Inspection on 03/11/08 for Elm Tree House

This inspection was carried out on 3rd November 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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Elm Tree House 30/11/07

Elm Tree House 19/02/07

Elm Tree House 11/05/06

Elm Tree House 17/11/05

Similar services:

Trevayler Residential Care Home

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Elm Tree House 37a Ogle Street Hucknall Nottingham NG15 7FQ     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: Karmon Hawley     Date: 0 3 1 1 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 28 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 28 Information about the care home Name of care home: Address: Elm Tree House 37a Ogle Street Hucknall Nottingham NG15 7FQ 01159633573 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Elizabeth Pasik Type of registration: Number of places registered: Carisbrooke Healthcare Ltd care home 17 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: Within the total number of beds, a maximum of 17 may be used for the category DE(E) Within the total number of beds, a maximum of 17 may be used for the category OP Within the total number of beds, a maximum of 2 may be used for the category MD(E) Date of last inspection Brief description of the care home Elm Tree House is a converted family house providing residential care for up to seventeen (17) older people. The home is situated in a residential area near the heart of Hucknall, within walking distance of shops and local amenities. The home is comfortable and homely and has pleasant gardens to the rear. There is a car park Care Homes for Older People Page 4 of 28 Over 65 17 2 17 0 0 0 Brief description of the care home available at the front of the building. The home has recently been registered to provide services for people with Dementia and Mental Health Conditions. 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: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star this means that people who use the service experience adequate quality outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people living at the home and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. One regulatory inspector conducted the unannounced visit over 1 day, including the lunchtime period Care Homes for Older People Page 6 of 28 A review of all the information we have received about the home was considered in planning this visit and this helped decide what areas were looked at. The main method of inspection we use is called case tracking which involves selecting the care plans of 4 people and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. The registered manager, members of staff and people who use the service were spoken with as part of this visit. A partial tour was undertaken by the regulatory inspector, which included looking at the bedrooms of those people who we case tracked and communal areas of the home. The service sent us their Annual Quality Assurance Assessment when we asked for it. This gives us information in regard to the developments and improvements that have taken place over the previous year and information about the services, facilities and staff. We have used some of this information in this report. The current weekly fees for the service range from 294 pounds to 348 pounds. These fees do not include the cost of hairdressing, chiropody, and personal toiletries. This information is made available on the point of enquiry. What the care home does well: What has improved since the last inspection? What they could do better: Medication must not be signed for before it has been administered to ensure that people using the service receive their medication as prescribed. Staff employed with only a POVA 1st in place must be supervised whilst waiting for a satisfactory criminal record bureau check. This will ensure that people using the service are protected from potential abuse. Liaison with the Environmental Health Officer must take place in regard to the laundry practices that take place in the care home. This will ensure that people using the service are protected by the infection control practices in place. Care Homes for Older People Page 8 of 28 It must be ensured that sufficient staff are available at all times to carry out various duties within the care home. This will ensure that there are sufficient numbers of staff to carry out necessary tasks such as cooking and laundry whilst other staff are available to meet the personal needs of people using the service Staff must carry out safe manual handling practices at all times. This will ensure that people using the service are assisted to move in a safe manner. The manager must ensure that good practices are carried out and maintained at all times. This will ensure that the health and welfare of people using the service is maintained at all times. Liaison with the Fire Authority must take place in regard to the practice of wedging open fire doors and the discussed practices implemented to ensure that people using the service are protected. 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 9 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 10 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. People who may wish to use the service are assured that staff can meet their needs before they decide to move into the home. The service does not offer intermediate care. Evidence: The manager or deputy manager visits people who may wish to use the service to carry out a preadmission assessment to see if staff can meet their needs before a decision to move into the care home is made. The case files examined show us that these assessments are taking place as required. People may also visit the care home and spend time there to get a feel for what it would be like to live at the home before they make a decision to move in. Care Homes for Older People Page 11 of 28 Evidence: The service does not offer intermediate care. Care Homes for Older People Page 12 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. The health and personal care needs of people using the service are met and their privacy and dignity is maintained. Evidence: Plans of care are in place for peoples identified