Inspection on 26/09/08 for Abbey House

This inspection was carried out on 26th September 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Abbey House 26/09/06

Abbey House 28/11/05

Abbey House 31/05/05

Abbey House 16/11/04

Abbey House 08/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 16/12/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Abbey House 20 - 22 Albert Road Bexhill on Sea East Sussex TN40 1DG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Deborah Calveley     Date: 2 6 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. the things that people have said are important to them: They reflect 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. 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 Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Abbey House 20 - 22 Albert Road Bexhill on Sea East Sussex TN40 1DG 01424222534 01424225789 abbey@angelhealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Leah Ramshaw Type of registration: Number of places registered: Angel Healthcare Ltd care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Abbey House is a well-maintained, large detached Victorian property situated in the centre of Bexhill-on-Sea in East Sussex. The shops, transport and Bexhill seafront are all within easy walking distance from the home. The interior of the house has been extensively refurbished to provide a pleasing and comfortable environment for up to twenty-three older people. Residents accommodation is all in single rooms, provided on three floors, with level access via a passenger lift. The residents private garden at the rear of the premises is well maintained. 0 Over 65 23 Care Homes for Older People Page 4 of 26 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: The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report those living at Abbey House will be referred to as residents. This was a key inspection that included an unannounced visit to the home and follow up contact with residents representatives and visiting health and social care professionals. This unannounced inspection was carried out over 6 hours on the 26 September 2008. There were 21 residents living in the home on the day, of which four were case tracked Care Homes for Older People Page 5 of 26 and spoken with. During the tour of the premises eight other residents both male and female were also spoken with. The purpose of the inspection was to check that the requirements of previous inspections had been met and inspect all other key standards. A tour of the premises was undertaken and a range of documentation was viewed including the Service Users Guide, Statement of Purpose, care plans, medication records and recruitment files. Four members of care staff, the domestic and the cook were spoken with in addition to discussion with the Manager and registered provider. Telephone contact was made with visiting professionals following the visit and their views and comments are incorporated into the report along with the comments from two resident surveys. The information received verbally during the site visit has been incorporated into this report. An Annual Quality Assurance Assessment (AQAA) was received from the Manager completed in full prior to this key inspection. As from April 2008, the fees currently range from 361.00 pounds to 430.00 pounds per week. Additional charges are made for individual newspapers, visitors’ meals, chiropody and hairdressing. What the care home does well: What has improved since the last inspection? Since the last key inspection all the required documents for newly recruited and existing staff are obtained before the commencement of work. The manager was registered as manager by the CSCI in February 2007 and is working towards a management qualification. An annual development plan for the home has been produced that is based on a systematic cycle of planning-action-review, reflecting the aims and outcomes for residents. Care Homes for Older People Page 7 of 26 What they could do better: 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 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 9 of 26 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. The home provides prospective residents and relatives with a good level of information about the home, its facilities, services and the costs involved. The admission procedures allow for the needs of prospective residents to be assessed by a competent person before admission. The registered person now confirms in writing that having regard to the assessment made on any prospective service user that the home can meet those needs. Evidence: There is a Statement of Purpose and Service Users Guide in place, which contains information about the home and the services it provides along with the qualifications of the staff. A recommendation of good practice is that a covering statement is inserted regarding the regular updates of the training undertaken. Care Homes for Older People Page 10 of 26 Evidence: It was confirmed whilst talking to residents that the contract arrangements were clear and understood. There is a copy of the terms and conditions of residency included in the homes information documents. A review of the care documentation confirmed that pre-admission assessments are completed by the manager and /or the registered provider. The last three admissions to the home were identified and the records relating to the admission procedures followed were reviewed. This confirmed that pre admission assessments are completed and provide a clear assessment of prospective residents care needs. These are completed by one of the management team and discussion with the acting manager confirmed that these are used to ensure new admissions to the home are appropriate and that the home have the staff equipment and environment to meet their care needs. Prospective residents are seen either in their home or hospital before admission and the input from relatives and other professionals is used whenever possible. This approach should be more clearly recorded on the assessment documentation to demonstrate the procedure followed. The home has recently started to confirm in writing that having regard to the assessment