Inspection on 16/04/09 for Ferncross

This inspection was carried out on 16th April 2009.

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

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

Other inspections for this house

Ferncross 01/07/09

Ferncross 18/04/07

Ferncross 30/03/06

Ferncross 28/06/05

Ferncross 18/10/04

Ferncross 25/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 20/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ferncross 4 Crossdale Avenue Cross Cop Heysham, Morecambe Lancashire LA3 1PE     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: Marie Cordingley     Date: 1 6 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Ferncross 4 Crossdale Avenue Cross Cop Heysham, Morecambe Lancashire LA3 1PE 01524850008 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Draycombe House Care Ltd care home 15 Number of places (if applicable): Under 65 Over 65 0 4 dementia old age, not falling within any other category Additional conditions: 11 0 The home may accommodate eleven service users in the dementia (DE) category and four named service users in the category of old age (OP). All further admissions to the home must be of the dementia (DE) category. No more than fifteen service users may be accommodated in the home at any one time. Date of last inspection Brief description of the care home Ferncross is situated in Heysham and is a home for older people who have a dementia. The home can accommodate a maximum of fifteen people in mainly single bedrooms. A double bedroom is available. The bedrooms are located on the ground and first floor. A passenger lift gives access to the first floor for those who require it. There are 2 lounges and a separate dining room. There is also a well-maintained garden where the people can sit/walk in safety. The current fees for receiving care at this home are 390 to 425 pounds per week Care Homes for Older People Page 4 of 29 Brief description of the care home according to the assessed needs of the individual. Draycombe House Care Ltd owns the home and Mrs Ann Withers one of the Directors of the company manages the home on a day to day basis. Care Homes for Older People Page 5 of 29 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 inspection of this home included an unannounced site visit which was carried out over one day. As the visit was unannounced the residents, staff and manager did not it would be taking place until the inspector arrived. During the visit we spoke with a number of residents, carers and the manager/owner of the home. We also looked at a variety of documents including residents care plans and staff personnel files. We carried out a tour of the home viewing all communal areas and a selection of residents private accommodation. Care Homes for Older People Page 6 of 29 As part of the inspection we carried out a case tracking exercise. This involved us looking closely at the care of a small number of residents from the point that they were admitted to the home. Prior to our visit we wrote to a number of residents and staff members and invited them to take part in a written survey. In total we received responses from six residents (or their relatives) and three staff members. We asked the manager/owner of the home to complete a comprehensive self assessment before we visited. The self assessment looked at all aspects of the service and asked the manager to identify strengths of the service as well as areas for development. The assessment was returned to us within agreed timescales and completed to a good standard. What the care home does well: We received a very good response to our written survey with nine completed questionnaires returned to us. The feedback in the surveys was very positive and the majority of people were very complimentary about all aspects of the service provided. Comments included; We have a very good, clean home and people are looked after in the nicest possible way. The home gives a very good standard of care and a good homely atmosphere. All staff are extremely attentive. We are made to feel very welcome when we visit. We feel that staff treat the residents with great care and respect. The positive comments we received in the surveys were echoed by people we spoke to during our visit. One resident said The staff here are absolutely grand. Another said, I feel very lucky to be here, I feel very safe. Throughout our visit we observed staff going about their duties in a very pleasant and professional manner. Residents appeared content and comfortable and relaxed in the presence of carers and the manager. We observed very positive interaction between carers and residents and carers seemed to have plenty of time to spend with residents. Ferncross has a small number of residents and a very low turnover of staff. When we spoke with staff it was apparent that they had a very good understanding of each resident and their individual needs. In addition, carers and the manager demonstrated a person centred approach and were able to give a number of examples of person centred working put into practice. During our visit we noted that residents were able move about the home freely and a variety of activities were going on, including singsongs, games of dominoes and one to one chats with carers. Some residents were seen to be enjoying spending time with the homes pet dogs. People we consulted both in writing and during our visit confirmed that staffing levels at the home were adequate to meet the needs of people living there. We also saw evidence that staffing levels were changed in line with peoples needs, for example an extra carer had been rotad on duty for several weeks whilst one resident needed extra care. Carers we consulted demonstrated a good understanding of their role and spoke very positively of the home. I love working here, and This is the best home I have ever worked in are examples of the comments they made. The home has a good approach to staff training and records showed that the majority Care Homes for Older People Page 8 of 29 of carers had completed their mandatory training in areas such as moving and handling and additional training, including working with people with dementia and abuse awareness. In addition, over half the staff at the home hold nationally recognised qualifications in care at level two or above. The owner of the home manages it on a full time basis and makes herself constantly available to residents, relatives and staff. A number of people we consulted commented that she was very approachable and open to peoples views about the running of the home. Throughout our visit she demonstrated a commitment to providing a good standard of care for people using the service. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 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 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensure that they have a good understanding of each residents needs before they are admitted. Evidence: The home has a Service User Guide which is provided to people wanting to find out more about the service provided. This is a useful document that describes the facilities available and fees payable for care and accommodation. The guide also gives a picture of daily life at the home covering areas such as mealtimes and activities. In discussion the manager confirmed that the guide is only available in a standard written format. We made a recommendation that the guide be made available in other formats such as audio, so that more people have access to the information. We received six completed surveys from residents or their relatives. Five people who Care Homes for Older People Page 11 of 29 Evidence: responded told us that they were given enough information about the home to make an informed decision. The remaining person told us that their social worker had made the decision on their behalf as they needed accommoation urgently. In discussion, the manager explained that she felt it was very important to spend time with people during admission to provide reassurance and support. This was reflected on one survey we received which included the comment We were given plenty of time to look around the home and ask questions. The owner spent time with us answering any concerns we had. As part of our case tracking exercise we viewed several residents pre admission assessments. These assessments contained a good level of information about peoples care needs. It is important that homes gather this information because it means that the prospective resident can be assured that their needs will be met at the home and also means that staff have enough information to plan peoples care effectively. The home dont use a standard format when carrying out an assessment. We made a recommendation that a standard format be used so that people carrying out the assessment are assisted in obtaining all the necessary information. We also recommended that assessments always be carefully dated so that the home can demonstrate that these were carried out prior to the residents admission. Care Homes for Older People Page 12 of 29 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. People are satisfied with the way their care is provided. Improvements need to be made to the way medication is managed to ensure the safety and wellbeing of residents. Evidence: We received six completed surveys from people who live at the home or their relatives. Five of the people who responded told us that they always received the help and support they needed, one person said they usually did. During our visit we spoke with a number of residents. People told us they were very happy living at the home and were very complimentary about the staff and the manager. One resident said of the staff, They are all grand. We looked at care plans for a number of residents as part of our case tracking exercise. Care plans covered the majority of peoples general daily care needs but we noted that in most cases the information was brief. In a few examples we found that Care Homes for Older People Page 13 of 29 Evidence: some aspects were not covered for example, some peoples more complex behavioral needs. Despite some gaps in care planning information all the carers we spoke with were able to demonstrate a good understanding of each resident and the help they required. As such, we were satisfied that the shortfalls in paperwork had not resulted in the standard of care provided at the home being compromised. However, we discussed the care planning systems currently used and made some recommendations as to how they could be improved on the basis that gaps in care planning information could potentially lead to gaps in the care provided. We viewed records relating to residents medication and the homes medication store. We found that the home have generally safe procedures in place to manage peoples medication but found evidence that the systems werent always consistently followed. We found some errors in residents medication administration records. We also noted that the errors had been continued in some examples, for several days. This indicates that carers were sometimes copycat signing medication records and not always checking the records carefully. It was difficult to audit some medications because systems for booking in medicines and keeping a running total on stocks were not always being followed. Whilst the manager advised us that there were systems in place for checking that all carers dealing with medication were competent to do so, there was no documentary evidence, such as recorded competency assessments, available for us to view. We confirmed that the home do not have any appropriate storage for controlled drugs (drugs that are liable to misuse) or medicines requiring refrigeration. We discussed our findings in relation to the management of medication and have made some requirements and recommendations in relation to the area to help ensure residents safety and wellbeing. Care Homes for Older People Page 14 of 29 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 are supported to engage in activities that are in line with their individual preferences. Evidence: People that we consulted told us that the routines of the home were flexible and designed to meet residents individual preferences. One resident told us that he liked to have a number of short naps throughout the day. He said that this was never a problem and that if he slept through a meal time carers would ensure his meal was ready when he wanted it. The care plans we viewed contained some information about peoples preferred daily routines and social histories, although in some cases the information was quite brief. Despite this, carers showed a good understanding of peoples individual likes and dislikes and were able to give a number of examples of activities provided for residents on an individual basis. During our visit we saw a variety of things going on. One resident was enjoying some music, some people were having a game of dominoes and at one point a resident Care Homes for Older People Page 15 of 29 Evidence: joined a staff member in the kitchen which she clearly enjoyed. Records showed that there is a variety of activities provided including quizzes, arts and crafts and singsongs. In addition, some residents enjoy trips out to places such as the theatre and local beauty spots. Everyone who responded to our