Inspection on 02/09/08 for Broomfield Nursing Home

This inspection was carried out on 2nd September 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 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Broomfield Nursing Home 27/09/07

Broomfield Nursing Home 02/04/07

Broomfield Nursing Home 24/05/06

Broomfield Nursing Home 05/01/06

Broomfield Nursing Home 28/04/05

Broomfield Nursing Home 25/01/05

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Broomfield Nursing Home Yardley Road Olney Bucks MK46 5DX     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: Chris Sidwell     Date: 0 2 0 9 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 27 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 27 Information about the care home Name of care home: Address: Broomfield Nursing Home Yardley Road Olney Bucks MK46 5DX 01234 711619 01234 717054 broomfield@atlantishealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Type of registration: Number of places registered: Atlantis Healthcare Ltd vacant care home 49 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: 5 (five) of the above places are designated for EMI care Elderly physically frail 20 of whom receive personal care One service user under the age of sixty five 0 0 Over 65 0 0 Date of last inspection Brief description of the care home Broomfield Nursing Home is situated in the town of Olney and is privately owned. Local amenities are within walking distance to the home. The home is registered for 49 residents, including 5 who have dementia. The home cares for people who need support with personal care only and those requiring nursing care. Care Homes for Older People Page 4 of 27 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 inspection was conducted over the course of five days and included an unannounced visit to the home. The key standards for older people’s services were covered. Information received about the home since the last inspection was taken into account in the planning of the visit. Prior to the visit, the manager completed an annual quality assurance self-assessment. Residents and families were spoken to on the days of the unannounced visit. Discussions took place with the manager, nursing, care and ancillary staff. Care practice was observed. A tour of the premises and examination of some of the required records was also undertaken. The homes approach to equality and diversity was considered throughout. The home was last inspected on 26 September 2007. Care Homes for Older People Page 5 of 27 What the care home does well: What has improved since the last inspection? What they could do better: The Statement of Purpose and Service Users guide should be updated to reflect the management arrangements in the home. They should also include the complaints procedure, which should be displayed in the home. The care plans must be updated regularly and plans for care must be developed where a residents risk assessment identifies that they may be at risk. Residents medication requirements must be clearly described, in the care plan and on the medication record, particularly when the resident is on a variable dose regime. The activities coordinator should have training in the provision of therapeutic activities for the elderly and for those with cognitive decline. The home should continue to develop the activities, tailoring them to individual’s wishes and involving a wider range of staff to ensure that there are meaningful activities throughout the home on a regular basis. Care Homes for Older People Page 6 of 27 Residents should be involved in developing the menus and should be supported to make their own choices, nearer to the time that they are going to eat. Further advice is available in the Commission for Social Care Inspection guidance ‘Highlight of the day’ available on www.csci.org.uk Clinical waste must be stored in pedal operated waste bins with lids. The general and clinical waste bins must be kept clean and stored discretely. The organisation should use the department of Health’s ‘Essential steps’ to assess their infection control practices to ensure that residents are protected from the risk of acquired infection. Further information is available on www.dh.gov.uk. The management oversight of the home has lacked continuity over the last year. The proprietor must appoint a permanent manager, who should register with the Commission for Social Care Inspection. The proprietor must also notify the Commission for Social Care Inspection of any significant changes to the home. The proprietor must also ensure that the requirements of the fire safety authority are implemented in full. 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. 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 8 of 27 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. Information about the home is available to prospective residents and their care needs are assessed with them, prior to their move, to ensure that they can be met. The information should be updated to ensure that it describes the home accurately to help people make an informed choice as to whether the home can meet their needs and wishes. Evidence: The home has information available to potential residents in the form of a statement of purpose and service user’s guide. These are being updated to reflect management and other changes in the home. Neither the service users guide nor the statement of purpose describe the homes complaints policy. The operational manager said that she would address this. The operational manager or homes deputy manager visits Care Homes for Older People Page 9 of 27 potential residents before they move to the home to meet them and to assess their needs. Potential residents and their families may visit the home prior to moving to the home, although many move following a stay in hospital. One family member was spoken to and said that they had visited the home on behalf of their relative and that their family mamber had been visited by the previous manager before they moved. The home does not offer intermediate care for those in need of rehabilitation. Care Homes for Older People Page 10 of 27 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. Resident’s personal, healthcare and medication needs are met, promoting their dignity and wellbeing. There is a need to improve