Inspection on 09/12/08 for Hallcroft Care Home

This inspection was carried out on 9th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hallcroft Care Home 22/08/06

Hallcroft Care Home 27/07/05

Hallcroft Care Home 05/01/05

Hallcroft Care Home 14/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Hallcroft Care Home Croft Avenue Hucknall Nottingham NG15 7JD     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: Janet Morrow     Date: 1 0 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Hallcroft Care Home Croft Avenue Hucknall Nottingham NG15 7JD 01159680900 01159632388 hallcroft@fshc.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Tamaris Healthcare (England) Ltd Name of registered manager (if applicable) Mrs Joyce Murphy Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Conditions of Registration: The registered person may provide the following category of service only: Care Home with Nursing to service users of the following gender: Both whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - OP Maximum Numbers: The maximum number of service users who can be accommodated at Hallcroft Care Home is: 40 Date of last inspection Brief description of the care home Hallcroft is a purpose built home, set in a residential area of Hucknall, Nottinghamshire. Hallcroft has forty beds with Nursing care being provided in the home. There are 36 single rooms and 2 double rooms, which all have en-suite facilities. In addition there are 7 WCs 5 bathrooms, one with a parker bath and 1 shower. A passenger lift provides access to both floors. A pleasant garden area is provided. The fees currently charge at the home range from 277 pounds to 455 Care Homes for Older People Page 4 of 30 care home 40 Over 65 40 0 Brief description of the care home pounds per week. Additional cost for hairdressing and podiatry interventions are not included in the fees charged at the home. Care Homes for Older People Page 5 of 30 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: This inspection visit was unannounced and took place over two days for a total of 12.25 hours. The Commission had received a complaint prior to the inspection visit and enquiries were made about this and they are referred to in the relevant sections of the report. The main method of inspection was case tracking; this is a method of randomly selecting people living within the home and discussing with them their expectations and experiences of living within the home environment. The case tracking method also analyses the records of the case tracked people to Care Homes for Older People Page 6 of 30 ascertain if their identified needs are being addressed appropriately within the care home setting and that their safety and well being is being maintained. On this occasion four peoples records were case tracked. Staff records were also examined. A tour of the building was undertaken. Ten of thirtytwo people currently accommodated, four relatives, nine members of staff, two visiting professionals and the manager were spoken with during the visit. The Commission for Social Care Inspection received ten surveys following the inspection visit; three from people living in the home, four from relatives and three from staff. Written information in the form of an annual quality assurance assessment had been received prior to the visit and informed the inspection process. What the care home does well: What has improved since the last inspection? What they could do better: The home must review its routine of care and medication administration in the morning to ensure that all people living in the home are having meals at a time they wish and that morning and lunchtime medication and meals are not being given too close together. This is because the current routine has the potential to adversely affect health and well being and quality of life. There must be a review of staff availability at key times such as mornings and also at weekends to ensure there are enough staff on duty to meet peoples needs. Peoples concerns must always be thoroughly addressed and the complaints procedure fully implemented to ensure that people are listened to. Where a risk is identified, there must be a care plan in place to address the risk to ensure that peoples health and safety is maintained. Medication administration procedures must ensure that all medication administration Care Homes for Older People Page 8 of 30 record charts are completed accurately so it is clear that people have received their medication as prescribed. Staff must always remember to knock on bedroom doors before entering to maintain peoples privacy. A programmed of activities must be implemented that takes into account individual needs and preferences. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 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 30 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. There was sufficient admission information available to ensure that peoples needs could be met. Evidence: Four peoples care records were examined. There were assessments available in the files examined. This was a pro-forma that covered all the essential areas regarding care and contained enough detail regarding the person. The written information supplied by the home stated that the manager wrote a letter to people who had been assessed to state whether or not their needs could be met. Assessments for risk of falls, nutrition, continence and pressure sores were in place on all four files examined. Written information from external professionals was also available. Care Homes for Older People Page 11 of 30 Evidence: Care Homes for Older People Page 12 of 30 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. Daily personal care routines did not always ensure individuals needs were met. Evidence: The complaint received by the Commission for Social Care Inspection highlighted a number of concerns related to the morning routines that did not always ensure that people received the necessary care and attention at a suitable time. The person concerned had not been assisted to get up and dressed on an identified occasion that had resulted in them being left wet and trying to get dressed themselves. Observation of the morning routine during the inspection visit showed that this varied. On the first day of the inspection, people were still being assisted with their morning care at 11am but on the second day, the