Inspection on 06/03/09 for Blackwater Mill Residential Home.

This inspection was carried out on 6th March 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Blackwater Mill Residential Home. 27/01/10

Blackwater Mill Residential Home. 06/10/08

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Winton House

Newbeech House

Treloar College

Rush Court

Extracts from inspection reports are licensed from CQC, this page was updated on 25/11/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Blackwater Mill Residential Home Blackwater Mill Country Retirement Home Blackwater Newport Isle Of Wight PO30 3BJ     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: Anita Tengnah     Date: 0 6 0 3 2 0 0 9 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. that people have said are important to them: They reflect the things 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 32 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 32 Information about the care home Name of care home: Address: Blackwater Mill Residential Home Blackwater Mill Country Retirement Home Blackwater Newport Isle Of Wight PO30 3BJ 01983520539 01983520539 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Buckland Care Ltd care home 50 Number of places (if applicable): Under 65 Over 65 50 0 old age, not falling within any other category physical disability Additional conditions: 0 50 The maximum number of service users to be accommodated is 50. The registered person may provide the following category/ies of service only: Care home only ? (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Physical disability (PD) - 4 Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Blackwater Mill Country Retirement Home is a registered care home that provides personal care to 50 service users in the older person category and people with a physical disability. Buckland Care Ltd owns the service. The home is a substantial detached three-storey property set in extensive landscaped grounds, which includes a lake. It is located in rural Blackwater approximately two miles south of Newport town centre with its shops and amenities. There is currently no registered manager at the service. Care Homes for Older People 0 6 1 0 2 0 0 8 Page 4 of 32 Care Homes for Older People Page 5 of 32 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: An unannounced inspection was carried out over one day on the 6th March 2009. As part of this visit we sent out the Annual Quality Assurance Assessment (AQAA) to the registered person at the service. This is one of the means of collecting data from the service. We also sent out service users surveys to people living at the home. We spoke to a number of the service users and three relatives at the time of the visit. We looked at the service users and the staff records as maintained at the home and observed practices. We have also used information as supplied by the home in the AQAA and other information that we have received from external agencies who have dealings with the home. Care Homes for Older People Page 6 of 32 Care Homes for Older People Page 7 of 32 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 32 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 32 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. There is an appropriate pre admission assessment process in place and the service users needs are assessed prior to admission to ensure that the home can meet them. The service does not provide intermediate care. Evidence: We looked at the pre admission records of two recently admitted service users. We found that detailed assessments of needs were available and there was evidence that the family were involved in the assessments as the service users were unable to fully participate themselves. One of the service users was admitted as an emergency respite care and the assessment was completed on the day of the admission. Care Homes for Older People Page 10 of 32 Evidence: Assessments of needs included moving and handling, weight, past medical history, mobility and the support they required to maintain their activities of daily living. The manager stated that this information is used in the formation of the initial care plans as required. The manager reported that other information such as the statement of purpose and the service users guide were made available to all prospective service users. The manager confirmed to us that the home does not provide intermediate care service. Care Homes for Older People Page 11 of 32 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. The assessments and new care plans have been developed and the ongoing development and reviews are needed to ensure that all identified needs are met. The medication management is inadequate and action is needed to safeguard people using the service. The service users are treated with respect and had positive comments about the way that they are treated. Evidence: As part of case tracking we looked at three care plans to assess how the home plans to meet the service users assessed needs. Risk assessments now form part of the overall assessments and care plans were developed. Assessments included personal care needs, moving and handling, nutritional screening, psychological and emotional needs,and skin integrity. We noted that there has been some changes in the monitoring of the service users and Care Homes for Older People Page 12 of 32 Evidence: one area was that weights had started to be monitored. The home has put in place a new care planning system for some of the service users since the last visit and this was in the process of being further developed for all them. We found that the new care plans and assessments were detailed and included good information that included referrals to other healthcare professionals. The assessments and care plans for continence management must be further developed as these were inadequate and did not contain clear information about the service users needs. Details such as type of continence product and the frequency of changes, types of creams applied. The manager reported that the service users were registered with doctors form the primary care trust and were well supported. Records seen showed that district nurses were involved in the management of pressure ulcers for one of the service users as needed. Detailed records were kept following doctors visits in order to inform practice. One person commented that the