the written care plans to ensure that they accurately reflect the care residents need and to ensure that their medication needs are accurately recorded and met. Evidence: The care of four residents was followed through. All had care plans, which had been updated intermittently. Resident’s personal and healthcare needs were identified and risk assessments had been undertaken. Of the four care plans seen however two did not have care plans to describe the care needed in response to the risk assessment. Residents had had a nutritional assessment and had been weighed regularly. Three of the four had lost weight since moving to the home and two had care plans to address this. One had seen a dietician. One resident’s risk of developing pressure damage was assessed and documented, although a written care plan to minimise this risk was not Care Homes for Older People Page 11 of 27 in place. Where appropriate, however, residents had the appropriate mattresses to help relieve pressure and records were kept to show that they were helped to change their position on a regular basis. Although the written care plans were incomplete no residents had acquired pressure damage and they were receiving the care they required. There was evidence in the care plans that the general practitioner visits regularly and that staff take action promptly if a resident’s health deteriorates. One general practitioner was spoken to and he felt that although care had improved in the home he remained unhappy with the communication and felt that care and communication varied depending which staff member was on duty. This was echoed by the general practitioner who returned the questionnaire. Residents were well groomed and their clothing was in a good state of repair. Staff were observed to be courteous to them and to respond to their wishes promptly. The residents spoken to said that they did not have to wait long for a response to their call bell although they all said ‘they are very busy’. One said ‘I sometimes wait longer at night’. All the residents seen had a call bell within reach. Residents said that their care is given in their rooms and that they see the doctor in their rooms. There are medication management policies and procedures in place and the staff spoken to were aware of these. Storage facilities are satisfactory. Records are kept of medication entering and leaving the home. The medication administration records were accurately completed. Controlled drugs were stored satisfactorily and all entries to the controlled drug register were signed. A contract is held for the disposal of unused medication. The registered nurses spoken to said that medication was not administered covertly. If a resident refused medication this would be recorded. If the medication was essential and the resident lacked the capacity to make the decision, the doctor and family would be informed and a way forward agreed. None of the residents in the home managed their own medication at present. One resident was prescribed a variable dose of insulin. This had been changed and there were two variable dose regimes in the medication record. The changes had been taken by verbal message and signed for by one qualified nurse. The nurse on duty knew which variable dose regime to follow but this was not clear in the medication record. This was discussed with the operational manager and she agreed to discuss this with the diabetic nurse specialist and ensure that the medication prescription and record was accurate. Whilst the medication management in the home has improved since the last inspection there is a need to ensure that prescriptions are clear, particularly variable dose regimes. Care Homes for Older People Page 12 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There have been improvements in the provision of activities for residents, bringing interest and diversion to the day. The food is of a good quality and served in pleasant surroundings, although more should be done to involve residents in the development of menus and to support them to make meaningful choices about what they eat. Evidence: There is an activities coordinator in post who arranges a programme of activities in the home and some visits outside of the home. The operational manager said that they wished to develop this in their plans for improvement over the next year. A variety of entertainers come to the home and music and singing is a popular session. One resident said I like the singing, when I am in the mood. Visitors are welcome at any time and one family member spoken to said that she had been made welcome whenever she visited. The residents said that the routines were flexible although one said it depends who is on duty and how busy they are. Care Homes for Older People Page 13 of 27 There is a varied menu. There is a choice of main meal. Soup and sandwiches or a light cooked supper is available and staff said that hot drinks and biscuits or sandwiches were available in the evening. Residents order their main meal the day before. On the day of the inspection the order form had been completed but not taken to the kitchen, the chef did not ask for it and all residents were served the same meal. There were a number of complaints, which the manager addressed, when this was brought to her attention. It appeared that this was a genuine error although the chef said that it happened before. This should be addressed to ensure that residents can exercice a genuine choice. Further advice can be found in The Commission for Social Care guidance Highlight of the Day which can be found on www.csci.org.uk. The dining room has been refurbished and looks out over a paved patio area. Carers served the meal and were observed to present it attractively. The tables were laid with tablecloths, cutlery and glasses. The carers were seen to support residents who could not eat unaided discretely. The practice of mixing pureed food in one bowl continues, although the carer said that this was how the resident preferred it. Care Homes for Older People Page 14 of 27 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. There are safeguarding and complaints policies and procedures in place, which protect residents. The complaints policy should be more widely available to ensure that residents and their families know how to raise