Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Amathea Care Centre Newlands Lane Workington Cumbria CA14 3JG 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: Nancy Saich
Date: 0 1 1 0 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 28 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 28 Information about the care home
Name of care home: Address: Amathea Care Centre Newlands Lane Workington Cumbria CA14 3JG 01325351100 0190063269 amathea@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Sharronn Miller Ms Collette Redhead Type of registration: Number of places registered: Trinity Care Limited care home 40 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: The registered person may provide the following categories of service only. Care home with Nursing - Code N To people of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE (maximum number of places: 20) Physical disability - Code PD The maximum number of people who can be accommodated is: 40 Date of last inspection Brief description of the care home Amathea is owned by Trinity Care Ltd which is a wholly owned subsidiary of Southern Cross Health Care Ltd. Southern Cross owns a number of residential care homes throughout Britain. The registered manager post is currently vacant but there is an Care Homes for Older People
Page 4 of 28 Over 65 0 40 0 20 0 40 Brief description of the care home acting manager who is applying to be registered with CSCI. The house is a new purpose built nursing home for people in the categories listed above. The home is situated in a residential area of Workington and is in easy reach of all the amenities of the town. The town has both bus and rail connections. The home has its own secure garden and parking to the front of the property. Accomodation is in single, ensuite rooms and is on two floors. The top floor is for people with dementia and the ground floor for older adults and people with physical disability. Further details can be accessed from the manager or from the company. 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: This was the main or key inspection for the year. The lead inspector Nancy Saich asked the manager to fill out a form called the Annual Quality Assurance Audit (the AQAA). This asks for details of what has improved in the home since the the last inspection and for the plans for the coming year. This was completed but returned to us later than the date we required. We had also undertaken a Random Inspection in July 2008 when we made four requirements and five recommendations. The letter following this inspection can be requested from our Preston office. We then sent out postal surveys to people who live in the home and to the staff group. We had a good response to these surveys and we quote from them in the report. The responses were fairly positive and gave us a good picture of what its like to live and Care Homes for Older People
Page 6 of 28 work in the home. Nancy Saich and Jenny Donnelly went to the home and completed an unannounced inspection on the above date. During this inspection we also completed a Short Observational FrameWork for Inspection (SOFI) observation on the unit for people with dementia. This involved Jenny Donnelly observing how residents interacted with each other and with staff for a period of two hours. This observation also takes into account activities and responses from residents. There was a positive outcome to this observation. We also toured the building, sat in lounges and shared a meal with residents. We spoke to the manager and to the staff on duty. We looked at files and documents that backed up what was said and what was seen. What the care home does well: What has improved since the last inspection? We had evidence to show that almost everyone on the staff had completed a basic awareness course on Adult Protection and now had good knowledge of what constitutes abuse. We saw that the problem we discovered with the fire door in July had been quickly resolved and that routine checks on fire systems and equipment were now upto-date. We had evidence from rosters and speaking to residents and staff to show that the staffing ratios in the home had been improved on since the problems they had had earlier in the summer. We saw that the manager had employed some new staff and changed the way existing staff work and that this meant residents received better care. At the random inspection we discovered that the manager had taken a person on to the staff without adequate checks on this persons background. This matter had been dealt with and new recruitment had been managed in a much improved way. All new staff had suitable checks on their identity and background. We also received evidence on the day to show that the manager had looked at training needs for all staff and had not only made sure that staff got formal training but had also introduced weekly workshops where staff could talk about specific issues related to their day-to-day work. One member of staff told us: I think things are getting better all the time with changes to recruitment and improvements to training...this is a relatively new home so it took some time to get us working at the right level...but I think we are getting there...we learn something new every day...things are going from strength to strength. Care Homes for Older People Page 8 of 28 We were pleased to see that the manager has completed all the work for her Registered Managers Award, is much more aware of the legal responsibilities of her role and has put in her application to become the registered manager for the home. We also had evidence to show that staff are improving the way they report and notify us of any accidents or events that affect the well-being of the people who live in the home. 