be accommodated is: 25)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 205.1 Tm (The registered person may provide the following category of service only: Care Home )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 190.52 Tm (Only \(Code PC\); To service users of the following gender: Either; Whose primary care )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 175.94 Tm (needs on admission to the home are within the following categories: Dementia \(DE\) 6, )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 161.36 Tm (Old age, not falling within any other category \(OP\) 25, Physical disability \(PD\) 5)Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 31.2 139.93 m 315.25 139.93 l S 0.001 w 1 1 1 RG 20.58 w 317.5 139.93 m 346.55 139.93 l S 0.001 w 20.58 w 348.8 139.93 m 377.9 139.93 l S 0.001 w 20.58 w 380.15 139.93 m 409.2 139.93 l S 0.001 w 20.58 w 411.45 139.93 m 440.55 139.93 l S 0.001 w 20.58 w 442.8 139.93 m 471.9 139.93 l S 0.001 w 20.58 w 474.15 139.93 m 503.2 139.93 l S 0.001 w 20.58 w 505.45 139.93 m 534.55 139.93 l S 0.001 w 20.58 w 536.8 139.93 m 565.9 139.93 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 151.34 m 568.1 151.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 128.51 m 568.1 128.51 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 152.42 m 30.07 127.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 316.37 152.42 m 316.37 127.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 347.67 152.42 m 347.67 127.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 379.02 152.42 m 379.02 127.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 410.32 152.42 m 410.32 127.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 441.67 152.42 m 441.67 127.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 473.02 152.42 m 473.02 127.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 504.32 152.42 m 504.32 127.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 535.67 152.42 m 535.67 127.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 152.42 m 567.02 127.43 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 135.15 Tm (Date of last inspection)Tj ET 0.95294 0.95294 0.95294 RG 17 w 31.2 116.64 m 565.9 116.64 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 107.01 m 568.1 107.01 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 108.09 m 30.07 34.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 108.09 m 567.02 34.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 126.26 m 568.1 126.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 107.01 m 568.1 107.01 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 35.8 m 568.1 35.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 127.34 m 30.07 105.93 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 127.34 m 567.02 105.93 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 35.5 113.07 Tm (Brief description of the )Tj ET /F1 12 Tf BT 1 0 0 1 177.31 113.07 Tm (care home)Tj ET /F1 12 Tf BT 1 0 0 1 35.5 93.82 Tm (Amberley is a purpose built private residential care home, registered to provide care )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 76.82 Tm (for 25 older people, this may include six older people with dementia and five older )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 59.83 Tm (people with physical disabilities. The home is situated on the main Stourbridge Road )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 42.83 Tm (between Dudley and Brierley Hill. It is on the main bus route to local towns and there )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 (17)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 30.07 610.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 768.18 m 567.02 610.77 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 28.99 611.85 m 568.1 611.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 766.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 787.43 m 567.02 766.02 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 35.5 773.16 Tm (Brief description of the )Tj ET /F1 12 Tf BT 1 0 0 1 177.31 773.16 Tm (care home)Tj ET /F1 12 Tf BT 1 0 0 1 33.25 756.16 Tm (are many local amenities close by. There is off road car parking to the front and rear of )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 739.16 Tm (the premises. Access to the home is through a small garden and patio area to the rear )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 722.16 Tm (of the property. There are three storeys, with accommodation for people on all floors. )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 705.16 Tm (A passenger lift services all floors. The accommodation comprises; communal lounge )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 688.16 Tm (and dining rooms and 21 single and 2 double bedrooms. Toilet and bathing facilities )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 671.16 Tm (are located on each floor and the main kitchen and laundry area are located on the )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 654.16 Tm (ground floor.)Tj ET /F1 12 Tf BT 1 0 0 1 33.25 637.16 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 33.25 620.16 Tm (The fees are available on application to the home. )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 (17)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 \(CQC\) carried out this random inspection visit to )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 705.57 Tm (monitor the safety and well being of people living at the home. This was because of )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 690.98 Tm (considerable changes and disruption to the management of a number of the )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 676.41 Tm (organisation's homes. There had been serious concerns about the conduct of the )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 661.83 Tm (organisation resulting in recent changes to the Responsible Individual nominated by the )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 647.24 Tm (company and to the management of the homes. The registered manager of Amberley )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 632.66 Tm (was recently nominated to take over the role of Responsible Individual and the current )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 618.09 Tm (acting manager was transferred to this home from another home owned by the company.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 603.51 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 588.92 Tm (We spent a day at the home and looked at the home's medication systems, care records, )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 574.34 Tm (the systems for dealing with complaints and safeguarding people, including staff )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 559.77 Tm (recruitment. We also looked at how people were supported and given assistance to meet )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 545.18 Tm (their daily needs. We looked around the premises and spoke to people living at the home, )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 530.6 Tm (staff and visitors.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 516.03 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 501.45 Tm (We looked at a sample of the medication held at the home. We noted that staff had )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 486.86 Tm (received medication training and were generally knowledgeable. However, some staff )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 472.29 Tm (including the acting manager, would benefit from additional familiarisation with the )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 457.7 Tm (medicines, as to their use, administration and potential side effects.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 443.13 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 428.55 Tm (There were some areas of good practice with medication well organised and we saw that )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 413.96 Tm (it was administered to people in a timely manner, with records available.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 399.39 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 384.8 Tm (However there were a number of areas, which needed to be improved. We noted that the )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 370.23 Tm (staff were not recording carried forward balances of medication stocks on the MAR )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 355.64 Tm (sheets, which meant that the accurate auditing of medication dispensed in original )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 341.07 Tm (containers could not be easily carried out.