Inspection on 12/11/08 for Oakwood Residential Home

This inspection was carried out on 12th November 2008.

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

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

Other inspections for this house

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Oakwood Residential Home South Crescent Fencehouses Houghton Le Spring Tyne And Wear DH4 6AG     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: Steve Tuck     Date: 1 2 1 1 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. 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 31 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 31 Information about the care home Name of care home: Address: Oakwood Residential Home South Crescent Fencehouses Houghton Le Spring Tyne And Wear DH4 6AG 01913853203 P/F Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Balwinder Singh Khera,Baljeet Kaur Khera Name of registered manager (if applicable) Mrs Winifred Leadbitter Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 20 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 - maximum number of places 20 Dementia Code DE, maximum number of places 20 Date of last inspection Brief description of the care home Oakwood is a registered care home providing personal care and accommodation for up to 20 older persons. The home is not registered to provide nursing care however community nursing services visit people who have these needs.The home was opened Care Homes for Older People Page 4 of 31 care home 20 Over 65 0 20 20 0 Brief description of the care home in 1990, is privately owned and has recently been recently purchased by the present owner. However the home has been inspected as a ‘new’ service which means that we could look at how changes in the way that the service is run by the new owners had improved peoples lives.The home can provide services for those people who have dementia type illness. But the home is not suitable for those people who have advanced or complicated dementia needs. Oakwood is a two storey building located on the main street in Fencehouses, close to local amenities. Peoples bedrooms are provided on both floors and there is a lift so that people can get access to the upstairs easily. The lounge and dining areas are on the ground floor along with other areas such as the kitchen laundry and staff rooms. There is a small patio area is located to the rear of the property. The home has a no smoking policy. The weekly fees for living at this home are £379 to £393 The costs of newspapers, hairdressing, private chiropody and toiletries are not included in the fees. Fees vary depending on peoples circumstances, further details can be found in the homes Service User Guide. Care Homes for Older People Page 5 of 31 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: Before the visit We looked at Information we have received since the last Key Inspection. How the service dealt with any complaints and concerns since then. Any changes to how the home is run. The providers view of how well they care for people. We asked them to examine their Care Homes for Older People Page 6 of 31 own service and write to us with the results. We sent surveys to people who use the home, people who arrange for people to live there those who visit the home to support people like doctors and therapists and the staff who work in the home to ask what they think about services there. The Visit An unannounced visit was made on 12 November 2008. During the visit we Talked with the people who use the service the staff the manager and the owner. Observed life in the home. Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff had the knowledgeskills and training to meet the needs of the people they care for. Looked around parts of the building to make sure it was clean safe and comfortable. Checked on what improvements had been made since the last visit. We told the manager and owner what we had found. What the care home does well: What has improved since the last inspection? What they could do better: People living at the home must have their needs and requirements met. They must be Care Homes for Older People Page 8 of 31 cared for in the way that has been agreed at an assessment or review described in their care plan and there must be enough staff at the home so that their needs can be met. Where people are at risk there should be assessments in place which show how these have been reduced. Plans of care must be written in enough detail to show the specific actions staff are to take to support peoples needs, preferences and lifestyle. And care plans must be written in enough detail so that they can be used to co-ordinate the work of staff and show if changes in peoples condition have taken place. Where people have dementia type illness, the home must follow current best practice to make sure that peoples plan of care and staff support is relevant to their history and needs. The way that medication is stored and given out must be improved. there must be accurate and verifiable records of drugs must be kept and the process for monitoring and making sure that medication is properly administered must be effective. This is so that people living at the home get the medication that they have been prescribed. There must be a plan in place which demonstrates how the quality of the home is to be improved which is based on the views of the people who use the service. This is to make sure that people living at the home know that their service will be improved. All people working in the home must have background checks carried out before they start working there to make sure that they are suitable to work with vulnerable people. There should also be an up to date copy of the agreed actions that staff should take if they witness or suspect abuse at the home. These are to make sure that people living at the home are properly protected. Care Homes for Older People Page 9 of 31 The owner should continue to improve the condition of the building, rooms and facilities. This is so that people living at the home have a comfortable place to live and valued lifestyle. The manager should make sure that new staff have training which is designed to introduce them to the home and to their role. They should get regular supervision from the manager or senior staff to help them develop their skills. 