Inspection on 06/05/09 for Anchor House

This inspection was carried out on 6th May 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Anchor House 08/05/07

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2009.

Key inspection report Care homes for older people Name: Address: Anchor House 11 Avenue Road Wheatley Doncaster DN2 4AH The quality rating for this care home is: zero star poor service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Valerie Hoyle Date: 0 6 0 5 2 0 0 9 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. things that people have said are important to them: 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 They reflect the We review the quality of the service against outcomes from the National Minimum Care Homes for Older People Page 2 of 26 Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Anchor House 11 Avenue Road Wheatley Doncaster DN2 4AH Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration Category(ies): old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home only – Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category – Code OP Date of last inspection: Brief description of the care home: Anchor House is registered as a care Home for up to 23 persons who require residential care. All bedrooms are single occupancy and located at ground and first floor levels. A chair lift and stairs access the first floor. There is a lounge and dining room with communal areas on the ground floor. The registered provider is Authentic Care Services Ltd and the Home has a manager in place, although she is not the registered manager. The Home is located in a residential area approximately one mile from Doncaster town centre. It is easy to access with a regular bus service. There is on street parking. There is a small garden to the front of the property and a larger garden to the rear. 0 8 0 5 2 0 0 7 Number of places (if applicable): Under 65 0 Over 65 23 Authentic Care Services Ltd Vacant Care Home 23 01302327004 01302327008 jas_toor@ntlworld.com Care Homes for Older People Page 4 of 26 The registered person makes information about the service available to residents and their families via the homes Statement of Purpose and Service User Guide, which are presented in a Service Users handbook. The last inspection report dated 8th May 2007 is available at the home. Information gained during this inspection confirmed fees are 389 pounds and 72 pence per week, additional costs include hairdressing, private chiropody and newspapers. Care Homes for Older People Page 5 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: zero star poor service How we did our inspection: The quality rating for this service is 0 star. This means that the people who use the service experience poor quality outcomes. This unannounced inspection took place over 7 hours starting at 09:00 finishing at 16:00; this included a partial inspection of the home. Seven people who use the service, two relatives, and the manager were spoken to during this inspection; their views are included throughout the report. Five staff were spoken to during this inspection including the cook, deputy manager, activity coordinator and care staff. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be Care Homes for Older People Page 6 of 26 taken. Occupancy at the home follows current trends with 19 of the 23 beds occupied. Three peoples care plans were looked at. Policies relating to medication, complaints, protection of vulnerable adults and handling of peoples monies were looked at. Three staff recruitment and training records were looked at to assess how people were protected. Procedures and risk assessments relating to health and safety were looked at and discussed with the deputy manager. The manager is Karen Greaves; she has the required management qualifications, competencies and skills, although she has not submitted a application to CQC to be registered. The AQAA was sent to the home and was returned to us on time, which demonstrates responsiveness and cooperation, however the AQAA only contained the minimum information and some sections were not fully completed. An Annual Quality Assurance Assessment is a self-assessment and a dataset that is filled in once a year by all providers whatever their quality rating. It is one of the main ways that we will get information from providers about how they are meeting outcomes for people using their service. The AQAA also provides us with statistical information about the individual service and trends and patterns in social care. The inspector would like to thank everyone who agreed to being interviewed as part of the inspection process, and the friendliness of staff. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: The home must ensure that they can continue to meet the needs of people who use the service. To ensure they do not provide a service to people who are outside their registration category. Medication procedures need to improve to ensure staff can safely administer medicines to people who use the service. Staff must follow best practise when recording medication received, administrated and returned to the pharmacist. Staffs competencies must be checked as they have not received refresher training since 2004. Quality assurance systems could be improved to include a question to check that people are aware about the homes complaints procedure and how to raise their concerns. The complaints records looked at confirmed that no complaints have been received since the last inspection of the home. The registered provider must complete a quality assurance report (Regulation 26) and make it available for inspection. This is not currently undertaken and the registered provider appeared to not be aware of her responsibilities under this regulation. The manager must ensure that recruitment procedures are followed when employing new staff, as essential checks had not been undertaken on the files looked at. Essential refresher training is required to ensure staff have the right skills and competencies to act in case of an emergency. Training is also required in the protection of vulnerable adults. The manager must submit an application to CQC to be registered, as she has not followed up the submission of an application in 2007. Care Homes for Older People Page 8 of 26 Essential health and safety checks must be undertaken and evidence must be sent to us to confirm they are undertaken. Sufficient staff must be on duty to ensure the home is maintained in a clean and hygienic manner. The refurbishment of the home must continue to ensure the furnishings are fit for purpose and bedrooms must be clean and have a good standard of furnishings. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Care Homes for Older People Page 9 of 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 10 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 the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are assessed before moving into the home, although the home must be able to demonstrate peoples needs can be met. Evidence: The home has an assessment document that is used to assess the needs of people who use the service prior to admission to the home. A completed assessment was looked at and it contained adequate information to make decisions on how staff will deliver the care. A number of care records looked at indicated that people needed support with their mental health. The manager should make sure that staff can continue to meet their mental health needs. They must make referrals back to social services if peoples needs change. This is to ensure the home does not provide care outside of their registration category. 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 the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans generally provided adequate information to protect people who use the service. Medication policies and procedures must be improved to make administrating medication to people safer. Evidence: A number of care plans were looked at. They included adequate information to enable staff to deliver peoples care. Risk assessments and daily records were sufficient to maintain peoples safety, and there was evidence that the plans were reviewed. The home continues to work closely with social services, commissioners/contracts compliance and they have agreed to offer further training to staff regarding care planning. Peoples health care needs were met and the home works closely with district nurses to ensure peoples nutritional and skin care needs are met. A number of people continue to be supported with their mental health needs with regular contact with consultants. Staff have had training on caring for people with dementia and they have access to the Older Adults Liaison Team for advice. The manager must ensure they can continue to meet the mental health needs of people and must refer people for reassessment where appropriate. Care Homes for Older People Page 12 of 26 The home had adequate medication policies although they should be reviewed to ensure they meet the Royal Pharmaceutical Society and CQC best practice guidelines. An audit of medication showed they were generally well managed although it was difficult to audit medication received for people on respite care. A number of records did not show the amount of medication received, date commenced or who had received the medication. One person had brought in medication in a dosage system but it did not describe the medication contained in the box. This poses significant risk to people as they may not receive medication as prescribed. Medication must only be administered with the original pharmacist labels. Two items brought in by a person were not listed on the household remedies record but were stored in the medication trolley. Photographs were missing from medication administration records and there was no record to confirm the temperature of the fridge used to store medicines. This should be undertaken daily. There was a number of medicines which were due to be returned which were dated February and March 2009. They had not been recorded in the returns book as required in the medication policy. There was a months supply of medication for one person that had not been booked in on their MAR charts. The supplying pharmacist had undertaken an audit in February 2009 and they continue to provide support at staff at the home. Staff had received training to administer medication, although most had received the training in 2004. There was no evidence to confirm further refresher training or observation of practice had taken place, or that staffs competencies had been checked. 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 the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to socialise with family and friends and mealtimes were well managed. Food stocks must be sufficient to ensure snacks and alternative menus are available. Evidence: The home has an activity coordinator who plans and facilitates social events for people who use the service. She keeps weekly records of the activities and completes social care plans for each individual. People enjoyed games of bingo in the morning and the coordinator spent time on a one to one basis in the afternoon. She said fund raising takes place to provide money for entertainment and she appeared keen and motivated to engage with people who use the service. Quality Assurance Surveys last completed identified that more outings and better entertainment was needed, and one person confirmed they wanted to go out more and said trips seemed to be limited but she enjoyed the activities provided in the home. Relatives and visitors to the home confirmed they were able to visit at any time. One relative said staff always made her feel welcome and they always keep her informed of any significant events that affect her parent. Meal times were appropriately managed. Staff offered support and people were given a choice of main course and liquid refreshment. The main meal was served at 12 noon which means people could go for long periods of time without a substantial meal. Consideration should be given to have the main meal later to ensure people do not go for long