Inspection on 17/03/09 for Magnolia Court

This inspection was carried out on 17th March 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Magnolia Court 06/08/07

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Magnolia Court 181 Granville Road London NW2 2LH     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: Teferi Degeneh     Date: 2 3 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 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 28 Information about the care home Name of care home: Address: Magnolia Court 181 Granville Road London NW2 2LH 02087319881 02083814182 magnolia@barchester.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Barchester Healthcare Homes Ltd Name of registered manager (if applicable) Ms Anne Mary Clare Lampard Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Magnolia Court provides nursing and care services for up to 54 older people. Barchester Healthcare Homes LTD, a private care sector provider, owns the home. The home accepts for admission people who require nursing care support from either local authorities or people who fund their own care privately. 0 Over 65 54 care home 54 Care Homes for Older People Page 4 of 28 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: The inspection took approximately ten hours to complete beginning at 07:55 am and ending at 17:00 pm on 17 March 2009. The manager was present throughout the inspection. Mrs Jane Shaw, a pharmacist inspector and an expert by experience were invited to help with parts of the inspection. The pharmacist inspector visited the home on 13 March 2009 to look at the way the medicines are managed. The expert by experience was present on the 17th March between approximately 9:30 am and 13:00 pm. An expert by experience is a person who has an experience of using a service, and who can give a better picture of what it feels to receive a service. Parts of the report produced by the expert by experience and that of the pharmacist inspector are used as evidence to support the judgments. Care Homes for Older People Page 5 of 28 The inspection activity undertaken by the lead inspector included a tour of the building, the examination of the residents files including care records, the examination of health and safety records, the viewing of staff rotas and discussions with and observation of people who use the service, care staff and the homes management. A number of relatives and friends who were visiting the residents were also spoken to. Thirteen feedback surveys, which were completed by the people who use the service, were also considered as part of this inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 7 of 28 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 8 of 28 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. New residents can be confident that their admission to the home is based on the outcome of their assessment and the ability of the home to meet their needs. Evidence: Eight residents files were selected randomly and examined. There was evidence of completed needs assessment in each of these files.The home has also received information and assessments from social workers and health professionals for those people who are not self funding. It was clear from the discussions with the manager that the home admits residents only if it believes that the needs of the persons referred can be met. Discussions with the people who use the service and their relatives indicated that information about the home was available to assist new residents to make a decision whether or not to be admitted to the home. A realtive who was visiting said that they chose this home as it is nearer to where they lived and as they believed that it would meet their cultural needs. Another person was quoted by Care Homes for Older People Page 9 of 28 Evidence: the expert by experience as saying that they looked at 14 different homes before deciding on this one. From discussions with the manager it was evident that prospective residents are encouraged to visit the home and that they are provided with the homes statement of purpose and service users guide. The service users guide, which was seen, contained information about the services, facilities and the staffing of the home. Care Homes for Older People Page 10 of 28 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. The care plans and risk assessments are good. These have enabled the people who use the service to receive care and support they need. The medication administration storage and administration systems in parts of the home are below the residents expectation and have potential to put them at risk. Evidence: The eight residents files examined showed risk assessment and care plans have been completed and reviewed. The care plans are detailed with information about the residents individual needs and how the staff can support them. The home also keeps daily records of interactions and significant events for each service user. From discussions with some residents, visitors and the manager it was evident that a physiotherapist visits the home to assess the residents and to provide training and advice in order to make sure that the people are safe at the home. Records in the files showed that the residents regularly see health care professionals. In a conversation a resident told us that they were getting ready to attend their health care appointment. The expert by experience, who observed and talked to many residents, noted: Care Homes for Older People Page 11 of 28 Evidence: Residents were all neatly dressed and most had their hair well coiffed. A comment was made to the expert by experience that a bed was not made for a resident even though it was late in the morning. A similar comment was made by a resident and a visitor regarding the late serving of breakfast. The expert by experience and the visitor thought that the staffing level (which will be mentioned below) was probably not sufficient to give the existing staff time to fulfil all the tasks required. The residents spoken to and those who completed the survey forms are happy with the way the staff treat them. A visitor said the staff are polite and do their best to provide care with respect and dignity. The issue