Inspection on 08/09/09 for Abbey Care Rest Home

This inspection was carried out on 8th September 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Abbey Care Rest Home 27/11/07

Abbey Care Rest Home 09/01/07

Abbey Care Rest Home 20/06/06

Abbey Care Rest Home 25/08/05

Abbey Care Rest Home 16/06/05

Abbey Care Rest Home 18/01/05

Abbey Care Rest Home 28/09/04

Similar services:

Thames House

Creative Support

Sunny Bank (P.R.S.) Ltd

Ashwood Court Unit 1

Thornton Lodge

Alfred House Residential Care Home

Barkerhouse Road (123)

Fernhaven

Extracts from inspection reports are licensed from CQC, this page was updated on 15/02/2010.

Key inspection report Care homes for older people Name: Address: Abbey Care Rest Home 14 Hampton Road Blackpool Lancashire FY4 1JB     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: Jacqueline Riley     Date: 0 8 0 9 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 28 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 28 Information about the care home Name of care home: Address: Abbey Care Rest Home 14 Hampton Road Blackpool Lancashire FY4 1JB 01253341458 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: abbey_care@yahoo.co.uk Mr Gulan Asger Abdullah Mukadam care home 11 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: 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: Dementia - Code DE (maximum number of places 10), Mental disorder, excluding learning disability or dementia - Code MD (maximum number of places 1). The maximum number of service users who can be accommodated is: 11. Date of last inspection Brief description of the care home Abbeycare is a registered facility, providing residential care for up to ten adults who have dementia and two adults with mental illness. The care home is situated in a residential area of Blackpool, close to amenities including shops and the transport network. The home is spacious, with service user rooms on the ground floor and first floor. There are two double bedrooms and seven single rooms. There are no en-suite facilities. There is a choice of two lounges with toilets in close proximity. Access to the Care Homes for Older People Page 4 of 28 Over 65 0 0 10 1 Brief description of the care home home is facilitated by a ramp. There is no rear garden area however the front garden is accessible for service users and regularly used during the summer months. There is a written Statement of Purpose and Service User Guide outlining the home purpose, and the services it will provide to residents. This information is made available to all prospective residents or their relative?s representatives to help them make an informed choice about going to live at the home. At the time of the inspection 8th September 2009 the information provided to the Commission showed that care home fees were £350 per week, any additional expenses including chiropody, newspapers and additional toiletries are met by the resident or third party. Care Homes for Older People Page 5 of 28 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: A key inspection of the home was undertaken which included an unannounced visit to the service over a four hour period on 8th September 2009.. We spoke to the registered owner, and one staff member. Surveys were left at the service on the day and collected later, however some of the comments we received from people using the service during the inspection are included in this report. We talked to people using the service, and asked about those peoples needs. We also looked at care plans, records, and daily notes for three people, this is called case tracking. As well as looking at records we looked around the home and talked to some people in their own rooms as well as the communal lounge. Every year the person in charge or manager is asked to provide us with written information about the quality of the service they provide, and to make an assessment Care Homes for Older People Page 6 of 28 of the quality of their service. We use this information, in part to focus on inspection activity. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: We looked at a number of care plans and found they require a review so that information which is out of date is removed. This will help staff using the plan identify the current needs of the person more easily. On two of the files we looked at there were no photographs of the person which needs to be in place for identification purposes and to meet requirements of the Care Homes Regulations 2001. We found medication for a person receiving respite care to be already prepared on admission. Staff administering the medication are signing to say they have administered the prescribed dose when they have not prepared the medication for administration. This poses a risk to the resident and the member of staff who cannot confirm what is in the prepared cassette. We saw the external paintwork requires attention so that the home is well maintained. By looking around the home we found all areas of the home require decoration and replacement of curtains and bedding to make it a well maintained environment and one which is pleasant for people to live in. There are very few ornaments, pictures and mirrors in the communal areas, which would enhance the home and make it more homely for people to live in. Part of the dining room wallpaper was stained and requires decorating. We saw plastic dining table covers are used for hygiene purposes. In order to make the dining experience a positive one for people living there consideration should be given to improving the environment. Care Homes for Older People Page 8 of 28 The middle lounge has limited natural light and appeared dark. As the rear lounge adjoining this room has a good natural light source and is unused consideration should be given to improve the area in order for it to be a pleasant environment in which people can use as a communal facility. Most radiator covers seen require painting so that they look complete and blend into the room. In addition the cover in the hall was broken and requires