Inspection on 16/06/09 for Gresley House Care Home

This is the latest available inspection report for this service, carried out on 16th June 2009.

CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Gresley House Care Home 15/10/07

Gresley House Care Home 12/02/07

Gresley House Care Home 16/08/06

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Key inspection report Care homes for older people Name: Address: Gresley House Care Home Market Street Church Gresley Swadlincote Derby DE11 9PN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Janet Morrow     Date: 1 6 0 6 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Gresley House Care Home Market Street Church Gresley Swadlincote Derby DE11 9PN 01283212094 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: gresleyhouse1@aol.co.uk Mrs Judith Dena Griffin,Stewart Westley Barker care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: 2 places within the total of 27 can be used for (PD) either sex aged 50 - 65 yrs. An additional PD place for CW - This person is named in the noticed of proposal (CW) this agreed place will cease on the termination of this person. For the home to accommodate one named person in the notice of proposal (PS) this agreed place will cease on the termination of this persons care at the home. Plus one (1) day care placement not regulated by Commission for Social Care Inspection. Date of last inspection Brief description of the care home Gresley House care home provides personal care and accommodation for up to 27 people aged 65 years and over, including 2 places for persons 50 - 65 years and 1 day Care Homes for Older People Page 4 of 30 Over 65 11 14 0 0 0 2 Brief description of the care home care place. Gresley House is situated in Church Gresley town centre, close to shops and local amenities; the home does not have a car park, however there is roadside parking outside the home. Residents have access to a well set out garden area. The home is situated on 2 floors and has 25 single rooms and 1 double room. Access to the first floor is by stairs and a passenger lift. The home has 4 lounge and dining areas. Information provided in July 2009 said that fees were within the Local Authority rates and there were no top up charges. Copies of the most recent inspection reports are available on request from the office at the home and are available on the Care Quality Commissions website: www.cqc.org.uk Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection visit was unannounced and took place over one day for a total of 7.25 hours. Progress against requirements and recommendations made at the previous key inspection undertaken in June 2008 was assessed. Care records, staff records and a random sample of policies and maintenance documents were examined. A partial tour of the building was undertaken. Case tracking methodology was used which means that the records of two people were looked at in detail and relevant staff and visitors were spoken with to find out what impact the service had for their well being and quality of life. Care Homes for Older People Page 6 of 30 Eight of the twenty-five people currently accommodated were spoken with. Two relatives, four members of staff, the manager and the responsible individual were spoken with. Eleven surveys were received: three relatives surveys and four surveys from people living in the home, one from a visiting professional and three from staff. Written information in the form of an annual quality assurance assessment was provided by the home prior to the inspection visit and informed the inspection process. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 8 of 30 following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was sufficient admission information available to establish that peoples needs could be met. Evidence: The written information supplied by the home stated that as part of the admission process we offer to arrange viewings at any time and invite prospective service users & their families the opportunity to have a meal here. Two of the four service users surveys received responded that they received enough information about the home prior to moving in, one responded they did not receive enough information and one responded that they did not know. Two peoples care records were examined. There were assessments available in the files examined. These covered all the essential areas regarding care and contained enough detail regarding the person, although social history information was limited. Assessments for risk of falls, nutrition and pressure sores were in place on both files Care Homes for Older People Page 11 of 30 Evidence: examined. Written information from external professionals was also available. Peoples needs were generally met and a survey from a visiting professional commented that the home ensured that each clients needs are met individually. Two of the four surveys from people living in the home responded that their needs were usually met, one responded that they always were and one that they sometimes were. One survey also commented that they were not always given the time they needed to make themselves understood. