Inspection on 25/11/08 for Ashfield Court

This inspection was carried out on 25th November 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Ashfield Court 12/11/08

Ashfield Court 27/11/07

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ashfield Court Great Lime Road Forest Hall Newcastle Upon Tyne NE12 9DH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Janine Smith     Date: 2 5 1 1 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 29 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 29 Information about the care home Name of care home: Address: Ashfield Court Great Lime Road Forest Hall Newcastle Upon Tyne NE12 9DH 01912566344 01912566346 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms June Bowman Type of registration: Number of places registered: Southern Cross BC OpCo Ltd care home 46 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 46 The registered person may provide the following category of service only: Care Home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP - maximum number of places 46 Dementia, Code DE, maximum number of places 46 Date of last inspection Brief description of the care home Ashfield Court provides care for 46 older people who require residential care. Nursing care is not provided. The first floor provides accommodation for 24 service users who have dementia type illnesses. The doors on the first floor have code operated locks to help safeguard service users who may wander. The ground floor provides accommodation for 22 service users, who need care due to general old age. Each Care Homes for Older People Page 4 of 29 Over 65 0 46 46 0 Brief description of the care home service user has a single bedroom with an en-suite toilet and wash-hand basin. The home has been designed to meet the needs of people with physical disabilities and therefore has wide corridors and doorways for easy wheelchair access. There are a number of bathrooms, some of which have baths and showers suitable for use by people with mobility problems. There are attractive lounges and dining areas on each floor. The laundry and staff facilities are on the third floor of the building. There is a garden area to the rear which has gates fitted for added security. Car parking is provided at the side of the home. The home is located on a main road in Forest Hall, which provides good transport links. The local shopping centre is about a mile away. Information about the home, including inspection reports, was readily available in the reception area. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Before the visit we looked at: Information we have received since the last visit on 27th November 2007. How the service dealt with any complaints and concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service and their relatives, staff and other professionals. An unannounced visit was made by Mr M. Earnshaw, pharmacist inspector, on 12th November 2008. A separate detailed report has been written about his visit. An unannounced visit was made by Mrs J. Smith, Regulation Inspector, on 25th November 2008. Care Homes for Older People Page 6 of 29 During the visit we: Talked with people who use the service, relatives, staff, the manager and visitors. Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around parts of the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last visit. We told the manager what we found. 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 services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. There are some outstanding requirements for this service. We are not taking any enforcement action at this time, but would do so in future in these are not met. What the care home does well: What has improved since the last inspection? Staff ensure that footrests are in place before they transport anyone in a wheelchair, which means this can be done safely. The company is introducing a new system for meals, known as Nutmeg, which will provide a better choice of menus. The company have introduced a new Deputy Manager post, and this person had recently started work in the home. Care Homes for Older People Page 8 of 29 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 29 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 29 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. People who use the service have the information they need to help them decide if this is the right home for them. Evidence: The home has a Service Users Guide, which was available in the reception area. A copy of the last inspection report was also readily available. Three surveys were received from service users and all three said they received enough information about the home before they moved in, which helped them decide it was the right place for them. All three said they also received a contract. A care plan for someone recently admitted showed that assessments of the persons needs had been carried out before they were admitted, which helped the manager to be sure their needs could be met. Care Homes for Older People Page 11 of 29 Evidence: Intermediate care is not provided in this home. Care Homes for Older People Page 12 of 29 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. Service users health and personal care needs are looked after well, however the quality of care could be improved further if assessment and care planning was handled better. Evidence: Three care plans were looked at. These include a variety of physical and mental health assessments, which are designed to help highlight the help people need with their dayto-day care. A senior carer explained how these were used. The staff work hard to keep these up to date but it was found that these tools are not being used correctly and they are not fulfilling their purpose. For example, a tool known as MUST, which