Inspection on 30/09/08 for Clann House Residential Home

This inspection was carried out on 30th September 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Clann House Residential Home 03/03/09

Clann House Residential Home 06/05/08

Clann House Residential Home 30/05/07

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 05/12/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Clann House Residential Home Clann House Residential Home Clann Lane Lanivet Cornwall PL30 5HD     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: Alan Pitts     Date: 3 0 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Clann House Residential Home Clann Lane Clann House Residential Home Lanivet Cornwall PL30 5HD 01208831305 Telephone number: Fax number: Email address: Provider web address: julie.frape@btconnect.com Name of registered provider(s): Name of registered manager (if applicable) John Reid Clarkson,Susan Ann Clarkson Type of registration: Number of places registered: care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 34. The registered person may provide the following category of service only: Care home providing personal care 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- maximum 3 places Dementia- Code DEmaximum 34 places Mental disorder, excluding learning disability or dementia- Code MD- maximum 3 places Date of last inspection 34 3 0 Over 65 0 0 3 Care Homes for Older People Page 4 of 27 Brief description of the care home Clann House is situated in three acres of land and gardens, in a quiet rural setting a short distance from the village of Lanivet, near Bodmin. The home is registered to provide accommodation and personal care for up to twenty six older people with a dementia; it is also registered to care for named residents with mental healthcare needs (3), old age (3) and one resident with a learning disability over 65 years. The adapted farmhouse offers comfortable accommodation, with level access around most of the ground floor. The bedrooms offer views of the surrounding countryside. The home offers accommodation on both the ground and first floor, with stair lift provision for those who require it. An extension has been added to the home providing eleven en-suite bedrooms. Communal rooms comprise of three lounges, and a dining room. The dining room comfortably accommodates the residents. There is a central safe courtyard garden. The home has its own car parking with space for approximately 5 to 7 cars. A further extension has been built on to the side of the premises, and provides accommodation for a further 8 people. The accommodation in this new extension is not level access and is suited to people who are more mobile and more self sufficient. Information about the home (Statement of Purpose and Service User Guide) is available from the office, and information is provided in each bedroom. The fees for the home are between 384 and 482 pounds; this does not include toiletries, chiropody, hairdressing, clothing or other personal items. Use of the vehicle is charged at 40p per mile. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: zero star poor 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: This unannounced inspection took place over approximately 4.5 hours with two inspectors. We looked at documentation, toured the premises, met with residents and staff, and discussed our findings with the manager and registered provider. Part of the inspection was spent sitting observing what happens in the home and staff interactions with the people that live there. We also received 9 surveys completed by people that live at the home or their representative, and 3 staff surveys. Care Homes for Older People Page 6 of 27 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 240 7535. Care Homes for Older People Page 7 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents and/or their representatives are provided with comprehensive information to enable them to make an informed choice of home. Residents have their needs assessed prior to moving into the home. This is so that the home can assure them the prospective resident that they are able to meet their individual care needs. Evidence: The manager elect, Tina Atkinson, and the regional manager, Sharon Hughes, confirmed that copies of the Statement of Purpose and Service User Guide (documents that tell a person about the home) are kept in each of the bedrooms, and are given to prospective people as part of their welcome pack. This pack also includes the Complaints Procedure. The Statement of Purpose and Service User Guide were last reviewed in July 2008. We asked to see copies of contracts or terms and conditions for people who are living Care Homes for Older People Page 9 of 27 Evidence: in the home. The provider confirmed that everyone had a contract and this was confirmed by the care documentation belonging to the most recent admission to the home. As part of this inspection we looked at the assessments that were carried out prior to a person moving to Clann House. The care documentation of the person most recently admitted to the home showed that a proper pre-admission assessment had take place. The home does not provide intermediate care, though respite care is offered. Care Homes for Older People Page 10 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Many of the people who live at Clann House and their relatives feel that they are offered a good standard of care, however the home is not meeting the needs of people with more complex needs or difficult behaviours and so is placing them and others at risk. The home is putting people at risk with its current medication practices. Evidence: Comments received from the people who live at Clann House was very positive. Comments included ...the staff always respond within 5 minutes to our call bell, and arrive with an excellent caring response, and nothing is too much trouble. Surveys sent to relatives indicated that that people are happy with the service provided and peoples needs are met. As part of this inspection we spent time observing in