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 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. This home now only takes new residents if they are sure they will fit in with the exisiting users and that they know they can meet their care needs. Evidence: We spoke to a person who hadnt long been in the home and he was happy with the way he had been admitted. We also looked at his file and saw a good assessment of this persons needs and wishes. We spoke to staff and the manager about new residents and they confirmed that one of the senior staff always went to visit a new person to find out their nursing, care, psychological and social needs. We checked on other residents files and found these to have suitable social work assesments and assessments completed by staff. 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. Health and personal care in this home generally meet peoples needs but staff need to continue to look at the details of care delivery to make sure that people get the best care possible. Evidence: We looked at more than half of the written care plans in the home and we read a number of these in depth. We could see that all of the plans had been checked by the manager or by a senior manager as part of the companys quality monitoring.We could see that many of the care plans had been updated and reviewed and that staff were beginning to introduce strategies to help with things like challenging behaviour. However we did judge that for some people further work was needed on their care plans. We could see that senior staff had noticed shortfalls in some care plans. We recommend that this auditing continues and that staff are supported in making improvements to these. We had evidence from these plans and the daily notes and from residents themselves to show that medical attention was given to them when necessary. Professionals like
Care Homes for Older People Page 12 of 28 Evidence: Occupational Therapists and the Tissue Viability Nurse were used appropriately. We also saw some good plans that showed how nursing staff were giving people support and reviewing their nursing needs. However we also noted that some people needed a little more health care intervention. For example there was one person who we felt would benefit from a medication review with a psychiatrist. We also saw some examples of nursing plans where some nursing interventions were unclear. We checked on medication held on behalf of residents and we judged that the systems for managing these were good. We saw good examples of clear instructions and careful monitoring. There were one or two minor issues seen on the day and these were discussed with staff. We also noted that there had been an improvement to the way medication was given. At the last inspection we noted that the morning medication round had taken until mid-morning but on this visit medication was given sooner. We saw evidence to show that staff audited medication on a regular basis and that this means that any minor issues can be dealt with. We recommend that staff continue to monitor medication to make sure that there is always an audit trail and that drugs are used in date order as we found one or two examples of this not being done. We observed staff interacting with residents during our visit. We also undertook a SOFI observation. This lasted for two hours and we watched staff interacting with the people who live on the dementia care unit. During this we saw staff treating residents in a positive way showing warmth, respect and humour. We noted that staff were relaxed with the residents and that this approach had a positive outcome for people with dementia. We also noted on the unit for people with nursing needs that staff behaved in a respectful and polite way. We checked this out with residents and they confirmed that most staff treated them with dignity and respect and allowed them the levels of privacy they wanted. Care Homes for Older People Page 13 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents in this home have the kind of lifestyle choices that they want and need. Evidence: The lead Inspector arrived at the home just after 8 a.m. and found that only a few people were dressed and having breakfast. Both the dementia care unit and the unit for people with nursing needs were very relaxed and people were receiving care at the level and pace they wanted. This was a marked improvement from the random inspection when there wasnt enough staff available to give people the care they needed. We spoke to residents and checked the daily notes and discovered that residents felt they were given the right kind of attention. Our SOFI observation at lunchtime gave us evidence to show that people were given suitable support to help them at mealtimes. We met a number of visitors on the day who said that they could visit when they wished. We also had evidence to show that people went out to concerts and to the local tea dance and that several trips had been organised to places of interest. There is a monthly communion and local priests visit individual residents. On the morning of the visit it was nice to see residents and relatives from the dementia care unit being part of the coffee morning organised on the nursing care
