Inspection on 13/03/09 for Clifton Court

This inspection was carried out on 13th March 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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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: Clifton Court Clifton Drive Sprotbrough Doncaster DN5 7NL     The quality rating for this care home is:   two star good 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: Sue Turner     Date: 1 3 0 3 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 28 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 28 Information about the care home Name of care home: Address: Clifton Court Clifton Drive Sprotbrough Doncaster DN5 7NL 01302781693 01302781693 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mirus Care Limited care home 33 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of users who can be accommodated is : 33 The registered person may provide the following category of service only: Care Home only - Code PC To service users of the following gned - Either 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 number of places, 33 Date of last inspection Brief description of the care home Clifton Court is situated in the village of Sprotbrough located in the borough of Doncaster. It is approximately 3 miles from the city centre. There is a regular bus service fifty yards away from the home.Outside there is a small car park and pleasent gardens with a sitting area. Rooms are contained on two floors and served by a passenger lift. Assisted bathing facilities are available with private facilities in some rooms. There are a wide range of Care Homes for Older People Page 4 of 28 Over 65 33 0 Brief description of the care home individually furnished and decorated single and luxury single en suite bedrooms as well as double rooms for those who want to share. The manager said that the weekly fee is 390 pounds and 14 pence. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good 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: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This was an unannounced key inspection carried out by Sue Turner, regulation inspector. This site visit took place between the hours of 8.30 am and 3.45 pm. The manager is Emma Strutt who was present during the site visit. The manager was given verbal feedback during and at the end of the site visit. We also gave feedback over the telephone to the provider. Prior to the visit the manager had submitted an Annual Quality Assurance Assessment Care Homes for Older People Page 6 of 28 (AQAA) which detailed what the home was doing well, what had improved since the last inspection and any plans for improving the service in the next twelve months. Information from the AQAA is included in the main body of the report. On the day of the site visit opportunity was taken to make a partial tour of the premises, inspect a sample of care records, check records relating to the running of the home and check the homes policies and procedures. Time was spent observing and interacting with staff and people. Six staff, four relatives and eight people living in the home were spoken to. One professional visited the home and they were also spoken to. We checked all key standards and the progress made has been reported on under the relevant standard in this report. We wish to thank the people living in the home, staff, and relatives for their time, friendliness and co-operation throughout the inspection process. 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 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provided sufficient information to inform people about their rights and choices. People were encouraged to visit the home, look around and meet other people living there. Evidence: The home had a Statement of Purpose (SOP) and Service User Guide (SUG). These were available for people living in the home and anyone who may be considering living in the home. A copy of the SUG was seen in peoples rooms. Before people stayed in the home they were assessed by a social worker. The manager also carried out a pre assessment by visiting people in their own home or hospital. This meant that everyone could be assured that the home could meet the persons needs. People were invited to visit the home, try out the meals and spend time meeting the staff and seeing the services available. Any information collated from the needs assessment would then form the basis for the care plan. When staff were asked, are you given enough information about people to enable you to care for their Care Homes for Older People Page 10 of 28 Evidence: individual needs, they said always and usually. Relatives said, We came to look around here and other homes. We liked this one the best and we still think its the best. We chose this home because it was recommended to us by friends. We feel we made the right choice. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A range of health care professionals visited the home to support peoples care. Medication procedures protected peoples health and welfare. In the main, the health and personal care needs of people were met in a way that maintained their privacy and dignity. Evidence: Each person that lived in the home had an individualised plan of care. These were checked for three people. The AQAA said, We have a very good team of care staff who are all aware of their role to provide personal care. Care staff are courteous and treat people with respect and dignity at all times.We spoke to some relatives that had been involved in care planning and others who had chosen not to be involved. We looked at the care plans for three people. The care plan system had been recently changed. Care plans contained information about peoples health and personal needs. Care plans seen were written in a person centred way.The manager said that staff had undertaken training