routines appeared to have been completed before 10.30am. Several people spoken with stated that there was sometimes a wait before they could Care Homes for Older People Page 13 of 30 Evidence: go to the toilet and a visiting professional stated that they had observed that there was sometimes a wait before a call bell was answered. It was also observed that there were periods in the mornings when there were no staff in the main lounge area and people who were unable to reach a call bell then had no means of requesting assistance. The complaint had also stated that bedroom doors were left ajar, which meant that people were sometimes visible from the corridor. In the particular incident referred to, the person concerned did not have underclothes on and was visible from the corridor. Observation during the inspection visit showed that generally privacy and dignity was maintained and doors were closed. Staff usually knocked on doors but there was one occasion when a member of staff entered a room without knocking. People living in the home stated that staff were kind, good and helpful and that they were polite when assisting with personal tasks. Four care files were examined and all had a care plan in place.The detail of the plans showed that issues related to risk assessments were not always addressed, particularly in relation to risk of falls and pressure sores. For example, there was no care plan to address the risk of pressure sores on any of the four plans seen although all had a risk assessment stating that they were at risk. One person did not have a care plan to address the risk of falls although they had an assessment stating that they were at risk. Another person with an assessment stating they were at high risk of falling did have a care plan to address the risk. All care plans had been evaluated on a monthly basis. Those people who were being cared for on a residential basis had been referred to the district nursing service for treatment and assessments for pressure relieving equipment where appropriate. Weight was recorded on a monthly basis and one person who had had a medical problem had had their temperature, pulse, respiration and blood pressure recorded on a weekly basis. Access to health professionals was recorded in the care files and showed that visits from chiropodists, General Practitioners (GP), District Nurses and opticians took place. A visiting professional spoken with during the inspection visit stated that the home asked for assistance appropriately and that they thought the care was generally quite good. A general check on six medication administration record (MAR) charts showed that Care Homes for Older People Page 14 of 30 Evidence: charts were usually completed properly with the exception that codes not being used to show why someone had not received an as required medication and handwritten charts were not being checked and signed by two people for accuracy. The amount of medication received and the date it was received was recorded. Photographs were available to aid identification and staff specimen signatures were available to identify who had administered medication. Information about allergies was available, where relevant. Four peoples MAR charts were then examined in more detail. These were completed accurately and corresponded with the blister pack, with the exception of one medicine on one day that had been signed as given but was still in the blister pack. The administration of morning medicines was observed to continue until 11am and on the second day of the inspection visit, the lunchtime administration had been completed by 1.45pm. This meant that there was the potential for an insufficient time frame (less than three hours) between morning and lunchtime medicine administration for those people receiving medicines at both times. The controlled drugs record was examined and the amount of medicine on the written record corresponded with the amount in stock. Two people were signing the record. There were secure storage facilities for these medicines. The company had a detailed medication policy and the home also had a copy of the Royal Pharmaceutical Society guidelines on administering medicines in care settings. The medication policy also gave guidance on what were classed as homely remedies and how these were to be administered. Storage of medicines was satisfactory and refrigerator temperatures were within safe limits. Applications with a limited shelf life, such as eye drops, were labelled with the date of opening and were within their use by dates. Care Homes for Older People Page 15 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A lack of activities on some occasions and lack of choice for daily routines had the potential to adversely affect peoples quality of life. Evidence: An activities organiser was employed by the home, although the permanent member of staff undertaking this had been on sick leave for a lengthy period. The manager stated that this had had an impact on the amount of activities being undertaken. There was no activity seen being undertaken during the visit and at one point both music and the television were on at opposite ends of the lounge, which was distracting. However, external entertainment had been arranged on two days following the visit. Some people had their own hobbies and jigsaws and books and newspapers were in use. The manager stated that movement to music occurred on a weekly basis. People were observed to get up and have breakfast at different times. However, it was not clear if this was always at a time of their choosing. Staff spoken with stated that getting up times were alternated to ensure the same people did not always get up late and the complaint raised showed that the individual concerned was trying to get up Care Homes for Older People Page 16 of 30 Evidence: themselves without assistance and had missed breakfast. The home was making efforts to be inclusive and make contacts with the local community under a project called connecting with community. They had established links with the local church and people living in the home had attended a coffee morning. There was a room specified for activities and the home had a good range of materials to use including craft items and games. Visitors spoken with confirmed they could visit at any time and were made to feel welcome. There was a display board that had useful information for