Inspection on 29/09/08 for Cross Lane House

This inspection was carried out on 29th September 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cross Lane House 13/07/09

Cross Lane House 19/10/06

Cross Lane House 04/01/06

Cross Lane House 21/08/05

Cross Lane House 12/01/05

Cross Lane House 24/08/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 29/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Cross Lane House Cross Lane Ticehurst Wadhurst East Sussex TN5 7HQ     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sally Gill     Date: 2 9 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 © (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 27 Information about the care home Name of care home: Address: Cross Lane House Cross Lane Ticehurst Wadhurst East Sussex TN5 7HQ 01580200747 Telephone number: Fax number: Email address: Provider web address: VNew490814@aol.com Name of registered provider(s): Name of registered manager (if applicable) Mrs Amanda Patricia Newport Type of registration: Number of places registered: Mrs Amanda Patricia Newport,Mr Vincent John Newport care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Service users must be aged sixty-five (65) years or over on admission The maximum number of service users to be accommodated is eighteen (18) Date of last inspection Brief description of the care home Cross Lane House is registered to provide accommodation for up to 18 older people. Mrs Amanda Newport is the registered manager and is in day-to-day control of the home. The premise is a large detached converted country house. The property is set in approximately two acres of mature gardens with level walkways and seating areas. Accommodation is on three floors. There are fourteen single and two double bedrooms. The homes current policy is to offer the large double bedrooms as singles unless a married couple wish to share. This means that numbers of residents does not go usually go above 16. Eleven rooms have ensuite and all others have a wash hand Care Homes for Older People Page 4 of 27 Over 65 18 0 Brief description of the care home basin. People have the use of three bathrooms, which includes one assisted bath. The home has a lounge, dining room and very large hallway with seating. The home has a passenger lift. The home has parking for several cars and is situated down a quiet road just off the main road. A bus stop is at the end of the road and train station three miles away. The village of Ticehurst is five minutes walk with its general shops, chemist, cafe, church and pubs. The staff compliment consists of a manager, care assistants, cook, kitchen assistants and a maintenance/handyman. Care staff work a rota that includes a minimum of three staff on duty during the morning, two in the afternoon and two at night (one of which is a sleep in). The range of fees at the time of the inspection were 420.00 to 650.00 per week. Additional charges are made for telephone, toiletries, newspapers, hairdressing and chiropody. The last inspection report can be obtained from the home or down loaded from www.csci.gov.uk 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: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The previous inspection took place on 14th November 2006. This key inspection was carried out over a period of time and concluded with an unannounced visit to the home between 09.35am and 5.40pm. The manager and staff assisted during the visit. People that live in the home and staff were spoken to. Observations were made throughout the day. Sixteen people were living at the home on the day of the visit. Surveys were sent to the home for the manager to distribute to residents, staff and health and social care professionals. Nine were returned from services users, seven from staff and two from health and social care professionals. Generally these were Care Homes for Older People Page 6 of 27 positive although there were areas where people felt there could be improvement. Comments are incorporated into the report. The care of three people was tracked to help gain evidence as to what its like to live at Cross Lane House. Various records were viewed during the inspection and a part tour of the home undertaken. The home sent their annual quality assurance assessment (AQAA) to the Commission just outside the required timescale. The AQAA is a self-assessment picture of how the manager thinks they are doing against the national minimum standards. It is used to inform the inspection and this report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 8 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 9 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. People and their representatives have the information they need in order to make an informed decision as to whether this home is right for them and can meet their assessed needs. Evidence: People have detailed information about the home prior to moving in. An updated combined statement of purpose, service user guide and contract has been developed. This includes photographs of the home and garden. This is currently waiting to be printed. The manager advised once completed a copy will be put in each bedroom in a folder. An old version of the statement of purpose and service user guide is currently displayed in the front porch. One person who had recently moved into the home confirmed that they had received a part copy of the new document. Peoples needs are assessed. The manager undertakes a pre-admission assessment for Care Homes for Older People Page 10 of 27 Evidence: all people thinking of moving in, which is recorded. Assessments are then held on file. People have the opportunity to visit the home before they move in. People spoken to confirm they had been able to visit the home, they knew of the home before moving in or their families had visited for them. One person said they had spent about three hours in the home and was offered lunch and another said they had stay for the weekend. Intermediate care is not provided. Respite care can be provided vacancies allowing. Care Homes for Older People Page 11 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs are not always