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health and personal care needs were met in a respectful manner. Evidence: Two peoples care files were examined and both had a care plan in place. These contained the essential information for care to be provided, although one plan for a person more recently admitted had limited information. There was no specific information on how to manage dementia but the manager stated that new care plan formats were on order that were based on building on strengths and were specifically designed to address the specialist needs of those people with dementia. The written information supplied by the home also stated that plans for the next twelve months were to improve care planning documentation to provide more biographical information. Access to health professionals was clearly recorded and visits from Occupational therapists, District nurses, mental health practitioners, chiropodists, General Practitioners (GP) and opticians were documented. Weight was recorded monthly and there were monthly reviews of risk assessments for risk of pressure sores, falls and Care Homes for Older People Page 13 of 30 Evidence: nutrition. One relative spoken with said they were quite happy with the care and another said they were pleased with how their relative was looked after. Three of the four surveys received from people living in the home responded that staff usually listened and acted on what was said and one responded that they sometimes did and two surveys responded that they always received the medical attention required and two responded that they usually did. One survey from a relative said the care expected was always provided, one responded that it usually was and one did not give a response. A visiting professional survey commented that the home provides quality care to clients. There was mixed feedback about privacy and dignity issues. Positive comments were received such as the home respects privacy and dignity on a visiting professionals survey, a relatives survey commented that staff are very nice and patient, a survey from someone in the home commented that some staff are nice and some staff take time to listen and understand me, one person spoken with said they did not have to wait long for assistance when using the call bell and another person described staff as polite. However, negative comments included; Some staff dont show me respect and speak disrespectfully on a survey from someone living in the home, a relative spoken with said that occasionally their relative was wet and needed toileting more often, one person spoken with said they had been left in the toilet for a lengthy period on one occasion. These issues were discussed with the manager, who was aware of these, and was addressing them via staff supervision and through care reviews. Observation during the inspection visit showed that privacy and dignity was respected. A general check on four medication administration record (MAR) charts showed that generally charts were completed properly with codes being used to show why someone had not received an as required medication, handwritten charts were being checked and signed by two people for accuracy and the amount of medication received was recorded. There were no photographs available, however, to aid identification. Two peoples MAR charts were then examined in more detail. These were completed accurately and corresponded with the blister pack, with the exception of one medicine that was not in the pack although a code was used to indicate that the person was asleep at the time of administration. The drugs reference book available for use was out of date.There was a medication refrigerator available but this was not in use at the time of the inspection visit. Records showed that its temperatures had been recorded when in use. Care Homes for Older People Page 14 of 30 Evidence: The home did not have any controlled drugs in use at the time of the inspection visit. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Well managed meals, activities and contact with the community enhanced peoples quality of life. Evidence: The written information supplied by the home stated that there were dedicated staff hours for activities. Notices on display in the home referred to a range of games, puzzles etc, that were available. Records were available up until April 2009 that showed personal attention was provided on a individual basis such as hand and nail care as well as quizzes, discussion and armchair exercises. Two of the four surveys received from people in the home responded that there were always activities arranged, one responded that there usually were and one responded that they did not know. One survey commented staff take me shopping and to the post office. One person spoken with said there were all sorts of activities. People had their own daily routines and followed their own hobbies such as playing the piano, reading newspapers and doing puzzles. Relatives spoken with confirmed that they were able to visit at any time and stated that they were always made to feel welcome. People living at the home confirmed that visitors were welcome at any time and they are able to go out of the home with their Care Homes for Older People Page 16 of 30 Evidence: relatives if they wished. One relative spoken with described the home as friendly and another said they were told they could visit at anytime. All three relatives surveys confirmed they were able to keep in touch with people in the home. The home had received information on the Mental Capacity Act 2005 and the associated Deprivation of Liberty Safeguards. The manager and senior staff had attended training on this and the home had started to undertake assessments of peoples capacity to make decisions. The manager stated that no one in the home had an advocate at the present time. The serving of the lunchtime meal was observed and those people spoken with enjoyed the food. The meals served were well presented and nutritious. The dining area was pleasant and bright and tables were laid with cloths and condiments.One person spoken with said the food was ever so good, another said