Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Marsh House Residential Home Ulnes Walton Lane Ulnes Walton Leyland Lancashire PR26 8LT The quality rating for this care home is:
one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Marie Cordingley
Date: 1 5 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 32 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 32 Information about the care home
Name of care home: Address: Marsh House Residential Home Ulnes Walton Lane Ulnes Walton Leyland Lancashire PR26 8LT 01772600991 01772601893 marshhouseres@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Gail Phillips Type of registration: Number of places registered: Marsh House Care Home Limited care home 33 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 33 Date of last inspection Brief description of the care home Marsh House is registered to provide residential care and accommodation for up to 33 people. The home is situated in a rural area close to the towns of Chorley and Leyland. There are 23 single rooms and 5 double, some of which have en-suite facilities. There is a large dining room and a number of communal areas available for residents use as well as well maintained grounds with seating and patio areas. These areas are accessible to people who use a wheelchair and there is also a stair-lift in place. Ample car parking space is provided. The registered manager is Mrs Gail Phillips. At the time Care Homes for Older People
Page 4 of 32 Over 65 33 0 Brief description of the care home of this visit, the information given to the Commission showed that the fees for care at the home vary from 346 - 397 pounds per week, with added expenses for newspapers, hairdressing and chiropody. Care Homes for Older People Page 5 of 32 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is one star. This means that people who use the service experience adequate quality outcomes. The inspection included an unannounced site visit which was carried out over one day. As the visit was unannounced the manager did not know it would be taking place until we arrived. During the visit we spent time talking with the manager, staff and residents. We also examined a variety of paperwork including residents care plans and staff files. We carried out a tour of the home viewing all communal areas and a selection of Care Homes for Older People
Page 6 of 32 residents private accommodation. We also looked at a selection of polices and procedures. Prior to our visit we asked the manager of the home to complete a comprehensive self assessment which covered all areas of the homes management and also contained information such as numbers of staff and their qualifications. We also wrote to a selection of residents and staff and asked them to give us their views about the service provided. What the care home does well: What has improved since the last inspection? Following the last inspection of the home we made a number of requirements and recommendations. We found during this inspection that some work had been done to Care Homes for Older People Page 8 of 32 address these although there were some issues outstanding which are addressed later on in the report. We found some improvements had been made to peoples care plans in that they contained more information about the person and their individual preferences. There was also increased information about peoples preferences in relation to areas such as social activities. Information regarding communication was also improved and where people required support in relation to particular behaviours, this was addressed in their care plans. We also noted some improvement in the provision of activities. Since the last inspection, the home have employed a member of staff to concentrate on this area. We found that people were being offered more opportunities to take part in a wider variety of activities and the home had started to offer people the chance to enjoy trips out. During the last inspection we found examples where personal information about people had been recorded in a general communication book, compromising their privacy and dignity. We made a requirement in relation to this matter and were able to confirm during this inspection that the practice had ceased. During this inspection we noted that procedures for recruiting new members of staff had improved. For example, staff files viewed demonstrated that the manager had obtained a full employment history from candidates and had investigated any gaps in the history. We also found that the turnover of staff had decreased significantly resulting in more consistency for residents. Since our last inspection a number of carers have gained National Vocational Qualifications in care at level two or above and we were able to confirm that the home now meet the National Minimum Standard in this area. What they could do better: Making a decision about moving to a care home is an extremely important one and as such it is essential that people are provided with a good level of information to help them make an informed choice. All homes are required to provide a Service User Guide which contains useful information such as the services provided, fees and daily routines at the home. We viewed the homes Service User Guide and found that there was some information that was missing, for example details of the registered provider, and also some information that was out of date. We also noted that the Service User Guide was only available in a standard written format meaning that the information would not be accessible to some people. We made some requirements and recommendations in relation to these matters. We found that there had been some improvements to residents care plans but still noted some examples where information in care plans did not consistently reflect peoples needs. For instance, one care plan we viewed didnt