identified within their care plan. There are not clear procedures to manage some health care needs leaving people at possible risk. Medication systems need strengthening to fully protect people. The principles of respect, dignity and privacy are put into practice. Evidence: People cannot be confident that all their health, personal and social care needs are set out in their care plan. Three care plans were examined. Care plans did not evidence peoples involvement in their development. They were dated October 2007 and had no evidence of any reviews. Two contained good detail to inform staff about the needs the other contained limited information although this person was generally self-caring. Although two contained good detail they lacked key information such as catheter care and diabetes management, which could put people at risk. Staff spoken to were aware of the catheter care procedures but were not sure of the current procedures for diabetes management. Charts used to monitor personal care and bowel management lacked entries. Although the manager felt this was a result of poor recording and not a Care Homes for Older People Page 12 of 27 Evidence: lack of care. Daily note recording was good and this highlighted changes not followed through into the care plan. One person who had recently moved in did not have a care plan in place and staff were working from the pre-admission assessment. Care plans should detail all of peoples health personal and social care needs. People should be involved in the development and review of their care plan. They must be kept up to date and be reviewed regularly. A requirment is made. Peoples health could be put at risk. Catheter management was discussed with staff who could advise what procedures are in place although not recorded in the care plan. Staff were spoken to regarding the management of diabetes and were not clear about the current procedure in place or what is a safe reading when taking blood sugars for one person. The managers opinion varied from that of the staff member but was also not sure what is a safe reading. Advice and guidance must be sought. The care plan must reflect a clear safe procedure staff should follow to ensure consistency and people are not placed at risk. Staff should receive training in peoples associated conditions. The manager advised that she is making arrangements for staff training in this area and wound care. A health professional had recommended increasing a person fluid intake and when speaking to staff this had been implemented. However the care plan had not been changed. A health professional was visiting on the day of the inspection. They felt staff ask for advice, listen and then follow through into practice. They said there is always a happy atmosphere people are happy and so are staff. People have opportunities for exercise and some walk the gardens. Equipment is in place for the promotion of tissue viability. Medication systems need some improvement to fully protect people. Staff were observed administering medications and practices were observed to be safe. General storage of medication is safe. The storage whilst administering is not secure and a suggested improvement was discussed. Medication is logged into the home and out. However two entries could not be clearly tracked as returned and this must be strengthened. Medication details are contained within the care plan. Although changes are not always recorded accurately and short term medication is not always recorded. The manager advised that staff that administer medication have received training. One member of staff felt they had not received training although does administer. The manager advised that she is arranging refresher training for staff. Where prescription creams are stored in peoples bedrooms risk assessments should be in place. A requirement is made in relation to medication systems. People feel they are treated with respect and their right to privacy is upheld. People said staff are very kind, and sensitive when assisting with personal care. Observations confirmed good interactions between people and staff. One professional felt that staffs practice has improved since undertaking the National Vocational Qualification (NVQ) Care Homes for Older People Page 13 of 27 Evidence: training. They said staff are more aware and willing to ask the manager. Care Homes for Older People Page 14 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. People who use the service are able to make choices about their life style. Social and recreational activities only sometimes meet individuals expectations. People enjoy a variety of meals. Evidence: People have opportunities for activities. Since the last inspection people have been consulted about the choice of activities via a questionnaire. People confirmed an activities programme is now in place, which is displayed. This includes bingo, coordinated games, reminiscence, cross words, exercise to music, cards, scrabble and old films. Bingo was held on the day of the inspection. Twice a month outside entertainers come in to sing and play music. The manager advised that a garden fete had been held recently which involved families and the local community. The money raised is to be put towards day trips. Two religious services are held each month. Several people have newspapers delivered each day. Some people spoke of their enjoyment of just being able to read the paper, or sit and chat to others or walk in the gardens. The majority of people surveyed felt there were only sometimes sufficient activities. Two people felt the person who runs the activities has been off lately. The manager advised that she hopes to arrange staff training in activities in the future. It Care Homes for Older People Page 15 of 27 Evidence: is acknowledge this is an area, which has improved but could be developed further to meet everyone’s expectations. People are able to maintain contact with family and friends. People spoken to say they have family and friends visit. On the day of the inspection several people were visiting. People confirmed that they use the lounge or large hallway or their own rooms to see visitors. Each