Inspection on 30/11/09 for Holy Cross Care Home Limited

This inspection was carried out on 30th November 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Holy Cross Care Home Limited 20/07/06

Holy Cross Care Home Limited 16/02/06

Holy Cross Care Home Limited 07/12/05

Holy Cross Care Home Limited 22/11/04

Holy Cross Care Home Limited 28/06/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for older people Name: Address: Holy Cross Care Home Limited 150 Abbey Foregate Shrewsbury Shropshire SY2 6AP     The quality rating for this care home is:   one star adequate 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: Sue Woods     Date: 3 0 1 1 2 0 0 9 This is a review of 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 2 1 0 stars - excellent stars - good star - adequate 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. 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. Care Homes for Older People Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. 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 29 Information about the care home Name of care home: Address: Holy Cross Care Home Limited 150 Abbey Foregate Shrewsbury Shropshire SY2 6AP 01743343138 01743343138 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: None Holy Cross Care Homes Limited care home 57 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 57 The registered person may provide the following category of service only: Care Home Only (Code PC); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 57 Date of last inspection Brief description of the care home Holy Cross is a privately owned Care Home registered with the Care Quality Commission to provide a service for 57 Older people. The home is situated on Abbey Foregate close to Shrewsbury town centre. It is a well established Home set in elegant and comfortable surroundings. Ms Jane Welsman and Mr Leslie Jones own the Home. Ms Welsman has day-to-day management responsibility for the Home assisted by three deputy managers. The accommodation, originally a vicarage, has been further extended and refurbished to provide a 52 bedroomed facility over three levels. There is an established Staff group providing residents with consistency in a warm comfortable atmosphere. Holy Cross makes their services known to prospective Care Homes for Older People Page 4 of 29 Over 65 57 0 Brief description of the care home service users in The Statement of Purpose and Service Users Guide. The latest inspection report is available in the entrance hall. The care home rates are reviewed annually and service users are notified one month in advance. The only additional charges to service users are for hairdressing, toiletries and newspapers. This is clearly laid out in the terms and conditions. Consultation with people who live at the home takes the form of regular surveys. Residents meetings enable people to discuss issues and make suggestions for improvement and the manager also meets informally with people to gain direct feedback as to the quality of the service. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The unannounced key inspection of Holy Cross took place on 30th November 2009. The inspection began at 9.30 am and lasted six and three quarter hours. The inspection reviewed all twenty two of the key standards for care homes for older people and information to produce this report was gathered from the findings on the day and also by review of information received by CQC prior to the inspection date. A quality rating based on each outcome area for service users has been identified. These ratings are described as excellent good adequate or poor based on findings of the inspection activity. As part of the inspection we met with a number of people living at the home, three relatives, and with four staff on duty at the time of the visit. We also handed out surveys for completion by people living at the home, staff and visitors. Four were returned. Support for the inspection came from the manager who was on duty at the time. Four care files were reviewed in detail and extracts were seen from others. Other records referred to within the report were also seen. Prior to the inspection visit we looked at all of the information that we have received or asked for since the last key Care Homes for Older People Page 6 of 29 inspection. This included notifications received from the home. These are reports about things that have happened in the home and they have to let us know about by law, and an Annual Quality Assurance Assessment known as an AQAA. This is a document that provides information about the home and how they think that it meets the needs of the people living there. The AQAA accurately reflected the service offered by the home. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? The manager told us in the AQAA that Regular monitoring and updating has improved our service. Changes have been implemented and their impact monitored to ensure good practice. Areas of the home have been improved through decoration or replacement. Laundry facilities have been upgraded to improve standards. This reflects the managers commitment to continually review the service provided and act upon advice and guidance to ensure that the home continues to meet the needs of the people living at the home. Staff told us that food and events have improved and a person living at the home told us that the garden and the food had improved. These changes ensure better opportunities for people living at Holy Cross to lead full and active lives Care Homes for Older People Page 8 of 29 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 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who may like to live at Holy Cross are provided with sufficient information by the home prior to moving in to enable them to make a decision as to weather the home will be able to meet their needs however a better recorded assessment process will mean that the home can also demonstrate that they can be sure that the home can