Inspection on 26/01/09 for Kimberley Residential Home

This inspection was carried out on 26th January 2009.

CSCI 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

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Kimberley Residential Home 40 Miskin Road Dartford Kent DA1 2LS     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: Robert Pettiford     Date: 2 6 0 1 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 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Kimberley Residential Home 40 Miskin Road Dartford Kent DA1 2LS 01322291885 01322275410 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Kimberley Residential Home Ltd Name of registered manager (if applicable) Mrs Maureen Lesley Chater 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: The maximum number of service users to be accommodated is 22 The registered person may provide the following category/ies of service only: Care home only ? (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) Date of last inspection Brief description of the care home Kimberley residential home is registered for the accommodation of up to 22 older people. The premises have 8 single and 7 shared bedrooms situated on ground, first and second floors. Stair-lifts assist access to the first and second floors. Residents have the benefit of a number of communal areas, including a separate building in the rear garden. Weekly fees are £325-£335. Additional charges are made for hairdressing, chiropody and private medical prescriptions. Care Homes for Older People Page 4 of 30 care home 22 Over 65 22 0 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: The inspection took place at 8:40AM on 26th January 2009 We agreed and explained the inspection process with the manager. The owner of the home later joined for part of the inspection. The focus of the inspection was to assess the home in accordance with the Care Home Regulations 2001 and the National Minimum Standards for Older Persons. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. We used a varied method of gathering evidence to complete this inspection, pre Care Homes for Older People Page 6 of 30 inspection information such as discussion and correspondence with the registered provider/manager was used in the planning process. This was to support us to explore any issues of concern and verify practise and service provision. The home had completed an annual quality assurance assessment questionnaire (AQAA). This provided us with information relating to What the agency considers it does well, What we could do better, What has improved within the last 12 months and plans for improvement. The judgements have been made using the Key Lines of Regulatory Assessment (KLORA), which are guidelines that enable the Commission to be able to make an informed decision about outcome areas. Further information can be found on the Commissions website with regards to information on KLORAs and AQAAs. Documentation and records were read. Time was spent reading a sample of written policies and procedures, reviewing care plans and records kept within the home. Other areas viewed included risk assessments, pre-admission assessments, rotas, and training records. In addition an environmental tour took place. We identified several residents for case tracking (a review of the level of care and support needed, and if it is being provided in a way that treats them with respect and dignity). What the care home does well: What has improved since the last inspection? What they could do better: The inspection identified several areas that were in need of being addressed. The management of the home has recognised the shortfalls and has indicated a willingness to work with the Commission to ensure that any shortfalls are addressed. The main areas that were identified were :Of the five care plans sampled three did not have completed assessment that contained all the elements as required of the standards. The homes care plans do not currently use a socially led model. From the care plans viewed they were of a medical / clinical approach. The plan of care needs to better evidence social and personal goals including hopes, goals and aspirations where possible. The standard of internal decoration and fixtures and fittings are in need of repair, replacement and refurbishment. It was apparant during a tour of the building that it has not been decorated for some considerable time and a ongoing programme of maintenence and renewal was not evidenced. All core courses have not been undertaken for all staff to maintain current qualifications and for protection of residents. A quality assurance / auditing system is required to assess through a cycle of quality assurance with regard to compliance with the national minimum standards. The system currently in place is not sufficently developed to identify shortfalls within the service. The home evidenced that all required safety checks and associated certificates are in place. However we requested that the home reviews its fire risk assessment and its evnvironmental assessment to minimise risks within the home due to the date when they were prepared. Care Homes for Older People Page 8 of 30 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 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can not feel fully confident that their needs will be properly assessed prior to moving to the home and assessments are completed in accordance with the required standard. Intermediate care is not provided. Evidence: The service consults the assessment information to see if they can meet the prospective residents needs before they make the decision to accept the application for admission and offer a place. Evidence suggests that prospective residents should have a needs assessment before they go to live at the home. They are generally undertaken satisfactorily. However of the five care plans sampled three did not have completed assessment that contained all the elements as required of the standards. From training records and discussions with the manager and staff at time of inspection Care Homes for Older People Page 11 of 30 Evidence: we were of the opinion that staff have the necessary skills and ability to care for individuals who are admitted. The AQAA also confirmed information with regard to ensuring that the home can meet the needs of residents. The assessment process and evidence shown in the AQAA shows a limited understanding of the importance of promoting equality and diversity rather than just meeting needs in a reactive manner. We recommend that the manager reviews the homes equalities and diversity policy and ensures that all of the information and policies relating to residents are inclusive to all members of the community and that a better understanding is gained. It is therefore also recommended that the home considers giving staff and management Equality and Diversity training. Intermediate care is not provided. 