Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Abigail Lodge Care Home Gloucester Road Delves Lane Consett Durham DH8 7LB The quality rating for this care home is:
one star adequate 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: Elsie Allnutt
Date: 0 9 1 2 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 31 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 31 Information about the care home
Name of care home: Address: Abigail Lodge Care Home Gloucester Road Delves Lane Consett Durham DH8 7LB 01207502405 01207502439 abigail.lodge@fshc.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Tamaris Healthcare (England) Ltd Type of registration: Number of places registered: care home 60 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: Three persons within the category of PD aged 55 years and over may be accommodated commensurate with the home`s Statement of Purpose. Date of last inspection Brief description of the care home Abigail Lodge is a care home with nursing. It has two units, each with 30 beds. One is registered to provide care (including 24 hour nursing care) for people aged 65 or older, together with convalescence and palliative care for people aged 55 or older. The other accommodates people with dementia care needs (including 24 hour nursing care). The home is located on the edge of Consett, close to a supermarket and a public house. It was opened in 1995 and is a purpose-built, two storey building. All bedrooms are Care Homes for Older People
Page 4 of 31 Over 65 30 30 0 30 0 3 Brief description of the care home single with en suite facilities. There is a passenger lift in each unit. The home has large gardens that are well maintained and easily accessible. Care Homes for Older People Page 5 of 31 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 last inspection on this service was completed on 02/02/07. Before the visit we looked at: information we received since the last inspection; how the service dealt with any complaints and conerns since the last visit; any changes to how the home is run; the providers view on how they care for people; the views of people who use the service, their relatives, staff and other professionals. An unannounced visit was made on 09/12/08. During the visit we: talked to people who use the service, relatives, staff and visitors; looked at information about the people who use the service and how well their needs Care Homes for Older People
Page 6 of 31 are met; looked at other records that must be kept; looked around parts of the building to make sure that it is kept clean, safe and comfortable; checked what improvements had been made since the last visit. We told the manager/provider what we found. What the care home does well: What has improved since the last inspection? Improvements have been made to the homes assessment process. It has been developed to be more comprehensive and in a way that it can be used as a working tool that is reviewed monthly. This means that service users changing needs are recorded and addressed and a prompt is given to update care plans. Service users care plans have been reviewed and revised, these are now more person centred and guide staff clearly regarding how to give individual support. So that this is carried out safely and so that service users are supported to maximise their independence plans are in put in place to reduce identified risks. The administration of medication within the home has been reviewed and improved. The medication trolley is no longer left unattended and staff who have the responsibility of administrating medication have received up to date training regarding the policies and procedures to be followed. This means that no one except the person administrating the medication can access the trolley where the medication is stored and staff have the skills and knowledge how to administer medication appropriately. Although a bigger focus is needed to improve this area . some work has begun to improve the environment of the dementia care unit. Some pictures and articles have Care Homes for Older People Page 8 of 31 been hung around the unit which hopefully will attract service users attention and prompt their orientation. An activities organisor has been employed who is currently working with service users to find out their interests and personalities and plans are in place to develop a structured activity programme for the home and individuals. The amount of staff needed to support services effectively has been reviewed and increased. This means that more staff are available on each shift to attend to service users needs. The Organisation has employed a training manager who will address the training needs of the home and individual staff. This will raise the number of qualified staff in the home while enabling them to develop the skills, knowledge and understanding needed to address individual needs of service users. 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 9 of 31 Care Homes for Older People Page 10 of 31 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 11 of 31 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 receives good information about prospective service users on which they can make an informed decision about whether they can meet their needs prior to them moving into the home. This means that the home is confident they can support the person well and offer a good service. Evidence: The home has developed a Care and Health Assessment Profile, this document is completed as part of a new service users pre-admission and admission process. It records comprehensive information about the person including a personal profile, health and social care needs and any identified risks. The information recorded is used, with other information received from the referring agencies, to develop care plans for the individual. A scoring system identifies when a care plan is needed and when risk strategy plans need to be put into place and the overall score of the assessment
Care Homes for Older People Page 12 of 31 Evidence: placement identifies whether the person needs personal or nursing care. The document is used as an assessment tool and is reviewed monthly when any changing need is addressed, recorded and acts as a prompt to up date the care plan. Although this process is new and still needs time to assess its effectiveness it is included in the care files along with comprehensive assessments from referring agencies. Care plans reflect the assessed needs and identified risks. This service does not provide Intermediate Care. Care Homes for Older People Page 13 of 31 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. Suitable and effective arrangements are in place to meet service users healthcare needs and good procedures are in place for the safe administration of medicines. This promotes the health and welfare of service users and when all care plans are fully developed, will ensure that a consistent service is delivered. Evidence: Although there is still some inconsistency in the standard of care plans, much work is taking place to improve the system. Senior managers are currently working with senior staff to re-write care plans in a way that covers all aspects of individual service users needs. The new care plan format includes good information about the service users needs and how individuals are supported to maintain independence. They are person centred and guide staff to address the individuals needs, their preferred way of daily living and the way they like to be supported. Care Homes for Older People Page 14 of 31 Evidence: There is step by step guidance for staff to follow in relation