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 326.48 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 311.9 Tm (We undertook some random audits of medication stocks, the majority of which were not )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 297.33 Tm (accurate. There were only four of fifteen audits of medication records and stocks, which )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 282.74 Tm (were accurate. Examples were Lorazepam, an antipsychotic medicine where the )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 268.17 Tm (Medication Administration Record \(MAR\) chart from 6/6/09 showed four doses )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 253.59 Tm (administered, the total should have been 44 tablets remaining, and there were only 43 )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 239.01 Tm (tablets, a discrepancy of 1 missing tablet. Another person was prescribed Rampril, a )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 224.43 Tm (heart medication, where there should have been 15 remaining tablets but we could only )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 209.85 Tm (find a stock balance of six tablets for this person, which meant there was a discrepancy of )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 195.26 Tm (nine missing tablets. Another person's Adcal D3, calcium medication had a discrepancy of )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 180.68 Tm (eight tablets in excess. This meant that there were no assurances that people were )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 166.1 Tm (always receiving their medicines as prescribed by their doctor.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 151.52 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 136.95 Tm (There were a number of printed instructions on MAR sheets, which were 'as directed'. )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 122.36 Tm (These did not give sufficient guidance to staff working in the home and should be clarified )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 107.79 Tm (with the prescriber or pharmacy provider.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 93.21 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 78.63 Tm (We also noted that handwritten entries on MAR sheets had not been signed and )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 64.04 Tm (witnessed by two trained staff, which would demonstrate good practice and reduce the )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 49.47 Tm (risk of errors.)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 (17)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 ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (The bottles of liquid medication were sticky, as were some of the shelves in the drugs )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (trolley. We discussed the need to maintain the drugs trolley in a clean condition to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (maintain good standards of hygiene and infection control. We also recommended that )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (internal and external medicines should be stored separately to avoid contamination.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (We saw that two people had been prescribed a powerful antibiotic, Flucloxacillin, but the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (MAR charts with hand written entries did not show the quantity received and were not )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (signed and witnessed by two trained staff. The acting manager acknowledged that there )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (were no short term care plans in place for the people requiring this medication. Similarly )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (there was no care plan for the person requiring oxygen for 15 hours each day.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (It was positive that there were records to show that the doctors had ratified the use of )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (homely remedies for each person. There were also photographs with the MAR charts, )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (which reduced the risk of medication being given to the wrong person.)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 also looked at the storage and administration of controlled drugs, which was )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (satisfactory, with all records and balances of medication accurate. This meant that people )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (requiring these powerful medicines were receiving them as prescribed by their doctor.)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 (We looked at the care records for two people and noted that there were no care plans or )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (written protocols for the administration of when and as required \(PRN\) medication. We )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (looked at the daily records for one person and noted that there was only one entry which )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (indicated any agitated or aggressive behaviour. The lack of care plans and protocols for )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (the use of anti-psychotic medication meant that staff did not have clear guidance and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm (records showed that staff had administered this medication on 13 occasions in the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm (previous 12 days without any indication of the reason for its use or any evaluation of the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (effectiveness.)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 noted that care plans were very general with replicated standard statements, and not )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm (specific to individual assessed needs or person centred. There were no care plans in place )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm (for short term conditions or for the management of dementia. We recommended the use )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm (of behaviour monitoring charts for people described as having agitated, aggressive or )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 294.27 Tm (other challenging behaviours.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 279.7 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 265.11 Tm (The daily notes we saw were very basic, and we recommended that staff should be )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 250.54 Tm (trained and encouraged to make them more information and meaningful about the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 235.96 Tm (person's life and experience at the home. There was a key worker system, which was )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 221.38 Tm (positive and we recommended that carers as well as seniors should be involved in care )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 206.79 Tm (planning and completing daily progress records.)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 (From our observations of people in the home, they looked well presented and dressed )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 163.05 Tm (appropriately for weather and to maintain their dignity. A relative told us that the person )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 148.48 Tm (they visited always had different clothes on each day and looked nice.)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 home's systems to deal with complaints. We saw that there was a )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 104.74 Tm (complaints procedure displayed in the home and available in the Service User's Guide. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 90.15 Tm (Some of the information was out of date, it was recommended that this and other policies )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 75.57 Tm (should be reviewed and updated. There were no other alternative formats for people who )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 60.99 Tm (may not be able to read or understand written information.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 46.42 Tm ()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 (17)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 741.55 w 31.2 414.45 m 580.26 414.45 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.55 m 582.46 42.