Inspection on 19/11/08 for Brookside House care Home

This inspection was carried out on 19th November 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Brookside House care Home 23/11/06

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 26/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Brookside House care Home 35 Wagstaff Lane Jacksdale Nottinghamshire NG16 5JL     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: David Litchfield     Date: 1 9 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. 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 30 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 30 Information about the care home Name of care home: Address: Brookside House care Home 35 Wagstaff Lane Jacksdale Nottinghamshire NG16 5JL 01773608527 01773541059 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Farrington Care Homes Ltd Name of registered manager (if applicable) Lyn Castledine Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Situated in Jacksdale village, Brookside House is an established care home, owned by by Farrington Care Homes Ltd and provides personal care for up to twenty-five residents. The home has two lounges and there are twenty-one single and two double rooms all of which have washing facilities and telephone points. The bedrooms are located on both floors of the home, which have access to three bathrooms and four single toilets. The home provides equipment to support residents with mobility and a lift is provided. The home has attractive gardens and patio areas. The home is entered via the car park at the rear of the building. The home provides a comfortable, clean and homely environment with a family atmosphere generated by the staff team and current group of residents. Fees at the time of this inspection were £390 per week. Care Homes for Older People Page 4 of 30 care home 25 Over 65 25 25 0 0 0 1 Care Homes for Older People Page 5 of 30 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: We had previously visited the service on 23th November 2006. This latest inspection took place on 19th November 2008 and involved an eight hour visit to the home where we met with the manager, staff, people who use the service and family members. We spoke to people who use the service and family members. We wanted to understand more about their experience of the service and to see whether they are kept involved and their views listened to. We also found out this type of information through some surveys completed before our visit. Care Homes for Older People Page 6 of 30 We spoke to the manager to find out about her skills and experience. We wanted to see the way the home is managed and run, and the systems used to ensure that people receive the service they need and expect. We also spoke to members of staff to find out about their knowledge and skills, and see if they receive the right support and training to care for others. We looked closely at the records for four people who use the service to check what information is held about them. We wanted to see if the service was gathering essential information about their needs and expectations for the service, and about the particular way staff were to meet these requirements. We were interested in how they involved people in this planning process and how the service ensured that the things that make people different from others were recognised and planned for. We examined records about how staff are recruited to find out if this is done safely. We wanted to see if the right checks are made, and that they are given the training and support to work with vulnerable people. We also looked at other records at the service such as safety checks and policies. Finally, we considered other information we have received about the service since our last inspection. In particular we referred to a document the service has to complete about their work over a twelve-month period and about their plans for the next twelve months. What the care home does well: What has improved since the last inspection? What they could do better: There is not enough information being recorded about peoples needs and expectations. This information would ensure all staff fully understand each persons needs and expectations, and allow their individual service to be planned. There is very little information about what makes each person different and no clear record as to whether the person or others important to them were consulted. There is no written plan explicitly describing what each person needs and expects staff to do for them such as how people should support them with personal care or with their health. This was being done in the past but the manager told us it had stopped. It must begin again in full consultation with the person and others important to them, with enough information so staff can completely understand all their responsibilities. Many documents are not being signed so it cannot be clear who takes responsibility for the care described on them. Others records have not been checked or kept up-to-date so they may describe processes that are no longer appropriate or safe for people. This means staff may not be supporting people correctly. One of the services legal responsibilities is to be visited on a monthly basis by an appropriate person who gives them a report about the service people receive. Very few of these reports have been provided, and there was no record of the actions the manager takes to rectify any issues. Some staff did not show full knowledge and understanding of their responsibilities around keeping people safe from abuse. In particular they are not all aware of the role of outside organisations such as the local authority. Care Homes for Older People Page 8 of 30 Some improvements should be made to the way medication is being administered. There should also be a second member of staff countersigning and dating any handwritten medication records to ensure no mistake could be made. 