contain any guidance about the specific care they required to prevent pressure sores, however we did find that staff were aware of the residents high risk of pressure sores and were providing the right care to prevent them. Gaps in care planning can lead to gaps in the care provided and as such we discussed these areas with the manager and made a Care Homes for Older People Page 9 of 32 requirement in relation to the matter. We found some examples of errors that had occurred when managing peoples medication. There were some unexplained gaps in residents medication administration records, where staff had failed to sign to confirm that they had administered a certain medication. This was of concern as it could mean that a resident missed some medication that had been prescribed for them. We were also concerned to note that one resident had ran out of medication two days before our visit and as a result, had not received any medication throughout this time. This was discussed with the manager who explained that this had occurred due to an oversight. Not receiving prescribed medication can seriously affect residents health and wellbeing and as such we have made some requirements and recommendations in relation to these matters. Whilst the home has a complaints procedure in place we found that this didnt contain all the correct information. For example, there were no details of the registered provider and out of date information about processes to follow if a person is unhappy about the way their complaint has been handled. The guidance contained within the complaint procedure was not very clear and we also found that the procedure was only available in a standard written format making the information inaccessible to some people. When viewing records of complaints received by the home we were aware of one complaint that had been made and not recorded. It is important that all homes have a clear record of any complaint received and the action taken. We have made some requirements and recommendations in relation to these matters. We were not able to find any evidence that the registered provider monitors the quality of the service provided. The Care Homes Regulations require any provider who does not carry out the day to day running of the home to visit the home or arrange someone to do so on their behalf on a monthly basis. A report should then be carried out and maintained in the home. No such reports were available and the registered manager was unable to confirm that the visits take place. We have made a requirement in relation to this matter. 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 10 of 32 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 11 of 32 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People would benefit from being provided with more accessible, up to date information about the home. Evidence: A Service User Guide is available for people who are considering a move to the home. This document provides various information about daily routines, fees and the service provided and is designed to help people to make their decision. We viewed the Service User Guide and found that it contained the majority of information required but did note that some areas were out of date. For example, the guide didnt contain information about the registered provider of the home. We also noted that the guide was only available in a standard, written format. We discussed this with the manager and advised her that the guide should be made available in various formats, such as large print and audio so that everyone has equal access to
Care Homes for Older People Page 12 of 32 Evidence: the information. There are procedures in place to ensure that an assessment is carried out of a persons care needs before they are admitted to the home. This ensures that their care needs can be met at the home and that it is the right one for them. It also means that staff have an understanding of peoples needs from the point of their admission and can plan their care straight away. As part of our case tracking exercise we viewed a number of residents assessments. In general we found that pre admission assessments contained satisfactory information to ensure that carers had a good understanding of peoples needs. We were also able to confirm that each assessment we viewed had been carried out prior to the resident being admitted. Care Homes for Older People Page 13 of 32 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. Peoples care plans dont always reflect all their care needs which could lead to gaps in their care. Peoples health and wellbeing could be at risk if their medicines are not carefully managed. Evidence: We were able to confirm that there was a care plan in place for every resident, detailing their individual needs and the support they required. As part of our case tracking exercise we examined a number of residents care plans and found that in general, they provided a good level of information. However, we did find some examples where important information was missing. For example, we tracked the care of one resident who had been assessed as being at high risk of developing pressure sores. Whilst there was a pressure sore risk assessment in place, the residents care plan didnt contain any information about the action required by carers to minimise this risk. However, when we talked to carers they were aware of
