Inspection on 22/04/09 for Eltandia Hall Care Centre

This inspection was carried out on 22nd April 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Eltandia Hall Care Centre 14/12/09

Eltandia Hall Care Centre 29/04/08

Eltandia Hall Care Centre 25/09/07

Eltandia Hall Care Centre 18/10/06

Eltandia Hall Care Centre 19/10/05

Eltandia Hall Care Centre 17/05/05

Eltandia Hall Care Centre 25/11/04

Eltandia Hall Care Centre 09/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 06/08/2009.

Key inspection report CARE HOMES FOR OLDER PEOPLE Eltandia Hall Care Centre Middle Way Norbury London SW16 4HA Lead Inspector Jon Fry Unannounced Inspection 22nd April 2009 10:05 DS0000019089.V375362.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Eltandia Hall Care Centre DS0000019089.V375362.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Eltandia Hall Care Centre DS0000019089.V375362.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Eltandia Hall Care Centre Address Middle Way Norbury London SW16 4HA Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8765 1380 020 8765 1399 eltandia@schealthcare.co.uk www.schealthcare.co.uk Southern Cross (LSC) Ltd Terence O`connor Care Home 83 Category(ies) of Dementia (63), Dementia - over 65 years of age registration, with number (63), Old age, not falling within any other of places category (63), Physical disability (20) Eltandia Hall Care Centre DS0000019089.V375362.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. As agreed on 19/06/2006, Service users with Dementia, age 60 years and above can be accommodated within the home. 29th April 2008 Date of last inspection Brief Description of the Service: Eltandia Hall Care Centre is a purpose built home arranged over two floors. It has two residential units on the first floor and two units offering nursing care on the ground floor. One residential unit provides a mix of respite and permanent care for older people and the other unit provides long term care for older people with dementia. The nursing units offer long-term care for older people and care for younger adults with physical disabilities. People living there are provided with their own single bedroom accommodation with en suite toilet facilities. The home is situated in a residential area of Norbury. Public transport in the form of local bus services are close by. Eltandia Hall Care Centre DS0000019089.V375362.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is one star. This means the people who use this service experience adequate quality outcomes. Three Care Quality Commission (CQC) inspectors spent just over six hours in the home. We spoke to eighteen people who live there, one visitor, a visiting professional, three managers and eleven staff members. We looked at records and documents kept by the service including eight people’s care plans. A CQC pharmacy inspector made a separate visit to the service and looked at the medication administration on all four units. Surveys were returned from sixteen relatives, friends or advocates of people who live at the home. The manager sent us an annual quality assurance assessment (AQAA). The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. This also gave us some numerical information about the service. What the service does well: “On the whole not much to fault”, “it’s not bad here”, “it’s quite nice” and “no trouble at all” were some of the comments from the people who live there. “It’s first class”, “they try to accommodate my relative with their likes” and “they listen” were comments from relatives, friends or advocates. Other comments included “my relative is well looked after”, “they try to provide the best care possible” and “the residents are always treated kindly”. Medication is handled well. People get the right medication at the right time and the people who administer it are well trained. The environment is comfortable and well maintained. People we spoke to like the staff who work with them. Staff members receive the training they need to help them do their jobs. Eltandia Hall Care Centre DS0000019089.V375362.R01.S.doc Version 5.2 Page 6 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 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. Eltandia Hall Care Centre DS0000019089.V375362.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Eltandia Hall Care Centre DS0000019089.V375362.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good information is provided to people about the service in a user guide. Pre admission assessments are carried out before anyone moves in. EVIDENCE: Comments from people who live there included “It’s good here”, it’s ok”, “it’s pretty good here” and “I’m quite happy”. There is a Statement of Purpose and User Guide available. Extracts of the Statement of Purpose are available on audiotape on request. We saw that the User Guide is provided in a document holder in each room. This tells people about things like keys, valuables, healthcare facilities and Eltandia Hall Care Centre DS0000019089.V375362.R01.S.doc Version 5.2 Page 9 mealtimes. We have recommended that the User Guide be made more user friendly with more pictures of staff, places within the home and the local community. Some parts of the guide are also written in smaller print that may make it difficult to read for some people. We saw that people’s needs are assessed before they come to live at the home. Care files for eight people were looked at and these all contained fully completed pre-admission assessments. We have again recommended that the service look at the format in use to make sure that good quality information be captured especially around the person’s life, their preferences and the things they are still able to do. Some of the social profile information within the care plans seen was very brief and made it difficult to ‘see’ the person and not just their individual support needs. Eltandia Hall Care Centre DS0000019089.V375362.