the dining room, how people were treated. There were twelve continuous periods of five-minute observations (1 hour). Five residents were observed at different times. There were twenty nine staff Care Homes for Older People Page 11 of 27 Evidence: interactions with residents of which twenty one were seen to be inclusive, respectful and demonstrated warmth of feeling for the individual. Eight seen to be impersonal, instructing the client rather than engaging with them. Residents overall were seen to have a positive state of being, interacting with their environment, and with each other. Overall, staff explained things well and spoke appropriately with clients. Many of the people at Clann House have dementia or mental health needs and are not able to always explain their needs or difficulties. It is therefore important that there are written care plans that detail how needs are to be met to ensure that staff know the nature of the care they are to provide. Clann House uses a computerised system for all records, as well as printed copies. The printed copies did not always reflect the computerised version, amendments having been made to one or the other, but not both. We looked at the care plan documents for four people. We found that the care plans did not accurately reflect the care needs and capabilities of the individual residents, and there is a tendency for use of generic (pre-filled in) care plans. Care plan reviews were seen to have been signed as having taken place, but changes that came to light from other documentation were not evident when the content was discussed with the manager and regional manager. The registered provider, Mrs Clarkson, said that she would discuss the continued use of the computer system and possible alternatives with the regional manager and the manager as it was felt that the system itself may be an obstacle for staff. There was one care plan that showed residents or the people who were representing them were involved in planning or reviewing the care provided. The regional manager said that training arranged for the day previous on care planning had been cancelled by the trainer at short notice. Supporting documentation showed that clients have access to relevant professional health care agencies as needed, and a District Nurse was in attendance at the home on the day of the inspection. All the people that live at Clann House are registered with a local GP. We inspected the medication. A monitored dose system, prepared by the pharmacist, is used at Clann House. We looked at the records relating to the administration of medicines. There were serious anomalies in these records, one showing that a client had not been given their prescribed medication over several days because they had been asleep at the time (9am). Another showed a medicine as not given because it was not available, though the manager said that the client had not taken this medication for months and it should not be on the record. The manager said that she had reported this matter to the regional manager a week ago, but it was not evident that any action had been taken. An immediate requirement was left with the registered provider, who said that this matter would be dealt with as a matter of urgency. Medicines are stored securely. Care Homes for Older People Page 12 of 27 Evidence: Clients preferred names are recorded and used, though this is not always clear on the computerised system. Clients have access to a telephone for private use. Rooms have been fitted with new locks since the last inspection, allowing the individual to lock their room whilst ensuring staff access in an emergency. Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents value the activities provided, these have been extended and generally meet the needs of all the residents. Visitors are welcomed to the home at anytime. Choice is available to residents about the time and content of their meals. Evidence: The homes daily entries do not do justice to the efforts of staff to provide almost daily activities. There is an activity record that identifies the activity and the participants, but offers no information as to whether people enjoyed the event, or not. This record shows that there are frequent and regular activities. The daily entries in the care documentation, with the occasional exception, tend to be bland statements such as fine this morning, even with the more active residents that were identified by the manager and regional manager at the time of the inspection. There is no evidence that the people not listed as participating were given the opportunity to do so. Comments from the people that live at Clann House include: ...I enjoy vocal groups, musical events, and choirs..., and one who when asked if there were activities arranged that they could take part in said not that I am aware of. Staff were observed to be playing scrabble with a group of residents in the lounge, and there is no doubt that activities are available, but more should be done to ensure their availability to all. The Care Homes for Older People Page 14 of 27 Evidence: home has a recently purchased vehicle so that the people who live at Clann House can have more opportunities to go out. The manager confirmed that at least two of the people that live at Clann House access local facilities in the village as they wish. The visitors book and comments from residents confirm that contact with loved ones and friends is encouraged. The benefits of the daily entries providing a pen portrait of residents life styles (including times of waking and retiring) was discussed with the manager and the registered provider. Rooms are personalised with plenty of evidence of personal possessions being brought in. The home maintains a personal property record to reflect this. The days menu is displayed on the wall of the dining room, and shows that a choice is available. There is a record of food provided kept. Lunch was seen to be attractively presented and hot when served. The daily entries show if a resident has eaten well that day. Soft diets are