Inspection on 17/04/09 for Forest Edge Rest Home

This inspection was carried out on 17th April 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Forest Edge Rest Home 11/01/10

Forest Edge Rest Home 16/12/09

Forest Edge Rest Home 09/10/09

Forest Edge Rest Home 01/09/09

Forest Edge Rest Home 17/04/07

Forest Edge Rest Home 16/02/06

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 12/10/2009.

Key inspection report Care homes for older people Name: Address: Forest Edge Rest Home Southampton Road Cadnam Hampshire SO40 2NF The quality rating for this care home is: zero star poor service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Michelle Presdee Date: 1 7 0 4 2 0 0 9 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. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. things that people have said are important to them: 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 They reflect the We review the quality of the service against outcomes from the National Minimum Care Homes for Older People Page 2 of 25 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. 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 Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Forest Edge Rest Home Southampton Road Cadnam Hampshire SO40 2NF 02380813334 02380814963 forest.edge@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): John Henry Hughes, Mrs Linda Susan Hughes vacant care home 22 Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration Category(ies): dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: Number of places (if applicable): Under 65 22 22 0 Over 65 0 0 22 Date of last inspection: Brief description of the care home: 1 7 0 4 2 0 0 7 Forest Edge is a twenty-two bedded residential care home, opposite a garden centre, situated on the outskirts of the New Forest at Cadnam. The home is just less than four miles from the centre of Totton and close to the New Forest. The home is registered to accommodate twenty-two older people, including people with dementia or mental health problems, who are over 65 years. Forest Edge has twenty-two single bedrooms, all provided with an en suite toilet. The current scale of charges is £415.00 to £490 per week. Items not covered by the fees include hairdressing, chiropody, newspapers and luxury items. Care Homes for Older People Page 4 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: zero star poor service Our judgement for each outcome: Care Homes for Older People Page 5 of 25 How we did our inspection: During this inspection (we) The Commission were assisted by the manager. The manager has not yet been approved as the registered manager by the commission. We were advised by the person they had recently submitted their application form to become the registered manager of the home. We were able to speak to a lot of people living in the home, some in more depth than others. Staff on duty were spoken with. The home sent us their Annual Quality Assurance Assessment (AQAA) back on time, which detailed information on the home. A tour of the home including all communal areas, the kitchen, the laundry and some bedrooms chosen at random was taken on the day. Paperwork including assessments, care plans, menus, staffing records and safety checks were seen. All this information has helped form judgements in this report. The home is currently undergoing building work, to extend the home. The home is hoping to provide an extra six en-suite, single bedrooms. Building work was also taking place within the home to improve the homes conservatory. At the time of the inspection this limited the communal space for people living in the home as they were not able to access this room. Care Homes for Older People Page 6 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 7 of 25 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 8 of 25 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 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. Assessments are carried out before people move into the home but these do not give enough detail to ensure all a persons needs can be met. Evidence: The pre admission assessments of two people who had moved into the home in the last four months were viewed. The manager explained she felt a lot of the paperwork in the home was out of date and gradually she was introducing new paperwork systems into the home. The manager, who is not registered, explained at this stage she did not feel the staff were competent or confident enough to carry out assessments and care plans and so was taking all this on board herself. This raises concerns of how peoples needs would be met if the manager was absent. Evidence was seen that a basic pre admission assessment had been undertaken by the manager. However the evidence recorded was of a basic nature and it was agreed it was very difficult to see what the persons need were at that time, or why they had come into the home. In one example one person had a close relationship with her family and went home every week, where she would have a bath. This information was not recorded or detailed anywhere. In another example the assessment stated one thing but the daily notes contradicted this. One of these people were spoken to in their own room. They had no knowledge of an assessment being undertaken and could not remember signing any documents. The person had no information on the home in Care Homes for Older People Page 9 of 25 her room but a copy of the residents charter had been fixed to a wall in her room. Care Homes for Older People Page 10 of 25 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 the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People do not have adequate care plans to ensure all their needs can be met. Medication practices are not carried out competently and potentially put people at risk. Peoples privacy is not always respected. Evidence: The service user plans of four people were viewed. Two of these followed on from the assessments seen and two belonged to two people who had been in the home over a longer period. The manager explained she was in the process of changing all the care plans over to the new system, which had a new paperwork system. Some of those viewed had been changed over to the new system and others were still awaiting the change over. The new system uses a a booklet, which has pre-populated titles, where the information is filled out, for example details of next of kin, health care contacts, physical health, mental health, personal risk assessments, behaviour