Inspection on 05/11/08 for Brewster House

This inspection was carried out on 5th November 2008.

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

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

Other inspections for this house

Brewster House 17/01/07

Brewster House 27/02/06

Brewster House 21/11/05

Brewster House 04/03/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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: Brewster House Oak Road Heybridge Maldon Essex CM9 4AX     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: Alan Thompson     Date: 0 5 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 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: Brewster House Oak Road Heybridge Maldon Essex CM9 4AX 01621853960 01621857847 manager.brewster@runwoodhomes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Allison Squires Type of registration: Number of places registered: Runwood Homes Plc care home 64 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 25 persons) Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 64 persons) The registered person must not admit persons subject to the Mental Health Act 1983 or the Patients in the Community (Amendment) Act 1995 The total number of service users accommodated in the home must not exceed 64 persons Date of last inspection 0 0 Over 65 25 64 Care Homes for Older People Page 4 of 28 Brief description of the care home Brewster House is a large purpose built unit in the village of Heybridge near the town of Maldon in the county of Essex. The home accommodates 64 service users who are over the age of 65 years. All of the accommodation provided is on a single room basis spread over two floors with the exception of one shared or premium room. A large majority of the rooms have en suite facilities. There are four communal lounges throughout the home including a pleasant conservatory off the main dining room. Small seating areas can be found around the home for private and quiet visits. There is a choice of seven bathrooms and a shower room. The bathrooms are equipped with a variety of assisted baths and hoists. Outdoor space comprises an enclosed central courtyard with small pond and plant areas. There is a car park to the front of the property with ample spaces. The home is situated near to local shops and is on a public transport route to Maldon, Witham and Colchester. Fees for the home range between £389.83 and £700.00 weekly. They do not include the purchase of newspapers, toiletries, hairdressing and chiropody service. CSCI inspection reports can be obtained from the home, or via the CSCI internet website www.csci.org.uk. 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: 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 unannounced key inspection took place on Wednesday 5th November 2008. (Our most recent inspection before this was on 17/01/2007) The content of this report reflects the inspectors findings on the day of the inspection along with information provided by the service and feedback by service users, staff and other parties. The registered manager was at the home throughout the day and assisted the inspection process in a helpful and professional manner. The manager had completed and returned their Annual Quality Assurance Assessment (AQAA) to us prior to the inspection. This document gives homes the opportunity of recording what they do well, what they could do better, what has improved in the Care Homes for Older People Page 6 of 28 previous twelve months as well as their future plans for improving the service. Some of the information and detail provided within the AQAA has been included in this report. Discussions were entered into with the manager, service users, the deputy manager, visitors and staff on duty. CSCI survey questionnaires were also provided to service users, staff and stakeholders. We received eighteen completed surveys and reference to feedback from these has been made within this report. Random samples of records, policies and procedures were inspected and a tour of parts of the premises and grounds took place. All matters relating to the outcome of the inspection were discussed with the manager of the home, with full opportunity for discussion given and/or clarification where necessary. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that information provided by the home enables them to make an informed choice and that assessments would ensure that needs could be met. Evidence: Two staff visit prospective new service users to undertake an assessment of need. These will be the manager, deputy manager, a care team manager (CTM) from Brewster House, or they may be senior staff from a sister home from Runwood Homes. Evidence of this process was seen in two files for people admitted since the last inspection Assessment headings covered included background information, personal care, communication, behaviours, pressure care, safety, religious, family contact, mobility, personal hygiene, diet, vision, hearing, continence, manual handling, sleep, medication, oral care, falls, social needs and a dementia assessment. These contained Care Homes for Older People Page 10 of 28 Evidence: the information needed. Copies of assessments carried out by the placing authority were also seen. The manager confirmed that trial visits are available for prospective new service users and discussions with relatives and service users confirmed this. One said we could look at the home before deciding if it was what we wanted. A care plan is compiled after admission, as seen on individual files. