Inspection on 09/10/08 for Briar Dene

This inspection was carried out on 9th October 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Briar Dene 19/02/09

Briar Dene 25/10/06

Briar Dene 07/02/06

Briar Dene 20/12/05

Briar Dene 02/03/05

Briar Dene 09/09/04

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

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Ravensworth Lodge

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: Briar Dene 71-73 Burniston Road Scarborough North Yorkshire YO12 6PH     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: Pauline ORourke     Date: 1 3 1 0 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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Briar Dene 71-73 Burniston Road Scarborough North Yorkshire YO12 6PH 01723361157 F/P01723361157 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr John Kelly care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Briar Dene is a large, detached property standing in its own grounds on the north side of the town. The care home is located reasonably close to all main community facilities including the public transport network. There are parking spaces available for several vehicles. The building, a former hotel, has been adapted to provide care for a maximum of 27 people who are accommodated by virtue of age or infirmity. The home provides 25 single and one shared bedroom, all with en-suite facilities, on two floors and there is a passenger lift. Mr. John Kelly is the registered provider/manager and Mr. Mark Kelly helps in management of the service. Mr. Kelly together with a staff team made up of care staff, kitchen, dining room and domestic staff, provide accommodation, personal care, meals, laundry and domestic services. An activities organiser provides leisure and recreational activities for people on a weekly basis, and many people in the home are able to go out unaided or with the assistance of visitors or staff. Information, including Commission for Social Care Inspection reports, is given to prospective and established people in the home detailing the accommodation, facilities and services provided. The weekly fee is quoted by the provider as being Care Homes for Older People Page 4 of 28 Over 65 27 0 Brief description of the care home three hundred and eighty pounds to four hundred pounds per week in October 2008. People pay separately for hairdressing, private chiropody, toiletries, magazines, papers and transport. 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: The Commission for Social Care Inspection inspects homes at a frequency determined by how the home has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. More information about the inspection process can be found on our website www.csci.org.uk The key inspection has used information from different sources to provide evidence for this report. These sources include: Reviewing information that has been received about the home since the last inspection. Care Homes for Older People Page 6 of 28 Information provided by the registered person on an Annual Quality Assurance Assessment. Comment cards returned from people living at Briar Dene. A visit to the home by one inspector that lasted for six and a half hours. During the visit to the home twelve people who live there, four staff and two visitors were spoken with. Care records relating to four people, four staff members and the management activities of the home were inspected. Care practices were observed, where appropriate, and time was also spent watching the general activity within the home. This enabled the inspector to gain an insight of what life is like at Briar Dene for the people living there. The Registered Manager John Kelly was not present for the inspection but his son Mark Kelly was available throughout the day and at the end of the inspection for feedback. What the care home does well: What has improved since the last inspection? What they could do better: Whilst people said that they were happy at Briar Dene there are still areas of the service that require updating and improving. Prior to someone moving in to the home a member of staff goes out to see them and carry out an assessment of need. Currently the information gathered is quite basic. The assessment information gathered prior to admission should be detailed enough to develop a care plan highlighting all the areas of assistance and support required by the person concerned. The care plans seen had some detail on them but had not been signed by the person they were about, as a matter of good practice they should sign and date this document to demonstrate an understanding of what help they are receiving. The information provided to people coming in to the home in the form of a Service User Guide and Statement of Purpose should contain equality and diversity statement that outlines the different strands of the larger community whose needs could be met at Briar Dene. The medication systems need attention as the following areas need attention: The medication policy needs to be updated and improved Staff who are authorised to give medicines should provide a sample of their initials so that staff can be identified on the MAR sheet. The quantity of medication and the date received should always be recorded so that an audit trail can be followed if necessary. The standard of handwriting on the MAR chart was poor and not always clear. Medicines must be kept in locked cupboards and or rooms at all times. The storage of controlled drugs does not meet the legal requirements and a CD cupboard must be obtained. Care Homes for Older People Page 8 of 28 The person ordering the prescriptions on a monthly basis should have sight of the prescriptions before a supply is made. Staff training should be introduced to include aspects of the aging process such as Alzheimers, Parkinsons, to name a few. They should also have fire training on a regular basis as outlined in the guidance provided by North Yorkshire Fire and Rescue Service. This will enable them to have an understanding of problems older people face as well as being aware of the fire escape routes. The quality assurance system should be expanded to include stakeholders, visitors, and information from meetings held in the home. This will allow a fuller picture of the service provided at Briar Dene to be seen and developed. Current staff meetings are only held for senior staff and these should be expanded to include all staff working at Briar Dene this will allow all staff to be involved in the home. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 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 10 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 who are admitted to Briar Dene have their needs assessed before they are admitted, so that their needs can be met. Evidence: Three case records were examined, one of which was of someone who had been recently admitted to the home. These showed that prior to admission, information had been obtained about the person, their circumstances and background, and any needs, which were to be met. Some of this information was detailed but not all of the needs identified had any detail as to the type of support required. Discussion with people confirmed that they had had chance to visit the home prior to admission. Where someone is placed through the care management process his or her assessment information is used to inform the admissions process. The Statement of Purpose and Service User Guide were seen during this inspection Care Homes for Older People Page 11 of 28 Evidence: and they contained the information necessary to allow people to gain an understanding of what Briar Dene had to offer. These documents could be further improved by including an equality and diversity statement that outlines the different strands of the larger community whose needs could be met at Briar Dene. Care Homes for Older People Page 12 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. People receive the care and support they require but poor practice with the medication puts them at risk of receiving incorrect medicines. Evidence: Four care plans were seen and each of them contained a care plan. These are reviewed each month although there was no evidence that the person they were about had signed them. Staff keep daily records for each person and this information feeds in to the review process. Information in the care plans also indicated that people access health services as necessary. One person said the staff will call the doctor if you need one and feedback from health care professionals said Staff maintain good working relationships with the doctors and the nursing team and we have worked well with Briar Dene staff several times where someone has been near the end of life and have found them always kind, caring, willing and professional in their approach to the needs of all involved Care Homes for Older People Page 13 of 28 Evidence: A CSCI pharmacist inspector carried out an inspection of the medication systems.The medication policy needs to be reviewed. The current policy refers to nurses rather than care staff and does not provide enough information for staff on current legislation and guidance to make sure that safe practices are followed.The current and previous months Medication Administration Records (MARs) were looked at. There is a list of staff authorised to administer medicines but there are no examples of their signatures. This means it is not possible to identify who was involved in administration if a query or problem occurred. The quantity of medication supplied and the date received is not always recorded. The quantity of medication from one monthly cycle to another is not recorded on the new MAR. This means it is difficult to have a complete record of medication within the home and to check if medication is being administered correctly. This was particularly concerning for antibiotics as it was difficult to establish if the antibiotic had been given correctly. For example one person was prescribed antibiotic capsules at a dose of 1 four times a day. No record had been made of the quantity supplied. Twenty-two capsules had been recorded as administered at the end of the course, which is not a multiple of the four times a day dosage. Antibiotics must be accurately given to make sure the infection they were prescribed for is treated properly.The standard of handwritten entries and changes to medication was poor. A number of MARs had two medicines written in the same section. This means there is a risk that staff may misread the directions and give the incorrect medication or dose. To make sure there is an accurate record the quantity supplied, the date of entry, the signature of the person making the entry and a witness signature where possible should be included. Similar requirements are needed for a change of dose or cancelled medicines. Details of the person authorising the change should also be included. This makes sure there are accurate details from which administration of medicines can be done. The standard of accurate record keeping is poor; there were a number of gaps on the MARs. To demonstrate that people are getting their medication as prescribed the MAR should record each administration. The code O was used on a number of occasions to record no administration. However there was no definition on the chart to explain why the person had not received their medication. This means that there is incomplete information on how the person is taking their medication. The room where medicines are stored has a locked door. However on arrival at the home the door had been left open and a box of returned medicines was left out on the floor. The metal box used for storing fridge items in the kitchen fridge is lockable but was not locked on the day of the inspection. This means that medicines are not being stored securely and are at risk of being tampered with.The storage of controlled drugs is not suitable. It is now a legal requirement for all care homes to store controlled drugs in a cupboard that meets the specific legal requirements. There is no register for recording the receipt, administration and return of controlled drugs as required by law. The date of opening Care Homes for Older People Page 14 of 28 Evidence: on medicines with limited use once opened is not recorded. For example the pharmacy label on one bottle of eye drops was dated August 2008. Without a date of opening recorded it was difficult to know if these drops had reached the 28 day limit after opening and therefore