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Inspection on 21/07/09 for Harry Lord House

Also see our care home review for Harry Lord House for more information

This inspection was carried out on 21st July 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Service users have their care needs well met by friendly and competent staff. Comments from service users, when asked what the home did well, included: "Take care of me and give me a good cup of tea". "I love it here, I enjoy being here it`s a lovely place to be. This is my family the residents and staff, I was alone at home, I feel at home here. I would not want to be anywhere else." "Company, the food, friendly staff and help me when I need it". Medical support is provided in a timely manner. The procedures and practices relating to the storage and administration of medication make sure that service users get their correct medication. A range of activities is provided and service users told us they valued their freedom of choice around whether or not to participate in any communal activity. The provision of food was good. Service users were confident that they were protected from abuse or exploitation and that any complaint they may have would be responded to positively. Care is provided by friendly and competent well-trained and well supported staff team. The physical environment is safe, clean and hygienic.

What has improved since the last inspection?

The requirement made at the previous inspection in connection with staffing levels had been addressed. Similarly recommendations made following the last inspection had been or were continuing to be actioned. We were told that staff training had improved and that staff were confident about putting their learning into practice.

What the care home could do better:

The usefulness of some records would be improved by ensuring that they are effectively dated. Similarly when a service user`s circumstances change, care needs to be taken to update all relevant sections of the documentation. Whilst these administrative issues did not present as having a negative effect on service users, it did detract from the staff`s ability to demonstrate fully the quality of care provided. Staff recruitment must be undertaken more rigorously and in line with current minimum legal requirements regarding checking on the background of prospective staff. This is to minimise the risk of exposing vulnerable service users to inappropriate individuals. Written policies and procedures, relevant to the roles and responsibilities of the staff, should be available in the home. This will help to ensure that staff have access to a consistent reference point.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Harry Lord House 120 Humphrey Road Old Trafford Manchester M16 9DF     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: Sylvia Brown     Date: 2 1 0 7 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 28 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 28 Information about the care home Name of care home: Address: Harry Lord House 120 Humphrey Road Old Trafford Manchester M16 9DF 01618724156 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) : sue.burrell@trafford.gov.uk Trafford Metropolitan Borough Council care home 27 Number of places (if applicable): Under 65 Over 65 0 27 dementia old age, not falling within any other category Additional conditions: 27 0 The registered person may provide the following category of service only: Care Home only - Code PC. To service users of the follwing gender: Either. Whose primary care needs on admissions to the home are within the following categories: Old age, not falling within any other category - Code OP, Dementia - DE. The maximum number of service users who can be accommodated is: 27 Date of last inspection Brief description of the care home Harry Lord House is a care home, owned and managed by Trafford Metropolitan Borough Council. It is situated in a quiet residential area close to shops, public park and the Metro link at Trafford Bar The home is on the top two floors of Harry Lord House. Access to the first and second floors, where bedrooms and communal areas are located, is by a staircase as you enter the building, or by passenger lift which is situated within the ground floor accommodation. There are four lounges within dining areas and various bathing facilities, including shower and Parker bath. All bedrooms offer single occupancy. The fees for the home are #380:29 Care Homes for Older People Page 4 of 28 Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is one star. This means the people who use this service experience adequate quality outcomes. We (the Care Quality Commission) undertook a key inspection, which included an unannounced visit to the home. This meant that no one at Harry Lord House knew that the visit was going to take place. For the purpose of this inspection two service users were interviewed in private, as was one relative of a service user. Additionally discussions took place with the manager and three staff members were interviewed in private. Care Homes for Older People Page 6 of 28 All the key inspection standards were assessed at the site visit. We also looked at information we have about how the service has managed any complaints, what the service has told us about things that have happened in the service, these are called notifications and any relevant information from other organisations. Before the site visit, we asked for surveys to be sent out to some residents, and staff, asking what they thought about the care at the home. Seven residents, and one member of staff returned their surveys to us. Some of the information from these surveys is included in the report. We also asked the management of the home to fill in a questionnaire, called an Annual Quality Assurance Assessment (AQAA). This is a legal requirement. The AQAA told us what they thought they did well, what they need to do better and what they have improved upon. Where appropriate, some of these comments have been included in the report. We undertook a tour of the building and looked at a selection of service user and staff records as well as other documentation, including staff rotas, medication records and the complaints log. We have not received any complaints about the service since our last Key Inspection. What the care home