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Inspection on 07/10/08 for Little Hayes Care Home

Also see our care home review for Little Hayes Care Home for more information

This inspection was carried out on 7th October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 11 statutory requirements (actions the home must comply with) as a result of this inspection.

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

What the care home does well

The people who live in this home tell us that it is comfortable and clean, staff are very kind and they enjoy the activities that are arranged for them, although these are very limited. Several of them said, "its nice living here", and they all agreed the that food that is served is always very good. The "Expert by Experience" spoke to several residents who told her that they could choose how they spent their days, the time that they got up and the time that they went to bed. They showed her their rooms that they had been able to personalize with items that they had brought from home. Some of the residents are very frail and others have dementia so they are not all able to offer any input into the inspection process however, they seem to be happy and they look well cared for. The relatives of one resident, also told us how kind staff were and that care was always consistent whatever time of day they visited. Staff turnover within the home is quite low and residents benefit from a continuity of care that is familiar to them. We saw that pre- admission assessments are always undertaken prior to any resident being admitted into the home, to ensure that their needs could be met. They would be given copies of the homes Statement of Purpose, The Service User Guide and the latest inspection report in an A5 booklet format to take away to read. This will help them and their relatives decide whether the home and the services provided will suit them. Individual care plans are then drawn up which outline all of the care and support that residents will need. These ensure that all staff know exactly how people prefer to be supported and a regular review makes sure that any changing needs are identified.

What has improved since the last inspection?

Since the last inspection the ongoing redecoration programme has continued.Alterations have been made to the home to resite the kitchen and reorganize the communal space for residents. This has given them more choice about where they sit and has created a small quiet area for them where they could entertain their visitors.

What the care home could do better:

