Key inspection report
Care homes for older people
Name: Address: Langdale Residential Home 6 Church Street Sapcote Leicestershire LE9 4FG The quality rating for this care home is:
zero star poor service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Debbie Williams
Date: 1 5 0 4 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 30 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 30 Information about the care home
Name of care home: Address: Langdale Residential Home 6 Church Street Sapcote Leicestershire LE9 4FG 01455274544 F/P01455274544 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Miss Neemat Kassam,Mrs Yasmin Nazir Kassam care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: No person in category PD(E) to be admitted to the home when there are 7 persons of that category already accommodated within the home. No person to be admitted to the home in categories MD(E) or DE(E) when 5 persons in total of these categories/combined categories are already accommodated in the home. Date of last inspection Brief description of the care home Langdale Residential Home offers accommodation for 27 Older Persons, and is situated close to the centre of Sapcote, which offers local shops including a Post Office and local supermarket. Views from part of the home overlook the local Church and countryside. Langdale Residential Home offers two lounges and one dining area to the ground floor, Care Homes for Older People
Page 4 of 30 Over 65 5 5 27 7 0 0 0 0 Brief description of the care home with bedrooms being sited on the ground and first floor. Access to the first floor is via stairs, which has a chair lift and a passenger lift. The majority of bedrooms have ensuite facilities, which consist of a wash hand basin and toilet. Bathroom and showering facilities are located on both floors. An extension has nearly been complete so as to increase numbers by two residents, with a change of lounge set up, to make the lounge by the office much bigger. A copy of the last inspection report was available at the home. Care Homes for Older People Page 5 of 30 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: zero star poor service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection included a visit to the service. We visited the home on the 15th of April 2009. The main method of inspection was called case tracking which meant selecting three residents and tracking the quality of their care by checking records, discussion with them and with staff and observation of care practices. We checked all the standards which the Commission for Social Care Inspection have decided are key standards during this inspection. In some sections we have also checked additional standards, these will be detailed in the main report. At the time of this inspection the service was being monitored by social services following some concerns raised about the quality of care provided at Langdale House. The concerns were regarding management arrangements, staff training, moving and Care Homes for Older People
Page 6 of 30 handling and safeguarding policies and procedures. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: Langdale House is registered to accommodate people with dementia. Staff did not have the training they required to meet the specialist needs of people who have dementia. Staff must be trained to care for people with dementia, how to manage challenging behaviour effectively and how to provide meaningful activities for people with dementia. Because of the communication difficulties that can be experienced by people with dementia their vulnerability can be increased and therefore it is imperative that staff have a thorough understanding of safeguarding procedures and the protection of vulnerable adults. It was evident during this inspection that national and local safeguarding adults policies and procedures were not always followed and this put people living at Langdale House at risk. Assessment procedures and records did not meet the criteria required for the assessment of people moving into the home. Staff require a complete picture of individual needs and of potential risks. Care records and care plans did not address all individual needs and gave conflicting instructions to staff about the actions they should take. One person we case tracked did not have access to the health screening they required and we could find no evidence of any monitoring of their chronic condition. Some medication management records we looked at were not accurately maintained Care Homes for Older People
Page 8 of 30 and national guidance on the administration of medicines in care homes was not followed. The temperature for the medicines fridge was not being monitored accurately, this is required to ensure medicines are stored safely and in accordance with manufacturers guidelines. We found that the teatime and night medicine rounds were less than four hours apart and that some medicines prescribed when needed could possibly be given too close together. The management of medication should conform with best practice national guide lies in order to protect people from harm. We had some concern about whether routines of daily living were flexible in order to meet peoples individual needs and preferences and whether people were enabled to exercise choice and autonomy. Opportunities for stimulation through recreational and social activities was limited for some people. People must be given the opportunity to participate in activities that are meaningful to them and meet their individual needs. Specialist equipment used for moving and handling people with mobility difficulties must be fit for purpose, maintained and in good working order, this is to ensure that the risk for people using this equipment is minimized. Staff training in this area must be reviewed to ensure they have a thorough understanding of peoples individual needs. Langdale House has been without a registered manager for some time. A suitable person, qualified, competent and experienced to run the home in the best interests of people living there must be appointed. Staff require a clear sense of leadership and direction in order to meet the needs of people living at the home and protect them form harm. Recruitment procedures must be robust and ensure that all staff employed at the home are suitable to work with vulnerable adults in order to protect people from harm. 