meet those needs. Evidence: We spoke with a person currently staying at Holy Cross for a short time before returning home and she was very satisfied with the information that she had received about the home prior to her admission and felt that the home had sufficient information about her care and support needs to enable her to be confident that the home was the right place for her. According to the homes AQAA there have only been three people leave the home in the last year (excluding the people who visit for a planned short time) suggesting that the home is able to meet the care and support needs of people living at Holy Cross. Care Homes for Older People Page 11 of 29 Evidence: Assessments are carried out by health and social care professionals on most people before they move to Holy Cross but the manager can still not demonstrate that she carries out a full and comprehensive assessment of peoples needs when other assessments are not available. The manager said that she has a format to follow but does not always have the paperwork with her. Without this assessment the home may potentially admit someone whose needs they cannot meet. A relative visiting the home told us that he was very happy that his family member had got a place at Holy Cross. He said this is where I wanted her to come. This suggests that the home has a good reputation within the local community. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal and health care needs of the people who live at Holy Cross are well met enabling them to have a good quality of life however arrangements for the handling, recording and administering of medication continues to potentially place people at risk by not ensuring that people receive the medication they require when they require it. Evidence: We looked at the care and support received by four people to identify how the home meets peoples personal and health care needs. People told us that they were very happy with the care they received. Comments included How lucky we are here. Kindness all round everyone here is so lovely. One person was particularly complimentary about the support she receives while having a bath. She said she looks forward to a nice warm bath. She is never rushed and staff are always courteous. Other comments reflected that staff are professional and kind. One person who spoke with us felt that their health and personal care needs were very well met. People have access to see a GP or district nurse when needed meaning that the home Care Homes for Older People Page 13 of 29 Evidence: is supported to ensure peoples health care needs are fully met and that people can remain at Holy Cross while receiving essential treatment to keep them well. Staff said that the home does well looking after the residents. When people become unwell they are supported sensitively and their care plans are updated to reflect their changing needs. Health and social care professionals told us how they work closely with the home to ensure that people who live there are well supported and the home continues to meet peoples needs. One professional told us that staff are Very understanding of residents needs. The Manager is very accommodating. There is a nice homely atmosphere. Staff are concerned and interested in residents. Care plans identify peoples care and support needs so that staff can know how to meet those needs but plans were not so detailed in relation to meeting peoples social and emotional needs. The manager told us she is looking to include peoples life histories into their care plans and further work in this area will ensure that staff know more about the residents hopes and dreams, wishes and preferences and this will further improve the quality of care they receive . We also found that staff at the home make a number of decisions about peoples care and support. These decisions are made with peoples best interests at heart however some of these decisions relate to peoples ongoing safety and therefore should be recorded.(See requirement in outcome area 7). Medication arrangements at the home require review to ensure that they are safe and protect people living at the home. The home has a system in place to check that people receive the correct medication at the correct time however there were some gaps seen in the administration records of one person whos care we looked at meaning that some prescribed medication may not have been given correctly. This could impact on the health of the person who is already quite frail. Likewise records did not show accurately on all occasions the amount of medication on site. It was also not clear when medication, prescribed for as and when required, should be given and this may mean that the person could be given medication unnecessarily or inappropriately. Despite the fact that all staff administering medication receive training to do so safely there were some poor practices taking place within the home and the manager said that she will now review all processes to ensure they are safe. The home does not have a record to show that staff have been assessed as being competent to administer medication. The medication cabinet was well organised and the deputy manager detailed a robust system of checking medication in and out of the home. Care Homes for Older People Page 14 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Holy Cross are able to choose their life style, social activities and keep in contact with family and friends. People enjoy a varied diet according to their assessed needs and individual choice. Evidence: People living at Holy Cross are able to spend their days as they choose and although activities are on offer, people do not feel that they have to take part. This means that people feel in control of their lives. The majority of people we spoke with however enjoy taking part in a range of activities. The arrival of a new puppy within the home has made a positive impact on people who look forward to its daily visits. People we spoke with felt