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 41.47 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (The acting manager told us that there had been complaints since the last inspection, in )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (July 2008. We spoke to a relative and two people living at the home, who told us they )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (had no complaints but could tell the staff or manager if they wanted to complain. We )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (recommended that any minor concerns or 'grumbles' should be recorded, with resolutions )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (offered to demonstrate an open and proactive approach, which would encourage people )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (to raise any concerns.)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 home had policies and procedures to inform staff about abuse and responsibilities for )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (reporting suspicions or incidents. We saw that there was a programme of safeguarding )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (training and we saw certificates for 10 staff who had recently attended training provided )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (by Dudley Directorate of Adult, Community and Housing Services \(DACHS\). The acting )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (manager told us that three additional staff had attended this training in the first two )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (weeks in June and places for other staff had been booked. We spoke to two members of )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (staff who told us what they would do and who they would report to.)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 (The 'Safeguard and Protect' multi-agency procedure clearly stated that all safeguarding )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm (concerns should be reported to Dudley DACHS. The telephone number should be made )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (available to staff, relatives and people at the home so they can directly report any )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (suspicion or witnessed incident of abuse.)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 (We looked briefly around the premises we noted an area of serious concern. In bedroom )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (13 there was an area of hot water pipes next to the bed, not guarded and excessively hot )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (to touch. This was despite written assurances of remedial action from the registered )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (proprietor following the burns sustained from hot water pipes by the person in this )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (bedroom on the 13 February 2009. Additionally we saw that none of the hot water pipes )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm (in any other bedroom, bathroom or toilet were guarded, posing risks of harm to people )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm (living at the home. We discussed our serious concerns with the acting manager, who )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (acknowledged our findings. We issued an Immediate Requirement identifying the urgent )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm (actions to be undertaken. We also wrote to the company to confirm the serious concerns )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 352.6 Tm (and the actions required to safeguard people living at the home.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm (We were also concerned when we saw two people painting the corridors on the second )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm (floor, where they had put a protective covering placed haphazardly over two thirds of the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 294.27 Tm (corridor floor, presenting a tripping hazard. There were also open containers of paint on )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 279.7 Tm (the floor and there was an open bedroom with a frail elderly person sitting in their room )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 265.11 Tm (exposed to the paint fumes. The workmen were not supervised in this area. We asked the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 250.54 Tm (acting manager if there was a risk assessment in place relating to the redecorating taking )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 235.96 Tm (place in the communal area where people at the home and staff had to be in the vicinity. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 221.38 Tm (She acknowledged no risk assessments had been undertaken. The acting manager did )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 206.79 Tm (not have information about whether the painters were employed, self employed or )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 192.21 Tm (contractors. She told us that one of the Directors had arranged for them to work at the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 177.63 Tm (home. When we them about their employment status. They told us that they were friends )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 163.05 Tm (of the Director of the company and acknowledged that they did not have Public Liability )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 148.48 Tm (Insurance or CRB clearances. We discussed this information with the acting manager who )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 133.9 Tm (decided to request the painters to pack away their equipment and leave the home. We )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 119.32 Tm (emphasised the need to ensure all work activities at the home were appropriately risk )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 104.74 Tm (assessed with measures in place to safeguard the people living at the home. Furthermore )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 90.15 Tm (there should be serious consideration of implications of any work or activity, which could )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 75.57 Tm (compromise the home's insurance.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 60.99 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 46.42 Tm (In one bedroom we saw bedrails in place with pro pad pressure relieving mattress in use. )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 (17)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 741.55 w 31.2 414.45 m 580.26 414.45 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.55 m 582.46 42.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 41.47 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (The height of bedrails was less than 30mm, instead of the permitted height dimension of )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (200mm from uncompressed mattress to the top of the bedrails. There were also )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (excessive gaps and no headboard on the bed, though the acting manager did not know )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (the reason this was missing. We did not see appropriate risk assessments or regular )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (documented checks for bedrails, which might pose significant risks of harm to people at )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (the 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 (We noted that door locks on ground floor WC's were broken and there was also a toilet )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (roll holder. We asked why these items had not been repaired or replaced. The acting )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (manager told us that though the home had a small float of petty cash some time ago, )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (this was not regularly replenished. We were told the home managers in the company did )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (not have regular petty cash to deal with minor repairs or replacements. We strongly )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (recommended that the manager has the authority and sufficient financial resources to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (maintain the home so that people living have their rights to privacy, dignity and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (independence protected.)