periods without a hot meal. The manager said a hot choice of menu was available at tea time except for on Care Homes for Older People Page 14 of 26 Sundays, which included soup, beans or scrambled egg on toast. Meals are served directly into the dining room already plated up from the kitchen which is situated in the basement of the home. People were served their meals on large tea plates although none of the people seemed to mind having smaller portions. The choice of meal was displayed on the notice board, although this did not correspond with the menu compiled by the cook. The manager said shopping for food was undertaken weekly at local supermarkets. She said food is usually purchased to correspond with the menu. An inspection of the kitchen and stores found supplies extremely low. There was very little fresh produce and the freezer only had a few loaves of bread and small packets of fish and meat. Stores of tinned food and dry goods were also extremely low which concerned the inspector as there were little provision for snacks and alternatives for each meal provided. The manager said shopping normally takes place on Wednesdays (day of inspection), although it had not been undertaken due to assisting with the inspection process. 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 the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints and safeguarding procedures are followed although staff require training in the protection of vulnerable adults. Evidence: The complaints procedure needs to be updated as it has incorrect information about the name of the home and contact details of CQC. The AQAA confirmed that no complaints had been received in the last twelve months. Previous reports also states that no complaints had been received since 2006. The manager should ensure that people are aware of the process to raise concerns as some people said they were unaware of the procedure. The home has procedures to ensure people are protected and the manager has followed the procedures for the one incident recorded at the home. Social services have not concluded their investigations although the action taken by the manager ensured that peoples safety was maintained. The manager currently cascades training on the protection of vulnerable adults. However to ensure the information staff receive is consistent they should obtain training from an accredited source, so that staff are alert to the signs of abuse and know what action to take. 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 the 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 requires some refurbishment to ensure it is maintained in a clean and hygienic manner Evidence: A partial inspection of the building found areas requiring major refurbishment. Social Services contracts/compliance had been undertaking visits to the home and had made requirements to improve the infection control measures and the refurbishment of soft furnishings in both communal and bedroom areas of the home. Chairs in the lounges were in extremely poor condition and the dining facilities require deep cleaning. The manager said that there were plans to replace a number of the lounge chairs. Some of the furnishings in peoples bedrooms were poor, although the manager said new mattresses had been purchased for some of the bedrooms. Bedding and curtains were poor and did not match any of the decor. A number of carpets were in poor condition and a number of rooms had a stale unpleasant odour. Sluicing facilities had been fitted but not commissioned and bathrooms were generally untidy, and some had been used to store equipment. They looked like they were not used for bathing. Domestic arrangements at the home were inadequate to maintain a clean and hygienic environment. Domestic staff were only employed to work 5 days of the week with no cover at the weekend. The manager said care staff undertake basic cleaning during periods when there was no cover. Care Homes for Older People Page 17 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 the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have the skills and knowledge to fulfil their roles within the home, although some refresher training was needed. There was a stable staff group. Recruitment policies were generally followed, however some key records were missing. Evidence: The levels were adequate during the day as the manager, activity coordinator and domestic staff were available to give assistance. The levels in the afternoon and evenings must be kept under review as two staff to nineteen people is insufficient. This judgment was made taking into account the dependency levels of people living in the home. Domestic levels must be in sufficient numbers to ensure the home is maintained in a clean and hygienic state. There is a stable staff group with some staff that had worked at the home for a number of years. A number of staff recruitment files were looked at. One person did not have a Criminal Records Bureau check. There was no evidence to confirm gaps in employment had been checked or proof of identity had been checked. A risk assessment must be undertaken and she must not work unsupervised until clearance is received. Staff have adequate skills and competencies to meet the needs of people, although some essential refresher training is now required. Safeguarding adults, health and safety, infection control and food hygiene are all out of date. The manager said funding and training organisations had been identified for some of the training while other training still needs to be organised. Care Homes for Older People Page 18 of 26 The home continues to meet the required levels of NVQ qualified staff. They are commended for their commitment to gaining a recognised qualification. Care Homes for Older People Page 19 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 the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health and safety procedures do not ensure people who use the service are kept safe. The financial interests of people are safeguarded, and the home seeks the views of people who use the service. Evidence: The manager was appointed in 2006 and she has a number of years experience working in residential care. She has completed the Registered Managers Award and NVQ Level 4 in management. She submitted an application to CSCI in the summer of 2008, although this appears to have been lost. She must resubmit a new application to CQC to become the registered manager. The manager works generally off the rota, although she said she covers for carers where needed. She has responsibility for the day to day management of the home and she is in regular contact with the registered provider. An audit of peoples personal monies confirmed accurate recording takes place. A number of records showed negative balances. The manager should take steps to ensure people have sufficient funds available. Care Homes for Older People Page 20 of 26 The manager undertakes quality audits to ensure people can express their views on the quality of the service. The last quality assurance surveys were completed in November 2008. The manager was aware of the outcomes of the survey although they had not been formally collated or published. The survey could be developed further to give more options for people to express their views. The current survey only gives an option of answering yes or no to questions. Some additional questions about how to raise complaints could be added. The registered provider visits regularly, although she has not produced a Regulation 26 (quality report) which should be made available for inspection. When asked the registered provider said that she asks the manager what is happening at the home and what is needed. She did not interview people who use the service, their relatives and people working at the home, only the manager. She did not inspect the premises, records or any complaints. The management of health and safety systems were poor. Portable Appliance Testing (PAT) had not been undertaken since 2006. This poses significant risk of harm to people who use the service, as appliances may not be fit for use. Fire safety checks had not been undertaken and staff had not received any formal training in the last 2 years. This means staff may not understand action to be taken in the case of an emergency. Care Homes for Older People Page 21 of 26 Are there any outstanding requirements from the last inspection? Yes 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 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 4 14 Peoples needs must be 06/072009 assessed so that the home is clear that they can meet their needs. This will ensure that people are not admitted who fall outside the homes registration category. 2 9 13 Arrangements must be made 06/07/2009 to ensure that accurate records are kept of all medicines received, administered and leaving the home or disposed of.This helps to confirm that medication is being given as prescribed and facilitates Page 22 of 26 Care Homes for Older People accurate checking of stock levels. This will ensure people receive their medication as prescribed. 3 9 13 Medication must only be 06/07/2009 administered from its original packaging. To make sure the medication is as prescribed from the Pharmacist. 4 18 18 Staff must receive training to 06/07/2009 ensure they are alert to signs of abuse and know what action to take. To ensure people who use the service are safe and protected. Lounge chairs must be replaced, as the current chairs are in poor repair and are dirty. Dining room chairs must be deep cleaned. The furniture must be fit for purpose and maintained in a clean state to prevent cross infection. 6 26 23 Bedroom carpets must be 29/06/2009 deep cleaned or replaced in rooms with offensive odours. To ensure the rooms are fit for purpose. 7 27 18 Adequate staffing levels must 29/06/2009 be maintained, in the afternoon. Domestic levels must be sufficient to maintain a clean and hygienic environment. This will ensure peoples need can be met, and they can live in a clean home. 7 29 18 A new CRB must be obtained 29/06/2009 for all new staff employed at Page 23 of 26 5 19 23 29/06/2009 Care Homes for Older People the home. Proof of identity (passport and birth certificate) must be included in the employment checks and gaps in employment history must be checked and recorded. This will ensure the right people are employed to keep people safe. 8 31 26 The registered provider must 06/07/2009 undertake a monthly quality audit (Regulation 26) and the reports must be made available for inspection. So that we can assess the quality of the service provided. 9 38 23 Health and safety checks must be undertaken to ensure equipment is fit for use. This means making sure portable appliance testing takes place and fire safety training is provided for all staff. 06/07/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 Handwritten entries on the MAR must be accurately recorded and detailed. This makes sure correct information is recorded to administer medication safely. Sufficient supplies of food and snacks should be available at all times to enable people to make choices about the food they eat. Consideration should be given to having the meal later or a hot choice of food should be offered at teatime, so that people do not go for long periods without a substantial meal. The complaints procedure should be reviewed and updated Page 24 of 26 2 15 3 15 4 16 Care Homes for Older People to ensure the correct information is available to people who use the service. The staff should encourage people to express their concerns and the procedure should be discussed at residents meetings to raise the profile. 5 19 Soft furnishings including bedding curtains and towels should be replaced on a rolling programme to ensure they are in good condition. The manager should submit an application to CQC to be the registered manager. 6 33 Quality assurance audits should include areas to give people the opportunity to express views on making complaints. The results from the surveys should be publicised. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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