it was fairly good and a visitor was pleased that their relative was eating better since being at the home. Two of the four surveys received from people living in the home responded that they always liked the food, one responded that they usually did and one that they sometimes did. Diabetic diets were catered for but not all staff spoken with were knowledgeable about which people were in need of a diabetic diet. Food stocks in the kitchen were good and showed that a balanced diet was available. However, staff had not undertaken training in nutrition. Care Homes for Older People Page 17 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Clear systems and procedures ensured that complaints were addressed objectively and people were safeguarded. Evidence: The home had a clear complaints procedure that stated complaints would be investigated within seven days. The written information supplied by the home stated that one complaint had been received at the home since the last inspection visit in June 2008. There had been none received at the office of the Care Quality Commission (previously the Commission for Social Care Inspection). There was a format for recording complaints that showed what action would be taken in response to any complaints received. This was examined and it was clear what action had been taken in response to the complaint raised. Three of the four surveys received from people living in the home said they knew how to make a formal complaint and one said they did not know. All three relatives surveys said they knew how to make a complaint, with one responding that the home always addressed concerns raised properly and two responding that they usually did. A safeguarding adults policy and procedure was in place and the home had a copy of Care Homes for Older People Page 18 of 30 Evidence: the Derby and Derbyshire Local Authority procedures. The homes training record stated that safeguarding training had occurred in June 2009 and staff interviewed confirmed this and were aware of their responsibilities in reporting any potential abuse. The written information supplied by the home stated that there had been no allegations of abuse since the last inspection visit in June 2008. All three staff surveys received responded that they knew what to do if anyone raised concerns about the home. Care Homes for Older People Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was well maintained, which ensured people had safe and comfortable accommodation. Evidence: The written information supplied by the home stated that the home had a family feel to it and that there was a refurbishment and redecoration programme. It also stated that one of the ways it wanted to improve was by making the environment more dementia friendly. The home was clean, tidy and odour free at the time of the inspection visit. However, two of the three staff surveys received commented that the environment could be improved; one said the general appearance of the home is very run down and another said there was a need to re-decorate and repaint the home. One survey received from someone living in the home responded that the home was always fresh and clean and three responded that it usually was. There was a pleasant outdoor garden area that was well tended and was accessible for people to use and enjoy. Three peoples bedrooms were seen and these were personalised with private Care Homes for Older People Page 20 of 30 Evidence: possessions. New furniture had been provided in some bedrooms including beds, wardrobes, chests of drawers and bedside lamps. One bathroom was also due to be refurbished. The laundry was viewed and there were two washers, one with a sluice wash facility and two driers. All were in working order. The laundry was located in the cellar and was hot and stuffy making it an unpleasant environment to work in. People spoken with thought their laundry was done well, although one person spoken with said the wrong clothes were sometimes returned from the laundry. Staff spoken with were knowledgeable on how to control infections and confirmed that there was a plentiful supply of gloves and aprons. Care Homes for Older People Page 21 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were sufficient well trained staff to ensure peoples needs were met. Evidence: The duty rota for the week ending 14th June 2009 showed that there were three care staff on duty in the mornings and afternoons and two at night, plus two kitchen staff each day and two domestic staff three days per week and one four days per week. Although there appeared to be sufficient staff to meet most needs, comments received suggested there were occasions when this was not always the case. For example, all three surveys received from staff responded that there were sometimes enough staff to meet individual needs and all three had commented that more staff were needed; one said could have higher staff levels and another said provide more staff every shift. A relatives survey commented that it was sometimes awkward for the staff to attend when wanted but it is usually because they are busy. Three of the four surveys from people living in the home responded that there were usually enough staff when needed and one responded that there sometimes were. Staff spoken with said there were generally enough staff to meet needs but they were occasionally rushed. Three staff files were examined for recruitment information. This showed that generally a proper recruitment process was in place and that all the information required by the Care Homes Regulations 2001 was in place, including Criminal Record Bureau (CRB) checks, identity information