Care Homes for Older People Page 14 of 28 Evidence: unit. There were activities during the afternoon and our SOFI observation gave us evidence to show that people with dementia enjoyed the music session held on the unit. We saw evidence to show that staff had started to put a lot of thought into suitable activities for people with dementia. We were invited to sit with residents at lunchtime and we joined in a relaxed and sociable meal. The food was of a good standard and was well prepared and presented. The cook was very much a part of the daily life of the home and she spent some time making sure that residents were happy with the food provided. She had a good working knowledge of peoples nutritional needs and was aware of this part of peoples care plans. We also saw residents enjoying afternoon tea with good quality home baking. We judged that people were helped to eat well through the efforts of the staff team. Care Homes for Older People Page 15 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Senior staff in this service need to be more competent in handling safeguarding so that all service users will be properly protected. Evidence: The home had received one formal complaint since the last key inspection and this had been investigated thoroughly and action taken by Southern Cross when shortfalls were discovered. We were sent a copy of this complaint report and were happy with the way this had been managed. On the day of the visit we checked on the complaints log and spoke to residents and staff about how they made their wishes known. Residents said that they were aware of how to complain and several files showed that residents or their relatives felt comfortable enough to complain when a formal review was held. Southern Cross has a suitable complaints procedure and copies of this were available on the day. At our random visit on the 16th of July 2008 we made a requirement about keeping people safe from abuse. We were pleased to see that most staff have now received training on how to protect vulnerable people from harm. When we spoke to staff they had a good knowledge about what was abusive. We also had an example where a member of staff had reported potential abuse to the manager promptly and appropriately. We did however have evidence to show that there are still problems with how these matters are reported. On one occasion Southern Cross had taken action before a
Care Homes for Older People Page 16 of 28 Evidence: multidisciplinary strategy meeting was held and there was evidence to show that sometimes staff were confused about whether to make a referral to Social Services about the alleged victim or about the person who was allegedly the abuser. We judged that senior members of the team were still confused about the process but that the team were now much more aware of what constitutes abuse and were confident about reporting it. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This is a modern home that is kept to a good standard and allows people to be as independent and safe as possible. Evidence: Amathea is a modern, purpose-built home. It has been open for under two years. The home is divided into two units with the ground floor unit for people with nursing care needs. The first floor is a special unit for people with dementia. All of the bedrooms are single occupancy with ensuite facilities. There are suitable shared spaces around the building. The home was designed to make things easy for people who have poor mobility. Outside there is a secure garden with plenty of seating areas for residents to use in good weather. The home is situated in a residential area of Workington and is easy to access by car or by public transport. The town centre is a five-minute drive from the home. We were pleased to note that the staff team have added some touches to the dementia care unit so that people had interesting things to look at and to do in the shared spaces on this unit. We also thought that the colour coded doors and the nameplate on bedroom doors helped people who could become disorientated. The home was clean, warm and bright on the day of our visit. Everyone spoken to was pleased with the way the staff cared for their clothing and bed linens. There was no
Care Homes for Older People Page 18 of 28 Evidence: odour detected at any time during the day. We walked around the building and there was no hazards to be seen. The main kitchen and laundry were clean , organised and tidy. 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. This home has recently increased numbers of staff, changed the way they are deployed and is working hard on training and team development so that residents will be cared for appropriately. Evidence: When we made our random visit in July 2008 we discovered that there was not always enough staff available to cover all shifts. We made a requirement about this and on this visit we were told by the manager that Southern Cross had been working on this problem. We saw evidence to show that the rosters had been changed so that some people did not work such long hours and staff were deployed appropriately so that shifts could be covered. We looked at four weeks worth of rosters and saw that shifts had been covered so that there was enough staff available to care for residents. We also looked at staff files and discovered that people had been supported and assisted to improve their sickness absence. The manager had taken on some new staff and when we spoke to the existing staff team we found that they felt things had improved and they were under less pressure. We checked on the qualifications of staff and we discovered that care staff were qualified in level two National Vocational Qualification and that nurses employed by the company were suitably qualified.
