Inspection on 06/01/09 for Charlton House

This inspection was carried out on 6th January 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Charlton House 04/08/09

Charlton House 05/01/07

Charlton House 02/02/06

Charlton House 19/07/05

Charlton House 07/02/05

Charlton House 31/08/04

Charlton House 02/03/04

Extracts from inspection reports are licensed from CQC, this page was updated on 06/08/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Charlton House 55 Mannamead Road Mannamead Plymouth Devon PL3 4SR     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: Kim Fowler     Date: 0 8 0 1 2 0 0 9 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 29 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Charlton House 55 Mannamead Road Mannamead Plymouth Devon PL3 4SR 01752661405 01752661405 charltonhouse.residentialhome@me.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Gill Boyes,Mrs Tonya Gerry Name of registered manager (if applicable) Mrs Tonya Gerry 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 Additional conditions: The maximum number of service users who can be accommodated is 43 The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) Dementia (Code DE) Date of last inspection Brief description of the care home Charlton House is a large Victorian property, which is owned by Mrs Gill Boyes and her daughter, Mrs Tonya Gerry who is also the registered manager. Charlton House is registered as a care home for forty-three older people and include up to 5 people who may have dementia. The home is a large and spacious with 5 lounge rooms which gives the feeling of living in a much smaller home. Thirty rooms have en suite facilities. Care Homes for Older People Page 4 of 29 care home 43 Over 65 0 43 43 0 Brief description of the care home A limited amount of respite or short stay care is available when vacancies permit. A ramp at the main entrance, stair lifts and a passenger lift facilitates easier access for people with restricted mobility. The home is well situated in a residential area of Plymouth with local amenities and shops nearby. Information regarding the services provided at Charlton House can be obtained directly from the home. The current weekly fees range from 329 pounds to 405 pounds. Although these may vary depending on peoples individual needs. Care Homes for Older People Page 5 of 29 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 quality rating for this service is 1 star. This means the people who use this service experience adequate outcomes. The unannounced inspection took place over 2 days and started on the 6th January between 9:50 am and 2:20 pm. And the site visit concluded on the 8th January between the hours of 10:00am and 1:50pm. The Registered Manager, Tonya Gerry was available throughout the inspection. A warning letter was sent and a response requested from the home before the report was completed. This was in response to the medication errors that are highlighted in this report. The inspector made a tour of the building and spoke to most of the people living in the Care Homes for Older People Page 6 of 29 home and two visitors visiting at the time of the inspection. Documentation relating to the care planning process and the management of the home were examined. Any comments are in the relevant section of the report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 8 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are considering admission to the home can be confident that a full assessment with be completed before admission to ensure the home can meet their individual needs. Evidence: All files examined contained a pre-admission assessment. Also in place were the placing authoritys detailed care plans. The pre-admission assessments are either completed by the home before admission or by the placing authority if people are admitted under the RITA (Rapid Intervention Treatment and Assessment) scheme. Any people admitted via the RITA scheme are referred and admitted by the local authority. Each person is required to have a completed RITA care plan giving full details on individuals health and care tasks to be undertaken by the staff within the home. An Assessment of Care is also provided to the home to support the care plans. Care Homes for Older People Page 10 of 29 Evidence: These care plans also hold information on which professionals are involved in the continuing care of individuals. Completed pre-admission assessment ensures the home is able to meet the needs of individuals before admission. The homes AQAA returned to the Commission states, The home offers a one month settling in period. Care Homes for Older People Page 11 of 29 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 staff and manager provide good personal support to people who live at the home. Ensuring the promotion of privacy and dignity at all times. The homes poor practices relating to medication administration place people living at the home at risk. Evidence: Each file examined of people living at the home contained an individual care plan based on care needs and how the home would meet these needs. Each care plan is supported by other professionals assessments and included assessment from an Occupational Therapist. The daily care plans are easy assessable for staff on duty and risk assessments are held on individual files for the protection of all people living at the home. However one-person care plan has not been completed in full since there admission. Care Homes for Older People Page 12 of 29 Evidence: These care plans give detailed instructions to all staff as well as information to new staff to ensure intimate personal care is being provided in a manner that meets with the approval of people receiving the care. This is particularly important where people are unable to express themselves verbally. The manager stated that the risk assessments are reviewed regularly and updated as and when needed. Information