Care Homes for Older People Page 14 of 32 Evidence: the action they needed to take and we were also able to confirm that the resident had not developed any pressure sores at the home. As such, we were satisfied that the problem was in the record keeping as opposed to the care being provided. The care plans we viewed demonstrated that efforts had been made to plan peoples care in a person centred way by taking into account their individual wishes and preferences. We also noted that where relevant, there was reference to peoples needs in relation to areas such as communication and social activities. There are processes in place to assess the risk to residents in areas such as falling, developing pressure sores or becoming under-nourished. We viewed a number of these risk assessments and found some examples where carers had failed to take all the relevant factors into account and as a result generated incorrect results. For instance, when tracking the care of one resident we found that she had been assessed as being at medium risk in this area. However, on checking the assessment we found that she was actually at high risk. Another persons falling risk assessment stated that they were not at risk of falling but accident records showed that this resident had fallen on several occasions in recent months. We looked at the homes medication store and residents medication administration records. We found that medicines were generally well organised and stored appropriately. In addition, we were able to confirm that temperatures of the storage room and fridge used to store medicines were constantly monitored. We found that the home had a good system in place for recording the receipt and disposal of medicines so that regular checks could be made to help ensure people were receiving their medicines correctly. We checked a selection of medication administration records which were generally in good order. However, we did find some examples of unexplained omissions in the records. The omissions could mean that someone was not given a medicine that they were prescribed. We were also concerned to note that one resident had run out of medication several days before our visit and during this time had not received her medication. This was of concern because missing prescribed medication can put peoples health and well being at risk. We discussed the issues in relation to medication with the manager and have made some requirements and recommendations in relation to our findings. Care Homes for Older People Page 15 of 32 Care Homes for Older People Page 16 of 32 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. There are group activities provided on a regular basis but some residents would benefit from more individual activities. Evidence: We found that since our last inspection, there had been some improvement in the provision of activities for residents. The home has now employed an activities coordinator to oversee the area and ensure that there is a good selection of activities regularly provided that are in line with residents preferences. Activities that are regularly provided include, arts and crafts, exercise sessions, visiting musicians and quizzes. In addition, some residents have enjoyed trips out to places such as garden centres. One resident we talked to said There does seem to be a bit more going on these days. and a staff member said We usually have enough staff on so that we can spend time with residents doing activities. Care Homes for Older People Page 17 of 32 Evidence: Whilst there have been some improvements made in this area we noted that some of the people whose care we tracked generally chose not to take part in group activities. We discussed this with the manager who advised us that the activities coordinator was in the process of developing more one to one activities for some residents. We advised that peoples individual preferences in relation to activities should be recorded in their care plans. During our visit we observed a lunch time and evening meal. We noted that residents were able to choose from a number of options at each meal time and meals served looked appetising and nicely presented. The meal times were sociable and relaxed and tables were nicely arranged. Residents and staff chatted throughout and people who required support to eat their meals were given assistance in a discreet manner. A sample of menus confirmed that people are offered a varied and nutritious diet with choices available at each meal time. We were advised the the cook speaks to each resident on a daily basis to establish their choices for the day. We received positive feedback about the quality of food from most people who took part in our written survey and those we spoke with during our visit. One resident said I have never yet been disappointed with a meal, and another wrote The meals are always very good. I always enjoy them. Care Homes for Older People Page 18 of 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People would benefit from clearer guidance about how to raise concerns. If complaints are not carefully recorded there is a danger that they will not be dealt with properly. Evidence: There is a written procedure in place that gives people information about how to make a complaint. However, when we viewed the procedure we felt that it didnt provide clear enough guidance to people about the process they should follow. We also noted that the complaints procedure did not include the detail of the registered provider. The complaints procedure included timescales in which peoples complaints would be dealt with which was noted as being 48 hours. We felt that this was an unrealistic timescale. In view of our findings we spoke with the manager about the procedure and advised that it be reviewed to provide better information. We also advised the manager that the complaints procedure should be made available in a number of formats such as large print and audio so that everyone has equal access to the policy. The home keeps a record of all complaints that are received, details of their investigation and the outcome. However when viewing this record we noted that there were no details recorded regarding a complaint that was previously made through the Commission. We pointed this out to the manager and advised her that all complaints must be recorded.
