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9LA=:c'֝_Ns9T7Rs|MzZjשRjZrܥ)7vmՅQH(((((((((((((((((((((((((((((((( endstream endobj 7 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 59.55 w 22.95 46.39 m 561.53 46.39 l S 0.001 w /F1 10 Tf 0 0 0 rg BT 1 0 0 1 28.35 67.25 Tm ()Tj ET q 170.25 0 0 54 28.35 751.65 cm /img0 Do Q /F2 28 Tf BT 1 0 0 1 147.05 643.14 Tm (.H\\LQVSHFWLRQUHSRUW)Tj ET 20.58 w 27.33 599.07 m 557.15 599.07 l S 0.001 w /F3 24 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 551.37 Tm (Care homes for older people)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 6 Tf BT 1 0 0 1 28.35 540.33 Tm ()Tj ET /F2 6 Tf BT 1 0 0 1 28.35 533.09 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 31.2 519.31 m 160.38 519.31 l S 0.001 w 1 1 1 RG 20.58 w 162.63 519.31 m 563.65 519.31 l S 0.001 w 0.95294 0.95294 0.95294 RG 73.32 w 31.2 470.11 m 160.38 470.11 l S 0.001 w 1 1 1 RG 73.32 w 162.63 470.11 m 563.65 470.11 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 507.9 m 565.85 507.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 530.73 m 565.85 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S 0.001 w /F3 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 485.42 30.79 Tm (Page)Tj ET /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 515.95 30.79 Tm (2)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 523.58 30.79 Tm ( of )Tj ET /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 541.88 30.79 Tm (43)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 10 Tf BT 1 0 0 1 297.64 803.65 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 28.35 787.03 Tm (This is a review of quality of outcomes that people experience in this )Tj ET /F3 12 Tf BT 1 0 0 1 448.39 787.03 Tm (care home. We )Tj ET /F3 12 Tf BT 1 0 0 1 28.35 769.53 Tm (believe high quality care should)Tj ET /F5 12 Tf BT 1 0 0 1 85.05 749.53 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 100.35 749.53 Tm (Be safe)Tj ET /F5 12 Tf BT 1 0 0 1 85.05 733.53 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 100.35 733.53 Tm (Have the right outcomes, including clinical outcomes)Tj ET /F5 12 Tf BT 1 0 0 1 85.05 717.53 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 100.35 717.53 Tm (Be a good experience for the people that use it)Tj ET /F5 12 Tf BT 1 0 0 1 85.05 701.53 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 100.35 701.53 Tm (Help prevent illness, and promote healthy, independent living)Tj ET /F5 12 Tf BT 1 0 0 1 85.05 685.53 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 100.35 685.53 Tm (Be available to those who need it when they need it.)Tj ET /F3 12 Tf BT 1 0 0 1 28.35 651.03 Tm (The first part of the review gives the overall quality rating for the )Tj ET /F3 12 Tf BT 1 0 0 1 427.6 651.03 Tm (care home:)Tj ET /F5 12 Tf BT 1 0 0 1 85.05 631.04 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 100.35 631.04 Tm (3 stars - excellent)Tj ET /F5 12 Tf BT 1 0 0 1 85.05 615.04 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 100.35 615.04 Tm (2 stars - good)Tj ET /F5 12 Tf BT 1 0 0 1 85.05 599.04 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 100.35 599.04 Tm (1 star - adequate)Tj ET /F5 12 Tf BT 1 0 0 1 85.05 583.04 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 100.35 583.04 Tm (0 star - poor)Tj ET /F3 12 Tf BT 1 0 0 1 28.35 551.04 Tm (There is also a bar chart that gives a quick way of seeing the quality of care that the )Tj ET /F3 12 Tf BT 1 0 0 1 28.35 534.04 Tm (home provides under key areas that matter to people.)Tj ET /F3 12 Tf BT 1 0 0 1 28.35 500.04 Tm (There is a summary of what we think this service does well, what they have improved )Tj ET /F3 12 Tf BT 1 0 0 1 28.35 483.04 Tm (on and, where it applies, what they need to do better.)Tj ET /F3 12 Tf BT 1 0 0 1 364.74 483.04 Tm (We use the national minimum )Tj ET /F3 12 Tf BT 1 0 0 1 28.35 466.04 Tm (standards to describe the outcomes that people should experience.)Tj ET /F3 12 Tf BT 1 0 0 1 443.2 466.04 Tm (National minimum )Tj ET /F3 12 Tf BT 1 0 0 1 28.35 449.04 Tm (standards are written by the Department of Health for each type of care service.)Tj ET /F3 12 Tf BT 1 0 0 1 28.35 409.54 Tm (After the summary there is more detail about our findings. The following table explains )Tj ET /F3 12 Tf BT 1 0 0 1 28.35 392.05 Tm (what you will see under each outcome area.)Tj ET [] 0 d 0.5 w 0 0 0 RG 22.69 383.86 m 572.15 383.86 l S 0.001 w [] 0 d [] 0 d 0.5 w 22.69 50.22 m 572.15 50.22 l S 0.001 w [] 0 d [] 0 d 0.5 w 22.7 383.86 m 22.7 50.22 l S 0.001 w [] 0 d [] 0 d 0.5 w 572.15 383.86 m 572.15 50.22 l S 0.001 w [] 0 d /F3 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 370.56 Tm (Outcome area \(for example )Tj ET 0 0 0 RG 0.001 w 0 Tr /F3 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 173.59 370.56 Tm (Choice of home\))Tj ET 0 0 0 RG 0.001 w 0 Tr /F3 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 340.26 Tm (These are the outcomes that people )Tj ET 0 0 0 RG 0.001 w 0 Tr /F3 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 216.34 340.26 Tm (staying in care homes should experience.)Tj ET 0 0 0 RG 0.001 w 0 Tr /F3 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 435.79 340.26 Tm (They reflect the things )Tj ET 0 0 0 RG 0.001 w 0 Tr /F3 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 328.11 Tm (that people have said are important to them:)Tj ET 0 0 0 RG 0.001 w 0 Tr 1 0.9451 0.76078 RG 82.23 w 30.6 263.37 m 562.45 263.37 l S 0.001 w 0.95294 0.95294 0.95294 RG 39.99 w 29.47 285.61 m 563.57 285.61 l S 0.001 w 1 1 1 RG 39.99 w 29.47 243.37 m 563.57 243.37 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 27.27 264.49 m 565.77 264.49 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 306.73 m 565.77 306.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 264.49 m 565.77 264.49 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 222.25 m 565.77 222.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.35 307.81 m 28.35 221.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.7 307.81 m 564.7 221.17 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 34.87 291.05 Tm (This box tells you the outcomes that we will always inspect against when we do a key )Tj ET /F3 12 Tf BT 1 0 0 1 34.87 273.55 Tm (inspection)Tj ET /F3 10 Tf BT 1 0 0 1 95.78 273.55 Tm (.)Tj ET /F3 12 Tf BT 1 0 0 1 34.87 248.81 Tm (This box tells you any additional outcomes that we may inspect against when we do a )Tj ET /F3 12 Tf BT 1 0 0 1 34.87 231.31 Tm (key inspection.)Tj ET /F3 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 191.8 Tm (This is what people )Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 131.32 191.8 Tm (staying in this care home experience:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 28.35 154.64 Tm (Judgement:)Tj ET 1 0.9451 0.76078 RG 39.99 w 30.6 123.34 m 562.45 123.34 l S 0.001 w 1 1 1 RG 39.99 w 29.47 124.46 m 563.57 124.46 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 27.27 145.58 m 565.77 145.58 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 103.34 m 565.77 103.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.35 146.66 m 28.35 102.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.7 146.66 m 564.7 102.26 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 34.87 129.9 Tm (This box tells you our opinion of what we have looked at in this outcome area.)Tj ET /F3 12 Tf BT 1 0 0 1 517.79 129.9 Tm (We )Tj ET /F3 12 Tf BT 1 0 0 1 34.87 112.4 Tm (will say whether it is excellent, good, adequate or poor.)Tj ET /F3 12 Tf BT 1 0 0 1 28.35 86.53 Tm (Evidence:)Tj ET 1 0.9451 0.76078 RG 22.5 w 30.6 63.97 m 562.45 63.97 l S 0.001 w 1 1 1 RG 22.5 w 29.47 65.1 m 563.57 65.1 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 27.27 77.47 m 565.77 77.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 52.72 m 565.77 52.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.35 78.55 m 28.35 51.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.7 78.55 m 564.7 51.65 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 34.87 61.78 Tm (This box describes the information we used to come to our judgement.)Tj ET endstream endobj 11 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 12 0 obj<>>> endobj 13 0 obj <>stream 0 J 0.8 0.8 0.8 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F3 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 485.42 30.79 Tm (Page)Tj ET /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 515.95 30.79 Tm (3)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 523.58 30.79 Tm ( of )Tj ET /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 541.88 30.79 Tm (43)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 28.35 779.1 Tm (We review the quality of the service against outcomes from the National Minimum )Tj ET /F3 12 Tf BT 1 0 0 1 28.35 762.1 Tm (Standards \(NMS\).)Tj ET /F3 12 Tf BT 1 0 0 1 144.87 762.1 Tm (Those standards are written by the Department of Health for each )Tj ET /F3 12 Tf BT 1 0 0 1 28.35 745.1 Tm (type of care service.)Tj ET /F3 12 Tf BT 1 0 0 1 28.35 705.6 Tm (Copies of the)Tj ET /F3 12 Tf BT 1 0 0 1 111.71 705.6 Tm (National Minimum Standards )Tj ET /F3 12 Tf BT 1 0 0 1 290.49 705.6 Tm ( )Tj ET /F3 12 Tf BT 1 0 0 1 302.34 705.6 Tm (Care Homes for Older People)Tj ET /F3 12 Tf BT 1 0 0 1 477.18 705.6 Tm ( can be found )Tj ET /F3 12 Tf BT 1 0 0 1 28.35 688.11 Tm (at www.dh.gov.uk or bought from The Stationery Office \(TSO\) PO Box 29, St Crispins, )Tj ET /F3 12 Tf BT 1 0 0 1 28.35 670.61 Tm (Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the )Tj ET /F3 12 Tf BT 1 0 0 1 28.35 653.11 Tm (Stationery Office is also available: )Tj ET /F3 12 Tf 0 0 1 rg BT 1 0 0 1 238.73 653.11 Tm (www.tso.co.uk/bookshop)Tj ET /F3 12 Tf 0 0 0 rg BT 1 0 0 1 28.35 613.12 Tm (The mission of the Care Quality Commission is to make care better for people by:)Tj ET /F5 12 Tf BT 1 0 0 1 85.05 596.12 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 100.35 596.12 Tm (Regulating health and adult social care services to ensure quality and safety )Tj ET /F3 12 Tf BT 1 0 0 1 99.25 580.12 Tm (standards, drive improvement and stamp out bad practice)Tj ET /F5 12 Tf BT 1 0 0 1 85.05 564.12 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 100.35 564.12 Tm (Protecting the rights of people who use services, particularly the most )Tj ET /F3 12 Tf BT 1 0 0 1 99.25 548.12 Tm (vulnerable and those detained under the Mental Health Act 1983)Tj ET /F5 12 Tf BT 1 0 0 1 85.05 532.12 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 100.35 532.12 Tm (Providing accessible, trustworthy information on the quality of care and )Tj ET /F3 12 Tf BT 1 0 0 1 99.25 516.12 Tm (services so people can make better decisions about their care and so that )Tj ET /F3 12 Tf BT 1 0 0 1 99.25 500.12 Tm (commissioners and providers of services can improve services.)Tj ET /F5 12 Tf BT 1 0 0 1 85.05 484.12 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 100.35 484.12 Tm (Providing independent public accountability on how commissioners and )Tj ET /F3 12 Tf BT 1 0 0 1 99.25 468.12 Tm (providers of services are improving the quality of care and providing value )Tj ET /F3 12 Tf BT 1 0 0 1 99.25 452.12 Tm (for money.)Tj ET /F2 14 Tf BT 1 0 0 1 28.35 390.28 Tm (5HDGHU,QIRUPDWLRQ)Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 28.35 368.85 m 224.05 368.85 l S 0.001 w 1 1 1 RG 20.58 w 226.3 368.85 m 567 368.85 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 28.35 346.02 m 224.05 346.02 l S 0.001 w 1 1 1 RG 20.58 w 226.3 346.02 m 567 346.02 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 28.35 323.19 m 224.05 323.19 l S 0.001 w 1 1 1 RG 20.58 w 226.3 323.19 m 567 323.19 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 28.35 300.36 m 224.05 300.36 l S 0.001 w 1 1 1 RG 20.58 w 226.3 300.36 m 567 300.36 l S 0.001 w 0.95294 0.95294 0.95294 RG 128.64 w 28.35 223.5 m 224.05 223.5 l S 0.001 w 1 1 1 RG 128.64 w 226.3 223.5 m 567 223.5 l S 0.001 w 0.95294 0.95294 0.95294 RG 38.16 w 28.35 137.85 m 224.05 137.85 l S 0.001 w 1 1 1 RG 38.16 w 226.3 137.85 m 567 137.85 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 26.14 357.43 m 569.2 357.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 334.6 m 569.2 334.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 311.77 m 569.2 311.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 288.94 m 569.2 288.94 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 158.05 m 569.2 158.05 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 380.26 m 569.2 380.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 357.43 m 569.2 357.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 334.6 m 569.2 334.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 311.77 m 569.2 311.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 288.94 m 569.2 288.94 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 158.05 m 569.2 158.05 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 117.64 m 569.2 117.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.22 381.34 m 27.22 116.57 l S 0.001 w [] 0 d [] 0 d 2.25 w 225.17 381.34 m 225.17 116.57 l S 0.001 w [] 0 d [] 0 d 2.25 w 568.12 381.34 m 568.12 116.57 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 31.2 364.08 Tm (Document Purpose)Tj ET /F3 12 Tf BT 1 0 0 1 229.15 364.08 Tm (Inspection report)Tj ET /F3 12 Tf BT 1 0 0 1 31.2 341.25 Tm (Author)Tj ET /F3 12 Tf BT 1 0 0 1 229.15 341.25 Tm (Care Quality Commission)Tj ET /F3 12 Tf BT 1 0 0 1 31.2 318.42 Tm (Audience)Tj ET /F3 12 Tf BT 1 0 0 1 229.15 318.42 Tm (General public)Tj ET /F3 12 Tf BT 1 0 0 1 31.2 295.59 Tm (Further copies from)Tj ET /F3 12 Tf BT 1 0 0 1 229.15 295.59 Tm (0870 240 7535 \(telephone order line\))Tj ET /F3 12 Tf BT 1 0 0 1 31.2 272.76 Tm (Copyright)Tj ET /F3 12 Tf BT 1 0 0 1 229.15 272.76 Tm ( Care Quality Commission 2010)Tj ET /F3 12 Tf BT 1 0 0 1 229.15 255.18 Tm (This publication may be reproduced in whole or in part )Tj ET /F3 12 Tf BT 1 0 0 1 229.15 240.6 Tm (in any format or medium for non-commercial purposes, )Tj ET /F3 12 Tf BT 1 0 0 1 229.15 226.02 Tm (provided that it is reproduced accurately and not used )Tj ET /F3 12 Tf BT 1 0 0 1 229.15 211.44 Tm (in a derogatory manner or in a misleading context. The )Tj ET /F3 12 Tf BT 1 0 0 1 229.15 196.86 Tm (source should be acknowledged, by showing the )Tj ET /F3 12 Tf BT 1 0 0 1 229.15 182.28 Tm (publication title and Care Quality Commission 2010.)Tj ET /F3 12 Tf BT 1 0 0 1 31.2 141.87 Tm (Internet address)Tj ET /F3 12 Tf 1 0 0 rg BT 1 0 0 1 229.15 141.87 Tm (www.cqc.org.uk)Tj ET endstream endobj 14 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 15 0 obj <>stream 0 J 0.8 0.8 0.8 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F3 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 485.42 30.79 Tm (Page)Tj ET /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 515.95 30.79 Tm (4)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 523.58 30.79 Tm ( of )Tj ET /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 541.88 30.79 Tm (43)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 14 Tf BT 1 0 0 1 28.35 795.65 Tm (,QIRUPDWLRQDERXWWKHFDUHKRPH)Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 31.2 774.22 m 267.95 774.22 l S 0.001 w 1 1 1 RG 20.58 w 270.2 774.22 m 565.65 774.22 l S 0.001 w 0.95294 0.95294 0.95294 RG 73.32 w 31.2 725.02 m 267.95 725.02 l S 0.001 w 1 1 1 RG 73.32 w 270.2 725.02 m 565.65 725.02 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 675.82 m 267.95 675.82 l S 0.001 w 1 1 1 RG 20.58 w 270.2 675.82 m 565.65 675.82 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 652.99 m 267.95 652.99 l S 0.001 w 1 1 1 RG 20.58 w 270.2 652.99 m 565.65 652.99 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 630.16 m 267.95 630.16 l S 0.001 w 1 1 1 RG 20.58 w 270.2 630.16 m 565.65 630.16 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 607.33 m 267.95 607.33 l S 0.001 w 1 1 1 RG 20.58 w 270.2 607.33 m 565.65 607.33 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 762.8 m 567.85 762.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 687.23 m 567.85 687.23 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 664.4 m 567.85 664.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 641.57 m 567.85 641.57 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 618.74 m 567.85 618.74 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 785.63 m 567.85 785.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 762.8 m 567.85 762.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 687.23 m 567.85 687.23 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 664.4 m 567.85 664.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 641.57 m 567.85 641.57 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 618.74 m 567.85 618.74 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 595.91 m 567.85 595.91 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 786.71 m 30.07 594.84 l S 0.001 w [] 0 d [] 0 d 2.25 w 269.07 786.71 m 269.07 594.84 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.77 786.71 m 566.77 594.84 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 34.05 769.45 Tm (Name of care home:)Tj ET /F3 12 Tf BT 1 0 0 1 273.05 769.45 Tm (Summer Court Hall Residential Home)Tj ET /F3 12 Tf BT 1 0 0 1 34.05 746.62 Tm (Address:)Tj ET /F3 12 Tf BT 1 0 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1 1 RG 20.58 w 355.5 472.8 m 565.9 472.8 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 552.71 m 568.1 552.71 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 529.88 m 567.8 529.88 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 507.05 m 568.1 507.05 l S 0.001 w [] 0 d [] 0 d 2.25 w 354.37 576.61 m 354.37 551.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 484.22 m 568.1 484.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 575.54 m 568.1 575.54 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 552.71 m 567.8 552.71 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 529.88 m 568.1 529.88 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 507.05 m 568.1 507.05 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 484.22 m 568.1 484.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 461.39 m 568.1 461.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 576.61 m 30.07 460.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 354.37 508.12 m 354.37 460.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 576.61 m 567.02 460.31 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 34.05 559.35 Tm (Name of registered provider\(s\):)Tj ET /F3 12 Tf BT 1 0 0 1 355.5 559.35 Tm (Hexon Limited)Tj ET /F3 12 Tf BT 1 0 0 1 34.05 536.52 Tm (Name of registered manager \(if applicable\))Tj ET /F3 12 Tf BT 1 0 0 1 34.05 513.69 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.05 490.86 Tm (Type of registration:)Tj ET /F3 12 Tf BT 1 0 0 1 358.35 490.86 Tm (care home)Tj ET /F3 12 Tf BT 1 0 0 1 34.05 468.03 Tm (Number of places registered:)Tj ET /F3 12 Tf BT 1 0 0 1 358.35 468.03 Tm (37)Tj ET /F3 10 Tf BT 1 0 0 1 28.35 449.09 Tm ()Tj ET /F3 10 Tf BT 1 0 0 1 28.35 432.09 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 63.99 w 32.32 389.77 m 564.47 389.77 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 401.18 m 567.8 401.18 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 424.01 m 567.8 424.01 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 401.18 m 567.8 401.18 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 357.77 m 567.8 357.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 425.09 m 30.07 356.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 298.32 402.26 m 298.32 356.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.72 425.09 m 566.72 356.7 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 34.05 407.83 Tm (Conditions of registration:)Tj ET /F3 12 Tf BT 1 0 0 1 34.05 385 Tm (Category\(ies\) :)Tj ET /F3 12 Tf BT 1 0 0 1 302.3 385 Tm (Number of places \(if applicable\):)Tj ET /F3 12 Tf BT 1 0 0 1 302.3 364.42 Tm (Under 65)Tj ET /F3 12 Tf BT 1 0 0 1 435.37 364.42 Tm (Over 65)Tj ET 1 1 1 RG 20.58 w 31.2 342.98 m 297.3 342.98 l S 0.001 w 20.58 w 299.55 342.98 m 431.45 342.98 l S 0.001 w 20.58 w 433.7 342.98 m 565.6 342.98 l S 0.001 w 35.16 w 31.2 312.86 m 297.3 312.86 l S 0.001 w 35.16 w 299.55 312.86 m 431.45 312.86 l S 0.001 w 35.16 w 433.7 312.86 m 565.6 312.86 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 282.74 m 565.6 282.74 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 331.57 m 567.8 331.57 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 294.16 m 567.8 294.16 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 271.33 m 567.8 271.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 354.4 m 567.8 354.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 331.57 m 567.8 331.57 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 294.16 m 567.8 294.16 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 271.33 m 568.1 271.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 233.92 m 568.1 233.92 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 355.47 m 30.07 232.84 l S 0.001 w [] 0 d [] 0 d 2.25 w 298.42 355.47 m 298.42 293.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 432.57 355.47 m 432.57 293.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.72 355.47 m 566.72 232.84 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 34.05 338.21 Tm (dementia)Tj ET /F3 12 Tf BT 1 0 0 1 302.4 338.21 Tm (0)Tj ET /F3 12 Tf BT 1 0 0 1 436.55 338.21 Tm (12)Tj ET /F3 12 Tf BT 1 0 0 1 34.05 315.38 Tm (old age, not falling within any other )Tj ET /F3 12 Tf BT 1 0 0 1 34.05 300.8 Tm (category)Tj ET /F3 12 Tf BT 1 0 0 1 302.4 315.38 Tm (0)Tj ET /F3 12 Tf BT 1 0 0 1 436.55 315.38 Tm (25)Tj ET /F3 12 Tf BT 1 0 0 1 34.05 277.97 Tm (Additional conditions: )Tj ET /F3 12 Tf BT 1 0 0 1 34.05 255.14 Tm (The Home may admit up to 37 service users when the building works are completed )Tj ET /F3 12 Tf BT 1 0 0 1 34.05 240.56 Tm (and a Certificate of Completion issued under the Building Act 1984 Building Regulations)Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 31.2 219.13 m 315.25 219.13 l S 0.001 w 1 1 1 RG 20.58 w 317.5 219.13 m 346.55 219.13 l S 0.001 w 20.58 w 348.8 219.13 m 377.9 219.13 l S 0.001 w 20.58 w 380.15 219.13 m 409.2 219.13 l S 0.001 w 20.58 w 411.45 219.13 m 440.55 219.13 l S 0.001 w 20.58 w 442.8 219.13 m 471.9 219.13 l S 0.001 w 20.58 w 474.15 219.13 m 503.2 219.13 l S 0.001 w 20.58 w 505.45 219.13 m 534.55 219.13 l S 0.001 w 20.58 w 536.8 219.13 m 565.9 219.13 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 230.54 m 568.1 230.54 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 207.71 m 568.1 207.71 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 231.62 m 30.07 206.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 316.37 231.62 m 316.37 206.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 347.67 231.62 m 347.67 206.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 379.02 231.62 m 379.02 206.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 410.32 231.62 m 410.32 206.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 441.67 231.62 m 441.67 206.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 473.02 231.62 m 473.02 206.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 504.32 231.62 m 504.32 206.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 535.67 231.62 m 535.67 206.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 231.62 m 567.02 206.63 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 34.05 214.36 Tm (Date of last inspection)Tj ET /F3 12 Tf BT 1 0 0 1 328.2 214.36 Tm (2)Tj ET /F3 12 Tf BT 1 0 0 1 359.53 214.36 Tm (4)Tj ET /F3 12 Tf BT 1 0 0 1 390.86 214.36 Tm (1)Tj ET /F3 12 Tf BT 1 0 0 1 422.18 214.36 Tm (1)Tj ET /F3 12 Tf BT 1 0 0 1 453.53 214.36 Tm (2)Tj ET /F3 12 Tf BT 1 0 0 1 484.86 214.36 Tm (0)Tj ET /F3 12 Tf BT 1 0 0 1 516.18 214.36 Tm (0)Tj ET /F3 12 Tf BT 1 0 0 1 547.53 214.36 Tm (9)Tj ET 0.95294 0.95294 0.95294 RG 17 w 31.2 195.84 m 565.9 195.84 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 186.21 m 568.1 186.21 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 187.29 m 30.07 39.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 187.29 m 567.02 39.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 205.46 m 568.1 205.46 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 186.21 m 568.1 186.21 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 40.22 m 568.1 40.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 206.54 m 30.07 185.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 206.54 m 567.02 185.13 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 192.28 Tm (Brief description of the )Tj ET /F3 12 Tf BT 1 0 0 1 177.31 192.28 Tm (care home)Tj ET /F3 12 Tf BT 1 0 0 1 35.5 173.03 Tm (Summer Court Hall is located in the seaside town of Hornsea on the coast of the East )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 156.03 Tm (Riding of Yorkshire, close to all local amenities. It has parking facilities for several )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 139.03 Tm (vehicles.)Tj ET /F3 12 Tf BT 1 0 0 1 35.5 122.03 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 35.5 105.03 Tm (The home is registered for thirty-seven older people, a maximum of twelve may have )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 88.03 Tm (dementia and are cared for in a separate area of the home. The home does not provide )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 71.03 Tm (nursing care. Currently the service is without a manager.)Tj ET /F3 12 Tf BT 1 0 0 1 35.5 54.03 Tm ()Tj ET endstream endobj 16 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 17 0 obj <>stream 0 J 0.8 0.8 0.8 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F3 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 485.42 30.79 Tm (Page)Tj ET /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 515.95 30.79 Tm (5)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 523.58 30.79 Tm ( of )Tj ET /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 541.88 30.79 Tm (43)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 17 w 31.2 804.03 m 565.9 804.03 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 794.4 m 568.1 794.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 795.48 m 30.07 655.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 795.48 m 567.02 655.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 813.65 m 568.1 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 794.4 m 568.1 794.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 656.15 m 568.1 656.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 814.73 m 30.07 793.