Inspection on 06/08/09 for Harewood House

This is the latest available inspection report for this service, carried out on 6th August 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Extracts from inspection reports are licensed from CQC, this page was updated on 28/03/2010.

Key inspection report Care homes for older people Name: Address: Harewood House 47 West Street Scarborough North Yorkshire YO11 2QR     The quality rating for this care home is:   one star adequate 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: Denise Rouse     Date: 0 6 0 8 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 29 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 29 Information about the care home Name of care home: Address: Harewood House 47 West Street Scarborough North Yorkshire YO11 2QR 01723501477 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: TM & TR Ltd care home 29 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 29 The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either; whose primary care needs on admission to the home are within the following categories: Old Age, not falling within any other category - Code OP, maximum number of places 29 Dementia Code DE, maximum number of places 29 Date of last inspection Brief description of the care home Harewood House is a large Victorian building situated on the South Cliff in the seaside town of Scarborough, in North Yorkshire. There is ramped access to the home. The home provides care and accommodation for up to 29 older people, including those with a dementia related condition. Accommodation is provided over three floors with passenger lift access to all floors. The majority of bedrooms have private toilets and washbasins. There are two dining rooms and three lounges for people to use, and there is a ramp to allow access in and out of the home. Care Homes for Older People Page 4 of 29 Over 65 0 29 29 0 Brief description of the care home The home is located approximately half a mile away from the local shops where there is access to a Post Office, a public house, hairdressers and grocery stores. There is close access to a regular bus service into the town that is approximately one mile away. The Esplanade, which affords beautiful views across the South Bay, is a fiveminute level walk away from the home. People that express a wish to use this service and their representatives are provided with a brochure when they make initial enquiries. This gives them information about the services provided at Harewood House. The most recent inspection report is also included with this information. Fees charged on 6 August 2009 ranged from £345.00 for respite care, up to £400.00 per week. Care Homes for Older People Page 5 of 29 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: one star adequate 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: The quality rating for this service is 1 star. This means people who use this service experience adequate quality outcomes. The evidence used in this report has includes: A review of the information held on the homes file since its last inspection. Information submitted by the registered provider in the Annual Quality Assurance Assessment, AQAA. Information received from surveys completed by four people living at the home, one member of staff and one health care professional. An unannounced visit to the home by one inspector. Care Homes for Older People Page 6 of 29 Evidence gained by direct observation during the site visit. This involved speaking with people living at the home, to some relatives, the deputy manager and staff from all departments to gain their views. Inspection of records, including care profiles, medication administration records, staff files and some of the homes policies and procedures. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations. But only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will take place. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: Care plans and risk assessments must be reviewed monthly or as peoples needs change to make sure they reflect the care that people currently need. The medication trolley must be secured to the treatment room wall when not in use so that it is stored securely. Medication received at the home must be counted and the amount received recorded so that accurate records are kept to help protect people. The management team should look at how they may be able to provide further social stimulation to people with dementia needs to make sure that peoples social needs continue to be met. Care Homes for Older People Page 8 of 29 The information about how to contact the Care Quality Commission should be updated to reflect our new contact details so that people can contact us if they wish. Staff must not be allowed to commence work at the home without all necessary pre employment checks being undertaken and the results of the known, to make sure that people are protected from people who may not be suitable to work in the care industry. New staff who commence work at the home on a POVA first Check before their full Criminal Records Bureau Check result is known should be supervised at all time, the supervision arrangements should be recorded and be made available for inspection. The numbers of staff provided throughout the day and night should be kept under review to make sure that people receive the care, support and social stimulation they need when they need it. The home environment must be improved to make sure that it supports people with poor memory to gain their bearings and where possible to help them find their way around. One bedroom requires redecorating and the top floor corridor carpets require replacing. Repairs are required in the laundry to make sure that it can be thoroughly cleaned and access must be restricted when the laundry is unmanned. Fire doors must not be held open by inappropriate