Inspection on 19/08/08 for Belle House

This inspection was carried out on 19th August 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Belle House 21/09/07

Belle House 19/05/06

Belle House 18/10/05

Belle House 17/05/05

Belle House 25/10/04

Belle House 22/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Belle House Belle Hill Old Town Bexhill-on-sea East Sussex TN40 2AP     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: June Davies     Date: 1 9 0 8 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Belle House Belle Hill Old Town Bexhill-on-sea East Sussex TN40 2AP 01424221624 01424732704 britheadoffice@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Britannia Care Homes Ltd care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of residents to be accommodated is sixteen The people accommodated will be aged sixty five years or over on admission The people accommodated will have senile dementia type illness Date of last inspection Brief description of the care home Belle House is registered to accommodate up to sixteen older people with a dementia type illness. The building is an old converted property situated in the old town area of Bexhill on Sea, close to local amenities. The main town centre with its access to bus and rail routes is approximately half a mile away. Accommodation is provided on two floors and a stair lift is fitted to assist access to first floor accommodation. The registered providers are Britannia Care Homes Ltd who also own another three homes in the area. The home makes CSCI reports available to prospective residents and/or their relatives/representatives upon request. The fee charged as of April 2006 is #345 to #400 per week. Additional charges are made for chiropody and hairdressing. 16 Over 65 0 Care Homes for Older People Page 4 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection took place on the 14th August 2008 over a period of 8 hours. During this time the inspector spoke with the registered provider, registered manager, two members of staff and three residents. The inspector also viewed documentation relating to the key standards inspected and used information obtained from the Annual Quality Assurance Assessment which was sent into the Commission by the registered manager. Care Homes for Older People Page 5 of 26 What the care home does well: What has improved since the last inspection? Staffing levels have improved since the last key inspection on the 21st September 2007. The registered manager ensure that there are three care staff on duty throughout the day with two care staff on night duty. A requirement was made at the previous key inspection for residents to have their nutrition assessed on a regular basis. While this requirement had not been met at the beginning of this key inspection, it was during the course of this key inspection that the registered provider ordered sit on weighing scales so that all residents can be weighed on a regular basis. All residents may have access to a telephone, which they may use in the privacy of the dining room. A present there are 15 residents who live in Belle House, and two communal bathrooms are provided. The ground floor bathroom has been made into a wet room and the majority of residents prefer to have a shower rather than use the first floor bath. From the staff files viewed the inspector found evidence that staff now receive regular supervision. This was also confirmed by a member of staff interviewed during this key inspection. Care Homes for Older People Page 6 of 26 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 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 8 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents move into the home knowing that their needs can by met by knowledgeable and skilled staff. Evidence: Three care plans were viewed with one showing that the Manager had carried out a comprehensive pre-admission assessment and had also gained pre-admission information from the care manager of the funding local authority. Two care plans of residents who had been in the home for a number of years did not have the homes pre-admission assessment because the residents were admitted from out of the area, but the registered manager had obtained information from care managers and psychiatrists. These pre-admission assessments gave a wealth of information relating to care needs for these residents. Care Homes for Older People Page 9 of 26 Evidence: The home does not offer intermediate care. Care Homes for Older People Page 10 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are specific as to the residents assessed needs, but further improvements need to be made to ensure that all aspects of the residents care is recorded. Medication in the home is well managed, but the Manager must ensure that discussion takes place with the pharmacy in regard to delivering medication out of cycle. Staff respect the privacy and dignity of the residents at all times. Evidence: The three care plans viewed were well written, and gave the staff the information they need to ensure the assessed needs of the residents can be met. All daily living had risk assessments attached and these are also reviewed on a monthly basis and more often if the needs arises. Care plans had been reviewed on a monthly basis, and each care plan contained a weekly report. It was noted that none of the pre-admission assessments or care plans had been signed up to by the resident and or their relative, representative. A requirement is being made that resident and or their relatives, Care Homes for Older People Page 11 of 26 Evidence: representative sign up to the plan of care. While care plans give good information as to the personal hygiene needs of the residents, and night staff have a personal hygiene task sheet, this was not available to day staff and while personal hygiene tasks should be written onto the daily record this has not always happened. While each care plan contained a risk assessment as to each residents tissue viability, there was no evidence to suggest that staff check tissue viability on a regular basis, although there was evidence around the home that district nurses had supplied pressure relieving equipment, such as air