Inspection on 07/05/09 for Castlefort Grange

This inspection was carried out on 7th May 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Castlefort Grange 30/03/10

Castlefort Grange 16/05/07

Castlefort Grange 09/11/06

Castlefort Grange 10/05/06

Castlefort Grange 11/10/05

Castlefort Grange 08/06/05

Castlefort Grange 16/11/04

Castlefort Grange 29/04/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 12/10/2009.

Key inspection report Care homes for older people Name: Address: Castlefort Grange 39 Castlefort Road Walsall Wood Walsall West Midlands WS9 9JL     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Pam Grace     Date: 0 7 0 5 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Castlefort Grange 39 Castlefort Road Walsall Wood Walsall West Midlands WS9 9JL 01543371754 01543454353 castlefort.grange.care@unicom.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Castlefort Grange Care Ltd care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 23 The registered person may provide the following category of service only: Care Home Only (Code PC); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 23 Dementia (DE) 23 Date of last inspection Brief description of the care home Castlefort Grange is registered to care for 23 older people, 7 of whom may require dementia related care. Situated in the Walsall Wood area of Walsall, there are local amenities and shops reasonably close by, though not within walking distance for the majority of people using the service. However, with satisfactory public transport links close at hand access to Brownhills and Walsall is readily achievable. The home has undergone major building work, providing additional rooms, and increasing the size of some existing bedrooms to include an en-suite toilet. Accommodation now totals 17 Care Homes for Older People Page 4 of 28 23 0 Over 65 0 23 Brief description of the care home single and 3 double bedrooms. In addition, the lounge has been extended and a conservatory added. There is also a separate dining area and large, accessible garden. 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 overall quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The last inspection on this service was completed on 16th May 2007. This key unannounced inspection was carried out over one day, by one inspector. The inspection had been planned using information gathered from the Care Quality Commission (CQC) database, the Annual Quality Assurance Assessment (AQAA) document that had been completed by the care manager, comments received from staff, people who use the service and their relatives. The key National Minimum Standards for Older People were identified for this inspection and the methods in which the information was gained for this report included case tracking, general observations, document reading, speaking with staff, Care Homes for Older People Page 6 of 28 people who use the service and their visiting relatives. Observation of the environment was also undertaken. At the end of our inspection, feedback was given to the registered care manager and registered provider, outlining the overall findings of the inspection, and giving information about the requirements and recommendations that we would make. We were informed during our visit that the lift had been out of order for four nights, and that some people using the service had not been able to utilise their own room for sleeping. Alternative sleeping arrangements had been made. However, the fault was rectified and the lift was working when we left the home. People spoken with were positive about the care they were receiving. We observed people who were unable to communicate. Our observations showed that these people were well cared for, and were happy in their surroundings. The service and the Care Quality Commission had made no referrals under the Adult Protection Safeguarding protocol, and no complaints had been received since the previous inspection. There were 2 requirements, and 14 recommendations made as a result of this unannounced inspection. The current fees are not included in this report, the reader may wish to obtain more up to date information direct from the service. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: People wishing to use the service and their representatives should be provided with up to date information, to enable an informed choice about where to live. People wishing to use the service should have their needs assessed, prior to moving in, to ensure that the service can safely meet those needs. Individual risk assessments should be in place and kept up to date. Care plans should include up to date and individual falls risk assessments, to ensure Care Homes for Older People Page 8 of 28 the safety of the people using the service. Staff should adhere to the homes policy and procedure for the safe recording of all medication administered, this will ensure the safety of the people using the service. The routines of daily living and activities available should be flexible and varied to suit peoples expectations, preferences and capacities. Thus ensuring that peoples experiences match their expectations. There needs to be a regular meeting for people using the service, ensuring that they have their say, and can contribute towards the day to day running of the home. The complaints procedure should be readily available and on display in the home. Thus ensuring that people using the service know whom to complain to, and how to make a complaint. The service should ensure that the information they have in regard to Adult Protection and Safeguarding protocols is up to date. Thus ensuring the safety of the people using the service. Consideration should be given to the storage of mobility equipment and continence aids. This is to ensure the safety of the people using the service. Staff training, and staffing levels must be maintained to ensure the safety of the people using the service. Staff should receive training in regard to the Mental Capacity Act 2007, Deprivation of Liberty protocols and guidance, and Adult Protection Safeguarding, to ensure the safety and welfare of the people using the service. Staff should receive a minimum of three paid days training per year, including in house training, and have an individual training and development assessment and profile. Thus ensuring that staff receive training which is appropriate to their role and responsibilities. Quality Assurance systems should be re-instated and expanded to include other professionals. Thus ensuring that all stake holders are able to have their say about the service. Care staff should receive supervision as per the National Minimum Standard. This will ensure that staff receive the ongoing training and support that they need. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who may use the service and their representatives should have their needs assessed, and be provided with the information needed to choose a home that will meet their needs. Evidence: The Annual Quality Assurance Assessment completed by the care manager told us: We ensure that any potential residents and families are informed of our services and are invited to come and look around. Potential residents are invited to come in for the day. The Statement of Purpose and Service User Guide were not readily available for us to view, and we were therefore not able to confirm that these documents had been reviewed. We recommended that prospective people wishing to use the service, Care Homes for Older People Page 11 of 28 Evidence: undertake to visit and spend time in the service, prior to making a decision to move in. We also recommended that the service should display their most recent inspection report, and complaints procedure. We examined three care plan records, two of these showed that an assessment of need based upon activities of daily living had been undertaken, prior to the person moving in. However, one person who had been re-admitted to the home from hospital had not been re-assessed by the service before being re-admitted. This was highlighted and discussed with the care manager and registered person, we recommended that this should always be undertaken, especially when there has been a change of level of need. This is to ensure that the persons needs can safely be met by the service. 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. The health and personal care that people receive should be based upon their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: The Annual Quality Assurance Assessment completed by the care manager told us: Privacy and dignity for residents are respected at all times. The care that we provide is delivered considerately and effectively, and all care needs are fully met, and these are set out in the residents care plan. We examined three care plan records. The model of care plan used by the home is based upon activities of daily living. This included health, personal and social care needs. However care plans had not been reviewed, and one person recently readmitted from hospital needed re-assessing to ensure that staff knew exactly how to safely care for her. There were also no individual falls risk assessments in place. There were old and discontinued care plan records in the office, these needed to be appropriately archived. This was highlighted and discussed with the care manager and the registered person at the time. Care Homes for Older People Page 13 of 28 Evidence: The following comments were received from people using the service, we like it here, they do try their best to look after us, I have no worries at all. Visiting relatives confirmed their satisfaction with the service, and the way in which their relatives were being cared for. Comments from relatives included the following, we visit when we want to, and we notice that all the residents are well cared for here.Weve always found her clean when we visit, her hair is done, and weve noticed that the meals are good. We looked at medication administration records, and spot checked the storage and returns system in place. We noted and discussed an error in regard to the recording of controlled medication, this was highlighted and discussed at the time with the care manager, and was subsequently rectified. We recommended that the medication trolley is secured to the wall, and that the service should consider purchasing a medication fridge which would securely store medication requiring storage below room temperature. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience 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 are sometimes able to make choices about their life style, however, there are not enough staff to ensure that social, educational, cultural and recreational activities meet individual expectations. Evidence: The Annual Quality Assurance Assessment completed by the care manager told us: We make sure that all residents are clean and tidy and all their daily life needs are set out in their care plans. Relatives and people spoken with confirmed their satisfaction with the activities on offer, however, comments received included, we could do with a bit more to do during the day, our relative looks bored sometimes when we come in, and so do some of the others. It was also acknowledged by people using the service that staff do not get the time to sit with us, and just have a chat, its a shame, they are always too busy. This was highlighted and discussed with the care manager and the registered person. This will be addressed more fully under staffing. Mealtimes were observed, and people confirmed that the food was good and nutritious. The care manager is covering for the deputy cook at present. Care Homes for Older People Page 15 of 28 Evidence: There was little evidence of meetings held for the people using the service, to enable them to have their say, and to contribute towards the day to day running of the home. Care Homes for Older People Page 16 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 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 are protected from abuse, and are able to express their concerns, however, they should have access to information regarding how to complain. Evidence: The Annual