does well: What has improved since the last inspection? What they could do better: The usefulness of some records would be improved by ensuring that they are effectively dated. Similarly when a service users circumstances change, care needs to be taken to update all relevant sections of the documentation. Whilst these administrative issues did not present as having a negative effect on service users, it did detract from the staffs ability to demonstrate fully the quality of care provided. Staff recruitment must be undertaken more rigorously and in line with current minimum legal requirements regarding checking on the background of prospective staff. This is to minimise the risk of exposing vulnerable service users to inappropriate individuals. Written policies and procedures, relevant to the roles and responsibilities of the staff, should be available in the home. This will help to ensure that staff have access to a consistent reference point. Care Homes for Older People Page 8 of 28 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 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users needs are assessed before moving to the home to ensure that their needs can be appropriately met. Evidence: We were told in the AQAA that all potential service users had a full assessment completed by a qualified social worker. We were also told that a home or hospital visit was completed by Harry Lord House staff prior to admission. We looked at a small selection of service users files. These contained written evidence that assessments had been undertaken. In one example seen, the assessment from the Trafford mental health and social care service was not dated, but the manager was confident the assessment had been done before the service user moved to the home. Care Homes for Older People Page 11 of 28 Evidence: Staff who we asked, also confirmed that service users needs are assessed before being admitted to the care home. Harry Lord House does not offer intermediate care. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users health, personal and social care needs are met by the consistent implementation of policies and procedures. Staff practices also serve to promote the dignity of the service users. Evidence: The manager told us in the AQAA that each service user had a plan of care. We looked at a small selection of service users files, each of which had a written care plan. Generally the care plan was developed from a comprehensive set of assessments which addressed a wide range of physical and social needs. The level of detail varied and in one example seen there was little evidence that the plan of care had been amended on the basis of the homes own assessment. The manager reported that this situation had come about because of different administrative processes for short stay service users. Some records contained contradictory information, for example in connection with Care Homes for Older People Page 13 of 28 Evidence: whether an individual could bear their own weight and how many staff were required to assist them. Discussion with the manager and staff indicated that this was an administrative issue created by changing circumstances not being reflected in all parts of the record. Staff who we talked to demonstrated a good understanding of the needs of individual service users. They told us that they were confident that the overall system regarding care planning and information transfer between staff worked well. There was evidence that the manager was periodically auditing case files and identifying areas where more information is required. This is good practice. Service users and visitors who we asked, spoke positively about the care provided by the staff. One service user said it is a good place and we are well looked after. Service users who completed a survey for us, all said that the staff always listened and acted on what they said and that they received the care and support they needed either always (5) or usually (2). Other comments included, cant fault it, care is good. [you] only have to ask for something and you get it. and [staff] look after people in a nice way. There was good documentary evidence that service users had appropriate contact with the full range of medical services available in the community. Nutritional screening was undertaken and there was documentary evidence that the degree of monitoring of weights and food and fluid intake varied depending on the assessed risk for each individual service user. In one record seen there was good evidence that this monitoring had triggered appropriate medical intervention in a timely manner. All service users, visitors and staff who we asked were confident that medical support was obtained quickly when needed. All service users who returned a survey to us said that they got the medical care they needed either always (6) or usually (1). We looked at a small sample of medication administration records which presented as being appropriately maintained. These demonstrated that service users were being given the correct medication in the correct dose at the correct time. Medication presented as being appropriately and securely stored. We were told that no service user was prescribed controlled drugs at the time of this visit. Service users and visitors who we asked, told us that people were treated with respect and had their dignity and privacy maintained. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. An appropriate range of activities is available for service users, and visitors are welcome in the home which enhances service users fulfilment and social stimulation. The provision of food to maintain service users health and well-being is good. Evidence: The manager told us that there was a flexible and varied activity programme. Discussion with service users and staff confirmed that different activities are on offer periodically, including quizzes, a singing physiotherapist, dominoes, netball, bingo and simply sitting and chatting. There is no compulsion to participate in any activity. One service user we spoke to, cited as amongst the best things about the home [you are] free to do anything within reason. The manager also told us that occasional outings are organised but limited due to a lack of funds. Service users who completed the survey for us said there were activities to take part in either always or (4) or usually (3). All service users visitors and staff who we asked, confirmed that there was no Care Homes for Older People Page 15 of 28 Evidence: unreasonable restrictions on visitors. One visitor told us they felt they were made very welcome and the staff are always willing to talk to them. Service users who we asked, told us they were free to spend their time how they wished and there were no restrictions on such things as getting up and going to bed. There was a varied menu in place which also offered a choice. Records were maintained of which meals were chosen by individual service users each day. This provided documentary evidence that vegetarian and halal needs were catered for. Some of the dating on these documents was somewhat haphazard, which may impair their credibility, for example some had no dates and one was dated 09/09/09 (several weeks in the future). One meal was sampled during this visit which was pleasantly presented and tasty. Service users who completed the survey for us varied in their response to being asked if they liked the meals, with 2 saying always, 3 saying usually, and 2 saying sometimes. Service users who we asked at the visit, told us they enjoyed the food, one describing it as excellent, and amongst the best things about the home, and another said food is good and the sweets are lovely. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are protected from abuse or exploitation by the homes policies and practices and are confident that any complaints they may have would be dealt with appropriately. Evidence: The manager told us in the AQAA that the complaints procedure was displayed for service users and visitors to see. All service users who completed a survey for us said that they knew how to make a formal complaints and that they knew who to speak to if they were not happy. We looked at the complaints log which had two complaints recorded since the previous key inspection. All service users and visitors who we spoke to, were confident that any complaint would be dealt with appropriately. One visitor told us that if they had reason to speak to staff they always got a very positive response. This visitor described staff as very positive and open. This attitude from staff would probably make it easier for any service user or visitor to raise any complaint at an early stage. An observation made in a survey form returned by a staff member was, staff make all the residents feel at home, safe, secure and have built up trust with the residents. Care Homes for Older People Page 17 of 28 Evidence: We were told by the manager that all staff had received training in POVA (protection of vulnerable adults). We looked at a random selection of staff files, all of which contained documentary evidence that this training had been done. Staff who we talked to said they were confident that service users living in the home were protected from abuse and exploitation. They also told us that they were aware of the possibility of abuse, understood what they needed to do if they became concerned and that if necessary, they would whistle blow. Service users and visitors who we asked were confident that either they or their relatives were safe. We have not been made aware of any concerns complaints or allegations since last key inspection. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is appropriately maintained, decorated and cleaned to enable service users to live in a pleasant, safe and hygienic environment. Evidence: The layout of Harry Lord House is unusual for a care home for older people in that accommodation is provided on the first and second floors, with the ground floor being used by various community groups. At the time of this visit the home was experiencing some difficulties with the lift, which had a sign on it asking people not to use it as it may break down. The manager informed us that it was still serviceable if absolutely necessary. She also informed us that funding had been agreed for a replacement lift. During the unannounced visit made as part of the inspection process a tour of the building was undertaken. This included communal areas and a selection of service users bedrooms. There was clear evidence that people could personalise their own bedrooms. Other than the lift mentioned above, no items were identified as needing repair or replacement in connection with the physical environment of the building. The building presented as clean and tidy with no unpleasant smells. Comments from Care Homes for Older People Page 19 of 28 Evidence: service users, staff and visitors all indicated that this was the usual state of the building. One service user told us they were particularly appreciative of the extra effort made by staff to ensure that flowers brought in by family members were always kept in freshwater. All service users who returned a survey to us said that the home was always fresh and clean. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The numbers and skills mix of staff on duty promotes the independence and well being of service users. Recruitment procedures are not sufficiently robust to minimise the risk of inappropriate people being ercruited. Evidence: The manager told us that staffing levels during the day (07:30 to 21:30), were expected to be maintained at the level of four carers plus one senior. We looked at the staff rota for the week beginning 12/07/09 which confirmed that these staffing levels were achieved. There was a significant use of agency staff to maintain this identified level of staffing. Over reliance on agency staff to cover for permanent posts can, in some circumstances, lead to a lack of continuity of care, which can in turn lead to service users experiencing a poorer quality of care overall. The manager told us that although the number of shifts covered by agency staff was comparatively high, these sessions tended to be covered by the same agency personnel. This resulted in a higher level of consistency than might otherwise have been expected. Discussion with staff and service users confirmed that there was no discernible negative impact on the experience of service users created by the use of agency staff. Care Homes for Older People Page 21 of 28 Evidence: Staff were described by service users as lovely and generally nice and very very good. Service users who returned a survey to us all said that staff