in person centred care and this was reflected in the way care plans were completed. Care plans seen contained details of all health care contacts, appointments and Care Homes for Older People Page 12 of 28 Evidence: treatments, and the home supported access to these to ensure health was maintained. Access to dentists, chiropodists and opticians was available. Care plans had been updated, however information that was no longer current or relevant remained on one persons files. This made it difficult to establish the persons present care needs and requirements. Staff completed daily records at the end of each shift. Those seen related to the care plans. The daily record completed for one person did not truly reflect what had been observed by us during lunch. See the following section, daily life and social activities for further details. People seen looked well cared for, were dressed appropriately and had received a good standard of personal care and support. People said, Staff are good and help me if I need it. I used to stay here on respite so I knew how kind all the staff were. Thats why I came in here permanently. The staff are very good and help me with my continence. It could be worse and it could be better. One professional said, I have no concerns about the home. People are well cared for and staff are aware of their personal needs. Senior carers administered medications. The senior carer said that all seniors had undertaken training in medication administration. She said they had recently had some updated training provided by the pharmacist. Medicines were securely stored in locked trolleys. The Medication Administration Records (MAR) sheets were completed fully with staff signatures. The manager carried out regular checks of the medication systems. During the site visit we observed that people were cared for in a friendly way. Staff were skillful in ensuring that people maintained their privacy and dignity when receiving personal care. In the lounges we saw that many chairs had incontinent seat pads. The manager said that people didnt always sit in the same chair so these were put on most chairs in case someone had an accident.We believe that these should be removed so that peoples dignity and privacy is upheld. Care Homes for Older People Page 13 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were able to maintain contact with family and friends. A limited range of activities was on offer. Further activities and outings would promote choice and maintain peoples interest. Peoples mealtime experience varied. People were not adequately supported and observed at mealtimes. Evidence: People said they were able to get up and go to bed when they chose, and were seen to walk freely around the home, if able. One relative spoken to said they were able to visit at any time and were made to feel very welcome. Staff took time to make sure friends and family were made to feel comfortable whilst visiting their loved one. Some people said they preferred to stay in their room at certain times of the day and that the staff respected their decision. Two activities co ordinators worked each afternoon from Tuesday to Friday. On the day of the visit people were involved in exercise and bingo. People were asked are there activities arranged at the home that you can take part in. They said, We have bingo, quizzes and knitting. I think there is a lack of activities and would like to do more. We only get about an hour on some afternoons, which makes the mornings boring. Things are much better than they were. Care Homes for Older People Page 14 of 28 Evidence: Relatives said, There does always seem to be something going on when I visit. My mother chooses not to be involved in any activities. We observed breakfast and lunch being served in the dining room. Choices were available and staff were aware of peoples meal preferences. At breakfast people had a choice of cereals, grapefruit or porridge followed by bread or toast with preserves. People said that cooked breakfasts were available every day if requested. Some people had bacon sandwiches. At lunchtime the dining room tables were set nicely with tablecloths, cutlery and matching crockery. Condiments were on the tables and cold drinks were available. Staff were available to attend to people over lunch. People said, We dont usually get all this attention at meal times, this is not the norm. Staff usually sit on the settees and eat their own lunch whilst we eat ours. We asked the manager about this. She said that some staff did eat at the same time but this didnt mean that people were left unattended.We believe that if staff are on their break they should use the staff room. Staff who are not on their break should be in constant attendance in the dining room during mealtimes. On the day of the visit there was alot of dissatisfaction about the lunchtime meal. A significant number of people said the fish was dry. People also said the dessert, of fruit pie didnt have any sugar in it and the they couldnt cut through the pastry. We observed alot of waste left on peoples plates. People said, The puddings are usually much nicer than it was today. The food isnt bad. Its good quality food that comes so if its not nice its the way its been cooked. Most of the time I enjoy my meals. One relative said, Mum has put on weight whilst shes been here and is looking better for it. The manager said that some issues about food and meals had been highlighted in the quality assurance surveys. She was addressing these issues with the catering staff. One person seen was not eating his/her lunch. The senior carer kept reminding a carer to try to encourage the person to eat. He/she was saying they didnt like it. Eventually the meal was removed and a plateful of sandwiches was offered to him/her. These were also left untouched. The persons care plan said that he/she needed