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 (Generally the premises were not being maintained to acceptable standards. Work was )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (needed to remedy the untidy garden areas, the flaking exterior paintwork and dirty )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (windows. The interior of the home also needed attention in many areas. Some examples )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm (were carpets were faded, worn and stained in communal corridors, and some bedrooms, )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm (also had some unpleasant malodours. The very small laundry also needed renovation to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (maintain the integrity of walls and flooring for effective infection control measures, )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (especially as there were recent infections at the home.)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 (The acting manager appointed to this home on 13 February 2009 acknowledged that she )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm (had not undertaken an audit of the premises and there was no documented repairs, )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm (replacement and maintenance programme in place. She told us that a new handyperson )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (had been employed for all the homes but she had not met him. She informed us that the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm (Director had recruited this person and there were no personnel records held at this home.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 352.6 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm (The majority of WC's needed to be redecorated. We saw a bathroom with walk in shower, )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm (where the non slip bath mat had stains and mould on the underside and the acting )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm (manager disposed of this during the inspection visit. We saw a WC with a raised seat in )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 294.27 Tm (need of thorough cleaning. We saw some bathing and toilet facilities, which had been )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 279.7 Tm (painted but not finished to a good standard. For example the window frame and sill had )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 265.11 Tm (not been painted and paint splashes had been left on the flooring.)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 (There were some improvements such as the new carpet in main lounge, and the WC and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 221.38 Tm (bathroom doors on ground floor had been painted red for orientation, though this had not )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 206.79 Tm (been done throughout the first and second floors. In the kitchen there were new units, )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 192.21 Tm (work surfaces and flooring. A replacement door to exterior had also been provided as the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 177.63 Tm (previous door was not closing properly. However all of the improvements to the kitchen )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 163.05 Tm (had been required in an Environmental Health Officer's report. It appeared that the work )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 148.48 Tm (was carried out reactively as opposed to proactively.)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 saw that there were 21 people accommodated at the home, with a range of diverse )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 104.74 Tm (needs. We looked at copies of staff rotas and discussed the staffing levels with the acting )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 90.15 Tm (manager in relation to occupancy and dependency levels. We asked the acting manager )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 75.57 Tm (to tell us about the people accommodated, to identify what were their diagnosed )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 60.99 Tm (conditions were and the numbers of people in each registration category. She )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 46.42 Tm (acknowledged that she was not aware of each person's primary diagnosed needs or the )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 (17)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 (category numbers of people in each registration category. From discussions we )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (established there were about nine people who needed two staff to assist them with )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (personal care needs and about five people who needed feeding and others assistance to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (eat. People were accommodated on three floors and some people chose to stay in their )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (rooms, which was positive that they had this choice.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (We saw that the staffing levels were four carers on the early shift, with a domestic and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (cook. The acting manager told us that her hours were usually supernumerary but on the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (day of this inspection she was covering the cook's duties because he was sick. It was )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (evident that she also covered senior care shifts when the need arose. We were also told )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (that one of the directors had recently reduced the number of carers on the late shift to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (three. We assessed that this was not sufficient to provide safe levels of cover at this )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (home or to be able to meet each person's needs. We required that and that the former )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (staffing levels must be reinstated immediately until such time a staffing proposal is )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (submitted to the CQC. This must take account of people's needs and the amount of time )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm (care staff spend undertaking ancillary duties such as laundry, catering and cleaning on )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm (late shifts. As already highlighted there must be sufficient resources to improve the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (standards of cleanliness and infection control throughout the home. There must also be )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (allocated time for activities and socialisation for people living at the home.)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 (We looked at a sample of two personnel files of staff recently employed. The files were )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (generally well organised with a recruitment checklist. However the recruitment process )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (was not robust and did not provide safeguards for people living at the home. As already )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (highlighted there were no recruitment records for the handyperson due to commence )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (work at the home. Other examples were the application form only requested 10 years )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm (employment history, instead of a full employment history. One person's application form )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm (had an employment gap of a year, which had not been explored. The other person's )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (application form did not give sufficient information about employment dates and gave no )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm (employment history since 2001, which had not been explored. Both staff files only )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 352.6 Tm (contained one satisfactory written reference and one person's reference form had been )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm (returned with the comment, "no record of this person." The acting manager )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm (acknowledged that there was no evidence that this had been explored or that another )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm (reference had been obtained. She told us the recruitment had been undertaken by the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 294.27 Tm (previous Responsible Individual, Jenny Green. There were no job descriptions, or copies )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 279.7 Tm (of interview questions and answers on personnel files, which would demonstrate good )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 265.11 Tm (practice and there were and no copies of evidence of identification on one person's file.)