is used to identify whether people are at risk of malnutrition, was not being used correctly. Only one factor, a residents body mass index, was being taken into account when scoring the tool. Similar findings were made at the last two key inspections. There were up to date care plans in place of variable quality. Mostly, these tended to be impersonal and lacking in detail. For example, a care plan for a service user who Care Homes for Older People Page 13 of 29 Evidence: has had several falls, did not describe the nature or impact of her visual impairment on her day-to-day life. However, this did not have a detrimental effect on the quality of care provided. The manager and a senior carer confirmed that retraining in the use of these tools is about to take place. The records did show that residents were receiving routine and necessary healthcare when needed and their weight was being monitored regularly. Service users who completed a survey, said they always received the care and support they need, as well as medical support. One said, the staff are friendly and helpful and when I had a fall they were very supprotive to make sure I was ok. Another said, the care staff give me my medication regularly and the doctor has attended to me when needed. Two surveys were received from health professionals who visit the home, who both said that service users health care needs were usually met by the home. One said, A patient has hospital acquired pressure sores. This resident has been well cared for in the home. Staff seek advice when patients are at risk of pressure damage or have other health needs. Both health professionals who completed a survey said that service users privacy and dignity was usually respected. Service users were observed to be well-dressed in their individual styles. Their glasses (where worn) and teeth looked very well cared for and were sparkling clean. A pharmacist inspector carried out a separate inspection of the medication arrangements. This followed notification of two medication errors involving controlled drugs, which have occurred since the last inspection. The pharmacy inspection identified that some improvements were required in storage arrangements and record keeping, but overall medication was being managed well and appropriate steps had been taken to ensure that all medication was administered correctly. Care Homes for Older People Page 14 of 29 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 live their lives as they wish and can choose from a reasonably good range of food and activities. Evidence: Some time was spent mid morning in a lounge on the first floor used by people with dementia. The carers put on music cassettes and encouraged residents to sing and clap. Residents actively enjoyed this. The carers did not notice, however, that the television set was also switched on with sound in the same lounge, at the same time as the music was playing. Staff also spent time chatting with residents, organising card games and reassuring them when necessary. When the community nurse came to a see a resident, a carer carefully explained this to the service user and provided assistance in a caring and sensitive way. It was noticed a tray of orange drinks had been left on a side table and looked untouched. During this time residents were served other drinks and mince pies. Three surveys were received from service users, who said that there was always or sometimes activities they can take part in. One mentioned, painting, lotto, pattern work with coloured patterns, films and musical nights. A relative sent a photograph Care Homes for Older People Page 15 of 29 Evidence: which showed his mother enjoying a musical entertainment. The following comments were also received from relatives who completed surveys. The home encourages good comradeship between residents. Treats residents maturely, the home fosters a friendly welcoming atmosphere. Maintains a relaxed relationship between staff, residents and visitors. Relatives spoken to said that they were always welcomed into the home. A relative commented in a survey, They have encouraged my mother to maintain some independence rather than doing everything for her. If she wishes to remain in her own room they dont force her to go to the lounge but would encourage her if there was an activity on offer. Mixed views were received about the food. In surveys, one resident commented, I think they could have a better selection at teatime. A relative said in a survey, the home provides a good standard of food and drink. Another said, the meat is often tough and unable to be eaten. My relative relies on eating sandwiches. On the day of inspection, the cook was unwell and the manager took over her duties. A choice was prepared for lunch of bacon chop and accompaniments or a mince dish followed by bread and butter pudding or banana and custard. A birthday cake was also made for a birthday celebration. The manager said that a new system was to be adopted for meals, known as Nutmeg and was able to show the new menus which were to be put in place. These showed more choice would be provided for evening meals and also vegetarian meals. A visitor said his relative did not always eat well, due to her dementia, but the staff help her. Care Homes for Older People Page 16 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to express their concerns and have access to a robust complaints procoedure. Steps are taken to protect them from abuse. Evidence: The manager said that they had received two complaints since the last inspection, one about a resident not wearing this spectacles and another about an unsuitable bed. Three service users and five relatives, who made comments through surveys, said they knew how to make a complaint if they were not happy about anything and