mattresses and pressure relieving cushions. One resident who has been bed ridden for a number of years had specialised pressure relieving equipment and a turning sheet has also been completed by staff to show that this resident is turned every two hours. There was evidence in care plans regarding an assessment being requested from the continence nurse, but there was no evidence to support that this had occurred. A number of the residents have been supplied with continence aids. While the community psychiatric nurse does visit the home from time to time there is no evidence in the care plans of when these visits take place or what the outcomes of these have been. The activities programme from both within in the home and from external professionals to the home, shows that residents have the opportunity to exercise on a regular basis. There was some evidence in care plans viewed that where a resident is able to use stand on scales there weight is taken monthly, but this is not the case for those residents who are unable to use stand on scales. This was discussed with the registered provider during this key inspection and she immediately ordered some sit on scales to ensure that all residents can be weighed on a regular basis, to ensure their nutrition can be assessed and any concerns reported directly to their general practitioner. All residents have access to their general practitioner as and when the need arises, these visits are recorded on a general practitioner visits sheet at the back of the care plan. There was some evidence that residents have regular access to an optician, but there was no evidence to show that chiropody or dentist visits are recorded and therefore there was no available evidence to show that these health care professionals have visited the residents in the home. A recommendation is being made that personal hygiene tasks carried out during the day for residents are recorded, and a requirement that visits from all health care professionals are recorded, with reasons given for the visit, and for follow up of these visits to be recorded. An audit was carried out of medication used in the home. The medication policies and procedures are up to date, and contained information in regard to receipt, recording, storage, administration and disposal of medication as well as the management of controlled drugs, PRN (as needed) medication, self medication and the administration of over the counter medication. It was noted however that the list of staff trained in administration of medication did not contain all the staff members signatures or initials. All monthly records of administration had been signed off appropriately. There Care Homes for Older People Page 12 of 26 Evidence: were some medication that had run out of stock, and both the deputy manager and the manager explained that they do order re-order medication when it is running out, but the pharmacy does not always deliver these in a timely way. For one resident, there appeared to be some confusion over a medication prescribed by St Annes Hospital where the resident had visited the consultant psychiatrist who had reduced this residents medication, but had not prescribed the reduced dosage. On the day of this inspection the manager and deputy manager were trying to contact the consultant psychiatrist to get this medication supplied. For two residents who are prescribed a medication that needs to be taken half and hour before food there was no guidance for staff regarding this. The medication trolley and medication cupboard are in a clean and hygienic condition. Controlled drugs are well managed, with appropriate entries in the controlled drugs register, signed off by two staff. All unused medication is returned to the pharmacy on a regular basis. The inspector noticed that the eye drops and some liquid medication was not dated on the bottle on the day of opening. During a tour of the home and at other times the inspector noted that staff respect the privacy and dignity of the residents, by knocking on doors before entering, ensuring that toilet and bathroom doors are shut when in use, and at mealtimes while assisting the residents to feed. Staff speak to residents in a friendly and respectful way. The home has a portable telephone that residents may use in the privacy of the dining room. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have numerous activities from which to choose, as well as an excellent variety of outside entertainers to ensure that their social needs are met. Visitors are welcome into the home at all times. The meals in the home are good offering both choice and variety and catering for special diets. Evidence: Residents are able to make choices as to how they spend their day. One resident does not wish to mix with other residents in the home and they spend their time in their own bedroom. All the residents are able to make choices as to when they get up in the morning or go to bed at night. Many of the residents like to get up early. There is a wealth of activities on offer to the residents. Many external entertainers are brought in to the home including, Music for Health, Pat a dog, the registered providers dog has just qualified as a pets for therapy dog, motivation, hairdressing, hymns and Care Homes for Older People Page 14 of 26 Evidence: prayers carried out by the local Church of England, Land Army Girls, a violin and keyboard player. Internal activities are too numerous to mention and all activities are appropriate for those residents who have a dementia type illness. An internal and separate external activities book is kept, and this contains many photographs taken while an activity is taking place. The manager must ensure that names are not kept collectively within these books to ensure the home meets with the Data Protection Act, this also applies to other books and lists kept in the home where residents names are kept collectively. One resident said, I thoroughly enjoy the activities offered in the home and they always make me happy. Another resident did not see the point of activities and prefers to stay in their bedroom and provide their own entertainment. The inspector observed a number of residents sitting at a dining room table