on one file showed that a risk assessment had been completed for a person who was at risk of falling and was updated and reviewed regularly. All people living at the home have access to all health care services and information was recorded onto care plans in each persons file that there was input from other professionals including GPs, chiropodist and consultants based at the local hospital. All care plans give full details and instructions to staff on what health care needs are to be carried out and by whom. Most people living in the home were spoken with and some were able to confirm that their health care needs were met and one person said, I have seen the Doctor recently. A visiting District Nurse was spoken with and confirmed that the District Nurse team visit regularly and the home will call for extra support when needed. The District Nurse confirmed that the staff will assisted with treatments when needed and will always carry out treatments on individuals between their visits. One survey returned to the home under what they do well states, The loving care shown to residents when unwell. Two senior care staff talked through the medication procedure for the home. The home uses the blister pack system for administration. Both staff confirmed that they had attended medication training including an Advance Medication training course with the local pharmacist. One staff file examined held a medication training course certificate. The blister packs were checked for the lunchtime medication. This showed that a number of people had not received their medication as prescribed on one day. The MARs (Medication and Record sheets) were checked for the corresponding day and were blank and did not record why each person did not receive their medication on that day nor was any information recorded onto the daily records for individuals. One senior staff spoken with stated that they had made the decision not to administer the medication on one date. Care Homes for Older People Page 13 of 29 Evidence: The medication trolley showed that the home held Temazepam medication for one person and this was not held in accordance with The Misuse of Drugs and Misuse of Drugs (Safe Custody) (Amendment) Regulations 2007. This states that Temazepam must be stored in a controlled drug cabinet and good practice would be to record this medication into the controlled drug book as well as the MARS records. The Controlled Drugs were examined and found to be incorrect. One person is prescribed a medication every 96 hours. The records show that this pain relieving controlled drug had been administered inconsistently and with poor recording practices. The Controlled Drug Record book and Controlled Drug cabinet were examined. The Commission was unable to reconcile the stock indicated in the Controlled Drug record with the stock held in the Controlled Drug cupbaord. The controlled drug book showed that some days the controlled drugs were not signed for, only one signature for other days, gaps in between days with no record of administration but the number of medication held had decreased on the next recorded date and one controlled drug only had a sheet printed by the home for staff to sign but no MARS record. Errors in the administration, recording and storage of medication in particular the controlled drugs places people receiving medication at risk. At the end of the inspection a letter was sent to the home requesting that they inform the Commission of their plans to resolve the errors highlighted within the medication systems. The letter from the home stated that it has updated staff in medication training and the homes pharmacist has carried out a pharmacist inspection to assist the home in correcting the medication errors. All staff involved in dispensing of medication has been sent a letter by the home highlighting the errors and the issues raised within the inspection. The Registered Manager, Mrs Tonya Gerry, has also agreed to be involved in checking and observing the medication administration and recording system. The homes AQAA returned under what we have improved over the last 12 months states, Worked with senior staff to ensure that those accountable for medication are adhering to the medications policies and procedures, and assessing any further needs for training. It goes onto say, The officer in charge has undertaken random checks on medication to ensure all staff involved are following policies and procedures. Care Homes for Older People Page 14 of 29 Evidence: Most people living at the home were spoken with during this inspection and some were able to confirm that the staff respects their privacy and dignity at all times. Observed during the inspection were staff knocking on peoples doors to promote privacy and shutting the bedroom door when attending to a person personal care needs. One person living in the home said, they always shut my door and another stated, The staff help me with my bath in private. Care Homes for Older People Page 15 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Charlton House can be confident that the home offers good wholesome meals. The home welcomes and encourages families and friends to visit. Evidence: People were observed moving freely around the home. Some people remained in their individual bedrooms and one person said, I like to stay in my own room. Staff were seen interacting with people and discussing everyday topics and included assisting individuals when needed showing staff were aware of the needs of people living in the home. An activities programme was displayed in the home and this included a singer, chair aerobics, trip to see the Christmas Lights and a hairdressers visit. One person confirmed that they had seen the Christmas lights and had attended other activities within the home. Care Homes for Older People Page 16 of 29 Evidence: The hairdresser was in attendance during the inspection and was spoken with and confirmed