written survey told us that they were very satisfied with the meals at the home. One relative commented that their loved one had gained some much needed weight during their stay at the home. We observed people having lunch and noted that this seemed to be a pleasant and relaxed occasion. People seemed to be enjoying their meals and people requiring assistance were supported in a discrete and dignified manner. We discussed menus and were advised that whilst people werent offered a choice of main meal on a daily basis, staff were well aware of individual residents likes and dislikes and always ensured these were taken into account when providing meals. However, we made a recommendation that consideration be given to offering at least two alternatives on a daily basis. We found that menus are only currently provided in a standard written format. We made a recommendation that other formats be considered for example, pictorial menus to help ensure that people are fully aware of the choice available to them. Care Homes for Older People Page 16 of 29 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 are enabled to raise concerns and can be confident that their concerns will be taken seriously. Evidence: The home has a clearly written complaints procedure in place which provides guidance to people wishing to raise concerns and also explains peoples rights if they are not satisfied with the way their complaint has been dealt with. We received six surveys from people who live at the home or their relatives and every respondent stated that they were aware of how to make a complaint. One resident we spoke with during our visit said I wouldnt be afraid to say if I wasnt happy about something. The owner of the home also manages it on a full time basis and as such is always available to discuss any concerns people may have. During our visit she spoke of the importance of being approachable so that people would feel able to raise any issues they may have. All complaints are recorded and we noted that the home had received one complaint since their last inspection. This was received through the Commission and records confirmed that the manager had responded to this concern in an appropriate and Care Homes for Older People Page 17 of 29 Evidence: timely fashion. All homes are required to have procedures in place to help protect people from abuse (safeguarding procedures). We were able to confirm that the home had the procedures in place and that they provided a good level of information, including the roles of other agencies such as social services. Staff training records demonstrated that all carers had received training in safeguarding and in discussion they were able to demonstrate a good understanding of the area and the action they should take if they suspect that a resident has been the victim of abuse. Care Homes for Older People Page 18 of 29 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 are provided with comfortable, homely accommodation. Evidence: Ferncross is a spacious home with a variety of communal areas for residents use including several lounges and a dining room. Currently all the people who live at the home have their own bedroom because the homes two shared rooms are only used as singles. Residents also have the benefit of well maintained, spacious gardens. One resident we spoke with told us how she enjoyed the gardens and even on the days she chose not to sit out, enjoyed sitting at the window to watch the birds. Another resident we spoke with told us how pleased he was to have an area in the home where he could enjoy a cigarette. Efforts had clearly been made to make this area as comfortable as possible for the resident including the provision of a stereo and heating and he described the room as champion. We carried out a tour of the home and found all areas to be clean, warm and comfortable. We looked at a selection of residents bedrooms and noted that these were nicely personalised with pictures, ornaments and other similar treasured Care Homes for Older People Page 19 of 29 Evidence: possessions. During our tour we noted that one of the upstairs bathrooms was somewhat cluttered with a large number of personal hygiene items. Whilst the items were not a risk to the residents safety, we did advise the manager to seek alternative storage for the items so that the bathroom was more comfortable for people using it. Five of the six residents who responded to our written survey told us that the home was always fresh and clean. The sixth respondent said that it usually was. We found all areas to be clean during our visit. We were able to confirm that the home has procedures in place to prevent the spread of infection and staff training records confirmed that all carers had been provided with training in this area, to assist them in working in a safe manner. Care Homes for Older People Page 20 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive their care from carefully recruited, well trained staff. Evidence: We viewed a selection of staff personnel files which confirmed that the home follow careful procedures when recruiting new staff. All the files we viewed contained evidence of appropriate background checks, for example, previous employment references and Criminal Records Bureau disclosures. People who responded to our written survey and those we spoke with during our visit told us that staffing levels at the home were always ample. One carer wrote We have enough staff which makes it a happy place for residents, and a relative told us Carers are very attentive and always on hand. Rotas showed that staffing levels were constantly monitored in line with peoples changing needs. We saw one example where one resident had been quite unwell for several days and needed additional care, and we noted that extra staff had been put on duty for the whole period. We were able to confirm that all new carers are provided with induction training at the start of their employment. The induction covers a number of areas and is in line with Care Homes for Older People Page 21 of 29 Evidence: Skills for Care Standards. One carer who responded to our written survey wrote Everything was covered and explained which helped me to know my job and enjoy my work. In discussion the manager confirmed that new starters are required to complete a probation period during which they are provided with constant support and guidance. It was also confirmed that regular meetings are held throughout the probationary period although records were not always made of such meetings. We made a recommendation that probationary meetings and discussions held within them are recorded and signed by both parties In discussion