Inspection on 11/12/08 for Church Farm

This inspection was carried out on 11th December 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 18 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Church Farm 08/07/09

Church Farm 01/05/09

Church Farm 03/07/07

Church Farm 13/10/06

Church Farm 06/09/05

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Church Farm Yarmouth Road Hemsby Great Yarmouth Norfolk NR29 4NJ     The quality rating for this care home is:   zero star poor 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 Patience     Date: 1 3 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 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: Church Farm Yarmouth Road Hemsby Great Yarmouth Norfolk NR29 4NJ 01493730181 01493531599 rsonshomes@btopenworld.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): R Sons (Homes) Limited Name of registered manager (if applicable) Mrs Anne Morley 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: Date of last inspection Brief description of the care home Church Farm offers residential accommodation to a maximum of 40 service users in the registration category of older people. The building is a period residence that has been adapted over the years to meet the needs of older people and extended to include purpose built accommodation. Service users rooms are situated on the ground and first floor of the building. Twenty-four of the rooms have en suite facilities and all others have washbasins with access to WCs and bathrooms close by. There are four separate communal areas and a conservatory, which has been designated a smoking area for staff and residents. The grounds are well maintained comprising of a garden and large car park at the front of the property and a courtyard in the centre of the home. Church Farm is located in the seaside village of Hemsby, 5 miles north of Great Care Homes for Older People Page 4 of 31 care home 40 Over 65 28 12 0 0 Brief description of the care home Yarmouth. The home is situated in a quiet location away from the main centre of Hemsby and is within walking distance of the local shop. There are very few local facilities, however it is a short drive to the town of Great Yarmouth, which has numerous shops and other facilities. The surrounding areas of Hemsby also offer a number of pubs and restaurants situated on the edge of the broads that can provide some very pleasant outings. The fees range from £281 to £450 per week with hairdressing, chiropody, nespapers and toiletries being an extra charge. Care Homes for Older People Page 5 of 31 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: zero star poor service Choice of home Health and personal care Daily life and social activities Complaints and protection peterchart Environment Staffing Management and administration Poor Adequate Good Excellent How we did our inspection: This is a key unannounced inspection and includes information gathered since the last inspection in 2007. We also completed a site visit that took approximately 7 hours. During the site visit we spoke with residents, relatives and staff. We also looked at records relating to residents, staff and the running of the service. The manager was present during the inspection and was provided with feedback when the inspection visit was finished. Care Homes for Older People Page 6 of 31 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 Care Homes for Older People Page 7 of 31 240 7535. Care Homes for Older People Page 8 of 31 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 31 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. Before people decide to move into the home their needs are assessed so the service knows they can care for them and they know the home is a place they would like to live. Evidence: The home has policies and procedures in place for admitting new people into the home. A copy of the service users guide is supplied to people along with a statement of purpose. Both of these documents are on display in the entrance hall and can be accessed by people coming into the home. We looked at the records relating to one person recently admitted to the home and found that a care needs assessment had been supplied by the social worker and provided information about the persons needs before they came to the home. A pre admission assessment was also completed. Care Homes for Older People Page 10 of 31 Evidence: Care Homes for Older People Page 11 of 31 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples care and health needs are not being properly assessed and this means staff do not have guidance about how peoples needs should be met. Medication management practices place people at risk and do not consider the principles of the Mental Capacity Act. Evidence: We looked at the care records relating to 6 people living in the home and made observations of those people going about their daily lives in the home. We also spoke with one resident and one relative. Each resident has a file containing records relating to their health and care needs. The home has just completed the process of transferring information from old records to new records. We found that the quality of information was variable, not all files contained photographic ID and there were shortfalls in the care, health and risk assessments. Daily records provided only brief information about peoples daily lives and events. In the case of a newly admitted person, an initial care needs assessment Care Homes for Older People Page 12 of 31 Evidence: had been completed and stated that it should be reviewed in a week but there was no evidence of review and no other care plans or health assessments written. Care plans for other residents had been reviewed but this was not consistent in all cases. Some residents records showed they were diabetics but there was no care plan in place setting out how the person should be supported with this condition, for instance the frequency of blood sugar monitoring, use of medication and diet. In addition, care plans were not person centred and contained little information about the way in which people would like to be supported to live their lives. Some files did not contain all relevant care plans. We also found that the home did not complete falls assessments where there was documentary evidence of people having falls. For instance accident reports showed in less than a month one person had 13 falls yet there was no falls assessment or plan