risk assessments and a nutrition screening. It was agreed with the manager all service user plans did not go into sufficient detail, to ensure peoples needs could be met. For example whilst in the home it was clear one person had difficulty relaxing and would Care Homes for Older People Page 13 of 29 Evidence: constantly walk around the home. Staff also explained that this person would try and leave the home, which would put them at risk. Staff and another person living at the home explained how the person became disorientated and had gone into another residents room. This resident had become very distressed by this person walking into their room and it was clear the person entering her room had become both verbally Care Homes for Older People Page 11 of 25 and physically aggressive. However when looking at the care plan there was very little information recorded on this behaviour or on how it should be managed. A risk assessment had been completed but this was out of date and did not relate to the present behaviour. It was also noted in this persons room a punch key lock had been fitted to the door. It was noted the persons family had agreed to this. However no assessment or care plan or risk assessment had been completed, which was agreed under the circumstances was one of the first things which should have been completed. In another example it stated the person enjoyed line dancing, but there but there was no information as to whether this took place. It was noted for one person it stated the person did not like food and notes had been added to say could be at risk of malnutrition but there was no details of how this should be managed on the care plan, to ensure they received a balanced diet. It did not relate to meals, meal times or where meals should be served. The person was spoken to and stated she did did not like the meals. No evidence could be found that care plans had been reviewed on a monthly basis to ensure peoples changing needs were met. It was noted in peoples service user plans details of a persons health professionals contacts were recorded. The manager advised the home had good relationships with health professionals in the area who would visit on request. People spoken to stated the home would access professionals on their request. The home has a drugs policy and procedure, which we were advised any staff member involved with the administration of drugs has received training on. The manager explained at the current time some staff were having difficulty with the medication procedure and more training had just been arranged. One member of staff on duty was able to correctly go through the procedure for the administration of drugs but also stated some staff made errors on a regular basis with the recording of medication. The home keeps two drug trolleys one of the ground floor and one on the second floor. Medication was checked on both floors. It was clear from those records checked there were errors. For one person one medication had not been signed for, for three days. In another example one medication had not been signed for, for the last 17 days in the evening but had been administered. Also for this person their take as necessary medication records were not clear. It could not be established if the medication had been administered and not signed for or if it had been given to someone else. A risk assessment had been completed but this had not been signed or dated. For another person it was clear the medication administered the previous day had not been signed Care Homes for Older People Page 14 of 29 Evidence: for causing the member of staff on duty the next time to sign in the wrong place. The morning medication of everyone upstairs we were advised had been administered but records had not been signed for. Whilst walking around the home we found one tablet in the bathroom, which puts any person at risk of taking medication which, they have not been prescribed for. Prescribed creams were also seen in bedrooms and in the main bathroom, it was agreed these must be kept in lockable storage space. Controlled medication was being stored and recorded appropriately. Records matched the stocks of medication held. All rooms are single within the home and everyone spoke to stated they could spend as much time in their room as they wish. All stated their visitors were shown into their own room or they all go into the main part of the home. One member of staff walked into a persons room whilst we were talking without knocking. It was also noted Care Homes for Older People Page 12 of 25 sometimes the daily notes could be written in a manner which demonstrated a little more respect for the people living in the home, however these were the minority and not the majority. It was noted incontinence pads were stored in peoples room on display, to respect peoples privacy it would be better if these were not on display. Notices which related to staff were displayed around the home and in peoples room. Care Homes for Older People Page 13 of 25 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 the service adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are offered choices but these are restricted by the lack of varied social activities and a choice at lunch time. Evidence: In the AQAA we were advised the home has employed a formal entertainer to improve social activities and community contact. The manager stated this would give individuals choice and it is hoped it is an area that can be further improved. During the visit it was difficult to establish what social activities take place. The formal entertainer was visiting during the day of the visit and people enjoyed joining in, except one person who did state she enjoyed the activity part of the show, but thought the quiz/discussion was patronising. A programme of social activities were not displayed in the home and individual care plans did not detail any social activities. The home did have games and books around the home. The manager stated they always celebrated special events for example Easter, poppy day, pancake day and pumpkins at Halloween. One person attends church and a religious service is offered in the home on a monthly basis. Most people spoken to felt there could be more activities one person stated, There is not enough to do. People spoken to looked forward to their relatives visiting and most stated they would be taken out by their relatives. People Care Homes for Older People Page 16 of 29 Evidence: confirmed their visitors could call at any