carers told us that they received lots of training to help them carry out their roles well. One carer said The training here is the best I have ever had, it really helps you be more confident. Records showed that carers are provided with training in all the key health and safety areas such as moving and handling, and areas such as working with people with dementia. We were also able to confirm that well over half of the carers employed at the home had National Vocational Qualifications in care at level 2 or above. People who work at the home told us that they felt very well supported. One carer commented that because the manager worked alongside them on a daily basis, support and guidance was always available. The fact that staff feel valued and well supported is reflected in the very low turnover of staff at the home. Care Homes for Older People Page 22 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home benefits from strong leadership and is run in the best interests of residents. Evidence: Ferncross is a small, friendly home which is managed on a full time basis by the homes owner. Throughout our visit the manager was helpful and cooperative and expressed a desire to address the areas we identified for development without delay. The feedback we received from residents, relatives and staff during our written survey and discussions held throughout our visit were extremely positive. Residents and their relatives were highly complimentary about the staff and manager and the staff told us they received a good amount of training and were well supported. The home enjoys a very low turnover of staff which means that residents receive consistent care from people they know well. Care Homes for Older People Page 23 of 29 Evidence: Whilst formal meetings for residents and relatives are not held, the owner manages the home on a full time basis and is always available to speak with people who live and work there. Staff we spoke with told us that they were always encouraged to express their views and opinions about the running of the home. The home holds the Investors in People Award which means they must meet additional, externally monitored standards in relation to staff training. There is a health and safety policy in place which is supported by a number of additional procedures in areas such as fire safety and coshh (control of substances hazardous to health). Staff training records showed that health and safety training is given high priority and we were able to confirm that all staff had been provided with training in moving and handling and the majority of staff had received training in first aid. During our tour of the home we did notice some items in communal bathrooms which could have been a hazard to residents, namely toiletries. We raised this with the manager who immediately arranged to have the items removed. We advised the manager to review the homes coshh procedures and ensure that all staff had a good understanding of them in light of this. Care Homes for Older People Page 24 of 29 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 25 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Care plans must contain a 31/05/2009 full picture of residents care needs. This is so that carers have enough information to provide the care that people need. 2 8 13 The risks to people in areas 31/05/2009 such as falling or developing pressure sores must be assessed and a plan put in place to reduce the risks identified. This is to help ensure that people are kept safe. 3 9 13 Appropriate storage for medicines requiring refrigeration must be provided at the home. This is to help ensure residents safety and wellbeing. 14/07/2009 4 9 13 Appropriate storage for controlled drugs must be provided at the home. 14/07/2009 Care Homes for Older People Page 26 of 29 This is to help ensure the safety and wellbeing of people who live and work at the home. 5 9 18 The competence of all carers 31/05/2009 responsible for administering residents medication must be regularly assessed. This is to help ensure that staff manage residents medication in a safe manner. 6 9 13 Systems must be in place to effectively monitor medication stock and records. This is so that any errors can be quickly identified and adressed. 7 9 13 Residents medication must be administered as prescribed. This is because residents safety and wellbeing is at risk if they do not receive their medication as prescribed. 31/05/2009 31/05/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 The Service User Guide should be made available in a variety of different formats so that more people have access to the information. Care needs assessments should always be dated so that the home can demonstrate that these were carried out Page 27 of 29 2 3 Care Homes for Older People prior to the residents admission. 3 3 A standard format should be used for pre admission assessment to help ensure that all relevant areas are covered. A standard format for care planning should be used so that all staff understand the system and how to use it effectively. Current care planning information should be kept in one file for each resident so that carers can access information quickly and easily. Information which is out of date and no longer relevant should be removed from residents care plans so that staff are only working with current information. Care plans should contain more person centred information to help carers provide a more individualised service. Handwritten entries on medication administration records should be witnessed and double signed to reduce the risk of errors being made. Each residents medication file should include a photograph to help reduce the risk of any errors being made. A record of sample signatures of people who administer medication should be maintained so that signatures can be quickly idfentified on medication administration records. People should be provided with choices of meals on a daily basis. Consideration should be given to making menu information available in other formats for example pictorial. The complaints procedure should be made available in a variety of different formats so that more people have access to the information. Alternative storage should be found for residents personal hygiene items currently stored in the first floor bathroom. This is so that the area is more pleasant and comfortable for residents. The homes policy and procedures for the control of substances hazardous to health should be reviewed to help ensure the safety and wellbeing of residents 4 7 5 7 6 7 7 8 7 9 9 10 9 9 11 12 13 15 15 16 14 19 15 38 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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