Quality Assurance Assessment completed by the care manager told us that the service would adhere to the next inspection report. This means that they will follow the homes existing policies and procedures. We noted during our visit, that there was an out of date Adult Protection Safeguarding protocol and procedure in the office. This was highlighted and discussed with the care manager at the time. There had been no complaints and or Vulnerable Adult Safeguarding referrals made to the service since the previous inspection, and the home has a comments and concerns book available for anyone visiting the home to write in. We noted there was no complaints procedure on display in the main entrance hallway, and recommended that this be rectified as soon as possible, to ensure that people using the service and their representatives know how to make a complaint if they wish to. People spoken with were very aware of whom to speak to, if they wished to complain. Comments received included, I know to speak to a member of staff, but I dont want to complain anyway. We have no complaints whatsoever about the home, we find that staff are helpful, and our relative is well looked after. Care Homes for Older People Page 17 of 28 Evidence: We were unable to spot check individual peoples finances on this occasion. This was because the necessary records were not on the premises. We were however shown that peoples finances are kept securely. This will need to be monitored at the next inspection. We looked at three staff recruitment records. There had previously been a requirement made in regard to ensuring that all practices, documentation, and record keeping in respect of employment, should be reviewed and a more thorough system established. This requirement was well evidenced by the recruitment records seen which were clear, consistent, and showed an improvement upon the previous inspection. Staff spoken with very aware of their role in relation to the protection of vulnerable adults, however, staff were unable to recall when they had received appropriate training. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home enables people who use the service to live in a safe, well maintained and comfortable environment, which encourages independence. Evidence: The Annual Quality Assurance Assessment completed by the care manager told us: We make sure that the home is clean and tidy and free from unwanted smells, and also risk assessments followed. We observed that many areas of the home were being used for inappropriate storage of items. For example one end of the dining room was being used for storing a persons personal possessions, boxes etc.. The main entrance hall was piled high with boxes containing continence aids, and the area was also used for zimmer frames. This was highlighted and discussed with the care manager at the time and rectified. Suggestions were put forward in relation to the usage of one of the downstairs toilets. The homes lift was out of order on our arrival, this had been the case for approximately four days. The registered person had commissioned an engineer to fix the fault and a part had needed to sent for. By the time we left the building the lift was in full working order again. However, we noted that under Regulation 37, the care manager had not informed us of the lift being out of order. This was also highlighted Care Homes for Older People Page 19 of 28 Evidence: and discussed with the care manager and the registered person. Hoists had been serviced, wheelchairs and other aids and adaptations were well maintained. People spoken with confirmed their satisfaction with their rooms, and rooms observed were personalised and comfortable, with furnishings in good order. The garden has a safe, and level access for people using the service, this included a patio area, which is well kept. People told us that they liked sitting out during the summer. Care Homes for Older People Page 20 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home should be trained, skilled and in sufficient numbers to support the people using the service, in line with their terms and conditions, and to support the smooth running of the service. Evidence: The Annual Quality Assurance Assessment completed by the care manager told us: Staff are trained to the standards required. We do not have a big staff turnover. 2 written refs are obtained, staff are employed on a POVA first Risk assessments are also done App forms contain full employment history Staff training is continuously being updated. We spoke with staff, and examined appropriate records which included recruitment records, the staff training matrix, and rota for the month of May 2009. Staff spoken with could not recall when they had last attended a staff meeting, or a supervision session. The staff rota evidenced that there had been shortfalls of staff, for example only two staff on the morning of the 11th May 2009. Staff told us that they were exhausted, and that this was due to their being poor staffing levels and the amount of work they were expected to do, which included laundry. Staff recruitment records showed an improvement upon the previous inspection when Care Homes for Older People Page 21 of 28 Evidence: a requirement had been made in regard to their inconsistency. That requirement had been met. The staff training matrix which was subsequently sent to us by the care manager, showed that staff had not received mandatory update and refresher training. Staff could not recall when they had last received training in relation to Adult Protection Safeguarding, and had not received any training in relation to the Mental Capacity Act 2007, and or the Deprivation of Liberty protocol and procedure. Staff, relatives and people spoken with during our visit confirmed that there arent enough staff on duty to run activities, and that this happened most days. All of the above were highlighted and discussed with the care manager and the registered person. In particular, the need to keep under review, peoples level of need and the staffing ratio provided. The registered person confirmed that some