means. The hot water boiler and dishwasher in the kitchenette must be removed into the main secure kitchen.To make sure that peoples health and safety is protected. If you want to know what action the person responsible for this care home is taking 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 29 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 29 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. People are assessed before they are offered a place in the home to make sure their needs are known and can be met. Evidence: People who are considering moving to the home have a full assessment of their needs undertaken by a person who is competent to carry out this assessment. Information is gained by speaking with the person and to their chosen representative.Care plans hospital discharge information and information from relevant health care professionals is gathered to make sure that the individuals full and current needs are understood. The manager considers if the person would fit in with the people currently living at the home and she also considers if the staff have the relevant skills to meet the persons needs. Emergency admissions do not take place without a full care plan being sent to the home for the manager to review. Care Homes for Older People Page 11 of 29 Evidence: People are invited along with their chosen representatives to look round the home or stay for a trial period where they can experience the services the home has to offer them. This allows staff time to get to understand the persons individual needs in detail and can help people decide if the home is the right place for them. Information is available to people in the service user guide and statement of purpose. The last inspection report and is also available to people which helps to inform people what is available to them. Information is made available to people about the Mental Capacity Act and Deprivation of Liberty so that people are aware of this issues which help to protect peoples rights. The home does not provide Intermediate care. Care Homes for Older People Page 12 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their health needs known however a consistent approach to care planning and reviewing need to be developed to make sure that people receive support in line with their identified needs and wishes. Medication systems in operation require strengthening to make sure that peoples health and wellbeing is protected. Evidence: Although there are care plans and risk assessments in place these have not been reviewed on occasion. New care planning documentation is being developed. The current use of different documentation was seen to be confusing and might lead to people not being given the correct support that they need. Priority should be given to developing a consistent method of record keeping for all of the people living in the home. Health care professionals visit the home and people are escorted to appointments to help make sure their medical needs are met. Specialist advice is sought as required from Community Psychiatric Nurses and Psychiatrists. The home have specialist equipment available so that people who require this to maintain their skin integrity or Care Homes for Older People Page 13 of 29 Evidence: help staff to move them safely can be protected. The provider sent us some information before we visited in their Annual Quality Assurance Assessmant, as follows we ensure we do not discriminate against residents, we promote individuals and enhance their life style by using a person centered approach. During our visit we saw that people were addressed politely by staff and staff were seen knocking on bedroom doors before they entered peoples bedrooms to maintain peoples privacy and dignity. However we found that staffing levels have recently been reduced and staff are not able to supervise as they would like. They do not have sufficient time to take people outside of the home in line with their assessed care needs. During the inspection staff had to be alerted to assist one lady who was undressing in public in a communal area. Although staff came to assist immediately sufficient staffing needs to be provided to make sure that people are supervised and that their privacy and dignity is protected at all times. Medication systems in operation in the home were inspected. The medication trolley is stored in a downstairs cupboard, however the trolley is not attached to the wall. Medications received at the home are checked in by staff who have received medication training. However staff just tick the Medication Administration Record and do not record how the quantity of medication received and the member of staff receiving this does not initial the MAR chart. This must be put into place to make sure that accurate records are kept. Care Homes for Older People Page 14 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their social needs recorded however activities are mainly provided informally, and this may not meet everyones full social needs. People receive a nutritious diet. Evidence: Everyone has a social care plan which gives information about their preferred routines and social activities. However we saw that staff were very busy and didnt have time to spend with people. The home doesnt have an activities coordinator or a scheduled programme of activity. Some unscheduled activities are made available to people, on an ad hoc basis but one member of staff told us they are pushed to do activities. Occasionally entertainers visit the home or people are taken out for a drive in the countryside or are taken to local amenities. However staff have been reduced to three in the afternoons. This has meant that staff have not been able to take people out on an afternoon. One member of staff spoken with said We can manage with three staff on an afternoon, we can spend time with people, but