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans address individual needs and are kept up to date. These documents could be made more person centred. Improved systems are now in place to address healthcare needs and these need to be continued. Medicines are handled well. EVIDENCE: We looked at the care plans for eight people. Clearly a lot of work has recently gone into improving the plans and we saw evidence of senior staff auditing them to make sure they were up to standard. Good things seen in people’s care plans included detailed information about how to communicate with a person, guidance on providing re-assurance to family members and how to help the person with how they like to look each day. As with the assessments in place, we have recommended that the home Eltandia Hall Care Centre DS0000019089.V375362.R01.S.doc Version 5.2 Page 11 keeps looking at how to make the plans more individualised and include more of the person’s history, likes and dislikes and social / emotional needs. One person had a different ‘short term’ care plan in place but they had been living at the service since the end of 2008. This meant that their care plan had not been reviewed or updated in the same way as the others we looked at. We have asked that the home look at this system to make sure that a standard care plan is used if the person stays for a certain period of time. We saw some very good interaction between staff and the people living there. Staff told people what they were going to do when helping them and there was a lot more staff time spent talking with people than at previous inspections. This is very positive and needs to be continued. Staff we spoke to had a better understanding of what they should be doing in their role as key worker to individuals. The managers told us that they had been working with people to define this role All the people we spoke to said they were treated with dignity and respect by the care staff. The home has its own dignity champion who helps promote these issues amongst the staff team. Care planning and assessment around individual health needs has been much improved by the home in recent months. We saw that good records were kept for people about what they ate and drank each day, their weight and risk of developing wounds. A tissue viability nurse we spoke to said that staff had been working well to heal some significant wounds and referrals were being made when required to their team. The Commission now needs to see the improvements around people’s health and personal care sustained. We looked at medication records, medication storage areas and training on all four units. Medicines are handled well, storage facilities are good and the manager and staff in charge of medication were knowledgeable on medication issues. We saw that all prescribed medicines were available at the home, and records of administration together with stock checks showed that residents are receiving their medicines on time and as prescribed. Trained nurses administer medicines on the nursing units, and care coordinators do this on the residential and respite units. All staff who give medicines have appropriate training, including recent medication refresher training. We have made some recommendations about medication in this report. This is to help develop best possible practice within the service. Eltandia Hall Care Centre DS0000019089.V375362.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are provided with good opportunities to take part in a variety of activities. Food is of a good quality and progress has been made in making mealtimes a more relaxed and pleasant occasion. EVIDENCE: People told us “I have enough to do”, ”I can join in the activities or not, it’s my choice”, “plenty to do”, ”my family visit”, “I attend a church service once a month, could do more”. Other people said “there’s not enough to do – no mental stimulus” and “I’d like to get out and about”. “Loads of activities”, “need more activities and social events” and “entertainments and outside trips have greatly improved lately” were comments from relatives, friends or advocates of people who live at the home. Eltandia Hall Care Centre DS0000019089.V375362.R01.S.doc Version 5.2 Page 13 There are two activities co-ordinators for the home. They facilitate activities for everyone living at the home and co-ordinate the staff to provide their own programme on each unit. The home has its own activities room, a reminiscence lounge, a snoozelen and a sensory garden. We saw lots of photographs around the home showing trips to places such as the natural history museum, the London aquarium and the local pub for lunch. These trips are repeated for each unit on a four weekly cycle. A weekly trip also goes to the local mini-market for a small group of people. We saw staff on one unit running a word game for people and this was getting lots of people involved. Staff told us they did bingo, seated exercises and quizzes as well as attending sessions arranged by the activity co-ordinators. A film show was going on the day of our visit in one unit. A visitor also comes to the home every week to do a quiz. We heard people who use the service talking about this happening and it seemed like quite a highlight for individuals. We have recommended that the home looks at how it helps people to regularly attend religious services. Staff told us that there were a lot of people who wanted to go to Church particularly on the unit for younger people. Another potential area for improvement is to provide more things for people to use and do on each unit. Lots more rummage boxes, props and interactive items should be made available. This has been done to an extent on one unit for older people but we recommend this work be developed further. Mealtimes have improved since the April 2008 inspection visit. We looked at the mealtime experience for people on three units and saw that this was much more relaxed. Staff helped people in an unhurried fashion and had a good knowledge of individual likes and dislikes. Another great improvement was the free availability of drinks and snacks on each unit. People who live there said “it’s all very nice”, “very good”, “simple fare but good”, “good” and “so-so”. People we spoke to generally did not know what was being served for lunch. We have recommended that the picture menus be introduced to help people make choices and to be clearly displayed each day to show people what is on offer. Eltandia Hall Care Centre DS0000019089.V375362.