were confident their concerns would be dealt with. One service user said, I have no complaints at all. Two health professionals who completed surveys said that any concerns were always or usually dealt with appropriately. Four members of staff who completed a survey were very clear about what to do if a service user had concerns or complaints. During the visit, two members of staff confirmed that they had received training about protecting vulnerable adults from abuse. Evidence of this training was seen on the staff records viewed and in the training schedule. The home has a whistle blowing policy and a carer could describe what this was about. Care Homes for Older People Page 17 of 29 Care Homes for Older People Page 18 of 29 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 a well-maintained home, which is kept clean and safe. Evidence: Each service user has a single bedroom with an en-suite toilet. Bedrooms seen were clean, comfortable and individualised. The manager said that residents prefer to use the bath which has mobility aids. As a result one bathroom has been converted to a hairdressing room and another one being used for storage. There have been two outbreaks of sickness and diarrhoea due to viruses since the last inspection. The home appropriately sought advice from the local Infection Control Team. The housekeeping manager explained the cleaning routines in the home and the processes used to avoid cross-infection. Staff are provided with protective clothing. Three residents who completed a survey said that the home was always or sometime clean and hygienic. A relative who completed a survey said the home was kept clean, healthy and warm. A health professional who completed a survey said, the home is fresh and clean. Each room is comfortable and individual. Care Homes for Older People Page 19 of 29 Care Homes for Older People Page 20 of 29 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. Staff in the home are trained and usually in sufficient numbers to support the people who live in the home. Weaknesses in the vetting system for new staff could potentially place service users at risk. Although there are some concerns about handover of information, this does not appear to affect the quality of care provided. Evidence: There were 43 service users staying in the home and a new admission due that day. Examination of the rotas and discussion with the manager and staff showed that the numbers of care staff are as follows: Between 8 am to 2 pm there are 7 care staff; between 2 pm to 8 pm 6; and between 8 pm to 8 am there are 3. The above includes a senior carer on each shift and floor. The managers hours are not included in the above, nor staff employed for other tasks such as food preparation, cleaning or laundry. The company have recently introduced a new post of deputy manager, and this person had recently started work in the home. Three residents who completed a survey said that the staff are always available when they needed them and that the staff listened and acted on what they say. One said, Care Homes for Older People Page 21 of 29 Evidence: staff are wonderful and very attentive. A relative said, there is no lack of support and very helpful. Another said, kind and caring they appear to be. Four staff who completed surveys felt that there were not always enough staff, due to absences through sickness and long delays in replacing staff who have left. All felt that more staff were needed. One said, sometimes when (there are) only three staff on the EMI (first floor) and one or two residents are unwell the workload can be very heavy. Staff spoken to during the inspection felt that staffing needed to be increased on the first floor through the night, especially as some residents may get agitated or have a fall and need more staff input. The manager said that she has requested that the company provide an additional night carer and she expected this to be approved. She also thought that the addition of the deputy managers post would help with the general workload on staff. Most of the carers who completed a survey said they were kept up to date with issues affecting residents but one said that carers are no longer involved in handovers (meetings of incoming/outgoing care staff between shifts to exchange information about service users wellbeing). The carer thought that the lack of handovers makes it harder to keep up to date. Another carer also expressed concern that the lack of handovers would cause delays in passing on important information about service users wellbeing. The manager was aware of these concerns, which had come about as the company which took over the running of the home about a year ago, only pays staff for the length of their shift. This means that if staff give or receive a verbal handover of information before or after their shift, they must do this in their own time unpaid. The records of two staff recruited recently showed that pre-employment checks had been carried out, including two references and checks with the Criminal Records Bureau. Applicants are also required to complete a declaration as to any cautions or convictions they may have. Both declarations had been signed but one person had not answered the question asked about cautions or convictions. A record of induction training was seen on one of the staff records looked at but not the other. The manager said that the member of staff had their induction pack with them. Four staff completed surveys and all four said their induction training covered most of what they needed to know to do the job when they started. One said, it gave me a lot of information as to how to deal with not only residents but also their family and visitors, and also what standards of care I would be expected to give. The manager said that 