of some missing laundry items was mentioned by a few residents to the expert by experience. The manager said this issue has been addressed by marking all the items that go to the laundry. The home is currently taking part in the local authoritys new initiative of Gold Standards Framework. This initiative requires the home to ensure that the residents are supported to make informed decisions about the care they receive. From discussions and observations it was clear that friends and relatives can visit the residents in private. The home has a system of monitoring the medical needs of the residents, especially pressure sores. We noted in the files the evidence the home keeps to show the medical care provided and the changes that take place in the health condition of the residents. We also noticed evidence of referral to hospital specialists and for palliative care. We found a seizure chart for a resident who had fits. Discussions with the manager and an examination of the files indicated that the health and nutrition needs of the residents are assessed and reviewed thereafter regularly. From the residents files and discussions with the staff and relatives it was evident that residents have access to specialist medical, nursing, dental, pharmaceutical, chiropody services and care from hospitals. A visiting carer said they were happy with the physiotherapy input that they did not mind paying additional money for the service. It was evident from the residents and discussions with the manager that each resident has their own general practitioner, who visits them regularly. The receipt, storage and administration of medicines were inspected by the CSCI pharmacist inspector.The pharmacist inspector concluded that the recording, storage and administration of medication was generally good but would benefit from making more improvements especially in some areas. For example, in one instance a tablet was not recorded as being given even though it was difficult to prove this as the stock balance was not known. The pharmacist was satisfied to notice that the protocols were in place for residents prescribed tube feeds because they were unable to swallow. There was evidence that the dietitian reviewed these residents regularly and also other residents who were losing weight or who could not swallow. We discussed the frequency of blood Care Homes for Older People Page 12 of 28 Evidence: tests for monitoring lithium toxicity as one resident had been in hospital after such event. We inspected controlled drugs and noticed that all balances in the register were correct. We noticed however that that not all controlled drugs were stored in a cupboard meeting the requirements of the Misuse of Drugs Act because there was not enough room. We also looked at the lancets in use for checking blood sugar and noted that they were not of the professional type. This is a risk in causing the transmission of blood borne infections. Care Homes for Older People Page 13 of 28 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. Even though there are some efforts made by the home to provide the residents with activities and meals, not all residents have benefited from such efforts. Some residents are not engaged, and the others are not appropriately supported or provided with the meals that meet their needs. Evidence: The home has a fulltime entertainment and activities organiser. The manager told us that she is actively seeking to employ more activity co-ordinators. She also said that two volunteers are being recruited. A number of people spoken to had mixed views about the activities provided. Some said they are happy with the activities while the others were not impressed saying that the activities were not stimulating and did not meet their needs. One person said: The activities are appalling. Another person wrote in the survey form: This [activity] is difficultt due to the infirmity of residents, but some effort is made, not particularly well done to my limited observation. We never go out other than to the garden. This comment seems to partly contradict with the views of others that indicate that some people are taken out to shopping centres and parks. The expert by experience noted that the activities provided on the day of the visit could be improved in both content and presentation. The expert by experience Care Homes for Older People Page 14 of 28 Evidence: also commented: There were far too many people crammed into the allotted lounge area and all in all it was not a nice experience for anyone I think. The notes of the expert by experience confirms how the garden is used effectively: The gardens are very well used and she [the manager] intends to have some raised beds made in the summer so that people using wheelchairs can do some planting out. From the observations of some residents staying in their bedrooms, we were not able to see evidence that they are engaged. The home has a rotating menu. There are two chefs. The manager told us that the residents are consulted about the meals during weekly focus group meetings that take place on Wednesday. A number of the people we spoke to were happy about the meals. However, there were some people who were not happy with the way the meals were served. For example, one person said they were given a meal which was different from what they had ordered. This was raised with the manager who admitted that that kind of incident had happened before and actions were put in place to prevent it from reoccurring. From observations we found out that the staff available to help the residents with their meals were not sufficient to take enough time to look after the residents. A member of staff was seen trying their best to help two residents at the same time. This resulted in them being hurried, not concentrating and inconveniencing the residents. The manager was made aware of this issue at a feedback time and she agreed to look into ways of increasing the staffing level particularly at peak hours (please see below about staffing). From discussions with the manager and the chef it was clear that the meals were fresh and reflect the religious and dietary needs of the people who use the service. From the residents files we noted