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People using the 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 service has a complaints procedure in place. Staff are provided with training on safeguarding people. EVIDENCE: The service has a procedure which tells people how to make a complaint, who will deal with them and that they will be resolved within 28 days. This procedure is displayed in the reception of the home and is part of the guide given to people. We recommend that the procedure be made available in different formats. Pictures of important people in the process may be helpful so that individuals know who to go to. We saw that a complaints folder is kept and this listed the issue and what action has been taken by the service. As stated in the summary, there have been a number of Safeguarding alerts made to the Local Authority. This resulted in a number of meetings between the home, the Local Authority, other placing authorities and the Care Quality Commission. The Local Authority suspended any placements at Eltandia Hall Eltandia Hall Care Centre DS0000019089.V375362.R01.S.doc Version 5.2 Page 15 Care Centre until they were satisfied that all the issues raised had been resolved. We saw that Safeguarding training has been arranged for all staff and the individual staff members we spoke to confirmed that they had received this important training. The Local Authority Safeguarding leaflets had been supplied to the people living there and these were in evidence during our visit. Eltandia Hall Care Centre DS0000019089.V375362.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23, 24 and 26. People using the 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 are provided with a comfortable and well maintained place to live. Further work could be carried out to make bathrooms less clinical in appearance. EVIDENCE: The home is well maintained and people have comfortable bedrooms with ensuite facilities. We saw that people have personalised their rooms with their own furniture and pictures. The home was clean and smelt fresh when we visited. There is an attractive garden area and the home has created a raised sensory area for people to sit out in. Eltandia Hall Care Centre DS0000019089.V375362.R01.S.doc Version 5.2 Page 17 We saw that the layout of the lounges has been improved and they now have a more homely feel with chairs in groups and small tables available. As stated previously, we saw that one unit has more items available such as soft toys and dolls. Memory boxes have also been put up by some doors in this unit to help people find their bedrooms along with door knockers and letter boxes. This should be repeated in other parts of the home. All the lounges could have many more interactive items such as rummage boxes, typewriters, dolls houses and other sensory items. Hallways could also be used to provide points of interest and have items hanging for people to interact with. We think that the bathrooms still need to be improved. They are not homely in appearance and are very clinical in their feel. One person who lived on the upper floor of the home said “the biggest thing is the lack of freedom”. People living on this floor are unable to access the garden freely and have to pass locked doors with keypads to leave the unit. We have recommended that the home think about this and try to find ways to open up the home and its gardens whilst helping people to stay safe. Eltandia Hall Care Centre DS0000019089.V375362.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are provided with good opportunities for training which helps in making sure that they have the skills and knowledge to meet the needs of the people they support. EVIDENCE: People’s comments about staff included “staff help”, “she’s good”, “staff listen”, “staff are nice”, “very helpful”, “excellent staff” and “they’re alright”. A relative, friend or advocate said “I have always found the team leaders and the more permanent staff are always caring and efficient”. They went on to say “I sometimes feel the more casual members of staff are not always supervised properly”. Care staff we spoke to felt that the service was improving with one person saying that staff were now ‘more interested’ in their work. One member of staff felt that the service could do better by paying more attention to how staff are implementing their training. Eltandia Hall Care Centre DS0000019089.V375362.R01.S.doc Version 5.2 Page 19 The staff training programme continues to be strong with courses attended including manual handling, customer care, food hygiene, Safeguarding and Fire Safety. Other courses lined up include challenging behaviour and dementia. The home told us that just under 50 of staff have or are working towards the NVQ qualification. We saw that the trained nurses had recently undergone skills competency assessments and this would be used to identify their further training needs. The three staff records we looked at were well maintained with all the required information kept on file. This includes a Criminal Record Bureau (CRB) check Eltandia Hall Care Centre DS0000019089.V375362.