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive good care in a way that respects their privacy and dignity, based on agreed identified needs. Evidence: Five care plans were inspected. Included was background information, personal details, and next of kin contacts. Assessments of identified needs were recorded with instructions of the care required to meet these needs. Areas of assessment were based on those identified upon admission and added to afterwards. Care plans seen included a dependency assessment, continence assessment, and mental status assessment questionnaire. There were risk assessments on pressure care, nutrition, manual handling, falls, mental health and general risks. There were records of reviews and of daily staff observations, weight had been recorded and records had been kept of GPs visits and treatment and on any other medical consultations. There was a separate care plan for night time needs. Care Homes for Older People Page 12 of 28 Evidence: Care plans are reviewed regularly by the CTM with key workers involved in ensuring that daily notes record any changing needs. Care plans seen had been signed as agreed by the service user and appropriate relative, and the manager. The manager said that Brewster House gets good support from District Nursing services on pressure care assessment and with the supply of appropriate aids and treatment. Continence issues are supported by the community continence team with one of homes CTMs ensuring regular communication and updates on changing service users continence needs. Hearing needs are provided for by GP referral to a local hospital. Dental services are available to service users by visiting a community based dentist. Some service users continue to visit their own dentist outside the home. GPs from two different practices visit twice weekly and at other times on request, and a chiropodist and an optician also visit to provide treatments and services to service users. Records of visits with written outcome notes were seen. The homes medication policies and procedures were seen and included detailed instructions and guidance on ordering, receipt, storage, administration, self medicating and returns of unused stocks. These polices included Runwood Homes guidance and a Brewster House policy geared to local needs and procedures. This included guidance on obtaining emergency supplies, homely remedies, as and when needed medication and medication for short stay service users. In house training had been provided to staff on medication practice. Only CTMs or the manager deal with medication and competency assessments are carried out by the manager or deputy manager before new staff take on this role, and at least three times a year after. Evidence of these was seen, however there was not any evidence of any external training or formal training in the safe handling of medication to underpin the in house procedures. This is not a regulatory shortfall and the practice and competency of staff who deal with medication is not being faulted. However a good practice recommendation is that additional evidenced training is provided to staff to supplement that given in house. This issue was discussed with the manager who said that Runwood Homes had commenced a safe handling of medication training course at other homes but that this had not yet been available to Brewster House staff. Medication administration records were inspected no shortfalls were noted. Discussions with individual service users and comments made in surveys returned confirmed that they thought they were treated with respect by staff, and staff on duty were seen to be attentive and helpful in their dealings with service users. Comments Care Homes for Older People Page 13 of 28 Evidence: made included the regular staff here are good, the staff are helpful, I am quite happy here. 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 living in Brewster House can expect to have a lifestyle that matches their expectations through opportunities for activity, and enjoyable food. Evidence: Service users meetings had taken place and minutes of issues discussed had included food, activities and staffing. The manager said that these meetings take place once a month. A quarterly newsletter is also compiled and sent out to relatives to keep them informed about the home. The home has two activities coordinators posts although at the time of the inspection one post was vacant. The person in post had received training on providing activites to people in care, this included for people who have dementia. There was a programme of planned activities displayed in the communal rooms and individual records had been kept of activities offered daily to each service user. These included games, cards, discussions, walks and shopping trips, nail care, indoor games, bingo, quizzes, arts & crafts and visiting entertainers. Outings had begun, community transport is used for this. The manager said that places visited and Care Homes for Older People Page 15 of 28 Evidence: planned so far included lunch out, local attrations and theatre trips. The manager also said that local clergy visit weekly to hold a service in the home and church visitors also come in regulary to see individual service users, and also take them to church if they wish. Leisure facilities available to service users include access to relaxation and sensory rooms in the day centre joined onto the rear of the home. A hairdresser visits twice weekly to provide hairdressing to service users. Four service users spoken with said they took part in activities and that they were usually enjoyable, although some spoken with were not interested in taking part at all and some said that they would like more activities offered them as they did not think much went on at all. When asked, service users told the inspector that their family and friends could visit at anytime and that staff always made them welcome. Relatives spoken with confirmed that they visit regularly and at any time. Inspection of private rooms evidenced that service users had been permitted to bring their own personal items with them on admission. There was also confirmation of this direct from service users, who, when asked, told the inspector of the