Since the last inspection the Registered Manager has left the home and there have been two temporary appointments and then a period of time with no designated manager. Another person has just been appointed to this role. Many of the issues that concerned us at this visit we considered were directly attributable to the lack of a stable management structure. There has been no staff training or supervision, including what we consider to be mandatory sessions such as moving and handling, fire safety, health and safety and adult protection. We saw errors in medication administration and were concerned about wound care practices in the home. Lately there have been limited opportunities for residents and their relatives to contribute their views and influence the running of the home.We raised concerns about the temperature of the hot water in bathrooms and the shower room and issued an immediate requirement to ensure that this was regulated to an acceptable temperature to avoid the risk of residents being scalded. We are not always notified of incidents that have happened in the home which affect the wellbeing of residents so we are not always able to monitor their safety. Also people have told us that their complaints are not always responded to according to the homes own procedures. We raised some concerns about staffing levels in the home especially at night time and have recommended that the Registered Providers consider reviewing these.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Little Hayes Care Home 29 Hayes Lane Kenley Surrey CR8 5LF     The quality rating for this care home is:   zero star poor 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: Alison Ford     Date: 0 7 1 0 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 © (2008) 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: Little Hayes Care Home 29 Hayes Lane Kenley Surrey CR8 5LF 02086606626 02086682449 littlehayes@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Julia Barbara Christodoulides Type of registration: Number of places registered: Diplotec Ltd care home 50 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Daytime staffing levels would have to be:- 4 Qualified nurses and 8 care assistants between 8:00am and 2:00pm. 3 Qualified nurses and 7 care assistants between 2:00pm and 8:00pm. Nighttime staffing levels would have to be: - 2 Qualified Nurses and 3 Care assistants between the hours of 8:00pm and 8:00am. Date of last inspection Brief description of the care home Little Hayes is a 50-bed home, which offers nursing care to the elderly. The home is situated in Kenley, an attractive semi-rural area that is in close proximity to a mainline rail station and good road and bus links. The only potential difficulty with access is that the visitors on foot would have to climb a short, but steep hill to the home. The home offers 36 single bedrooms and 7 double bedrooms over two floors, some with en-suite facilities. There are two passenger lifts for ease of access although the home is very Care Homes for Older People Page 4 of 30 Over 65 10 40 0 0 Brief description of the care home spread out in its layout and it is quite disorientating at first. There are various communal areas available for all of the residents and a garden. The stated aim of the home is to provide its residents with a secure, relaxed and homely environment in which their care, well being and comfort is of prime importance. Copies of the Statement of Purpose for the home and the latest inspection report can be requested from the home. Inspection reports can also be obtained from The Commission for Social Care Inspection via the internet. At the time of this latest inspection fees ranged from £390 - £680 depending on the room occupied and the dependency of the resident. These and any extra charges payable would be discussed prior to admission. 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: The last inspection on this service was completed on 15/01/08. This report follows an unannounced visit to the home which we undertook as a part of the inspection process.Two inspectors spent a total of six hours in the home. During this time we walked around the home and spoke with several of the 38 residents living there and also some of the staff members on duty. We were accompanied on the visit by an Expert by Experience. This is someone who has had experience of using social care services in some way.Our Expert has visited nursing homes with inspectors in the past although not those caring for people with dementia. She was able to spend time chatting with residents to try and find out what Care Homes for Older People Page 6 of 30 they thought about the home and she also sat with them at lunch time. We looked at some of the residents care plans care plans and various records, that the home is required to keep as evidence of its commitment to the health and safety and well being of the people who use the service were also seen. In compiling this report consideration has also been given to other information made available to The Commission throughout the inspection year, which includes complaints and notification of incidents. In addition we have received an Annual Quality Assurance Assessment from the home. This document has to be completed every year and is designed to give those people who own and manage care homes the opportunity to tell us how they support those who use their service, how well they meet the aims and objectives of the home and of their plans for the future. What the care home does well: What has improved since the last inspection? What they could do better: Since the last inspection the Registered Manager has left the home and there have been two temporary appointments and then a period of time with no designated manager. Another person has just been appointed to this role. Many of the issues that concerned us at this visit we considered were directly attributable to the lack of a stable management structure. There has been no staff training or supervision, including what we consider to be mandatory sessions such as moving and handling, fire safety, health and safety and adult protection. We saw errors in medication administration and were concerned about wound care practices in the home. Lately there have been limited opportunities for residents and their relatives to contribute their views and influence the running of the home. Care Homes for Older People Page 8 of 30 We raised concerns about the temperature of the hot water in bathrooms and the shower room and issued an immediate requirement to ensure that this was regulated to an acceptable temperature to avoid the risk of residents being scalded. We are not always notified of incidents that have happened in the home which affect the wellbeing of residents so we are not always able to monitor their safety. Also people have told us that their complaints are not always responded to according to the homes own procedures. We raised some concerns about staffing levels in the home especially at night time and have recommended that the Registered Providers consider reviewing these. 