time, they were always made welcome by the offer of a hot beverage and they could see their visitors in private. The manager did state she would like to employ a person to be in charge of social activities. Care Homes for Older People Page 14 of 25 In the AQAA we were advised, people can exercise choice in food routines of daily living personal and social relationships and religious beliefs. People spoken to confirmed they were able to spend their time how they wished, some were pleased they were able to stay in their rooms if they wished and have meals in their room. Staff spoken to stated breakfast usually lasted over two hours to accommodate peoples choice of when they got up in the morning. The manager has removed the bathing rota to be more flexible to meet peoples needs and increase choice. The cook confirmed there was no restriction on the budget and good quality food is purchased. The kitchen was well stocked and fresh fruit and vegetables were evident. People spoken to felt there was little choice at lunch times with regard to the meals they were given. One person stated We very seldom get a choice and people dont know what we like and dislike. This was echoed by another person who stated she had given up telling staff she did not like a certain food and just took it out from the meals when they were given to her. Another person when asked about the meals stated There not too bad. The manager stated if someone did not like the main choice an alternative could be found and there was always a vegetarian option. It was agreed this was not a choice especially as it relied on the person themselves having to ask for something different rather than be presented with a choice. As the home is currently having building work the home is without a separate dining room, but tables were laid and some people chose to have their meals in their room. Care Homes for Older People Page 15 of 25 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 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 can be confident their complaints will be acted upon and staff have adequate training in adult protection to ensure people are kept safe. Evidence: In the AQAA we were advised the home has reviewed the complaints procedure and introduced a complaints log. The complaints procedure in the home clearly displayed all the correct information. People spoken to stated they felt they were able to complain and all spoken to stated the manager was very approachable. The complaints log was seen and six complaints had been made, all had been dealt with in a reasonable timescale. It was noted one complaint related to staff not answering the front door for a short period. It had been found the staff were outside having a cigarette. Appropriate action had been taken. On the day of the inspection three members of staff were outside together. This did leave some staff on duty, but staggered breaks would benefit the people living at the home. In the AQAA we were advised staff have been given knowledge on safeguarding but the AQAA identifies this is an area where staff need more training. The manager confirmed training in this area was being looked for, for staff. From notifications and the complaints log it was clear the home was taking appropriate action where necessary. Care Homes for Older People Page 16 of 25 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 the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are not currently provided with a clean and safe environment. Evidence: The AQAA states the home is clean, comfortable and odour free. Staff have been trained in infection control. Rooms and water temperatures are checked monthly. The AQAA identifies the home is in need of refurbishment and brightening up. It states this will be done when the building work has been completed. During the visit all communal areas and seven bedrooms were randomly chosen to be viewed. It was noted not all areas were clean and safe. The manager explained it was difficult to keep the home dust free whilst building work was taking place. Some areas however did not relate to just dust. Two bedrooms viewed were in need of vacuuming. The upstairs bathroom and sink needed cleaning. Two bedrooms seen had splits in the carpet, which posed a risk. One carpet had a bald patch in it. Two vanity units were cracked. One wardrobe door did not shut. Prescribed creams, shampoo, bars of soap and other substances were left out in peoples rooms and the bathroom. One member of staff was noted going from inside the home, out side into the kitchen and then outside again, whilst wearing the same pair of plastic gloves. On arrival to the home there was an unpleasant smell. Whilst walking around the home the home did not seem to smell. One person in the home stated, The home smells a bit. The issue of safety was raised as one fire door had tape around the handle and the other had a bolt fitted. It was explained this was to deter one person from leaving the home. It was agreed this was placing everyone at risk and the building was made safe during the visit. The manager did state once the building work was finished the whole home would be re-furbished, but was unsure what this would include. Care Homes for Older People Page 17 of 25 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 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 trained staff group who have all had appropriate checks to ensure people are safe. Evidence: In the AQAA we were advised the home employs several staff of mixed ages and mixed abilities. All staff have appropriate checks. Weekly meetings with senior staff and monthly meetings with all staff take place. The manager informed us she currently has thirteen members of care staff, one cook and one cleaner. Three more members of staff have been recruited but they are awaiting checks and references. The duty rota reflected and we were advised from 7:00AM until 8:00PM there is three members of care staff on duty. The cook works from 10:00AM until 2:00PM week days. At weekends an extra member of staff is on duty to cook lunch. At night time one member of staff works a waking duty and one works a sleep in duty. The manager advised us due to the current high needs of people from May there is going to be four care staff on duty on the morning shift and two members of staff will work a night duty. People spoken to felt there was always enough staff on duty. One person did state she could not always find staff. Comments from people on the staff included kind, helpful and