repairing. The single bed in a persons room without a mattress should be either replaced or removed, as it looks unsightly. Some of the bedding seen does not match and in one instance there was no valance on the bed, making it look unfinished. Some curtains and bedding looked tired and in need of replacement to make peoples rooms look homely and well maintained. In one room we found the call bell was to far from the bed for the person to use without getting out and requires an extension lead so the person can use it safely when in bed. We saw in one instance personal allowance is paid out on a daily basis and whilst this is signed weekly it must be signed when paid to the person so there is a full audit trail. A staff record looked at did not have in place the date of commencement. This is necessary so that there is evidence the person did not commence work in the home until satisfactory fitness checks had been received. 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 28 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 28 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. Peoples needs are assessed before they move into the home to ensure their care needs can be met. Evidence: We found there has been one admission to the home since the previous inspection. By looking at the assessment information it confirmed the persons needs had been identified by the contracting authority and the home were provided with this information at the point of admission so they knew the persons general needs. In addition they carry out their own assessment of need so they are able to meet the persons needs. We looked at other files which had in place assessment information from social workers and Community Psychiatric nurses as well as hospital discharge forms providing information for the home to meet the individual needs of people who live there. Care Homes for Older People Page 11 of 28 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. Peoples health needs are being met by staff who respect their welfare, however some care practices as well as medication practices have the potential to pose risk and impede privacy and dignity. Evidence: We looked at the care records of three people. Two live at the home permanently and the other person has regular respite stays at the home. We found the home records the needs of people based upon a full assessment and includes evidence of care planning. They look at various needs of people including risk assessment. We found records to be complete however in two instances the records held information which was dated and should be removed and archived so that the staff can clearly follow the current care planning record. There was evidence people have access to health care services with clear records of visits to hospital appointments, action taken to meet medical requirements, and evidence of district nurse and G.P., support. Care Homes for Older People Page 12 of 28 Evidence: People we spoke to told us their experiences of receiving hospital treatment and how the home meets their special dietary needs. Comments included, I need special food and they get it for me, I have been in bed since I came back here and this is a special bed, which I like. We saw there are review sheets on the two permanent files we looked at. However they were just blank sheets with dates of review and a no change comment or ditto. There must be evidence the files have been looked at in all areas so there is a clear audit trail of information. We saw where risk is identified there were areas which did not provide additional information about how the risk would be managed, which means staff may not have all the information they need to ensure risk is managed effectively. On two of the most recent admissions there were no photographs on file for identification purposes and to meet the Care Homes Regulations 2001. We looked at how the home manages medication and found there is a locked metal wall cabinet containing blister packs of prescribed medication for people living at the home. We looked at how medication is recorded and found to it be accurate and up to date with staff only signing the record when a drug is administered. We checked the stock control and found that to be accurate. We looked at the medication for a resident on short stay at the home and found there is now a record for administering prescribed medication for people on short stay. However, we found the medication had been made up for the duration of the stay prior to admission by another person, which poses a risk to the resident and the member of staff as they cannot confirm the contents of the cassette when administering this medication. We advised the owner to stop this practice as there is a risk potential. We looked at how the home maintains dignity and privacy for people living there. We found staff talk to people with respect, and two people spoke to told us they like the staff and think they are very kind. We noted a residents room which is also a double occupancy room, is being used by the sleeping watch staff. We were told by the owner the resident requires attention at times during the night time period and becomes very anxious when there are no staff close by. The issue has been discussed with the family who told the inspector they are very satisfied with the situation and feel staff respect their relatives privacy and dignity , whilst making sure their care needs are met and they do not become anxious. Comments included, this is a very good care home and my relative has the best care I can hope for I do not want things to change, they Care Homes for Older People Page 13 of 28 Evidence: have all the time in the world for my relative and others living there. In order to make sure the situation is monitored, there should be evidence of regular reviews taking place so that if the resident requires more assistance then the staff ratio will increase. Care Homes for Older People Page 14 of 28 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. The daily routines are flexible although the