playing dominoes after lunch. Two residents and members of staff went on a trip to a local farm to pick strawberries and had a wonderful time. One of the residents said I would like to go again. Visitors are made welcome by staff and are able to visit the home at any time. None of the residents are able to manage their own finances and have made arrangements with relatives or representatives to do this for them. The inspector viewed the menus for the home and found them to offer a varied, balanced and nutritious diet. Residents are able to choose their favourite meal on one day a week, and this is cooked for them. Five of the residents prefer to have a liquidised diet. These liquidised meals have all the food liquidised separately and are served in an attractive and appetising manner. Some residents require assistance with eating and staff do this discreetly, while giving their full attention to the resident they are feeding. Two residents prefer to eat in their own bedroom, and on the day of the inspection one resident chose to have her lunch in the communal lounge. Four residents spoken to say that the food in the home is very good. While most of the residents have differing levels of dementia and do not always recall what they have ordered, it was suggested that pictorial menus might be more relevant and meaningful to the residents. The cook is able to provide specialised diets as and when required, at the present time one vegetarian and diabetic diets are catered for. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents know that the complaints will be listened to and acted upon. Staff have a good knowledge of protecting vulnerable adults to ensure that residents are not placed at risk. Evidence: The complaints policy and procedure is up to date and it displayed in a prominent position within the home. The registered manager has received two complaints since the last inspection, and from viewing the complaints file the inspector was satisfied that these complaints were properly recorded, and investigated with timely replies of outcomes sent out by letter to the complainants. One resident stated that they would know how to complain and would approach the registered manager if they were not happy with the service they receive. The policy and procedure for the protection of vulnerable adults was reviewed in February 2008. 81 per cent of staff have received Safeguarding Vulnerable Adults training, and a further training course is due in the near future to ensure that all staff have received this training. No one is allowed to start work in the home without Protection of Vulnerable Adults Register and Criminal Records Bureau checks being carried out prior to the commencement of employment. There have been no adult protection issues since the last key inspection. Care Homes for Older People Page 16 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of the environment within the home is good providing the residents with an attractive and homely place to live. Infection control procedures in the home are good ensure that residents are not placed at risk of cross infection. Evidence: This home offers a comfortable and domestic environment to the residents who live there. All rooms throughout the home are well decorated and furnished with domestic style furniture. Every bedroom has en suite facilities. The inspector did note that in some en suite the call bell would have been out of reach for clients if they fell on the floor. In one bedroom the sash cord was broken in the window, and needs attention, the registered manager stated that she would get the handyman to repair the broken sash. All bedrooms are bright and airy. The communal dining rooms and lounge are all well decorated and maintenance of furniture and fittings is good. All visitors who visit the home are requested to use the alcohol hand rub provided in the main entrance to ensure that infections are not carried into the home. Communal bathrooms have a supply of disposable gloves and plastic aprons for staff to use when carrying out personal hygiene tasks and cleaning up spillages. Staff also use disposable gloves for administering medication. Ten out of the eleven care staff have received infection control training. The laundry room has one industrial washing Care Homes for Older People Page 17 of 26 Evidence: machine that has a clinical washing facility, and there are two tumble driers. Each resident has a basket in which clean laundered clothing is placed and then delivered to the appropriate residents bedroom. The laundry room was generally well ordered. The home has a contract for clinical waste collection. It was noted on the day of this key inspection that in the main entrance hall there was a slight offensive odour and in one of the first floor bedrooms there was an offensive odour. Care Homes for Older People Page 18 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are employed in sufficient numbers to meet the present assessed needs of the residents. The manager ensures that recruitment is rigorous and this helps to ensure that residents are not placed at risk. Many of the staff have the qualifications, skills and knowledge to ensure the needs of the residents are met. Evidence: The home is well staffed at the present time there are always three care staff on the day time shifts and one waking and one sleeping night staff. The staff rota, information from the Annual Quality Assurance Assessment sent in by the home and observation by the inspector on the day of this Key Inspection gives evidence of good staffing levels. One member of staff said that it is much better now that there are three carers on duty during the day shift and staff do have time to spend with the residents in activities and one to one. The home also employs two cleaners two cooks and a handyman. An administrator is also employed in the home but she also carries out administrative work for other homes in the group. One resident said that they thought there were enough staff on duty. 54 per cent of staff have gained their NVQ level 2 and in some cases also have a NVQ Care Homes for Older People Page 19 of 26 Evidence: level3. 