to how individuals healthcare needs are to be met. For example body maps demonstrate any pressure areas that need attention and clear care plans guide staff in the care tasks to be carried out. There is a clear record of all interventions taken and strategy plans, that can be tracked througout the care plan, are in place to reduce any identified risks. Assessments are in place regarding the use of bedrails, with signed consent forms and the identified risks have been addressed. The bed and rails used are compatible and monitored regularly with records in place. Nutritional screening identifies where care plans are needed and weight is monitored accordingly. Service users are supported to attend healthcare appointments and these are recorded with the outcome in the care files. Healthcare specialists are referred to fpr specialist advice, for example one care plan includes clear guidelines given by a speech and language specialist regarding someones swallowing ability. This guides staff to use thickeners in fluids to avoid choking and to make this process safer and more comfortable for the service user. The daily notes regarding this appropriately records the daily success of its use. Although a monitoring system is in place not all care plans are currently evaluated effectively. This is an important process so that service users changing needs are recognised and addressed appropriately. This was discussed with the operations manager who agreed to address this with senior staff. Staff attended to service users in a sensitive and competent way, however there have been some recent reports to indicate that poor care practice has compromised the dignity of service users. The home has seriously addressed such allegations by carrying out investigations, following their disciplinary procedures and arranging training for staff so that the homes policies and procedures, surrounding the promotion of dignity, are recognised and followed. Emphasis is focussed on informing staff and delivering training regarding service users diverse needs. The home has signed up with Stirling University and it is planned that all staff will undergo the universitys dementia care training programme. There are also plans for the Companys dementia care specialist to visit the home next month to give advice in relation to how the environment can be improved to assist service users with the orientation of their surroundings. All staff are to receive training regarding promoting peoples dignity next month. Following recent medication errors the procedures regarding the administration of medication have been reviewed and improved, for example the security of the
Care Homes for Older People Page 15 of 31 Evidence: medication trolley has been addressed and it is no longer left unattended during the administration process. Suitable procedures are in place regarding the administration of medication and staff are suitably trained regarding this. Only trained senior staff are responsible for this task and medicines are safely stored and managed and the manager is responsible for carrying out a weekly audit of medication. The manager was advised to discuss the storage and recording of the drug diazepam with the pharmacist so that the security of this drug can be more directly monitored. Care Homes for Older People Page 16 of 31 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. Although daily routines within the home are flexible and the food served is of good quality, well planned and enjoyed by service users, the activities available do not always meet the individual needs of service users. However the good ideas beginning to emerge in relation to developing activities further so that all service users individual preferences and needs are addressed is promising. This will mean that service users lives will be more interesting and varied. Evidence: An activities coordinator has recently been employed and is in the process of receiving training and getting to know service users and their needs. So that effective support is received a monthly meeting is held with other activity coordinators within the organisation and plans are in place to meet the services director to discuss her role and how this is to fit in with the homes aims and objectives. Although there is no actiivities structure in place as yet, some service users were engaged in personal activity. People were chatting in the lounge, one service user was enjoying doing a word puzzle and others discussed a singer who had entertained service users the previous day. One service user who was independently mobile
Care Homes for Older People Page 17 of 31 Evidence: discussed the positive structure to their day which includes walking out independently for a newspaper, quietly reading it and spending part of the day involved in their favourite pastime, horseracing. The service user feels that staff takes an interest in them, their preferences and their chosen way of life and supports their independence and automony. Although some service users enjoy a varied way of life service users with less independence were less involved in activity, here more encouragement, support and opportunity to develop interesting and active livestyles is needed. Discussions with the managers identified the homes plans to action this. As part of the new care planning system, the home has plans to develop service users individual social histories, so that they can be used as a base to develop social programmes and stimulating activities that will inspire and motivate individuals to take part in, that are individual to them and that they enjoy and at times find comforting. The food served is good and nutritious, service users were complimentary about this and stated; The food is usually good and you get your fill. I have no complaints about the food, you get a choice. There is plenty of variety. A menu is vailable in each dining room that informs service users of what is on offer each day. If anyone does not like the offer of the choices given for the main meal there is a list of alternative food at the back of the menu to choose from. One person who did not like either of the choices on offer on the day asked if they could have an omelette, this was quickly prepared and served. Care Homes for Older People Page 18 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has comprehensive procedures in place to address complaints and allegations seriously. However due to the lack of strong leadership, some poor practice within the home has put service users at risk of abuse. Evidence: The home has a comprehensive complaints procedure of which service users and their representatives are aware. Several complaints have been appropriately recorded over the past twelve months and all demonstrate the action taken, the outcome of the investigation and whether the complaint had been resolved. Service users are confident that their concerns and complaints are listened to and addressed appropriately and they are encouraged to discuss their concerns on a daily basis so that they can be addressed directly. Some of the complaints made and recorded have been referred following the local authoritys safeguarding procedures and as a result have been appropriately investigated and addressed. Some of the issues raised include allegations of bad care practice, poor management of medication and general poor management of the home. These issues have been reported to the appropriate agencies who are working with the home to improve the service delivered. The home is working through an action plan in order to improve the general welfare of the service users living there.