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 (On a positive note there was evidence of an in house induction on the staff files and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 221.38 Tm (evidence of the Skills for Care Common Induction Standards being completed.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 206.79 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 192.21 Tm (We discussed the management arrangements for Amberley Care Home with the acting )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 177.63 Tm (manager, Tracey Williams, and the acting Responsible Individual, Yvonne Hughes. We )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 163.05 Tm (clarified information contained in a letter sent to the CQC, which stated that Tracey )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 148.48 Tm (Williams would be the acting manager at The Mount Care Home. We were told that a )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 133.9 Tm (decision had been made that Tracey Williams would move from The Mount to take up a )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 119.32 Tm (post as manager at Amberley and a newly employed acting manager would be the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 104.74 Tm (manager at The Mount Care Home.)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 (We were told that Tracey Williams had previously worked at Amberley for seven years as )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 60.99 Tm (a night care assistant, promoted to senior carer and then promoted to deputy manager. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 46.42 Tm (She had been requested to go to The Mount Care Home and she then returned to )Tj ET endstream endobj 20 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 21 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (9)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (17)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 425.82 w 31.2 572.32 m 580.26 572.32 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 28.99 358.28 m 582.46 358.28 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 357.2 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 357.2 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (Amberley as interim acting manager in February 2009. We were told she had an NVQ 3 )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (qualification and had recently enrolled on the Leadership and Management for Care )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (Services Award, with training provider GB Training. She also had an NVQ level 2 Team )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (Leading award and up to date mandatory training.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (The acting manager told us she was aware of the voluntary agreement with the CQC that )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (there should be no further admissions to the home until there was satisfactory evidence )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (that the management arrangements are stabilised and there could be assurances for the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (safety and well being of the people living in the homes owned by the company.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (There were some rudimentary quality assurance checks but as already identified there )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (was insufficient evidence of rigorous audits, with remedial actions for improvements. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (Examples were the concerns about the management and administration of medication, )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (the standards of the premises, the lack of rigorous recruitment and lack of risk )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (assessments to safeguard people at the home.)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 were told the company director and previous Responsible Individual had not provided )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (supervision sessions for the manager. The acting manager and the new acting )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (Responsible Individual \(RI\) acknowledged there were no recorded Regulation 26 visits )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm (and reports. We were told that the acting \(RI\) frequently visited the home and was )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm (planning to introduce unannounced Regulation 26 visits and Reports in the near future.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (We looked at the fire safety records, which appeared satisfactory and noted that there )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (were regular fire drills, which had included night staff and new staff.)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 also looked at accident records and Regulation 37 notifications. However the acting )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm (manager acknowledged there was no accident analysis and evaluation, which would be )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (good practice to identify trends and identify risks, which could be controlled or minimised. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm (It was positive that risk assessments for bed rails completed during the inspection visit. )Tj ET /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 340.21 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 1 175.95 340.21 Tm (does well:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 166.38 w 31.2 245.83 m 580.26 245.83 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 330.14 m 582.46 330.14 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 161.51 m 582.46 161.51 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 331.22 m 30.07 160.44 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 331.22 m 581.38 160.44 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 313.96 Tm (This random inspection was conducted with full co operation of the recently appointed )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 299.38 Tm (acting manager and acting responsible individual.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 284.8 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 270.22 Tm (We saw that some improvements had been made, such as a new carpet in the lounge )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 255.64 Tm (and some refurbishments in the kitchen required by Environmental Health Officers.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 241.06 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 226.48 Tm (The staff were friendly and made efforts to talk to people living at the home. For example )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 211.9 Tm (we saw staff talking in a reassuring manner and at a level and pace that people )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 197.32 Tm (understood. A relative told us that staff always made them feel welcome and they were )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 182.74 Tm (offered a drink. They told us, "All residents look well presented and she always wears )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 168.16 Tm (different clothes, never wears the same clothes two days running.")Tj ET /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 141.2 Tm (What they could do better:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 88.58 w 31.2 86.84 m 580.26 86.84 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 132.26 m 582.46 132.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 41.42 m 582.46 41.