concerns should they wish. Evidence: There are complaints policies and procedures in place. The complaints procedure has been updated since the last inspection, although this had not yet been posted in the main entrance hall. The complaints procedure was not in the service users guide or in the statement of purpose. The operational manager said she would address this. A complaints record is kept and complaints were responded to promptly. Two residents spoken to said that they knew who to complain to. One said that the staff are very helpful, I only have to ask and they are happy to oblige. One said that she had raised a concern with the manager who had dealt with it promptly. The Commission for Social Care Inspection has been made aware of four concerns, two of which had been addressed by the home and two of which were made anonymously. One was about difficulty in getting into the home and the other about the unsightly dustbin area at the front of the home. These were shared with the manager, on the day of the inspection, who said that she would address them. Care Homes for Older People Page 15 of 27 The home has a copy of the local multi agency safeguarding strategy. The training matrix showed that staff have had safeguarding training and those spoken to were confident that they could report any concerns to the manager. There was evidence that concerns are reported appropriately to the local authority, which is the lead agency in these matters. One resident spoken to said I feel safe here. Care Homes for Older People Page 16 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Some areas of the home have been refurbished to make it a pleasant place to live in. There is a need to ensure that the home complies with requirements made by the fire safety authority and meets best practice in infection control to ensure residents are protected from possible harm. Evidence: There has been a programme of redecoration at the home and new furniture has been bought for some bedrooms. Some hospital style height adjustable beds have been bought with compatible bed rails for residents requiring nursing care. One dining room has been redecorated and new flooring has been laid. The communal areas have not been repainted and the carpets are worn in places, which might present a trip hazard. The operational manager said that the redecoration programme had been stopped for the present. She was uncertain why. The Fire Safety Authority last inspected the home in October 2006 and a number of requirements were made. Some have been implemented although not all. The intumescent and cold smoke seals have not been fitted to all bedroom doors and damaged doors have not been replaced. The doors leading to the kitchen and laundry do not yet have visual access. The manager said that an action plan was submitted to Care Homes for Older People Page 17 of 27 the owner but that this has not yet been implemented. This must be addressed as a matter of urgency. The home has a copy of the latest Department of Health Infection Control guidance for care homes. It has not yet been implemented in full. Staff were observed to wash their hands and use alcohol hand gel. The home was clean and tidy and there were no offensive odours. There were a number of waste bins in the home, which contained clinical waste but which did not have lids and were not pedal operated. This should be addressed. The clinical and general waste bins in the front car park were dirty and unsightly and gave the home an institutionalised appearance. The storage arrangements for these should be reviewed. There was a pile of unsightly old furniture at the side of the home, which should be removed. The organisation should use the department of Health’s ‘Essential steps’ to assess their infection control practices to ensure that residents are protected from the risk of acquired infection. Further information is available on www.dh.gov.uk. The laundry was clean and well managed. The full time laundry assistant took pride in her work. Two residents spoken to said that they used to have problems with missing clothes but that this has improved greatly since the laundry assistant had been employed. Care Homes for Older People Page 18 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient staff who have had training in safe working practices to meet residents needs. The recruitment files did not hold up to date information to verify staff details, which may put residents at risk. Evidence: The home is registered for people who require support with personal care and for those who need nursing care. On the day of the unannounced visit seventeen residents needed help with personal care and thirteen needed nursing care. There were two qualified nurses and six carers on duty. The residents spoken to said that carers came promptly when they rang the bell and that they were not rushed. One said it is busy in the mornings and you sometimes have to wait but is quieter in the afternoons. Another that the carers are very kind, I only have to ask. There has been an improvement in the amount of training offered to staff since the last inspection and most staff have had mandatory training in safe working practices. There were records in the files to show that staff have an induction programme. The files of four members of staff were examined, two who had started work during Care Homes for Older People Page 19 of 27 2008 and two registered nurses who were on duty on the day. Three of the files had the required documents to verify the persons identity. Two references, work permits and Criminal Records Bureau disclosures had been sought before the staff member started work. There was a copy of one staff members registration with the Nursing and Midwifery Council (NMC). Gaps in employment history had been checked at interview. None of the files contained an up to date photograph of the employee. One staff members file did not contain a copy of their passport, up to date registration status with the NMC or a current work permit. The operational manager said that she had phoned the immigration department and been told that the employee was able to work. Verification as to continuing nursing registration status was confirmed on the day of the visit. The manager has written to the employee to request the required documents. It will