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 31 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 31 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. There is information about what the home has to offer people and improvements are being made so that the needs of people who are to be admitted to the home are known and agreed before they move in. Evidence: The way that the home finds out about the needs of new people who are to be admitted could not be assessed at this inspection because no one has moved there since the current owners took over. However the owner has shown that he is carrying out a review of how peoples needs will be looked at and understood by staff so that they can be assured that the home is right for them. The information that is given to people who may wish to move to the home has been improved so that they have a good understanding of what the home can offer them, how they can complain, a copy of the homes contract and the latest inspection report. Care Homes for Older People Page 12 of 31 Evidence: The owner is to make further improvements. The owner and the manager are careful not to admit people who they are unable to support as the home is not suitable to support everyone. For example, although the home is registered to provide services for people who have dementia type illness, they are unable to support people whose symptoms and needs are severe or complex. This is because the home and the way that care is provided has not been designed for people who need high levels of dementia care support. People living at the home have an agreement about the purpose of their stay, proposed length of stay, and fee levels so that they know their rights and what will be provided to support them. The home does not provide short term care to help people to recover from illness or injury before returning home. Care Homes for Older People Page 13 of 31 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. Each person has an individual plan of care which should set out in detail their preferences and how their assessed needs will be met. But these are not always carried out nor do they fully describe the measures which staff are to use which makes it difficult for them to consistently meet peoples needs. Evidence: All people who live at the home have a plan of care which gives a description of how their needs are to be met. Since the sale of the home to a new owner a review of peoples care planning arrangements had been started but was not complete at the time of this inspection. Care plans had not been reviewed and updates were not completed. Staff have a variety of knowledge and experience of caring for people living at the home but this information is not yet successfully combined in the care plans so that these can be used to consistently provide fully coordinated care. All of the staff interviewed could describe peoples needs, preferences and histories however the Care Homes for Older People Page 14 of 31 Evidence: potential areas of good practice were not generally shared with colleagues nor were these written down in care plans. The manager and owner agreed that improving the quality of care plans was one of the objectives for this service. There were some records in place which show that the staff and manager have considered how to protect people from risks however these were not always completed. Staff at the home judge how to support people who are at risk from falls and help them to use equipment which maintains their fitness and independence around the home. They also help people to remain independent and use community facilities without the support of staff when they are able, but the ways that the manager makes sure that they are as safe as possible is not written down in their care plan. For example The arrangements for someone who has a regular activity with outside of the home was not recorded in their care plan. Some people use speech and phrases which are difficult to understand but are well known by staff so they can make choices for example at mealtimes but these were not written in their care plans. The home provides care to people who have become frail and may also have dementia type illness. Care planning arrangements for these people do not yet reflect current best practice. For example care plans do not specify how people who have an altered sense of time or reality are to be supported or what their personal timescales actually are. Care plans which place the person at the centre of a network of support for their needs and lifestyle requirements are yet to be put in place. This can be particularly important for people who become increasingly reliant on staff as their level of needs increases. Due to their levels of need people who live at the home are not able to organise their own medicines and appointed staff therefore help in this area. Staff who are trained in this area administer medication at the home. Medication is securely stored and records are kept which should help staff to make sure that people living at the home have the medication that they have been prescribed. But records examined had mistakes. For example. Two people had received medication that had not been signed for. One person had one less medication in stock than they should have had but this could not be accounted for. Care Homes for Older People Page 15 of 31 Evidence: The relationships between staff residents and relatives were friendly and professional. Care was delivered in private and staff were seen to knock on doors and wait for permission before entering. People living at the home said, They know what I like. Its been my home for a long time now. These lasses are angels they look after you well here. Care Homes for Older People Page 16 of 31 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. Some people who live at the home are encouraged and supported by the staff to lead fulfilling lives. But this could be improved if staff had a better way of supporting the lifestyle needs of people who are more needy or have a dementia type illness. Evidence: The manager and staff help people who live in the home to stay in contact with family members and friends. People who are able to get around the home or local community on their own and staff talked about what they do both inside and out of the home. For example visiting their local club and shop. For some of the people who are unable or do not wish to leave the building there are some limited activities which take place. There is an activity co-ordinator and staff do spend time with people, talking to them and helping them to fill their time. However the activities co-ordinator is also employed to provide care for people at busy times and staff are needed to meet the care needs of people living at the home leaving them little time to provide all but basic opportunities. The manager also acknowledged that it was difficult trying to get people to engage in any type of activity. Care Homes for Older People Page 17 of 31 Evidence: The home provides for a small number of people who have dementia type illnesses. Although staff do spend time talking to people, which is good, there is also little for people to engage in. A programme of activities, specifically designed to support, interest and help to structure the lives of people who have a variety of memory loss is not yet in place. Staff at the home like to encourage relatives or friends to visit regularly