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. Anyone considering moving into this service would have their needs assessed to make sure that it was a suitable place for them to live in and they would be happy there. Their families would be encouraged to be involved in the admission process and they could visit the home first if they were able to. Evidence: Prior to their admission, anyone considering moving into this home would have an assessment undertaken by a senior member of staff. This is so that the home can be sure that it will meet the persons needs and that they are able to provide the support that they will require. For those people who are funded by the local authority there is also a Care Managers assessment which provides the home with information about the persons needs and limitations and outlining the support that will be needed. We were able to see all of this information in the care plans that we looked at. Care Homes for Older People Page 11 of 30 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. People have an individual care plan which reflects the care and support that they need and they are always treated with dignity and respect. However, they cannot be sure that they are always protected by the homes medication procedures. Evidence: Four care plans were seen. They were in good order and contained up to date information so that staff are able to see how they should support the people that they are caring for. They are reviewed regularly so that any changes are identified and addressed. Some concerns were raised about wound care practices. It was considered that the guidance regarding frequency of dressings was inadequate which could put some people at risk of developing other complications. It also highlighted a need for further teaching in this area. The previous deputy matron had undertaken the role of link tissue viability nurse and it is recommended that consideration should be given to Care Homes for Older People Page 13 of 30 Evidence: appointing someone else to do this now. Medication storage and records were assessed and it was judged that the system is inadequate and has the potential to put residents at risk. There were instances where medication had not been signed for or it had been omitted with no reason given. Some medication had been prescribed to be given as directed and no directions were available. Some medication was out of date. Registered Nurses administer medication in this home and their Code of Professional Conduct makes them accountable for making sure that they do this correctly and that residents are not put at any risk from not being given their medication as it has been prescribed. These issues will need to be addressed without delay and medication management should be audited on a regular basis to ensure that errors are noted and rectified as soon as possible. The people that we spoke with said that staff were kind and caring. They treated them with respect and kindness and nothing was ever too much trouble for them. One said that staff were angels. The staff that we met during our visit were welcoming and helpful , they were happy to talk with us and receptive toward the inspection process. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. They consider that life in the home suits them, they are able to make choices in their daily lives and generally they enjoy the food that is served to them. There is only a limited range of activities organized and this should be expanded upon to provide residents with more stimulation. Evidence: Generally, people living in the home seem to think that the daily lifestyle there suits them although, for some of them their advanced stages of dementia makes it difficult for them to communicate and contribute to the inspection process. Those people who were able to talk with us said that they can request to stay in bed a bit longer if they want too and that they can choose how they spend their days. All of the residents looked happy and well cared for. We saw that people had been able to bring personal possessions in with them when they come into the home to make their bedrooms more homely. Some had photographs, ornaments and pictures or small pieces of furniture. Our Expert by Experience spent time with one resident who had brought her own televison and lots of books in with her. Other residents were able to tell her that they were quite happy Care Homes for Older People Page 15 of 30 Evidence: living in the home. Residents seemed to spend quite a lot of time sitting in their rooms alone and when we saw the activities programme it is quite limited. It is recommended that more could be done to interest and stimulate residents and consideration should be given to expanding the activities that are offered. Visitors that we spoke with said that they are always made welcome and that they were happy with the way that they saw staff speaking to their relatives when they visited. The lunchtime meal was served during the inspection. The Expert by Experience sat with residents while they had their lunch and she said that the food was hot and her only concern was that sometimes people might have been given too much on their plate and it was off putting. Residents have always been complimentary about the meals whenever we visit and the cook has worked in the home for some time and knows what they like. Records are kept detailing the meals that residents have and people also have nutritional care plans in order to help staff to monitor whether they are eating enough. 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. Complaints are not always responded to in a timely manner and incidents occurring in the home are not always reported to us. Therefore we cannot be sure that the people who use this service are safe. Evidence: There is a complaints procedure in the home which details how any concerns will be addressed. There is a copy of this in the Service User Guide as well. Since the last inspection there have been three concerns raised which are still being investigated under the local authority safeguarding procedures. One also included concerns about the providers failure to respond, in accordance with the homes procedures. Of the other two incidents the Registered Provider has still only reported one to us despite being reminded of their responsibilities under the Care Homes Regulations. This information is required, by law, so that we can plan our inspection activity and monitor the well being of the people using the service. Without evidence to show that this regulation is being complied with we cannot be sure that people are safe. A repeated failure to provide this information may lead to further action being taken against the Registered providers. So that people who live in the home the home are protected from those who have Care Homes for Older People Page 17 of 30 Evidence: been judged as being unsuitable to be working with vulnerable people,all of the staff have had appropriate clearance from the Criminal Records Bureau. However, there has not been any staff training regarding the recognition and reporting of abuse since February . This training must be updated on a regular basis so that all staff are aware of the steps that must be taken should they suspect that abuse is occurring in the home. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The redecoration and refurbishment plan is ongoing although this must include work to the outside of the property. On the day of the inspection the home was clean, warm and cosy and there were no malodours. Evidence: Since the last inspection there has been a considerable amount of work undertaken in the home to help improve the lives of the residents. The kitchen has been resited and a new lounge /diner has been created. An additional lounge has also been created at the front of the home and the original garden room is now being used as a dining room. New areas have been tastefully decorated and the arrangements have provided residents with more choice as to where they sit. Attention is still needed to the outside of the property. Rendering, window and door frames are in need of repair; the paintwork is chipped and peeling and frames are beginning to rot. Guttering still needs replacing. One of the windows in the garden lounge is still broken and cannot be opened . The driveway, which has always been hazourdous due to the steepness of the incline, Care Homes for Older People Page 19 of 30 Evidence: is full of potholes despite attempts to repair it and could pose a safety risk for both residents and their relatives many of whom are quite frail and elderley. The Registered Provider has told us that these issues will be adressed in the near future. Care Homes for Older People Page 20 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. There may not always be enough staff to meet the needs of the people living in the home and