staff called the doctor when they think it is necessary As part of the care plans reviews staff must ensure that these contain up to date information about the service users current needs in order to inform practice. Further development of wound care plans should be in place to include body map and current information about pressure ulcers. One of the service users records showed that their skin was intact, however we found that they had a pressure ulcer that was being treated. Other areas such as indwelling catheter care plans and records were needed in order to inform practice. Another care plan indicated that a service user was on Warfarin, the manager reported that this had been discontinued and the care plan was updated at the time of the visit. Staff must ensure that care plans are reviewed and updated in order that they accurately reflect the current care needs of the service users. We looked at the records of food and fluid record for three service users at the time of the visit. We found that the records were poor and indicated that people had not received any food or fluids for between twelve and fourteen hours. This was brought to the attention of the person in charge and must be addressed. We noted that this appeared to be particularly an issue during the evening and night shifts where the records were not completed. We looked at the medication management at the service that the staff undertook on behalf of the service users. The home was using the monitored dosage system and had Care Homes for Older People Page 13 of 32 Evidence: put in place appropriate medicines lockable trolleys on each floor for the safe keeping of the service users medicines. This was a marked improvement from the last visit and we observed that staff ensured the trolley was within view and secure when administering medicines. A sample of the Medication Administration Record (MAR ) sheets was looked at and this indicated that records of oral medications administered were maintained. A random sample of the stock that we audited indicated that this was an area that had improved greatly and records of medicines received were maintained and accurate with the stock balance. The manager confirmed that controlled drug cupboard had been ordered and would be put in place to ensure that this meets with the current Regulation. We found that there were a number of creams and ointments, local analgesic cream and potent angina sprays that were found in the service users bedrooms. The creams and ointments were not all labelled with the service users names and pose infection control risks and must be addressed. The manager confirmed that there was no risk assessment in place for medication that was being self administered. Any medication that the service users are self administering must be carried out within a risk assessment framework to ensure that they receive their correct medication. These medications must be stored securely in order that they do not pose a risk to the other service users. We found that changes to the prescription for analgesia from regular use to as required were not managed appropriately. There was no record to show on whose authority the prescription was changed. Staff must ensure that any medication transcribed contain two signatures to eliminate risk of error in particular for medication such as Oramorph which was not available at the time of the visit. Another service user was prescribed a medication to be taken one at night as required and we found that this had been given every night for a month. No record of any action that had been taken as part of reviewing this with the doctor was available. Three visitors were spoken to on the day of the visit. They all said that their relatives always looked well cared for and clean. Comments were that the staff were very nice, friendly and treated their relatives with respect and were kind. Care Homes for Older People Page 14 of 32 Evidence: Other comments were that things have improved recently and staff were available and regularly came in to see those service users who remained in their bedrooms. We observed that the staff were courteous when supporting the service users with their care. Comments that we have received from the service users and those we spoke to indicated that they were satisfied with the way that staff treated them. One comment indicated that the staff were reluctant to assist the service user to go out in the garden as they are always rushed and the comment was that they plead lack of time, overworked and under staffed. Care Homes for Older People Page 15 of 32 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. There is a well planned activity programme in place that received high degree of satisfaction from the service users. The service users are supported well in maintaining contacts with their family and friends. The meals are well managed, offering choice and variety and meet with the overall satisfaction of the service users. Evidence: The home has an activity coordinator who was working five days a week and a planned activity programme was available at the service. We observed the activity programme on the day of the visit that appeared interactive and the service users said they always enjoyed. Comments were we have a lot of fun We received a number of positive comments about the activities that were provided at the service . Some of the comments included that it is the song you sing and the smile you wear that makes the sunshine everywhere. Care Homes for Older People Page 16 of 32 Evidence: My mother does not wish to take part in activities. Another comment was there are lots of activities available during the week. Enjoy scrabble, quiz, discussion group and film. We have an excellent coordinator that works very hard to bring us new interests. A service users said we have an excellent activity coordinator who takes an enormous amount of trouble. I always look forward to the activities. The home has an open visiting policy and the records of visitors, as maintained at the service indicated that people visited at all times of day. We spoke to three relatives at the time of the visit and they all said that they were always made welcome and offered hot drinks at teatime. Another relative was confident that their relative would settle in and said that the staff had been very kind and supportive following their relatives admission that was arranged as an emergency. We