staff had recently left the home, and that he was in the process of actively recruiting to those posts. Care Homes for Older People Page 22 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of the home is based upon respect and openness. However, the administration of the home is inconsistent, and poor staffing levels have resulted in adequate outcomes for people using the service. Evidence: The Annual Quality Assurance Assessment completed by the care manager told us: Low level of complaints Good staff retention Low staff turnover Good relationship with local GP, DNs and SWs, high level of referrals maintained Afternoon in house activities including outside entertainers coming in Varied menu with local butcher and farm shop, fresh local fruit and veg Our home provides a warm ambience, friendly and all of these are in the best interests of the residents. Records are updated on a regular basis. Hot water pipes being covered Care Homes for Older People Page 23 of 28 Evidence: Adhere to our inspection report Policies and procedures are up to date, and follow all guidelines. The home provides an ambience, which is warm, friendly and inclusive, however people using the service do not have a forum in which to have their say in the day to day running of the home. There had been no complaints and no Adult Protection Safeguarding referrals received since the previous inspection. A minimal amount of activities are provided by a staff team that are exhausted and tired from caring for people because there are shortfalls in staffing levels. This can only result in the service being rated as adequate, as the outcomes for people using the service are only adequate. Staff spoken with could not recall when they last attended a staff meeting. Staff supervision and training have been neglected as a result of their being shortfalls in staffing levels, the deputy and the care manager have needed to cover for staff sickness and absence, this has taken them away from the essential day to day management of the home, and has resulted in the poor management of essential records. Operationally, the home needs to be better organised, with the right staffing levels, and lines of accountability being clearly defined and observed. We were unable to evidence that financial procedures in operation in the home protect people using the service. However, we observed that peoples monies are kept securely. This will be monitored at the next inspection. Recruitment practices and record keeping have improved since the previous inspection. Health and Safety Policies, Procedures, Practices were satisfactory. Quality Assurance practices need to be re-instated, and expanded upon, to include other professionals such as the General Practitioner, Dentist, Pharmacist, Optician, District Nurse, Community Psychiatric Nurse. Care Homes for Older People Page 24 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 25 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 1 27 18 Staffing levels must be maintained. Staffing levels must be maintained to ensure the safety of the people using the service 07/05/2009 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 17 Risk assessments must be 31/07/2009 kept up to date in regard to the people using the service. To ensure the safety of the people using the service 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 1 People wishing to use the service and their representatives should be provided with up to date information, to enable an informed choice about where to live. People wishing to use the service should have their needs assessed, prior to moving in, to ensure that the service can safely meet those needs. Care plans should include up to date and individual falls risk assessments, to ensure the safety of the people using the service. Page 26 of 28 2 3 3 7 Care Homes for Older People 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 4 9 Staff should adhere to the homes policy and procedure for the safe recording of all medication administered, this will ensure the safety of the people using the service. The routines of daily living and activities available should be flexible and varied to suit peoples expectations, preferences and capacities. Thus ensuring that peoples experiences match their expectations. There needs to be a regular meeting for people using the service, ensuring that they have their say, and can contribute towards the day to day running of the home. The complaints procedure should be readily available and on display in the home. Thus ensuring that people using the service know whom to complain to, and how to make a complaint. The service should ensure that the information they have in regard to Adult Protection and Safeguarding protocols is up to date. Thus ensuring the safety of the people using the service. Consideration should be given to the storage of mobility equipment and continence aids. This is to ensure the safety of the people using the service. Staff should have appropriate mandatory update and refresher training according to their role and responsibilities. Staff should receive a minimum of three paid days training per year, including in house training, and have an individual training and development assessment and profile. Thus ensuring that staff receive training appropriate to their role and responsibilities. Staff should receive training in regard to the Mental Capacity Act 2007, Deprivation of Liberty protocols and guidance, and Adult Protection Safeguarding. Thus ensuring the safety of the people using the service. Quality Assurance systems should be re-instated and expanded to include other professionals. Thus ensuring that other stake holders are able to have their say. Care staff should receive supervision as per the National Minimum Standard. This will ensure that staff receive the training and support that they need. Page 27 of 28 5 12 6 14 7 16 8 18 9 19 10 30 11 30 12 30 13 33 14 36 Care Homes for Older People Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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. 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!