setting out what action should be taken to minimise further falls. There were also shortfalls in other risk assessments, such as those for behavioural disturbances and environmental risks to peoples safety. It was noted when entering peoples bedrooms that there were a number of walking aids in rooms when the residents were in the communal areas. There were also a number of walking frames in the corner of the communal lounge and so not accessible to people when they need them. We noted that the home does not have a system in place for properly assessing peoples nutritional needs. For instance it was recorded in the notes of one person that they were losing weight yet no assessment had been completed in response to this and no action plan settting out how to minimise the risk of further weight loss. The service is also not monitoring weights on a monthly basis. We spoke with one person who said the staff do what she needs and they are very good. A visitor to the home also said their relative was well cared for and was happy living in the home. We did note some practices that do not necessarily promote dignity and privacy. For instance, we saw a care assistant enter someones room without knocking first, we also found unnamed toiletries in shared bathrooms indicating they were for communal use. The home has CCTV cameras positioned around the home and although these are intended to be on entrances and exits they also view, lounge areas, corridors and lifts. This does not promote privacy. We looked at the homes medicine management practices using medication charts, peoples care notes and by observation. Medicines are stored in a dedicated storage Care Homes for Older People Page 13 of 31 Evidence: room which was locked during the time of inspection, however, we found that some medicines prescribed for external application were being stored non-securely in peoples rooms placing their health and welfare at risk. In the medicine storage room, the temperature of the medicine refrigerator was below the accepted range. This was also evident by daily records. The arrangements in place for the storage of controlled drugs do not meet the Misuse of Drugs (Safe Custody) Regulations. We observed part of the lunch time medicine round and saw that procedures followed by staff were satisfactory, however, the home gives some people their medicines concealed in yoghurt. There were no records indicating that peoples mental capacity had been assessed and that where they do not have mental capacity this way of administering medicines was in their best interest. There were also no records of contact with GPs about this or contact with the pharmacy to ensure the medicines can be crushed and are compatible with foodstuffs used. Care plans relating to the ways in which medicines are to be given to people were also not available. When we looked at current medication records we found gaps in records where we could not determine if medicines had been given to people as prescribed. Some records indicated when medicines had not been administered but the reasons why were not clear. There were no records for the administration of medicines prescribed for external application. There was also a lack of records for the receipt of medicines and no way of accounting for medicines to show they had been given properly. We found discrepancies with antibiotic medicines and anticoagulant warfarin tablets. In addition, warfarin schedules were not clearly set out on medication charts. For a person prescribed warfarin, we noted that a blood test due 9th January 2009 had not been carried out and there was no recorded evidence that the home had taken action to ensure this. We noted some medicines where there were no medication chart records and where we could not determine if the medicines were still in use. The home does not have identifying photographs alongside medication charts to assist in safe medicine administration. There was also no information relating to peoples known allergies and medicine sensitivities. We found no evidence that arrangements had been made for peoples medication to be reviewed regularly by prescribers. Care Homes for Older People Page 14 of 31 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home will be provided with a choice of good quality meals. However, they may not always be supported to make their own decisions and are not offered activities and occupation based on their interests, hobbies and individual needs. Evidence: As already written in the health and personal care section, we found that care plans lacked detailed person centred information about people. The records contained brief information about peoples social and emotional needs and whilst some contained life history information others did not. Social care plans were not individualised and did not necessarily promote life in the home that was consistent with peoples previous experiences and expectations. There was no records of activities to demonstrate what activities people were involved in. However, the manager said that life story work had commenced and they were hoping to develop activities in this way but at present there were no activities records or plans. The home employs an entertainer who provides activities once a week. On the day of the visit bingo and a quiz were on offer. Some people were seen watching television Care Homes for Older People Page 15 of 31 Evidence: and some were reading papers and books. However, one person spoken with said there was not a lot to do but doesnt want to do anything. They said they used to knit and read but cant be bothered now. The manager said there is insufficient time allocated to meet everyones needs in respect of individualised activities. We observed the mealtime experience and spoke with the cook. The home employs a cook and a kitchen assistant who work 7:30 - 15:30. At teatime a member of the care team prepares and serves tea. Lunch was served at approximately 12 noon and the majority of people were eating in the dining room. The dining room tables seat small groups of people and the tables were set for lunch with table cloths, place settings and cutlery. The cook said he visits all residents each morning and offers them a choice of two meals for lunch. One resident confirmed the cook comes round daily with a list of foods and offers different things to eat. The meal served on the day looked good and people appeared to enjoy it. Some people needed help with their