lack of social activities means people are not provided with a stimulating environment and may become bored. Peoples dietary needs are taken into account so they enjoy a varied diet. Evidence: We talked to two of the people living at the home and found they tend to make their own choices as to what they do in their lives. One person told us they like to go out when they choose to and they have always done this. Comments included, I go out every day, sometimes for a cuppa and other times for a drink, they give me money every day. There were two other people using the communal lounge during the visit, but due to the level of dementia could not communicate, however they looked comfortable and got up frequently and move around whilst the inspection was ongoing. We did not find there was any structured approach to planning activities either individually or as a group. This has the potential to have a detrimental affect on people living there as they are not provided with activities or stimulation which may benefit them. There should be a range of activities available to people so that they can make their own decisions and for these decisions to be recorded, so that this Care Homes for Older People Page 15 of 28 Evidence: information can be used as part of the care planning review processes. We saw there is information about how people with dementia conditions could be stimulated and gave examples, however this needs to be used in conjunction with staff working in the home so a plan can be developed. Meals and mealtimes were seen to be flexible. Two people were eating breakfast in the dining area during the morning period. They told us people have their own routines and come to the dining room at various times. A main meal is made for the lunchtime period, however again some people choose to eat at times of their choice. People using the service said they liked the meals very much and liked the way they can have what they choose. Comments included, I have special food and they know what I can have and cant have. We saw the home meets the special dietary needs of one person well, with evidence of how the diet can be managed and what specific food types must be used. Care Homes for Older People Page 16 of 28 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 know how to complain and are confident their concerns will be listened to. Evidence: We saw the home has a complaints procedure which is included in the Statement of Purpose and Service User Guide as well as being on the dining room notice board. Comments included, I tell the manager if Im not happy about something. There have been no complaints recorded since the previous inspection and no complaints have been received by the Care Quality Commission. People we spoke to said if they are not happy with something they tell the staff and it usually gets sorted out. There are local policies and procedures for safeguarding people so they are protected. We spoke to one staff member who said they are aware of the policies but have yet to receive training. Care Homes for Older People Page 17 of 28 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Lack of maintenance, decoration and furnishings means that peoples comfort is limited. Evidence: The home windows and doors have now all been replaced with UPVC so that insulation of the home is improved. We looked around the home and found the environment has not been maintained or developed since the previous inspection. There is a need for general decoration throughout the home. We saw there was staining of the wallpaper in the dining room which the owner said they would address. This room is sparse and no evidence of pictures or small artifacts which would make it homely. The owner chooses to use wipe clean surfaces on the dining tables for cleanliness and hygiene purposes. In order to make this room more homelike the owner should consider an environment which would make the dining experience a more positive one by way of decoration. The middle communal lounge has little natural light and is sparse. The owner told us people who use this room can use artificial lighting but choose not to. As the rear lounge is now unused and there is a natural light source, the owner should consider developing this for the benefit of people living there. We looked at peoples rooms. A double room had an additional single bed without a mattress. We advised the owner to either make this up or remove it as it was Care Homes for Older People Page 18 of 28 Evidence: unsightly. Bedding does not match and curtains require replacement in some rooms. Furniture in most rooms does not match. In one single room the call bell was to far away from the bed for the person to use and requires an extension so they can call for assistance from the bed if necessary. Most radiator covers require painting and the one in the main hallway needs repairing as parts of the paneling is broken and looks unsightly. Two people living at the home have hospital beds with specialist mattresses for pressure care, as one person is bedfast and the other spends a lot of time in bed due to medical condition. Both these rooms are on the ground floor so that the staff are always available and close by. External paintwork is in need of improvement as it is flaking around the windows and on the remaining woodwork. The first floor bathroom is unused now and the ground floor walk in shower is the bathing facility used by people living in the home. We spoke to some people using the service and people who visit the home on a regular basis. They told us they were generally satisfied with things but said it does need improvement in decoration. Care Homes for Older People Page 19 of 28 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. People receive care and support from staff who have the skills to support them. Evidence: This home is generally staffed by family members who live on the premises, however there has been one new member of staff commence work at the home since the previous inspection. We looked at the recruitment and training for