Inspection on 07/11/08 for Blackmore House

This inspection was carried out on 7th November 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Blackmore House 08/09/09

Blackmore House 06/06/07

Blackmore House 12/09/06

Blackmore House 10/11/05

Blackmore House 29/07/05

Blackmore House 06/12/04

Blackmore House 29/06/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Blackmore House School Drive Bromsgrove Worcestershire B60 1AY     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Martin George     Date: 0 7 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 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Blackmore House School Drive Bromsgrove Worcestershire B60 1AY 01527575222 F/P01527575222 manager.bmhouse@bcop.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Paula Georgina George Type of registration: Number of places registered: Broadening Choices for Older People care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The home may accommodate on a respite basis 1 named service user under the age of 65 years in the category dementia (DE). Date of last inspection Brief description of the care home Blackmore House was built in 1989 as a care home for older people. The home is single storey and incorporates an activity centre that helps to maintain links with the local community. The home provides single bedroom accommodation for a total of 28 people who are accommodated in 5 bungalows. Each bungalow represents a virtually self-contained living environment with a lounge/dining space, toilets and bathrooms, bedroom accommodation and a kitchenette. Three of the bungalows each accommodate 4 people, while two of the bungalows accommodate 8 people. Emphasis Care Homes for Older People Page 4 of 28 Over 65 28 28 28 0 0 0 Brief description of the care home is placed on creating a homely living environment. Blackmore House provides a care service for older people with or without a physical disability and for older people with dementia. Broadening Choices for Older People (BCOP) is the registered provider however, the building is owned by, and leased from Worcestershire County Council. As all beds are block purchased by Worcestershire County Council Social Services the standard bed fee applies at three hundred and eighty one pounds per week. Additional charges apply for items such as private chiropody, toiletries, magazines, newspapers and hairdressing. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection was carried out by a single inspector 09:05 and 16:40. As part of the inspection all National Minimum Standards defined as key by the Commission for Social Care Inspection were considered. Information about the performance of the home was sought and collated in a number of ways. Prior to inspection we were provided with written information and data about the home through their annual quality assurance assessment (AQAA). Information from the last key inspection report and surveys provided to us by people using the service and their relatives were analysed prior to inspection to help us formulate a plan for the visit and to help us in determining a judgement about the quality of care provided by the home. Care Homes for Older People Page 6 of 28 On the day of the inspection we spoke to the manager, deputy manager, staff, people living at the home and their relatives. We also undertook a tour of the premises and observed practice, which provided evidence in support of the records we also checked on the day. This approach allowed us to assess how well outcomes were being met for those receiving a service. What the care home does well: What has improved since the last inspection? 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 8 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home makes sure they get necessary information prior to admission and this informs the care plan. People using the service would be better informed about what is provided if each bungalow had a personalised welcome guide. Evidence: The statement of purpose has recently been updated, although there is no date on the document to confirm when this occurred. This document also acts as the welcome guide for people living at the home. It would be good to see consideration given to producing a seperate document for this purpose, which is more concise, better suited to meet the capacity of people with dementia and personalised to the particular bungalow they occupy. This would be consistent with the caring approach promoted by the home and with the explanation given by the manager of how each bungalow caters for different levels of need. Care Homes for Older People Page 10 of 28 Evidence: Families and people interested in using the service can visit the home to help them decide if it is the right resource. One relative who is a member of the Friends of Blackmore House support group stated that he and several other relatives he frequently speaks to would choose Blackmore House over other potential options. The home acquires an adult care assessment (ACA) prior to agreeing to provide a service. On the day of admission senior staff meet with the person being admitted and their family to discuss particular needs. As mentioned at the last key inspection there are times allocated for admissions, which the manager feels help to reduce disruption to people currently living at the home. The service does not provide intermediate care. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are regularly reviewed to ensure they meet current needs of people living there but risk assessments should be more relevant to individual vulnerabilities. People living at the home are protected from the risk of medication errors by an effective system. Evidence: The individual care plans have information about the health and personal care needs of people living at the home. The plans are reviewed regularly and updated where necessary. Where plans are updated the previous plan is kept and they are filed in chronological order with the most recent at the top. This system is effective as it allows easy auditing of how each individual is progressing and whether outcomes are being met. There are risk assessments for identified areas of vulnerability that are consistent with needs identified in the care plans. Many of the risk assessments however are not specific enough about strategies to manage or minimise the identified risks. One Care Homes for Older People Page 12 of 28 Evidence: example of this relates to an individual who requires cot sides. The strategy for managing this is given as staff to monitor and be aware of the hazards of cot sides. This is not outcomes focussed as it does not provide staff with practical advice on how to safeguard the individual from potential harm associated with cot sides. Activities of daily living sheets are completed and kept alongside care plans. These are a useful record of how particular needs of individuals are being managed. Unfortunately some columns were undated, leaving us unclear when the entries referred to. Some entries were a little confusing as they did not clearly identify the outcome in a particular area. An example of this relates to urinary incontinence where on some days there is a tick but on other days the word self is entered. The ongoing problem of the home being too hot in warm weather because of the glass domed corridor is partly resolved. The garden areas for each bungalow have been made secure so that the sliding doors can be opened to help cool the interior and give people living there the opportunity to walk outside without being able to wander off and come to harm. There is a risk assessment on the care plan of each individual but there is no mention of this way of cooling the interior as a strategy for managing the excess heat. Also the risk assessments are too generic, failing to address individual needs and capabilities (such as limited mobility). There is an ongoing safeguarding matter, which relates to a concern expressed by the family of a person who had lived there. The home is working hard to resolve this matter and is liaising with all relevant parties. Both the social worker and the Commission for Social Care Inspection have been kept fully informed and involved as appropriate. Our observations on the day gave no concern about the quality of care provided to people using the service. Observations also gave us reassurance that the need for privacy and dignity was respected. A relative of a person currently living at the home stated that he had total confidence in all the staff at the home and could not envisage a safer place for his mother to be looked after. He stated that staff always kept him informed of any concerns and were always friendly and knowledgeable about his mother. Medication storage, administration, recording, temperature monitoring and disposal are all well managed. The senior who explained the procedure and practice satisfied us that people living there are properly safeguarded in this important aspect of their care. Medication Administration Records were up to date and had all necessary signatures. Systems and storage arrangements for controlled drugs are in place although no controlled drugs are currently being adminstered. Care Homes for Older People Page 13 of 28 Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service benefit from having a well organised activity centre as part of the overall package of care. Evidence: The activity centre (previously called the day centre) provides a range of activities that are available to all people who use the service. The activities register shows what has been offered and who has taken part. The manager explained about a cognitive stimulation group that is organised every Wednesday in co-operation with the Mental Health team. People using the service can decline activities and the home respects this and sees it as being responsive to individual choice. We were satisfied with the range of activities available and that the approach to activities is person centred, meaning it takes account of preference and individual capability. We feel the home should continue to explore ways of ensuring all those who use the service are regularly engaged in suitable physical and cognitive activities to keep their body and mind stimulated. The home is reasonably flexible in terms of daily routines and this is supported by a staff team who, based on observations on the day, are aware of individual preferences Care Homes for Older People Page 15 of 28 Evidence: and needs. Flexibility also applies to visitors, who are made welcome at all reasonable times. The managers and staff liaise regularly with family members to ensure they are satisfied that their relatives are receiving the quality of care they expect. Menus we looked at provided evidence of a wide range of choice and options suitable for vegetarian and other dietary preferences. People we spoke to all gave positive comments about the food, such as very nice and tasty usually, nothing I dont like. All the bungalows have pleasant dining areas that are suitable for a relaxed mealtime ambiance. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The open communication with other agencies helps to safeguard the vulnerable adults the home cares for. Evidence: There have been no complaints lodged at the home or with the Commission for Social Care Inspection since the last key inspection. Information about how to make a complaint is readily available for those who use the service and their family members, as well as visiting professionals. The information is written in easy to understand language. One criticism is that there is no recognition of diversity and it may be worth developing information that is suited to the main ethnic groups within the potential catchment area of the home. The manager stated that all current users of the service are white British but the home should be proactive and develop the service to be able to provide care to people from other ethnic groups. At the time of inspection there was still an allegation that had not yet been fully resolved, regarding alleged inadequate levels of supervision of a person who had lived at the home, which resulted in unexplained bruising. The home has been open about the concerns raised and has tried to resolve the matter with the family but there is a difference of view about what may have occurred. A resolution is still being sought and relevant agencies and individuals have been kept fully informed and involved as necessary. Observed practice on the day suggested acceptable levels of supervision of Care Homes for Older People Page 17 of 28 Evidence: those living there. Based on our obervation and brief discussions we found safeguarding practice to be quite good. Our observation was supported by a relative of a person currently living there, who spoke glowingly about the managers and staff at the home and had no hesitation in expressing the view that he had total confidence in their ability to keep his mother protected from preventable harm. Training provided to staff on protection of vulnerable adults and on dementia care helps them to understand and respond to the needs of those they care for. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are provided with a pleasant living environment that is well maintained, both physically and hygienically. Reasonable efforts are being made to safeguard individuals from potential risks associated with heat caused by the glass roof in the corridor. Evidence: The home is seperated into five defined living areas, called bungalows and they all have an entrance off a glass domed central corridor. The central corridor has seating areas so that those who wish to can relax there or those with limited mobility can take a brief rest if walking the whole length of the corridor becomes too much for them. The bunglalows are homely environments, all having access through sliding doors into a dedicated, contained garden area. There has been refurbishment since the last key inspection and decor throughout is good. Whether some of the paintwork in the bungalows will pass the test of time is in some doubt as it looks as if painting has been done directly onto varnished wood without first sanding down and scuffing near the floor is already bringing paint off. This needs careful monitoring and attention so it does not leave people living there with a shabby environment. Care Homes for Older People Page 19 of 28 Evidence: The laundry and kitchen areas meet health and safety standards although it was unfortunate that at the time of our tour of the building the agency cook was engaged in baking and we noted egg shells on a kitchen counter, flour on the kitchen floor (creating a slip hazard) and the lid of the bin left open. Discussion with both managers satisfied us that this was not normal hygiene standard in the kitchen area and the awareness of potential infection risks to those using the service was fully recognised. The laundry was well ordered and one of the machines had a sluicing facility. The system used minimised the risk of peoples clothes getting lost or mixed up with other peoples clothes. The home has a room used as a hairdressing area. We were told the hairdresser comes once a fortnight. Unfortunately the room is also used for storage and we do not feel that people should be expected to have their hair done in a room where they are surrounded by stacks of incontinence pads. We would like management to consider the dignity issues associated with this. The previously identified problem of the home becoming uncomfortably hot during warm weather because of the glass roof along the length of the corridor remains to some extent. The home has tried to respond to prior concerns raised by the Commission for Social Care Inspection but unless the roof is replaced it is difficult to see how it can be fully resolved. In terms of safeguarding people who use the service from potential harm resulting from heat related problems there is the opportunity to open the sliding doors in the individual bungalows which helps reduce the interior temperature and also allows individuals to gain easy access to the contained and safe garden areas. General standards of cleanliness and hygiene were acceptable and met requirements. An added bonus for the people living there on the day of our visit was that they were having their cleaning done by a very engaging and friendly cleaner, which makes a small but important difference to the everday experience of those living there. The two larger bungalows had sluicing facilities in the toilet area. We were pleased to see alcohol scrub dispensers at the entrance to each bungalow, but we did note that not everybody used them on every occasion they entered a bungalow. This needs to be reinforced to ensure infection control practice is consistently robust to fully safeguard people living there. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are cared for by a team of staff that have been carefully selected, trained and qualified to ensure they can meet their needs and safeguard them from identifiable harm. Evidence: Our discussions with people using the service and family members evidenced a very high level of confidence in the staff team. Staffing numbers throughout the day are sufficient to meet the needs of the people living there and our observations on the day gave us no concern about levels of supervision. We are however aware of an ongoing disagreement between the home and the family of a person who used to live there about poor levels of supervision, which at the time of inspection remained unresolved. Training provided to staff covers all mandatory requirements and also includes other areas that enhance the knowledge and skills to help staff deliver outcomes focussed care to the people using the service. We feel though that more staff should undertake the two day dementia training and attend training on the mental capacity act, to help them better meet the complex needs of people living at the home. We are satisfied that the commitment to the qualification of staff helps to ensure individuals receive a competent standard of care. Care Homes for Older People Page 21 of 28 Evidence: Recruitment practices are good and adhere to all expected safeguards to ensure people using the service are protected as well as possible from the risk of being harmed by unsafe carers. We were provided with no evidence that any of the people who use the service are involved in any stage of the staff recruitment process. During this visit we did not examine staff meeting minutes or check frequency of staff supervision. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receiving a service are well cared for but how the home provides evidence of the way they meet outcomes needs further development . Evidence: The manager is very experienced and social work qualified and knows a great deal about the people she provides a service to. She has still not yet completed her Registered Manager Award, which was almost completed at the time of the last key. It seems there were some difficulties with the college and she has now changed colleges. To meet the requirements for her post she needs to complete this award without undue delay. The deputy manager takes on primary responsibility for all administration tasks. The managers seem to compliment each other well and our observations on the day evidenced that they lead a team who provide a person centred service, meaning that individual needs are recognised and responded to, but there needs to be better written Care Homes for Older People Page 23 of 28 Evidence: evidence of this to support the work actually being done and to show how outcomes for those receiving a service are being met. The records we looked at did not provide sufficient evidence of progress being made by those receiving a service or how the work being done by staff improved their quality of life. We were however pleased by several comments from both those living at the home and family members that the home provided a wonderful service. One such written comment received by a person living at the home stated that staff are attentive, kind and caring. Regarding the quality of care provided by the home a relative stated that my father is known as the person he is at Blackmore, he is well cared for and loved. The flexibility and caring attitude leads to proper person centred care. We feel the knowledge and awareness of diversity issues could be developed to ensure the home could respond sensitively to a range of ethnically diverse needs should that become necessary. Although we accept that all those using the service are currently white British and it is very rare to provide services to other ethnic groups we feel the service should be proactive and widen the knowledge and understanding of the staff team around diversity issues. We discussed with the managers the need to make the information in the Annual Quality Assurance Assessment more comprehensive, indicating clearly what areas the home sees as needing improvement and showing that it is responding to changes in legislation and Government initiatives. Quality Assurance systems need further development and the manager needs to show clearly how she monitors all areas of practice, including safeguarding, infection control, fire related matters, hygiene standards, medication, water temperatures, manual handling techniques, food handling and hygiene and equipment safety. All of these important areas impact directly on how well those receiving a service are safeguarded from potential harm and how effectively outcomes are being met. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 8 13 Risk assessments must identify strategies to eliminate or minimise potential risks. To properly safeguard people living at the home from identifiable harm 30/01/2009 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 1 The home should consider providing bungalow specific welcome guides that are suitable to the level of need and capacity of the people living there. The home needs to consider ways of ensuring that all people who use the service, however reluctant to engage, are encouraged and supported in partaking in cognitive and physical stimulation activities to help keep body and mind relatively healthy The home should develop complaints information that is suitable for the main ethnic groups that are within the catchment area of the home so that they are prepared to meet outcomes for individuals from diverse ethnic groups. The room used for hairdressing should not be used for storage as it is not conducive to creating the right 2 12 3 16 4 20 Care Homes for Older People Page 26 of 28 environment for people having their hair done. 5 26 It needs to reinforced that every person entering a bungalow should use the alcohol scrub dispensers provided to fully safeguard those living there from potential infection risks. It would prove beneficial to people using the service if more staff undertook the two day dementia course and training on the mental capacity act, to help them meet outcomes more effectively. The quality assurance systems need further development to show how the managers are monitoring all aspects of service delivery to ensure outcomes are being met The manager needs to evidence how she monitors all aspects of health and safety to ensure those receiving a service are fully safeguarded from potential harm 6 30 7 33 8 38 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!