that she attended regularly and there was always a queue of people waiting to have their hair done. All family visits and contact is recorded into individual files and daily records examined showed recent family visits for several people living in the home. The home also holds regular family events and held a recent wine and cheese evening. All bedrooms visited contained personal possessions and items and one person living at the home said that the home encouraged them to bring in items from home. All people who were able to made positive comments about the food provided. One of the cooks was spoken with during the inspection about the menus and food on offer. The homes 4 weekly menus was displayed for all to see and showed a varied and nutritional diet. A record was also held to ensure that all people received a mixed and varied diet. It was evident from the food seen served at lunch time on the first day, Tongue, savory rice, tomatoes and an alternative of corn beef followed by home made rice pudding or fruit and ice cream, that the food was home cooked using fresh products. The meal was well presented and freshly prepared. The second day meal served was Beef Cobbler, fresh vegetable and mash potatoes and was freshly prepared and enjoyed by all. The homes AQAA states, Continue to offer a wider range of activities. One person said they had made a complaint about the food but this was dealt with straight away and it had been a personal choice on the food being served and the cook had discussed a different menu for them. There is a small kitchen and lounge area available for the people living in the home to make drinks and snacks if they wish. The comments received from people living at the home about the food provided included, great, wonderful and excellent and plenty of it. One person said of the lunch observed being served, Lovely and I can have seconds. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home can be confident that any complaints or concerns raised will be listened to, acted upon and well managed by the home, which protects the welfare of all. Evidence: Each individual file holds a complaints procedure and a copy of this is available in the main entrance hall. Any complaints would be recorded into individual care plans. Mrs. Gerry the Registered Manager confirmed that no complaints had been received and also stated that she is available must days and would deal with any concerns that were raised. The Commission had not received any complaints. Most of the people living at the home were spoken with and some were aware of the homes complaints procedure and a few stated that they had never had any need to use it. The homes hold coffee morning and cheese and wine evening to meet with family and friends to discuss any issues. Surveys are regularly sent out and the last surveys received by the home were dated September 2008 all showing positive comments. Two people raised concerns during the inspection. One person raised concerns about another person entering their room at night. The manager confirmed that they were Care Homes for Older People Page 18 of 29 Evidence: aware of this and had now put equipment in place to stop this. One other person raised concerns about a staff member and the manager confirmed that they would speak to the person concerned and also the staff member. Some of the staff members on duty were interviewed during this inspection. The discussion with these staff members confirmed that many had completed the Adult Protection training. With further training booked. This training was carried out by the local authority and it was clear from the information given to the inspector from some staff they had a clear knowledge and understanding of the Adult Protection process. A new Safe Guarding DVD supports this training and this would be shown to the staff to ensure all staff are updated on their training. The homes Aqaa records that, Service Users and their relatives can be provided with advocacy service information. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Charlton House continues to maintain a clean and suitable environment for its stated purpose and the people who live at the home can be assured that they will live in an attractive and comfortable home that is regularly maintained. Evidence: The home is safe and well maintained and suitable for its stated purpose. It is very comfortable, warm and light home. Several people living at the home confirmed this is usual. One relative commented that the home is, Excellent and always clean. The gardens and patio area are to the front of the house are well maintained and assessable for all. The home employs a maintenance person to carry out repairs. The home was very clean, hygienic and free from offensive odours and the process for the removal of clinical waste was discussed and was satisfactory dealt with. The small kitchen and lounge area available for people in the rear of the building did have some chemicals in an unlocked cupboard. The manager stated that there is usually staff in that area to assist people, however the home would ensure that these items were put in the lockable cupboard available. Care Homes for Older People Page 20 of 29 Evidence: Several of the staff confirmed they had not completed any infection control training and staff records confirm that some staff had not had any training since 2006. Staff confirmed that the home provided disposable aprons and gloves for their protection. Infection control training would ensure staff are aware of new legislation and how to manage infections within the home. Since the last inspection the home has continued to redecorate were needed and has benefited from new lounge chairs, new bedroom furniture and a new decking area for people with limited mobility. Care Homes for Older People Page 21 of 29 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. Regular staff training would ensure that only suitable qualified, competent