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 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Langdale House do not have their needs thoroughly assessed or met. Evidence: At the time of this inspection the providers had decided not to admit any new people to the home while they were working towards improvement and therefore assessment of the admission and assessment process was limited. Assessment records were in place for the people we case tracked and these included risk assessment. In some instances care records contained conflicting information and were not very user friendly and potentially confusing for staff. Staff did not have the relevant skills or experience to carry out risk assessments. The service is registered to accommodate people with dementia and mental health needs. Staff did not have the skills to meet the specialist needs of people with dementia and the care provided in this area was not based on current good practice guidance.Written information about understanding people with dementia was included
Care Homes for Older People Page 11 of 30 Evidence: within peoples care records. 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Langdale house did not always have their health and personal care needs met and were put at risk by poor medication management and care planning. Evidence: We case tracked three people living in the home and looked at their care records and care plans. Care records and care plans gave conflicting advice regarding the actions staff should take to meet peoples needs. Care records were not signed or dated and in some instances identified a need but did not give staff the instruction they required to meet this persons needs. Since the last inspection the providers had changed the care planning documentation. While some improvements had been made, it was evident that care records did not provide the information staff required or were not user friendly for staff. Care practice was observed during this inspection which did not follow the instructions given within the care plan or the risk assessment for the need identified and this put the health,welfare and safety of people living at the home at risk. Care Homes for Older People Page 13 of 30 Evidence: Evidence was seen within care records of people having access to health care services such as GPs, community nurses and opticians. Community nurses were responsible for the assessment and treatment of pressure sores and the provision of equipment to prevent or treat pressure sores. One person we case tracked had not had access to health screening for a particular medical condition. The providers told us that this was because it was not possible to arrange for screening to take place at the home, a requirement was made that further advice should be sought regarding this from a relevant health care professional. Interactions observed between staff and residents during this inspection were positive. Staff were observed treating people in a respectful and kind manner throughout the day. We found that the health care needs of one person were not being met as there were no arrangements for blood tests to be carried out and the care plan did not describe how staff should meet this persons needs. We watched people being given their medicines at lunchtime and saw that national guidance on the administration of medicines in care homes was not followed. We noted that administration records were complete for the current month. However, we saw that a medicine for one person was signed as given for four days but the record on the medication chart was crossed out and entered in error was written and signed. We found two discrepancies between the quantity of medicine in stock and the records of medicines entering and leaving the home. We also found that the record of the disposal of medicines was incomplete so some medicines could not be accounted for. We saw that staff sometimes needed to write details of prescribed medicines on the medicine chart. There was no signature on the chart to indicate that the details were checked by a second staff member. We found that the teatime and night medicine rounds were less than four hours apart and that some medicines prescribed when needed could possibly be given too close together. We saw that the home has a separate refrigerator for storing medicines.We found that the fridge temperature is not adequately monitored. We noted that the reference book on medicines was out of date. We found that four members of staff had been trained to give a particular injection and two staff were in the process of being trained. The cupboard used to store controlled drugs complied with legal requirements. Care Homes for Older People Page 14 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Langdale House are not always helped to exercise choice or given opportunities for stimulation through recreational and social activities that meet their needs individual needs or preferences. Evidence: Staff were observed giving out a hot drink and biscuits to people sitting in the lounge during the morning. People were not offered a plate or side table to assist them or promote their independence and rather than offer people a choice of biscuit staff selected biscuits and put them in to peoples hands. This did not promote choice or dignity for people living in the home. Care plans were in place for peoples social, cultural and religious beliefs. Information was available for staff regarding peoples preferences regarding social and cultural needs and evidence was seen within care records of these needs being met. It was difficult to assess whether routines of daily living were made flexible to meet peoples needs, there was a large proportion of people being helped to get up, washed and dressed by the night staff, staff spoken with were unsure whether people living in the home were always given choice in this area. A requirement was made regarding