I would like to take people out in an afternoon for a drive, we cannot do that when there is only three staff. When the residents increase staffing will increase. Peoples religious needs are known and provided for by local clergy who visit the home Care Homes for Older People Page 15 of 29 Evidence: on request. The catholic priest attends ever six weeks. A chiropodist and hairdresser also visit to provide their services to people for their convenience. We were told that resident and relative meetings are not currently held owing to lack of interest. Instead staff ask for peoples views when they visit the home so that informal information is gained to see if people are happy with the service being provided. The kitchen was inspected. The food looked appetising and nutritious. Special diets are catered for and supper is available. The menu is not displayed. Special crockery and cutlery equipment is provided for people who need this to help them eat independently. People who need assistance are fed by patient staff in an unhurried manner so that their nutritional needs are met. There is a kitchenette off one of the dining areas which has a dishwasher and hot water boiler, which might pose a risk to people living in the home or to people visiting. Care Homes for Older People Page 16 of 29 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. People are confident that their complaints would be listened to, and acted upon. Evidence: The complaints policy is available to everyone in the home and to their chosen representative. One relative spoken with said they were happy to raise any issues and felt they would be dealt with appropriately. There have been no complaints received since the last inspection, issues raised would be investigated. The information about how to contact the Care Quality Commission should be updated to reflect our new contact details so that people can contact us if they wish. A whistle blowing policy and procedure is in place. Staff receive training about how to safeguard people during their induction and at regular intervals thereafter. Staff spoken with knew what to do if an allegation of abuse were to occur, this helps to protect people. Deprivation of liberties has been considered for people living in the home and advocates can be provided for people who require this service to help protect their rights. Care Homes for Older People Page 17 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is comfortable however further improvements need to be made to make sure that it meets the needs of the people who live there and who have poor memory, and to make sure that peoples health and safety is protected. Evidence: All areas of the home were inspected. A secure door entry system is in operation so that people cannot leave the home unsupervised and are protected from unauthorised people entering the home. There is a small yard with garden furniture which is flat and accessible. There are two lounge areas and two dining areas on the ground floor for people to use.The home continues to make some improvements to the environment, a new call system has been fitted, some bedrooms have been decorated and some carpets have been replaced. All bedrooms are currently used as single occupancy and they can be personalised. However two fire doors were found to be wedged open and these wedges were removed to make sure that fire doors could be effective if the fire alarm was to be activated. The top floor hall carpet was worn thin in places and requires replacing. One bedroom on this floor required redecorating following a leaking roof which had been repaired, this had damaged the ceiling wallpaper and the wallpaper at the top of the wall required replacing, to make sure that this room was pleasant for the person to live in. Further work needs to be undertaken to improve internal signage and think about how Care Homes for Older People Page 18 of 29 Evidence: the home may be decorated to help people with poor memory to find their way around. No memory boxes or personalized door names were present which may have helped to help with orientation. These issues must be addressed to make sure that all areas of the home are suitable for the needs of the people who live there. Toilets and bathrooms throughout the home now have hand wash and hand towels available for people to use. Hand wash facilities are now available throughout all areas of the home this helps to maintain infection control. The laundry was inspected some floor tiles on the plinth that the washers stand on and some tiles on the step were damaged and require replacing, the laundry floor also needs to be re painted so that it is sealed to make sure that thorough cleaning of the complete laundry floor can take place to help maintain infection control. Care Homes for Older People Page 19 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are enthusiastic and keen to provide good care however staffing levels impacts on the delivery of quality care. Evidence: Recently the number of staff on duty has been reduced due to a temporary decrease in occupancy. One member of staff told us I think people get as much care as they would get anywhere. The home have achieved over fifty percent of care staff who hold the National Vocational Qualification at level two or three, this helps to make sure that care staff have the skills they need to deliver care. Pre employment checks are undertaken.However one member of staff commenced their induction at the home without a Criminal Records Bureau Disclosure. The manager told us that this was an error and not usual practice however this did not help to protect people from staff who may not be suitable to work with vulnerable people on this occasion. New staff receive induction training and this helps them to understand what is required of them and gives them the skills they need to give care. There