looked at the meal management at the service which showed they had a planned menu and the weeks menu was available to the service users. We observed the lunchtime meal and this corresponded with the choices that people had been offered inn the day. The meals looked well balanced, varied, freshly cooked and nicely presented. We spoke to seven service users and two relatives at lunchtime and they all said that the meals were very good and no complaint. The service users were offered choices and staff stated that they went round and helped the service users with their choices from the menu. Comments about meal included Food is excellent and plentiful and the resident always took her meals in her room. My mother loves her food especially the pudding and always eats everything. The food is very good and nothing is too much for the staff. One comment that we received was the standard of food, choice offered to those who eat in their rooms is very inferior to that offered in the dining room. Another comment was I find the food very boring and not always cooked properly. Care Homes for Older People Page 17 of 32 Evidence: We observed that homemade cakes and gateaux were available to the service users. There were different types of puddings and the chef went round with the sweet trolley and choices were offered to the service users. Care Homes for Older People Page 18 of 32 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 complaint process is satisfactory and people say that they would approach the staff with their concerns. Staff are aware of the process in referring any safeguarding issues and training for staff was being further developed. Evidence: We looked at the complaint procedure and records of complaint as maintained in the complaint log for the service. This showed that details of concerns are recorded and records of investigation and outcomes are maintained. There were two records of complaint that had been received since the last visit. One of these had been investigated and responded to and detail of this was maintained and the manager confirmed that this was resolved. Another complaint received and the home has referred to Social services as safeguarding. The outcome of this investigation was not known at the time of the visit. During our last visit we made a referral to social services regarding the lack of care relating to people living at the home. This was thoroughly investigated and the home was acting on the recommendations made as part of the investigation. Care Homes for Older People Page 19 of 32 Evidence: The six service users we spoke to were satisfied with their care and said that they would talk to the staff if they were unhappy. We looked at the staff training matrix as provided by the home and this indicated that eleven staff have completed training in safeguarding adults and ongoing training is planned for the rest of this year. Care Homes for Older People Page 20 of 32 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 service users are accommodated in a warm, homely environment that meets their needs. There is an infection control procedure in place, however items including creams and ointments that may be used as communal was not managed adequately. Evidence: We looked at a number of the service users bedrooms, communal lounges and dining room as part of this visit . The home was warm and clean and in good decorative order and furnishing appropriate to the service users needs. It was evident that there is an ongoing programme of refurbishment to ensure that the environment meets the needs of the service users. The service users reported that they spent as much time in their bedrooms as they preferred. The rooms were personalised and it was evident that people are supported to bring with them items of personal belongings on admission. Other comments were: All those who responded say that the home is always fresh and clean Comment from a service user was one of the thing that attracted me to the home was the cleanliness and the fresh air. Equipment and aids were available to support and maintain the service users independence as needed. Care Homes for Older People Page 21 of 32 Evidence: As reported in the previous section the creams and ointments must be managed effectively to promote and safeguard the welfare of people living at the home. These were not labelled and may pose infection control risks to the service users. Care Homes for Older People Page 22 of 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing levels are adequate to meet the current service users needs. There is an ongoing training programme in place to update the staff skills. The recruitment process is inadequate and needs further development to ensure this meets with current regulation. Evidence: The home has a duty roster for the care staff and a separate one for the ancillary staff. The manager confirmed that dedicated staff are available and evidence from the duty plan showed that the carers are not responsible for food preparation and cleaning duties. The duty roster showed that there are five staff on the early and late shifts and three staff on night duty. This indicated that action has been taken following the last inspection as staff were working excessively long hours. The manager reported that recruitment of staff is ongoing at the time of the visit. People we spoke to reported that there has been some improvement in staffing and staff appeared to be able to pop in see the people who are in their bedrooms at Care Homes for Older People Page 23 of 32 Evidence: regular intervals. Comment was staff come in and have a chat and this did not happen before. Another person said that they were worried about the staffing situation and the care, however there has seen some improvement and feel much happier. Other comments from our surveys were : Staff are very caring and helpful. Good home. Staff fantastic. Call bells not always attended to. Staff does not always listen at first time of asking. Staff available to meet needs sometimes. The staff are excellent but are under pressure. It is impossible to give the support that should be given. The home has introduced an induction programme for the staff as this was an area of concerns following the last inspection. The manager reported that this is being developed to ensure it meets with the Skills for Care guidance. Staff comments included: There are adequate staff on night