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 133.33 m 30.07 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 133.33 m 581.38 40.35 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 116.07 Tm (There must be robust management arrangements are in place at all times and any )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 101.49 Tm (changes must be notified to the CQC without delay. This is to give assurances that all )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 86.91 Tm (persons living at the home are safe from all risks of harm.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 72.33 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 57.75 Tm (We were concerned that some of the medication practices observed were potentially )Tj ET endstream endobj 22 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 23 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (10)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 536.06 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 554.36 16.38 Tm (17)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 367.5 w 31.2 601.47 m 580.26 601.47 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 28.99 416.6 m 582.46 416.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 415.52 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 415.52 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (unsafe. The organisation must make sure that all staff who are involved in the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (administration of people's medication are trained and competent, and that everyone )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (living at the home receives their medication as prescribed by their doctor, with )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (safeguards in place to maintain their health and well being.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (Plans must be put in place to meet the needs of people with complex needs such as )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (dementia.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (The premises was not being maintained to acceptable standards, it was shabby, dirty and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (had unpleasant malodours in places. There must be a properly planned maintenance )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (programme with arrangements to keep all areas of the home clean and fresh at all times )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (to create a pleasant place for people living there.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (There must be adequately numbers of trained, experienced and competent staff with )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (robust and thorough employment checks in place at all times to make sure the people )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm (living at the home are safe and cared for appropriately.)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 (There must be improved quality assurance audits of all areas of the service, including )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (medication, the premises and risks of accidents to people living at the home. There were )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm (other significant areas of health and safety at the home, which required prompt attention )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm (and improvement, such as the use of bedrails. We were also seriously concerned to see )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (that hot water pipes, which had previously caused an injury to someone living at the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (home, were left unguarded, despite written assurances this work had been carried out. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (We issued immediate requirements for those areas, which required the most urgent )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (action.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 400.54 Tm (If you want to know what action the person responsible for this care home)Tj ET /F1 12 Tf BT 1 0 0 1 483.55 400.54 Tm (is taking )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 384.54 Tm (following this report, you can contact them using the details set out on page 2.)Tj ET endstream endobj 24 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 (17)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 ()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 1 548.37 742.58 Tm (5)Tj ET 0.95294 0.95294 0.95294 RG 124.56 w 32.32 615.67 m 564.97 615.67 l S 0.001 w 1 1 1 RG 20.58 w 31.2 564.8 m 91.05 564.8 l S 0.001 w 20.58 w 93.3 564.8 m 197.4 564.8 l S 0.001 w 20.58 w 199.65 564.8 m 289.45 564.8 l S 0.001 w 20.58 w 291.7 564.8 m 473.8 564.8 l S 0.001 w 20.58 w 476.05 564.8 m 566.1 564.8 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 30.07 577.3 m 30.07 552.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 577.3 m 567.22 552.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 608.77 m 568.4 608.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 576.22 m 568.3 576.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 577.3 m 92.17 552.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 577.3 m 198.52 552.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 577.3 m 290.57 552.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 577.3 m 474.92 552.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 680.2 m 568.4 680.2 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 608.77 m 568.4 608.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 576.22 m 568.4 576.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 553.39 m 568.3 553.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 681.28 m 30.07 575.14 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 609.85 m 92.12 575.14 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 609.85 m 198.52 575.14 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 609.85 m 290.62 575.14 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 609.85 m 475.02 575.14 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 681.28 m 567.32 575.14 l S 0.001 w [] 0 d /F1 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 662.99 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 34.05 644.58 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 34.05 629.99 Tm (been met.)Tj ET /F1 12 Tf BT 1 0 0 1 95.57 629.99 Tm ( )Tj ET /F1 12 Tf BT 1 0 0 1 104.02 629.99 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 34.05 615.41 Tm (Act 2000, )Tj ET /F1 12 Tf BT 1 0 0 1 96.58 615.41 Tm ( Regulations 2001 and the National Minimum Standards.)Tj ET /F1 10 Tf BT 1 0 0 1 31.2 597.59 Tm (No.)Tj ET /F1 10 Tf BT 1 0 0 1 96.1 594.59 Tm (Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.5 594.59 Tm (Regulation)Tj ET /F1 10 Tf BT 1 0 0 1 294.6 594.59 Tm (Requirement)Tj ET /F1 10 Tf BT 1 0 0 1 479 594.59 Tm (Timescale for )Tj ET /F1 10 Tf BT 1 0 0 1 479 582.45 Tm (action)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 (17)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 475.62 w 32.32 508.73 m 564.97 508.73 l S 0.001 w 1 1 1 RG 388.08 w 31.2 466.08 m 91.05 466.08 l S 0.001 w 388.08 w 93.3 466.08 m 197.4 466.08 l S 0.001 w 388.08 w 199.65 466.08 m 289.45 466.08 l S 0.001 w 388.08 w 291.7 466.08 m 473.8 466.08 l S 0.001 w 388.08 w 476.05 466.08 m 566.1 466.08 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 30.07 662.32 m 30.07 269.84 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 662.32 m 567.22 269.84 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 92.17 269.84 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 662.32 m 198.52 269.84 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 662.32 m 290.57 269.84 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 662.32 m 474.92 269.84 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 28.99 270.92 m 568.3 270.92 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 /F1 12 Tf BT 1 0 0 1 34.05 645.06 Tm (1)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 645.06 Tm (38)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 645.06 Tm (13)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 645.06 Tm (Action must be taken to )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 630.48 Tm (devise and implement )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 615.9 Tm (documented risk )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 601.32 Tm (assessments for all )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 586.74 Tm (unguarded hot water pipes in )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 572.16 Tm (the home, identifying control )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 557.58 Tm (measures with immediate )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 543 Tm (effect.