furniture and personal items they had brought in with them. Information for service users and their relatives on how to access independent advocacy support was displayed in the home. This had been used by some for advice relating to issues outside the home. Service users had recently been given surveys to fill in by the manager to ask for their views on the food. Comments made lead to some changes to the homes menus. These were seen as were daily nutrition records, and showed choice and variety in the food served. Portion sizes eaten had been recorded so that staff could see quickly if a service user looses their appetite. There were also nutrition assessments for each service user that included a monthly weight monitoring check. Any appreciable weight losses or gains were reported to the GP for advice on whether any health checks were needed. The cook confirmed that the main daily meal is lunch with at least two choices and that there is also a choice at tea. Cooked breakfasts were on the menu on alternate days and hot suppers are provided to those who feel hungry at night. Food stocks were good and service users spoken with at the inspection were satisfied with the food and confirmed that there was always a choice. One service user said the food is good and I get plenty of it. Others when asked, said the food is very good, the food is fine, I cant complain at all I get more than enough to eat. However comments made in several surveys returned to CSCI mentioned that the meat is sometimes tough. The manager was made aware of these comments so that she could keep check on the Care Homes for Older People Page 16 of 28 Evidence: quality of the meat purchased in future. Care Homes for Older People Page 17 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. Service users are cared for in an environment where they are comfortable to raise concerns and know that these would be dealt with appropriately. Evidence: The complaints procedure was seen and contained guidance on how to make a complaint and who to complain to. Also included were timescales for responses from staff. There was a standard template for staff to record any concerns and a log of compliments, comments and complaints received. Evidence was seen from this to confirm that records are maintained in the home of complaints and of any investigation and resulting outcomes. Information in the AQAA states that ten complaints had been received in the twelve months leading up to 1st August 2008. Records inspected evidenced that these had been dealt with appropriately. Service users spoken with said they knew who to speak to if they had any concerns, and they seemed confident that any concerns would be investigated properly. Surveys from relatives indicated that they were confident that complaints or concerns would be dealt with appropriately. The homes policy on adult protection was inspected. There was written guidance for staff on recognising and reporting abuse, and action to be taken by staff if abuse is suspected. Staff spoken with displayed awareness of this subject and procedure and Care Homes for Older People Page 18 of 28 Evidence: had received training on adult protection procedures, certificates were seen to evidence this. All new staff are provided with a staff handbook which includes a code of practice and defines their responsibilities regarding safeguarding vulnerable people and their duty to report any concerns to the manager. The homes induction training also covered adult protection and safeguarding vulnerable people. Care Homes for Older People Page 19 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. Service users live in a safe, mostly well maintained environment with access to comfortable and pleasant accommodation and facilities. Evidence: Brewster House provides a spacious, bright, comfortable and mostly well maintained environment. The site visit included a tour of the premises when it was noted that the home was clean and tidy, and there was no evidence of any unpleasant odours. The bedrooms, lounges and dining room were well decorated but some door frames had damaged and chipped paintwork that should receive attention. Carpets and furnishings were of a good quality and were clean. The bathrooms had aids and adaptations to meet the needs of the people using the service, and there were sufficient toilets sited close to communal rooms. The manager said that all seven bathrooms had wcs and there were four separate communal wcs. There are sixty three bedrooms (sixty two singles and one shared) in the home and sixty of these had a private en suite wc and one room also had a private shower. Bedrooms seen were well decorated, clean, comfortable and made homely with peoples personal possessions. During discussion with service users all who expressed a view confirmed that their rooms were comfortable and kept clean. Comments made included, my room is cleaned every morning, the staff clean my room regularly my Care Homes for Older People Page 20 of 28 Evidence: room is kept clean for me. Comments from relatives were generally positive however one thought that the large ground floor dining area could be kept cleaner at times. This comment was relayed to the manager. There are four lounges around the home these were bright and spacious. The garden area was an enclosed courtyard at the centre of the building. The laundry was on the ground floor. The equipment in place was suitable for the size of the home and there was sufficient space for staff to work in. Care Homes for Older People Page 21 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. A team of properly recruited and trained staff look after service users. Evidence: The homes staffing rota was inspected and showed daytime staffing levels as eight carers on mornings and afternoons except between the hours of 1100 and 1700 when there were several carers on duty. In addition to this there are two