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 30 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 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with information about the service, but do not benefit from a record of all the needs and expectations they have from the service. Evidence: We were told that people or their representatives are welcome to visit the home. The manager says she always makes sure she meets people. A family member of someone who uses the service told us me and my daughter came for a look around. A person who uses the service told us that her daughter came to look around and then explained to me. I liked the sound of it. We heard people get a brochure that tells you all about the home, what they do and the caring. We saw this information and it has lots of useful information about the service and also how to make a complaint. The manager has kept the guide up-todate. Care Homes for Older People Page 11 of 30 Evidence: A family member told us that the manager had a lot of questions, and asked all about the care the person would need. Staff confirmed that if we have a client come to us with any need or disability we are made aware of these before they arrive, and we heard that staff are always given up to date information for the needs of our residents. The manager also told us they find out lots of information about the person before a service is provided. However, we saw that very little of this information is recorded in peoples files. There is some information written down about their background, their basic personal care and health needs but there is not much detail. There is no information recorded about who provided the information, and how people who use the service were involved in the process. We also saw there was no information about the things that make each person different from others for example about their religious or cultural background. In one case a person was stated as Christian but with no further information about what this means to the person, or their needs and expectations from the service about this. The manager informed us one person has diabetes but was not directly stated anywhere in her records. There was some information about recent medical appointments elsewhere in her file that indicate her health needs are being met, but staff are not provided with explicit information about what her health needs are or about their role around this. The manager told us the service does not provide intermediate care. Care Homes for Older People Page 12 of 30 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. Peoples care needs are not being adequately planned for which may mean those needs are not being fully met, although people are treated with respect and dignity. Evidence: We looked closely at peoples files to see whether there is clear, written information about how each person needs and wants to be supported. We found this has not been done. The manager confirmed that they have not developed plans to describe exactly what staff are expected to do, although the guide about the service says this plan is produced before people are admitted. We heard that this was an oversight following an effort to simplify records. Some people who had been using the service for longer had some old plans dating from before our last inspection, but these were very brief and had not been updated. There was no indication of who had been involved in producing the plan, including whether the person themselves had been consulted about the care they expect from the service. Care Homes for Older People Page 13 of 30 Evidence: We did see each person has a record referred to as a care plan update that did give some indication that peoples changing needs were being considered, but it did not give specific guidance around exactly how to support each person. These records are not signed, so it is not clear who writes them, although the manager told us senior staff take responsibility for it. There is a daily diary kept about each persons activities, that staff use to understand what has been happening in each persons life. There are also other records, such as records of people having falls or medical appointments. However, many of these have no signature so it is unclear who wrote them if their accuracy needed to be checked. We did see some records showing that people have regular contact with appropriate health services, but as there are no plans of care, staff are not provided with appropriate information about meeting each persons health needs. One person had a document in her file for monitoring blood sugar levels but this had not been completed since early 2007. The manager was not initially aware if it needed to be completed or not, and there were no instructions to staff as to whether they should be using it. On closer examination of other records, it was eventually established that other health professionals were now monitoring the persons needs in this area, but this was not made clear to staff. We saw that people are supported with their medication. The service has a policy for how they manage medication, but the policy had not be reviewed since 2003 to see if it was still appropriate. We saw that records are kept of administered medication which is stored safely. We also saw that some medication record sheets are hand-written but these records are not counter-signed and dated to help ensure that no error has been made. Peoples files also have very little information about how they are different from other people and no information about the support they might need around this. For example we saw that some people have a religion mentioned in their file, but no plan about any support they may need around it. The manager said that she has not been able to maintain the required documentation at the service. She agreed that peoples records do not give enough information for staff to know how to care for them. Staff told us that they understand how to care for people from what they are told by family and friends and by generally talking to the residents. Staff told us that they feel Brookside has a very happy feel to it and that the service looks after the service users, family and friends by being a caring friendly home. Care Homes for Older People Page 14 of 30 Evidence: People told us they are happy with the service they receive. One person told us from day one nothing is too much trouble, I have always had wonderful care and support. We heard that if youre poorly, they look after you and whatever I need, its there. We heard from a family member that they have had no worries here. We observed staff interacting with people and saw that they were gentle and respectful, treating people in a dignified manner throughout. Care Homes for Older People Page 15 of 30 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 have appropriate social contact and activities, and make choices in their lives. Evidence: We saw that the service organises activities for people