and people living there said that they like it when people visit and make them feel welcome. Information about advocacy is available although no one has used an advocate. Some people living at the home have brought small items with them making their rooms homely and reflective of their previous lifestyles, religious beliefs or cultural backgrounds. People living at the home are encouraged to make choices about their diet. Most said that they like the meals at the home and that they are asked what they would like to eat. Staff were seen asking people about their choice of meal and size of portion to make sure that people got what they wanted. Comments from some of the people living at the home were, I like the food. I enjoyed lunch. Staff are available during meals to offer support and assistance where needed. The cook has a good knowledge of the meals which people living at the home prefer. He understands the benefit of using fresh ingredients to help people to remain healthy. Menus were available which confirmed that a range of meals are provided which give people a balanced diet and refreshments are available throughout the day and night. Where people need it food supplements are available to help people to maintain their health for example if they have diabetes or have difficulty maintaining their weight. Care Homes for Older People Page 18 of 31 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 living at the home and their families can make a complaint if they are unhappy, have a grievance or dispute which helps them to have control over their lives and there are measures in place which should protect people who live at the home from being harmed which helps to promote their safety and security. Evidence: There is a complaints procedure which people can use if they are not happy. This informs people about who they should make a complaint to and how much time that a complaint will take to look at. There is a record kept at the home of all complaints, which includes details of any investigation and the outcome. In practice most people at the home said that they are likely to speak out if they have a grievance or dispute. One person said I just speak to Wyn shell sort it out. No one has approached the Commission for Social Care Inspection (CSCI) because they have been unhappy with the way that the home has managed their complaint. Whilst there have been no instances where abuse has been shown to have taken place, the home has an adult protection procedure which can be used where necessary to protect people living at the home. Staff have guidance and training about what to do if they see or suspect abuse is taking place and all staff spoken to showed that they knew what to do and what they expected to happen so that people remain protected. Care Homes for Older People Page 19 of 31 Evidence: Although a previous example of the procedure was available, and up to date version had been placed in storage whilst repairs to the home took place. The manager agreed to order a replacement and confirmed after the inspection that this was now available at the home. Care Homes for Older People Page 20 of 31 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. Improvements that are taking place to the building, facilities and furnishings are making it a more comfortable and safe place for people to live. Evidence: Although work is still taking place, since taking ownership of the home the new owner has concentrated on bringing conditions there up to a minimal useable standard. The home was in a state of disrepair and had suffered from fire damage in one bedroom. A summary of work carried out includes, Replacing the downstairs bathroom with one which helps people who have mobility problems to use it. Replacing the laundry equipment with that which is fit for use in a care home. Replacing fire protection alarm systems. Rebuilding a bedroom and office downstairs. Replacing bedding sheets and pillows. Care Homes for Older People Page 21 of 31 Evidence: Cleaning and decorating smoke damaged areas. Decorating the entrance corridors and staircases. Changing carpets in some of the rooms and corridors. One person said, I want my room decorated next. There is a routine of cleaning which helps to keep the home suitable for use and pleasant for residents and visitors. A carpet cleaner has been purchased which helps to keep any odours under control. The home is inspected by the Fire Prevention Service and overseen the local authority to make sure that risks from an accidental fire are lessened and a safe and healthy environment is promoted for the people who live and work there. Inspections in both of these areas had taken place within the last twelve months. The laundry is now organised and equipped with modern machinery so that people can be confident that their clothing and personal linen is hygienically cleaned within a reasonable space of time. The owner intends to continue with the refurbishment to improve the levels of comfort and convenience for the people living there. Care Homes for Older People Page 22 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Most staff have been trained to make sure that their care practice is good but at times there are not enough staff on duty which makes it hard for them to effectively meet the needs of the people who live at this home Evidence: Rotas for the week of the inspection showed that there were insufficient staff on duty at the home. There is usually at least two members of care staff on duty each day and night. But some staff have recently left the home which has made it difficult for the manager to make sure that enough staff are available. The manager said that she has reduced laundry hours to try to get enough care staff. The manager was also working alongside staff. Despite these measures there remained a shortfall between 8-10am on 10 and 11 November. Almost all of the staff have undertaken National Vocational Qualifications (NVQ) at Level 2 or 3 which should verify that they have the skills and experience to carry out their work and support people with sufficient competence. The manager has made deliberate attempts to recruit staff from similar cultural backgrounds as the people living at the home. In some cases they share the same community and social links which helps to make sure that people are confident with Care Homes for Older People Page 23 of 31 Evidence: the way in which they are supported. One new staff have been employed at this home in the past 6 years. The manager described the recruitment practices which appeared to be robust and should safeguard vulnerable people from unsuitable workers. There was evidence that employment checks had been attempted although it was impossible to independently verify if these had been carried out before the person started work. Care Homes for Older People Page 24 of 31 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 