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 814.73 m 567.02 793.33 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 800.47 Tm (Brief description of the )Tj ET /F3 12 Tf BT 1 0 0 1 177.31 800.47 Tm (care home)Tj ET /F3 12 Tf BT 1 0 0 1 33.25 783.47 Tm (The bedrooms are arranged on both the ground and first floor, with a lift and stairs )Tj ET /F3 12 Tf BT 1 0 0 1 33.25 766.47 Tm (providing access for residents. The home has a lounge with a conservatory, and a )Tj ET /F3 12 Tf BT 1 0 0 1 33.25 749.47 Tm (separate dining room in the main part, and a connecting lounge and conservatory in )Tj ET /F3 12 Tf BT 1 0 0 1 33.25 732.47 Tm (the dementia care unit. There are bathrooms and toilets on each of the floors.)Tj ET /F3 12 Tf BT 1 0 0 1 33.25 715.47 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 33.25 698.47 Tm (The current fees for residents range from 374 to 420 a week and are primarily )Tj ET /F3 12 Tf BT 1 0 0 1 33.25 681.47 Tm (based on their assessed needs. This was correct on 23rd February 2010. Information is )Tj ET /F3 12 Tf BT 1 0 0 1 33.25 664.47 Tm (available in the statement of purpose and service users guide.)Tj ET endstream endobj 18 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 19 0 obj <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]>>/Length 532/Matrix [1 0 0 1 0 0]>>stream xMo0>exyT 7ġ*ea|^%K,VNzg<s?Xc2"H4KdImw}Fˏ+e4ޓc4 |>KBNc% %֐3+6!͑{= V$x:|^.OZXm&fٕM?I_[5 i89H2;]tHkE-|%~wƊ=(l(ng Ah2*(cHHL3N@PpVP=&@*n(MLzvH.tٶ!JFU8l3WmGlX+%)(;zu^|M:bvYq6]:n޼6W?t9^(iz#%[IU _}S)3Mš: (lVW(ȜN8@~~9M {g;ԅ坦/w`_ZkۮrIJV޵N<:f}vGk_h endstream endobj 20 0 obj<> endobj 21 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F3 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (6)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 515.2 31.8 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 533.49 31.8 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 14 Tf BT 1 0 0 1 28.35 795.65 Tm (6XPPDU\\)Tj ET /F3 12 Tf BT 1 0 0 1 28.35 774.7 Tm (This is an overview of what we found during the inspection.)Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 31.2 754.22 m 381.05 754.22 l S 0.001 w 1 1 1 RG 20.58 w 383.3 754.22 m 566.2 754.22 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 765.64 m 568.4 765.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 742.81 m 568.4 742.81 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 766.71 m 30.07 741.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 382.17 766.71 m 382.17 741.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 766.71 m 567.32 741.73 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 34.05 749.45 Tm (The quality rating for this )Tj ET /F3 12 Tf BT 1 0 0 1 191.92 749.45 Tm (care home)Tj ET /F3 12 Tf BT 1 0 0 1 255.59 749.45 Tm ( is:)Tj ET /F3 12 Tf BT 1 0 0 1 410.5 749.45 Tm (zero star poor service)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 717.31 Tm (2XUMXGJHPHQWIRUHDFKRXWFRPH)Tj ET /F3 10 Tf BT 1 0 0 1 212.29 641.27 Tm (Choice of home)Tj ET /F3 10 Tf BT 1 0 0 1 164.41 601.02 Tm (Health and personal care)Tj ET /F3 10 Tf BT 1 0 0 1 145.18 560.77 Tm (Daily life and social activities)Tj ET /F3 10 Tf BT 1 0 0 1 157.95 520.52 Tm (Complaints and protection)Tj ET /F3 10 Tf BT 1 0 0 1 226.36 480.27 Tm (Environment)Tj ET /F3 10 Tf BT 1 0 0 1 251.17 440.02 Tm (Staffing)Tj ET /F3 10 Tf BT 1 0 0 1 127.47 399.77 Tm (Management and administration)Tj ET q 0.75227 0 0 0.75161 305.05 334.32 cm /Xf1 Do Q 1 1 1 RG 20.58 w 31.2 283.08 m 567.85 283.08 l S 0.001 w 206.51 w 32.32 167.28 m 566.72 167.28 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.2 271.66 m 567.85 271.66 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 271.66 m 568.92 271.66 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 62.9 m 568.92 62.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.2 272.74 m 31.2 61.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.85 272.74 m 567.85 61.82 l S 0.001 w [] 0 d /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 278.3 Tm (How we did our inspection:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 35.17 255.48 Tm (The quality rating for this service is 0 star. This means that the people who use the )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 240.9 Tm (service experience poor quality outcomes.)Tj ET /F3 12 Tf BT 1 0 0 1 35.17 226.32 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 35.17 211.74 Tm (This inspection report is based on information received by the Care Quality Commission )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 197.15 Tm (\(CQC\)since the last key inspection on 24 November 2009, including information )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 182.57 Tm (gathered during a site visit to the home. The unannounced visit was undertaken over )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 167.99 Tm (one day by one inspector. It began at 9.00 am and finished at 7.20 pm. On the day of )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 153.41 Tm (the visit the inspector spoke with people who live in the home, staff, the managers, a )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 138.84 Tm (visiting professional and a relative.)Tj ET /F3 12 Tf BT 1 0 0 1 35.17 124.25 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 35.17 109.68 Tm (Inspection of the premises and close examination of a range of documentation, )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 95.1 Tm (including three care plans were also undertaken.)Tj ET /F3 12 Tf BT 1 0 0 1 35.17 80.51 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 35.17 65.93 Tm (At the end of this visit, feedback was given to the managers on our findings, including )Tj ET endstream endobj 22 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]/XObject<>>>/MediaBox[0 0 595 842]>> endobj 23 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F3 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (7)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 515.2 31.8 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 533.49 31.8 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 309.18 w 32.32 657.94 m 566.72 657.94 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 30.12 813.65 m 568.92 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 502.22 m 568.92 502.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.2 814.73 m 31.2 501.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.85 814.73 m 567.85 501.15 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 32.92 802.72 Tm (any requirements and recommendations that may be in the key inspection report.)Tj ET /F3 12 Tf BT 1 0 0 1 32.92 788.14 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 32.92 773.56 Tm (At the last inspection of this service a quality rating of 0 stars was awarded which )Tj ET /F3 12 Tf BT 1 0 0 1 32.92 758.98 Tm (meant that people receive a poor service. Subsequently a Statutory Requirement )Tj ET /F3 12 Tf BT 1 0 0 1 32.92 744.4 Tm (Notice \(SRN\) was issued, informing the provider that they were in breach of Care )Tj ET /F3 12 Tf BT 1 0 0 1 32.92 729.82 Tm (Homes Regulations 2001.)Tj ET /F3 12 Tf BT 1 0 0 1 32.92 715.24 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 32.92 700.66 Tm (Although this inspection was a key inspection, inspecting all of the key standards, it )Tj ET /F3 12 Tf BT 1 0 0 1 32.92 686.08 Tm (also included assessment against compliance with the requirements of the Statutory )Tj ET /F3 12 Tf BT 1 0 0 1 32.92 671.5 Tm (Requirement Notice. We explained to the managers at the time that the visit would )Tj ET /F3 12 Tf BT 1 0 0 1 32.92 656.92 Tm (entail collecting evidence under the police and criminal evidence act, \(PACE\) that could )Tj ET /F3 12 Tf BT 1 0 0 1 32.92 642.34 Tm (be used for enforcement against the home if the regulations had been breached. We )Tj ET /F3 12 Tf BT 1 0 0 1 32.92 627.76 Tm (ensured that they were fully aware of the procedure and gave them a list of any )Tj ET /F3 12 Tf BT 1 0 0 1 32.92 613.18 Tm (documents that we photocopied.)Tj ET /F3 12 Tf BT 1 0 0 1 32.92 598.6 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 32.92 584.02 Tm (We have reviewed our practice when making requirements to improve national )Tj ET /F3 12 Tf BT 1 0 0 1 32.92 569.44 Tm (consistency. Some requirements from previous inspection reports may have been )Tj ET /F3 12 Tf BT 1 0 0 1 32.92 554.86 Tm (deleted or carried forward into this report as recommendations , but only when it is )Tj ET /F3 12 Tf BT 1 0 0 1 32.92 540.28 Tm (considered that people who use services are not being put at significant risk of harm. )Tj ET /F3 12 Tf BT 1 0 0 1 32.92 525.7 Tm (In future, if a requirement is repeated, it is likely that enforcement action will be taken.)Tj ET /F3 12 Tf BT 1 0 0 1 32.92 511.12 Tm ()Tj ET endstream endobj 24 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 25 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F3 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (8)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 515.2 31.8 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 533.49 31.8 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 20.58 w 31.2 786.36 m 567.85 786.36 l S 0.001 w 122.64 w 32.32 712.5 m 566.72 712.5 l S 0.001 w 20.58 w 32.7 638.64 m 569.35 638.64 l S 0.001 w 297.6 w 33.82 477.3 m 568.22 477.3 l S 0.001 w 20.58 w 33.45 315.96 m 570.1 315.96 l S 0.001 w 239.4 w 34.57 183.73 m 568.97 183.73 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.2 774.95 m 567.85 774.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 774.95 m 568.92 774.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 650.06 m 568.92 650.06 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.2 776.03 m 31.2 648.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.2 650.06 m 569.35 650.06 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.7 627.23 m 569.35 627.23 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.62 627.23 m 570.42 627.23 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.62 327.38 m 570.42 327.38 l S 0.001 w [] 0 d [] 0 d 2.25 w 33.45 304.55 m 570.1 304.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 33.45 327.38 m 570.1 327.38 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.37 304.55 m 571.17 304.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.37 62.9 m 571.17 62.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.7 628.31 m 32.7 326.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 33.45 305.63 m 33.45 61.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.85 776.03 m 567.85 648.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 569.35 628.31 m 569.35 326.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 570.1 305.63 m 570.1 61.82 l S 0.001 w [] 0 d /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 781.59 Tm (What the )Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 90.52 781.59 Tm (care home)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 154.2 781.59 Tm ( does well:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 10 Tf BT 1 0 0 1 567.85 784.25 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 35.17 758.76 Tm (Whilst visiting the home we noted that interactions between the staff and the people )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 744.18 Tm (who live in the home were positive and a relative told us that she thought the staff )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 729.6 Tm (were nice. We saw that the food provided was of a good standard and appeared )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 715.02 Tm (appetising. Additionally there is a system in place if people wish to raise a complaint, )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 700.44 Tm (this would help people to be involved in the development of the home. The new )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 685.86 Tm (management team had begun to make improvements and are seeking additional )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 671.28 Tm (support to ensure medication practices in the home are made safe.)Tj ET /F3 12 Tf BT 1 0 0 1 35.17 656.7 Tm (Controlled drugs are stored and recorded appropriately.)Tj ET /F3 10 Tf BT 1 0 0 1 568.97 710.95 Tm ()Tj ET /F3 10 Tf BT 1 0 0 1 31.2 636.53 Tm ()Tj ET /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 32.7 633.87 Tm (What has improved since the last inspection?)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 10 Tf BT 1 0 0 1 569.35 637.09 Tm ()Tj ET /F3 10 Tf BT 1 0 0 1 31.2 475.75 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 36.67 611.04 Tm (Although the owner of the service acknowledged the failings found at the last visit to )Tj ET /F3 12 Tf BT 1 0 0 1 36.67 596.46 Tm (the home and has made some attempts to rectify these, this has not made enough )Tj ET /F3 12 Tf BT 1 0 0 1 36.67 581.88 Tm (impact to improve the overall standards of support and care received by people. In )Tj ET /F3 12 Tf BT 1 0 0 1 36.67 567.3 Tm (respect of the large amount of work required in order to meet minimum standards the )Tj ET /F3 12 Tf BT 1 0 0 1 36.67 552.72 Tm (work undertaken to improve has been minimal.)Tj ET /F3 12 Tf BT 1 0 0 1 36.67 538.14 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 36.67 523.56 Tm (Overall peoples support in the meeting of their personal care needs has improved and )Tj ET /F3 12 Tf BT 1 0 0 1 36.67 508.98 Tm (some peoples appearances have improved. However, this is not the case for everyone )Tj ET /F3 12 Tf BT 1 0 0 1 36.67 494.4 Tm (living in the home.)Tj ET /F3 12 Tf BT 1 0 0 1 36.67 479.82 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 36.67 465.24 Tm (The owner has spent some money and maintenance work has been undertaken )Tj ET /F3 12 Tf BT 1 0 0 1 36.67 450.66 Tm (towards improving the general environment of the home, including the purchasing of )Tj ET /F3 12 Tf BT 1 0 0 1 36.67 436.08 Tm (some new bedroom furniture.The shower room has been tidied and is now uncluttered, )Tj ET /F3 12 Tf BT 1 0 0 1 36.67 421.5 Tm (offering a more relaxing area for showering.Toilets and bathrooms have soap and hand )Tj ET /F3 12 Tf BT 1 0 0 1 36.67 406.92 Tm (wash facilities in place in them, this supports people in maintaining their personal )Tj ET /F3 12 Tf BT 1 0 0 1 36.67 392.34 Tm (hygiene.)Tj ET /F3 12 Tf BT 1 0 0 1 36.67 377.76 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 36.67 363.18 Tm (New managers have been employed and they have completed work to try to improve )Tj ET /F3 12 Tf BT 1 0 0 1 36.67 348.6 Tm (the home including the development of a template for new care plans, but as this has )Tj ET /F3 12 Tf BT 1 0 0 1 36.67 334.02 Tm (yet to be implemented.)Tj ET /F3 10 Tf BT 1 0 0 1 570.47 475.75 Tm ()Tj ET /F3 10 Tf BT 1 0 0 1 31.2 314.41 Tm ()Tj ET /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 33.45 311.19 Tm (What they could do better:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 10 Tf BT 1 0 0 1 31.2 182.18 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 37.42 288.36 Tm (There are a large number of outstanding requirements in this home. One of the )Tj ET /F3 12 Tf BT 1 0 0 1 37.42 273.78 Tm (requirements was identified in a Statutory requirement notice of breach of regulations )Tj ET /F3 12 Tf BT 1 0 0 1 37.42 259.2 Tm (following the last visit to the home and this still has not been met. Further action may )Tj ET /F3 12 Tf BT 1 0 0 1 37.42 244.62 Tm (now be taken.)Tj ET /F3 12 Tf BT 1 0 0 1 37.42 230.04 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 37.42 215.46 Tm (Due to the large number of outstanding requirements, it is clear that the home )Tj ET /F3 12 Tf BT 1 0 0 1 37.42 200.88 Tm (continues to not be well managed, further action may be taken by the CQC.)Tj ET /F3 12 Tf BT 1 0 0 1 37.42 186.3 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 37.42 171.72 Tm (Peoples assessments and care plans could be developed further to include more detail )Tj ET /F3 12 Tf BT 1 0 0 1 37.42 157.14 Tm (of their needs so that staff are fully aware of these and can work to meet them. )Tj ET /F3 12 Tf BT 1 0 0 1 37.42 142.56 Tm (Peoples records should be kept up to date so that staff are aware of the latest needs of )Tj ET /F3 12 Tf BT 1 0 0 1 37.42 127.98 Tm (people and peoples medication needs must be met, medication must be administered )Tj ET /F3 12 Tf BT 1 0 0 1 37.42 113.4 Tm (as prescribed. There is a lack of social and leisure activities, meaning that peoples )Tj ET /F3 12 Tf BT 1 0 0 1 37.42 98.82 Tm (needs for social stimulation and activity are not being met, people may be bored.)Tj ET /F3 12 Tf BT 1 0 0 1 37.42 84.24 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 37.42 69.66 Tm (Staffing levels and peoples needs at meal times could be assessed to ensure that there )Tj ET endstream endobj 26 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 27 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F3 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (9)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 515.2 31.8 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 533.49 31.8 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 338.34 w 34.57 643.36 m 568.97 643.36 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 32.37 813.65 m 571.17 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.37 473.06 m 571.17 473.06 l S 0.001 w [] 0 d [] 0 d 2.25 w 33.45 814.73 m 33.45 471.99 l S 0.001 w [] 0 d [] 0 d 2.25 w 570.1 814.73 m 570.1 471.99 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.17 802.72 Tm (are enough staff to support people and that their needs are being met, additionally )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 788.14 Tm (staff should always have rest breaks between working shifts to make sure that the risk )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 773.56 Tm (of accidents and errors is reduced and peoples needs are met. Furthermore people )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 758.98 Tm (should be supported by a staff team that receive training so that they can fully meet )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 744.4 Tm (peoples needs.)Tj ET /F3 12 Tf BT 1 0 0 1 35.17 729.82 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 35.17 715.24 Tm (The home should be maintained and managed to a good standard so that it does not )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 700.66 Tm (pose a risk to peoples safety. Risk assessments and daily maintenance should take )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 686.08 Tm (place. The home should be clean throughout, so that is relaxing and comfortable for )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 671.5 Tm (people. Sufficient quantities of all medicines must always be made available. Medicines )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 656.92 Tm (must be given strictly according to the directions of the prescriber. Medication records )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 642.34 Tm (must be accurate and detailed in describing exactly what medicines are received, )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 627.76 Tm (given, and disposed of. All medicines must be stored securely at temperatures and )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 613.18 Tm (conditions recommended by the manufacturer. All staff must be fully trained in safe )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 598.6 Tm (medication handling and shown to be competent to give and record the use of )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 584.02 Tm (medicines. The home's medication policy and procedure documents should be updated )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 569.44 Tm (to reflect current best practice. Information should be gathered about people's )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 554.86 Tm (medication taking preferences. Guidance should be kept for those medicines prescribed )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 540.28 Tm (to be given as and when needed.)Tj ET /F3 12 Tf BT 1 0 0 1 35.17 525.7 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 35.17 511.12 Tm (The home should be well managed, peoples needs should be met and their safety )Tj ET /F3 12 Tf BT 1 0 0 1 35.17 496.54 Tm (ensured.)Tj ET /F3 12 Tf BT 1 0 0 1 35.17 481.96 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 28.35 458.5 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 28.35 438.51 Tm (If you want to know what action the person responsible for this )Tj ET /F3 12 Tf BT 1 0 0 1 416.37 438.51 Tm (care home)Tj ET /F3 12 Tf BT 1 0 0 1 480.04 438.51 Tm ( is taking )Tj ET /F3 12 Tf BT 1 0 0 1 28.35 421.01 Tm (following this report, you can contact them using the details on page 4.)Tj ET /F3 12 Tf BT 1 0 0 1 28.35 401.02 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 28.35 381.02 Tm (The report of this inspection is available from our website )Tj ET /F3 12 Tf BT 1 0 0 1 380.85 381.02 Tm (www.cqc.org.uk.)Tj ET /F3 12 Tf BT 1 0 0 1 28.35 361.02 Tm (You can get printed copies from )Tj ET /F3 12 Tf BT 1 0 0 1 225.22 361.02 Tm (enquiries@cqc.org.uk or by telephoning our)Tj ET /F3 12 Tf BT 1 0 0 1 28.35 341.03 Tm (order line 0870 240 7535.)Tj ET endstream endobj 28 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 29 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F3 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (10)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 31.8 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 31.8 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 777.09 Tm (Details of our findings)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 26 w 31.2 744.15 m 565.9 744.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 34.05 741.14 Tm (&RQWHQWV)Tj ET 1 1 1 RG 16 w 28.35 700.15 m 566.93 700.15 l S 0.001 w /F3 12 Tf BT 1 0 0 1 28.35 696.09 Tm (Choice of home \(standards 1 - 6\))Tj ET 16 w 28.35 678.15 m 566.93 678.15 l S 0.001 w /F3 12 Tf BT 1 0 0 1 28.35 674.09 Tm (Health and personal care \(standards 7 - 11\))Tj ET 16 w 28.35 656.15 m 566.93 656.15 l S 0.001 w /F3 12 Tf BT 1 0 0 1 28.35 652.09 Tm (Daily life and social activities \(standards 12 - 15\))Tj ET 16 w 28.35 634.15 m 566.93 634.15 l S 0.001 w /F3 12 Tf BT 1 0 0 1 28.35 630.09 Tm (Complaints and protection \(standards 16 - 18\))Tj ET 16 w 28.35 612.15 m 566.93 612.15 l S 0.001 w /F3 12 Tf BT 1 0 0 1 28.35 608.09 Tm (Environment \(standards 19 - 26\))Tj ET 16 w 28.35 590.15 m 566.93 590.15 l S 0.001 w /F3 12 Tf BT 1 0 0 1 28.35 586.09 Tm (Staffing \(standards 27 - 30\))Tj ET 16 w 28.35 568.15 m 566.93 568.15 l S 0.001 w /F3 12 Tf BT 1 0 0 1 28.35 564.09 Tm (Management and administration \(standards 31 - 38\))Tj ET /F3 12 Tf BT 1 0 0 1 28.35 544.09 Tm (Outstanding statutory requirements)Tj ET /F3 12 Tf BT 1 0 0 1 28.35 522.22 Tm (Requirements and recommendations from this inspection)Tj ET endstream endobj 30 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 32 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F3 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F3 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (11)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F3 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Choice of home )Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 206.25 w 32.32 610.38 m 562.53 610.38 l S 0.001 w 0.95294 0.95294 0.95294 RG 85 w 31.2 672.13 m 563.65 672.13 l S 0.001 w 1 1 1 RG 119 w 31.2 567.88 m 563.65 567.88 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 507.25 m 565.85 507.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 506.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 506.17 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 702.57 Tm (People are confident that the care home can support them. This is because there is an )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 685.57 Tm (accurate assessment of their needs that they, or people close to them, have been )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 668.57 Tm (involved in. This tells the home all about them and the support they need. People who )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 651.57 Tm (stay at the home only for intermediate care, have a clear assessment that includes a )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 634.57 Tm (plan on what they hope for and want to achieve when they return home.)Tj ET /F3 12 Tf BT 1 0 0 1 35.5 615.32 Tm (People can decide whether the care home can meet their support and accommodation )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 598.32 Tm (needs. This is because they, or people close to them, have been able to visit the home )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 581.32 Tm (and have got full, clear, accurate and up to date information about the home. If they )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 564.32 Tm (decide to stay in the home they know about their rights and responsibilities because )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 547.32 Tm (there is an easy to understand contract or statement of terms and conditions between )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 530.32 Tm (them and the care home that includes how much they will pay and what the home )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 513.32 Tm (provides for the money.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 489 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 467 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F2 12 Tf BT 1 0 0 1 369.04 467 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 28.35 444.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 141.85 w 34.6 369.25 m 562.54 369.25 l S 0.001 w 1 1 1 RG 22.5 w 32.35 431.17 m 564.79 431.17 l S 0.001 w 119.35 w 33.47 358 m 563.66 358 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 418.8 m 565.87 418.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 419.88 m 32.35 296.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 419.88 m 564.79 296.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 418.8 m 564.79 418.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 297.2 m 565.87 297.2 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 427.86 Tm (Judgement:)Tj ET /F3 12 Tf BT 1 0 0 1 36.62 403.12 Tm (People using this service experience )Tj ET /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 403.12 Tm (adequate)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 319.4 403.12 Tm (quality outcomes in this area. We have )Tj ET /F3 12 Tf BT 1 0 0 1 36.62 385.