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 528.42 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 513.84 Tm (Action must be taken to )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 499.26 Tm (arrange for all hot water )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 484.68 Tm (pipes accessible to people )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 470.1 Tm (living at the home, to be )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 455.52 Tm (appropriately guarded in a )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 440.94 Tm (timescale to be identified to )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 426.36 Tm (the Care quality Commission.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 411.78 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 397.2 Tm (Action must be taken to )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 382.62 Tm (notify the appropriate Health )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 368.04 Tm (and Safety Agency of the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 353.46 Tm (accident, without further )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 338.88 Tm (delay.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 321.3 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 306.72 Tm (This is to safeguard people )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 292.14 Tm (living at the home from risks )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 277.56 Tm (of harm.)Tj ET /F1 12 Tf BT 1 0 0 1 478.9 645.06 Tm (06/07/2009)Tj ET 0.95294 0.95294 0.95294 RG 188.74 w 32.32 138.04 m 564.97 138.04 l S 0.001 w 1 1 1 RG 89.45 w 31.2 87.28 m 91.05 87.28 l S 0.001 w 89.45 w 93.3 87.28 m 197.4 87.28 l S 0.001 w 89.45 w 199.65 87.28 m 289.45 87.28 l S 0.001 w 89.45 w 291.7 87.28 m 473.8 87.28 l S 0.001 w 89.45 w 476.05 87.28 m 566.1 87.28 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 30.07 134.2 m 30.07 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 134.2 m 567.22 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 165.68 m 568.4 165.68 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 133.13 m 568.3 133.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 134.2 m 92.17 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 134.2 m 198.52 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 134.2 m 290.57 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 134.2 m 474.92 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 234.66 m 568.4 234.66 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 165.68 m 568.4 165.68 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 133.13 m 568.4 133.13 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 30.07 235.74 m 30.07 132.05 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 166.75 m 92.12 132.05 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 166.75 m 198.52 132.05 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 166.75 m 290.62 132.05 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 166.75 m 475.02 132.05 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 235.74 m 567.32 132.05 l S 0.001 w [] 0 d /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 221.48 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 34.05 201.48 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 34.05 186.9 Tm (Standards Act 2000, )Tj ET /F1 12 Tf BT 1 0 0 1 166.31 186.9 Tm (Regulations 2001 and the National Minimum Standards. The )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 172.32 Tm (registered person\(s\) must do this within the timescales we have set.)Tj ET /F1 10 Tf BT 1 0 0 1 31.2 154.5 Tm (No.)Tj ET /F1 10 Tf BT 1 0 0 1 96.1 151.5 Tm (Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.5 151.5 Tm (Regulation)Tj ET /F1 10 Tf BT 1 0 0 1 294.6 151.5 Tm (Requirement)Tj ET /F1 10 Tf BT 1 0 0 1 479 151.5 Tm (Timescale for )Tj ET /F1 10 Tf BT 1 0 0 1 479 139.35 Tm (action)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 116.94 Tm (1)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 116.94 Tm (7)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 116.94 Tm (12)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 116.94 Tm (The registered persons must )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 102.36 Tm (ensure there are care plans )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 87.78 Tm (in place for the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 73.2 Tm (administration of when and )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 58.62 Tm (as needed medication and )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 44.04 Tm (staff act appropriately to )Tj ET /F1 12 Tf BT 1 0 0 1 478.9 116.94 Tm (20/07/2009)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 (17)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 739.3 w 32.32 414.45 m 564.97 414.45 l S 0.001 w 1 1 1 RG 111.06 w 31.2 628.16 m 91.05 628.16 l S 0.001 w 111.06 w 93.3 628.16 m 197.4 628.16 l S 0.001 w 111.06 w 199.65 628.16 m 289.45 628.16 l S 0.001 w 111.06 w 291.7 628.16 m 473.8 628.16 l S 0.001 w 111.06 w 476.05 628.16 m 566.1 628.16 l S 0.001 w 271.44 w 31.2 434.65 m 91.05 434.65 l S 0.001 w 271.44 w 93.3 434.65 m 197.4 434.65 l S 0.001 w 271.44 w 199.65 434.65 m 289.45 434.65 l S 0.001 w 271.44 w 291.7 434.65 m 473.8 434.65 l S 0.001 w 271.44 w 476.05 434.65 m 566.1 434.65 l S 0.001 w 213.12 w 31.2 190.13 m 91.05 190.13 l S 0.001 w 213.12 w 93.3 190.13 m 197.4 190.13 l S 0.001 w 213.12 w 199.65 190.13 m 289.45 190.13 l S 0.001 w 213.12 w 291.7 190.13 m 473.8 190.13 l S 0.001 w 213.12 w 476.05 190.13 m 566.1 190.13 l S 0.001 w 37.64 w 31.2 62.49 m 91.05 62.49 l S 0.001 w 37.64 w 93.3 62.49 m 197.4 62.49 l S 0.001 w 37.64 w 199.65 62.49 m 289.45 62.49 l S 0.001 w 37.64 w 291.7 62.49 m 473.8 62.49 l S 0.001 w 37.64 w 476.05 62.49 m 566.1 62.49 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 571.5 m 568.3 571.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 297.81 m 568.3 297.81 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 82.44 m 568.3 82.44 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 685.89 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 685.89 m 567.22 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 717.36 m 568.4 717.36 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 684.81 m 568.3 684.81 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 685.89 m 92.17 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 685.89 m 198.52 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 685.89 m 290.57 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 685.89 m 474.92 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 786.35 m 568.4 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 717.36 m 568.4 717.36 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 684.81 m 568.4 684.81 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 571.5 m 568.3 571.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 297.81 m 568.3 297.81 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 82.44 m 568.3 82.44 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 30.07 787.43 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. 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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. 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34.05 540.73 Tm (7)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 540.73 Tm (38)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 540.73 Tm (13)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 540.73 Tm (To ensure that the risk )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 526.16 Tm (assessments for bed rails are )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 511.58 Tm (expanded to incorporate all )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 496.99 Tm (areas of risk to the person, )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 482.42 Tm (including risks of entrapment )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 467.83 Tm (and incompatibility with the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 453.26 Tm (bed and or mattress.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 435.67 Tm (This is to safeguard people )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 421.1 Tm (living at the home from risks )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 406.52 Tm (of harm.