Care Homes for Older People Page 15 of 30 Evidence: this. Opportunities for stimulation through leisure and social activities was limited and staff did not have the skills or experience to meet the specialist needs required to meet the needs of people with dementia in this area. A game of bingo was played in the lounge during the afternoon of this inspection, while this was enjoyed by some people living at the home, others were unable to participate. Two people did not seem to participate in any meaningful activity throughout the day and staff interaction with them was very limited. There were no restrictions on visiting and people could receive their visitors in private. The lunch time meal was observed and the meal appeared to be appetizing and nutritious. Staff spoken with said they had access to the kitchen at all times in order to make drinks or snacks for residents. A choice of meal was offered at every mealtime. Staff were seen assisting residents with their meals in a sensitive manner. Care Homes for Older People Page 16 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Langdale House are not protected from harm. Evidence: The provider has a complaints procedure which was available at the home. Due to communication difficulties experienced by many of the people living at Langdale House, it would be difficult for people to communicate their complaints or concerns. Evidence was seen within care records of an incident that should have been reported immediately to social services as part of safeguarding adults policies and procedures, staff did not follow safeguarding procedures or report this incident. Two staff members spoken with were aware of the correct procedures to follow in line with national and local safeguarding adults policies and procedures. One staff member spoken was not. Staff spoken with had been given leaflets regarding safeguarding adults or had previously attended training in this area but had not had any recent training from the providers at Langdale House. Staff spoken with had not received training in caring for people with dementia or challenging behaviour, this is despite having to deal with incidents of physical and verbal aggression on a day to day basis. We looked at staff records and recruitment procedures. One staff member had been
Care Homes for Older People Page 17 of 30 Evidence: employed for two months had only just been checked with the Criminal Records Bureau and Protection of Vulnerable Adults list, these checks should be done before staff commence employment in order to ensure that people living at the home are cared for by staff who are suitable to work with vulnerable adults. The providers hold a bank account for peoples personal money where this is required. Items and services such as hairdressing are paid for by the provider and an invoice is then raised for this amount. Records for this are stored on computer. It is recommended that a monthly audit is carried out of all transactions and that evidence is available for inspection which demonstrates a clear audit trail of these transactions. Care Homes for Older People Page 18 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. A homely and comfortable environment was provided. Not all specialist equipment was fit for use or properly risk assessed. Evidence: We undertook a partial tour of the premises, all areas of the home seen were clean and appeared comfortable and homely. Peoples private rooms were personalized with their own possessions. We looked at records for maintenance and fire safety checks and saw that these were being carried out on a regular basis. The service has three hoists for use for people with mobility problems. One of the hoists was found to be broken but was still being used, we asked the provider to stop using this hoist. Staff had received training in infection control and this minimized the risk of cross infection for people living at Langdale House. Care Homes for Older People Page 19 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff require further training in order to meet the needs of people living at Langdale House. Recruitment procedures did not protect people living at Langdale House. Evidence: Staffing levels were sufficient to meet the needs of people living at Langdale House, however consideration should be given to the deployment of staff in order to ensure that routines of daily living are made flexible to meet peoples individual needs and preferences. Staff had received all mandatory health and safety training and a programme of National Vocational Training in care was in place. Staff had not received any recent training in dementia care, safeguarding adults or challenging behaviour, a requirment was made regarding this. One recently employed staff member was spoken with, they confirmed that induction training was provided, this person also said they were unable to take part in any moving and handling procedures as they had not yet received the training. We looked at staff records and recruitment procedures. One staff member had been employed for two months had only just been checked with the Criminal Records Bureau and Protection of Vulnerable Adults list, these checks should be done before