meals and staff were around to provide it in a discrete and sensitive manner. It was noted that people are only offered a choice of one drink each mealtime and the kitchen assistant said they offer a different flavoured drink each day. The home does not publicise the menus and there is little in the way of prompts and reminders about what the menu of the day is. The cook said the menus are prepared on a three week rota basis. He uses feedback from care assistants and knowledge of what people like to plan the meals on offer. Softened diets and special dietary needs are catered for. The cook said that the home uses fresh produce such as fresh fish and vegetables. On the day of the site visit visitors were seen entering the home without restriction. One relative said they were always welcome in the home and found staff very approachable. It was difficult to establish how the home maintains contact with the community and religious groups as records did not show this information. It was also difficult to assess how the home supports people to make their own decisions in respect of their daily lives, as there was a lack of evidence in this respect. Care Homes for Older People Page 16 of 31 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 in the home are protected by staff who know what safeguarding vulnerable people means. They know how to make complaints and that they will be handled properly. Evidence: The service has policies and procedures in place for making complaints and raising concerns. The complaints policy is on display in the entrance hall and is contained within the service users guide. It is in need of up dating to ensure if people are not happy with the way a complaint has been dealt with they have the correct details of who to contact. The manager said the home has not received any complaints since the last inspection. A resident and relative said they would know who to talk to if they had a complaint to make. There is also a suggestions box so people can make comments about how the service could be improved. Staff are trained in safeguarding and this has been up dated recently. Staff are aware of the procedures for reporting safeguarding concerns. Where safeguarding issues have arisen they have been dealt with appropriately. Care Homes for Older People Page 17 of 31 Care Homes for Older People Page 18 of 31 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. People living in the home can enjoy spacious homely accommodation. However, it is in need of some refurbishment and repair. In addition, there are some health and safety risks. Evidence: We looked at the premises. Some areas are tatty and look in need of some refurbishment. For instance, the conservatory chairs appeared worn and dirty as did the carpet. Some of the communal toilets and bathrooms are in need of repair and redecoration. Some did not contain hand soap or towels. There were various unnamed toiletries and items such as razors and steradent tablets in the communal bathrooms that could pose a risk to people if misused. The lounge/ dining area is an open plan large room with a television in one area and radio in the other. The carpet looked stained and dirty in places and some other areas of the home also looked dirty such as the bathrooms and toilets. There is signage around the home to assist people to orientate around the building and to the facilities. However, some rooms did not have a name or number on them and appeared as though no one occupied the rooms. Some of the bedrooms entered looked homely and comfortable. At least one had an unpleasent odour but looked clean and tidy. Care Homes for Older People Page 19 of 31 Evidence: The conservatory is used as a designated smoking area. However, the ventilation was inadequate and smoke was filtering through to other parts of the home. The home has CCTV in operation and there were cameras dotted throughout the premises. These should only be used on the main entrance and where they are currently located they could possibly breach peoples freedom and privacy. We looked at the laundry arrangements. The service employs a laundry person. The door to the laundry was unlocked when we tried it and the items contained within could be a risk to peoples safety. There are procedures in place for ensuring laundry is dealt with efficiently and considering good infection control procedures. Clean named laundry is sorted into individual named baskets to ensure people have the correct laundry returned to their room. We checked the records relating to health and safety checks such as fire safety and electrical testing and these were in order. All staff are trained in fire safety but are awaiting health and safety training. Care Homes for Older People Page 20 of 31 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. People living in the home will have their needs met by adequate numbers of staff during the daytime but this may not be the case during the night. Not all staff are trained and competent to meet the needs of people with dementia. Evidence: The home appears to be well staffed during the daytime shifts and people were receiving the support needed. More time is needed for activites and the service needs to review their approach to activities for people with dementia type illnesses. There are only two members of staff on duty at night. We asked the deputy manager if they felt this was sufficient for the 37 people who were living in the home and we were told that night staff had good routines and were able to manage to meet peoples needs during this time. We looked at accident records and found that almost 50 of accidents that occurred between 27/12/08 and 13/01/09 happened during the night shift. We asked the manager about staff training and were told that staff had been provided with mandatory training. However, some staff were awaiting updates. The training plan and matrix was in the process of being drawn up for 2009 and was not available on the day of the site visit. We asked the manager to send it to us but at the time of Care Homes for Older People Page 21 of 31 Evidence: writing the report it had not been received. When we asked if all staff had been trained in dementia care, the manager told us that only senior staff had been given this training. The manager also confirmed that staff had not been trained to deal with specific needs of residents, such as diabetes and the Mental Capacity Act. We checked the files relating to new staff