bedroom has a telephone point and nearly everyone has activated this service. People choose how to spend their time and make day-to-day decisions about their lives. People said they are able to get up and go to bed when they wish. People were asked if they wanted to join the activity. People confirmed they had brought in their own possessions and one person was taking delivery of their heavier belongings on the day of the inspection. People confirmed the food is good and they enjoy their varied diet. One said onions upset me but every effort is made to give me meals, which do not contain onions or onion flavouring. Another said they have what you like on the menu or they get it for you. There is a four-week rotating menu in place. Since the last inspection people have been consulted about the menus via a questionnaire and the menus revised. Breakfast can be taken on trays in bedrooms and is fruit juice, cereals or porridge and toast. Lunch is the main meal and everyone is encouraged to the dining room to make it a social event. The main meal is not a choice menu but alternatives are available followed by a desert. Supper is soup and a light meal or sandwiches as an alternative plus a desert. Lunch on the day of the inspection was homemade fish pie, cabbage and roasted vegetables with home made apricot crumble and custard. Special diets including soft, vegetarian and diabetic are catered for. Fruit and vegetables are purchased locally and other produce is from the supermarket or cash and carry. Care Homes for Older People Page 16 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to express their concerns, and have access to a complaints procedure. People are protected from abuse although updating staffs training could enhance this. Evidence: People feel confident any complaints would be resolved but do not have any. Only one person said they did not know how to complain. There is a complaints procedure displayed within the front porch. This was updated during the visit to display the up to date details of the Commission. The manager advised that there have been no complaints made to the home since the last inspection. Equally the Commission has received no complaints during this time. There is a complaints/suggestions book situated in the front porch of the home. People are protected from abuse but staff training could enhance this. The home has policies and procedures in place regarding safeguarding adults. Staff spoken showed good knowledge of where to report any abuse or neglect both inside and outside of the home. Some staff have previously had safeguarding adults training although this was in 2005. The manager advised that safeguarding refresher training is planned for October 2008. 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. People live in a light, airy, clean, pleasant and comfortable home. Evidence: People live in a homely and comfortable environment. The manager advised that the majority of the home has been upgraded in the past four years. This has been done to a good standard resulting in a very pleasant home. See comments under management regarding fire safety tests. One person confirmed they had chosen the colour scheme for their room. Bedrooms are personalised and some of people have brought items of furniture and ornaments. People confirm they are happy with their rooms. One said I like this room it is very quiet. Another said it is small but all right for me. People are able to enjoy light and airy communal accommodation. The home is set in large grounds with pathways for walks, which are enjoyed by people living at Cross Lane House. The home was clean, tidy and hygienic throughout. Care Homes for Older People Page 18 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are sufficient in numbers and moving towards being a qualified team. Staff would benefit from further training. People are not fully protected by robust recruitment processes. Evidence: The numbers of staff meets peoples needs. The manager advised that there are three staff on duty 8am to 2pm and two staff on duty 2pm to 8pm. This is in addition to the manager and other ancillary staff such as cook, domestic and maintenance/gardener. All comments about the staff were positive. Only one person felt there is only sometimes staff around when you need them. People felt they were very kind and helpful. Staff felt they worked well as a team and get to spend time one to one with people that live there. People receive care from a qualified staff team. Information provided stated that four staff have obtained their National Vocational Qualification NVQ level 2 or above and another five are working towards this. When completed this will more than meet the 50 recommended by the National Minimum Standards. People are not fully protected by the homes recruitment processes. Three staff files were examined. The home application form only asks for 10 years employment history Care Homes for Older People Page 19 of 27 Evidence: and regulations require a full employment history to be obtained, which it had not. Application forms showed gaps in employment histories, which had not been checked out, and a satisfactory written explanation made that is required. For one employee only one written reference had been obtained instead of two. For another the last employers reference had been obtained from a colleague and not the establishment. For two employees actual start dates could not be found recorded and had to be best guessed. A requirement is made regarding recruitment. Further staff training could enhance staff skills. A Skills for Care induction is now in place and currently one new member of staff is undertaking this. The manager advised where applicable other staff complete an orientation induction. This is not evidenced and should be. One member of staff had completed a medication competency questionnaire but management had not assessed this. Most staff are trained in mandatory subjects and refresher training is planned for fire. The first aid training has not been updated since January 2005 and must be. Three staff missed the practical session of moving and handling and this needs to be