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F3 12 Tf BT 1 0 0 1 36.62 358.75 Tm (We looked at standards 3 & 6.)Tj ET /F3 12 Tf BT 1 0 0 1 36.62 341.25 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 36.62 323.76 Tm (Peoples' needs are not fully assessed prior to entering the home, this could mean that )Tj ET /F3 12 Tf BT 1 0 0 1 36.62 306.26 Tm (their needs are not all known and met.)Tj ET /F3 12 Tf BT 1 0 0 1 28.35 281.52 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 189.3 w 34.6 176.68 m 562.54 176.68 l S 0.001 w 1 1 1 RG 22.5 w 32.35 262.33 m 564.79 262.33 l S 0.001 w 167.93 w 33.47 164.87 m 563.66 164.87 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 249.96 m 565.87 249.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 251.04 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 251.04 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 249.96 m 564.79 249.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 259.02 Tm (Evidence:)Tj ET /F3 12 Tf BT 1 0 0 1 36.57 234.27 Tm (We looked at the care files for four of the people who live in the home. There had not )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 216.78 Tm (been any new admissions to the home since the last visit.)Tj ET /F3 12 Tf BT 1 0 0 1 36.57 199.28 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 36.57 181.79 Tm (We saw that the assessments in these files had not been amended since the last visit )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 164.29 Tm (to the home. They continue to include only basic information, with some gaps and )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 146.79 Tm (were not person centred. One persons assessment included the following information, )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 129.3 Tm (' What is health usually like?', with the response, '1 carer possibly 2.' This does not )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 111.8 Tm (describe the persons' health, needs or what support they require and will not assist )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 94.31 Tm (the person in having their needs met.)Tj ET endstream endobj 34 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 35 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F3 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F3 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (12)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 248.82 w 34.6 686.99 m 562.54 686.99 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 227.45 w 33.47 675.18 m 563.66 675.18 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 559.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 559.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 560.34 m 565.87 560.34 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 779.1 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 761.6 Tm (The managers told us that they have not undertaken any work regarding people's )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 744.11 Tm (existing care plans but that they have developed a new care file that is to be )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 726.61 Tm (introduced for each person in the home. We looked at this new file and it included a )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 709.11 Tm (large variety of forms and review documents. It also included a template letter that )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 691.62 Tm (would be used by the home, following an individual assessment to formally state that )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 674.12 Tm (their needs can be met by the home.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 656.63 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 639.13 Tm (We saw that people continue to have copies of the assessments undertaken by the )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 621.63 Tm (Local Authority.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 604.14 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 586.64 Tm (When asked, the managers confirmed to us that the home continues not to provide )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 569.15 Tm (intermediate care and so standard 6 does not apply.)Tj ET endstream endobj 36 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 37 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F3 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F3 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (13)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F3 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Health and personal care )Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 172.25 w 32.32 627.38 m 562.53 627.38 l S 0.001 w 0.95294 0.95294 0.95294 RG 102 w 31.2 663.63 m 563.65 663.63 l S 0.001 w 1 1 1 RG 68 w 31.2 576.38 m 563.65 576.38 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 611.5 m 565.85 611.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 611.5 m 565.85 611.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 541.25 m 565.85 541.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 540.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 540.17 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 702.57 Tm (Peoples health, personal and social care needs are met. The home has a plan of care )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 685.57 Tm (that the person, or someone close to them, has been involved in making. If they take )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 668.57 Tm (medicine, they manage it themselves if they can. If they cannot manage their )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 651.57 Tm (medicine, the care home supports them with it, in a safe way. Peoples right to privacy )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 634.57 Tm (is respected and the support they get from staff is given in a way that maintains their )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 617.57 Tm (dignity.)Tj ET /F3 12 Tf BT 1 0 0 1 35.5 598.32 Tm (If people are approaching the end of their life, the care home will respect their choices )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 581.32 Tm (and help them feel comfortable and secure. They, and people close to them, are )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 564.32 Tm (reassured that their death will be handled with sensitivity, dignity and respect, and )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 547.32 Tm (take account of their spiritual and cultural wishes. )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 523 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 501 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F2 12 Tf BT 1 0 0 1 369.04 501 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 28.35 478.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 194.33 w 34.6 377.01 m 562.54 377.01 l S 0.001 w 1 1 1 RG 22.5 w 32.35 465.17 m 564.79 465.17 l S 0.001 w 171.84 w 33.47 365.76 m 563.66 365.76 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 452.8 m 565.87 452.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 453.88 m 32.35 277.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 453.88 m 564.79 277.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 452.8 m 564.79 452.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 278.71 m 565.87 278.71 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 461.86 Tm (Judgement:)Tj ET /F3 12 Tf BT 1 0 0 1 36.62 437.12 Tm (People using this service experience )Tj ET /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 437.12 Tm (poor)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 290.57 437.12 Tm (quality outcomes in this area. We have )Tj ET /F3 12 Tf BT 1 0 0 1 36.62 419.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F3 12 Tf BT 1 0 0 1 36.62 392.75 Tm (We looked at standards 7,8,9 & 10.)Tj ET /F3 12 Tf BT 1 0 0 1 36.62 375.25 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 36.62 357.76 Tm (Peoples' plans of care continue to require more detail and supporting documents are )Tj ET /F3 12 Tf BT 1 0 0 1 36.62 340.26 Tm (not always completed. This means that peoples needs may not be met fully.)Tj ET /F3 12 Tf BT 1 0 0 1 36.62 322.77 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 36.62 305.27 Tm (Poor practice in medication issues means that people do not always have their )Tj ET /F3 12 Tf BT 1 0 0 1 36.62 287.77 Tm (medication needs met.)Tj ET /F3 12 Tf BT 1 0 0 1 28.35 263.03 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 170.82 w 34.6 167.43 m 562.54 167.43 l S 0.001 w 1 1 1 RG 22.5 w 32.35 243.84 m 564.79 243.84 l S 0.001 w 149.45 w 33.47 155.62 m 563.66 155.62 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 231.47 m 565.87 231.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 232.55 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 232.55 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 231.47 m 564.79 231.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 240.53 Tm (Evidence:)Tj ET /F3 12 Tf BT 1 0 0 1 36.57 215.79 Tm (We examined four of the plans of care for the people who live in the home.)Tj ET /F3 12 Tf BT 1 0 0 1 36.57 198.29 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 36.57 180.79 Tm (At the last inspection of the home it was found that the care plans lacked detail and )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 163.3 Tm (were basic. The managers told us that no amendments have been made to the care )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 145.8 Tm (plans since the last visit to the home. However, when we looked at care plans it was )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 128.31 Tm (clear that the previous manager had amended some of these and they do contain )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 110.81 Tm (more detail. However, this is not the case for all of the care plans; it is concerning that )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 93.31 Tm (the current managers are not aware of the content of peoples care plans and when )Tj ET endstream endobj 38 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 39 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F3 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F3 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (14)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 779.1 Tm (they were last reviewed.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 761.6 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 744.11 Tm (We looked at the care records and found that they were not always comprehensive. )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 726.61 Tm (One persons care file included a section for personal care, it recorded that they )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 709.11 Tm (required cream to their skin each day but the cream was not identified and was )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 691.62 Tm (described as '? cream.' Without these details staff may be unsure of the task and )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 674.12 Tm (peoples needs may not be met. Another persons care plan included how they were to )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 656.63 Tm (be supported when they became upset and agitated, the instructions to staff were, )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 639.13 Tm ('staff to resolve any issues immediately'. This is not detailed enough and does not )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 621.63 Tm (offer enough instruction to staff for them to be able to support this person fully, )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 604.14 Tm (consequently this persons anxiety may remain and increase. When we spoke to staff )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 586.64 Tm (and asked them how they knew what peoples needs were they told us that they would )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 569.15 Tm (read the care plans and files. If these records are not up to date or not detailed )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 551.65 Tm (enough then staff will not be working to meet peoples latest needs.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 534.15 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 516.66 Tm (At the last visit to the home we had concerns about peoples personal care and )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 499.16 Tm (appearances as these were not to an acceptable standard. At this visit we noted that )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 481.67 Tm (overall people in the main area of the home have had their personal care needs met. )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 464.17 Tm (However the people who live in the dementia care unit did appear to have less )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 446.67 Tm (personal care than other residents in the home, with people looking untidy and )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 429.18 Tm (disheveled. We looked at the record keeping undertaken by the staff regarding )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 411.68 Tm (people's personal care. Daily records would include that people had been assisted with )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 394.19 Tm (their personal care and there were monthly and daily record sheets for personal care )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 376.69 Tm (or bathing. We saw that these records had not been completed regularly and that )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 359.19 Tm (some of the records for the month of February were blank. We spoke to a relative of )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 341.7 Tm (one of the people who live in the home, they felt that the staff addressed this persons )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 324.2 Tm (personal care needs and supported them well. However, our observations did not )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 306.71 Tm (qualify this.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 289.21 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 271.71 Tm (There were separate records of bathing, kept in the bathrooms of the home. These )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 254.22 Tm (were fastened to the wall and included the date, water temperature and name of the )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 236.72 Tm (resident. This method of recording is not appropriate, does not account for a persons )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 219.23 Tm (dignity and is not good practice. One of the managers removed these records at the )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 201.73 Tm (visit and developed a new recording sheet for the bath temperatures that does not )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 184.23 Tm (include peoples' names.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 166.74 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 149.24 Tm (We saw that there was some improvement in the meeting of peoples health needs and )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 131.75 Tm (in seeing their GP or a district nurse. Records are kept of professional visits to the )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 114.25 Tm (home and these included the GP and district nurse. We saw the district nurse on the )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 96.75 Tm (day of the visit and she confirmed that there had been some small improvements to )Tj ET endstream endobj 40 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 41 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F3 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F3 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (15)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 779.1 Tm (the home, this included peoples personal appearances and the cleanliness of the )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 761.6 Tm (home. However she felt that systems in the home could be improved upon so that )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 744.11 Tm (staff were more organised, particularly in relation to the storing of notes and medical )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 726.61 Tm (aids, for example, dressings.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 709.11 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 691.62 Tm (We looked at the records of peoples' health needs, these reflected that the GP and )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 674.12 Tm (district nurses are seen by people. One relative told us that the home always see to )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 656.63 Tm (their relatives' health needs and call the GP if needed. At the last visit to the home it )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 639.13 Tm (was found that staff were not proactive in obtaining medical attention quickly for )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 621.63 Tm (people. Overall we saw that people had received medical attention , although one )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 604.14 Tm (persons' records noted that a potential medical problem had re-occurred, and it was )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 586.64 Tm (two days before the staff arranged medical attention for this. This does not ensure )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 569.15 Tm (that peoples health needs are met.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 551.65 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 534.15 Tm (People continue to have a nutritional screening tool included in their care file. These )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 516.66 Tm (tools do not always contain the persons' name, are not individual and have no review )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 499.16 Tm (dates on them. We saw individual record sheets to monitor peoples' weights, these )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 481.67 Tm (were not up to date but the manager showed us a separate record book, were people )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 464.17 Tm (weights were recorded. These were on the whole up to date. It is recommended that )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 446.67 Tm (there is only one record kept for each persons weight monitoring.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 429.18 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 411.68 Tm (At the last visit it was noted that one person had needs associated with nutritional )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 394.19 Tm (intake and that the care plan stated, 'carers aware that dietary supplements have )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 376.69 Tm (been prescribed', but did not include what these were, when the person was to have )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 359.19 Tm (them and if they were to be provided only when the person declined to eat all of their )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 341.7 Tm (meal. Another care plan was seen at this visit and it also included, 'has prescribed )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 324.2 Tm (dietary supplements', again it did not include what these were, or when these were to )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 306.71 Tm (be offered.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 289.21 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 271.71 Tm (There was some evidence that the home has liaised with specialist nurses to help )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 254.22 Tm (people with managing their behaviour. However, one example seen was a record that )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 236.72 Tm (a service user had dragged a member of staff to their bedroom and that it had taken )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 219.23 Tm (the assistance of a second member of staff to free the first person. There was no )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 201.73 Tm (evidence that any support work had been completed regarding this to protect both the )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 184.23 Tm (person concerned and the staff supporting them. This persons' care plan included a )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 166.74 Tm (section for mental health challenging behaviour. Although it described that this person )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 149.24 Tm (did demonstrate challenging behaviour, one of the methods for managing this by staff )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 131.75 Tm (was to use distraction methods and to observe interactions. This does not include )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 114.25 Tm (enough detail to support the individual and the staff in managing these )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 96.75 Tm (behaviours.Another person had identified in their care plan that they required support )Tj ET endstream endobj 42 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 43 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F3 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F3 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (16)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 779.1 Tm (as they could become agitated and frustrated. Yet one of their prescribed medications )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 761.6 Tm (had not been administered for 7 days. The lack of this could be uncomfortable for the )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 744.11 Tm (person and increase their agitation and frustration. This practice does not meet this )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 726.61 Tm (persons needs.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 709.11 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 691.62 Tm (We saw for one person that they had a behaviour record chart, this recorded how they )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 674.12 Tm (managed going to the toilet and any associated behaviours. This persons care plan )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 656.63 Tm (provided by the Local Authority stated ' Carers to be particularly supportive and )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 639.13 Tm (understanding.' regarding this need. However, staff comments included, 'bad )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 621.63 Tm (behaviour', 'he lied and denied it', and 'told to calm down'. This is judgemental and )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 604.14 Tm (does not respect the dignity of the service user.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 586.64 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 569.15 Tm (We noted that when the dementia unit has been added to the main part of the home )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 551.65 Tm (one of the connecting doors had been left in place, but is not used and does not open. )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 534.15 Tm (During the visit we observed that one person in the dementia unit repeatedly )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 516.66 Tm (attempted to open this door through to the main lounge. It was clear that the person )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 499.16 Tm (found it distressing and frustrating that they could not open the door, this does not )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 481.67 Tm (protect peoples dignity and must be addressed.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 464.17 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 446.67 Tm (Peoples' files included a document called 'advanced life of care plan', which included )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 429.18 Tm (sections, 'for what is important to me at the end of my life', 'who I should be with )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 411.68 Tm (when I die', 'my religious beliefs are', and 'I have a specific request', none of these )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 394.19 Tm (were completed. consequently people's choices and control are not respected.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 376.69 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 359.19 Tm (We looked at the risk assessments in peoples' files, again there was no evidence that )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 341.7 Tm (these had been updated since the last visit to the home. It was found that risk )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 324.2 Tm (assessments did not always link to care plans and were not always reviewed. People )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 306.71 Tm (had a form, entitled, 'care plan risk assessment/need', but these did not contain the )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 289.21 Tm (persons' name and were not individualised, with no date for review.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 271.71 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 254.22 Tm (One person had a risk assessment for the risk of smoking. It identified that smoking )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 236.72 Tm (carried a risk of burns to clothing and skin, but the only actions to be taken were that )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 219.23 Tm (all smoking is supervised by either care staff or the service users wife. On a separate )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 201.73 Tm (document for the same service user, smoking is identified as a risk alongside two )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 184.23 Tm (other areas of risk. In this document the actions required to reduce the risk is, )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 166.74 Tm ('supervised smoking outside in the garden'.