available, and care is taken to ensure that such meals are presented in a manner that is attractive. The people who live at Clann House said the meals have always been to the highest order, and now and again I have meals I am not happy with, but I always inform staff. Care Homes for Older People Page 15 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people that live at Clann House are protected by an effective complaints procedure and there is protection from an increasingly knowledgeable and trained staff in respect of safeguarding. There is more to be done to ensure the protection of adults from abuse. Evidence: There is an easy read complaints procedure displayed in the entrance to the home. A copy of the complaints procedure is available in each bedroom. A recent quality assurance survey sent out to clients, and relatives and visitors to the home also included a question whether the respondent knew how to voice concerns. Comments from the people that live at Clann House included: There is a complaint form at the front door, We now understand the procedure. One of the responsibilities a care home has is to protect people from abuse, and the Commission expect homes to be proactive in this matter. When we looked at care records and discussed the matter with the manager and regional manager it was apparent that some individuals had engaged in very difficult behaviours, which had placed themselves or other people at risk. The home has recently made a safeguarding referral to the Department of Adult Social Care, but this was done after prompting from the inspector. There is ongoing safeguarding training taking place, which the manager and registered provider said would continue until all staff had received this Care Homes for Older People Page 16 of 27 Evidence: training. Safeguarding has been included as a topic at recent team meetings, and the minutes were seen to support this. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at Clann House benefit from accommodation that for the most part has been designed to meet their needs. The accommodation is clean and odour free. Evidence: We looked around the home with the Manager, as part of this inspection. The rooms seen were all clean and in good order, there were no unpleasant odours. Some of the people had brought items of their own in to decorate their rooms, and a couple of people have tea-making facilities. All of the rooms are of a good size and many have ensuite bathrooms or showers. The most recent extension to the home can provide accommodation for a further eight people. These rooms are down a corridor where there is a door with a keypad; there are a few steps even for rooms on the ground floor. The Manager is aware of the type of people who could be accommodated in these rooms. People who needed more care and support live in other parts of the home. There is a central courtyard around which there are bedrooms the dining room and lounge. This means that people are free to wander freely in the rooms and corridors that surround the courtyard, or use the courtyard itself. This part of the home provides Care Homes for Older People Page 18 of 27 Evidence: safe accommodation for people who may have dementia or memory problems to walk safely and not to be enclosed. The garden area to the side of the house would benefit from further planting and seating facilities. Bedroom door locks have been replaced since the last inspection to provide a facility for residents to lock their doors, whilst allowing staff overiding access in case of emergency. The staff have a master key for all the doors. The main building has also been completely rewired since the last inspection, work having only recently completed. The registered provider said they would forward a copy of the relevant electrical certificate once received. There is liquid soap in many of the bathrooms and toilets, that needs to be periodically topped up. The manager and regional manager agreed to establish a proper cleaning schedule for these. The kitchen and laundry areas are well equipped and were seen to be clean and organised. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The numbers of staff on duty are adequate. The recruitment procedures are generally robust to safeguard residents. Training is encouraged and facilitated, but more can be done. Evidence: Information provided by the Home shows that in excess of 50 of care staff have a National Vocational Qualification Level II or above. A training matrix is being implemented so that staff training needs can be better monitored, but this was not in place at the time of the inspection. The regional manager said that they were in the process of obtaining copies of staffs training certificates. This will be useful to establish the baseline from which the training needs will arise. Training has been arranged since the last inspection in safeguarding and Manual Handling, and the registered provider said that this would continue, especially in respect of the former. The regional manager said that the induction for one recent member of staff had taken place over the prescribed period of four days, but had signed to say that the staff member had completed their induction on the same date and the trainees signature was not included. One member of staff was discussed and identified as eligible for the National Training Organisation induction (www.skillsforcare.org.uk). Comments received from staff included: [Care and Support] is getting better under the new management, but also team morale is low at present. There have been significant Care Homes for Older People Page 20 of 27 Evidence: staff changes since the last inspection, which inevitably causes some disruption to staff and managerial systems. There is a manager elect, supported by the regional manager, but the position of registered manager is vacant at the moment. The registered providers also have hands-on involvement with the home, and Mrs Clarkson was present at the time of the inspection. As discussed with the registered provider, the home will benefit and improve