12 of the 24 care staff (50 ) have achieved a National Care Homes for Older People Page 22 of 29 Evidence: Vocational Qualification (NVQ) at level 2 or 3. Carers spoken to confirmed the training they had had and evidence was seen on a sample of staff records. The staff spoken to said they felt confident that the training they had, had given them the skills needed to carry out their job. Four staff completed a survey and all said that they had received good training, although one thought they had not had enough information about diversity and equality, whilst another thought the training in this area had been very helpful. One added that they had been well supported by management and colleagues to gain the knowlege and experience needed. Relatives who completed surveys said that the staff always or usually had the right skills and experience to look after people properly. Two health professionals who completed surveys said that the care staff usually had the right skills and experience to support residents social and health care needs. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and adminstration of the home is based on openess and respect and there are effective quality assurance systems. Evidence: Mrs June Bowman has managed the home well for some years and is registered by the Commission. Comments received from staff who completed surveys included, the manager is always available to discuss any problems or concerns within the home, I have found my line manager very approachable and supportive. The company has a quality assurance system in place, which includes regular audits of systems in the home as well as surveys of service users and other interested stakeholders in the service. Some service users have money, which is kept in a bank account looked after by the homes administrator. There are systems in place to record the amounts belonging to Care Homes for Older People Page 24 of 29 Evidence: each resident, interest accrued, and to give receipts when monies are paid in. The administrator also updates computer records about the fees paid by or on behalf of residents, but these were not available on the day of the inspection. The company carries out internal audits. The administrator felt that it was sometimes difficult to carry out his job effectively as the reception area he works in is cramped, noisy and provides little storage space. The manager was aware of these concerns and was trying to address them. There is a training programme in place to ensure that the staff team are given training in moving and handling skills, fire safety, first aid, food hygiene and infection control. Evidence of training was seen on the staff files looked at and confirmed by the staff spoken to. A sample of servicing/maintenance documentation was seen for some of the hoisting equipment and gas appliances. Records are kept of checks carried out to ensure that water temperatures and window opening restrictors protect residents from harm. Records also showed the checks carried out on the fire safety systems. Care Homes for Older People Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action 1 7 15(1) Each service users plan of 31/05/2009 care must fully describe their needs and the help they require from care staff. It is advisable that all care plans cover the areas outlined in Standard 3.3 of the National Minimum Standards. For instance, recording any difficulties a service user has with their vision and how this affects their day to day life and what help they need from staff; recording each residents nutritional status, their preferred or required dietary requirements, what help they need with eating. Staff must be given training as necessary to meet this requirement. Written entries in the care records must be signed and readable, as otherwise important information may be misunderstood. 2 8 14(2) Assessments of risk, 31/05/2009 including malnutrition, falls, pressure areas, must only be carried out by care staff who are fully trained in the assessment process and able to put an effective plan of action in place, where required. Page 26 of 29 Care Homes for Older People 3 9 13 All medication, including medicines awaiting disposal, must be stored safely and securely. This will protect medicines from loss, theft or being tampered with. 12/12/2008 4 9 13 MAR charts for as required medication must contain adequate information about the dose and timing of administration. This will make sure that medicines are given as intended by the doctor thereby protecting the health of the individual. 12/12/2008 5 9 13 Medication with limited use once opened must only be used in line with the manufacturers recommendations. This makes sure that medicines are always safe to give when needed 12/12/2008 Care Homes for Older People Page 27 of 29 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 29 19 Declarations made by 28/02/2009 applicants for posts in the home in respect of any cautions or convictions must be carefully checked to ensure that the applicant has answered the question put. This helps to ensure that unsuitable people are not employed and so helps to safeguard the service users. 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 12 The television should not be played at the same time as music activities take place in the lounge especially for people with dementia. This will help to reduce the noise and distraction level. The staff should be encouraged to have verbal handovers between shifts and should be paid to do this. This encourages good communciation about the needs of residents and good teamwork. 2 27 Care Homes for Older People Page 28 of 29 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 29 of 29 - 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. 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