that the home can meet the assessed needs of the prospective resident. The manager was able to verbally demonstrate her knowledge and awareness of the different specialities required in the home and ensures that the carers employed have attended relevant courses to deal with the needs of the elderly and also specialised courses for certain diseases. Trial visits to the home can be arranged. The manager confirmed that residents are invited to a trial period to ensure suitability of the home, this is clearly stated in the Statement of Purpose and in the statement of terms and conditions. One resident spoken with said she had stayed at the home for respite care and decided to stay once she had met the staff and other residents. Intermediate or rehabilitative care is not provided at Abbey House. Care Homes for Older People Page 11 of 26 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. Care plans provide a framework for the delivery of care, however they do not provide guidance to care staff on providing a consistent approach on meeting the care needs of all the residents. The home was found to be meeting residents health and general needs with accessed additional specialist support when needed. Procedures and practices in the home allow for the safe administration of medicines and allow the privacy and dignity of residents to be promoted. Evidence: The care planning systems in place were discussed and reviewed with the manager during the inspection, and as discussed the format used at present is confusing and needs to be reviewed as to its suitability for staff to follow and complete. The care documentation pertaining to five residents were reviewed in depth as part of the inspection process. The majority of residents were found to have care plans specific to their needs, and evidenced regular review. The care plans reviewed included risk assessments for health needs, such as continence assessments, falls and trips, moving Care Homes for Older People Page 12 of 26 Evidence: and handling and medication reviews and demonstrated that overall the needs of residents are assessed and evaluated on a regular basis. However the risk assessments need to be based on clear criteria and then followed up within the care plan with clear guidance for staff to follow. Whilst these shortfalls did not impact on the positive outcomes of the residents at this time due to the knowledge the staff have on individual resident the home needs to ensure that the shortfalls are addressed to protect the residents and promote their health and well being. As the manager had already identified the care planning shortfalls and was able to demonstrate her plans to improve a requirement has not been made at this time, but will be reviewed in depth at the next key inspection. The handover observed during the site visit confirmed that Staff received a full report on each resident daily. Residents spoken with were very complimentary regarding the care provided at the home. Comments included, lovely place very good staff home from home. There are policies and procedures in place for staff to refer to regarding the safe administration storage disposal and recording of medication. The clinical room is located off the dining area, it is small but kept tidy and the space well used. There is a lockable medicine trolley and this is used for dispensing the medicines safely. The manager was informed of the new legislation regarding the storage cupboards to be used for controlled medicines and advice is to be sought from their dispensing pharmacist.The systems for recording and checking controlled drugs were found to be thorough. The Medication Administration Charts (MAR) were viewed, a few gaps were identified and these need to be followed up by the senior staff. Feedback from a health professional was positive regarding the home and confirmed that advice was sought as and when required. The district nurse visits the home to see residents who are receiving treatment for pressure damage. There are at present two diet controlled diabetics living in the home and the staff spoken with were aware of the dietary needs of these residents. The interaction between residents and staff was seen to be respectful and considerate and the atmosphere was pleasant and inclusive. Each of the residents were addressed by their preferred name and their clothes well laundered. Care Homes for Older People Page 13 of 26 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. Social activities and meals continue to be creative and provide variation and interest for people living in the home. Residents are supported and enabled to make a range of choices about their lives as well as maintaining links with friends and relatives in the community. Evidence: Activities in the home take place during the afternoon and fit in with everyday life at Abbey House and therefore are not planned in advance. The activity programme was found displayed on the notice board in the dining area and it confirmed that Tai chi takes place every other week alternating with keep fit, there are also visits by musicians, magicians and aromatherapy sessions. The activities in the home are enjoyed by the people who live there and only positive comments were received. Discussion took place with residents regarding discussing at the residents meetings their views and expectations regarding activities. Residents are enabled to go out with family and to day care centres. Residents and visitors spoken with, felt the level of support given to people regarding their wishes and in meeting their expectations regarding their daily life was Care Homes for Older People Page 14 of 26 Evidence: appropriate. Residents are facilitated to maintain their independence for as long as they are able, this needs to be linked more robustly to their individual care plans and monitored to identify any changes. There are no restrictions on visiting times as long as consideration is shown to all the residents. Visitors were seen at various times throughout the site visit and the interaction with staff was positive. There is a large dining room which leads into a lounge area and a small sitting area to the rear of the dining room, residents can