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 149.24 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 131.75 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 114.25 Tm (The managers told us that four people in the home use bed side rails. We looked at )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 96.75 Tm (two of these and found that they fitted loosely under the mattresses. One of these had )Tj ET endstream endobj 44 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 45 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F3 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F3 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (17)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 779.1 Tm (a specialist mattress in place, however the straps to hold the mattress in place were )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 761.6 Tm (not fastened. Not fitting correctly increases the risks when they are being used, for )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 744.11 Tm (example there is a larger gap were people may become entrapped. The manager )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 726.61 Tm (fastened these at the time when attention was drawn to them. We looked at one )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 709.11 Tm (persons' risk assessment for the use of bed side rails. This assessment was basic and )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 691.62 Tm (had been reviewed once in Dec 2009, since its completion in December 2008. It is )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 674.12 Tm (very basic and does not cover all of the areas listed in the Health and Safety )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 656.63 Tm (Executives guidance on bed rail risk management. This document coves 23 separate )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 639.13 Tm (risk assessments areas, including, for example, if the occupant has been assessed and )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 621.63 Tm (if the manufacturer has provided advice on any contra-indications for its )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 604.14 Tm (use/foreseeable mis use. The risk assessment in the home does not contain this detail. )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 586.64 Tm (Following the last visit to the home a Health and Safety officer from the Local )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 569.15 Tm (Authority visited the home. They addressed the concerns relating to safety issues )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 551.65 Tm (including bed side rails. At the time the manager of the service stated that they had )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 534.15 Tm (accessed HSE information regarding bed side rails and was completing new risk )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 516.66 Tm (assessments and staff training. Following this inspection of the service the Health and )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 499.16 Tm (Safety officer has re-visited the service. Their response is included later in this report.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 481.67 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 464.17 Tm (The pharmacist inspector spent 5 hours in the home looking at the medication )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 446.67 Tm (ordering, storage, handling and disposal arrangements, examining medication )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 429.18 Tm (administration record charts \(MARs\) and speaking to staff. The outcome is as follows.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 411.68 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 394.19 Tm (We found evidence that some people had not received their prescribed medicines for )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 376.69 Tm (some days at a time as none were available in the home to give. The lack of clear )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 359.19 Tm (medication receipt, transfer and administration records means it is not possible to be )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 341.7 Tm (certain that everyone living in the home always receive their prescribed medicines )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 324.2 Tm (exactly as directed. Medication management processes in the home still do not follow )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 306.71 Tm (best practice and we found a lack of awareness of current professional guidance.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 289.21 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 271.71 Tm (When we examined the 19 current MARs for accuracy and completeness we found )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 254.22 Tm (difficulties in being sure everyone had received all their prescribed medicines )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 236.72 Tm (correctly. For example, four MARs showed that five prescribed items were not )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 219.23 Tm (available to give at times when they were needed, four MARs contained a total of nine )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 201.73 Tm (administration gaps without any explanation given, and five MARs contained )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 184.23 Tm (inadequate records of the use of six prescribed skin care products. Where )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 166.74 Tm (administration gaps or omission codes were seen on the MARs, insufficient additional )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 149.24 Tm (information was found explaining why these doses hadn't been given. We found little )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 131.75 Tm (additional information about when and how people living in the home prefer to receive )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 114.25 Tm (their medicines or about how to give medicines prescribed 'when required'. Such )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 96.75 Tm (information helps staff to give medicines consistently and correctly and also helps to )Tj ET endstream endobj 46 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 47 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F3 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F3 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 423.78 w 34.6 599.52 m 562.54 599.52 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 402.41 w 33.47 587.7 m 563.66 587.7 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 384.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 384.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 385.38 m 565.87 385.38 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 779.1 Tm (reduce the risk of refusals or omissions. One MAR contained an extra hand written )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 761.6 Tm (dose instruction which had not been signed, dated or witnessed. Hand written entries )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 744.11 Tm (and changes to MARs must be clear, detailed and complete and safe arrangements )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 726.61 Tm (must be made to ensure staff know the reasons for the changes. A second person )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 709.11 Tm (should always check these entries for accuracy so that all staff follow the changes on )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 691.62 Tm (the MARs correctly.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 674.12 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 656.63 Tm (We found that whilst the medication store room was secure it was a very cramped )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 639.13 Tm (working environment as care files and office equipment were also kept in this room. )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 621.63 Tm (One medication cupboard was unable to be locked and there were no room )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 604.14 Tm (temperature records for the room. All medicines must be stored securely at )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 586.64 Tm (temperatures recommended by the manufacturer as this will help staff to know )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 569.15 Tm (medicines are safe to use when needed. The arrangements for storing and recording )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 551.65 Tm (the use of controlled drugs meet current standards.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 534.15 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 516.66 Tm (So that all staff know exactly what is expected of them, the home's medication policy )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 499.16 Tm (and procedures should be updated in line with professional best practice guidance )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 481.67 Tm (published by the Royal Pharmaceutical Society and the Care Quality Commission. We )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 464.17 Tm (were told that a new pharmacy supplier was now working with the home and that a )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 446.67 Tm (programme of medication safety and systems update training had commenced. Having )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 429.18 Tm (well trained up to date staff all of whom follow best practice guidance helps to reduce )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 411.68 Tm (the risk of medication errors.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 394.19 Tm ()Tj ET endstream endobj 48 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 49 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F3 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F3 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (19)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F3 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Daily life and social activities )Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 138.25 w 32.32 644.38 m 562.53 644.38 l S 0.001 w 0.95294 0.95294 0.95294 RG 119 w 31.2 655.13 m 563.65 655.13 l S 0.001 w 1 1 1 RG 17 w 31.2 584.88 m 563.65 584.88 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 594.5 m 565.85 594.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 594.5 m 565.85 594.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 575.25 m 565.85 575.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 574.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 574.17 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 702.57 Tm (Each person is treated as an individual and the care home is responsive to his or her )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 685.57 Tm (race, culture, religion, age, disability, gender and sexual orientation. They are part of )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 668.57 Tm (their local community. The care home supports people to follow personal interests and )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 651.57 Tm (activities. People are able to keep in touch with family, friends and representatives. )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 634.57 Tm (They are as independent as they can be, lead their chosen lifestyle and have the )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 617.57 Tm (opportunity to make the most of their abilities. People have nutritious and attractive )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 600.57 Tm (meals and snacks, at a time and place to suit them.)Tj ET /F3 12 Tf BT 1 0 0 1 35.5 581.32 Tm (There are no additional outcomes.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 557 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 535 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F2 12 Tf BT 1 0 0 1 369.04 535 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 28.35 512.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 194.33 w 34.6 411.01 m 562.54 411.01 l S 0.001 w 1 1 1 RG 22.5 w 32.35 499.17 m 564.79 499.17 l S 0.001 w 171.84 w 33.47 399.76 m 563.66 399.76 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 486.8 m 565.87 486.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 487.88 m 32.35 311.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 487.88 m 564.79 311.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 486.8 m 564.79 486.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 312.71 m 565.87 312.71 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 495.86 Tm (Judgement:)Tj ET /F3 12 Tf BT 1 0 0 1 36.62 471.12 Tm (People using this service experience )Tj ET /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 471.12 Tm (poor)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 290.57 471.12 Tm (quality outcomes in this area. We have )Tj ET /F3 12 Tf BT 1 0 0 1 36.62 453.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F3 12 Tf BT 1 0 0 1 36.62 426.75 Tm (We looked at standards 12,13,14 & 15.)Tj ET /F3 12 Tf BT 1 0 0 1 36.62 409.25 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 36.62 391.76 Tm (People are not offered opportunities for activities or stimulation. Their social and )Tj ET /F3 12 Tf BT 1 0 0 1 36.62 374.26 Tm (leisure needs are not met.)Tj ET /F3 12 Tf BT 1 0 0 1 36.62 356.77 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 36.62 339.27 Tm (People receive limited choices with their dietary needs.)Tj ET /F3 12 Tf BT 1 0 0 1 36.62 321.77 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 28.35 297.03 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 204.82 w 34.6 184.43 m 562.54 184.43 l S 0.001 w 1 1 1 RG 22.5 w 32.35 277.84 m 564.79 277.84 l S 0.001 w 183.45 w 33.47 172.62 m 563.66 172.62 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 265.47 m 565.87 265.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 266.55 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 266.55 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 265.47 m 564.79 265.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 274.53 Tm (Evidence:)Tj ET /F3 12 Tf BT 1 0 0 1 36.57 249.79 Tm (At the last visit to the home it was noted that there was only minimal social )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 232.29 Tm (stimulation for the people who live in the home. This was seen again at this visit.)Tj ET /F3 12 Tf BT 1 0 0 1 36.57 214.79 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 36.57 197.3 Tm (There is a large screen television in both of the lounges in the home. The television in )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 179.8 Tm (the dementia unit of the home was on a music channel. One of the staff told us that in )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 162.31 Tm (their opinion the introduction of the wide screen televisions had actually reduced the )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 144.81 Tm (opportunity for interaction with the people who live in the home. Apart from the short )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 127.31 Tm (conversations that staff were able to hold with service users, the majority of people )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 109.82 Tm (received no other opportunities for stimulation or social activities. One person was )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 92.32 Tm (visited by a relative and went out with them. A second person went out for lunch with )Tj ET endstream endobj 50 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 51 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F3 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F3 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (20)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 779.1 Tm (a member of staff and later told us that they had enjoyed this experience and had ate )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 761.6 Tm (their lunch at the home of the member of staff. We did not see any risk assessments )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 744.11 Tm (for this or evidence that this practice follows the polices within the home.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 726.61 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 709.11 Tm (We looked at the records of activities people had been offered, the only records of )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 691.62 Tm (activities included that there is a motivational person who visits twice a month and )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 674.12 Tm (that people are visited by their relatives. There are no other activities recorded, we did )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 656.63 Tm (not observe any additional activities either in the main area of the home or in the )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 639.13 Tm (dementia care unit.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 621.63 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 604.14 Tm (The dementia care unit remains sparse and people were sat with no activity and with )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 586.64 Tm (the television to listen to. At the last visit an activities board had been available, this )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 569.15 Tm (was not observed at this visit.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 551.65 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 534.15 Tm (When we spoke to staff they told us that people can play dominoes, read and listen to )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 516.66 Tm (music.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 499.16 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 481.67 Tm (A relative told us that there are not a lot of activities in the home.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 464.17 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 446.67 Tm (Subsequent to this visit the manager told us that the chiropodist now undertakes hand )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 429.18 Tm (care and that an activities person is being employed in the home for 5 days each )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 411.68 Tm (week.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 394.19 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 376.69 Tm (There was limited evidence that people have choices in their daily lives. The menus )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 359.19 Tm (have been adapted to offer two choices of the main meal. We observed on the day of )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 341.7 Tm (the visit that this included either sausages or fish, with potatoes and vegetables. The )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 324.2 Tm (records included that one person had chosen sausages but the staff member said this )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 306.71 Tm (was incorrect and gave them fish. When we spoke with the staff member they told us )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 289.21 Tm (this was because the person required a softer diet and would not be able to eat )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 271.71 Tm (sausages. We saw that no-one had attempted to provide a choice for people who )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 254.22 Tm (require a soft diet. When we spoke to staff individually and asked them about the )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 236.72 Tm (choices that people can make each day they told us that they can choose whether to )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 219.23 Tm (have the television on or not, whether to go out for a walk,, what to eat, what to wear )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 201.73 Tm (and who to sit with.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 184.23 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 166.74 Tm (We observed that staff continue to serve the main meal from a bain-marie, which )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 149.24 Tm (enabled them to provide people with the right amount of food of their choice. )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 131.75 Tm (However, we observed that there were 4 staff on duty, one person served lunch, and )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 114.25 Tm (two supported people in the main part of the home, leaving only one person to )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 96.75 Tm (support the people in the dementia care unit. This staff member worked hard to )Tj ET endstream endobj 52 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 53 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F3 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F3 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (21)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 178.84 w 34.6 721.99 m 562.54 721.99 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 157.46 w 33.47 710.18 m 563.66 710.18 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 629.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 629.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 630.32 m 565.87 630.32 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 779.1 Tm (support several people at once, this does not encourage a relaxing meal time. Neither )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 761.6 Tm (does it ensure that people have enough support to eat their meals. We spoke to the )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 744.11 Tm (managers and staff about this. The managers told us that they would normally assist )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 726.61 Tm (the staff in supporting people over a lunchtime. However, the managers do not work )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 709.11 Tm (at the weekends and staffing levels do not increase, meaning that people do not )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 691.62 Tm (always receive enough support with their diets.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 674.12 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 656.63 Tm (A relative told us that they felt the food offered had improved and that people now get )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 639.13 Tm (two choices of their main meal of the day.)Tj ET endstream endobj 55 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 56 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F3 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F3 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (22)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F3 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Complaints and protection )Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 87.25 w 32.32 669.88 m 562.53 669.88 l S 0.001 w 0.95294 0.95294 0.95294 RG 68 w 31.2 680.63 m 563.65 680.63 l S 0.001 w 1 1 1 RG 17 w 31.2 635.88 m 563.65 635.88 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 645.5 m 565.85 645.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 645.5 m 565.85 645.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 626.25 m 565.85 626.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 625.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 625.17 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 702.57 Tm (If people have concerns with their care, they or people close to them know how to )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 685.57 Tm (complain. Any concern is looked into and action taken to put things right. The care )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 668.57 Tm (home safeguards people from abuse and neglect and takes action to follow up any )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 651.57 Tm (allegations.)Tj ET /F3 12 Tf BT 1 0 0 1 35.5 632.32 Tm (Peoples legal rights are protected, including being able to vote in elections.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 608 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 586 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F2 12 Tf BT 1 0 0 1 369.04 586 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 28.35 563.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 141.85 w 34.6 488.25 m 562.54 488.25 l S 0.001 w 1 1 1 RG 22.5 w 32.35 550.17 m 564.79 550.17 l S 0.001 w 119.35 w 33.47 477 m 563.66 477 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 537.8 m 565.87 537.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 538.88 m 32.35 415.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 538.88 m 564.79 415.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 537.8 m 564.79 537.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 416.2 m 565.87 416.2 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 546.86 Tm (Judgement:)Tj ET /F3 12 Tf BT 1 0 0 1 36.62 522.12 Tm (People using this service experience )Tj ET /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 522.12 Tm (poor)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 290.57 522.12 Tm (quality outcomes in this area. We have )Tj ET /F3 12 Tf BT 1 0 0 1 36.62 504.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F3 12 Tf BT 1 0 0 1 36.62 477.75 Tm (We looked at standards 16 & 18.)Tj ET /F3 12 Tf BT 1 0 0 1 36.62 460.25 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 36.62 442.76 Tm (People are at risk of not having their health, and social care needs met due to poor )Tj ET /F3 12 Tf BT 1 0 0 1 36.62 425.26 Tm (quality of care plans, risk assessments and medication practices. )Tj ET /F3 12 Tf BT 1 0 0 1 28.35 400.52 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 308.3 w 34.6 236.18 m 562.54 236.18 l S 0.001 w 1 1 1 RG 22.5 w 32.35 381.33 m 564.79 381.33 l S 0.001 w 286.93 w 33.47 224.37 m 563.66 224.37 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 368.96 m 565.87 368.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 370.04 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 370.04 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 368.96 m 564.79 368.