Care Homes for Older People Page 19 of 31 Evidence: Staff had a good understanding of abuse and the safeguarding procedures and are more aware of their responsibilities and are more confident in reporting incidents of abuse and poor practice. However due to the lack of a permanent manager in the home, some staff are unsure of who to discuss such incidents with. Not all staff are up to date with training regarding the local authoritys safeguarding adults procedures, however the home has plans to deliver training regarding this and a training session regarding treating people with dignity, in January 2008. Service users or their representatives are responsible for looking after their personal finances, the home does not receive any pocket monies for any service user. Locked facilities are available in individual rooms or small amounts of money can be kept in the office following individual comprehensive recording procedures. Care Homes for Older People Page 20 of 31 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. Service users live in an environment that is designed to address their needs safely and that is clean and comfortable. However further developments will ensure that the needs of people with dementia are fully addressed and that their independence and feeling of well being is promoted. Evidence: The home is clean, nicely decorated and well maintained, however some areas are beginning to show signs of wear and tear. Although some areas of the home have been redecorated there are other areas that would benefit from being brought up to date and some carpets that are stained and worn would benefit from being replaced. The home is spacious and offers enough room for the use of wheelchairs and other appliances to enable service users to be effectively supported with mobility. There are enough lounge areas to offer service users a place to socialise and rest, however if the easy chairs were arranged in smaller groups this might enable service users to socialise and chat with each other more easily. This is particulary evident in the first floor lounge where the chairs are placed around the walls of the room. Although it is acknowledged that small areas of work to further develop the dementia care unit have taken place, this work needs to be developed further so that the
Care Homes for Older People Page 21 of 31 Evidence: environment stimulates, motivates and supports service users who may be confused to feel more confident, secure and content about their surroundings. Some interesting discussions took place with the managers in relation to how this can be achieved. More emphasis was directed to the importance of developing service users social histories, so that the information recorded can be used as a base to develop individual activity areas within the unit based on individuals preferences and experiences. The aim being to attract and motivate individuals into activities that they enjoyed in former years or that might act as a diversion during times of aggression and frustration. Staff carry out their duties with health and safety in mind and the clean and tidy environment reflects the effective domestic routines carried out. The gardens that surround the home are attractive, well maintained and are accessible to service users. The home has addressed the requirements and recommendations of the fire and environmental services following previous visits, making the environment a safe place in which to live. Care Homes for Older People Page 22 of 31 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. The home has a competent staff team that effectively meets service users care needs and robust recruitment procedures ensures that their welfare and interests are protected, however staff are in need of consistent leadership. Evidence: The home has recently reviewed the staffing resources needed for this home and as an outcome has increased the number on duty. There are now four carers and a senior member of staff on duty on each floor and in addition the manager and a team of domiciliary staff, including kitchen staff are available. Staff work with competence and committment and discussed the improvements they have found within the service. They feel more confident that people are listening to their concerns and that care practice is improving within the home. It is felt that the training opportunities now offered have helped with this. Recent training regarding dementia care and safe guarding adults have equipped staff with more understanding of good care practice as well as the understanding of service users behaviours. Although staff are confident that the service is developing in a positive way they demonstrated their concerns regarding the inconsistent leadership that they have experienced for some time now and confirmed that they look forward to having one
Care Homes for Older People Page 23 of 31 Evidence: person to manage the home and to look towards as a leader of their team. The number of staff qualified in NVQ is below 50 and it is hoped that the new training manager currently being recruited by the Company will address this. A training matrix identifies individual staffs training needs and records in staff files confirms the training attended. Most staff are up to date with mandatory training and plans are in place to address those who are not. Other training is organised to address service users needs and this includes dementia care training, conflict and resolution, death and dying and diet and diabetese. The induction programme programme has been developed to reflect the Skills for Care induction standards. This means that staff receive good training from the start of employment and the standards achieved are compatible with NVQ standards. Rigorous recruitment procedures are in place and staff files include a completed