were available when you need them either always (6) or usually (1). The manager had told us in the AQAA that all staff undertook a 12 week induction course and that 20 of the 23 care staff had undertaken NVQ training to level II or above. The NVQ is a nationally recognised qualification intended to improve the knowledge, skills and competency of staff. We were also told that staff had access to a wide range of training opportunities. Staff who we spoke to confirmed that they had access to training, that the management was encouraging and supportive of training. Staff also told us that their individual training needs were addressed through supervision and their personal development plans. We checked a small random selection of staff records to verify this information. There were training records which included first aid, moving and handling, POVA (protection of vulnerable adults) and evidence that dementia training was being undertaken. We were told that only one member of staff had been recruited since the last key inspection. Much information in connection with staff recruitment and vetting is held at Trafford Borough Councils Headquarters and we did not seek to view it on this occasion. However, the information which was available at Harry Lord House, indicated that a full employment history had not been obtained. There was also clarification that a CRB (criminal records bureau) disclosure had been obtained after the staff members date of employment, but no record of a POVA first disclosure. A satisfactory POVA first disclosure allows staff to work under close supervision until the full CRB disclosure is obtained. The manager was confident that the councils recruitment procedures were robust. However we asked the manager to seek clarification from Trafford Borough Councils Human Resources Department regarding the date of the POVA first receipt. The manager subsequently informed us that a POVA first declaration had not been received. Staff who we spoke to were very positive about the experience of working at Harry Lord House, for the benefit of service users, and described a good supportive management structure and good teamwork with their colleagues. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is competent to run the home, use the quality audit systems and implement the health and safety procedures for the benefit of service users and staff. However, there are gaps in the administrative infrastructure which jeapordise this. Evidence: The registered manager had been found to have the appropriate qualifications and experience to run a care home at previous inspections. She told us that she continues to attend relevant training courses, both to consolidate her learning and increase her knowledge of current developments. The manager was aware of the relatively new Deprivation of Liberty Safeguarding requirements and told us that no applications for approval had been required. The manager told us in the AQAA that there were no written policy and procedures in connection with several areas of practice. These included several crucial policies in connection with, for example, continence promotion, individual planning and review, Care Homes for Older People Page 23 of 28 Evidence: management of service users money, missing service users and pressure relief. This did not imply that staff practices were inappropriate but that a consistent framework to act as a reference point if necessary, was not available. There was good evidence that the responsible individual arranged for regular independent visits to the home to ensure that standards are maintained. Copies of these reports were looked at and presented as being comprehensive and thorough. There was evidence of a quality audit having been undertaken to the year end 2008. The manager told us that the outcomes from this audit had been sent to service users families and was available in the entrance hall. We looked at a small selection of records held in connection with any money held on behalf of service users, or purchases made on their behalf. The records presented as being appropriately maintained to protect the interests of the service users. The manager had told us in the AQAA that equipment in use in the home was serviced and tested as necessary. We looked at the records relating to testing of the fire detection and alarm system which presented as being appropriately maintained. The situation regarding the passenger lift is addressed in the environment section of this report. All staff who we asked, told us that personal protective equipment, such as disposable gloves and aprons to minimise the risk of cross infection were always available and used. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 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 22 19 The registered person must 30/09/2009 not allow any person to start work without having obtained all the required information to enable them to make a reasonable decision that the person does not pose a risk to vulnerable service users. Minimally this includes a full employment history, two written references and a CRB disclosure, or, in exceptional circumstances, a POVA First declaration. This is to minimise the risk of exposing vulnerable service users to inappropriate staff. 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 26 of 28 1 7 The Responsible Individual should ensure that all documents are effectively dated. Where appropriate information should be updated consistently, to reflect the changing needs of any service user. The responsible person should ensure that records are held at Harry Lord House which demonstrate that the required vetting procedures had been followed in connection with all staff. This should include evidence of a full employment history together with an explanation of any gaps in employment, the receipt and verification of appropriate references, and a Criminal Record and Bureau disclosure (or minimally a POVA first declaration). The responsible individual should ensure that written policies and procedures covering all essential areas of practice are available as a reference point for staff and managers at Harry Lord House. 2 22 3 37 Care Homes for Older People Page 27 of 28 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). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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