who use the service. There are entertainers booked in each month and we heard from family members that people enjoy this. There are other activities arranged each day and a record is kept of whether people wanted to take part or not including sing-a-longs and bingo. A staff member told us I like to stimulate them and it can be surprising what they can do. That day people had been watching DVDs about times in the past, and we saw that staff were interacting with people throughout the day. A person who uses the service told us the activities are daily and are very good. We saw that people are free to have visitors and saw some people had family visiting them on the day of our visit. Family told us the service keep us informed and you can come anytime you like. Staff told us people are encouraged to make choices in their lives such as choosing what to watch on TV or to not join in entertainment. We saw that peoples daily Care Homes for Older People Page 16 of 30 Evidence: record included some information about choices they had made around things like the clothing they wanted to wear. A person who uses the service told us their wishes and comments are always listened to. We observed a mealtime and it was calm and not rushed. We saw that one person had chosen to eat on her own away from the others. There is a four-week menu that is varied and nutritious and we saw that choices are on offer. People who use the service told us they get you what you want to eat and the meals we receive are varied and extremely good. A family member told us the food smells nice. Care Homes for Older People Page 17 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have access to a complaints process but do not benefit from staff who fully recognise and understand their responsibilities around keeping people safe. Evidence: Before the inspection, we had asked the service to provide us with information about their plans for improvement in each area. In regard to complaints and protection the manager had left this section blank, indicating there were no future plans to develop this area of their work, and this was confirmed on our visit with the manager. A person who uses the service told us the staff and management go out of their way to make everybody happy and safe in every aspect. The manager told us the service has not received any complaints since their last inspection and we have not received any. We saw that people are provided with information about how to make a complaint in their service guide and also on a poster in the communal areas. Staff told us I have always been told of our complaints procedure and a family member told us that they felt theyd accept it if I needed to complain. We looked at how the service keeps people safe from the risk of abuse. We saw that Care Homes for Older People Page 18 of 30 Evidence: there had been one concern reported to the local authority and that steps were taken by the manager including letting us know about the situation. We saw that staff have been trained in this area although we heard mixed opinions from staff about this training. Despite recent developments around how services should keep people safe, one staff member told us the training didnt teach me anything new. We heard from another that the training helps you to know where to go if you see something you dont like but another told us that as the trainer came from another area, they were not aware of the local authority procedures for reporting. We saw that there was a copy of the local authority reporting procedure and we asked staff about their understanding of this. We heard from one staff member that she would tell the manager but wouldnt get in touch with other bodies despite this being part of the policy. Care Homes for Older People Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a homely, clean environment. Evidence: We saw that the building is kept clean and presentable. The building is well maintained and saw that a record is kept of the maintenance work required and undertaken. There is also a cleaning record, ensuring that all areas are kept clean and hygienic. A person who uses the service told us the home is clean and always fresh smelling, so important There is plenty of room for people with large communal areas and lots of space. Staff told us we try to keep it as much like being at home as possible. We observed someone who uses the service helping in the kitchen and heard that people are welcome to make use of the kitchen; the manager saying it is their home. A person who uses the service told us it is more homely than another she had lived in. We saw that people have comfortable and individualised bedrooms and sufficient bathrooms, and there are suitable facilities for safe handling of peoples laundry. Care Homes for Older People Page 20 of 30 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 are supported by sufficient staff that are trained and safely recruited. Evidence: We looked at how the manager recruits staff. We saw that people have checks made beforehand such as criminal checks and references taken. The manager told us that she interviews new staff but we saw no records of this, or of what was discussed. The manager told us staff are given an introduction to the service, such as showing them the policies and the environment but there is no record made of this. They then complete a induction that covers aspects of their work such as their roles and how to communicate with people. A signed record is kept of this process. We heard from a staff member that I found the induction did cover everything we needed to know and my induction helped me a lot when I started my job. We saw that people receive lots of training around things like first aid, health and safety and infection control. In most cases this was up-to-date, although some people were waiting to update training around moving and handling. We saw that there was a plan to do this, with lists of training coming up and members of staff assigned to the training. Care Homes for Older People Page 21 of 30 Evidence: We looked at rotas and observed that there were enough staff to support people. We heard from someone who uses the service that the staff are always around and you never have to wait. The manager told us they had increased staffing levels to enable activities to take place. Care Homes for Older People Page 22 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared for by well supported staff, but use a service