may be unsafe to use. The person in charge of ordering monthly medication should have sight of the prescriptions before a supply is made. The prescription is the authority for the staff to administer medication to the person. This also provides an opportunity to check if any new medicines or dose changes are included. Any problems with prescriptions can be addressed at this point rather than after the supply has been made. Throughout the visit the interactions between staff and people in the home was friendly, respectful. This was also observed by visiting professionals who said staff develop a genuine rapport with people in the home and the staff are pleasant and respectful to the people in the home. People in the home said the staff are good and respond quickly if I use the call bell and the staff are good, polite and respectful Staff spoken with said that their induction included instruction about being polite and treating people with respect at all times. Care Homes for Older People Page 15 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 are able to make choices on a daily basis and are supported to do this by the staff. They enjoy a good meals and a social and recreational programme helps them to maintain their interests and hobbies. Evidence: People are encouraged to follow their own daily routines and people in the home reflected this. One said there are activities to do each afternoon if I want to join in I can and things are arranged if you want to take part in them An activities organiser is employed and recent organised events include, a banjo singer, Macmillan coffee morning, music therapist a local choir visiting and clothes fairs. People can have visitors at any reasonable time and several spoken with said that they were always made welcome and offered refreshments and they are kept informed of any concerns about their relative. A visitors policy is available and it is kept in the Service User Guide. People are encouraged to manage their own financial affairs and information about independent advice is given to people on admission to the home. Where someone Care Homes for Older People Page 16 of 28 Evidence: needs support with their daily monies then it is kept in the safe and records are kept. The records and cash amounts seen were accurate and up to date. The meals provided are freshly cooked each day using local produce where possible. The meals are planned a week in advance but only the main course is clearly identified, the vegetables are seasonal so this element of the meal is flexible. The meal at lunch time offers an alternative rather than a direct choice whilst there is a choice for the tea meal. People in the home do not directly influence the menus but their opinion is sought or offered to the manager. People said most of the meals are good and the food is alright the food is brilliant. 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. People are able to make a complaint using information provided by the home and are protected by the awareness of staff of potential abuse. Evidence: There is a complaint procedure in place and people spoken with were clear about who they would take any concerns to. One person said I would tell the head nurse if I was not happy and I would go to Mr Kelly if I had any problems. Feedback received through the surveys indicated that people knew who to speak to if they were unhappy. Staff spoken with were aware of the complaints policy and the Whistle Blowing policy. An Adult protection protocol is in place and staff were aware of their responsibilities under this procedure. However, this protocol needs updating to bring in line with the local authorities guidelines as outlined in the document No Secrets. Staff have received training in Adult protection issues through their National Vocational Qualifications level 2 course. There was no evidence that further training to ensure staff remain aware of this policy has been provided. 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 excellent 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 warm, comfortable and safe environment. They can access all areas of the home, which encourages independence. Evidence: Briar Dene is a two-storey building and has a lift so that people can access all areas. A tour of the building was carried out and it was seen to be well maintained, clean and odour free. The health and safety checks to ensure the safety of the building have been carried out. People have their own bedrooms and those seen had been personalised by the individual. There is one communal lounge, this room is a large open plan room and the furniture is arranged to encourage small groups of people to sit together or people can choose to sit by themselves. Feedback received from people in the home said the home is kept spotless and clean and the home itself is in lovely surroundings with trees and gardens which are looked after regularly The laundry is well situated and suitable for the needs of the home. Care Homes for Older People Page 19 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. People in the home are supported by staff who have been vetted before they started their employment and who receive some training to help them in their role. Evidence: At the time of the visit there was a team manger, three care workers, and four ancillary staff on duty. The staff team meets the needs of the people in residence. Staff spoken with said that there was usually enough staff on duty to allow for the level of support required by people to be provided there was also some opportunity for activities in the afternoon. The people in the home said the staff are wonderful and will do anything for you, the staff are very good at all times and cheerful. Feedback from a health care professional said the staff are pleasant, respectful to the clients and visiting professionals. More than 50 of the staff have completed a National Vocational Qualifications level two in care. Staff also said that they also keep their health and safety training up to date. Staff who manage the medication have completed the learning distance course in the safe handling of medicines. Staff said that they did receive supervision but this was not always recorded. The senior staff also have regular team