their training may not always be up to date. Evidence: On the day of the inspection there were 38 residents in the home. There were 8 members of care staff on duty and three of those were trained nurses. In addition the manager was in the home although it was only her second day. Although in theory this should be sufficient numbers of staff the layout of the building makes this home particularly difficult to manage from a staffing perspective. We saw that carers get everyone up and dressed and then leave them in their rooms until they are able to bring anyone who wishes to downstairs to the lounge. In practice this means that they are not able to be moved until almost lunchtime. One member of staff then stays with the residents who wish to remain in their rooms although most residents actually require to be supported by two staff. This means that in order to comply with residents care plans they would need to summon help. Of particular concern was the night time rota. We were told that there is only one trained nurse at night with three care staff . Staff say that it takes approximately two hours to complete the drug round which suggests that some residents may not be Care Homes for Older People Page 21 of 30 Evidence: getting their medication at the required intervals. It is recommended that serious consideration should be given to increasing staffing levels especially at night. We looked at the personnel files of three members of staff recruited since the last inspection. Two of them were incomplete. One had no photograph, one of a trained nurse,had no evidence that a check had been made on their NMC registration. All staff files must contain all of the information required by the Care Homes Regulations. We looked at staff training records and noted that they were not always up to date and some staff had not had their mandatory training. This includes moving and handling and fire safety. We recommended that there should be a needs analysis done so that any gaps in staff training can be identified and addressed.Training can then be planned to meet the needs of the people in the home.For example in moving and handling, fire safety, recognition of abuse,diabetes and wound care. Mandatory training needs must be addressed as a priority. Care Homes for Older People Page 22 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. There has been a lack of management structure which has lead to shortfalls in the home and health and safety practices do not always ensure residents protection. Evidence: We considered that the majority of the concerns that we raised during the inspection were mainly attributable to the lack of a stable management structure since the previous Registered Manager left the home in February. This includes poor practices with regard to wound care, lack of training and supervision for staff and a failure to respond to complaints and notify The Commission of untoward incidents. A new manager is now in place although, when we visited, it was only her second day in the home. She is very experienced and well qualified and has already identified many of the issues and is planning how to address them. We were confident that with appropriate support she will be able to achieve this. Care Homes for Older People Page 23 of 30 Evidence: There was little evidence of any recent quality assurance or processes designed to seek the views of the people who use the service although a questionnaire had been sent out by one of the interim managers. There was no evidence available of any visits undertaken by the Registered Provider in line with regulation 26 although we were told that she is frequently in the home. We looked at staff supervision records.These were very patchy, most staff have not received supervision for the last ten months. We noted also that there did not seem to be a clear understanding of its purpose which is to monitor performance and identify training needs. It is recommended that supervision should be included in the topics needing to be addressed through the intended training programme. All staff must be able to access supervision as part of their performance management and development and those who are delivering it, must themselves ,have training to help them fulfill this role. Maintenance certificates showed that equipment has been maintained appropriately however it was noted that the temperature of the hot water in two of the bathrooms and in the shower room was too high. An immediate requirement to rectify this situation was given. This was complied with before the specified timescale. We also saw a fire door blocked with garden chairs, they were removed during the visit. Care Homes for Older People Page 24 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 25 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 There must be clear 01/01/2010 directions for the frequency of administration of all items of medication So that there is evidence that residents are receiving their medication in accordance with the wishes of their doctor. 2 9 13 All items of medication must 30/10/2008 be within their use by date So that residents are not put at risk from out of date preparations. 3 9 13 The administration and non 30/10/2008 administration of medication must be recorded accurately. So that there is evidence that people are receiving their medication as it has been prescribed by their doctor. 4 16 37 Significant events which affect the wellbeing of the 30/10/2008 Care Homes for Older People Page 26 of 30 people who use the service must be reported to The Commission in accordance with the regulations So that The Commission can monitor activity within the home and plan the frequency of inspections to ensure that people are safe. 5 18 18 All staff must receive regular 30/10/2008 training so that they are able to recognise suspected abuse and that they know how to report it. In order to ensure that staff feel confident to report any concerns that they might have 6 18 22 Complaints must be responded to in a timely way,accordance with the homes own procedures In order that people can fee reassured that their concerns will be taken seriously. 7 29 19 All staff files must contain all 30/10/2008 of the information required by the Care Homes Regulations In order to ensure the safety of the people who use the service. 8 30 18 All staff must be up to date with their mandatory training 30/10/2008 30/10/2008 Care Homes for Older People Page 27 of 30 In order to ensure the safety of the people using the service. 9 33 26 There must be evidence of visits made by the Registered Provider in line with Regultion 26. In order to provide evidence that they are happy with the level of service thatis being provided. 10 33 24 There must be evidence of an effective quality assurance programme in place. So that the people who use the service are able to contribute their views and influence the service that is provided. 11 35 18 All staff must receive regular 30/12/2008 supervision. In order to monitor their performance and identify any training needs. 30/12/2008 30/12/2008 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 8 It is recommended that a link nurse should be appointed to assume responsibility for wound care in the home in order to promote and monitor best practice. It is recommended that there should be an increase in teaching relating to the management of wound care to ensure that all trained nurses are aware of the current best practice guidelines. It is recommended that the activities programme should be Page 28 of 30 2 8 3 12 Care Homes for Older People expanded to offer more interest and stimulation to residents. 4 5 27 30 It is recommended that the staff complement should be increased in order to meet the needs of the residents. It is recommended that a training needs analysis should be undertaken in order to identify and address shortfalls in staff training. 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 © (2008) 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!