this staff member and found it to be in place with records of a full employment history, two references and fitness checks. However there was no commencement date for this employee resulting in it being difficult to identify when fitness checks were received and the date the staff member commenced work in the home. There must be evidence of commencement dates which follow satisfactory fitness checks so people are protected. We saw the employee has attended various training courses for mandatory training including first aid moving and handling. Other suitable courses being arranged which includes adult safeguarding. This will ensure staff know what action to take should an allegation of abuse be brought to their attention. We looked at the staff rota, which identifies who is on duty,and found there are four members of staff currently on the staffing rota. By talking to the owner we were informed of an additional member of the staff team who works in the home when not involved in their current work commitments. The owner should ensure the staffing Care Homes for Older People Page 20 of 28 Evidence: rota reflects who is available for duty at all times so there is a clear audit. Comments we received from a relative told us they are happy with the care their relative receives at the home. Three of the four staff have a national care qualification and one member of staff is enrolled to undertake this qualification in the near future so people have the knowledge and skills to provide care to people. As people living in the home have specialist needs in respect of dementia and mental health, staff should undertake training in these areas so they are informed of current good practice. Care Homes for Older People Page 21 of 28 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. The management of the home is based upon openness, however some of the management systems do not ensure the efficient running of the service. Evidence: We looked at how the home is run for the benefit of people who live there. We found there are limitations in how the home is managed on a day to day basis. This includes, limited stimulation for people living there. The homes environment is not satisfactorily maintained so that people do not have a homely atmosphere to live in. Records for the maintenance of equipment in the home were available with certificates for essential servicing in place, so that the health and safety of people using the service is protected. We looked at how the quality of the service is audited and found there is an informal approach whereby relatives visiting almost daily are spoken to as well as communicating with people who live there. Comments we received included, I go Care Homes for Older People Page 22 of 28 Evidence: there almost daily and I feel we have a good relationship with the staff, who we talk to all the time, they cant do enough, its like one big family, I enjoy my job at Abbey Care and its become part of my family. We looked at the financial records for people receiving weekly allowances. Whilst they are recorded and signed for by the person receiving the money, in one instance personal allowance is paid daily and this should be signed for day by the person receiving the money. All monies seen were found to be accurate when measured against the records for auditing purposes. Care Homes for Older People Page 23 of 28 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 28 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 9 13 All medication received into 30/09/2009 the home for people admitted for short term care must have adequate labeling and directions for use. Tis will ensure that staff have the confidence that they are administering the correct medication as directed by a doctor. By recording administered medication which had not been made up by the person has the potential to put the residents at risk as well as the member of staff. 2 19 23 Radiator covers must be fixed in place and undamaged against the hall radiator. There is a potential risk to people living in the home with radiator covers which are broken. 30/10/2009 Care Homes for Older People Page 25 of 28 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 be 26/02/2010 maintained in a good state of repair both internally and externally with all parts kept clean and reasonably decorated. Poor decoration internally and externally means people living there do not have homely environment in which to live. 4 31 10 The registered person must ensure the home is being managed in the best interests of people living there. By not having in place suitable environmental standards has resulted in people having the potential to have a negative impact on users of the service. 31/12/2009 5 35 17 There must be a record of all 30/09/2009 allowances paid to people at the time they are paid and for the person receiving the payment there must be a signature. By not having a signature of the person receiving a daily allowance the home cannot truly audit the amounts paid to the person. Care Homes for Older People Page 26 of 28 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 7 Care plans should have information which is out of date removed from the working file so that staff have the current information in a clear format to work from. Activities should be varied and include types of activities specifically designed for people with dementia so that they suit peoples expectations and capabilities. There should be evidence on recruitment records of the commencement date of an employer so that this can be cross referenced with the date fitness checks were received so people are protected. The home should use a more formal approach in gaining the views of people using the service so that it can be audited and the information used to form business planning for the service and to measure its effectiveness in meeting its stated aims and objectives. 2 12 3 29 4 33 Care Homes for Older People Page 27 of 28 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 28 of 28 - 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!