that is not meeting all its responsibilities to monitor quality and ensure good management. Evidence: We asked the manager about how she stays in touch with current developments in her work. We saw that the manager has continued to undertake appropriate training including training about keeping people safe and record keeping. However, she told us she finds it hard to keep up with changes, and is not aware of practice outside of Brookside as she has never met with other managers or visited any other services in her career. We saw the manager has not maintained all the records about people using the service as required by law, such as written plans of care. Before the inspection we asked the manager to complete a key document that tells us all about what they have been doing and their plans for the future. We use this information to better understand the kind of service people experience. It was provided in time but the manager gave us very brief and limited information that told us very little about the service people Care Homes for Older People Page 23 of 30 Evidence: receive. Some sections were left blank especially those about the future of the service and their plans for improvement. We saw that the manager had recently attended training to help her learn how to complete this type of self-assessment, but she told us that it was not very helpful and that she did not fully understand what was expected of her. We heard from staff that the managers doors always open and that she is very approachable. We heard that the manager likes to have discussions with us, likes to hear about any suggestions we have. We saw that there are some systems for monitoring the quality of the service. We saw that the manager had sought the views of people who use the service and family members through questionnaires. These had been last done 5 months prior to our visit, and had led to one recommendation for chairs to be updated. The manager told us she wanted to do this but was still waiting for approval from the head office. We also saw that a survey had recently been given to staff asking about their work and for any improvements that might be needed to the service. The manager told us that someone from the head office makes monthly unannounced visits, as required by law. However, there were no records of most of the visits as the manager told us she had not been provided with most of the reports. We saw that she had only received two reports in 2008. The manager says she keeps no records of any actions taken following these. We saw that the manager supports two individuals with their finances and saw suitable and accurate records are kept. We saw that the manager has systems in place to ensure the support of the staff members. Records are kept of regular meetings that detail observations of their practice such as their administration of medication or continence support, and discussions about training and development needs. We heard from staff that they receive brilliant support from the manager and that shell bend over backward if she can. We saw that there are systems in place to ensure people using the service and staff are in a safe environment. There are regular checks and activities around fire safely, and equipment is serviced and checked regularly. There are records of this along with records of monitoring the water temperatures. There are records showing the risks people face are considered and planned for and these are easy to follow. However many of these had been written more than four years previously, with no indication they had been checked to see if they were still appropriate. Care Homes for Older People Page 24 of 30 Evidence: We saw that there are comprehensive policies covering the operation of the service. It could be seen that some of these had been recently updated, but others appeared to be older. In one case there was a policy dated 2005 that mentioned the National Care Standards Commission, despite this organisation not existing since April 2004. Care Homes for Older People Page 25 of 30 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 30 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 18 13 Arrangements must be in place to ensure staff are knowledgeable about and able to implement current procedures around safeguarding vulnerable adults. This will ensure that people are safe and their human rights protected. 19/02/2009 2 31 24 A system must be maintained for reviewing and improving the quality of the service. This will ensure that people receive a service that is constantly improving. 19/02/2009 3 31 12 The manager will ensure that the care home is conducted so as to promote and make proper provision for the care of people using the service. 19/02/2009 Care Homes for Older People Page 27 of 30 This will ensure that people receive the service they need and expect. 4 33 26 The care home must be 19/02/2009 visited unannounced by an appropriate person monthly, and a report supplied to the registered manager. This will ensure people receive a service whose quality is monitored. 5 37 17 There must be up-to-date 19/02/2009 records kepts about each person using the service including all the information, documents and other records specified in Schedule 3. This will ensure that people receive are supported safely and correctly by fully informed management and staff. 6 38 13 There must be up-to-date assessments of any risks to peoples health and safety. This will ensure that people are safe. 19/02/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 3 The service should ensure that peoples assessments detail all their needs and expectations from the service, and show who was involved in the process. This will means people are in control of their service and confident that staff are Care Homes for Older People Page 28 of 30 fully aware of all their requirements. 2 4 Peoples assessments should indicate how they are different from others, such as their cultural or religious needs. This will ensure that staff understand and support what makes each person unique. Handwritten medication records should be signed and dated by two trained members of staff. This will ensure that no errors are made and people receive their medication safely. There should be a full record of what information staff are given on starting work. This will ensure that people are supported by staff who are fully aware of all their responsibilities. 3 9 4 30 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!