meetings, although not all staff are included in these meetings. Care Homes for Older People Page 20 of 28 Evidence: Four staff files were seen and these contained some of the necessary pre-employment checks, three of the four files seen only contained one written reference instead of two. Although for the most recently employed member of staff there were two references. There was no evidence that staff have received any training in the aging process covering topics such as Alzheimers or Parkinsons. Care Homes for Older People Page 21 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 home that is well managed but they have no input in to the development of the service they receive. Some health and safety systems are in place but others need to be implemented. Evidence: Mr Mark Kelly manages the home on a day-to-day basis and reports directly to the Registered manager Mr John Kelly. The Registered manager calls in to the home each day to ensure that everything is running smoothly. There is a very basic quality assurance system in place. This consists of questionnaires being given to people living in the home. It is recommended that this survey should be extended to include all stakeholders. It is also recommended that as part of the quality monitoring system regular meetings should be established to allow people living in the home to become more involved in the development of the service. Likewise the staff meetings should be expanded to include everyone working at the home and not just Care Homes for Older People Page 22 of 28 Evidence: for the seniors. This will allow everyone who is connected with the home to offer comment and suggestions as to the future development of the service. The annual quality assurance system should feed in to an annual development plan based on improving the service provided at Briar Dene. The Registered Manager has provided information to people in the home about where they may seek independent support with their finances. Where peoples monies are held in the office the cash and records seen tallied and were accurate. Proper records are kept along with receipts for any monies spent on behalf of someone in the home. The health and safety records were checked and all were found to be up to date. The fire safety training records were found to be out of date, guidance provided by the North Yorkshire Fire and Rescue Service states training should be provided in the first month of employment there should be two instruction periods, three monthly for staff on night duties and six monthly for staff on day duties. All accidents and incidents are recorded and when necessary they are reported to the Commission of Social Care Inspection. Care Homes for Older People Page 23 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 24 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 9 13 Medication must be given, as prescribed and accurate records must be kept for all medicines including controlled drugs Medication must be stored securely and safely. A system for the safe handling of medication with limited use once opened must be in place. This will make sure that people receive their medications correctly and the treatment of their medical condition is not affected This makes sure that medicines are safe to administer. 31/10/2008 2 9 13 Controlled drugs must be stored according to current guidance and safe custody regulations. 12/01/2009 Care Homes for Older People Page 25 of 28 This provides the extra security needed for this type of medicine and will help to prevent loss or diversion. 3 18 13 The registered person must update the Adult protection Policy to include the protocols as laid down by the Local Authority. This will mean that staff will be clear about their roles and responsibilities where adult abuse is suspected. 4 38 23 The registered manager must ensure that staff receive fire training in accordance with local guidance from the Fire and Rescue Service This will allow staff to learn and refresh the skills needed in case there is a fire. 30/01/2009 31/12/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 1 The Statement of Purpose and Service User Guide should contain a statement relating to the divesity strands that explicitly show that Briar Dene does not discriminate against any member of society. The information gathered before someone is admitted to the home should contain enough detail to allow the carers to provide the help and support someone requires. The care plan should be drawn up with the person it is about and they or their representative should sign it to show they have an understanding of the support to be provided. 3 3 4 7 Care Homes for Older People Page 26 of 28 5 9 Regular, monthly prescriptions should be seen before sending to the pharmacy. This means a check can be performed to see that all the requested medicines have been prescribed. The quantity of medication that is used from one monthly cycle to another should be recorded on the new MAR. This makes sure there is a method of tracking how much medication has been administered and to know how much stock there is. The medicine policy needs to be updated in line with current guidance so that staff understand how to handle and administer medicines safely. Handwritten entries and changes to MAR charts should be accurately recorded and detailed. This makes sure that the correct information and dose is recorded so a person receives their medication as prescribed. 6 15 People in the home should be more involved in planning the menus to ensure that food they particularly like can be included in their diet. Staff should receive training in issues relating to the aging process and in equality and diversity issues as well as the statutory training they receive. This will give them a better understanding of their role as a carer. The current quality assurance system should be expanded to include stakeholders views, staff views and views of families connected to the home. This will allow for everyone connected with the home to contribute to the annual development plan. 7 30 8 33 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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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. 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