and Protection of Vulnerable Adults (POVA) Care Homes for Older People Page 22 of 30 Evidence: First checks. However, one file had only one written reference and one POVA First check and one CRB check were received after the people concerned had commenced employment. The written information supplied by the home stated that twelve of seventeen staff had achieved a National Vocational Qualification at level 2 or above. The home was therefore meeting the target of having 50 of staff qualified to level 2 or above. Staff spoken with confirmed that mandatory health and safety training took place as well as courses relating directly to care. Training records showed that a course on tissue viability had taken place in October 2008, dementia awareness in May 2009 and on the Mental Capacity Act 2005 in May 2009. All three staff surveys received responded that they received training relevant to their role and to help understand individual needs. Two of the three relatives surveys received responded that staff usually had the right skills and experience and one responded that they always had. Care Homes for Older People Page 23 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was run in peoples best interests. Evidence: The home had had a manager in place for twelve months and she confirmed that she was about to apply to the Care Quality Commission to be registered. The manager had many years experience of working with older people and had also worked as a registered manager in other establishments. She was able to demonstrate in discussion that she was familiar with the diseases and conditions associated with old age. A quality assurance system had been developed that included quarterly audits of health and safety areas plus areas such as staff training. Feedback on the service was received from internal surveys and the last one was undertaken in May 2009 and showed that people living in the home were generally satisfied with the service provided. Staff meetings were also held and it was clear what action had been taken to improve in some areas, for example in relation to getting up times for people living Care Homes for Older People Page 24 of 30 Evidence: in the home. There was a system in place for dealing with peoples personal finances. Two peoples financial records were examined and were accurate. Receipts for individual purchases were available and two people were signing the record. Health and safety issues were generally addressed. A random sample of maintenance records showed that fire fighting equipment was checked in October 2008, gas safety in May 2009 and water safety in May 2009. The written information supplied by the home also confirmed this. Staff training records, and staff spoken with, confirmed that mandatory health and safety training was being undertaken; for example, infection control training had been provided in September 2008, moving and handling in June 2009 and fire safety in January 2009. However, there were no records seen that suggested first aid training had been provided since the last inspection in June 2008. Care Homes for Older People Page 25 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 10 The responsible individual must ensure that all care staff treat people living in the home respectfully. This is to ensure that people living in the home feel valued and respected. 28/08/2009 2 7 15 Care plans must always contain sufficient detail and include social needs. This is to ensure that staff know how to give the right care and support. 03/08/2009 3 29 19 All the information required by the Care Homes Regulations 2001 should be in place before staff commence work at the home. This must include a Protection of Vulnerable Adults (POVA) First check and two written references. This is to ensure that staff have been properly checked 20/07/2009 Care Homes for Older People Page 27 of 30 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action and are deemed suitable to work with vulnerable people and to meet legal requirements. 4 31 9 The manager must make an application to become registered with the Care Quality Commission. This is to ensure that a suitable and competent person is running the home in peoples best interests. 5 38 13 The responsible individual must ensure that all staff have up to date first aid training. This is to ensure that emergencies can be dealt with properly and people living in the home receive an appropriate and safe response. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 30/09/2009 30/09/2009 1 2 9 9 The home should obtain an up to date medicines reference book. The home should have photographs with the medication administration charts to aid identification and therefore minimise the risk of errors. Staff training on nutrition should be organised and all staff should be aware of dietary needs. Page 28 of 30 3 15 Care Homes for Older People Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 4 5 24 26 There should be continued attention paid to the decor of the home. The responsible individual should consider re-locating or refurbishing the laundry to make it a more pleasant place to work. The home should consider reviewing staffing hours to ensure there are enough staff on at key times so that people do not have to wait too long for assistance. The home should ensure that employment histories are detailed in months and not years. The home should ensure there is adequate supervision of staff who are working with a POVA check only before the full Criminal Record Bureau (CRB) arrives. This means working on day shifts rather than nights shifts. 6 27 7 8 29 29 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!