Care Homes for Older People Page 20 of 30 Evidence: staff commence employment in order to ensure that people living at the home are cared for by staff who are suitable to work with vulnerable adults. Care Homes for Older People Page 21 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. At the time of this inspection, Langdale House was not being run in the best interests of people living there. Evidence: There had not been a registered manager at this service for some time. At the time of this inspection the registered provider was taking responsibility for management at the home. Staff spoken with said that management at the home had recently improved and they felt well supported. A programme of quality assurance and audit was in place but considering the amount of shortfalls identified at this inspection, the system in place must have its effectiveness reviewed. Staff had received moving and handling training. It was unclear whether staff were qualified to carry out risk assessments for moving and handling. We found that staff were using a broken hoist and that care records gave conflicting advice about how
Care Homes for Older People Page 22 of 30 Evidence: people should be moved safely. For one person care records stated they could stand with the help of two staff yet staff were seen using a stand aid to help this person transfer. There was no record of any risk assessment for using this stand aid. Moving and handling practices did not promote safety for people living at Langdale House. We looked at records for maintenance and fire safety checks and saw that these were being carried out on a regular basis. The providers hold a bank account for peoples personal money where this is required. Items and services such as hairdressing are paid for by the provider and an invoice is then raised for this amount. Records for this are stored on computer. It is recommended that a monthly audit is carried out of all transactions and that evidence is available for inspection which demonstrates a clear audit trail of these transactions. Care Homes for Older People Page 23 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 24 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 3 14 People moving into the 29/05/2009 home must have their needs assessed and this assessment must be kept under review and revised at any time that this is necessary This is to ensure that people living at Langdale House have their needs met. 2 4 18 Staff must individually and collectively have the skills and experience to meet the specialist needs of people living at the home. This is to ensure that people with dementia or mental health have their specialist needs met. 26/06/2009 3 7 14 People living at Langdale House must have a plan of care based on a comprehensive needs assessment. The care plan must set out in detail the 30/05/2009 Care Homes for Older People Page 25 of 30 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 action which needs to be taken by staff to meet all aspects of health, personal and social care needs. This will ensure that people living at Langdale House have their needs met. 4 8 12 People living at Langdale House must have access to all required health care services. This is to ensure people have access to the health care services they require and receive the treatment they need. 5 9 13 Accurate records of the receipt, administration and disposal of medicines must be kept. This is necassary in order to demonstrate that medicines are administered as prescribed. 6 12 12 People must be given the opportunity for stimulation through recreational and social activities. Staff must receive the training they require to provide meaningful activity for people with dementia. 05/06/2009 29/05/2009 29/05/2009 Care Homes for Older People Page 26 of 30 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 This is to ensure people living at Langdale House have a fulfilled lifestyle. 7 12 12 People living at langdale House must be given opportunities to excersise choice. This is to ensure that choice and autonmy are promoted. 8 12 12 Routines of daily living must be made flexible in order to meet individual needs and preferences. This is to ensure that are able to make decisions about the care they receive. 9 18 13 National and local 29/05/2009 safeguarding policies and procedures must be adhered to and staff must receive training in this area. This is to protect people living at Langdale House from harm. 10 18 13 Staff must receive training in caring for people with dementia and safe management of challenging behaviour. This is to ensure that people living at Langdale House are protected form harm. 29/05/2009 22/05/2009 15/05/2009 Care Homes for Older People Page 27 of 30 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 11 22 13 Specialist equipment must be fit for use and properly risk assessed. This is to promote safety for people living at Langdale House 22/05/2009 12 31 8 A manager must be appointed to manage the home effectively. Langdale House must be managed in the best interests of people living there. 26/06/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 9 Handwritten entries on medication records should be signed by two members of staff who are qualified to administer medicines The times that medicines are administered in the afternoon and evening should be reviewed to ensure that there is a safe interval between doses of a medicine. All staff should follow the homes procedure for administering medicines. The homes procedure should not conflict with national guidance. The temperature of the medicine refrigerator should be monitored daily with a maximum/minimum thermometer It is recommended that a monthly audit is carried out of all transactions and that evidence is available for inspection which demonstrates a clear audit trail of these transactions. Consideration should be given to the deployment of staff and this is to ensure that routines of daily living are made
Page 28 of 30 2 9 3 9 4 5 9 18 6 27 Care Homes for Older People 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 flexible and meet peoples individual needs and preferences. Care Homes for Older People Page 29 of 30 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 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