CTMs in the mornings and one CTM in the afternoons and evening. The managers hours are supernumery as are the deputy managers hours on two days each week. On the remaining days the deputy manager is part of the care team and peforms the duties of a CTM. Night staffing is three waking carers and one CTM. In addition to the care staff there are two cooks employed who between then work every day and one part-time kitchen assistant. The home also has an administrator, one laundry person, four domestic staff, two activities coordinators and a maintenance person. The gardens are tended by Runwood Homes gardening team. Three staff recruitment files were inspected. Evidence was seen to confirm that application forms had been completed, interviews held, written references obtained, written terms & conditions issued, and criminal records checks undertaken. Copies of proof of ID, photographs and job descriptions were also on files. Care Homes for Older People Page 22 of 28 Evidence: Staff are encouraged to undertake NVQ training and evidence was provided to us to confirm that 82 per cent of carers had achieved their NVQ level 2 or 3 awards, with a further 8 per cent training for this award. Evidence was seen to confirm that new staff undergo initial 4 week induction training. This includes issue of a staff handbook to clarify the expectations of workers roles. Soon after the four week basic induction is completed new staff work on the full Skills for Care Common Induction Standards format. Staff spoken with confirmed they received induction training, they also confirmed that the manager is supportive and will respond quickly to any queries or concerns they may have regarding service users well being. All staff have an individual training record and there is a training matrix which identifies training undertaken for the whole team, as well as when updates are due. Training records seen and discussion with staff confirmed that staff had been provided training on induction, dementia, safeguarding (adult protection), medication, first aid, health & safety, fire awareness, manual handling, food hygiene, activities for people who have dementia and NVQ. The manager advised that training on dementia did include some awareness of challenging behaviours but we recommend that staff should have specific training on this subject. Care Homes for Older People Page 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well run home that is managed in their best interests. Evidence: The manager of Brewster House is a trained nurse and has 26 years experience in the care and nursing sector, and has been a manager of a care service since 1995. The manager has undertaken training to update her knowledge and skills and as well as being a qualified nurse also holds the Certificate in Management award. The quality assurance (QA) process at Brewster House involves an annual audit of the service by the registered provider. A copy of this comprehensive assessment was seen. This exercise includes writing to service users, relatives and health and social care professionals involved in the home to ask their views on the service provided. Responses in surveys were seen included in the report. The most recent audit report was completed in November 2007 and from this an annual development plan was compiled and an action plan to deal with any issues raised. This was seen at the Care Homes for Older People Page 24 of 28 Evidence: inspection. Other quality monitoring processes evidenced as used to gather views and opinions included catering surveys, a comments & suggestions box in the home, service user meetings, staff meetings and relatives meetings. The manager confirmed that personal allowance monies are held for safe keeping for all service users. Records had been kept of the balances held and of receipts for expenditure. A random sample of these were checked and found to be in order. Staff had received regular recorded 1 to 1 supervision from the management team. Records of this process were seen and included discussion on service users, training, personal development and actions to be taken. Staff spoken with said they received 1 to 1 supervision and support and that regular staff meetings took place. Random samples of records required to be kept were inspected. These included, accidents, complaints, assessments, care plans, staff rotas, staff recruitment, visitors book, fire drills, nutrition, medication, background information and fire procedures. All seen were satisfactory. Discussions with staff, management and inspection of records confirmed that training is provided to staff in moving and handling, fire safety, food hygiene, first aid and infection control. Certificates and service records were seen to confirm that the homes hoists, fire equipment and alarms, passenger lifts, gas boilers, portable electrical appliances and electrical installation supply had all been tested and/or serviced. Hot water temperature is regulated and manual checks are also carried out regularly, these were seen. Care Homes for Older People Page 25 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 26 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 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 The current in house medication training provided to staff should be underpinned by additional evidenced training on the safe handling of medication. This would provide staff additional formalised training on this subject. Door frames around the home would look cleaner and better maintained if painting and repairs were made to the damaged and chipped paintwork seen at the inspection. Staff training should include update training on working with people who may present behaviours that challenge. This is to provide staff with the knowledge and skills for their roles. 2 19 3 30 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. 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