Inspection on 26/11/08 for Linksway

This inspection was carried out on 26th November 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Linksway 23/11/07

Linksway 13/06/06

Linksway 22/11/05

Linksway 11/01/05

Linksway 14/07/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Linksway Linksway Nursing Home 17 Douglas Avenue Exmouth Devon EX8 2EY     The quality rating for this care home is:   two star good 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: Teresa Anderson     Date: 0 8 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Linksway 17 Douglas Avenue Linksway Nursing Home Exmouth Devon EX8 2EY 01395273677 Telephone number: Fax number: Email address: Provider web address: amberlinks@btinternet.com Name of registered provider(s): Type of registration: Number of places registered: Alextour Limited care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Notice of Proposal to Grant Registration for staffing/environmental conditions of registration issued 10/7/98 Date of last inspection Brief description of the care home This service was last inspected on 23rd November 2007. Linksway is a detached property with extensive grounds, in a residential area of Exmouth. The home has accommodation for up to 24 people over retirement age, on ground and first floors. The second floor of the building is unoccupied and not used as part of the care home. There is ramp access to the home, and a passenger lift between the two floors. On the first floor, some rooms are accessed via a small flight of steps, which is part-covered with metal ramps for assisted wheelchair use. Eight of the eighteen bedrooms have en suite toilet and wash facilities; the others have a washbasin within the bedroom. Some bedrooms can be used for double occupancy if people wish to share a room. The home has bathing and shower facilities accessible to people with mobility difficulties. There is no dining room specifically, but some people eat their meals in the ground floor lounge at the entrance to the home. A large function room is currently being used in part as Care Homes for Older People Page 4 of 30 Over 65 24 0 Brief description of the care home an office. There is a parking area outside the front entrance. Fees charged by this home are available direct from the home. Fees vary according to individuals needs and the size of the room (including if one person wants sole use of a double room). Services not included in this fee include hairdressing, chiropody, newspapers, magazines and incontinence aids. 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: two star good 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 unannounced inspection was undertaken as part of the normal programme of inspection. The visit to the home was undertaken by one inspector. It began at 10.00am and finished at 4.00pm. We (the commission) visited on a second day as some documents were not available for inspection on the first day (the manager was on study leave). During the inspection we spoke with the majority of people living here, with four members of staff and with one visitor. We also spoke with the manager and with one of the Company Directors. We saw all the communal and service areas of the home and the majority of bedrooms. We looked closely at records relating to three peoples care needs assessment, care planning, medication and care delivery. This is called case Care Homes for Older People Page 6 of 30 tracking and is the method used by the commission to evaluate peoples experience of living in a home. We also looked at records relating to training, recruitment, personal allowances and safety. Prior to the visit to the home the home provided us with information about this service in their Annual Quality Assurance Assessment (AQAA). In addition questionnaires, asking for feedback and comments about the home, were sent to ten people living at the home and five were returned. We sent ten to staff and three were returned and we sent some to health and social care professionals and none were returned. Where feedback was provided, this has been included in this report. What the care home does well: What has improved since the last inspection? What they could do better: Care Homes for Older People Page 8 of 30 During this inspection the following areas were highlighted for improvement. Information about the home is available but accessibility to this could be further improved to make it easier for people to understand and use. Ongoing work to the way that care is planned will help to ensure this is more person centred. Some people might need assessments relating to the chairs they use to ensure that these help them to remain independent and mobile. In addition some paper work relating to permissions for people living here need reviewing in line with the Mental Capacity Act. The way that some peoples social needs are met could also be improved. Improvements are needed to the way that medicines are managed to ensure this is completely safe. Volunteers employed by one family must undergo police checks to help ensure all the people living here are safe. The function room is being used as an office and consideration should be given to the amount of communal space available for people living here to use. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The information provided to people who consider coming to live here helps them to make a choice about where they live. People have their needs assessed so can be sure that the home can meet those needs. Evidence: In surveys four of the five people surveyed say they had enough information about this service before they came to live here. We spoke with some people who live here and they told us that their relatives had come to look around the home before they decided to live here and that this provided them with enough information. We looked at the information that the manager told us is given to people. This includes a contract which details the fee to be paid, terms and conditions of occupancy, a guide to the home and a booklet which includes the Statement of Purpose and policies and procedures. We spoke with the manager about these documents. She feels that the information available to people could be more accessible and has plans to further Care Homes for Older People Page 11 of 30 Evidence: develop this. We looked in care plans and found that people are assessed prior to coming to live here by a Registered Nurse. This helps to ensure that the home can meet each persons needs. Assessments are written in enough detail to ensure this decision can be made. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living here are treated with respect. Improvements to the way that care is planned and reviewed are ongoing and are having a positive effect on the care that people receive. The way that medicines are managed need further improvements to ensure that this is done as safely as it can be. Evidence: In surveys people say they always or usually get the care they need and that they always or usually get the medical care they need. We looked at three care plans. These show that doctors are asked to see people if they are unwell or if staff are concerned. Records also show that people are supported to see other healthcare professionals such as Speech and Language therapists, chiropodists, dentists and specialist nurses, which helps people to remain well. Care plans show that nurses working here carry out assessments of peoples needs and write a plan of care as to how these needs are to be met. We spoke with staff about Care Homes for Older People Page 13 of 30 Evidence: these care plans and their knowledge of them. They told us that the care planning format has recently changed and that they are still becoming familiar with this. Staff spoken with say they believe that care plans are becoming more detailed and that this will result in improved individual care. We spoke with the manager about care planning. She demonstrates an excellent understanding of indivualised and person centred care planning. She also talked of the work that is ongoing to make this a reality in this home. We saw that care plans include the persons preferred daily routine. This includes for example what time each person likes to get up, go to bed, what drinks they like, at what time, if they like the radio or TV on and what type of programmes they like. We saw in care plans that peoples risk of developing pressure sores, of becoming dehdrated and of becoming malnourished are assessed. Where risks are identified plans are put into place to address these risks. Some plans had been reviewed and actions changed if needed or continued if working. For example one person has been identified as being at risk of malnutrition. The plan of care tells staff to encourage this persons favourite foods and to ensure they have high protein and energy snacks. When weighed, this persons weight remained static. The GP was contacted and supplement drinks have been prescribed. One care plan informed staff that this person is at risk of choking. It gives staff clear instructions about how the risk might be minimised. However, it does not give staff clear instructions about what to do if this person does choke. We spoke with staff about this and were told that this has not been discussed with them and that a plan of action has not been devised. The manager said she would address this. We talked with staff about how they help people to move around the home. They showed us that each person undergoes a moving and handling assessment and that instructions are written down as to how they should do this. They say that if the instructions do not suit or a persons needs change, they tell a nurse who will carry out another assessment and change the actions needed. We saw staff using moving and handling techniques. We saw good techniques being used. However, we saw that one person whose needs change depending on their abilities on that day, sits in a chair that is very low. This means that staff have to stretch and potentially put themselves at risk when they help this person to stand or sit. Staff told us that a number of beds with adjustable height had recently been purchased and that this helps them to handle people safely. They say that there is enough moving and handling equipment in the home for their use. People we spoke with say that staff are gentle when they help them to move and that they feel safe in Care Homes for Older People Page 14 of 30 Evidence: staffs hands. One person of the fifteen people living here has a pressure sore. They were admitted to the home with this. This person has a plan of care as to how this should be managed and how often it should be reassessed. The Tissue Viability nurse has been contacted for advice and this person is cared for on appropriate pressure relieving equipment. In addition, this person says that although they are reluctant to take pain relieving medicines that the nurses offer this frequently. We looked at how medicines are managed generally. We saw in the information provided to people that they would be supported to manage their own medicines if they wish. Records show that this is agreed on a risk assessment basis. However, when we talked with one person who manages their own medicines, we found they did not have a locked space in which they could store their medicines. We found that there is ample storage space which is lockable for other medicines kept in the home, including a lockable fridge. We looked at records relating to medicines and we checked that two of these records were correct. We found that one person has more tablets than records show that they should have. Because records are incomplete we could not be sure how this has come about. We talked to the manager and she informed us that records of medicines carried over from month to month are not always kept and that she has not yet introduced the planned monthly audit system. We also found that one hand transcribed medicine had not been checked or signed by a second person as it should be. Medicines which are to be kept as controlled drugs are kept safely and securely. We observed staff interacting with people living here and saw them being courteous and respectful. Staff told us they know how people prefer to be addressed (and this is recorded) and we heard them using preferred names. For example some people prefer to be called by a name which is not their given or first name and others prefer to be addressed using their title. We talked to staff about how they help people to maintain their dignity and they told us they make sure people receive personal care in private, that they are discreet when discretion is needed and that each person is an individual who is different and that this should be respected. We saw examples of this during our visit to the home. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The provision of activities and ways of engaging the people who live here could be improved to further enhance the quality of peoples lives. People living here enjoy a varied and nutritious diet and are helped to make choices. Evidence: Care plans contain a lot of information about peoples life history and about their specific interests. Surveys returned to us told us that 2 of the 5 respondents feel that there are always activities arranged that they can take part in, and 3 felt that there were sometimes activities arranged that suited them. The information given to us by the home prior to our visit, told us that people living here have varied needs. We asked what activities are arranged to meet those needs and were told that there is a weekly quiz or bingo and there is music occasionally. One person told us they had never played bingo and did not want to start now. Another said that the people who attend the quiz have different mental abilities which means that people who are mentally fit have to put their needs and pleasures aside to accommodate the less able. Another person told us that there is a religious service and communion held monthly and that the minister visits individuals. Care Homes for Older People Page 16 of 30 Evidence: Care plans and discussions with staff demonstrate that special provisions are not made to meet the social needs of those people who have dementia or who are nursed in bed. However, we saw staff being very social and caring when providing care to these people. In addition peoples visitors are encouraged to visit and to be with their relatives/friends. One visitor told us that they can come and go as they like, at any time. They say they are offered refreshments and always made to feel welcome. Care plans also show that people who are less able to communicate their needs are enabled to make choices. Staff record what time for example people like to get up and go to bed and where they prefer to eat. We talked to staff about this and they say that they have this information and use it to help ensure that people live the life they like. In surveys people told us that they enjoy the meals served at Linksway. We were shown a menu by one person which offered choices of meals. This person also told us that if they do not like something they can ask for something else and always get it. They also told us that special requests are never a problem. Records show that the cook caters for special needs including those who need a diabetic or pureed diet and that the cook has recently attending training relating to preparing food for people with swallowing difficulties. Each day freshly baked cakes are offered at tea time which people describe as lovely and a real treat. 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. People living here are listened to and are safe. Evidence: In surveys people told us that they know how to make a complaint and who to speak with if they are not happy. One person told us they had no need to make a complaint and another that if they wanted anything they only had to speak with the manager. The home has received some minor complaints since the last inspection and all have been dealt with in the timescale set. People living here told us that they feel safe and well cared for. Those whom we could not talk with appeared to be relaxed in the company of staff and other people. One visitor told us that staff are always kind and caring. We saw in training records that staff have had training in relation to safeguarding people from abuse. We spoke with some staff about what abuse is and they have a good knowledge of the types of abuse. They also demonstrate that they know what to do if they suspect or observe any form of abuse. When we looked in care plans we saw some documents relating to invasive procedures, resuscitation and permissions which do not follow the guidance set out in Care Homes for Older People Page 18 of 30 Evidence: the Mental Capacity Act. The manager told us she was aware of this and planned to take action to remove them. Care Homes for Older People Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe and homely environment. Evidence: In surveys people told us that the home is always clean. We found the home to be clean, homely and relaxed. Records and the information provided by the home show that maintenance is ongoing. The manager reports there is at least one cleaner on duty each day, together with a handy man. We looked at some bedrooms and found they had all been personalised for use by the person occupying that room. Each bedroom has a Do not disturb sign so that people can have privacy when they wish. We looked in bathrooms and toilets and found them to be clean. We saw that there is equipment to help those people who are less mobile to have a bath. We saw records showing that baths have a thermostatic valve fitted to prevent scalding water being delivered and that the temperature of the water is checked weekly. This should be done at each use as thermostatic valves can fail. There are gloves, paper towels and liquid soap around the home, to promote good basic hygiene and we saw staff using these. The laundry is well equipped and appears Care Homes for Older People Page 20 of 30 Evidence: to be well organised. We looked in the lounge and saw that it is furnished with domestic furniture of good quality. The majority of the chairs in here are suitable for people with mobility problems. However, we noticed other chairs around the home which are lower and might not fully promote independence (see health and personal care). We also noticed that one communal room is being used as an office. The manager and one of the directors report that this room is still available for people to use if they wish. However, approximately a quarter of this room is dedicated office space and during this inspection it was offered to the commission and to a nurse from the Primary Care Trust for their use. People living here say they tend not to use this room. We talked to staff about equipment which helps them to move people with mobility problems around the home. They told us that they have enough. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from being cared for by a staff group who are experienced and caring. Improvements to the recruitment procedures have helped to ensure that people are kept safe from inappropriate staff. Evidence: We looked at the duty rota which shows that there is always one registered nurse on duty during the day and night. In the morning and afternoon there are 3 carers on duty and at night one carer. The manager works office hours and is supernumarey to those figures. In addition there are usually two cleaners on duty during the day, together with a cook, a kitchen assistant and a handyman. On the day of this inspection there were 15 people living here (the home can accomodate up to 24 people). We looked at what training staff have received and saw that training is ongoing and includes induction training, safeguarding, fire training and moving and handling. In surveys staff told us that the new manager has introduced more training which is relevant to their job and up to date. Many of the staff commented that they are studying for National Vocational Qualifications (NVQ) in care and the manager reports that over half of the care staff now hold this qualification. Staff say they feel well supported by the manager, both in their studies and in their work. Care Homes for Older People Page 22 of 30 Evidence: The manager reports that all new staff have a one day induction to the home and then undertake induction training which is based on that recommended by Skills for Care. We looked at the recruitment records of three members of staff. These are well organised. All staff had undergone robust checks prior to starting work. This includes proof of identity, two written references and an enhanced police check. One relative of a person living at the home uses volunteers. As yet these people have not undergone a police check as they should do. People living here say the staff are very caring and always pleasant and willing to help. Care Homes for Older People Page 23 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements, and planned improvements, in the overall managment of this service are improving the outcomes for people living at this home. Evidence: Since the last inspection a new manager has been appointed who has now registered with the commission. Sally Moyse has many years experience of working with older people and in management. Ms Moyse says that she normally works approximately 36 hours at this home and also works approximately six hours overseeing other homes owned by this company. In surveys and conversations staff say that the manager is approachable and has recognised staffs training needs. They say she is bringing the home up to date and that she is a good manager. People living here say she works behind the scenes and is doing a good job. Care Homes for Older People Page 24 of 30 Evidence: Staff told us that they had received refresher training in areas such as moving and handling and infection control. They say they feel this training is up to date and has helped them to do their job. The manager reports that the focus of her work thus far has been to build a team by addressing staff recruitment and retention issues, staff training and the staff compliment. Staff say this is having a real effect for them and the people living here who benefit from continuity of care. Prior to this inspection the management team provided the commission with information about the service when it was requested. Staff meetings are held, as are residents meetings. The manager reports that the latter are not well attended and has instead set up more social occasions, such as coffee mornings with scones, to bring people together. She sees this as an area to be further developed. We looked at how the safety of people living here is managed. We saw that regular fire checks, drills and training take place. The kitchen is clean and well organised. We noticed that whilst the cook is dishing up on one table that staff are bringing used trays back to the same table, which is not best practice. All foods are stored safely and the temperatures of the fridges and freezers are checked to ensure that food is kept at the correct temperature. We looked at how peoples personal allowances are managed and found that monies are stored safely and that records of monies kept are checked by two people, as is good practice, are up to date and are accurate. 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 9 13 All records in relation to 13/02/2009 medication should be kept up to date and be accurate. All hand transcribed entries relating to medicine must be checked and signed by a second person. People who look after their own (or some of their own) medicines must have a space in which to lock these. This will help to ensure that people get the right medicines, that all medicines are stored securely and that there is clear audit system in place so that medicine stocks can be checked and all medicines accounted for. 2 12 16 People living here should be consulted about the programme of activities arranged and these should match their expectations, abilities and preferences. 27/03/2009 Care Homes for Older People Page 27 of 30 This will help to further improve the quality of peoples lives. 3 20 23 (2) (e) It should be ensured that adequate communal space is available for people living here. This will help to ensure that people have the space they need to carry out a range of activities. 4 29 19 (1) (2) Criminal Record Bureau checks must be carried out on all staff working in the home. This includes volunteers employed by a person other than the registered person. This will help to ensure that only suitable staff have access to vulnerable people. 27/03/2009 13/02/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 Information about the home is available within a number of different booklets/papers. You should consider making this more accessible for people. The development of person centred care planning should continue to ensure that people always get the care the need in a way that suits them. An assessment should be carried out to ensure that the equipment people use (such as chairs) matches their mobility and moving and handling needs and ensures that they remain as independent as possible. You should ensure that forms relating to one person giving permission for another person relating to medical interventions are reviewed, in line with the guidance 2 7 3 8 4 18 Care Homes for Older People Page 28 of 30 relating to the Mental Capacity Act. 5 25 Each time a person is bathed the temperature of the bathing water should be checked to prevent the risk of accidental scalding. Consideration should be given to having another metal table in the kitchen so that food being served does not get mixed with food and trays being returned from peoples rooms. 6 38 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!