encouragement to eat. When the daily report was completed staff had recorded that the person had eaten with assistance. We spoke to the manager about this as the person had not eaten anything and had been offered very little assistance and encouragement. Care Homes for Older People Page 15 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. In the main there were systems in place to protect people. However as there were some staff who had not received training in adult safe guarding this could result in people being put at risk of abuse. Evidence: People and their families had been provided with a copy of the homes complaints procedure, which was also on display in the entrance hall. This detailed who to speak to at the home or, if preferred, external to the home to make a complaint, should they wish to do so. The complaints procedure directed people to the manager to deal with any complaints. If the manager was unable to resolve complaints then people were directed to the provider of the service. The home kept a record of complaints, this detailed any action that had been taken and the outcome of the complaint. The home had not received any complaints or had any safe guarding referrels since the new owners had taken over. The AQAA stated, Relatives are encouraged to voice any concerns with the manager or senior care staff if they have any issues. The home has a strict policy on the Protection of Vulnerable Adults and how to contact the Adult Protection Team. The manager said that the majority of staff had completed training in adult safe guarding, but there remained some staff that had not completed the training. Staff spoken to were aware of their role and responsibilities in dealing with any alleged safeguarding incidents. The home had copies of and were working with the revised South Yorkshire protocols for adult safeguarding. People spoken to said they felt safe Care Homes for Older People Page 16 of 28 Evidence: living in the home. Relatives said, If I have any issues I can go to any of the staff and they will sort things out . The manager is very good at dealing with things quickly. I have never needed to use the complaints procedure but I know what to do if I need to. Care Homes for Older People Page 17 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was maintained to an adequate standard. Procedures for the control of infection did not fully protect peoples health and welfare. Evidence: The AQAA stated, Over the last three month we have decorated various rooms, laid down new carpets and new pine furniture to update the home.Fire Dorgards have now been fitted to all the doors.Locks have been fitted to all chest of drawers.All wardrobes have now been fitted to the walls with safety brackets. Peoples rooms are now identified with their individual name plates on their door. The home was clean and tidy. Lounge and dining areas were domestically furnished. Bedrooms were personalized. The toilets and bathrooms were in need of updating and making more homely. One person said, I asked the provider about a television aerial and he sorted this for me very quickly. Most areas of the home smelt fresh and clean. There were unpleasant odours in certain parts of the home that lifted during the day. Staff were observed using protective aprons and gloves. Staff said they had undertaken training in infection control. We observed that the carers walked in and out of the kitchen throughout the day. The handyman/gardener also walked into the kitchen, through the back door. No one used protective aprons when entering the kitchen. The Environmental Health Officer had also reported that he had observed a person in the kitchen with an apron Care Homes for Older People Page 18 of 28 Evidence: on that had been used when they had provided personal care to a person. We talked to the manager about the risk of cross infection and advised that the kitchen door should be kept shut and a notice displayed instructing people not to enter the kitchen area. Two people said that the cutlery and crockery was not always as clean as it should be. They said that they believed that there should have been a dish washer so that pots were washed thoroughly. Care Homes for Older People Page 19 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing numbers were not always appropriate to meet the assessed needs of people. Recruitment information obtained for staff was sufficient to adequately protect the welfare of people. Staff had completed training. Evidence: Staff interviewed said that they enjoyed working at the home and got a lot of job satisfaction. On the day of the site visit there were 30 people living in the home. Staffing levels were being maintained at a minimum. During the morning there was one senior carer and two carers on duty. Staff said that there were nine people that had a degree of confusion or dementia. Two people were also blind. This meant that the dependency levels of people were high. At certain times throughout the day carers were also expected to cover laundry and kitchen duties. At weekends there was no domestic cover and in the week domestics only worked during the morning. This meant that carers would also have to carry out essential cleaning tasks. Only two staff worked during the night, which would also have an effect on the daytime carers. We believe that due to the dependency levels of people currently living in the home , these staffing levels are not adequate. People said, Sometimes we feel we are putting on the carers which frustrates us and we feel upset. Staff listen but dont always have the time to do what we ask. Care Homes for Older People Page 20 of 28 Evidence: The staff are lovely but theyre just so busy. The manager had undertaken a review of staff training and had identified the shortfalls. Mandatory training had been booked and further training in specialized topics