that activities have again continued to improve over the last six months and the homes self assessment completed by the manager said that the home listens to the views and requests of the people who live at the home to improve opportunities and activities. Records of residents meetings showed that entertainment and activities are discussed and peoples suggestions are actioned. Care Homes for Older People Page 15 of 29 Evidence: Visitors to the home told us that they are always made very welcome. People tell us that they like the meals at Holy Cross and are able to choose what they eat. One person told us the food is excellent and one family member was pleased that since her relative had moved to Holy Cross he had put on weight and was now much healthier as a result of the meals. The menu reflected the food on offer on the day of our visit and people were seen to enjoy lunch either in the dining room or in their own rooms. Although staff were clearly busy at this time the people living at the home were enjoying a relaxed and unhurried meal. Care plans contain nutritional risk assessments and changes are made to peoples diets to enable them to receive the foods they need to keep them fit and well. Care Homes for Older People Page 16 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Holy Cross are protected by procedures in place for managing complaints, concerns and allegations of abuse and can be confident that their views and concerns will be listened to and acted upon Evidence: Everyone that we spoke with living at Holy Cross said that they had no concerns or complaints about the home. There is a complaints procedure in place and records show that the majority of complaints are dealt with informally. When complaints are made the manager responds sensitively and makes changes to ensure that people living at the home remain happy. A relative of someone who lives at Holy Cross told us that when concerns have been raised with the home in the past that they have been dealt with very well. The manager told us that people share their views and comments about the home in residents meetings which we saw to be well recorded. The manager also stated that she tries to speak with people informally on a daily basis and always asks if people have any concerns or complaints. People living at Holy Cross said they would be happy to share any concerns with the manager if they had any. Records show that staff have received training in relation to Abuse and all staff who spoke with us were aware of complaints procedures and said that they would be confident to recognise and report any incidents of abuse or poor practice within the home. The home has worked with the local safeguarding team twice in the last twelve Care Homes for Older People Page 17 of 29 Evidence: months to investigate allegations of suspected abuse. Both were unsubstantiated. A social care professional told us that the home cooperated fully with the investigation. Care Homes for Older People Page 18 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Holy Cross is clean and generally well maintained providing the people who live there with a comfortable place to live. Evidence: At the time of the inspection we found the home to be clean and tidy. Bedrooms seen were personalised and no hazards were identified although we did ask the manager to carry out assessments of risk relating to the use of bed rails. Maintenance work takes place promptly and by a designated worker. A visitor to the home told us that he has approached this worker directly for minor repairs and had been happy with the prompt response. The manager said that she has recently purchased radiator guards to reduce the risk of people being burned on exposed radiators. This shows that the manager constantly reviews potential hazards within the home and takes action to reduce risks thus keeping people safe. A complaint raised to the home earlier in the year referred to a cracked pane of glass in a bedroom window. We saw that this has still not been repaired and it is quite fragile. The manager said that this will be replaced as soon as the person currently uses the room for respite leaves. In the mean time she will carry out an assessment to ensure it is safe. Care Homes for Older People Page 19 of 29 Evidence: Some communal corridors have recently been redecorated and people said in the latest residents meeting that they were very pleased with the result. The home uses an industrial cleaner weekly to reduce offensive odours within the home but this may need to be increased in one area of the home and the manager said she will respond to this. The home has an effective infection control policy and procedure and measures in place are reducing the spread of infection within the home keeping people safe. Disposable gloves and aprons were seen readily available and in use by staff and liquid soap and paper towels were seen in all communal bathrooms, again reducing the spread of infection within the home. Care Homes for Older People Page 20 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at Holy Cross receive good care and support from a trained and competent staff team enabling their needs to be effectively met within the home. Thorough recruitment practices ensure that only staff who are suitable to work with vulnerable people are appointed to work at the home however improvements to recording practices will better evidence that the home ensures the protection of vulnerable people Evidence: Everyone who we spoke with said that enjoyed working at Holy Cross. One staff member said that this was her first job in care and she loved it. Staff told us that they were well supported, well trained and had sufficient time to carry out all tasks required of them. People who live at Holy Cross and visitors to the home were very complimentary of the staff team. They were described as lovely and caring. One person said the care that she received was excellent. Staff gave examples of ongoing training courses and