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. Residents do not benefit from having fully clear individual plans that are comprehensive, and evidence that residents are fully involved in the process and contribute towards setting their hopes aspirations and goals. Residents can feel confident that they are fully supported with their health care needs. Residents are potentially at risk due to the homes medication policy and practise. Evidence: The staff of the home are committed to supporting all residents including those to make informed decisions, understand the range of options which are available to them. Evidence of this was gathered through taking to the residents, staff, and the manager. The inspector viewed and discussed with the manager the care records relating to several residents at the home. In the care plans viewed there were limited guidelines Care Homes for Older People Page 13 of 30 Evidence: in respect to support needed in the care plans viewed. One resident did not have a care plan at all, only an assessment. We were also unable to evidence the home undertakes regular reviews monthly. The homes care plans do not currently use a wholly socially led model. The care planning approach needs to move away from a clinical / medical base to one with includes social and personal goals including hopes and aspirations in more detail. The home needs to introduce a person centred care planning system that has a holistic approach. Limited involvement of the residents was evidenced within the care planning system. However evidence from discussions with residents would suggest that this is not the case. The inspector viewed a sample of care records and specific health care records relating to several residents. Records viewed confirmed residents had access to a range of health care input as and when required and as part of regular health checks. This included access to their chosen G.P (where possible), Dentist, Optician and Chiropodist in addition to identified specialist health care input. The Home facilitates residents keeping hospital appointments and seeing their own GP. Evidence was seen of regular healthcare checks to promote healthcare of residents. It is evident through talking to members of staff at the home that the emotional health of the residents is of a high priority to the home and that staff are pro-active in maintaining and supporting residents with their emotional needs in order to maintain their quality of life. It was confirmed in discussions with many of the residents who lived at the home that they felt well supported and that the staff treated them with respect and dignity. Some residents spoke of the support they received and the activities they enjoyed. Risk assessments were reviewed within the home and discussed with the manager. Assessments seen detailed how to support residents to minimise risks for personal safety however on examples evidenced they had not been been updated and reviewed regularly. We visited the home at 8:40AM. During the inspection we noted that residents were seen making choices about their lives and were seen to be part of the decision process and a relaxed atmosphere was noted with the residents interacting with staff. Many residents spoken with expressed satisfaction of the quality of the service. One resident said You can do what you like another said Carers treat me well The inspector viewed the storage arrangements and some records including Medication Administration Record (MAR) sheets. These were seen to be completed correctly on examples viewed. No protocols for the administration of PRN/As Required Medication were in place to ensure that such medication is administered in a consistent manner. Care Homes for Older People Page 14 of 30 Evidence: The medication was seen not to be stored appropriately in accordance to guidence. The home did not have appropriate storage for controlled drugs in that it was kept with the other drugs in the drugs trolly. Medication policy used in the home was drafted by Kent County Council dated 2003. In our view it was not up to date and followed current guidence. The manager confirmed that all staff who dispense medication have received appropriate training. The home is required to seek advice from a pharmacist and ensure that the recording and administration of medication follows The Royal Pharmaceutical Society guidelines and the Misuse of Drugs Act 1971 and as amended. Daily records were not wholly comprentaneous in that they had gaps and full names of staff were not seen. It was strongly recommended that the home follow the Nursing and Midwifery Council guidance: Guidelines for records and record keeping. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be confident that they are offered a range of opportunities for personal development and activities which are appropriate to their needs and capabilities. Residents are supported to maintain contact with family and friends, which ensures they continue to receive stimulation and emotional support. The residents benefit from the appetising meals and balanced diet offered at the home. Evidence: Discussion with residents confirmed that the level of activities were of a good level and that they enjoyed stimulation through leisure and recreational activities both inside and outside the home. We joined residents at 9:30am and had the opportunity to speak to several of the residents who expressed their opinion of the home and the activities they participated in and enjoyed. Other residents were observed participating and interacting with staff. Residents have been enabled to and encouraged to participate in activities which they Care Homes for Older People Page 16 of 30 Evidence: had an interest in. The staff have a strong ethos and focuses on involving residents in all areas of their life, and actively promotes the rights of individuals to make informed choices, providing links to specialist support when needed. Evidence of this was observed from direct observation and comments made by the residents. It was confirmed that residents are enabled to maintain contact with relatives and friends where they wished to do so. Residents were consulted with regard to whom they saw. From observation, records viewed it was evident that residents were offered a choice of menus that meet their dietary needs and individual preferences. Residents are able to choose where to eat. Drinks are available upon request and served regularly along with snacks. Residents confirmed that they have been involved in planning and choosing what to eat where possible. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can feel confident that their concerns and complaints are taken seriously. However some amendments were noted as being needed. Residents are protected from the risks of abuse, but policies are in need of review. Evidence: A copy the complaints procedures was reviewed. The procedure included details of how to complain, timescales for response and information for referring a complaint to the service provider. The manager stated the home keeps a full record of complaints and this includes details of the investigation and any actions taken. It is reccommended that the complaints procedure be made available in larger print. The procedure should also make reference to being able to pass information to the Commission and Social Services at any time, not just after exhaustion of the homes policy. Residents within the service have an understanding of how to make a complaint as their capacity and understanding allows. Systems are in place to ensure that complaints are dealt with appropriately. The homes Policy for the Protection of Residents and staff Whistle blowing procedure Care Homes for Older People Page 18 of 30 Evidence: was discussed. The home did not have a safeguarding adults procedure that meets with current guidence on evidence seen and the manager did not have a up to date copy of Kent and Medways Safeguarding Adults Protocols. Full training has been provided for staff and was evidenced at time of inspection. The home promotes an open culture where residents feel safe and supported to share any concerns in relation to their protection and safety. Residents spoken with confirmed satisfaction of the service and a relative spoken with did not have any concerns. The manager stated that these shortfalls would be addressed as a priority. The manager stated that Criminal Record Bureau Checks (CRB) had been obtained for all staff . Evidence of this was seen by the Commission. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents do not benefit from living in a well maintained environment which provides a homely warm atmosphere with safe access to comfortable indoor and outdoor communal areas Residents are protected by the homes infection control procedures and policies Evidence: It was apparent that the individual and collective needs are being met in a generally comfortable environment. Although the building does have some limitations which impact on residents. These limitations are due to the geography of the building. The manager states that they can not be changed, but they are mentioned in the homes statement of purpose. This allows for any prospective resident to make an informed choice. The standard of internal decoration and fixtures and fittings are in need of repair, replacement and refurbishment. It was apparant during a tour of the building that it has not been decorated for some considerable time and a ongoing programme of maintenence and renewal was not evidenced. The manager is aware of the shortfalls and the owner who later joined the manager during the inspection agreed. The owner stated that a programme would be put in place to address the concerns and ensure Care Homes for Older People Page 20 of 30 Evidence: actions are taken to improve the environment. The premises have a number of separate communal areas for residents in addition to the lounge, for example, a secluded room at the rear and a separate conservatory in the garden. The home has 8 single and 7 shared bedrooms on ground, first and second floors. There are stair lifts to the first and second floors. Handrails have been fitted throughout the home for residents safety. There is a stand-alone conservatory at the rear of the premises that is used by some residents. Another area at the rear of the premises provides space for visitors to meet residents in private and a separate visitors room is available. People who use services can personalise their rooms. They also say the home is clean, warm, well lit and there is sufficient hot water. Five bedrooms have en-suite toilet facilities. There are 2 bathrooms both of which have manual bath hoists. The garden is suitable for use by frail older people. There are laundry facilities and a food store in the basement. The how does not have a sluice, but the manager stated that protective wear is available for staff and she ensures that infection control guidlines are followed. The manager stated that the washing machine is suitable for the residents needs. The AQAA states that staff are trained in infection control. 