for example dementia was being delivered. The AQAA stated, Under new management all care staff are up to date with relevant training and encouraged to receive as much training as possible at regular intervals, which will help improve the standard of care delivered.All new care staff have had full inductions and are currently in place to start their NVQS. Staff were able to talk about the various training courses that they had attended which included, Moving and Handling, Food Hygiene, First Aid and Fire. Domestic staff said they had not received training in moving and handling loads. The manager said that this had been recognized and was due to take place in the near future. A number of care staff had completed the NVQ Level 2 in care and others had commenced the training. The number of staff trained met the required minimum of 50 per cent of the staff team trained to NVQ Level 2 in Care. Three records of employment were checked. These included references, certificates of training, health checks and evidence of Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) check. Application forms did not ask for peoples dates of previous employment. This meant that the manager was unable to establish if a person had given their full employment history or if there were any gaps in their employment. Care Homes for Older People Page 21 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The managers leadership approach benefited people and staff. Quality assurance systems meant that the home was run in the best interests of everyone. Peoples monies were safely handled, which ensured that finances were accurate and safeguarded. Peoples health and safety had been promoted and protected. Evidence: The manager had been recently promoted from deputy manager to manager. She was in the process of registering with us and had completed the Registered Managers Award (RMA). She was clearly committed to ensuring that people living in the home were consistently well cared for, safe and happy. One professional said The manager is very supportive when I need to discuss peoples care. Staff said that they found the manager very approachable and could go to her at any time to discuss their work and peoples care. The provider carried out Regulation 26 visits. He visited the home on a regular basis to keep himself up to date with the service. Staff said that he was available for them to speak to should they wish to. Each month he completed a report detailing his Care Homes for Older People Page 22 of 28 Evidence: findings. Any actions that were identified were then carried out. Quality Assurance questionnaires were sent out to people, relatives and professionals on a regular basis. We saw evidence that appropriate action was taken by the provider and manager following the comments received from surveys. Staff, relative and resident meetings were arranged and minutes from these were seen. The home handles money on behalf of some people. This was checked for three people. Account sheets were kept, receipts were seen for all transactions and monies kept balanced with what was recorded on the account sheet. Formal staff supervision, to develop, inform and support staff took place at regular intervals. Staff said that they found this useful and beneficial. Fire records evidenced that fire alarm checks took place. Staff said that they had received fire training and fire drills. A fire risk assessment had been completed in April 2008. We saw that people were being moved around in wheelchairs with footplates fitted for their safety. Care Homes for Older People Page 23 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 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 Staff must make sure that what they record on the daily record is a true reflection of the days events. So that peoples health, safety and welfare is maintained. 20/03/2009 2 7 15 The information in care plans must be up to date and relevant. So that staff are aware of peoples current needs and preferences. 20/03/2009 3 15 13 Where people have been assessed as needing assistance and support during mealtimes, this must be provided. So that peoples individual needs are met. 20/03/2009 Care Homes for Older People Page 25 of 28 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 4 18 18 All staff must be provided with training in adult safe guarding procedures. So that people are not put at risk of abuse. 20/03/2009 5 26 23 All crockery and cutlery must be thoroughly washed and sanitized. So that the risk of cross infection is reduced. 20/03/2009 6 26 23 Staff that do not work in the 20/03/2009 kitchen must not enter the kitchen, unless they have put on protective work wear. So that the risk of cross infection is reduced. 7 31 18 Staffing numbers must be 20/03/2009 appropriate to the assessed needs of people and the size of the home. So that people care and support needs are consistently met. 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 9 12 Chair seat pads used for incontinence should not be placed randomly in communal areas. People should be provided with a programme of activities, which suits their expectations, preferences and capacities. Page 26 of 28 Care Homes for Older People Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 3 4 5 6 7 19 19 31 31 31 Toilets and bathrooms should be made to look more homely. Refurbishment and redecoration of the home should continue so that the environment is of a high standard. Application forms should ask for dates of previous employment so that any gaps in this can be checked out. Domestic staff should complete training in the moving and handling of loads. There should be a deputy manager in post. Care Homes for Older People Page 27 of 28 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 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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