0ther staff are working towards this qualification. The inspector viewed two staff personnel files and found that all staff complete an application form, although this forms needs updating to request a full employment history, together with written explanations for any gaps in employment. The inspector was able to speak with the administrator about the application form who said that she would up date it immediately. Before a member of staff is employed to work in the home, two written references are sought, and checks are carried out with the Protection of Vulnerable Adults Register and Criminal Records Bureau. All personnel files showed at least two forms of identification one of which was a recent photograph. Both files had evidence of initial induction as well as Skills for Care Induction. The majority of staff have completed their mandatory training with just two or three staff left to complete this training, the registered manager and provider stated that training would be completed this year, together with any staff who need to update their training. Many of the staff have also completed job related training to ensure there is a good skill mix of staff who have the skills and knowledge to meet the needs of the residents. Care Homes for Older People Page 20 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager has a good understanding of the areas in which the home needs to improve. Planning is in place and sets out how this improvement will be resourced and managed. There are good arrangements in place for staff supervision to ensure that staff have a good understanding of the ethos of the home and are able to identify any further training which will help them meet the needs of the residents. Health and safety practices in the home are good ensure that residents and staff live and work in a safe environment. Evidence: The manager is registered with the Commission for Social Care Inspection, she has completed her NVQ level 4 and Registered Manager Award. From observation on the day of the inspection and from what staff told the inspector the registered manager is Care Homes for Older People Page 21 of 26 Evidence: always available to both residents and staff and there is good team work in the home. The registered manager has developed a good quality assurance system in the home where the views of residents and their relatives/representatives are sought, there was evidence that some professionals visitors to the home are asked for their opinion of how the home operates for its residents, but this could be further developed to ensure that all professionals visiting the home are requested to give their opinion on the quality of care in the home. There is a good annual development plan and risk assessments in place for fire and health and safety. The registered manager also carries out monitoring of systems used in the home, but this needs to be further developed to included cleaning standards. The registered provider has now employed a consultant to carry out the regulation 26 visits to the home. Two of these reports were viewed by the inspector and found to contain detailed information of what the home does well and where there were areas for improvement The registered manager does not manage any of the residents personal allowances. Where a resident makes a request for expenditure, the home makes this purchase on the residents behalf using funds from petty cash. Receipts are then kept in the home and residents relative/representative is billed at the end of the month. The inspector viewed staff supervision and annual appraisal forms, and one member of staff stated that she received regular supervision. The majority of staff have received mandatory training in health and safety issues. From information contained within the Annual Quality Assurance Assessment sent into the Commission by the registered manager the inspector was able to ascertain that all appliances used in the home have up to date maintenance checks. The manager checks fire points, emergency lighting and hot water temperature each week and these are recorded in the appropriate logs. There has been a Legionella test carried out in the home. All residents accidents are clearly recorded in a Health and Safety executive accident book, where falls are recurring, the registered manager informs the residents general practitioner. Care Homes for Older People Page 22 of 26 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 23 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 The registered person must ensure that residents and or their relatives/representatives sign up to their plan of care. Residents and or their relatives/representatives must agree to the plan of care written by the home which has been based on pre-admission assessment. 29/12/2008 2 8 12 The registered person must 29/12/2008 ensure that visits made by health care professionals are recorded in the plan of care. Residents must be able to access health care professionals as and when necessary these visits must be recorded with an explanation for the reason of the visit and follow up reports written to follow up on the health care provided. Care Homes for Older People Page 24 of 26 3 26 16 The registered person must ensure that the premises is kept free from offensive odours. The home must be kept free from offensive odours to prevent cross infection to residents who live in the home. 29/12/2008 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 8 It is good practice to ensure that personal hygiene tasks carried out on behalf of the residents are recorded. Daily records are a good source of evidence to show that care is being provided, as detailed in the care plan, however the term All care given is not helpful or adequate. Daily records when well written, help to ensure a consistent approach and good quality of care for residents. The registered manager should ensure that there is an up to date list of staff that have received medication training. This list should contain the signatures and initials of the staff. All eye drops and liquid medication should be dated on the bottle on the day of opening, to ensure that the medication is used within 28 days of opening. 2 9 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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