is a training record kept for each member of staff, as well as a training programmer for the year to Care Homes for Older People Page 20 of 29 Evidence: make sure moving and handling, fire, infection control, safeguarding adults and training in all other relevant subjects is provided regularly for all staff. Meetings are held so staff can air their views, those not able to attend can read the minutes so they are kept informed. Care Homes for Older People Page 21 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a home that has an experienced manager. However peoples health and safety may be placed at risk. Evidence: The home is run by an experienced manager and there is an assistant manager in place. Staff said the management team were supportive. The manager undertakes training to help her develop her skills so that she can continue to manage the home effectively, support is also provided by the proprietor. Quality assurance systems are in place to look at how the home is running and how the services being delivered can be improved. People are sent yearly surveys to ask for their views about the home. Questionaires are now sent yearly to relatives, Community Psychiatric Nurses and to District Nurses to gain their views about the service being provided at the home. Any issues identified are addressed by the management team. Staff meetings are held however resident and relatives meetings have not been attended recently so the staff ask people if they are happy with the Care Homes for Older People Page 22 of 29 Evidence: service that is being provided to them to gain some feedback. Health and safety checks are undertaken. The improvements being made internally to the building should continue to be made and consideration must be given to how the home could improve the decor and signage for people who have poor memory to help them find their way around the home. On the day of the site visit two fire doors were found to be wedged open. We advised that any action to allow people ease of access around the home must be by agreement of the fire and rescue service and must not jeopardise people living or working in the home. There is a kitchenette off one of the dining areas which has a dishwasher and hot water boiler. The home must carry out a risk assessment and consult with the environmental health authority regarding the siting of this equipment. AQAA: Docs kept up to date re safe running of home. Checks carried out kept up to date infection control, food hygeine, fire safety and water temps. Certificates kept. Risk assessmants in place. Care Homes for Older People Page 23 of 29 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 24 of 29 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 7 15 People must have their care plans and risk assessments reviewed monthly. To make sure that peoples current needs are provided for. 30/09/2009 2 9 13 The medication trolley must be secured to the treatment cupboard wall when not in use. The quantity of medication received at the home must be recorded on the medication administration record and must be signed for by the staff who are receiving it. To make sure that the medication trolley is stored securely. To make sure that accurate records are kept to help protect people. 30/09/2009 Care Homes for Older People Page 25 of 29 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 3 19 23 The home must develop 30/10/2009 their signage and look at how the environment can be improved. To make sure that people with poor memory can be assisted to find their way around. 4 19 23 The top floor corridor carpet that is worn in places must be replaced. The bedroom which has had water damage to the ceiling and top of the wall must be redecorated. To make sure that the home is pleasant for people to love in. 30/10/2009 5 26 13 The laundry broken floor 30/10/2009 tiles must be replaced, the floor must be sealed and the worktops must be repaired. The laundry must be kept securely locked when unmanned by staff. To make sure that all areas can be thoroughly cleaned to maintain adequate infection control. To maintain peoples health and safety. Care Homes for Older People Page 26 of 29 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 6 29 19 Staff must not commence work at the home without A POVA First Check result being gained. To make sure that people are suitably protected from staff who may not be suitable to work in the care industry. 30/09/2009 7 38 13 Fire doors must not be held open by inappropriate means. To make sure that peoples health and safety can be protected . 16/09/2009 8 38 13 The hot water boiler and Dishwasher in the kitchenette must be removed into the main secure kitchen. To help protect people from possible scalds. 16/09/2009 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 1 12 The management team should look at how they may be able to provide further social stimulation to people with dementia needs to make sure that peoples social needs continue to be met. The information about how to contact the Care Quality Commission should be updated to reflect our new contact 2 16 Care Homes for Older People Page 27 of 29 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 details so that people can contact us if they wish. 3 27 The numbers of staff provided throughout the day and night should be kept under review to make sure that people receive the care, support and social stimulation they need when they need it. New staff who commence work at the home on a POVA first Check before their Full Criminal records Bureau check result is known should be supervised at all time, the supervision arrangements should be recorded and be made available for inspection, to help to maintain peoples safety. 4 29 Care Homes for Older People Page 28 of 29 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. 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