choose to sit where they wish, people residents were seen sitting where they want including the garden. Many of the residents have individualised their bedroom with items from home and residents and relatives spoken with confirmed that they are encouraged by staff to make it homely. One residents room had his own furniture and carpet in, which was good to see. It was observed during the inspection that the routines at the home are flexible, residents spoken with confirmed that they were consulted about all aspects of their lives. The home has an advocacy policy in place and the information regarding this is available to all residents. The inspector was invited to lunch, which was a well prepared and a very tasty fish pie with vegetables and trifle for pudding. The residents were seen to enjoy their lunch and said their tastes were taken into consideration and catered for. The daily mealtime choices are discussed with residents on the day before, the menu is also displayed in the dining room. Records are kept of all the meals served, it would be beneficial to also include amount eaten as it identifies appetite trends and picks up problems early. Fresh fruit was seen in all areas of the home which the residents can eat at anytime, all the tables have a small pot of sweets for residents to enjoy. The residents comments included, nice food pretty good choices very willing to cook something different if I want it. The kitchen was clean and tidy, cleaning schedules were in place and staff complete the safer cooking better business in accordance with the environmental health agency. The main storage of dried food and tins is kept in the shed in the garden and clean and well organised. Care Homes for Older People Page 15 of 26 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. The home has a formal complaints system and residents stated that they feel their views are listened to and acted upon. Staff receive training to protect residents from abuse Evidence: The complaint policy and procedure is clear and uncomplicated and a copy of this is readily available in the home, Statement of Purpose and the Service Users Guide. A system of recording complaints was demonstrated to the inspector during her visit to the home. The home has not received any complaints since the last inspection. Relatives and residents spoken with confirmed that they were confident that any complaints or concerns that they had would be listened to and responded to effectively. The home has relevant guidelines on the protection of vulnerable adults and staff have all received appropriate safeguarding training. The manager has a clear understanding of adult protection guidelines and is aware of how to initiate an investigation if required. Care Homes for Older People Page 16 of 26 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. Abbey House provides a comfortable, clean and safe environment for those living in the home and for those visiting. Residents are enabled and encouraged to personalise their room, and rooms are homely and reflect the resident’s personalities and interests. Evidence: The layout and location of the home is well suited for its stated purpose and is satisfactorily maintained by the employed handyman. There is a small, private rear garden, with seating area, which is attractively planted and safe for use by residents. The tour of the home evidenced that communal areas are comfortably furnished and pleasantly decorated, these include a quiet lounge and a large dining area with adjoining seating area. Residents bedrooms were furnished and decorated to a good standard with some demonstrating that residents are enabled to bring in their own furnishings and ornaments. There are adequate communal bathrooms and shower rooms in the home, with specialist equipment to ensure all residents can have a bath or shower. There is a suitable passenger lift which provides access to all areas of the home. Care Homes for Older People Page 17 of 26 Evidence: Call bells are provided in all areas and staff were seen to be attentive and ensured residents had access to these and when used were responded to in a timely manner. The home staff are aware of how to procure special mattresses and seat cushionswhen required.The lighting in the home is of domestic quality and there are above bed lights as well as the main ceiling lights. The manager has this responsibility for ensuring that water temperatures are controlled and monitored monthly and a record kept. There are systems in place for monitoring safety issues such as fire checks, fire drills, PAT testing, electrical tests and gas and boiler checks and all the rooms are routinely checked for safety and maintenance issues. The records in the home and the AQAA completed by the manager confirmed they were up to date. There are Polices and procedures in place for infection control measures and these are updated regularly. Gloves and aprons are freely available and used when appropriate. The home was clean and free from offensive odours on the day of the inspection. The laundry room was clean, but the floor needs to be repaired/replaced to ensure it is impermeable. Care Homes for Older People Page 18 of 26 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. Residents are supported and protected by sufficient numbers of suitably trained staff to meet their needs and safe recruitment practices in the home. Evidence: The staffing rota was viewed as part of the inspection process and the staffing levels were seen to be sufficient to meet the needs of the residents at this time. It was confirmed by the manager that there is flexibility of the staffing levels and they are adjusted according to the changing needs of the residents. One resident felt that there were not enough staff on duty in the morning and that it would be good to have more staff on. The rota identifies staff on shift. Staffing levels include three care staff on duty each morning and in the afternoon and evening, there is also a domestic and chef on and a kitchen helper who serves tea and coffee and helps with lunch duties. There is one waking and one sleeping care staff on duty at night. A selection of staff recruitment files were viewed and