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. Residents care, social and emotional needs are promoted by the employment of caring staff but not in such numbers to fully support their needs. Residents can not feel fully confident that staff are trained appropriately. Residents are protected by the homes recruitment procedures. Evidence: A high proportion of residents have very significant sensory impairments, physical disabilities, mental health difficulties and significant memory loss. Bedroom accommodation and facilities are dispersed over a large area (i.e. 3 floors served by stair lifts). Carers have wide responsibilities including laundry, cooking, serving meals and personal care. A domestic worker cleans the premises on weekdays. From discussions with the manager, observations and reviewing the staff rotas, weekend cover was less and in the view of the Commission insufficient. At present the home has three AM, two PM and a staff member working 4 to 7PM and two staff at nights. At the weekend however the home does not employ a staff member 4 to 7pm. The manager was requested to review all staffing to ensure that it was adeqate and able to carry out required tasks and meet the needs of residents. Care Homes for Older People Page 22 of 30 Evidence: Staff are receptive to residents needs and work together as a team. The staff training records indicated planned and undertaken training for many of the staff. Core training in Infection control, Moving and Handling, Basic Life support, fire training, food hygiene, and Adult protection has been provided. However not all staff have recieved the required updates to training and have completed all of the core training. The manager was aware of the shortfall and is requested to provided a training plan to the Commission. The manager is required to evidence that individual and group staff training needs had been identified and that courses are booked. Staff have achieved NVQ qualifications in Care to level 2 or above, thus meeting with the required standards. The manager confirmed that the home has a development programme for all new staff. however it does not currently meet with the Sector Skills Councils workforce training targets. The manager is aware of this shortfall and will contact Skills for Care for full details of the required induction standards. The home showed that it undertakes a recruitment practice including submission of an application form detailing all previous work history, requests proof of identity and copies of qualification certificates, seeks two written references, and confirms work status. Evidence of this was obtained from the recruitment files sampled. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents generally receive good outcomes with regard to the quality of care but can not be fully confident that the home is managed appropriately. The quality assurance systems of the service needs to be improved, including training, the environment and staffing which is in need of review. Residents can feel overall confident that their health and safety is protected. Evidence: The manager is actively involved in the day-to-day management of the home and works with staff and residents. Outcomes for the quality of care are good. However the manager needs to be given the time to manage the home without having to provide significant carer duties as well, if the require improvement are to be made. The required progress relating to the environment, staffing levels, training, and maintenance of documents required by regulation needs to be achieved and the momentum needs to be maintained. Care Homes for Older People Page 24 of 30 Evidence: Quality assurance was discussed and the views and opinions of many of the residents and stakeholders sought. The residents spoken with confirmed a great deal of satisfaction living within the home and felt confident that their views and opinions were valued by both staff and management. A quality assurance / auditing system is required to assess through a cycle of quality assurance with regard to compliance with the national minimum standards. The system currently in place is not sufficently developed to identify shortfalls within the service. The home evidenced that all required safety checks and associated certificates are in place. However we requested that the home reviews its fire risk assessment and its evnvironmental assessment to minimise risks within the home due to the date when they were prepared. Evidence was seen of safety checks carried out within the home. The manager stated that she will ensures that health and safety is reviewed. No requirment has been made at this time. 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 The registered person shall, after consultation with the resident, or a representative, prepare a written plan (the service users plan) as to how the service users needs in respect of their health and welfare are to be met. To ensure that a plan of care is in place that supports residents with their needs. 26/04/2009 2 9 13 The home is required to 26/02/2009 seek advice from a pharmacist and ensure that the recording and administration of medication follows The Royal Pharmaceutical Society guidelines and the Misuse of Drugs Act 1971 and as amended. Care Homes for Older People Page 27 of 30 To ensure that the administration of medication protects residents health and safety. 3 19 23 The registered provider shall 26/07/2009 have a programme of maintenence that ensures that the premises to be used as a care home is of sound construction and kept in a good state of repair externally and internally. To maintain a well maintained homely environment. 4 30 18 The registered persons shall ensure that staff receive training and induction that meet with the Skill for Care Councils current guidance, law and supports residents with their needs To ensure that residents needs are met and that they are protected as far as possible with regard to health and safety. 5 33 24 The registered person shall establish and maintain a system for reviewing at appropriate intervals,and improving,the quality of care provided at the care home. To monitor the standard of care within the home. 26/03/2009 26/07/2009 Care Homes for Older People Page 28 of 30 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 It is recommended that the home uses a controlled drugs book for the recording of controlled drugs. Care Homes for Older People Page 29 of 30 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 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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