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 378.02 Tm (Evidence:)Tj ET /F3 12 Tf BT 1 0 0 1 36.57 353.27 Tm (There continues to be a complaints policy available within the home. The managers )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 335.78 Tm (told us that there have not been any complaints received to the home since they have )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 318.28 Tm (worked there. The CQC has not received any complaints regarding the home since the )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 300.79 Tm (last visit.)Tj ET /F3 12 Tf BT 1 0 0 1 36.57 283.29 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 36.57 265.79 Tm (There is a copy of the multi-agency policy and procedure for safeguarding vulnerable )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 248.3 Tm (people from abuse. Records of staff training reflected that since the last visit to the )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 230.8 Tm (home, staff have received training on this area and when we spoke to staff they were )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 213.31 Tm (positive in the actions that they would take and that they would support people with )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 195.81 Tm (this.)Tj ET /F3 12 Tf BT 1 0 0 1 36.57 178.31 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 36.57 160.82 Tm (We examined records of incidents that had occurred in the home, including those of )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 143.32 Tm (incidents between the people who live there. At the last visit to the home incidents )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 125.83 Tm (were not being reported to the CQC or the local authority. We saw that one incident )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 108.33 Tm (had been reported to the local authority and the commission have received some )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 90.83 Tm (notifications of incidents in the home.)Tj ET endstream endobj 57 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 58 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F3 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F3 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (23)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 248.82 w 34.6 686.99 m 562.54 686.99 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 227.45 w 33.47 675.18 m 563.66 675.18 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 559.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 559.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 560.34 m 565.87 560.34 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 779.1 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 761.6 Tm (We saw that there was one incident when someone had cut their head, that had been )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 744.11 Tm (dealt with by the home, but that had not been reported to the CQC. There was )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 726.61 Tm (another incident when a service user hit another service user on the head, that had )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 709.11 Tm (not been reported to either the commission or the local authority. A further incident )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 691.62 Tm (when a service user was admitted to hospital with a serious illness had also not been )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 674.12 Tm (reported to the CQC.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 656.63 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 639.13 Tm (We looked at peoples finances and how these are handled in the home. There are )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 621.63 Tm (systems in place and peoples monies are checked.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 604.14 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 586.64 Tm (Poor care planning, risk assessments and management of medication is placing people )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 569.15 Tm (at risk of harm as it can not be ensured that their needs are being met.)Tj ET endstream endobj 59 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 60 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F3 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F3 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (24)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F3 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Environment )Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 104.25 w 32.32 661.38 m 562.53 661.38 l S 0.001 w 0.95294 0.95294 0.95294 RG 34 w 31.2 697.63 m 563.65 697.63 l S 0.001 w 1 1 1 RG 68 w 31.2 644.38 m 563.65 644.38 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 679.5 m 565.85 679.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 679.5 m 565.85 679.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 609.25 m 565.85 609.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 608.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 608.17 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 702.57 Tm (People stay in a safe and well-maintained home that is homely, clean, pleasant and )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 685.57 Tm (hygienic. )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 666.32 Tm (People stay in a home that has enough space and facilities for them to lead the life )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 649.32 Tm (they choose and to meet their needs. The home makes sure they have the right )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 632.32 Tm (specialist equipment that encourages and promotes their independence. Their room )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 615.32 Tm (feels like their own, it is comfortable and they feel safe when they use it.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 591 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 569 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F2 12 Tf BT 1 0 0 1 369.04 569 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 28.35 546.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 159.34 w 34.6 462.5 m 562.54 462.5 l S 0.001 w 1 1 1 RG 22.5 w 32.35 533.17 m 564.79 533.17 l S 0.001 w 136.85 w 33.47 451.25 m 563.66 451.25 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 520.8 m 565.87 520.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 521.88 m 32.35 380.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 521.88 m 564.79 380.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 520.8 m 564.79 520.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 381.7 m 565.87 381.7 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 529.86 Tm (Judgement:)Tj ET /F3 12 Tf BT 1 0 0 1 36.62 505.12 Tm (People using this service experience )Tj ET /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 505.12 Tm (adequate)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 319.4 505.12 Tm (quality outcomes in this area. We have )Tj ET /F3 12 Tf BT 1 0 0 1 36.62 487.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F3 12 Tf BT 1 0 0 1 36.62 460.75 Tm (We looked at standards 19,20,24,25, & 26.)Tj ET /F3 12 Tf BT 1 0 0 1 36.62 443.25 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 36.62 425.76 Tm (Despite some decoration work being undertaken there continues to be a large amount )Tj ET /F3 12 Tf BT 1 0 0 1 36.62 408.26 Tm (of work required, including some health and safety work to ensure that people live in a )Tj ET /F3 12 Tf BT 1 0 0 1 36.62 390.77 Tm (clean, comfortable and safe home.)Tj ET /F3 12 Tf BT 1 0 0 1 28.35 366.02 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 273.81 w 34.6 218.93 m 562.54 218.93 l S 0.001 w 1 1 1 RG 22.5 w 32.35 346.84 m 564.79 346.84 l S 0.001 w 252.44 w 33.47 207.12 m 563.66 207.12 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 334.46 m 565.87 334.46 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 335.54 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 335.54 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 334.46 m 564.79 334.46 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 343.52 Tm (Evidence:)Tj ET /F3 12 Tf BT 1 0 0 1 36.57 318.78 Tm (The home comprises of a large old property that is used as the main care areas and a )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 301.28 Tm (newer extension that is the dementia care unit. The ground floor of the main home )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 283.79 Tm (comprises of bedrooms, a bathroom, the main lounge, a conservatory and dining )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 266.29 Tm (room, the managers offices and the kitchen. Upstairs there are further bedrooms and )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 248.79 Tm (another bathroom. The dementia care unit is on the ground floor and includes a dining )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 231.3 Tm (area/lounge, bedrooms, bathroom, the laundry room and a conservatory.)Tj ET /F3 12 Tf BT 1 0 0 1 36.57 213.8 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 36.57 196.31 Tm (Some painting has taken place in the home and this has improved the light in the )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 178.81 Tm (home. The manager told us that they have received some new bedroom furniture and )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 161.31 Tm (that a small amount is to be replaced each month.)Tj ET /F3 12 Tf BT 1 0 0 1 36.57 143.82 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 36.57 126.32 Tm (We completed a tour of the premises with either one or both of the managers present )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 108.83 Tm (at different times.)Tj ET /F3 12 Tf BT 1 0 0 1 36.57 91.33 Tm ()Tj ET endstream endobj 61 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 62 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F3 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F3 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (25)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 779.1 Tm (The lounge in the main part of the home has been painted and a new carpet has been )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 761.6 Tm (put in place. This carpet has not been well fitted and has marks on it. The manager )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 744.11 Tm (told us that they are hoping to replace this.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 726.61 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 709.11 Tm (The conservatory is adjacent to the lounge and the manager told us about two of the )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 691.62 Tm (service users who use this room. The radiator in here was not guarded.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 674.12 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 656.63 Tm (The lift is separate to the lounge at the side of the building. This area is dark and )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 639.13 Tm (undecorated and has two different patterned old carpets fitted.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 621.63 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 604.14 Tm (Some of the bedrooms were being used as storage and the manager told us that )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 586.64 Tm (people have moved rooms to accommodate refurbishment/redecoration.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 569.15 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 551.65 Tm (One bedroom had a bed that was unstable and the manager told us that this bed is )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 534.15 Tm (not currently used and is to be replaced. When we tried to open the curtains in this )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 516.66 Tm (room the pole and curtains fell down, additionally the window opening was not )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 499.16 Tm (restricted to protect people from falling out of the window.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 481.67 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 464.17 Tm (Another bedroom included a radiator without any guard to protect people from the risk )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 446.67 Tm (of burning and we saw that several radiator covers in other bedrooms were damaged. )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 429.18 Tm (The manager told us that staff have had to make holes in these to be able to access )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 411.68 Tm (the radiator temperature controls.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 394.19 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 376.69 Tm (The dementia care unit continues to be sparsely decorated and does not appear )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 359.19 Tm (comfortable or relaxing. We looked at peoples rooms, again some of these were being )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 341.7 Tm (used for the storage of furniture. One bedroom floor was very sticky with patches of )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 324.2 Tm (flooring missing.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 306.71 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 289.21 Tm (Many of the bedroom doors throughout the home have star locks on them. These )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 271.71 Tm (types of lock ensure that the door can be locked from the outside. However, they )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 254.22 Tm (cannot be opened from the inside when this lock is operated. The manager stated that )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 236.72 Tm (these locks were no longer in use. It is recommended that these are therefore )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 219.23 Tm (removed, as if they were used they would compromise both peoples safety, dignity )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 201.73 Tm (and choice.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 184.23 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 166.74 Tm (Many of the wardrobes in the dementia unit have hook and catch type locks added to )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 149.24 Tm (them to prevent people from opening them. This does not maintain peoples dignity, )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 131.75 Tm (and is a safety risk as one person has pulled at the wardrobe door until it has broken, )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 114.25 Tm (there is also the potential for the wardrobe to fall over. This was discussed with one of )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 96.75 Tm (the managers at the time of the visit who agreed this was not good practice.)Tj ET endstream endobj 63 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 64 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F3 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F3 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (26)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 779.1 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 761.6 Tm (All but one of the windows in the dementia unit were observed to have window )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 744.11 Tm (opening restrictors, however one window did not have a restrictor in place. The )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 726.61 Tm (dementia unit has key coded locks to assist people with their safety, however )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 709.11 Tm (previously one service users had left the home and was later found in the grounds. At )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 691.62 Tm (this time it was unclear how the person had left the home, fortunately they were not )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 674.12 Tm (harmed from his incident. The home must make sure that peoples safety is not )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 656.63 Tm (compromised through the lack of adequate maintenance and attention to the property.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 639.13 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 621.63 Tm (There were two people who required the use of a specialist mattress to help them with )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 604.14 Tm (a medical condition. Neither of these mattresses were fastened correctly to the bed )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 586.64 Tm (and one of the managers rectified this at the time of the visit.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 569.15 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 551.65 Tm (In another bedroom a stained mattress was stored against the wall , the manager was )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 534.15 Tm (unsure as to the reason for the mattress being in the persons room.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 516.66 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 499.16 Tm (Several of the rooms require redecoration, and currently have old furniture. One of the )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 481.67 Tm (managers told us that there is an ongoing programme of refurbishment and that 6 )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 464.17 Tm (bedrooms have been redecorated, with another 2 sets of new bedroom furniture being )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 446.67 Tm (supplied each month. As the home accommodates up to 37 people, with some double )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 429.18 Tm (rooms, this programme of refurbishment could take up to another 17 months.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 411.68 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 394.19 Tm (We saw the bedrooms that have been decorated and have some of the new furniture )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 376.69 Tm (in, these were comfortable and clean. The hot water outlets in these rooms all )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 359.19 Tm (exceeded 43 degrees centigrade and may pose a risk to people who are frail, the )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 341.7 Tm (managers agreed that this requires attention. This was reported to the Health and )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 324.2 Tm (Safety officer who visited the service. They found that mixer valves had been fitted to )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 306.71 Tm (wash hand basins and delivers temperatures of 37-44 degrees.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 289.21 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 271.71 Tm (At the last visit it was noted that several hot water outlets supplied water that was in )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 254.22 Tm (excess of 43 degrees centigrade, the managers told us that thermostatic mixer valves )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 236.72 Tm (are now in place. We found that the hot water in the bathroom was now being )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 219.23 Tm (provided at 35 degrees centigrade, which is probably now too cold as once the bath is )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 201.73 Tm (poured the temperature is likely to be much lower than 35 degrees.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 184.23 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 166.74 Tm (The home was generally clean throughout, but the upstairs bathroom toilet had faeces )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 149.24 Tm (on the base of it, as did a light switch in one of the bedrooms and the covers for bed )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 131.75 Tm (rails in another. This does not ensure that the polices for the control of infection are )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 114.25 Tm (followed and may compromise peoples health and safety. A relative told us that they )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 96.75 Tm (thought the home was a lot cleaner now than previously.)Tj ET endstream endobj 65 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 66 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F3 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F3 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (27)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 779.1 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 761.6 Tm (Bedrooms in the main part of the home and a couple in the dementia unit were )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 744.11 Tm (personalised to differing degree, reflecting the personality of the individual. Some of )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 726.61 Tm (the bedrooms were clean and tidy.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 709.11 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 691.62 Tm (At the last visit to the home a strong smell of urine was notice in the entrance hall, )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 674.12 Tm (this was not the case at this visit. Additionally the entrance hall has been painted.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 656.63 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 639.13 Tm (The kitchen area of the home has been divided so that it is not now used as a walk )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 621.63 Tm (way. The kitchen and servery continue to be in need of decorating and cleaning. The )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 604.14 Tm (main kitchen continues to be dated and some equipment remains close to the need for )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 586.64 Tm (replacement. We saw items in the fridge that were uncovered and not labelled with )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 569.15 Tm (the date of preparation and vacuum packed frozen raw meat had been left on a )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 551.65 Tm (surface to defrost.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 534.15 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 516.66 Tm (It was identified at the last visit to the home that environmental checks need to take )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 499.16 Tm (place regularly so that the managers pick up on these shortfalls. This continues to be )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 481.67 Tm (the case at this visit.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 464.17 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 446.67 Tm (Previously a refurbishment and redecoration plan was required, it is clear that some )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 429.18 Tm (work has commenced and that a plan is in place.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 411.68 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 394.19 Tm (Maintenance checks had been undertaken for the fire extinguishers, and the manager )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 376.69 Tm (told us that staff have undertaken training in fire safety. The records to show that the )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 359.19 Tm (fire alarm system had been maintained were not available at the visit but were )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 341.7 Tm (subsequently provided to the CQC.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 324.2 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 306.71 Tm (As a result of our visit we asked the Health and Safety officer from the Local Authority )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 289.21 Tm (to visit. This is their response: ' CQC requested that an Health and Safety Inspector )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 271.71 Tm (from the Local Authority visit to consider concerns about trip hazards in the kitchen )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 254.22 Tm (corridor, scalding risks, poor assessment of and poorly fitted bed rails.The Health and )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 236.72 Tm (Safety Inspector identified: - trip hazards had been addressed. - poor monitoring of )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 219.23 Tm (the homes safety management system to scalding from full body immersion with hot )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 201.73 Tm (water delivery at 55-57 degrees in several communal outlets and bedrooms in the EMI )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 184.23 Tm (area and other bathrooms. Certain bedrooms with residents without dementia were )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 166.74 Tm (also delivering temperatures above 43 degrees but there were no risk assessments in )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 149.24 Tm (place to account for these elected risks. - unclear procedures and assessments on use )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 131.75 Tm (of and spacing of bed rails.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 114.25 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 96.75 Tm (The managers response to these immediate concerns was proactive and undertook an )Tj ET endstream endobj 67 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 68 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F3 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F3 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (28)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 161.34 w 34.6 730.73 m 562.54 730.73 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 139.97 w 33.47 718.92 m 563.66 718.92 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 646.74 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 646.74 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 647.82 m 565.87 647.82 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 779.1 Tm (immediate review of all hot water outlets and arranged for thermostatically controlled )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 761.6 Tm (mixer valves to be fitted. A revisit identified that the manager had accessed HSE )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 744.11 Tm (information on bed rials and was introducing a more robust policy on their use.