needs, and instruct staff on the support that people using the service need in the majority of cases. In regard to diabetes mellitus information within the plan of care is limited in regard to the specific health care needs one may require, however there is evidence within the case file to demonstrate that people using the service are receiving this as required. Development has taken place to ensure that plans of care are more person centred and reflect peoples person likes and dislikes. Risk assessments are now in place for identified risks, however some information in regard to the safe use of bed rails was not in place. Staff spoken with however are able to discuss the actions that they take to ensure that people using these remain safe. We saw that bumpers are available for all bed rails during the tour of the Care Homes for Older People Page 13 of 28 Evidence: building. People using the service offered the following comments: the staff are lovely, and they care for you, we always get what we want here, the staff are very nice, nothing is too much trouble, the staff help me to have a bath when I want one, and I am well looked after, the staff are nice. Staff spoken with are able to discuss the care needs and the support of people using the service and the plans of care in place. Plans of care show us that people are supported to access specialist service such as the doctor, district nurse and optician as required and there is evidence of specialist equipment such as beds and mattresses available for people using the service. One person using the service told us that they can see the doctor if they need to and that staff would arranged this and another told us how the special feet protectors they wore kept them comfortable. On observing medication practices, improvement has been made in regard to the storage of medication, as this is now secure. There are no gaps in signing for medication to show that people are receiving their medication as prescribed. We observed one member of staff administering medication, who had received training in the safe administration of medication, however they signed for the medication before the person had taken this. When questioned they stated initially that this is normal practice, however then said that it was not and that they had felt under pressure as they were being observed. One person using the service told us, the staff look after my medication, I am happy with the arrangements in place. We saw staff interact with people using the service in a positive manner, being kind and considerate to their needs at all times. Staff spoken with are able to discuss how they ensure that peoples privacy and dignity is maintained when offering personal care, such as ensuring that they knock on doors and cover people up when necessary. People using the service told us, the staff are very kind and respectful, and I am very happy here, the staff are very good and treat me well. Care Homes for Older People Page 14 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are enabled to live an independent life as they wish, maintain contacts with people that are important to them and partake in activities of their choosing. Evidence: An activities coordinator supports people to carry out and join in activities on a daily basis. Activities such as bingo, dominoes, arts and crafts and trips out are on offer. On the day of the visit some people were joining in a game of bingo and another was doing an arts and craft session with a member of staff. Following this an outside entertainer played music and sang old times song with people. One person said that they had really enjoyed this. People using the service offered the following comments in regard to the activities on offer, there is generally something for us to do everyday, the staff tend to keep us occupied, I enjoy a game of bingo, and I sometimes spend some time in the garden. The activities coordinator told us how they have spent time ensuring the each person using the service is supported in activities of their choosing and being part of the local community if they wish. A Halloween party has taken place and a bonfire party has Care Homes for Older People Page 15 of 28 Evidence: been arranged. So that people can maintain contact with those that are important to them there are no restrictions on visiting. Visitors are encouraged to spend their time in the dining room or a persons bedroom so as to ensure that other people using the service are not disturbed. This practice is following a concern that had been raised from a person using the service who felt that at times they were disturbed by the amount of visitors in the main lounge. The service does not have a visitors policy outlining this; the manager said that she would put one in place to ensure that everyone is aware of this arrangement. People using the service told us, I often have visitors, I am very lucky, they are made welcome when they come, I tend to take them to my bedroom as it is more private there, and my daughter comes to see me, I either see her in the lounge or dining room, it depends what is happening, we are happy with the arrangements in place. Staff spoken with confirmed that visitors are made welcome when they come to the care home. People using the service told us that the routine of the care home is flexible, I can do as I want, and spend my time as I like, I enjoy living here. Staff spoken with also confirmed this and we saw people occupying themselves and walking freely around the home throughout the visit. Staff feel that people are able to make their own choices and decisions about their lives; there is evidence of peoples personal preferences within plan of care. An appealing menu is on offer to people using the service, and alternatives to the main menu are available if required. People using the service told us, I get plenty to eat, I didnt used to eat before I came here, now I eat very well, and the food is very good, I eat everything put in front of me. There is not a cook employed in the afternoon, therefore the meal on offer is usually sandwiches, with a hot choice a couple of times a week. People using the service did not feel that this was a problem, however a member of staff spoken with