application form, 2 references and a Criminal Bureau Check (CRB). Care Homes for Older People Page 24 of 31 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 reviewing of the homes policies and procedures and the discussions with service users and their representatives are identifying areas of the service that need to be changed and developed further. However the inconsistency of the general management of the home has lead to confusion and instability within the home over recent months. Evidence: There has been no registered manager in the home for some time. The recruitment of a recent new manager failed and managers from other homes in the organisation have acted as temporary managers until a permanent manager is recruited. This has been closely monitored by the regional manager who has had direct contact with the home at appropriate weekly intervals. Although much work to improve the service has been put into action by the temporary managers the inconsistency of leadership has confused staff and service users. Both
Care Homes for Older People Page 25 of 31 Evidence: are now looking forward to having one person to lead the service and someone who is consistent in their approach that they can develop a professional and supportive relationship with. Policies and procedures are currently being reviewed, adapted where needed and brought to the attention of staff. They are discussed in staff meetings and staff are becoming aware of their responsibilities, the standards set by the home and the outcomes of good practice. Service users and their families are informed of any changes in the service during residents meetings where they have the opportunity to discuss their concerns and ideas for the development of the service. A quality system is in place that monitors the quality of the service provided. This involves gaining feedback from service users, relatives and professionals involved with the home and the outcomes are made available to prospective service users. Good health and safety records are kept and advice from other agencies such as the fire service and the environmental health is welcomed and put into practice. Care Homes for Older People Page 26 of 31 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 27 of 31 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 12 16 The registered provider 28/02/2009 must ensure that the plans that are in place to develop various meaningful activities for all service users based on individual need and preference must be put into action and recorded. So that the needs and interests of all of the service users living at the home are addressed and that they live lives that are active, interesting and varied. 2 13 16 The registered provider must ensure that opportunities to take part in activity in the local community is offered to all service users based on their needs and preferences. So that links with the community are developed and/or maintained and service users do not become socially isolated. 28/02/2009 Care Homes for Older People Page 28 of 31 3 18 13 The registered provider must ensure that staff receive training to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. So that service users are safeguarded from abusive practice whether through deliberate intent, negligence or ignorance. 28/02/2009 4 18 12 The registered provider 28/02/2009 must ensure that: the homes policies and procedures regarding good care practice are followed and the health and welfare of service users is maintained; and that staff are encouraged to maintain good and professional relationships with each other and service users at all times. So that service users are safeguarded from abusive practice whether through deliberate intent, negligence or ignorance. 5 31 9 The registered provider 31/03/2009 must ensure that a person is appointed to solely manage the home and be registered with the Commission for Social Care Inspection. So that service users live in a home that is managed by a person that is fit to do so and who can approach their Care Homes for Older People Page 29 of 31 responsibilities fully and competently. 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 So that the care planning system is consistent and all service users benefit from this improvement, the plans to review and up date all care plans within the home should continue. The evaluation process of the care plans should be taken seriously and addressed consistantly, so that any changing need is addressed appropriately. It is strongly recommended that, in the best interests of service users, advice is sought from the homes pharmacist regarding the storage and the recording of the drug diazepam. So that the dignity of service users is always maintained it is strongly recommended that the home continues to follow their disciplinary procedures when the standard of staffs care practice fails to meet the standards set by the home and the National Minimum Standards. It is strongly recommended that service users individual social histories are developed and used as a base line to develop individual activity programmes that are monitored, reveiwed and developed as part of the care plans. It is recommended that the plans to develop the dementia care unit, so that it supports service users to maintain independence while also promoting their well being through motivation and self control, continues to be developed. It is strongly recommended that all staff work through the NVQ standards so that they are equipped with the appropriate skills and competencies required of their role. 2 9 3 10 4 12 5 19 6 30 Care Homes for Older People Page 30 of 31 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 © (2009) 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. Care Homes for Older People Page 31 of 31 - 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!