decision-making and overall management of the home has helped to improve staff practice and quality of care for the people who live at the home. But there are further improvements that the owner needs to make to put this service in a better position that will improve the quality of life for people living there. Evidence: The manager has over ten years experience of working as the manager at this home and has completed a National Vocational Qualification (NVQ) in management at level 4. The owner has been active in supporting the manager in her role and has been present at the home personally managing the improvements and giving management direction to staff and arranging for equipment and facilities to be put in place. He has shown commitment to the service and has stated that he intends to considerably improve standards at the home. The owner has drawn up an improvement plan which has been based on the last Care Homes for Older People Page 25 of 31 Evidence: inspection at the home and has demonstrated that he is committed to seeing through these improvements. Although the manager works alongside staff for the majority of the time, formal supervision with staff on a one to one basis does not yet take place. At the time of the inspection the manager had prepared questionnaires for people who live at the home and their relatives to comment about the quality of the service they receive. These were to be sent out shortly. People who live at the home have their finances protected by Durham County Council who monitors how the home assists them to spend their allowances. There are records in place which show how any cash which is held on peoples behalf is accounted for. The owner has given assurances that there is a realistic business or financial plan for the home which he is using to develop the business. This has enables the owner to carry out necessary repairs or refurbishment with good business planning which will bring benefits to the quality of life for the people who live there and become a profitable business for the owner. Building works have taken place which will require that tests are carried out to make sure that they are safe and suitable for use in this care home. The owner has given assurances that these will be carried out once work has been completed. There were no noticeable hazards at the home throughout the inspection and arrangements are in place to minimise risks for service users and staff. The home is also subject to inspections by the Fire Authority and local authority environmental health officers to make sure that the home is safe. Inspectors from both of these agencies have visited the home in the last 12 months. Care Homes for Older People Page 26 of 31 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 31 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 7 15 The manager must make sure that there are care plans in place which have enough detail to show the specific actions staff are to take to support their needs preferences and lifestyle. Reviews must reflect the progress towards those goals. This is to make sure that staff plan and review how they work with people and that they write this down so that everyone in the home works in the same way. This is a new Requirement. 15/02/2009 2 9 13 The manager must make sure that there is an accurate record of all medication held and administered at the home. This is to make sure that people get the treatment they have been 15/01/2009 Care Homes for Older People Page 28 of 31 prescribed.This is a new Requirement. 3 27 18 The manager must make sure that there is sufficient suitably qualified and experienced staff working at the home. This is to make sure that people get good quality support from competent well trained staff.This is a new Requirement 4 29 19 The manager must make sure that all people working in the home have background checks carried out before they start working there. This is to make sure that all staff employed at the home are suitable to work with vulnerable people.This is a new Requirement. 15/12/2008 15/12/2008 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 1 The manager should make sure there is a Service User Guide that can be used by the people who live at the home. This is so that people have important information about the home, their rights as residents and how they can complain. The manager should make sure that all support for people with dementia type illness follows current best practice and this is recorded in each persons care plan. This is to make sure that people with dementia are properly cared for at the home. The manager should make sure that there are assessments in place which show how all people who are taking risks are 2 7 3 7 Care Homes for Older People Page 29 of 31 supported to be as independent and safe as possible. And the interventions that staff are to carry out to make sure that this remains the case. 4 9 The manager should make sure that the way that medication is counted and checked is reviewed until stocks and records are accurate. This is to make sure that the home has systems in place which makes sure that people get the medication treatment that they have been prescribed. Staff support for people to take part in meaningful activities should be improved andactivities should be designed so that they help to support people who have dementia type illness. The manager should make sure that there is an up to date copy of the agreed actions that staff should take if they witness or suspect abuse at the home. This is to make sure that people living there are properly protected. The owner should continue to improve the condition of the building, rooms and facilities. This is so that people living at the home have a comfortable place to live and valued lifestyle. The manager should make sure that new staff have training which is designed to introduce them to the home and to their role of supporting the people who live there. This is to make sure that they have an understanding of the work that they do and so their skills in supporting people can begin to develop. The manager and owner should make sure that they hear the views of people who live at the home and their relatives so that they can take steps to improve the way the service is run if that is required. This is so that peoples rights are protected and so they have some control over their lives. The manager should make sure that all staff have one to one supervision to make sure that they understand their role in achieving the aims of the home and can discuss their work, the people they support and the training they need. This is to make sure that they continue to develop their levels of skill and remain effective workers. 5 12 6 18 7 19 8 30 9 33 10 36 Care Homes for Older People Page 30 of 31 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. 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