relatives and visitors and this included details about advocacy services. The serving of the lunchtime meal was observed on one day and ten people spoken with stated that they enjoyed the food. A variety of options were available and individual preferences were taken account of. The menu was on display in the entrance of the home and these showed that there were nutritious options available. Several people described the food as good. The kitchen was clean and hygienic and food stocks were good. Refrigerator temperatures were recorded and showed that food was stored at safe temperatures. A member of the kitchen staff had a good working knowledge of dietary needs and had undertaken a course on nutrition. The dining area was clean and bright and the tables were well laid. Care Homes for Older People Page 17 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The process of addressing complaints did not always ensure that peoples concerns were listened to and dealt with satisfactorily. Evidence: The company had a corporate complaints procedure that was on display but it did not give a time frame for a response, although the service user guide stated that complaints would be responded to within 48 hours. The area manager addressed written complaints. The written information supplied by the home stated that eleven complaints had been received by the home in the last twelve months. There were records available that showed these were addressed and what action had been taken as a result. However, the record did not state if the complainant was satisfied. The complaint received by the Commission for Social Care Inspection indicated that the complaint had not been adequately addressed. The complaint record showed that it had been recorded as an informal complaint and it referred only to an issue regarding mealtimes and not the full details. People spoken with, and their relatives, stated that they knew who to speak to if they had any concerns and most stated that they were confident their concerns would be addressed in a courteous manner. Care Homes for Older People Page 18 of 30 Evidence: The company had a corporate policy on safeguarding adults that was detailed and informative and contained information available about referring people to the Protection of Vulnerable Adults (POVA) list. However, the Department of Health guidelines on referring to the list were not available. The home also had an up to date copy of the Local Authoritys safeguarding procedures. Staff spoken with confirmed that they were aware of their responsibilities to report any suspicions of abuse. Safeguarding training had taken place in May 2008. The written information provided by the home in November 2008 stated that there had been no allegations of abuse in the previous twelve months. Care Homes for Older People Page 19 of 30 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. The standard of the environment was good providing people with an attractive and homely place to live. Evidence: The home provided a clean and well-decorated environment for peoples enjoyment. All communal areas were well decorated, appropriately lit and free of obstacles. The communal toilets were maintained to a satisfactory standard and the home was odour free throughout. There was a secure, well maintained garden area in which patio furniture and a gazebo was available for people and their visitors to enjoy in the summer months. Appropriate and safe access to the garden area was via ramps and steps. However, some old furniture had been dumped in one part of the garden area that was an eyesore. The manager stated that a skip was on order to dispose of it. A handy person was employed and repairs were attended to promptly. People living in the home were encouraged to have personal mementos in their rooms. The laundry area was well organised, and the equipment in good working order. Care Homes for Older People Page 20 of 30 Evidence: Peoples personal clothing was well laundered and ironed. There were good communication methods in place to ensure all staff were fully informed if anyone had an infection. Staff spoken with were clear about infection control procedures and said there was plenty of protective equipment, such as gloves and aprons, available. Care Homes for Older People Page 21 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Inadequate numbers of staff at key times of day did not ensure that peoples needs were met in a timely manner. Evidence: The complaint raised with the Commission for Social Care Inspection identified that care tasks in the morning were sometimes going on until lunchtime and as a consequence people were missing breakfast and had been left undressed until lunchtime. On the first day of the inspection, breakfast was still being eaten at 11am and on the second day medicines were being administered at 10.45am. A visitor also commented that they were surprised to find their relative being given breakfast at 10.30am on one occasion when they visited. The number of staff available on the morning shift and at weekends was discussed with staff but no staff spoken with felt that care was compromised or that there were insufficient staff to perform care duties in a timely manner, although one stated that six care staff in the morning would be better. However, one staff survey received responded that there were sometimes enough staff to meet individual needs and one responded that there were never enough staff. Relatives spoken with also commented that the home appeared short staffed and identified weekends as a particular problem. One relative spoken with commented that staff seemed rushed off their feet. Care Homes for Older People Page 22 of 30 Evidence: Staff rotas were examined for the period relating to the complaint and for the week of the inspection visit, 8th -14th December 2008. This showed that there was always a nurse on duty with the manager being supernumerary during the day and either four or five care staff available for thirty-two people currently accommodated. There were generally three carers and one nurse on duty at night but on three occasions during the week 9th -16th November 2008 there were two care staff. On the day related to the complaint, there were five care staff recorded as being on duty on the rota on both the morning and afternoon shift and three care staff at night. The written information supplied by the home stated