the training records seen reflected that mandatory and specialist training to meet identified needs takes place. Although records were not up to date the manager had a record of recent training which reflected staff comments. Staff files contained the majority of information required to ensure the home could demonstrate that only people suitable to work with vulnerable people were appointed Care Homes for Older People Page 21 of 29 Evidence: and the manager accepted suggestions in relation to obtaining references and recording interview outcomes to further improve this process. Care Homes for Older People Page 22 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at Holy Cross benefit from being supported by an approachable and caring management team enabling them to lead a good quality of life. The health and safety and welfare of people living at the home and the staff team is promoted and protected enabling them to feel safe within the home however records do not reflect all assessments of risks or decisions made by the home and as a result people may be vulnerable. Evidence: The manager of Holy Cross is experienced and well respected by people who live at the home, the staff team, relatives and visitors to the home. The manager is aware of her responsibilities and updates her knowledge to reflect current good practice guidelines and new legislation. This ensures good quality of care within the home. We have previously made recommendations to the manager about improving record keeping and at the time of this visit we found that record keeping is still an issue. The home has a health and safety policy which states that the home should formally assess risks and this does not always happen. The home could not demonstrate on all Care Homes for Older People Page 23 of 29 Evidence: occasions that people were being safeguarded and this could make people living at Holy Cross and the home its self vulnerable. Not all records were inadequate however. The home maintains good records in relation to the money that the home keeps on behalf of people living at Holy Cross, which clearly shows income and expenditure. The system is audited by the manager and copies of records are given to family members to show openness. These measures protect people living at the home and the home its self from mistakes or allegations. Quality assurance systems within the home are good and ensure that everyone has the opportunity to share their views of the home either formally or informally. People feel that they are listened to and issues are resolved to their satisfaction. Recording in relation to monitoring safety checks have also improved since our last visit and the manager was able to show that fire safety equipment is regularly checked ensuring, as far as is possible, peoples safety in the event of a fire. The home has acted upon requirements made by the Environmental Health Officer to improve standards of hygiene within the home and an Infection control audit carried out by Shropshire Partners In Care found improvements also. These improvements will mean that people living at Holy Cross receive care that promotes their safety and wellbeing in these areas. The manager has made sure that everyone living at Holy Cross has had a Mental Capacity assessment and is confident that no one living at the home is currently having their liberty deprived. Care Homes for Older People Page 24 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 3 14 People must not be admitted 31/12/2009 to the home without having an assessment of care and support needs that enables the home to identify if that persons needs can be met at the home and that can inform a care and support plan. This is to make sure that that no one is admitted inappropriately putting them at risk of not having their needs met. Records must accurately reflect the amount of medication on site and the reasons why medication has not been administered as directed must be recorded. This is to provide an audit trail of medication to show that people have received the required medication at the correct time. 31/12/2009 2 9 13 Care Homes for Older People Page 26 of 29 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 3 9 13 Protocols must be developed 31/12/2009 and implemented to make sure that staff know under what circumstances they can administer medications prescribed as and when required. This is to make sure that people do not receive medication inappropriately placing their health and welfare at risk. 4 37 17 Records must be accurate, available and up to date at all times. This is to demonstrate that the people living at the home receive the care they require and that the home is operating safely and in the best interests of the people they support 31/12/2009 5 38 13 Risks to peoples health and 31/12/2009 wellbeing must be identified, assessed and recorded. This is to ensure that as far as is possible people are safe and the home can show that it is operating safely and in peoples best interests. Care Homes for Older People Page 27 of 29 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 7 We recommend that care plans be developed to reflect peoples social and emotional needs as well as their wishes, aims and goals. This will support staff to meet those needs and further improve peoples quality of life We recommend that all staff have a recorded competency assessment to demonstrate that they are aware of safe procedures in relation to the administration of medication. We recommend that the cracked pane of glass be made safe until it can be replaced and be replaced before anyone else is admitted to that room. We recommend that all information required by Schedule 2 of the Care Homes regulations 2001 and a record of interview are available for review to show the home has a robust recruitment process in place. 2 7 3 19 4 29 Care Homes for Older People Page 28 of 29 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 29 of 29 - 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!