Care Homes for Older People Page 20 of 28 Evidence: We looked at the files of the latest recruits and found these to be in order. At the last inspection we did discover that someone had been taken on without appropriate checks. This problem was resolved and there have been no further instances of new staff starting before background checks are completed. We spoke to a number of staff on duty on the day and received several surveys from others. We discovered that they were receiving suitable levels of training and everyone we spoke to had completed training in adult safeguarding. We spoke to nursing staff and they confirmed that they had regular updates to training in clinical procedures as well is attending some of the other training completed by all staff. Staff told us that they had received training on all sorts of topics and that they had started to have a weekly informal training session where one of the nurses led discussion groups on things like assessment, care planning, dementia care and manual handling. Staff said they liked this as they could focus on individual needs. There was also formal training being undertaken on the day of our visit. This home has only been open for a relatively short time and we were pleased to see that there is both formal and informal training and staff development being undertaken. We look forward to seeing the outcomes of this work. 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. This service needs to make sure that all management systems are running as efficiently as possible so that service users have a safe and organised home to live in. Evidence: This home has had a change of manager in the last year and the new manager is in the process of becoming registered. On the day of the inspection she told us that her application had been completed and she was waiting for an interview date. When we completed the random visit in July 2008 we considered that the new manager had experience of working in nursing homes and in hospital settings but that she was still in the process of understanding what this new role might mean. At this visit we could see that she had familiarised herself with the legislation and had started to look at things like management systems. We had evidence to show that senior managers from Southern Cross were giving her support and that a more experienced manager had spent a week with her helping her look at management systems and time management. We judged that she had made a great deal of
Care Homes for Older People Page 22 of 28 Evidence: progress since she took up her post and she now feels ready to be the registered manager. She has told us that she had completed her Registered Managers Award in the last six months and was waiting for the certificate to confirm that she had completed this. Our surveys and discussions with residents and staff give us evidence to show that people are beginning to feel confident in her ability and that they find her to be approachable. Southern Cross has a company Quality Assurance system that helps managers to discover the opinions of residents and other interested parties. It also allows for all aspects of the operation to be monitored and audited on a regular basis. A full audit had taken place after the first year of operation and we could see that quality monitoring happens on a regular basis. We look forward to receiving a copy of the next quality monitoring audit when it is completed. We checked on money kept on behalf of residents and found that everything was in order. The administrative officer explained the system to us and told us that residents money was checked on a monthly basis by the company. We learned that Southern Cross had completed a partial audit of residents money after the first year of operation and no problems had been found. We checked on the records of supervision for the staff and found that these had been done on a regular basis and that the content was now more detailed. Staff confirmed that they received regular supervision from senior staff and nurses confirmed that they had clinical supervision. During both our inspections this year we read a number of records and files and we found that in general Southern Cross have good recording systems. We judged that in some instances records may be too extensive and we talked to the manager about how to deal with this kind of volume. She agreed to look at things like archiving to help make the systems work more smoothly. We checked on records of accidents and incidents that the manager needs to inform us of under the regulations of the Care Standards Act. We could see that the staff team have improved the way they record and inform us but we were concerned that there is a delay in these notifications arriving with us. We recommend that Southern Cross look into why this is happening. We did not receive the AQAA for this service on time although we were told that it had been completed sometime before the due date. Again we want Southern Cross to look into the reasons for such delays When we visited the home in July we found a problem with a fire door that the company had dealt with quickly. At this visit we saw no apparent hazards and we saw some improvements had been made to lessen risk further. We saw some good examples of regular checks on equipment and systems in the home. We had evidence to show that things like food hygiene were being dealt with correctly. We looked at fire safety in the home and we could see that there were good systems
Care Homes for Older People Page 23 of 28 Evidence: to deal with this. We had evidence to show that things like the emergency lights and fire extinguishers were checked on a regular basis. When we checked on the fire log book we discovered that some staff had not received enough drills and instructions for them to be confident about how to manage a fire situation. We also noted that the fire risk assessment was out of date and the new assessment needs to be completed. Care Homes for Older People Page 24 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 25 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 18 13 All staff members who are 28/11/2008 left in charge of the service must be made fully aware of the local protocols for reporting Adult Protection appropriately. Southern Cross must make sure that all senior staff are competent in managing this process. This must be done in order to protect vulnerable older people from abuse and in order to comply with regulation 13 (6) 2 38 23 The registered person must 28/11/2008 ensure that all staff receive fire drills and instructions on a regular basis and that fire risk assessment is updated regularly. This must be done to lessen the risk of fire and to allow all staff to be confident in managing fire safety. 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 It is recommended that the registered person continues to review and update care plans to ensure that each plan contains sufficient detail and clear strategies to give good care to every resident. It is recommended that the registered person continues to review the arrangements for health care in the service. It is recommended that the registered person continues to keep the management of medication under review. It is recommended that the registered person continues to support the new manager so that a successful registration can be completed without delay It is recommended that the registered person review the systems for notifying or responding to CSCI. 2 3 4 8 9 33 5 37 Care Homes for Older People Page 27 of 28 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 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!