who had started work recently. The homes recruitment practice was in order and all the necessary pre employment checks had been completed. Staff supervision is not taking place and the home must establish and implement a plan of staff supervision. Care Homes for Older People Page 22 of 31 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that has an experienced registered manager. However, there are shortfalls in the management systems that do not promote the best interests of residents. Evidence: The service has a registered manager who has worked in the home for several years. The manager is currently undertaking a advanced course in dementia studies. We did not fully assess the homes quality assurance processes on this occasion. However this report shows that quality audits are either not in place fail to identify areas for improvement. The manager said that regulation 26 visits are not currently being carried out. We checked how the service supports people with their personal finances. Small amounts of money are held on behalf of some residents. The money is held in Care Homes for Older People Page 23 of 31 Evidence: individual wallets and kept in the safe. Records of financial transactions are maintained and these were crosschecked with money held and found to be correct. We were told by the manager that staff are not being supervised on a regular basis. We have highlighted other areas in this report where the home has failed to identify risks to peoples health and safety and applied a risk management strategy to protect people from potential harm. Care Homes for Older People Page 24 of 31 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 7 17.1a & 3a The scriber of care plans must date and sign each entry. 30/08/2007 Care Homes for Older People Page 25 of 31 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 17 The service must ensure that residents records are maintained in accordance with schedule 3 of the Care Homes Regulations. So that peoples health and welfare is safeguarded. 02/03/2009 2 7 15 People living in the home 02/03/2009 must have their holistic needs assessed and reviewed monthly and set out in a written plan of care. This is so that staff know what peoples needs are and have clear individualised information about how to meet them 3 8 12 The service must enable 02/03/2009 people to make their own decisions about how they want their health and welfare needs to be met. Decisions made on their behalf must only be made in accord with the principles of the Mental Capacity Act. Page 26 of 31 Care Homes for Older People This is so that peoples best interests are promoted and their health and welfare is safeguarded. 4 8 13 The service must ensure 02/03/2009 that unnecessary risks associated with people living in the home are identified and eliminated. This is so that peoples health and welfare is safeguarded. 5 8 12 The service must support people living in the home to receive proper treatment and make proper provision for their health and welfare. This is so that peoples health and welfare is safeguarded. 6 9 13 The service must make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the home. So that peoples health and welfare is safeguarded. 7 10 12 The service must promote privacy and dignity at all times. This is so that peoples health and wellbeing is promoted. 8 12 16 people living inthe home must be consulted about their social and 02/03/2009 02/03/2009 02/03/2009 02/03/2009 Care Homes for Older People Page 27 of 31 psychological needs and each have an individualised plan as to how they should be met. This is so that peoples health and wellbeing is promoted. 9 19 23 The home should provide equipment suitable to needs of the people accommodated. This relates to proper signage. This is so that people are suported to maintain their independence. 10 19 23 The conservatory must be adequately ventilated at all times to ensure that smoke does not drift into other parts of the home. This is so that peoples health and well being is promoted. 11 19 23 The CCTV cameras must be confined to the main entrance only This is so that peoples rights are not compromised. 12 19 23 The premises should be kept 16/03/2009 in a state of good repair with all areas kept clean and reasonably decorated. This is so that peoples health and well being is promoted 13 19 13 Risks to peoples safety 02/03/2009 must be identified and as far as possible eliminated. Page 28 of 31 16/03/2009 02/03/2009 02/03/2009 Care Homes for Older People This is so that people are safeguarded from harm. 14 27 18 There must be adequate numbers of trained and competent staff on duty at all times. This is so that peoples health and welfare is safeguarded. 15 30 18 Staff must be provided with training that is suitable for the work they need to perform. This is so that peoples health and welfare needs are met effectively. 16 33 26 The service must ensure that monthly regulation 26 visits are carried out. This is so that shortfalls in service provision are identified and improved. 17 33 24 The service must have effective quality assurance systems in place. This is so that shortfalls in service provision are identified and improved. 18 36 18 Staff must be provided with supervision and have their competence assessed at regular intervals. This is so that peoples health and welfare is safeguarded. 16/03/2009 02/03/2009 02/03/2009 16/03/2009 02/03/2009 Care Homes for Older People Page 29 of 31 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 7 It is recommended that staff are given guidance about recording information about peoples daily lives and how they are conducted. It is recommended that the home ensures they support people to make their own decisions in respect of daily life and that this is demonstrated by their record keeping. It is recommended that people are offered a choice of drinks with their meal. It is recommended that the home displays menus in a format suitable for the needs of the people living in the home. It is recommended that the home up dates the complaints policy so that it contains the correct contact details for the Commission for Social Care Inspection. It is recommended the service continues to make the environment more suitable for older people with dementia, drawing on best practice guidance. 2 14 3 4 15 15 5 16 6 19 Care Homes for Older People Page 30 of 31 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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