said that it is sometimes difficult looking after people and preparing the meals as well. Care Homes for Older People Page 16 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are assured that their complaints will be listened to and acted upon to ensure that they are resolved. People using the service are not fully protected from abuse. Evidence: The service has received two complaints since the previous visit in regard to the standards of care and quality of the food. There is evidence within the complaints book to show us that both of these complaints have been investigated and resolved. The complaints procedure is on display in the main entrance of the care home so people may access this. People using the service told us, I have no complaints, I know who to talk to if I was unhappy, I get on well with staff and have a good rapport with them, I have no complaints, and I am very happy here and have no complaints, I would talk with the staff if I was worried about anything. Staff spoken with are able to discuss how they would handle a complaint should one be received to ensure that this is dealt with and resolved. Staff have undertaken training in safeguarding adults and when spoken with show a good understanding of their roles and responsibilities in ensuring that people using the Care Homes for Older People Page 17 of 28 Evidence: service remain safe. All staff have a satisfactory Criminal Record Bureau check (a police check to see if an individual has a police record or caution) in place with the exception of one person who is currently working with a POVA 1st (a check to see if a person has been put on a register where people have been known to abuse vulnerable adults) until their criminal record bureau check is received. The manager told us that this person is working supervised, however we saw them attending to peoples personal needs without supervision twice during our visit. On discussing this with members of staff they are aware that people with only a POVA 1st should be supervised at all times and gave explanations for why these incidents had occurred. We set an immediate requirement in regard to this to ensure that the manager implemented a supervisory policy immediately to ensure that people using the service are protected. Care Homes for Older People Page 18 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. People using the service live in a clean and comfortable home, however their safety is compromised due to the current laundry procedures that take place as these undermine safe infection control measures. Evidence: There is evidence of routine maintenance taking place; new flooring has been laid in the dining room and new carpets and curtains in several other rooms. The home is clean and tidy throughout and peoples bedrooms are personalised. The laundry room is also clean and tidy, however this is adjacent to the main building. Twice during the visit we saw staff taking laundry, which was not bagged or covered pass the kitchen and through the dining room to the laundry room. This was discussed with the manager who stated that laundry is normally bagged and taken around the back of the building. On discussing this with staff they confirmed this but said that they take laundry through the front door as the back gate is locked. 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. People using the service are supported by sufficient numbers of staff, however this is compromised when staff are carrying out duties other than care tasks. Staff are well trained in compulsory areas, however the welfare of people using the service is compromised when staff do not maintain good practices. Evidence: The duty rota showed us that three members of staff are on duty in the morning in addition to the cook and domestic staff; two care staff are on duty in the afternoon and at night. In the afternoons care staff are responsible for ensuring that the laundry is kept up to date and for preparing the afternoon tea. The laundry room is situated adjacent to the main building; this means that when staff are undertaking laundry tasks, only one member of staff remains in the building to care for people using the service. We spoke to the manager and senior care assistant about this as if the member of staff in the building needed urgent assistance; it would prove very difficult to summon help. Staff spoken with said that the staff team get on well together and that there are sufficient numbers of staff available, however one member of staff did express concerns about the staffing levels in the afternoons due to the above. Care Homes for Older People Page 20 of 28 Evidence: People using the service told us, there are enough staff, if even there are less we all still get cared for, we never have to wait for things, and I look after myself mainly, but the staff are here to help me when needed. The annual quality assurance assessment told us that eight members of staff have undertaken the National Vocational Training level 2 (a nationally recognised work and theory based qualification to enhance peoples skills in caring for people using the service.) several other members of staff are also working towards this qualification and we saw three members of staff undertake a training session on communication with the national vocational assessor whilst we were visiting. To ensure that new members of staff are aware of their roles and responsibilities they undertake an induction when they first commence work at the care home. There is evidence of this training taking place on staff files. One member of staff was seen to work through their induction booklet when we were visiting, and they stated that staff are being very helpful in ensuring that they know all that they need to know. Staff personnel files show us that these contain all the documentation required by law such as references and proof of identification to ensure that people using the service are protected from unsuitable people being employed. Staff spoken with are able to outline the recruitment practices that they undertook and confirmed that they have had the necessary checks. One member of staff is currently working with only a POVA 1st in place as discussed in standard 18. There is no evidence that this person is being supervised whilst waiting for the criminal record bureau check to be returned. This was discussed with the manager and an immediate requirement set to ensure that required practices to protect people using the service are put into place. Each member of staff have an individual training file which shows us that they have attended compulsory training as required. Staff spoken with said that they felt supported in their training and development. During our inspection we saw two members of staff carry out an unsafe manual handling manoeuvre, this was discussed with the manager and the senior member of staff. It was ascertained that training has been undertaken, however the manager stated that she will revisit this to prevent further reoccurrence. One person using the service said, I think that the staff are well trained, they know how to look after us. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service live in a satisfactory managed home, where they are given a say in how it is run and managed. Evidence: The manager is registered with us to run and managed the care home. She remains up to date with her training and has now completed the Registered Managers Award, (a nationally recognised work and theory based qualification designed to develop management skills.) Staff spoke highly of the manager and said that she is very approachable at all times and that she supported them in their day-to-day work. People using the service also spoke highly of the manager and throughout the day we saw that they maintained good and comfortable relationships with her. People using the service are able to have a say in how the home is run and managed by way of residents meetings and quality assurance questionnaires. Results of the latest questionnaires are displayed in the main entrance of the care home. These are Care Homes for Older People Page 22 of 28 Evidence: mainly positive and offered the following comments: we have no problems with the care, the staff are very patient with mum, I have never found a bad smell when I come in, I do not think she could be in better care, and I love being at Elm Tree House. There is also evidence that people using the service have actively been involved in the social arrangements that take place in the home. The residents meeting minutes show us that they have made suggestions about the recent activities that have taken place. The manager carries out a quality assurance assessments on the standards of care, results of which we saw, she stated that she also audits the medication, however did not keep records of this. Within staff training files there is evidence that staff are undertaking supervisions where they are given the opportunity to discuss their training and development. Staff spoken with confirmed that these take place and said that they are useful to them. People may keep personal money in the care homes safe if they wish to. On checking these accounts they correspond with the accounting sheet and receipts are available for all transactions. The manager stated that people can access this money at any time, staff spoken with confirmed this. Plans of care also outline who is responsible for people’s finances so that staff are aware of these arrangements. The annual quality assurance assessment outlines the maintenance and servicing checks and during out visit we saw that both the gas and electrical certificates are up to date. Accident records are mainlined as required and the accidents that have occurred in the care home are minimal. Fire records show that the systems are checked as required, however there are no records to show that staff have undertaken fire drills. The manager said that these take place and have been recorded in the past, however these records could not be located. On several staff members training files there are certificate that cover fire drills, however not on all staffs. During the tour of the care home we saw three fire doors that had been wedged open, we requested that these were removed immediately. 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 1 18 19 Staff employed with only a 04/11/2008 POVA 1st in place must be supervised whilst waiting for a satisfactory criminal record bureau check. This will ensure that people using the service are protected from abuse. 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 9 13 Medication must not be 28/12/2008 signed for before it has been administered. This will ensure that people using the service are protected by the medication practices and receive their medication as prescribed. 2 26 23 You must liaise with the 15/12/2008 Environmental Health Officer in regard to the laundry practices that take place in the care home. This will ensure that people using the service are protected from cross infection. Care Homes for Older People Page 25 of 28 3 27 18 You must ensure that sufficient staff are available at all times to carry out various duties within the care home. This will ensure that there are sufficient numbers of staff to carry out necessary tasks such as cooking and laundry whilst other staff are available to meet the personal needs of people using the service. 30/12/2008 4 30 13 You must ensure that staff carry out safe manual handling practices at all times. This will ensure that people using the service are assisted to move in a safe manner. 30/12/2008 5 31 12 The manager must ensure that good practices are carried out and maintained at all times. This will ensure that the health and welfare of people using the service is maintained at all times. 30/12/2008 6 38 23 You must liaise with the Fire 04/12/2008 Authority in regard to the practice of wedging open fire doors. You must implement the practices discussed with the Fire Authority and cease the practice of wedging open fire doors. Care Homes for Older People Page 26 of 28 This will ensure that people using the service are protected. 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 13 A visitors policy is implemented to ensure that people using the service and relevant others are fully informed. Care Homes for Older People Page 27 of 28 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. 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!