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 and 38. People using the 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 recent improvements in management, quality monitoring and communication need to be sustained. EVIDENCE: The manager has been at the home since April 2008 and has now been registered with the Commission. He has considerable experience of working in care environments. Eltandia Hall Care Centre DS0000019089.V375362.R01.S.doc Version 5.2 Page 21 Recent Safeguarding issues looked into by the Local Authority highlighted a number of areas where improvement was needed. Additional management support was bought in to help troubleshoot issues and this support manager was present during our visit. An improvement plan was drawn up by the organisation and we saw that good progress was being made in its implementation. Key themes highlighted during the Safeguarding process include communication and leadership. This is crucial - each unit clearly needs strong leadership – senior staff leading each shift and role modelling for other staff. We think this will be key to the home’s sustained improvement. Staff need the leadership and guidance they are now receiving to continue in addition to all the training they are receiving. Improved quality monitoring systems have been introduced and we saw that people’s care files and recording charts are regularly being looked at to make sure that they are being kept properly. This is important to make sure that health needs are being properly addressed. Health and Safety records looked at were up to date for areas such as Fire Safety and hot water temperatures. Eltandia Hall Care Centre DS0000019089.V375362.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 3 X 3 X X 3 Eltandia Hall Care Centre DS0000019089.V375362.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 (2) Requirement In order to make sure that peoples needs continue to be met, care plans must be reviewed each month and updated as required. This is with particular reference to short term care plan formats in use at the home. Timescale for action 01/07/09 Eltandia Hall Care Centre DS0000019089.V375362.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP1 OP3 Good Practice Recommendations The user guide should be made available in user friendly formats with larger print, pictures and photographs. We recommend that the assessment format should be reviewed to make sure that good quality person centred information is captured. This can then be used to inform the care plan from when the individual moves in. Relatives, friends or advocates could be asked to contribute information if the person cannot give this himself or herself. The home should continue to look at ways to make the care plans more person centred and better reflect the individual’s life and preferences. The plan in place should direct the care to be person orientated and less task based. Better background information about the person and their life should be recorded. More life story books should be developed with the individual and their family or friends. These books should be available and regularly used to help communication and engagement. Staff should also think about developing their own life story books to share. It is recommended that the home consult with the supplying pharmacist to ensure that the medicine for one person living there will not be affected by adding to hot liquids. This is as part of an agreed procedure. With reference to one person who attends a day service, the home could make arrangements to either send the medication with the individual, or alter the timing so that medicines can be given before leaving or after returning to the home to ensure effective pain control. The home should ensure that staff record when all prescribed medicines are used, including creams, and it DS0000019089.V375362.R01.S.doc Version 5.2 Page 25 3. OP7 4. OP7 5. OP9 6. OP9 7. OP9 Eltandia Hall Care Centre 8. OP12 8. OP12 would be good practice to add the area of application to the medication record. The home should look at how it supports people with their religious / spiritual needs. Support should be made available to facilitate people’s regular attendance at their chosen places of worship. Care staff should continue to see the provision of social and emotional care as important parts of their work. Care staff could look at how people could be more involved in the daily life of the home. This could be helping with preparation of meals, serving food and drink, helping with laundry or cleaning. It is recommended that a suitable vehicle be purchased for sole use by the home. The menus should be produced in picture formats for the people who live there. These need to be displayed clearly in each unit. The complaints procedure needs to be produced in user friendly formats. Photographs of important people in the process should be included. The communal lounges and hallways should contain lots of occupational items such as rummage boxes, soft toys and dolls, hats, dressing tables, typewriters, dolls houses, wedding dresses, glasses, keys and other sensory items. Memory boxes by bedroom doors should be used in other units. The home should think about how to open up the environment allowing individuals more free movement and better access to the garden. The bathrooms should be looked at to see if they could be made more pleasant and homely. Additional support management and senior staff should be retained at the home to make sure that ways of working and recording systems are firmly embedded. 9. 10. 11. OP12 OP15 OP16 12. OP19 13. 14. 15. OP20 OP21 OP32 Eltandia Hall Care Centre DS0000019089.V375362.R01.S.doc Version 5.2 Page 26 Care Quality Commission London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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