that a dietitian is consulted and the residents weights are monitored. We have seen a jug of water in each of the bedrooms. The staff informed us that the jugs are filled with fresh water every morning. There is also a kitchenette on each of the two floors from where snacks are served. A few residents said occasionally they do not get their breakfast on time due to probably staff shortage. On the day of the inspection breakfast was being served around 9 Oclock. Some people commented that shortage of staffing also meant that their breakfast gets cold before it reaches them. An example mentioned here was toast, which a person said was not fresh when they were given. Discussions with the manager and the administrative staff showed that the home does not manage the residents finances. However, the home invoices the people for their expenses and these are paid for either by the residents or their representatives. From records such as the visitors book and residents files it was clear that the residents are visited by their relatives and friends. Observations and conversations with the people who use the service and visiting relatives indicated that the residents are visited by their family, friends, and professionals. A visitor told the expert by Care Homes for Older People Page 15 of 28 Evidence: experience and the inspector that they regularly come to see a friend. We also spoke to other visitors who said that they and their family visit a resident. Care Homes for Older People Page 16 of 28 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 who use the service are confident that they are protected by the availability in the home of trained staff and satisfactory complaints and adult safeguarding policies. Evidence: The AQAA states that the home sees complaints as an opportunity to improve the service. It also confirms that all complaints are documented and resolved where possible and in accordance with the homes policies and procedures. Six complaints have been recorded since the last inspection. These were all investigated and resolved by the manager. The visitors and residents spoken to confirmed that they can speak to the staff and the manager if they have concerns. The home has informed the Commission for Social Care Inspection whenever there have been safeguarding issues. There is a complaints procedure. A visitor told us how they can contact the manager by telephone or email. Conversations with the visitors indicated that their concerns are listened to by the manager. The homes complaints procedure is displayed in the foyer of the home. The AQAA confirms that the home has obtained the local authoritys safeguarding Adults policies and procedures. It also confirms that the staff have been provided with a training which gives them the skills and knowledge of safeguarding the people who use the service. The files of the staff we examined contained evidence of safeguarding training. The staff spoken to demonstrated their knowledge and skills of safeguarding Care Homes for Older People Page 17 of 28 Evidence: people by ensuring their human rights and by treating them with respect and dignity. The home has a whistle blowing policy. Care Homes for Older People Page 18 of 28 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. There are good arrangements in place to to enable the residents to live in a safe and comfortable environment. Evidence: The expert by experience commented that Magnolia Court is very clean and bright and in good material shape. There was no bad smell in all the areas we checked. The visitors spoken to said that the home was always clean and tidy. A visitor said that they always found the bedroom clean and tidy. The home has a full time handy person who is responsible for the maintenance of the facilities. A number of the residents spoken to said they liked their rooms. Observations showed that the residents were able to bring their personal possessions with them to the home. The home has appropriate facilities and equipment for the residents wellbeing. The AQAA, records and certificates showed that systems are in place for the regular maintenance of these facilities and equipment. The home is located in a quiet residential area. There is a car parking space for the staff and visitors at the front and there is a well looked after garden at the back of the building. Care Homes for Older People Page 19 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The availability of trained and experienced staff has benefitted the people who use the service. The residents safety and welfare can be more reassured when the home provides care staff in sufficient number. Evidence: It has been mentioned above that the number of the staff available to help the residents with their meals was not sufficient to give them enough time to look after the residents. We also noted our observation that the staff were hurried when they were helping some residents with their lunch. Discussions with the manager and an assessment of the rota showed that there are three care staff and a nurse in charge on each of the floors. A number of the residents were high dependency which meant that they would require two members of staff to support them. A resident said that occasionally they had to wait for too long for staff until they have finshed their duties with the other residents. Another resident said that the staff do the basics only and they relied on their relatives for many of their needs. A number of the residents and visitors spoken to were complementary about the staff. A resident said the staff do their best. Another visitor confirmed that the staff treat the residents well. The expert by experience quoted a resident as saying: It is good here and all the staff are very polite and pleasant. However, another comment made to the expert by experience and also recorded in the survey questionnaries indicated that some staff were not able Care Homes for Older People Page 20 of 28 Evidence: to communicate very well with the residnets. From discussions with the manager and the staff and from the examination of a number of staff files and the AQAA it is clear that the staff have attended training on food hygiene, healt and safety, first aid, safeguarding