patient. The staffing records of two members of staff were viewed. These demonstrated the home undertook a good recruitment procedure. All the necessary forms, checks and references were available. It was possible to establish staff have undertaken training courses in moving and handling, stoma care, first aid, fire, adult abuse and medication. Two members of staff spoken to confirmed training was available and was useful. The manager confirmed just under 50 of staff have a achieved a National Vocational Qualification (NVQ) Level 2. More staff are booked on to study for this and some staff have booked to do a NVQ Level 3. We were advised all care staff undertake an induction period and process. Evidence of this was seen in staff files. One person on duty on the day was working as an extra as Care Homes for Older People Page 18 of 25 part of their induction period. Care Homes for Older People Page 19 of 25 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 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. People are supported by a manager, but people are not consulted on the running of the home and there is currently no effective way of quality assurance in the home, to seek peoples views on the home. Evidence: The manager has had previous employment working as a registered manager and has the relevant qualifications. The manager told us she has recently submitted an application to become the registered manager of the home. People spoken to were aware of the manager and comments included she is lovely and she is very helpful. In discussion with the manager is was clear she was aware of most of the homes short comings in assessments, care plans, medication, environment but felt she did not have enough time to put things right. However these issues do reflect on the management and the organisation of the home. When asking to see copies of Regulation 26 visits it was clear these were in the managers handwriting; one had been signed by the provider. The manager stated the provider did call in and did offer support but not in a formal way, which offered her the chance to sound off. At the current time the home has not managed to carry out any effective quality assurance and monitoring. The manager stated in the AQAA this was an area that she was hoping to do. Once the conservatory has been finished the manager is considering starting a carers group where feedback could be obtained. We were also advised a comments and action book would be put in the conservatory. Care Homes for Older People Page 20 of 25 The registered manager and provider are not the appointee for any persons finances. They manage the personal allowance for a few people in the home. The manager Stated, this was an area she was hoping to improve and try and see if people were able to manage their own finances. Staff reported they received on-going support from the manager and evidence was seen most staff members had received at least one formal supervision session. The manager was aware this was not enough and knew she had to do more formal supervision sessions with staff. In the AQAA we were advised the home has a range of policies and procedures relating to health and safety, which are reviewed on a regular basis. The homes laundry was well organised and took into account relevant health and safety legislation. It was clear from service records seen all equipment in the home is routinely serviced. The fire logbook was seen, which indicated the necessary test had been done within the timescales. Staff had received training in fire issues from an external company in January 2009. Care Homes for Older People Page 21 of 25 Are there any outstanding requirements from the last inspection? Yes No 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 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 3 14 Any person moving into the home must have had a full assessment, which gives a picture of their current abilities and needs. A good assessment will enable the manager and staff to ensure the persons needs can be met. 30/06/2009 2 7 15 Service user plans need to clearly state all a persons needs and state how these should be met. Clear support plans will ensure that a persons needs and choices will be met. 30/07/2009 Care Homes for Older People Page 22 of 25 3 9 13 The medication procedure 30/06/2009 regarding the storage, administration and recording of medication needs to be followed to ensure the safety of people. Following the medication procedure will ensure the home. This will ensure each person takes the medication they are prescribed, when it has been prescribed. 4 12 16 People should be consulted about leisure and social activities and the home should look at how it can provide these. 30/06/2009 5 19 13 People should be consulted and provided with a choice of social activities they wish to join in. Bringing activities into the home and going out into the community gives people a wider choice. All areas of the home must 30/06/2009 be maintained to ensure the safety of people living in the home. People need to be provided with a safe environment to live. All items which pose a potential risk to people living in the home must be removed to ensure their safety. It is vital people can leave the building in the case of a fire through the fire exits to ensure their safety. All items of furniture in the 30/07/2009 home must be clean and fit for purpose at all times. All areas should be clean and furniture in tact for the comfort and hygiene of people living in the home. 6 26 16 Care Homes for Older People Page 23 of 25 7 33 24 A system for involving 30/06/2009 residents and seeking their feedback about the quality of care provided must be put in place. Any system must also include seeking views from other interested parties. It is essential the views of those living at the home and those visiting are encouraged, so they can shape the changes made. This will ensure the home is run in the best interests of those living in the home. 8 36 18 All staff must receive a minimum of six formal supervision sessions in a twelve month period. Staff must be given formal support and the opportunity to discuss any learning needs or concerns they may have. 30/07/2009 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 Care Homes for Older People Page 24 of 25 Helpline: 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). 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. Care Homes for Older People Page 25 of 25 - 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!