and experienced staff are working in the home. All staff files containing all required pieces of information would protect the people living at the home. Evidence: The homes rotas and the staff confirmed that there is sufficient staff employed to care for the number of people currently living at the home. On the day of the inspection there were 42 people living in the home and on duty were the manager and deputy manager as well as 2 senior care staff, 7 care staff, a cook 3 cleaners and a handyman. Thus providing evidence that the home had sufficient staff to support people currently living in the home. Some of the staff on duty during the inspection were spoken with and some confirmed that they hold a NVQ qualification. The manager confirmed 19 of the staff within the home currently hold this qualification. Examination of staff files showed that most staff had the required pre-employment checks, including CRB (Criminal Record Bureau Disclosure) in place ensuring as far as Care Homes for Older People Page 22 of 29 Evidence: possible unsuitable staff are not employed. However one staff file examined did not contain the 2nd reference and this could place people living at the home at risk. One staff member stated that their recruitment and selection process was fair and they had completed a CRB check. The homes Aqaa states, All staff working within the home completes mandatory annual training. The staff-training files provided evidence that regular training was not routinely carried out. Very little training had been undertaken in 2008 and some files showed staff had not had training in Fire Safety since 2006, First Aid since 2003, Infection Control training since 2006, Manual Handling since 07 and many staff not completing Health and Safety for a number of years. Some training was booked for later this year and included Dementia and POVA (Protection of Vulnerable Adults) training. The manager confirmed that she had difficulty ensuring staff attend the training that is booked. Updated and regular staff training would ensure that the people living in the home are care for by suitably trained people. One staffs file held an Induction package but this had not been completed and filled in. Induction training is provided by Training Agency package and all staff receive the home Staff Hand book. One staff said they had been encouraged to complete their NVQ training. One staff member said Excellent home to work in. Another said, Lovely staff team. The people living at the home said of the staff, Excellent, The staff are wonderful and a family member said, My relative is well looked after and the staff have been lovely. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The owners, manager and their staff team strive to provide a homely, stimulating environment that respects people who live at the home. Evidence: The Registered Manager, Mrs Tonya Gerry was available throughout both inspection days to assist, as was the deputy manager. Both the manager and deputy hold the Registered Managers Award and an NVQ in Care. One person living in the home said of the management, Wonderful people and one staff said, They are supportive. The home has recently competed surveys within the home and visiting family, friends and professionals. All made positive comments and any issues highlighted were dealt with individually and the outcome recorded onto the survey forms. Additional forms are always available by the main entrance for people to place in the box provided. Care Homes for Older People Page 24 of 29 Evidence: The comments received under the best aspects of the home included, The friendliness and compassion of the staff toward my relative and their professional outlook. Another said, encourage their independence. One person living at the home thought they had completed a form recently and said any issues they raised were acted upon. The AQAA states, We provide a safe place for service users to keep valuables and money. A record of anything kept is maintained. Sampling of records indicated equipment is serviced regularly and maintained in good order. This included lifts and hoists and the Fire Log book. The accident records were examined and daily records examined and showed that oneperson accident had not been recorded onto an accident form. The Regulation 37 notices, this is a notification of death, illness and other events, sent to the Commission by the home were discussed and agreed that the home need to provide more information to enable the Commission to establish the full facts of any accident that occurs within the home. Care Homes for Older People Page 25 of 29 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 29 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 All care plans must be 31/03/2009 completed in full. This would ensure the staff are able to meet the needs of people living in the home. All medication, in particular controlled drugs should be recorded, audited and any errors or changes reported to the GP and recorded onto individual files. This would ensure that all people living in the home receive the correct medication. 31/03/2009 2 9 11 3 30 18 All staff must have regular and updated training to meet the needs of people living in the home. Regular staff training would ensure that only suitable qualified, competent and experienced staff are working in the home to 31/03/2009 Care Homes for Older People Page 27 of 29 protect the health and welfare of all. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 24 29 Staff would benefit from Infection control training. The Registered Provider must obtain the required preemployment checks for all persons working in the home prior to the commencement of their employment. Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or 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) 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 29 of 29 - 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!