be a requirement of this report that the recruitment files are checked and that they contain the required documents. Care Homes for Older People Page 20 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and financial arrangements of the home are unclear and it is not known when a permanent manager will be appointed to give continuity of care for residents. Although there has been some refurbishment throughout the year, essential fire safety requirements relating to the building have not been put in place, putting residents at risk. Evidence: The manager has recently been made redundant. The organisations operational manager has been asked to act as manager. She has experience managing care homes and holds the National Vocational Qualifications in Care and Management at Care Homes for Older People Page 21 of 27 level 4. She is not a qualified nurse. She was uncertain as to the reasons for the managers redundancy or how long she would be acting as manager. The proprietor did not notify us of changes to the management of the home, as he is required to do. Although the previous manager had been in post for approximately a year, she had not registered with us and the home has not had a registered manager since 2006. The operational manager said that residents have been told that the manager will not be coming back and she is supporting them through the change. The operational manager of the home was not aware of the business plan for the home and had been told that all refurbishment should be halted at present. The Commission for Social Care Inspection is aware that some power bills were not paid on time since the last inspection, although these have now been paid. Although some refurbishment has been undertaken, important items requiring expenditure from the last fire officers reports have not yet been actioned. The operational manager has been responsible for regular quality assurance visits to the home and records were kept to show that these were done. The operational manager said that the proprietor would be undertaking these in future. A quality assurance programme is in place and care plans and medication practices have been audited. A residents and family questionnaire has been circulated although the results have not yet been analysed. Resident meetings are chaired by the activities coordinator. There are health and safety policies and procedures in place. Most staff have received training in safe working practices and there are plans to ensure that all staff have up to date training as required. There is evidence to show that most equipment is maintained and serviced regularly. There was no evidence in the home to show that gas equipment had been serviced and the gas safety certificate was not in the home. The operational manager said that she could remember the service being undertaken and felt that the certificate would be at the organisations head office. She agreed to send a copy to us. There is a fire risk assessment and staff have received fire training. Fire alarms, emergency lighting and self-closing doors are tested regularly. The home has not yet complied fully with the requirements of the last fire safety officers report, which must be addressed. Care Homes for Older People Page 22 of 27 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 23 of 27 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 7 15 Care plans must reflect the care needed by residents to meet their assessed needs To ensure that residents , their families and staff are clear about the care that residents should receive. 28/11/2008 2 9 13 Changes to variable dose medication regimes should be in writing and it must be clear which is the current regime being followed. To ensure residents recieve the correct medication. 31/10/2008 3 16 22 The updated complaints policy and procedures should be described in the homes Statement of Purpose and the service users guide. To ensure that residents and their families know how to raise concerns should they wish to do so 28/11/2008 Care Homes for Older People Page 24 of 27 4 19 23 The proprietor must comply 28/11/2008 with the requirements of the fire safety authority To protect residents from harm should there be a fire. 5 26 13 The infection control procedures must be improved. Foot operated clinical waste bins with lids should be provided. The external clinical and general waste bins must be kept clean. To minimise the risk of acquired infection for residents. 28/11/2008 6 29 19 The recruitment files must contain the documentation listed in Regulation 19 and schedules 2 and 4 of the Care Homes regulations 2001 In order to ensure that the correct checks as to the suitability of the care worker are made. 28/11/2008 7 31 8 The proprietor must appoint a permanent manager who must register with the Commission for Social Care Inspection. To ensure continuity and safe care for residents 28/11/2008 8 33 38 The proprietor must notify the Commission for Social Care Inspection of managerial changes and other significant issues affecting the home. 31/10/2008 Care Homes for Older People Page 25 of 27 To ensure that the information held about the service is accurate. 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 11 1 The statement of purpose and service users guide should be updated to reflect the management arrangements in the home and to include details of the complaints procedures. The home should continue to develop the activities, tailoring them to individual’s wishes and involving a wider range of staff to ensure that there are meaningful activities throughout the home on a regular basis. The activities coordinator should have training in the provision of therapeutic activities for the elderly and for those with cognitive decline. Residents should be involved in developing the menus and should be supported to make their own choices, nearer to the time that they are going to eat. Further advice is available in the Commission for Social Care Inspection for Social Care Inspection guidance ‘Highlight of the day’ available on www.csci.org.uk Clinical and general waste bins should be stored discretely to improve the entrance to the home 12 12 13 12 14 15 15 19 Care Homes for Older People Page 26 of 27 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. 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