further from a settled period with strong leadership from a registered manager. The rating of good for this section is given in part for the Commissions confidence in the registered providers commitment to further improving the home. We looked at some of the staff files during the inspection and this showed that there are usually enough staff on duty, though this is balanced by one staff members comment dont always have the time to do activities. Additionally it is difficult to fully assess the adequacy of staffing levels until the care plans are reviewed to ensure they accurately reflect the care needs of the residents. Examination of personnel files showed that the home is generally adhering to a robust employment procedure, though care should be taken to ensure the suitability of the references provided and taken up (one provided only a character reference with no comment on suitability for the position applied for). When we looked around the house people were up, dressed and there was no evidence of a lack of care. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager has yet to register with CSCI therefore the legal responsibilities are with the registered provider at this time. The residents will benefit from the appointment of a registered manager. Feedback is sought from residents and/or their relatives regarding the way in which the home is run. Risk assessment practices require improvement. Evidence: There have been significant changes since the last inspection, and there is currently a vacancy for the position of registered manager. The manager elect, Mrs Atkinson, has achieved NVQ Level 2, 3, and 4 in care, and also the Registered Managers Award. Mrs Atkinson has worked in the position of assistant manager at another care home for approximately 3 years. Mrs Atkinson is supported by the regional manager, Sharon Hughes, and the registered providers. One resident commented I feel the home has excellent team management...caring and helpful, always ready to assist, but the requirements identified in this report are predominantly of a managerial nature in that Care Homes for Older People Page 22 of 27 Evidence: there has been insufficient oversight of care practices (medicines) and systems (care plans and risk assessments). The home and the people that live there will now benefit from a period of stability and the appointment of a registered manager to provide clear direction and leadership. The regional Manager said that Quality Assurance forms had been sent out to find out about peoples views about the service. A sample questionnaire was seen and these forms are also available in the entrance hall. One response has been received, but it is anticipated that more will be returned. The manager elect and regional manager said that the feedback would be analysed and a summary of the findings published (possibly in the Service Users Guide). Financial records were not inspected at this time, but these have historically been well recorded and accurate. Staff files supported the managers statement that staff supervision had commenced, and would continue to be provided to all staff. The home accommodates a number of people with complex needs that includes behaviours that challenge the service. Some of the people present as a potential risk to others. When we spoke with the manager and regional manager and examined the care records it was not evident that the changes in need and potential risk had been reflected in the risk-assessments and care plans, meaning that there is a tendency for events to be reacted to rather than managed. The premises and equipment within are regularly maintained and checked. Physical improvements have been made to the premises since the last inspection. Care Homes for Older People Page 23 of 27 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 15 (1) All people using the service 01/08/2008 must have an up to date detailed Care Plan, based on an assessment of need. This will ensure that they receive person centred support that meets their needs. The individual or their representative must be consulted. The system for record 01/09/2008 keeping must be reviewed. Care records must be kept up to date, be readily accessible by those who need to use them and be suited to their purpose. 2 37 15 Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 9 13 The registered person shall 23/10/2008 make suitable arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. People that live at the home must be protected by safe administration practices that ensure they receive their prescribed medication in the correct dose at the correct time. 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 people using the service 01/01/2009 must have an up to date detailed Care Plan, based on an assessment of need. The individual or their representative must be consulted. This will ensure that they receive person centred support that meets their needs. 2 31 8 The registered providers must appoint a registered manager. 01/02/2009 Care Homes for Older People Page 25 of 27 The people that live at Clann House and the staff will benefit from a clear sense of direction and leadership. 3 38 13 The registered providers must ensure that as far as possible residents and staff are not subjected to avoidable risk. Current and accurate riskassessments will assist the home to manage risk, rather than react to incidents. 01/01/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 12 The registered provider should ensure that all the residents have the opportunity to participate in activities available, and that the daily entries in the care documentation reflect the lifestyle of the residents. The registered provider should ensure that safeguarding training continues until all staff have received this training, and ensure that the home has a proactive ethos to safeguarding. The registered provider should continue to assess and monitor training needs and encourage staff development. 2 18 3 30 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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