adults, moving and handling, dementia, medication, fire safety and infection control. The AQAA also states that a number of staff have achieved a care qualification equivalent to the naational vocational qualification (NVQ) level 2. The home also encourages the staff to attend training and improve their knowledge and skills. A member of staff told us that they are supported by the home to undertake training through Open University. The manager said there is a training and development plan for all the staff. Tthe staff files which were seen contain copies of job applications, two written references, job descriptions, terms and conditions of employment and evidence of satisfactory criminal record bureau (CRB) checks. The manager said all staff and volunteers start work only after their satisfactory CRBs are received. There are policies and procedures on equal opportunity and recruitment of staff. Care Homes for Older People Page 21 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management system of the home is good and the residents and their relatives are able to be listened to and influence the quality of the services. The safety and well being of the residents will further be ensured when action is taken to reduce and eliminate accidents and incidents. Evidence: The manager, who has been recently appointed, is well liked and respected by the visitors and residents we spoke to. A number of the visitors said the manager has made improvements since she came. They said they can talk to her if they have concerns. On the day of the inspection we observed some people who came to see the manager as part of a pre-planned appointment. From conversations and documents it was evident that the manager makes herself available to people through various means including telephone, letters and email. The manager said she has previous management experience and training. She is now registered by the Commission for Social Care Inspection. At the last inspection a requirement was made for the manager Care Homes for Older People Page 22 of 28 Evidence: to ensure that the care staff receive regular supervision. The manager said she has started supervision of the staff. However, she is yet to organise a formal supervision whereby notes of the sessions are kept. The manager is aware that each member of staff needs to be supervised by a senior member of staff who is able to supervise them. The manager said the residents and their relatives are consulted about the quality of the services and facilities regularly through meetings. She said that the residents weekly focus group meeting is one of the ways she uses to listen to the residents and improve the quality of the service. The company also has a formal quality assurance system which enables it to carry out satisfactory surveys by sending survey forms to the people who use the service and their relatives. The manager said that the outcome of the satisfactory surveys are analysed and discussed with the residents. As mentioned earlier the home has a handy person who ensures the maintenance of the facilities and equipment. The manager has confirmed in the AQAA that all electrical equipment and other facilities are either checked or serviced to ensure that they are safe to be used. Records of maintenance and certificates of safety are kept by the handy person. The records showed that fire doors, escape routes, extinguishers and fire alarms have been checked. There are four full time cleaners who ensure clean communal and areas and bedrooms. It was noted earlier in this report that risk assessments have been completed for the residents. We checked the accident and incident record and found out that there have been fifteen recorded incidents between January and March 2009. Most of these incidents involved falls of some residents. It was evident from conversations with the manager and the records that the home has taken steps to address the incidents. It was also clear that the home has informed (as appropriate) the relatives. The manager knows that the home needs to take more action to reduce the number of the incidents. Care Homes for Older People Page 23 of 28 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 28 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 robust regular auditing to ensure that medicines are recorded accurately This is to protect the health of the residents. 11/06/2009 2 9 13 The registered person must ensure that professional lancing devices for testing blood glucose. This is to prevent the transmission of blood borne infections. 11/04/2009 3 9 13 There must be risk assessments in place for residents prescribed Lithium or similar medicines. This is to prevent known side effects and toxicity occurring. 11/04/2009 4 9 13 The home must store all Controlled Drugs in a cupboard meeting the requirements of the Misuse of Drugs Act. 11/06/2009 Care Homes for Older People Page 25 of 28 This is to ensure that controlled drugs are apporpriately stored and mistakes or abuse of drugs are avoided. 5 12 12 After consultation, each resident must be provided with activities that meet their needs. This will enable the residents to be engaged. 6 15 16 Meals that have been requested by the residents or planned in the menu must be provided on time. This ensures that the residents receive the meals that meet their needs. 7 27 18 The staffing number must be 29/05/2009 reviewed and increased. This will ensure that there are adequate number of staff on shift to meet the needs of all the residents. It would also mean that the staff would not be hurried when they support the residents. 8 36 18 All staff must be supervised. 31/07/2009 This ensures that there is a two way communication which enables the staff to resolve any issue and improve the quality of care for the residents. 30/04/2009 15/05/2009 Care Homes for Older People Page 26 of 28 9 38 13 Action must be taken to reduce or eliminate the number of falls and accidents. This is to ensure safety and well being of the residents. 15/05/2009 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 Care Homes for Older People Page 27 of 28 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. 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