address. Only twelve staff have attended safeguarding adults training and all staff should receive this training. Staff should receive training in relevant subjects such as diabetes and catheter care. The manager advised that she is in discussions with two professionals to do training. One staff member surveyed felt staff should have training in equality and diversity. A requirement is made in relation to training. Care Homes for Older People Page 20 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. People live in a home where the manager acknowledges that some areas have slipped and she is keen to work hard to pull these areas back up. Quality assurance systems have not been effective in highlighted shortfalls. Peoples health, safety and welfare is not always promoted and protected. Evidence: People live in a home where the manager runs the home with commitment. There has recently been a management structure change within the home. This caused a period of unsettledness within the home which staff say is now beginning to be sorted out. One person surveyed said the manager is not always around so not always sure who’s in charge. The manager is now picking back up the day-to-day issues and paperwork systems of the homes workings. The manager has nearly completed her Registered Manager Award (RMA) and has an NVQ in care level 4. Staff say she is a good manager. Care Homes for Older People Page 21 of 27 Evidence: Quality assurance systems are not operating in peoples best interests. A quality assurance questionnaire was sent out in June to ask people their views of the home. This information has not been collated or fed back to people living in the home. One residents meeting was held in June 2008 although there are no minutes or notes. People have been asked about menus and activities and changes have been as a result. Staff advised they have had one team meeting held after the management changes. Staff supervision is not within recommended timescales, which is bi-monthly. Improved record keeping would safeguard peoples financial interests. The manager advised that the home currently holds a small amount of savings for two people. These were examined. Both showed a difference in cash to the balances recorded. The manager was able to give explanations for both. A written explanation made at the time of receipt or withdrawal would be good practice. Staff feel well supported but formal supervision is lacking. Staff spoken to say they feel well supported. Some staff surveyed felt they lacked formal supervision, which was confirmed by records. Peoples health, safety and welfare is not always promoted and protected. Records confirmed that most equipment had been serviced within required timescales. However the hoist, which is in daily use showed that it was due for service on 19/05/08, and records could not be found to confirm this had taken place. Action must be taken to address this. The servicing of fire equipment was up to date but interim tests required by the home were not. The last recorded were March 2008. The manager advised that lighting has never been tested in between servicing and extinguisher tests have never been recorded. The home must contact the Fire Safety Officer for advice and guidance on required testing and records. The last fire drill was carried in February 2008 and again this is not in line with requirements. The accident book was examined. Reports were stored inline with confidentiality however accident records cannot be tracked under the current system. This needs to be addressed and suggestions were discussed. See training for comments regarding mandatory staff training. Care Homes for Older People Page 22 of 27 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 23 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 29 19 The registered person must have a robust recruitment procedure in place. In particular a full employment history must be obtained. Gaps in employment history must be checked and a written explanation recorded. Two written references must be obtained which will include the last employer. Regualtion 19 of the Care Homes Regulations 2001 says that the registered person must not employ a person to work unless he has obtained in respect of that person the information and document specified in paragraphs 1-9 of Schedule 2 29/10/2008 2 30 18 The registered person must ensure staff receive suitable and sufficient training Regualtion 18 of the Care Homes Regulations 2001 says that the registered person must ensure staff receive training appropriate to the work they are to perform. 10/11/2008 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 Care Homes for Older People Page 24 of 27 Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 The registered person must 10/11/2008 have for each service user a written care plan in place which reflects all the individuals health, personal and social care needs. Care plans must contain clear guidance to staff on the management of care and health needs. The plan must be kept up to date and regualrly reviewed. Regulation 15 of the Care Home Regulations 2001. The registered person shall after consultation with the service user prepare a written plan as to how the service users needs in respect of health and welfare are to met. The registered person shall keep the service users plan under review and revise the service users plan. 2 10 13 The registered person must have a robust medication system in place. In particular a safe system for tracking and returning medicines brought into the home A risk assessment in place where prescription creams are not stored securely Staff that administer 10/11/2008 Care Homes for Older People Page 25 of 27 medication must have received training Regulation 13(2) of the Care Home Regulations 2001. The registered person must make suitable arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. 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 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 © (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 27 of 27 - 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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