Care Homes for Older People Page 19 of 32 Evidence: The manager and carers that we spoke to demonstrated a good understanding of safeguarding procedures. Carers were well aware of whistle blowing procedures and confirmed that they would feel comfortable in reporting any abuse or poor practice. One carer said There are very high standards here and anything like that would be stopped straight away. Whistle blowing and safeguarding are included in the induction training of new staff and in viewing training records we noted that some carers had completed additional training in this area. We made a recommendation to the manager that all staff be provided with external training in safeguarding as soon as possible after their employment. Care Homes for Older People Page 20 of 32 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with comfortable accommodation but there are some areas that would benefit from being updated. Evidence: Marsh House is a spacious home with the majority of accommodation offered on a single room basis. There are a lot of communal areas in the home including several lounges and dining rooms. In addition, there are very well maintained, safe gardens. During our visit we carried out a tour of the home viewing all the communal areas and a selection of residents private accommodation. We found that in general, the home was warm, clean and comfortable. We also noted that some improvements had been made within the home since our last inspection. However, there are some areas within the home that would benefit from refurbishment. This was discussed with the manager who advised us that there was a programme currently in place which would eventually see all areas of the home updated. The majority of people who responded to our written survey told us that the home was usually fresh and clean. However, one person expressed some concerns and said that
Care Homes for Older People Page 21 of 32 Evidence: at times, some areas were below standard. We discussed this with the manager who advised us that domestic hours had recently been increased to ensure good standards are consistent. There are guidelines in place for staff regarding infection control and all carers are provided with training in the area. Care Homes for Older People Page 22 of 32 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 homes careful recruitment procedures help protect the residents safety and wellbeing. Evidence: We viewed a number of staff personnel files that confirmed the home follows careful procedures when recruiting staff. In all the files we viewed we found evidence that all the staff members had been asked to complete a detailed application form including a full employment history. We were also able to confirm that where any gaps in a persons employment history existed they had been investigated by the manager. There were references in place on all the files we examined as well as a Criminal Records Bureau disclosure. All these documents had been obtained before the staff member had commenced employment. All new staff members are provided with induction training to familiarise them with the home and the policies and procedures. A more detailed programme is then followed in line with Skills for Care standards which covers areas such as good principles of care. Carers we spoke to and those who responded to our written survey told us that they had found their induction training very useful. One carer said It gave me lots of confidence and I feel as though I knew what was expected of me.
Care Homes for Older People Page 23 of 32 Evidence: Each carer is provided with ongoing training in a number of areas such as moving and handling, infection control and safeguarding adults. All the carers we consulted told us that they were satisfied with the training provided. However, it was difficult to determine exactly what training each carer had received as the training matrix was not available, although carers we spoke with and those who responded to our written survey told us that they felt the training provided was adequate to help them carry out their roles. We made a recommendation that a training matrix be maintained at all times within the home so that the manager can have access to this information when needed to help her plan training effectively. Over half the staff team now hold National Vocational Qualifications in care at level 2 or above. This is an improvement and means that the home are now achieving the national standard in this area. In discussion, people told us that they were generally satisfied with the staffing levels at the home. One person said There always seems to be plenty of us on duty, we dont have to rush the residents. During our visit there appeared to be ample numbers of staff on duty and on checking rotas we found that these staffing levels were usually maintained. Care Homes for Older People Page 24 of 32 Management and administration
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home benefits from a competent manager who is able to recognise areas that should be developed. However, the registered provider also needs to monitor standards and be aware of what is happening in the home. Evidence: The home is one of a number operated by the same registered provider. However, in discussion we found that policies and procedures had not been reviewed by the registered provider following the purchase of the home. We were unable to find any evidence that the provider had suitable arrangements in place to monitor the running of the home. For example, there were no arrangements in place to carry out monthly visits as required by the Care Homes Regulations. The registered manager has been in post for a number of years and is suitably qualified and experienced. Throughout the inspection she demonstrated a good understanding of her role and the need to constantly monitor quality.