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 726.61 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 709.11 Tm (Following the latest inspection by the Commission the H&S officer re-visited and are to )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 691.62 Tm (undertake a further meeting with the home to consider progress on risk assessments )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 674.12 Tm (and policy reviews.')Tj ET /F3 12 Tf BT 1 0 0 1 34.32 656.63 Tm ()Tj ET endstream endobj 69 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 70 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F3 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F3 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (29)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F3 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Staffing )Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 104.25 w 32.32 661.38 m 562.53 661.38 l S 0.001 w 0.95294 0.95294 0.95294 RG 85 w 31.2 672.13 m 563.65 672.13 l S 0.001 w 1 1 1 RG 17 w 31.2 618.88 m 563.65 618.88 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 609.25 m 565.85 609.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 608.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 608.17 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 702.57 Tm (People have safe and appropriate support as there are enough competent staff on duty )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 685.57 Tm (at all times. They have confidence in the staff at the home because checks have been )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 668.57 Tm (done to make sure that they are suitable to care for them. Their needs are met and )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 651.57 Tm (they are cared for by staff who get the relevant training and support from their )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 634.57 Tm (managers.)Tj ET /F3 12 Tf BT 1 0 0 1 35.5 615.32 Tm (There are no additional outcomes.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 591 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 569 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F2 12 Tf BT 1 0 0 1 369.04 569 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 28.35 546.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 176.84 w 34.6 453.75 m 562.54 453.75 l S 0.001 w 1 1 1 RG 22.5 w 32.35 533.17 m 564.79 533.17 l S 0.001 w 154.34 w 33.47 442.51 m 563.66 442.51 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 520.8 m 565.87 520.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 521.88 m 32.35 363.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 521.88 m 564.79 363.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 520.8 m 564.79 520.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 364.21 m 565.87 364.21 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 529.86 Tm (Judgement:)Tj ET /F3 12 Tf BT 1 0 0 1 36.62 505.12 Tm (People using this service experience )Tj ET /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 505.12 Tm (poor)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 290.57 505.12 Tm (quality outcomes in this area. We have )Tj ET /F3 12 Tf BT 1 0 0 1 36.62 487.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F3 12 Tf BT 1 0 0 1 36.62 460.75 Tm (We looked at standards 27, 28, 29 & 30.)Tj ET /F3 12 Tf BT 1 0 0 1 36.62 443.25 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 36.62 425.76 Tm (People are supported by staff who have received some training, and who now have )Tj ET /F3 12 Tf BT 1 0 0 1 36.62 408.26 Tm (some supervision. However, the reduction in staffing numbers and poor practices in )Tj ET /F3 12 Tf BT 1 0 0 1 36.62 390.77 Tm (relation to covering staff sickness does not ensure the safety of the people living in )Tj ET /F3 12 Tf BT 1 0 0 1 36.62 373.27 Tm (the home or that their needs are fully met. )Tj ET /F3 12 Tf BT 1 0 0 1 28.35 348.52 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 256.31 w 34.6 210.18 m 562.54 210.18 l S 0.001 w 1 1 1 RG 22.5 w 32.35 329.34 m 564.79 329.34 l S 0.001 w 234.94 w 33.47 198.37 m 563.66 198.37 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 316.97 m 565.87 316.97 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 318.04 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 318.04 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 316.97 m 564.79 316.97 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 326.03 Tm (Evidence:)Tj ET /F3 12 Tf BT 1 0 0 1 36.57 301.28 Tm (There have been changes to the staffing levels during the day. There are now only 2 )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 283.79 Tm (carers throughout the day in both sections of the home , previously there were three )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 266.29 Tm (in the main part of the home. There are three staff to support all service user )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 248.79 Tm (throughout the night. The managers told us that this was due to a reduction by 3 of )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 231.3 Tm (the amount of service users residing in the home. They told us that there were 21 )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 213.8 Tm (people living in the home at the time of the visit. Due to the amount of requirements )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 196.31 Tm (and concerns raised at the last visit it would be advisable that the home does not )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 178.81 Tm (amend the staffing levels until there is clear improvement in the standards in the )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 161.31 Tm (home.)Tj ET /F3 12 Tf BT 1 0 0 1 36.57 143.82 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 36.57 126.32 Tm (We looked at the duty rotas and at the actual staffing returns. There have been )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 108.83 Tm (problems with staffing the home due to staff sickness. On two separate occasions staff )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 91.33 Tm (have worked a 12 hour day shift and stayed on duty and completed a 12 hour waking )Tj ET endstream endobj 71 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 72 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F3 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F3 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (30)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 633.73 w 34.6 494.54 m 562.54 494.54 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 612.36 w 33.47 482.73 m 563.66 482.73 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 174.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 174.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 175.42 m 565.87 175.42 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 779.1 Tm (night shift. This has been organised by the managers of the home. They told us that )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 761.6 Tm (they are not allowed by senior management to use agency staff to support the home )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 744.11 Tm (when staff are absent. People working for 24 hours without a break from the home is )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 726.61 Tm (poor practice, it increases the risks of accidents happening and peoples needs not )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 709.11 Tm (being met.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 691.62 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 674.12 Tm (The manager told us that they have not employed any new staff this year, although )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 656.63 Tm (they are planning to do so and are awaiting references and Criminal Record Bureau )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 639.13 Tm (checks to be returned prior to people commencing employment. These checks help to )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 621.63 Tm (make sure that only people suitable for the role and who do not hold a criminal )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 604.14 Tm (conviction that may prevent them from working with vulnerable people are employed.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 586.64 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 569.15 Tm (We looked at the recruitment records for three of the people who work in the home. )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 551.65 Tm (All of these files included an application form, 2 written references and a CRB check. )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 534.15 Tm (Two of the references received were not clear and had not been verified to ensure that )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 516.66 Tm (they were from the person that they had been requested from. Two of the three files )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 499.16 Tm (included details of the staff induction, this was described as being designed in order to )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 481.67 Tm (comply with TOPSS.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 464.17 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 446.67 Tm (We looked at the training records held in the home. The new managers have removed )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 429.18 Tm (records of training that were provided by the previous organisation and told us that )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 411.68 Tm (they are planning to retrain the staff. Since the last visit to the home staff have )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 394.19 Tm (received training in Safeguarding Vulnerable People, Fire and medication )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 376.69 Tm (administration.The managers of the home also told us about the National Vocational )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 359.19 Tm (Training \(NVQ\), currently there are 2 staff who hold an NVQ level 3, 5 staff who hold )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 341.7 Tm (an NVQ level 2 and 3 staff who hold the Registered managers award.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 324.2 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 306.71 Tm (At the last visit to the home large gaps in training were found, for example, moving )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 289.21 Tm (and handling, health and safety, basic food hygiene, infection control, and first aid, )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 271.71 Tm (these courses have yet to be undertaken. Additionally a training plan should be )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 254.22 Tm (produced for the staff team as a whole.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 236.72 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 219.23 Tm (The managers have undertaken disciplinary meetings,with two staff members, )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 201.73 Tm (although these have not been notified to the CQC.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 184.23 Tm ()Tj ET endstream endobj 73 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 74 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F3 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F3 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (31)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F3 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Management and administration )Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 189.25 w 32.32 618.88 m 562.53 618.88 l S 0.001 w 0.95294 0.95294 0.95294 RG 85 w 31.2 672.13 m 563.65 672.13 l S 0.001 w 1 1 1 RG 102 w 31.2 576.38 m 563.65 576.38 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 524.25 m 565.85 524.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 523.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 523.17 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 702.57 Tm (People have confidence in the care home because it is led and managed appropriately. )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 685.57 Tm (People control their own money and choose how they spend it. If they or someone )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 668.57 Tm (close to them cannot manage their money, it is managed by the care home in their )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 651.57 Tm (best interests. The environment is safe for people and staff because appropriate health )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 634.57 Tm (and safety practices are carried out.)Tj ET /F3 12 Tf BT 1 0 0 1 35.5 615.32 Tm (People get the right support from the care home because the manager runs it )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 598.32 Tm (appropriately with an open approach that makes them feel valued and respected. The )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 581.32 Tm (people staying at the home are safeguarded because it follows clear financial and )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 564.32 Tm (accounting procedures, keeps records appropriately and ensures their staff understand )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 547.32 Tm (the way things should be done. They get the right care because the staff are )Tj ET /F3 12 Tf BT 1 0 0 1 35.5 530.32 Tm (supervised and supported by their managers.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 506 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 484 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F2 12 Tf BT 1 0 0 1 369.04 484 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 28.35 461.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 159.34 w 34.6 377.5 m 562.54 377.5 l S 0.001 w 1 1 1 RG 22.5 w 32.35 448.17 m 564.79 448.17 l S 0.001 w 136.85 w 33.47 366.25 m 563.66 366.25 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 435.8 m 565.87 435.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 436.88 m 32.35 295.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 436.88 m 564.79 295.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 435.8 m 564.79 435.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 296.7 m 565.87 296.7 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 444.86 Tm (Judgement:)Tj ET /F3 12 Tf BT 1 0 0 1 36.62 420.12 Tm (People using this service experience )Tj ET /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 420.12 Tm (poor)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 290.57 420.12 Tm (quality outcomes in this area. We have )Tj ET /F3 12 Tf BT 1 0 0 1 36.62 402.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F3 12 Tf BT 1 0 0 1 36.62 375.75 Tm (We looked at standards 31,33,35,36, 37 & 38.)Tj ET /F3 12 Tf BT 1 0 0 1 36.62 358.25 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 36.62 340.76 Tm (Although some improvements in the home have been made, the health and safety of )Tj ET /F3 12 Tf BT 1 0 0 1 36.62 323.26 Tm (the people in the home continues to be compromised and people are not fully )Tj ET /F3 12 Tf BT 1 0 0 1 36.62 305.77 Tm (protected from the risk of harm.)Tj ET /F3 12 Tf BT 1 0 0 1 28.35 281.02 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 188.81 w 34.6 176.43 m 562.54 176.43 l S 0.001 w 1 1 1 RG 22.5 w 32.35 261.84 m 564.79 261.84 l S 0.001 w 167.44 w 33.47 164.62 m 563.66 164.62 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 249.46 m 565.87 249.46 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 250.54 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 250.54 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 249.46 m 564.79 249.46 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 258.52 Tm (Evidence:)Tj ET /F3 12 Tf BT 1 0 0 1 36.57 233.78 Tm (The previous manager is no longer working in the home and since January 2010 there )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 216.28 Tm (have been 2 managers employed in the home. The managers told us that they have )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 198.79 Tm (been addressing the requirements of the previous inspection but that as they address )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 181.29 Tm (each problem another one appears. They told us that there are problems with the staff )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 163.79 Tm (culture in the home and that the staff do not always assist in improving practice. The )Tj ET /F3 12 Tf BT 1 0 0 1 36.57 146.3 Tm (managers told us that they are addressing this.)Tj ET /F3 12 Tf BT 1 0 0 1 36.57 128.8 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 36.57 111.31 Tm (The home does not have a manager registered with the Commission.)Tj ET /F3 12 Tf BT 1 0 0 1 36.57 93.81 Tm ()Tj ET endstream endobj 76 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 77 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F3 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F3 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (32)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 779.1 Tm (At the last visit there was not a certificate of registration on display and it was noted )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 761.6 Tm (that this is now in place.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 744.11 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 726.61 Tm (The management and quality of the home continues to require improvement. The new )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 709.11 Tm (managers have undertaken some work, although there are a number of requirements )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 691.62 Tm (that remain outstanding including the medication practices in the home and )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 674.12 Tm (consequently the meeting of peoples health needs. Systems in the home for care )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 656.63 Tm (support, care planning, risk management, staff training, and environmental checks all )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 639.13 Tm (continue to require attention. As noted at the last visit to the home these areas )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 621.63 Tm (require urgent attention to ensure the health, safety and welfare of the people living in )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 604.14 Tm (the home. Additionally the managers have allowed staff to work excessive hours that )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 586.64 Tm (may place people at risk. Of the previous recommendations only 2 have been met, )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 569.15 Tm (some have been removed and are now requirements but the large majority remain, )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 551.65 Tm (this demonstrates a lack of commitment from the management in improving the )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 534.15 Tm (service.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 516.66 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 499.16 Tm (The owner of the home has undertaken regulation 26 visits to the home, as part of )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 481.67 Tm (this he assessed the medication system in the home but did not see the discrepancies )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 464.17 Tm (or address these found at this visit. This system is not adequate and must be )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 446.67 Tm (improved upon to ensure that these visits are effective and assist the management )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 429.18 Tm (and quality of the home.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 411.68 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 394.19 Tm (The new managers told us that there is a quality assurance system in the home and )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 376.69 Tm (that they have started to work with this. They told us that there are not many )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 359.19 Tm (relatives of whom they can consult or ask their opinion regarding the service and are )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 341.7 Tm (addressing this. This system is not adequate as it does not address any of the areas )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 324.2 Tm (for improvement.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 306.71 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 289.21 Tm (We looked at the supervision records for the staff. The new manager has recently )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 271.71 Tm (developed a plan for supervising the staff. Some supervision has taken place and the )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 254.22 Tm (new manager has also used these sessions for training. For example one person has )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 236.72 Tm (received three separate sessions, one regarding medication, one regarding reporting )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 219.23 Tm (incidents and one as a supervision session. The records for the other two staff showed )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 201.73 Tm (that they have received one supervision each. The managers have identified that there )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 184.23 Tm (are cultural concerns within the home and robust supervision practices would help to )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 166.74 Tm (address this.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 149.24 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 131.75 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 114.25 Tm (As at the last visit not all of the required records were in place and up to date. This )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 96.75 Tm (included assessment of individual need, care planning, risk assessment, staff training )Tj ET endstream endobj 78 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 79 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F3 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F3 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (33)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 388.79 w 34.6 617.01 m 562.54 617.01 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 367.42 w 33.47 605.2 m 563.66 605.2 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 419.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 419.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 420.37 m 565.87 420.37 l S 0.001 w [] 0 d /F3 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 779.1 Tm (and environmental checks. These records continue to require attention for them to be )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 761.6 Tm (at an acceptable standard and this must now be addressed as a matter of urgency.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 744.11 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 726.61 Tm (At the last inspection there were a number of health and safety issues that required )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 709.11 Tm (addressing. The health and safety officer for the Local Authority visited the home and )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 691.62 Tm (advised them regarding these issues. However although some work has been )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 674.12 Tm (completed to address the hot water issues, several hot water outlets in bedrooms )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 656.63 Tm (were above the recommended 43 degrees centigrade, specialist mattresses were )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 639.13 Tm (found unfastened with one being fitted to a bed with a bed rail that was also easy to )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 621.63 Tm (move and not all of the windows in the home have opening restrictors.The health and )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 604.14 Tm (safety officer for the Local Authority has been notified of these issues.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 586.64 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 569.15 Tm (We looked at the finance systems in the home. People have individual wallets and )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 551.65 Tm (receipts are kept of expenditure. The managers showed us that the balances were )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 534.15 Tm (correct in individual wallets, they also explained the receipts system in the home.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 516.66 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 34.32 499.16 Tm (We looked at some of the maintenance records in the home. This included that )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 481.67 Tm (maintenance checks had been undertaken to ensure that systems were safe on the )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 464.17 Tm (electrical appliances, the lift, electrical wiring and gas systems in the home, no )Tj ET /F3 12 Tf BT 1 0 0 1 34.32 446.67 Tm (concerns were raised in these checks.)Tj ET /F3 12 Tf BT 1 0 0 1 34.32 429.18 Tm ()Tj ET endstream endobj 80 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 82 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F3 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (34)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 31.8 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 31.8 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.99216 0.9451 0.76078 RG 36.25 w 29.47 793.28 m 564.97 793.28 l S 0.001 w 0.95294 0.95294 0.95294 RG 17 w 28.35 804.03 m 566.1 804.03 l S 0.001 w 17 w 28.35 784.78 m 422.1 784.78 l S 0.001 w 17 w 424.35 784.78 m 467.1 784.78 l S 0.001 w 1 1 1 RG 17 w 469.35 784.78 m 494.1 784.78 l S 0.001 w 0.95294 0.95294 0.95294 RG 17 w 496.35 784.78 m 539.1 784.78 l S 0.001 w 1 1 1 RG 17 w 541.35 784.78 m 566.1 784.78 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 26.14 794.4 m 568.3 794.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 813.65 m 568.3 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 794.4 m 568.3 794.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 775.15 m 568.3 775.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.22 814.73 m 27.22 774.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 423.22 795.48 m 423.22 774.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 468.22 795.48 m 468.22 774.