duty. Other comments were that training was being introduced and staff have a better understanding of the service users individual needs. Have completed moving and handling. One comment was that induction not very good and was shown medication. I had nine hours induction and was working nights as the key worker. No one remained to go through the medication round with me. Care Homes for Older People Page 24 of 32 Evidence: This was brought to the attention of the manager as it unclear if this was a recent incident. The recruitment records of three new staff were looked at as part of this visit. We found that the staff completed an application form and references were sought. We found that one of the staff had only one reference. The manager stated that this would be looked into. The manager was unable to locate the application form for another staff. Two of the staff had commenced work following POVA first checks but prior to their full Criminal Record Bureau CRB had been received. The manager must put in place arrangements as per CRB guidance to ensure that the service users are not put at risk of harm. This must include detailed records of supervision of those staff, as this was not available at the time of the visit, although the manager said that the staff worked in pairs. We looked at the training records as maintained at the home , it was evident that there has been a marked improvement in the training that have been developed for the staff. Some of the recent training included health and safety, dementia care, first aid, infection control, moving and handling and safeguarding adults. Care Homes for Older People Page 25 of 32 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. The manager must submit an application as part of the fit person process that is outstanding at the time of the visit. There is an internal audit process in place that is being further developed. The service users personal allowance is well managed and protect them from risk of abuse. There is a satisfactory sysytem in place for the health and safety of people living at the service. However fire safety training and records are inadequate. Evidence: The home has a appointed a manager in January 2009 who will need to complete the fit persons process in order to register with the Commission. The manager has a number of years experience in the care of the elderly and said that she has the Care Homes for Older People Page 26 of 32 Evidence: support of the provider in her role to manage the service. We have not as yet received an application from the manager to register with us, the manager reported that she had commenced the process and applied for her CRB. People we have spoken with say that there have been some positive changes since the new managers appointment, however it was early days. One of the staff commented Had one meeting since new manager started and another one planned. The home has developed and started a supervision programme for the staff as part of monitoring care and staff practices. Staff commented that this was going well but it is all new at present. The responsible person has commenced their monthly unannounced visits and records of October 08 to January 09 visits were available. This is part of their internal monitoring system to look at care practices, service users satisfaction and meeting their commitment as per the statement of purpose. The manager reported that the provider was planning an audit of the service users views towards the end of the summer. We looked at a sample of the service users personal allowance as managed by the home. We found that there was a clear monthly audit that included a detailed ongoing record of amount received and expenditures. Receipts were maintained of all transactions such as hairdressing, chiropody, shopping and amount deducted and invoices raised as appropriate. Information that we have received indicates that there is an ongoing programme in place for the servicing of equipment and testing of fire equipments as required. The provider keeps us informed and sends us reports of incidents that are detrimental to the welfare of the service users as required. We noted that according to the training record, ten of the staff have completed fire safety training. The registered person must ensure that all staff complete mandatory training including fire safety and records of these are maintained. Further information should be sought from the fire service regarding frequency of training required. As reported in the previous sections of the report, the staff must ensure that medications and care records are managed appropriately and do not put the service users at risk of harm. These are currently not managed safely and in the best interests Care Homes for Older People Page 27 of 32 Evidence: of the service users. Care Homes for Older People Page 28 of 32 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 29 of 32 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 14 The registered person must ensure that detailed assessments and care plans relating to nutritional needs are maintained. So that they receive their diet and fluids safely and records are maintained 30/04/2009 2 9 13 The registered person must ensure that arrangements are in place for the safe management of medication at all times. So that people are not put at risk of harm and medication is stored safely at all times. 30/04/2009 3 26 13 The registered person must 15/05/2009 ensure that as part of infection control procedure all creams and ointments must be appropriately managed to reduce infection control risks. Care Homes for Older People Page 30 of 32 So that you can ensure that the service users are not put at risk of harm. 4 31 8 The registered person must ensure that an application is submitted for the manager to register with the Commission. So that there is someone responsible for the service and has completed the fit person process. 5 38 23 The registered person must ensure that all staff have completed mandatory fire safety training. So that the service users are not put at risk of poor practice. 30/05/2009 30/05/2009 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 Care Homes for Older People Page 31 of 32 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) 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 32 of 32 - 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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