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 391.93 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 478.9 540.73 Tm (10/07/2009)Tj ET 0.95294 0.95294 0.95294 RG 321.24 w 32.32 205.42 m 564.97 205.42 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m 568.3 278.32 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 279.4 m 92.17 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 279.4 m 198.52 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 368.29 m 568.4 368.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 298.72 m 568.4 298.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 278.32 m 568.4 278.32 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 226.33 m 568.3 226.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 159.76 m 568.3 159.76 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 78.61 m 568.3 78.61 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 30.07 369.37 m 30.07 277.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 299.8 m 92.17 277.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.47 299.8 m 198.47 277.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 369.37 m 567.32 277.24 l S 0.001 w [] 0 d /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 352.11 Tm (Recommendations)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 34.05 334.52 Tm (These recommendations are taken from the best practice described in the National )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 319.95 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 34.05 305.36 Tm (improving their service.)Tj ET /F1 10 Tf BT 1 0 0 1 34.05 284.55 Tm (No)Tj ET /F1 10 Tf BT 1 0 0 1 96.15 284.55 Tm (Refer to Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.45 284.55 Tm (Good Practice Recommendations)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 262.14 Tm (1)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 262.14 Tm (7)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 262.14 Tm (It is recommended that carers as well as seniors should be )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 247.55 Tm (involved in care planning and completing daily progress )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 232.98 Tm (records to make them more meaningful.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 210.15 Tm (2)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 210.15 Tm (7)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 210.15 Tm (That the all health care risk assessments and care plans )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 195.57 Tm (include all of each persons assessed needs, and accurately )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 180.99 Tm (reflect all changes to health and needs, and be referred for )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 166.4 Tm (professional advice where necessary.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 143.57 Tm (3)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 143.57 Tm (8)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 143.57 Tm (It is recommended that serious consideration should be )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 128.99 Tm (given to use of Antecedent, Behaviour, Consequence \(ABC\) )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 114.42 Tm (records to evaluate the effectiveness of strategies and use )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 99.83 Tm (of PRN medication for residents with challenging or )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 85.25 Tm (distressed behaviours.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 62.42 Tm (4)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 62.42 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 62.42 Tm (That internal and external medication should be stored )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 47.85 Tm (separately and the drugs trolley and containers should be )Tj ET endstream endobj 36 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 37 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (16)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 536.06 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 554.36 16.38 Tm (17)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 719.01 w 32.32 424.6 m 564.97 424.6 l S 0.001 w 1 1 1 RG 17.58 w 31.2 686.47 m 91.05 686.47 l S 0.001 w 17.58 w 93.3 686.47 m 197.4 686.47 l 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Tf BT 1 0 0 1 34.05 660.36 Tm (5)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 660.36 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 660.36 Tm (It was recommendation that Patient Information Leaflets )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 645.78 Tm (should be obtained from the pharmacist for medication )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 631.21 Tm (dispensed in blister packs, so that staff have written )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 616.63 Tm (guidance as to how medication should be administered, )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 602.04 Tm (what it is used for and to be aware of possible side effects.)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 (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 579.22 Tm (That all handwritten entries on MAR sheets are dated )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 564.64 Tm (signed and witnessed by staff who are trained and )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 550.05 Tm (competent.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 527.22 Tm (7)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 527.22 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 527.22 Tm (That carried forward stocks of medication are recorded on )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 512.65 Tm (each persons MAR sheet and random audits of medication )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 498.07 Tm (stocks should be carried out, with recorded remedial action )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 483.48 Tm (for any discrepancies.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 460.65 Tm (8)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 460.65 Tm (12)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 460.65 Tm (It is strongly recommended strongly recommended that )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 446.08 Tm (there should be allocated time for activities for a minimum )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 431.49 Tm (of 15 hours per week, with staff training to ensure )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 416.92 Tm (appropriate social stimulation was offered to everyone and )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 402.33 Tm (especially to people with dementia and sensory disabilities.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 379.51 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 379.51 Tm (18)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 379.51 Tm (The telephone numbers of social service departments who )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 364.92 Tm (support the people living at the home should be available )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 350.35 Tm (to staff, relatives and each person so that they can report )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 335.77 Tm (any suspected or witnessed abuse directly if needed.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 312.93 Tm (10)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 312.93 Tm (18)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 312.93 Tm (It was recommended that all staff should be given time to )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 298.36 Tm (read and familiarise themselves with the home's )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 283.77 Tm (safeguarding procedures and the 'Safeguard and Protect' )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 269.2 Tm (procedure for vulnerable adults with signatures and dates )Tj ET /F1 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(38)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 113.22 Tm (It is strongly recommend that a competent person should )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 98.64 Tm (undertake a visual check of bedrails in the home on a daily )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 84.07 Tm (basis to ensure that they are safe. 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Tel: 0870 600 5522. 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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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