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 495.22 795.48 m 495.22 774.08 l S 0.001 w [] 0 d [] 0 d 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0 d 2.25 w 28.99 616.8 m 568.4 616.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 430.59 m 568.3 430.59 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 229.8 m 568.3 229.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 61.78 m 568.3 61.78 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 721.86 m 30.07 615.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 650.43 m 92.12 615.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 650.43 m 198.52 615.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 650.43 m 290.62 615.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 650.43 m 475.02 615.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 721.86 m 567.32 615.72 l S 0.001 w [] 0 d /F3 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 703.57 Tm (Outstanding statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 34.05 685.15 Tm (These are requirements that were set at the previous inspection, but have still not )Tj ET /F3 12 Tf BT 1 0 0 1 34.05 670.57 Tm (been met.)Tj ET /F3 12 Tf BT 1 0 0 1 95.57 670.57 Tm ( )Tj ET /F3 12 Tf BT 1 0 0 1 104.02 670.57 Tm (They say what the registered person had to do to meet the Care Standards )Tj ET /F3 12 Tf BT 1 0 0 1 34.05 655.99 Tm (Act 2000, Care Homes Regulations 2001 and the National Minimum Standards.)Tj ET /F3 10 Tf BT 1 0 0 1 31.2 638.17 Tm (No.)Tj ET /F3 10 Tf BT 1 0 0 1 96.1 635.17 Tm (Standard)Tj ET /F3 10 Tf BT 1 0 0 1 202.5 635.17 Tm (Regulation)Tj ET /F3 10 Tf BT 1 0 0 1 294.6 635.17 Tm (Requirement)Tj ET /F3 10 Tf BT 1 0 0 1 479 635.17 Tm (Timescale for )Tj ET /F3 10 Tf BT 1 0 0 1 479 623.02 Tm (action)Tj ET /F3 12 Tf BT 1 0 0 1 35.5 603.61 Tm (1)Tj ET /F3 12 Tf BT 1 0 0 1 96.15 600.61 Tm (7)Tj ET /F3 12 Tf BT 1 0 0 1 202.5 600.61 Tm (15)Tj ET /F3 12 Tf BT 1 0 0 1 294.55 600.61 Tm (People must have their )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 586.03 Tm (assessed needs detailed in )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 571.45 Tm (care plans with clear task for )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 556.87 Tm (staff in how to meet them.)Tj ET /F3 12 Tf BT 1 0 0 1 294.55 539.29 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 294.55 524.71 Tm (This will help to ensure that )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 510.13 Tm (care is not missed.)Tj ET /F3 12 Tf BT 1 0 0 1 294.55 495.55 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 294.55 480.97 Tm (We will be considering )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 466.39 Tm (issuing a Statutory )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 451.81 Tm (Requirement Notice for the )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 437.23 Tm (breach of this regulation.)Tj ET /F3 12 Tf BT 1 0 0 1 478.9 600.61 Tm (22/01/2010)Tj ET /F3 12 Tf BT 1 0 0 1 35.5 417.4 Tm (2)Tj ET /F3 12 Tf BT 1 0 0 1 96.15 414.4 Tm (7)Tj ET /F3 12 Tf BT 1 0 0 1 202.5 414.4 Tm (15)Tj ET /F3 12 Tf BT 1 0 0 1 294.55 414.4 Tm (Care plans must be produced )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 399.82 Tm (in a timely manner and be )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 385.24 Tm (updated when significant )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 370.66 Tm (needs change.)Tj ET /F3 12 Tf BT 1 0 0 1 294.55 353.08 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 294.55 338.5 Tm (This will ensure that staff )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 323.92 Tm (have information quickly )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 309.34 Tm (about how to care for people.)Tj ET /F3 12 Tf BT 1 0 0 1 294.55 294.76 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 294.55 280.18 Tm (We will be considering )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 265.6 Tm (issuing a Statutory )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 251.02 Tm (Requirement Notice for the )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 236.44 Tm (breach of this regulation.)Tj ET /F3 12 Tf BT 1 0 0 1 478.9 414.4 Tm (22/01/2010)Tj ET /F3 12 Tf BT 1 0 0 1 35.5 216.61 Tm (3)Tj ET /F3 12 Tf BT 1 0 0 1 96.15 213.61 Tm (8)Tj ET /F3 12 Tf BT 1 0 0 1 202.5 213.61 Tm (13)Tj ET /F3 12 Tf BT 1 0 0 1 294.55 213.61 Tm (Risk assessments must )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 199.03 Tm (contain a full analysis of risk )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 184.45 Tm (and the measures needed to )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 169.87 Tm (reduce risk.)Tj ET /F3 12 Tf BT 1 0 0 1 294.55 152.29 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 294.55 137.71 Tm (This will help to ensure that )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 123.13 Tm (staff are fully aware of any )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 108.55 Tm (risk and what steps they )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 93.97 Tm (need to take to minimise it )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 79.39 Tm (and support people safely.)Tj ET /F3 12 Tf BT 1 0 0 1 294.55 64.81 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 478.9 213.61 Tm (22/01/2010)Tj ET endstream endobj 83 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 84 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F3 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (35)Tj ET 0.75294 0.75294 0.75294 RG 0.001 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34.05 763.45 Tm (been met.)Tj ET /F3 12 Tf BT 1 0 0 1 95.57 763.45 Tm ( )Tj ET /F3 12 Tf BT 1 0 0 1 104.02 763.45 Tm (They say what the registered person had to do to meet the Care Standards )Tj ET /F3 12 Tf BT 1 0 0 1 34.05 748.87 Tm (Act 2000, Care Homes Regulations 2001 and the National Minimum Standards.)Tj ET /F3 10 Tf BT 1 0 0 1 31.2 731.05 Tm (No.)Tj ET /F3 10 Tf BT 1 0 0 1 96.1 728.05 Tm (Standard)Tj ET /F3 10 Tf BT 1 0 0 1 202.5 728.05 Tm (Regulation)Tj ET /F3 10 Tf BT 1 0 0 1 294.6 728.05 Tm (Requirement)Tj ET /F3 10 Tf BT 1 0 0 1 479 728.05 Tm (Timescale for )Tj ET /F3 10 Tf BT 1 0 0 1 479 715.9 Tm (action)Tj ET /F3 12 Tf BT 1 0 0 1 292.3 698.74 Tm (We will be considering )Tj ET /F3 12 Tf BT 1 0 0 1 292.3 684.16 Tm (issuing a Statutory )Tj ET /F3 12 Tf BT 1 0 0 1 292.3 669.58 Tm (Requirement Notice for the )Tj ET /F3 12 Tf BT 1 0 0 1 292.3 655 Tm (breach of this regulation.)Tj ET /F3 12 Tf BT 1 0 0 1 35.5 632.92 Tm (4)Tj ET /F3 12 Tf BT 1 0 0 1 96.15 629.92 Tm (8)Tj ET /F3 12 Tf BT 1 0 0 1 202.5 629.92 Tm (12)Tj ET /F3 12 Tf BT 1 0 0 1 294.55 629.92 Tm (Prompt medical attention and )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 615.34 Tm (advice must be obtained for )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 600.76 Tm (issues affecting peoples' )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 586.18 Tm (health and welfare.)Tj ET /F3 12 Tf BT 1 0 0 1 294.55 568.6 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 294.55 554.02 Tm (This will ensure that people )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 539.44 Tm (receive medical attention )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 524.86 Tm (quickly and provide staff with )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 510.28 Tm (information they need to )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 495.7 Tm (care for people.)Tj ET /F3 12 Tf BT 1 0 0 1 294.55 481.12 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 294.55 466.54 Tm (We did issue a Statutory )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 451.96 Tm (Requirement Notice for the )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 437.38 Tm (breach of this regulation, this )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 422.8 Tm (was not complied with. We )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 408.22 Tm (will be taking further action.)Tj ET /F3 12 Tf BT 1 0 0 1 478.9 629.92 Tm (22/01/2010)Tj ET /F3 12 Tf BT 1 0 0 1 35.5 388.39 Tm (5)Tj ET /F3 12 Tf BT 1 0 0 1 96.15 385.39 Tm (9)Tj ET /F3 12 Tf BT 1 0 0 1 202.5 385.39 Tm (12)Tj ET /F3 12 Tf BT 1 0 0 1 294.55 385.39 Tm (Peoples' medication must not )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 370.81 Tm (be allowed to run out of )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 356.23 Tm (stock.)Tj ET /F3 12 Tf BT 1 0 0 1 294.55 338.65 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 294.55 324.07 Tm (This will ensure that people )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 309.49 Tm (receive the medication as )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 294.91 Tm (prescribed for them. We will )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 280.33 Tm (be considering issuing a )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 265.75 Tm (Statutory Requirement )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 251.17 Tm (Notice for this breach of )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 236.59 Tm (regulation.)Tj ET /F3 12 Tf BT 1 0 0 1 478.9 385.39 Tm (22/01/2010)Tj ET /F3 12 Tf BT 1 0 0 1 35.5 216.76 Tm (6)Tj ET /F3 12 Tf BT 1 0 0 1 96.15 213.76 Tm (30)Tj ET /F3 12 Tf BT 1 0 0 1 202.5 213.76 Tm (18)Tj ET /F3 12 Tf BT 1 0 0 1 294.55 213.76 Tm (The staff team must be )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 199.18 Tm (provided with training in )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 184.6 Tm (order to gain the right skills, )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 170.02 Tm (knowledge and experience to )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 155.44 Tm (care for vulnerable people )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 140.86 Tm (with a range of needs. )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 126.28 Tm (Included in this is mandatory )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 111.7 Tm (and service specific training.)Tj ET /F3 12 Tf BT 1 0 0 1 294.55 94.12 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 294.55 79.54 Tm (This will give staff confidence )Tj ET /F3 12 Tf BT 1 0 0 1 478.9 213.76 Tm (22/01/2010)Tj ET endstream endobj 85 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 86 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F3 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 31.8 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 31.8 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 582.54 w 32.32 520.13 m 564.97 520.13 l S 0.001 w 1 1 1 RG 163.38 w 31.2 626.86 m 91.05 626.86 l S 0.001 w 163.38 w 93.3 626.86 m 197.4 626.86 l S 0.001 w 163.38 w 199.65 626.86 m 289.45 626.86 l S 0.001 w 163.38 w 291.7 626.86 m 473.8 626.86 l S 0.001 w 163.38 w 476.05 626.86 m 566.1 626.86 l S 0.001 w 315.18 w 31.2 385.33 m 91.05 385.33 l S 0.001 w 315.18 w 93.3 385.33 m 197.4 385.33 l S 0.001 w 315.18 w 199.65 385.33 m 289.45 385.33 l S 0.001 w 315.18 w 291.7 385.33 m 473.8 385.33 l S 0.001 w 315.18 w 476.05 385.33 m 566.1 385.33 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 544.04 m 568.3 544.04 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 710.75 m 30.07 225.54 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 710.75 m 567.22 225.54 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 742.22 m 568.4 742.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 709.67 m 568.3 709.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 710.75 m 92.17 225.54 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 710.75 m 198.52 225.54 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 710.75 m 290.57 225.54 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 710.75 m 474.92 225.54 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 813.65 m 568.4 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 742.22 m 568.4 742.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 709.67 m 568.4 709.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 544.04 m 568.3 544.04 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 226.61 m 568.3 226.61 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 814.73 m 30.07 708.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 743.3 m 92.12 708.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 743.3 m 198.52 708.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 743.3 m 290.62 708.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 743.3 m 475.02 708.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 814.73 m 567.32 708.6 l S 0.001 w [] 0 d /F3 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 796.45 Tm (Outstanding statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 34.05 778.03 Tm (These are requirements that were set at the previous inspection, but have still not )Tj ET /F3 12 Tf BT 1 0 0 1 34.05 763.45 Tm (been met.)Tj ET /F3 12 Tf BT 1 0 0 1 95.57 763.45 Tm ( )Tj ET /F3 12 Tf BT 1 0 0 1 104.02 763.45 Tm (They say what the registered person had to do to meet the Care Standards )Tj ET /F3 12 Tf BT 1 0 0 1 34.05 748.87 Tm (Act 2000, Care Homes Regulations 2001 and the National Minimum Standards.)Tj ET /F3 10 Tf BT 1 0 0 1 31.2 731.05 Tm (No.)Tj ET /F3 10 Tf BT 1 0 0 1 96.1 728.05 Tm (Standard)Tj ET /F3 10 Tf BT 1 0 0 1 202.5 728.05 Tm (Regulation)Tj ET /F3 10 Tf BT 1 0 0 1 294.6 728.05 Tm (Requirement)Tj ET /F3 10 Tf BT 1 0 0 1 479 728.05 Tm (Timescale for )Tj ET /F3 10 Tf BT 1 0 0 1 479 715.9 Tm (action)Tj ET /F3 12 Tf BT 1 0 0 1 292.3 698.74 Tm (in how to care for people and )Tj ET /F3 12 Tf BT 1 0 0 1 292.3 684.16 Tm (help to ensure that care is )Tj ET /F3 12 Tf BT 1 0 0 1 292.3 669.58 Tm (not missed. Staff files to be )Tj ET /F3 12 Tf BT 1 0 0 1 292.3 655 Tm (audited and a training plan )Tj ET /F3 12 Tf BT 1 0 0 1 292.3 640.42 Tm (produced by the timescale )Tj ET /F3 12 Tf BT 1 0 0 1 292.3 625.84 Tm (for action date.)Tj ET /F3 12 Tf BT 1 0 0 1 292.3 611.26 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 292.3 596.68 Tm (We will be considering )Tj ET /F3 12 Tf BT 1 0 0 1 292.3 582.1 Tm (issuing a Statutory )Tj ET /F3 12 Tf BT 1 0 0 1 292.3 567.52 Tm (Requirement Notice for the )Tj ET /F3 12 Tf BT 1 0 0 1 292.3 552.94 Tm (breach of this regulation.)Tj ET /F3 12 Tf BT 1 0 0 1 35.5 530.86 Tm (7)Tj ET /F3 12 Tf BT 1 0 0 1 96.15 527.86 Tm (37)Tj ET /F3 12 Tf BT 1 0 0 1 202.5 527.86 Tm (17)Tj ET /F3 12 Tf BT 1 0 0 1 294.55 527.86 Tm (Records required for the )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 513.28 Tm (effective running of the home )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 498.7 Tm (must be in place and up to )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 484.12 Tm (date.)Tj ET /F3 12 Tf BT 1 0 0 1 294.55 466.54 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 294.55 451.96 Tm (This will enable agencies to )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 437.38 Tm (monitor how the home is )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 422.8 Tm (managed and be sure that )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 408.22 Tm (residents needs are being )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 393.64 Tm (met. This refers to initial )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 379.06 Tm (assessments of need, care )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 364.48 Tm (plans, risk assessments, )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 349.9 Tm (daily recording, medication )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 335.32 Tm (charts, monitoring records, )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 320.74 Tm (staff supervision and training )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 306.16 Tm (and environmental checks.)Tj ET /F3 12 Tf BT 1 0 0 1 294.55 291.58 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 294.55 277 Tm (We will be considering )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 262.42 Tm (issuing a Statutory )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 247.84 Tm (Requirement Notice for the )Tj ET /F3 12 Tf BT 1 0 0 1 294.55 233.26 Tm (breach of this regulation.)Tj ET /F3 12 Tf BT 1 0 0 1 478.9 527.86 Tm (22/01/2010)Tj ET endstream endobj 87 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 88 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F3 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (37)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 31.8 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 31.8 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 797.57 Tm (Requirements and recommendations from this inspection:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 782.15 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 32.32 719.78 m 564.97 719.78 l S 0.001 w 1 1 1 RG 20.58 w 31.2 677.13 m 91.05 677.13 l S 0.001 w 20.58 w 93.3 677.13 m 197.4 677.13 l S 0.001 w 20.58 w 199.65 677.13 m 289.45 677.13 l S 0.001 w 20.58 w 291.7 677.13 m 473.8 677.13 l S 0.001 w 20.58 w 476.05 677.13 m 566.1 677.13 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 30.07 689.63 m 30.07 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 689.63 m 567.22 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 721.1 m 568.4 721.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 688.55 m 568.3 688.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 689.63 m 92.17 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 689.63 m 198.52 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 689.63 m 290.57 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 689.63 m 474.92 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 776.09 m 568.4 776.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 721.1 m 568.4 721.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 688.55 m 568.4 688.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 665.72 m 568.3 665.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 777.17 m 30.07 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 722.18 m 92.12 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 722.18 m 198.52 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 722.18 m 290.62 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 722.18 m 475.02 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 777.17 m 567.32 687.47 l S 0.001 w [] 0 d /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 759.9 Tm (Immediate requirements:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 34.05 742.32 Tm (These are immediate requirements that were set on the day we visited this care home. )Tj ET /F3 12 Tf BT 1 0 0 1 34.05 727.74 Tm (The registered person had to meet these within 48 hours.)Tj ET /F3 10 Tf BT 1 0 0 1 31.2 709.92 Tm (No.)Tj ET /F3 10 Tf BT 1 0 0 1 96.1 706.92 Tm (Standard)Tj ET /F3 10 Tf BT 1 0 0 1 202.5 706.92 Tm (Regulation)Tj ET /F3 10 Tf BT 1 0 0 1 294.6 706.92 Tm (Requirement)Tj ET /F3 10 Tf BT 1 0 0 1 479 706.92 Tm (Timescale for )Tj ET /F3 10 Tf BT 1 0 0 1 479 694.77 Tm (action)Tj ET /F3 12 Tf BT 1 0 0 1 35.5 675.36 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 96.15 672.36 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 202.5 672.36 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 294.55 672.36 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 478.9 672.36 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 563.19 w 32.32 345.62 m 564.97 345.62 l S 0.001 w 1 1 1 RG 204 w 31.2 424.8 m 91.05 424.8 l S 0.001 w 204 w 93.3 424.8 m 197.4 424.8 l S 0.001 w 204 w 199.65 424.8 m 289.45 424.8 l S 0.001 w 204 w 291.7 424.8 m 473.8 424.8 l S 0.001 w 204 w 476.05 424.8 m 566.1 424.8 l S 0.001 w 221 w 31.2 210.05 m 91.05 210.05 l S 0.001 w 221 w 93.3 210.05 m 197.4 210.05 l S 0.001 w 221 w 199.65 210.05 m 289.45 210.05 l S 0.001 w 221 w 291.7 210.05 m 473.8 210.05 l S 0.001 w 221 w 476.05 210.05 m 566.1 210.05 l S 0.001 w 34.4 w 31.2 80.1 m 91.05 80.1 l S 0.001 w 34.4 w 93.3 80.1 m 197.4 80.1 l S 0.001 w 34.4 w 199.65 80.1 m 289.45 80.1 l S 0.001 w 34.4 w 291.7 80.1 m 473.8 80.1 l S 0.001 w 34.4 w 476.05 80.1 m 566.1 80.1 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 321.68 m 568.3 321.68 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 98.43 m 568.3 98.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 529.01 m 30.07 60.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 529.01 m 567.22 60.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 560.48 m 568.4 560.48 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 527.93 m 568.3 527.93 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 529.01 m 92.17 60.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 529.01 m 198.52 60.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 529.01 m 290.57 60.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 529.01 m 474.92 60.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 629.47 m 568.4 629.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 560.48 m 568.4 560.48 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 527.93 m 568.4 527.93 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 321.68 m 568.3 321.68 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 98.43 m 568.3 98.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 61.78 m 568.3 61.78 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 630.55 m 30.07 526.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 561.56 m 92.12 526.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 561.56 m 198.52 526.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 561.56 m 290.62 526.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 561.56 m 475.02 526.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 630.55 m 567.32 526.85 l S 0.001 w [] 0 d /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 616.28 Tm (Statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 34.05 596.28 Tm (These requirements set out what the registered person must do to meet the Care )Tj ET /F3 12 Tf BT 1 0 0 1 34.05 581.7 Tm (Standards Act 2000, Care Homes)Tj ET /F3 12 Tf BT 1 0 0 1 239.77 581.7 Tm (Regulations 2001 and the National Minimum )Tj ET /F3 12 Tf BT 1 0 0 1 34.05 567.12 Tm (Standards. The registered person\(s\) must do this within the timescales we have set.)Tj ET /F3 10 Tf BT 1 0 0 1 31.2 549.3 Tm (No.)Tj ET /F3 10 Tf BT 1 0 0 1 96.1 546.3 Tm (Standard)Tj ET /F3 10 Tf BT 1 0 0 1 202.5 546.3 Tm (Regulation)Tj ET /F3 10 Tf BT 1 0 0 1 294.6 546.3 Tm (Requirement)Tj ET /F3 10 Tf BT 1 0 0 1 479 546.3 Tm (Timescale for )Tj ET /F3 10 Tf BT 1 0 0 1 479 534.15 Tm (action)Tj ET /F3 12 Tf BT 1 0 0 1 35.5 514.74 Tm (1)Tj ET /F3 12 Tf BT 1 0 0 1 99.3 514.74 Tm (8)Tj ET /F3 12 Tf BT 1 0 0 1 201.55 514.74 Tm (12)Tj ET /F3 12 Tf BT 1 0 0 1 298.05 514.74 Tm (Detailed plans must be in )Tj ET /F3 12 Tf BT 1 0 0 1 298.05 497.74 Tm (place to guide staff on how )Tj ET /F3 12 Tf BT 1 0 0 1 298.05 480.74 Tm (to manage people whose )Tj ET /F3 12 Tf BT 1 0 0 1 298.05 463.74 Tm (behaviour may pose a risk )Tj ET /F3 12 Tf BT 1 0 0 1 298.05 446.74 Tm (to themselves or others.)Tj ET /F3 12 Tf BT 1 0 0 1 298.05 429.74 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 298.05 412.74 Tm (This will help to ensure 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298.05 182.18 Tm (This will enable us to )Tj ET /F3 12 Tf BT 1 0 0 1 298.05 165.18 Tm (monitor that the home is )Tj ET /F3 12 Tf BT 1 0 0 1 298.05 148.18 Tm (managing the incidents )Tj ET /F3 12 Tf BT 1 0 0 1 298.05 131.18 Tm (appropriately.)Tj ET /F3 12 Tf BT 1 0 0 1 482.1 250.18 Tm (07/04/2010)Tj ET /F3 12 Tf BT 1 0 0 1 554.05 250.18 Tm ()Tj ET endstream endobj 95 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 96 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F3 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (41)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 31.8 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 31.8 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 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This will help to provide )Tj ET /F3 12 Tf BT 1 0 0 1 202.5 486.08 Tm (important information to staff and visiting professionals )Tj ET /F3 12 Tf BT 1 0 0 1 202.5 471.5 Tm (involved in their care.)Tj ET /F3 12 Tf BT 1 0 0 1 34.05 448.67 Tm (6)Tj ET /F3 12 Tf BT 1 0 0 1 96.15 448.67 Tm (10)Tj ET /F3 12 Tf BT 1 0 0 1 202.5 448.67 Tm (Staff should receive further training in how to maintain )Tj ET /F3 12 Tf BT 1 0 0 1 202.5 434.09 Tm (privacy and dignity.)Tj ET /F3 12 Tf BT 1 0 0 1 34.05 411.26 Tm (7)Tj ET /F3 12 Tf BT 1 0 0 1 96.15 411.26 Tm (12)Tj ET /F3 12 Tf BT 1 0 0 1 202.5 411.26 Tm (A weekly or monthly at a glance log would alert staff to )Tj ET /F3 12 Tf BT 1 0 0 1 202.5 396.68 Tm (those residents that had not participated in anything so )Tj ET /F3 12 Tf BT 1 0 0 1 202.5 382.1 Tm (that this could be addressed.)Tj ET /F3 12 Tf BT 1 0 0 1 34.05 359.27 Tm (8)Tj ET /F3 12 Tf BT 1 0 0 1 96.15 359.27 Tm (14)Tj ET /F3 12 Tf BT 1 0 0 1 202.5 359.27 Tm (Residents should have more choice regarding the activities )Tj ET /F3 12 Tf BT 1 0 0 1 202.5 344.69 Tm (and occupations that they are able to participate in. 