Care Homes for Older People Page 25 of 32 Evidence: There are a number of ways in which quality is monitored within the home including satisfaction surveys which are issued to residents, their families and other stakeholders at regular intervals. We made a recommendation that results from these surveys be made available to residents and people enquiring about the home. We also made some recommendations about how quality monitoring exercises could be developed to ensure that the views of residents and their families are taken into account, for example by holding regular residents and relatives meetings. The home has a health and safety policy in place which is supported by a number of individual procedures in areas such as COSHH (control of substances hazardous to health) and infection control. In addition, all staff are provided with training in key health and safety areas such as moving and handling and fire safety. However, it was difficult to assess exactly what training each staff member had received. We advised the manager that she needed to implement a training matrix and have this available at all times so she could monitor this important area effectively. Care Homes for Older People Page 26 of 32 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 27 of 32 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 1 5 The Service User Guide must 31/01/2009 contain accurate and up to date information. This is so that people have the information they need to make an informed choice about moving to the home. Peoples care plans must adress all their assessed needs. This is so that carers understand the support people require. 31/01/2009 2 7 15 3 8 13 When carrying out risk assessments, all the relevant information must be taken into account. This is so that risk can be identified and minimised. 31/01/2009 4 9 13 Medicines must be given to people as prescribed. This is to help protect peoples safety and wellbeing. 31/01/2009 Care Homes for Older People Page 28 of 32 5 16 22 All complaints received must 31/01/2009 be properly recorded. This is so that the management can monitor complaints and demonstrate that any complaints have been dealt with properly. 6 16 22 The complaints procedure must contain up to date and accurate information. This is so that people can be assured their complaints will be dealt with properly. 31/01/2009 7 31 26 Monthly visits must be carried out by or on behalf of the registered provider. This is so that the registered provider can monitor standards within the home. 31/01/2009 8 38 18 Evidence must be held 31/01/2009 within the home to demonstrate that all staff have received training in the mandatory helath and safety areas. This is to help ensure the safety of people living in, working at or visiting the home. 9 38 23 A fire risk assessment must 31/01/2009 be completed and available within the home at all times. This is to help ensure the safety of people living in, working at or visiting the home. Care Homes for Older People Page 29 of 32 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 It is recommended that the Service User Guide be made available in a variety of different formats so that everyone has equal access to the information. It is recommended that the contents of residents care plans be reviewed, unnecessary information removed and files tidied so that they are more user friendly and so that information is easily accessible. Any contact with health care professionals on behalf of residents should be carefully recorded so that the home can demonstrate that they are providing adequate support in this area. It is recommended that procedures for auditing medication are reviewed so that errors can be identified and addressed more quickly. It is recommended that clearer information be recorded in relation to medications that are prescribed on an as and when required basis. All handwritten entries on residents medication administration records should be witnessed and double signed. Peoples individual preferences in relation to activities should be recorded in their care plans so that carers can provide the sort of activities they enjoy. When a residents food intake is being monitored, careful records should be kept of all meals taken so that an accurate record is maintained. The complaints procedure should be made available in a variety of formats so that everyone has equal access to the information. All carers should be provided with additional training in Safeguarding to help ensure the safety and wellbeing of residents. All carers should be provided with training in the Mental Capacity Act so as to ensure they have a greater understanding of residents rights. The refurbishment plan should continue so that all areas of the home are maintained to a good standard. A training matrix should be maintained within the home and available at all times so that staff training can be 2 7 3 8 4 8 5 9 6 9 7 12 8 15 9 16 10 18 11 18 12 13 19 30 Care Homes for Older People Page 30 of 32 planned effectively. 14 33 All results from quality assurance exercises should be provided to residents, their relatives and other stakeholders. Consideration should be given to holding regular residents and relatives meetings. 15 33 Care Homes for Older People Page 31 of 32 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 32 of 32 - 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!