demonstrate that a robust recruitment process has been maintained to protect residents and contained all the relevant information required, except for a photograph of the employee. There was evidence of health questionnaires, Criminal Record Bureau checks, two references, a resume of previous employment and work permits where necessary. All the paperwork is kept within a locked room. As identified the files need to include an identification Care Homes for Older People Page 19 of 26 Evidence: photograph of the employee and this was discussed. It was however discussed that staff on a trial period need to have all the same checks in place before commencing work in the home. There is an induction programme in place and this has been introduced for all new staff. Files seen confirmed this. New staff are required to complete an initial induction programme and undertake mandatory training, including fire and health and safety. This leads into foundation training, in preparation of NVQ training. At present 50 of staff have an NVQ qualification. The induction and foundation training is in line with the Skills for Care guidance. The provider facilitates training sessions and there is a training matrix in place. This evidenced that not all staff have received the necessary updates, however it was confirmed that there is a rolling programme of training, which will ensure that staff receive the training necessary to meet the residents needs and ensure safe practices.Staff spoken with said that training opportunities at the home are good and they are well supported by the fellow staff and the manager. Care Homes for Older People Page 20 of 26 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 is managed in an open and friendly manner with suitable quality monitoring systems. Residents financial interests are safeguarded. The health, safety and welfare of residents and staff are generally well promoted and protected. Evidence: The manager has been in post for two years and was registered by the commission in February 2007. She has the necessary experience to run the home effectively and is working towards gaining her National Vocational Qualifications 3 and 4. Timescales were discussed and she is aware of the need to undertake a management qualification and therefore this is not a requirement at this time. The management structure in the home is completed by a deputy manager who also has many years experience in caring for elderly people. Care Homes for Older People Page 21 of 26 Evidence: The atmosphere within the home is very relaxed, friendly and informal, which is appreciated by residents visitors and staff. The manager carries out regular meetings with residents and relatives to gather their views about the service provided. Regulation 26 visits carried out each month by a representative from the organisation. Customer surveys are sent to residents and families at least annually. There is business plan and maintenance plan in place for the home. The manager confirmed that small amounts of money and some valuables are held on behalf of residents although all residents have an allocated person to deal with their finances. Fees are invoiced on a monthly basis and most extras are invoiced at this time. Records relating to the monies and valuables held were discussed and available for review. It is recommended that the procedure for dealing with monies and valuables is formalised within a procedure, which includes two people checking and signing records. This will safeguard residents property and those staff dealing with it. Abbey House looked well maintained and systems are in place to report any problems to the maintenance team that need attention. Certificates relating to Health and Safety in the home were reviewed and found on the whole to be full. The fire training in place at this time needs to be reviewed, from discussion with the manager a fire trainer with the necessary expertise is needed to reinforce the in house training and reassure the staff that the procedures in place are current and safe. During the tour of the premises it was noted that many doors are wedged open, advice is to be sought from the fire department and also reflected in the environmental risk assessments. As discussed the environmental risk assessments need to be developed to ensure the residents safety at all times. Care Homes for Older People Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 38 23(4)(d) That all staff working at the home attend a fire safety training lecture, annually; such training to be provided by a professionally qualified person. 31/12/2006 Care Homes for Older People Page 23 of 26 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 26 13 That the registered person ensures that the laundry floor is impermeable to prevent cross infection. To protect the service users. 11/12/2008 2 38 13 That generic risk assessments are used to ensure residents safety. These should include risks presented by the garden. That accurate records on check made in the home are recorded. That full accurate policies and procedures that underpin practice in the home are readily available and adhered to ensure staff and residents safety. That the safety of the service users is promoted. 11/12/2008 3 38 23 That the registered person shall seek advice from the fire authority regarding the use of wedges throughout 11/12/2008 Care Homes for Older People Page 24 of 26 the home. That the fire training is undertaken by a competent person. That the safety of the service users is promoted. 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 1 A recommendation of good practice is that a covering statement is inserted into the Statement of Purpose and Service Users Guide regarding the regular updates of the training undertaken. That the care documentation system used is reviewed as to its suitability and effectiveness. That the risk assessments in use are based on clear criteria and followed up more robustly within the care documentation. 2 3 7 8 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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 © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. 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