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(Recommendations)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 34.05 779.89 Tm (These recommendations are taken from the best practice described in the National )Tj ET /F3 12 Tf BT 1 0 0 1 34.05 765.31 Tm (Minimum Standards and the registered person\(s\) should consider them as a way of )Tj ET /F3 12 Tf BT 1 0 0 1 34.05 750.73 Tm (improving their service.)Tj ET /F3 10 Tf BT 1 0 0 1 34.05 729.91 Tm (No)Tj ET /F3 10 Tf BT 1 0 0 1 96.15 729.91 Tm (Refer to Standard)Tj ET /F3 10 Tf BT 1 0 0 1 202.45 729.91 Tm (Good Practice Recommendations)Tj ET /F3 12 Tf BT 1 0 0 1 34.05 708.62 Tm (14)Tj ET /F3 12 Tf BT 1 0 0 1 96.15 708.62 Tm (19)Tj ET /F3 12 Tf BT 1 0 0 1 202.5 708.62 Tm (Food must not be left uncovered, helping to prevent the )Tj ET /F3 12 Tf BT 1 0 0 1 202.5 694.04 Tm (risk of infection from contaminated foods. )Tj ET /F3 12 Tf BT 1 0 0 1 34.05 671.21 Tm (15)Tj ET /F3 12 Tf BT 1 0 0 1 96.15 671.21 Tm (19)Tj ET /F3 12 Tf BT 1 0 0 1 202.5 671.21 Tm (Carpets must be re- fitted and kept clean, helping to )Tj ET /F3 12 Tf BT 1 0 0 1 202.5 656.63 Tm (ensure that people live in a clean and comfortable home.)Tj ET /F3 12 Tf BT 1 0 0 1 34.05 633.8 Tm (16)Tj ET /F3 12 Tf BT 1 0 0 1 96.15 633.8 Tm (20)Tj ET /F3 12 Tf BT 1 0 0 1 202.5 633.8 Tm (The lounge in the dementia care unit should be made a )Tj ET /F3 12 Tf BT 1 0 0 1 202.5 619.22 Tm (more homely and stimulating environment for people.)Tj ET /F3 12 Tf BT 1 0 0 1 34.05 596.39 Tm (17)Tj ET /F3 12 Tf BT 1 0 0 1 96.15 596.39 Tm (26)Tj ET /F3 12 Tf BT 1 0 0 1 202.5 596.39 Tm (The manager should complete environmental checks to )Tj ET /F3 12 Tf BT 1 0 0 1 202.5 581.81 Tm (monitor cleanliness so that shortfalls can be addressed )Tj ET /F3 12 Tf BT 1 0 0 1 202.5 567.23 Tm (quickly.)Tj ET /F3 12 Tf BT 1 0 0 1 34.05 544.4 Tm (18)Tj ET /F3 12 Tf BT 1 0 0 1 96.15 544.4 Tm (26)Tj ET /F3 12 Tf BT 1 0 0 1 202.5 544.4 Tm (All areas of the home must be well lit.)Tj ET /F3 12 Tf BT 1 0 0 1 34.05 521.57 Tm (19)Tj ET /F3 12 Tf BT 1 0 0 1 96.15 521.57 Tm (26)Tj ET /F3 12 Tf BT 1 0 0 1 202.5 521.57 Tm (The home should be kept clean.This will help to make sure )Tj ET /F3 12 Tf BT 1 0 0 1 202.5 506.99 Tm (that people live in a comfortable home where their hygeine )Tj ET /F3 12 Tf BT 1 0 0 1 202.5 492.41 Tm (and the infection control policies are not compromised.)Tj ET /F3 12 Tf BT 1 0 0 1 34.05 469.58 Tm (20)Tj ET /F3 12 Tf BT 1 0 0 1 96.15 469.58 Tm (27)Tj ET /F3 12 Tf BT 1 0 0 1 202.5 469.58 Tm (Staff should have adequate rest breaks between shifts. This )Tj ET /F3 12 Tf BT 1 0 0 1 202.5 455 Tm (helps to ensure that staff are not over tired and that risk to )Tj ET /F3 12 Tf BT 1 0 0 1 202.5 440.42 Tm (peoples safety is minimised.)Tj ET /F3 12 Tf BT 1 0 0 1 34.05 417.59 Tm (21)Tj ET /F3 12 Tf BT 1 0 0 1 96.15 417.59 Tm (31)Tj ET /F3 12 Tf BT 1 0 0 1 202.5 417.59 Tm (A manager should apply for registration with the )Tj ET /F3 12 Tf BT 1 0 0 1 202.5 403.01 Tm (Commission to add stability to the home.)Tj ET /F3 12 Tf BT 1 0 0 1 34.05 380.18 Tm (22)Tj ET /F3 12 Tf BT 1 0 0 1 96.15 380.18 Tm (33)Tj ET /F3 12 Tf BT 1 0 0 1 202.5 380.18 Tm (It is recommended the home obtains the views of )Tj ET /F3 12 Tf BT 1 0 0 1 202.5 365.6 Tm (professional visitors as part of the quality monitoring. This )Tj ET /F3 12 Tf BT 1 0 0 1 202.5 351.02 Tm (will enable a wider view of how the home is managed.)Tj ET /F3 12 Tf BT 1 0 0 1 34.05 328.19 Tm (23)Tj ET /F3 12 Tf BT 1 0 0 1 96.15 328.19 Tm (33)Tj ET /F3 12 Tf BT 1 0 0 1 202.5 328.19 Tm (Action plans should be produced to address any shortfalls )Tj ET /F3 12 Tf BT 1 0 0 1 202.5 313.61 Tm (highlighted in surveys and audits, and in view of the )Tj ET /F3 12 Tf BT 1 0 0 1 202.5 299.03 Tm (number of issues found during the visit, the audits need to )Tj ET /F3 12 Tf BT 1 0 0 1 202.5 284.45 Tm (be completed more thoroughly.)Tj ET /F3 12 Tf BT 1 0 0 1 34.05 261.62 Tm (24)Tj ET /F3 12 Tf BT 1 0 0 1 96.15 261.62 Tm (36)Tj ET /F3 12 Tf BT 1 0 0 1 202.5 261.62 Tm (Care staff members should have a minimum of six formal )Tj ET /F3 12 Tf BT 1 0 0 1 202.5 247.04 Tm (and documented supervision sessions per year. This will )Tj ET /F3 12 Tf BT 1 0 0 1 202.5 232.46 Tm (enable managers to monitor practice and provide staff the )Tj ET /F3 12 Tf BT 1 0 0 1 202.5 217.88 Tm (opportunity to disucss issues of concern.)Tj ET /F3 12 Tf BT 1 0 0 1 34.05 195.05 Tm (25)Tj ET /F3 12 Tf BT 1 0 0 1 96.15 195.05 Tm (38)Tj ET /F3 12 Tf BT 1 0 0 1 202.5 195.05 Tm (The system of bed rail checks should be carried out )Tj ET /F3 12 Tf BT 1 0 0 1 202.5 180.47 Tm (consistently. This will prompt staff to check they are safe )Tj ET /F3 12 Tf BT 1 0 0 1 202.5 165.89 Tm (and in good working order.)Tj ET /F3 12 Tf BT 1 0 0 1 34.05 143.06 Tm (26)Tj ET /F3 12 Tf BT 1 0 0 1 96.15 143.06 Tm (38)Tj ET /F3 12 Tf BT 1 0 0 1 202.5 143.06 Tm (Risk assessments for steradent must be completed and )Tj ET /F3 12 Tf BT 1 0 0 1 202.5 128.48 Tm (kept up to date.)Tj ET endstream endobj 100 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 101 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F3 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 11 Tf BT 1 0 0 1 522.2 31.8 Tm ( of )Tj ET /F3 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 31.8 Tm (43)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 22.5 w 22.95 802.41 m 560.45 802.41 l S 0.001 w /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 799.09 Tm (Helpline:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 10 Tf BT 1 0 0 1 28.35 781.11 Tm ()Tj ET /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 759.6 Tm (Telephone:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 95.88 759.6 Tm ( 03000 616161)Tj ET /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 739.6 Tm (Email:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 66.84 739.6 Tm ( enquiries@cqc.org.uk)Tj ET /F3 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 719.61 Tm (Web:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F3 12 Tf BT 1 0 0 1 64.35 719.61 Tm (www.cqc.org.uk)Tj ET /F3 12 Tf BT 1 0 0 1 28.35 699.61 Tm ()Tj ET /F3 12 Tf BT 1 0 0 1 28.35 679.61 Tm (We want people to be able to access this information. If you would like a summary in a )Tj ET /F3 12 Tf BT 1 0 0 1 28.35 662.12 Tm (different format or language please contact our helpline or go to our website.)Tj ET /F3 12 Tf BT 1 0 0 1 28.35 622.62 Tm (Copyright \(2009\) Care Quality Commission \(CQC\). This publication may be )Tj ET /F3 12 Tf BT 1 0 0 1 28.35 605.13 Tm (reproduced in whole or in part, free of charge, in any format or medium provided that it )Tj ET /F3 12 Tf BT 1 0 0 1 28.35 587.63 Tm (is not used for commercial gain. This consent is subject to the material being )Tj ET /F3 12 Tf BT 1 0 0 1 28.35 570.13 Tm (reproduced accurately and on proviso that it is not used in a derogatory manner or )Tj ET /F3 12 Tf BT 1 0 0 1 28.35 552.64 Tm (misleading context. 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/proportional put dup 182 /partialdiff put dup 183 /bullet put dup 184 /divide put dup 185 /notequal put dup 186 /equivalence put dup 187 /approxequal put dup 188 /ellipsis put dup 189 /arrowvertex put dup 190 /arrowhorizex put dup 191 /carriagereturn put dup 192 /aleph put dup 193 /Ifraktur put dup 194 /Rfraktur put dup 195 /weierstrass put dup 196 /circlemultiply put dup 197 /circleplus put dup 198 /emptyset put dup 199 /intersection put dup 200 /union put dup 201 /propersuperset put dup 202 /reflexsuperset put dup 203 /notsubset put dup 204 /propersubset put dup 205 /reflexsubset put dup 206 /element put dup 207 /notelement put dup 208 /angle put dup 209 /gradient put dup 210 /registerserif put dup 211 /copyrightserif put dup 212 /trademarkserif put dup 213 /product put dup 214 /radical put dup 215 /dotmath put dup 216 /logicalnot put dup 217 /logicaland put dup 218 /logicalor put dup 219 /arrowdblboth put dup 220 /arrowdblleft put dup 221 /arrowdblup put dup 222 /arrowdblright put dup 223 /arrowdbldown put dup 224 /lozenge put dup 225 /angleleft put dup 226 /registersans put dup 227 /copyrightsans put dup 228 /trademarksans put dup 229 /summation put dup 230 /parenlefttp put dup 231 /parenleftex put dup 232 /parenleftbt put dup 233 /bracketlefttp put dup 234 /bracketleftex put dup 235 /bracketleftbt put dup 236 /bracelefttp put dup 237 /braceleftmid put dup 238 /braceleftbt put dup 239 /braceex put dup 240 /.notdef put dup 241 /angleright put dup 242 /integral put dup 243 /integraltp put dup 244 /integralex put dup 245 /integralbt put dup 246 /parenrighttp put dup 247 /parenrightex put dup 248 /parenrightbt put dup 249 /bracketrighttp put dup 250 /bracketrightex put dup 251 /bracketrightbt put dup 252 /bracerighttp put dup 253 /bracerightmid put dup 254 /bracerightbt put dup 255 /.notdef put readonly def currentdict end currentfile eexec oc;jtD[2^t$cdreYjRZb@e F>" F+$l `v .H֢T)&wa{vIt%Նswg,lonrMWWIZ7p6\5JHrtPb E~1Cew|;d}Tym8 B T=:[RXz:F.V0zjQ 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All Rights Reserved %%CreationDate: Thu Oct 09 15:25:10 2008 % Converted from TrueType font 'VERDANA.TTF' by ttf2pt1 program % %%EndComments 12 dict begin /FontInfo 9 dict dup begin /version (Version 2.35) readonly def /Notice (Typeface and data 1996 Microsoft Corporation. All Rights Reserved) readonly def /FullName (Verdana) readonly def /FamilyName (Verdana) readonly def /Weight (Regular) readonly def /ItalicAngle 0.000000 def /isFixedPitch false def /UnderlinePosition -88 def /UnderlineThickness 59 def end readonly def /FontName /Verdana def /PaintType 0 def /StrokeWidth 0 def /FontType 1 def /FontMatrix [0.001 0 0 0.001 0 0] def /FontBBox {-30 -207 1447 1000} readonly def /Encoding 256 array dup 0 /.notdef put dup 1 /.notdef put dup 2 /.notdef put dup 3 /.notdef put dup 4 /.notdef put dup 5 /.notdef put dup 6 /.notdef put dup 7 /.notdef put dup 8 /.notdef put dup 9 /.notdef put dup 10 /.notdef put dup 11 /.notdef put dup 12 /.notdef put dup 13 /.notdef put dup 14 /.notdef put dup 15 /.notdef put dup 16 /.notdef put dup 17 /.notdef put dup 18 /.notdef put dup 19 /.notdef put dup 20 /.notdef put dup 21 /.notdef put dup 22 /.notdef put dup 23 /.notdef put dup 24 /.notdef put dup 25 /.notdef put dup 26 /.notdef put dup 27 /.notdef put dup 28 /.notdef put dup 29 /.notdef put dup 30 /.notdef put dup 31 /.notdef put dup 32 /space put dup 33 /exclam put dup 34 /quotedbl put dup 35 /numbersign put dup 36 /dollar put dup 37 /percent put dup 38 /ampersand put dup 39 /quotesingle put dup 40 /parenleft put dup 41 /parenright put dup 42 /asterisk put dup 43 /plus put dup 44 /comma put dup 45 /hyphen put dup 46 /period put dup 47 /slash put dup 48 /zero put dup 49 /one put dup 50 /two put dup 51 /three put dup 52 /four put dup 53 /five put dup 54 /six put dup 55 /seven put dup 56 /eight put dup 57 /nine put dup 58 /colon put dup 59 /semicolon put dup 60 /less put dup 61 /equal put dup 62 /greater put dup 63 /question put dup 64 /at put dup 65 /A put dup 66 /B put dup 67 /C put dup 68 /D put dup 69 /E put dup 70 /F put dup 71 /G put dup 72 /H put dup 73 /I put dup 74 /J put dup 75 /K put dup 76 /L put dup 77 /M put dup 78 /N put dup 79 /O put dup 80 /P put dup 81 /Q put dup 82 /R put dup 83 /S put dup 84 /T put dup 85 /U put dup 86 /V put dup 87 /W put dup 88 /X put dup 89 /Y put dup 90 /Z put dup 91 /bracketleft put dup 92 /backslash put dup 93 /bracketright put dup 94 /asciicircum put dup 95 /underscore put dup 96 /grave put dup 97 /a put dup 98 /b put dup 99 /c put dup 100 /d put dup 101 /e put dup 102 /f put dup 103 /g put dup 104 /h put dup 105 /i put dup 106 /j put dup 107 /k put dup 108 /l put dup 109 /m put dup 110 /n put dup 111 /o put dup 112 /p put dup 113 /q put dup 114 /r put dup 115 /s put dup 116 /t put dup 117 /u put dup 118 /v put dup 119 /w put dup 120 /x put dup 121 /y put dup 122 /z put dup 123 /braceleft put dup 124 /bar put dup 125 /braceright put dup 126 /asciitilde put dup 127 /.notdef put dup 128 /Euro put dup 129 /.notdef put dup 130 /quotesinglbase put dup 131 /florin put dup 132 /quotedblbase put dup 133 /ellipsis put dup 134 /dagger put dup 135 /daggerdbl put dup 136 /circumflex put dup 137 /perthousand put dup 138 /Scaron put dup 139 /guilsinglleft put dup 140 /OE put dup 141 /.notdef put dup 142 /.notdef put dup 143 /.notdef put dup 144 /.notdef put dup 145 /quoteleft put dup 146 /quoteright put dup 147 /quotedblleft put dup 148 /quotedblright put dup 149 /bullet put dup 150 /endash put dup 151 /emdash put dup 152 /tilde put dup 153 /trademark put dup 154 /scaron put dup 155 /guilsinglright put dup 156 /oe put dup 157 /.notdef put dup 158 /.notdef put dup 159 /Ydieresis put dup 160 /space put dup 161 /exclamdown put dup 162 /cent put dup 163 /sterling put dup 164 /currency put dup 165 /yen put dup 166 /brokenbar put dup 167 /section put dup 168 /dieresis put dup 169 /copyright put dup 170 /ordfeminine put dup 171 /guillemotleft put dup 172 /logicalnot put dup 173 /hyphen put dup 174 /registered put dup 175 /overscore put dup 176 /degree put dup 177 /plusminus put dup 178 /twosuperior put dup 179 /threesuperior put dup 180 /acute put dup 181 /mu1 put dup 182 /paragraph put dup 183 /middot put dup 184 /cedilla put dup 185 /onesuperior put dup 186 /ordmasculine put dup 187 /guillemotright put dup 188 /onequarter put dup 189 /onehalf put dup 190 /threequarters put dup 191 /questiondown put dup 192 /Agrave put dup 193 /Aacute put dup 194 /Acircumflex put dup 195 /Atilde put dup 196 /Adieresis put dup 197 /Aring put dup 198 /AE put dup 199 /Ccedilla put dup 200 /Egrave put dup 201 /Eacute put dup 202 /Ecircumflex put dup 203 /Edieresis put dup 204 /Igrave put dup 205 /Iacute put dup 206 /Icircumflex put dup 207 /Idieresis put dup 208 /Eth put dup 209 /Ntilde put dup 210 /Ograve put dup 211 /Oacute put dup 212 /Ocircumflex put dup 213 /Otilde put dup 214 /Odieresis put dup 215 /multiply put dup 216 /Oslash put dup 217 /Ugrave put dup 218 /Uacute put dup 219 /Ucircumflex put dup 220 /Udieresis put dup 221 /Yacute put dup 222 /Thorn put dup 223 /germandbls put dup 224 /agrave put dup 225 /aacute put dup 226 /acircumflex put dup 227 /atilde put dup 228 /adieresis put dup 229 /aring put dup 230 /ae put dup 231 /ccedilla put dup 232 /egrave put dup 233 /eacute put dup 234 /ecircumflex put dup 235 /edieresis put dup 236 /igrave put dup 237 /iacute put dup 238 /icircumflex put dup 239 /idieresis put dup 240 /eth put dup 241 /ntilde put dup 242 /ograve put dup 243 /oacute put dup 244 /ocircumflex put dup 245 /otilde put dup 246 /odieresis put dup 247 /divide put dup 248 /oslash put dup 249 /ugrave put dup 250 /uacute put dup 251 /ucircumflex put dup 252 /udieresis put dup 253 /yacute put dup 254 /thorn put dup 255 /ydieresis put readonly def currentdict end currentfile eexec oc;jtD[2^t$cdreYjRZb@e F>" F+$l `v .H֢T)&wa{vIt%Նswg,lonrMWWIZ7p6\5JHrtPb E~1Cew|;d}Tym8 B Tc gPUcOx {OqqQF4-UټXODU8o\kswKami%ޗﶥB$S/1LW~'T^<T4PX+ԯ({A34.KUĖn%*R_g!g(F4%ٸD K~ɕy8e!lcx# |< -}^^i(XlŨ3K a[y3E7Oz,߉1N6+Pj)cpS-mR\7߃Ra0bRTl,SQYKO׏C8y'߭sU5d}DҰMۭT[I[(㏭AK9%+,E B`6P( :8|NoYo>XImF;:Bŀÿ Kt,!fa"X0*Im Srߋ{8w;Ҵ+DIZy41Żp m`Z# 2;7aޗ8~$6<+p Uk!i͢m~~ I[z)*a0wmNQ ^\تw?@ċ=0}Ơ6YWUfo&|*aGѤrvʧ:q9h@) 6u%sBo$N?J6(Ah:m~\ZXݐ^NR(>^;:i~f6{'Y &'W|-}犁$$S Cp`Ӎ+Wǧ`q4{W_E&9YXs1sZQ<*`(SaD~e 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Data The Monotype Corporation plc/Type Solutions Inc. 1990-1992. All Rights Reserved %%CreationDate: Fri Oct 10 11:48:26 2008 % Converted from TrueType font 'TIMES.TTF' by ttf2pt1 program % %%EndComments 12 dict begin /FontInfo 9 dict dup begin /version (Version 2.76) readonly def /Notice (Typeface The Monotype Corporation plc. Data The Monotype Corporation plc/Type Solutions Inc. 1990-1992. All Rights Reserved) readonly def /FullName (Times New Roman) readonly def /FamilyName (Times New Roman) readonly def /Weight (Regular) readonly def /ItalicAngle 0.000000 def /isFixedPitch false def /UnderlinePosition -109 def /UnderlineThickness 49 def end readonly def /FontName /TimesNewRomanPSMT def /PaintType 0 def /StrokeWidth 0 def /FontType 1 def /FontMatrix [0.001 0 0 0.001 0 0] def /FontBBox {-77 -216 1009 877} readonly def /Encoding 256 array dup 0 /.notdef put dup 1 /.notdef put dup 2 /.notdef put dup 3 /.notdef put dup 4 /.notdef put dup 5 /.notdef put dup 6 /.notdef put dup 7 /.notdef put dup 8 /.notdef put dup 9 /.notdef put dup 10 /.notdef put dup 11 /.notdef put dup 12 /.notdef put dup 13 /.notdef put dup 14 /.notdef put dup 15 /.notdef put dup 16 /.notdef put dup 17 /.notdef put dup 18 /.notdef put dup 19 /.notdef put dup 20 /.notdef put dup 21 /.notdef put dup 22 /.notdef put dup 23 /.notdef put dup 24 /.notdef put dup 25 /.notdef put dup 26 /.notdef put dup 27 /.notdef put dup 28 /.notdef put dup 29 /.notdef put dup 30 /.notdef put dup 31 /.notdef put dup 32 /space put dup 33 /exclam put dup 34 /quotedbl put dup 35 /numbersign put dup 36 /dollar put dup 37 /percent put dup 38 /ampersand put dup 39 /quotesingle put dup 40 /parenleft put dup 41 /parenright put dup 42 /asterisk put dup 43 /plus put dup 44 /comma put dup 45 /hyphen put dup 46 /period put dup 47 /slash put dup 48 /zero put dup 49 /one put dup 50 /two put dup 51 /three put dup 52 /four put dup 53 /five put dup 54 /six put dup 55 /seven put dup 56 /eight put dup 57 /nine put dup 58 /colon put dup 59 /semicolon put dup 60 /less put dup 61 /equal put dup 62 /greater put dup 63 /question put dup 64 /at put dup 65 /A put dup 66 /B put dup 67 /C put dup 68 /D put dup 69 /E put dup 70 /F put dup 71 /G put dup 72 /H put dup 73 /I put dup 74 /J put dup 75 /K put dup 76 /L put dup 77 /M put dup 78 /N put dup 79 /O put dup 80 /P put dup 81 /Q put dup 82 /R put dup 83 /S put dup 84 /T put dup 85 /U put dup 86 /V put dup 87 /W put dup 88 /X put dup 89 /Y put dup 90 /Z put dup 91 /bracketleft put dup 92 /backslash put dup 93 /bracketright put dup 94 /asciicircum put dup 95 /underscore put dup 96 /grave put dup 97 /a put dup 98 /b put dup 99 /c put dup 100 /d put dup 101 /e put dup 102 /f put dup 103 /g put dup 104 /h put dup 105 /i put dup 106 /j put dup 107 /k put dup 108 /l put dup 109 /m put dup 110 /n put dup 111 /o put dup 112 /p put dup 113 /q put dup 114 /r put dup 115 /s put dup 116 /t put dup 117 /u put dup 118 /v put dup 119 /w put dup 120 /x put dup 121 /y put dup 122 /z put dup 123 /braceleft put dup 124 /bar put dup 125 /braceright put dup 126 /asciitilde put dup 127 /.notdef put dup 128 /Euro put dup 129 /.notdef put dup 130 /quotesinglbase put dup 131 /florin put dup 132 /quotedblbase put dup 133 /ellipsis put dup 134 /dagger put dup 135 /daggerdbl put dup 136 /circumflex put dup 137 /perthousand put dup 138 /Scaron put dup 139 /guilsinglleft put dup 140 /OE put dup 141 /.notdef put dup 142 /.notdef put dup 143 /.notdef put dup 144 /.notdef put dup 145 /quoteleft put dup 146 /quoteright put dup 147 /quotedblleft put dup 148 /quotedblright put dup 149 /bullet put dup 150 /endash put dup 151 /emdash put dup 152 /tilde put dup 153 /trademark put dup 154 /scaron put dup 155 /guilsinglright put dup 156 /oe put dup 157 /.notdef put dup 158 /.notdef put dup 159 /Ydieresis put dup 160 /space put dup 161 /exclamdown put dup 162 /cent put dup 163 /sterling put dup 164 /currency put dup 165 /yen put dup 166 /brokenbar put dup 167 /section put dup 168 /dieresis put dup 169 /copyright put dup 170 /ordfeminine put dup 171 /guillemotleft put dup 172 /logicalnot put dup 173 /hyphen put dup 174 /registered put dup 175 /overscore put dup 176 /degree put dup 177 /plusminus put dup 178 /twosuperior put dup 179 /threesuperior put dup 180 /acute put dup 181 /mu1 put dup 182 /paragraph put dup 183 /periodcentered put dup 184 /cedilla put dup 185 /onesuperior put dup 186 /ordmasculine put dup 187 /guillemotright put dup 188 /onequarter put dup 189 /onehalf put dup 190 /threequarters put dup 191 /questiondown put dup 192 /Agrave put dup 193 /Aacute put dup 194 /Acircumflex put dup 195 /Atilde put dup 196 /Adieresis put dup 197 /Aring put dup 198 /AE put dup 199 /Ccedilla put dup 200 /Egrave put dup 201 /Eacute put dup 202 /Ecircumflex put dup 203 /Edieresis put dup 204 /Igrave put dup 205 /Iacute put dup 206 /Icircumflex put dup 207 /Idieresis put dup 208 /Eth put dup 209 /Ntilde put dup 210 /Ograve put dup 211 /Oacute put dup 212 /Ocircumflex put dup 213 /Otilde put dup 214 /Odieresis put dup 215 /multiply put dup 216 /Oslash put dup 217 /Ugrave put dup 218 /Uacute put dup 219 /Ucircumflex put dup 220 /Udieresis put dup 221 /Yacute put dup 222 /Thorn put dup 223 /germandbls put dup 224 /agrave put dup 225 /aacute put dup 226 /acircumflex put dup 227 /atilde put dup 228 /adieresis put dup 229 /aring put dup 230 /ae put dup 231 /ccedilla put dup 232 /egrave put dup 233 /eacute put dup 234 /ecircumflex put dup 235 /edieresis put dup 236 /igrave put dup 237 /iacute put dup 238 /icircumflex put dup 239 /idieresis put dup 240 /eth put dup 241 /ntilde put dup 242 /ograve put dup 243 /oacute put dup 244 /ocircumflex put dup 245 /otilde put dup 246 /odieresis put dup 247 /divide put dup 248 /oslash put dup 249 /ugrave put dup 250 /uacute put dup 251 /ucircumflex put dup 252 /udieresis put dup 253 /yacute put dup 254 /thorn put dup 255 /ydieresis put readonly def currentdict end currentfile eexec oc;jtD[2^t$cdreYjRZb@e F>" F+$l `v .H֢T)&wa{vIt%Նswg,lonrMWWIZ7p6\5JHrtPb E~1Cew|;d}Tym8 B TcJ6*]h[zeKq)ƷW0jlBIf14%B[tnqNOדe{fC;1I^7^r5=[ySwF 5ZUͧ@;J7{Phx ғ*⿅΅V1lCd3Dk9+ ~Iic*x 2YC.eKgt_"t!Ztb$~iS[xdw +P7)%g9/-awT=JK/{ Q'y!kA,7 Α$?H}Om"s*5aks*HRUufn6i?kɝ=-0X%lϧQ4ݡ`rџ~D&#&:t]=.ok &DZђԺŠRq [j@3a*42K]sjϖjG_n 4Ϛ5. *Ly^w`ܮ64r/:!?u:};ߜ`dӤJY2R'wbTCI2CRNY2uD-.Y9y:2Cʸ`ͻq5dBpQŰ: TimM;f ]+ozY0,(Fh^ GirY E W| -R̵vVP ce޾'zH+1= PU~}fIa 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Data The Monotype Corporation plc/Type Solutions Inc. 1990-1992. All Rights Reserved %%CreationDate: Thu Oct 09 15:49:19 2008 % Converted from TrueType font 'ARIAL.TTF' by ttf2pt1 program % %%EndComments 12 dict begin /FontInfo 9 dict dup begin /version (Version 2.76) readonly def /Notice (Typeface The Monotype Corporation plc. Data The Monotype Corporation plc/Type Solutions Inc. 1990-1992. All Rights Reserved) readonly def /FullName (Arial) readonly def /FamilyName (Arial) readonly def /Weight (Regular) readonly def /ItalicAngle 0.000000 def /isFixedPitch false def /UnderlinePosition -106 def /UnderlineThickness 73 def end readonly def /FontName /ArialMT def /PaintType 0 def /StrokeWidth 0 def /FontType 1 def /FontMatrix [0.001 0 0 0.001 0 0] def /FontBBox {-46 -210 1000 896} readonly def /Encoding 256 array dup 0 /.notdef put dup 1 /.notdef put dup 2 /.notdef put dup 3 /.notdef put dup 4 /.notdef put dup 5 /.notdef put dup 6 /.notdef put dup 7 /.notdef put dup 8 /.notdef put dup 9 /.notdef put dup 10 /.notdef put dup 11 /.notdef put dup 12 /.notdef put dup 13 /.notdef put dup 14 /.notdef put dup 15 /.notdef put dup 16 /.notdef put dup 17 /.notdef put dup 18 /.notdef put dup 19 /.notdef put dup 20 /.notdef put dup 21 /.notdef put dup 22 /.notdef put dup 23 /.notdef put dup 24 /.notdef put dup 25 /.notdef put dup 26 /.notdef put dup 27 /.notdef put dup 28 /.notdef put dup 29 /.notdef put dup 30 /.notdef put dup 31 /.notdef put dup 32 /space put dup 33 /exclam put dup 34 /quotedbl put dup 35 /numbersign put dup 36 /dollar put dup 37 /percent put dup 38 /ampersand put dup 39 /quotesingle put dup 40 /parenleft put dup 41 /parenright put dup 42 /asterisk put dup 43 /plus put dup 44 /comma put dup 45 /hyphen put dup 46 /period put dup 47 /slash put dup 48 /zero put dup 49 /one put dup 50 /two put dup 51 /three put dup 52 /four put dup 53 /five put dup 54 /six put dup 55 /seven put dup 56 /eight put dup 57 /nine put dup 58 /colon put dup 59 /semicolon put dup 60 /less put dup 61 /equal put dup 62 /greater put dup 63 /question put dup 64 /at put dup 65 /A put dup 66 /B put dup 67 /C put dup 68 /D put dup 69 /E put dup 70 /F put dup 71 /G put dup 72 /H put dup 73 /I put dup 74 /J put dup 75 /K put dup 76 /L put dup 77 /M put dup 78 /N put dup 79 /O put dup 80 /P put dup 81 /Q put dup 82 /R put dup 83 /S put dup 84 /T put dup 85 /U put dup 86 /V put dup 87 /W put dup 88 /X put dup 89 /Y put dup 90 /Z put dup 91 /bracketleft put dup 92 /backslash put dup 93 /bracketright put dup 94 /asciicircum put dup 95 /underscore put dup 96 /grave put dup 97 /a put dup 98 /b put dup 99 /c put dup 100 /d put dup 101 /e put dup 102 /f put dup 103 /g put dup 104 /h put dup 105 /i put dup 106 /j put dup 107 /k put dup 108 /l put dup 109 /m put dup 110 /n put dup 111 /o put dup 112 /p put dup 113 /q put dup 114 /r put dup 115 /s put dup 116 /t put dup 117 /u put dup 118 /v put dup 119 /w put dup 120 /x put dup 121 /y put dup 122 /z put dup 123 /braceleft put dup 124 /bar put dup 125 /braceright put dup 126 /asciitilde put dup 127 /.notdef put dup 128 /Euro put dup 129 /.notdef put dup 130 /quotesinglbase put dup 131 /florin put dup 132 /quotedblbase put dup 133 /ellipsis put dup 134 /dagger put dup 135 /daggerdbl put dup 136 /circumflex put dup 137 /perthousand put dup 138 /Scaron put dup 139 /guilsinglleft put dup 140 /OE put dup 141 /.notdef put dup 142 /.notdef put dup 143 /.notdef put dup 144 /.notdef put dup 145 /quoteleft put dup 146 /quoteright put dup 147 /quotedblleft put dup 148 /quotedblright put dup 149 /bullet put dup 150 /endash put dup 151 /emdash put dup 152 /tilde put dup 153 /trademark put dup 154 /scaron put dup 155 /guilsinglright put dup 156 /oe put dup 157 /.notdef put dup 158 /.notdef put dup 159 /Ydieresis put dup 160 /space put dup 161 /exclamdown put dup 162 /cent put dup 163 /sterling put dup 164 /currency put dup 165 /yen put dup 166 /brokenbar put dup 167 /section put dup 168 /dieresis put dup 169 /copyright put dup 170 /ordfeminine put dup 171 /guillemotleft put dup 172 /logicalnot put dup 173 /hyphen put dup 174 /registered put dup 175 /overscore put dup 176 /degree put dup 177 /plusminus put dup 178 /twosuperior put dup 179 /threesuperior put dup 180 /acute put dup 181 /mu1 put dup 182 /paragraph put dup 183 /periodcentered put dup 184 /cedilla put dup 185 /onesuperior put dup 186 /ordmasculine put dup 187 /guillemotright put dup 188 /onequarter put dup 189 /onehalf put dup 190 /threequarters put dup 191 /questiondown put dup 192 /Agrave put dup 193 /Aacute put dup 194 /Acircumflex put dup 195 /Atilde put dup 196 /Adieresis put dup 197 /Aring put dup 198 /AE put dup 199 /Ccedilla put dup 200 /Egrave put dup 201 /Eacute put dup 202 /Ecircumflex put dup 203 /Edieresis put dup 204 /Igrave put dup 205 /Iacute put dup 206 /Icircumflex put dup 207 /Idieresis put dup 208 /Eth put dup 209 /Ntilde put dup 210 /Ograve put dup 211 /Oacute put dup 212 /Ocircumflex put dup 213 /Otilde put dup 214 /Odieresis put dup 215 /multiply put dup 216 /Oslash put dup 217 /Ugrave put dup 218 /Uacute put dup 219 /Ucircumflex put dup 220 /Udieresis put dup 221 /Yacute put dup 222 /Thorn put dup 223 /germandbls put dup 224 /agrave put dup 225 /aacute put dup 226 /acircumflex put dup 227 /atilde put dup 228 /adieresis put dup 229 /aring put dup 230 /ae put dup 231 /ccedilla put dup 232 /egrave put dup 233 /eacute put dup 234 /ecircumflex put dup 235 /edieresis put dup 236 /igrave put dup 237 /iacute put dup 238 /icircumflex put dup 239 /idieresis put dup 240 /eth put dup 241 /ntilde put dup 242 /ograve put dup 243 /oacute put dup 244 /ocircumflex put dup 245 /otilde put dup 246 /odieresis put dup 247 /divide put dup 248 /oslash put dup 249 /ugrave put dup 250 /uacute put dup 251 /ucircumflex put dup 252 /udieresis put dup 253 /yacute put dup 254 /thorn put dup 255 /ydieresis put readonly def currentdict end currentfile eexec oc;jtD[2^t$cdreYjRZb@e F>" F+$l `v .H֢T)&wa{vIt%Նswg,lonrMWWIZ7p6\5JHrtPb E~1Cew|;d}Tym8 B T13҂uGFsnA S1_ z.H@sV-umQ/ rgrVFcSctóinuk̾uA M[\b y9_ )(ib]o7PaZk=JI4wr QeR-ӐhX}Qt 1ݫja@K^ }= j"D3XU:*u?| 6&f]'(VY k?YODn7Or>TɩZfZvZ7N-N}.^1>dL,͝0n8^|0~ZPFP^̵x} Tj9th ?H2wr=\aK&cE"*X8)nXZI- Rҿ mRdokh_`V#wp; նגdRyf,jL%>lzr{,V\d6koXp a~( q;(I9zF<2(u4Z+(9%%W# )3Z+B gmMJۿ;5t2&M}wP-B*' lC7AEÐ-XaTu:RD/ ~Xmv@JO"Ⲕ!d #\8_A#~#aMzNNZ2>ieec5+#TMg]Ⴤ]p9jqe^alǣ̏:Ϯ6~O(SW™^tpTeͦVzĻ[ 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