that the company take training and supervision of their staff very seriously. Staff spoken with stated, and their training records confirmed, that mandatory heath and safety training had taken place in 2008. There had also been a number of courses related to care issues that had occurred; for example, care planning in October 2008, dealing with challenging behaviour in September 2008, effective communication in October 2008 and dementia in August 2008. Staff spoken with stated that access to training was good and two staff surveys received stated that training was given that was relevant to their role and kept them up to date with new ways of working. However, one survey stated they did not receive training relevant to their role. The written information supplied by the home stated that three of twenty-two care staff had achieved a National Vocational Qualification (NVQ) at level 2 or above, and that a further seven were undertaking the training. Records seen confirmed that this training took place. The home was therefore striving to meet the target of having 50 of its care staff trained to NVQ level 2. Four staff files were examined and showed that recruitment procedures were thorough and all information required by Schedule 2 of the Care Homes Regulations 2001 was in place, including identity information, Criminal Record Bureau (CRB) checks, two written references, a full employment history and Protection of Vulnerable Adults (POVA) checks. However, one staff survey responded no when asked if checks such as a Criminal Record Bureau (CRB) check were carried out prior to employment. Care Homes for Older People Page 23 of 30 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 was well run in peoples best interests. Evidence: The manager was a qualified nurse and had many years experience of working with older people. She had commenced work at the home in 2008 and had just successfully completed the process of becoming registered with the Commission for Social Care Inspection. The company had corporate quality assurance procedures that included an annual survey that was analysed. The most recent survey had generally positive comments with a total of 74 of respondents rating the home as very good or good. Some of the comments from the October 2008 survey seen stated that staff were dedicated and professional, that the home was run very efficiently and that there were high standards. Care Homes for Older People Page 24 of 30 Evidence: Three peoples financial records were examined and the amounts of cash held corresponded with the written record. Monies were held in a residents account with a bank and each person had their individual record that stated how much they had available in the account. There were receipts available for individual purchases that also corresponded with the record. Cash was stored securely. The written information supplied by the home stated that maintenance checks were up to date. For example, fire detection and fire fighting equipment was checked in May and July 2008 respectively, emergency lighting in August 2008 and water safety in April 2008. Mandatory courses in health and safety areas had been undertaken in 2008. For example, moving and handling training had occurred in May and June 2008 and infection control training in June 2008. However, there was no record to indicate that food hygiene training had been undertaken in 2008, although one member of staff said they had done this as part of their induction process. Care Homes for Older People Page 25 of 30 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 26 of 30 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 Identified risk assessments must have a care plan in place to address the risk. This is to ensure that all health risks are addressed and optimum health maintained. 01/02/2009 2 8 12 The morning care routines 01/02/2009 for assisting with personal and health care must be reviewed and action taken to address any issues. This is to ensure that people receive the help they need in a timely manner that does not adversely compromise their health. 3 9 13 The timing of the morning and lunchtime medication administration must be reviewed. This is to ensure that people are not receiving their morning and lunchtime medicines too close together 01/02/2009 Care Homes for Older People Page 27 of 30 as this could have an adverse impact on their health. 4 9 13 All medication administration charts must be completed accurately. This is to ensure there is a clear audit trail of medicines administered and that people receive their medication as prescribed. 5 10 12 Staff must always ensure 01/02/2009 they knock on doors before entering and that people are not visible when in a state of undress. This is to ensure that peoples privacy and dignity is maintained at all times. 6 12 16 There must be a planned 01/03/2009 programme of activities that takes into account individual needs and interests. This is to ensure that everyone is included in the range of activities on offer and that boredom is avoided. 7 15 16 The daily routines around breakfast time must be reviewed. This is to ensure that the routines of the home enable people to get up and have breakfast at a time that is suited to them. 8 16 22 All complaints must be fully addressed and the outcome recorded. 01/02/2009 01/02/2009 01/02/2009 Care Homes for Older People Page 28 of 30 This is to ensure that people are confident their concerns are listened to and addressed. 9 27 18 The home must review its deployment of staff at key times of day, such as morning. This is to ensure that people receive the help they need in a timely manner that does not compromise their privacy and dignity. 01/02/2009 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 9 Handwritten medication administration record charts should always be checked and signed by two people to ensure they are accurate. Codes should always be used when an as required medication has not been given. The old disused furniture in the garden area should be removed as soon as possible. The home should have 50 of its care staff with a National Vocational Qualification at level 2 or above. Training records should indicate which staff need to undertake food hygiene training and how long this is valid for. 2 3 4 5 9 19 28 38 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 30 of 30 - 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!