Inspection on 16/10/08 for Park House

This inspection was carried out on 16th October 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Park House 07/10/09

Park House 30/10/06

Park House 28/02/06

Park House 13/06/05

Park House 14/09/04

Park House 17/05/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Park House The Parade St Marys Isles of Scilly TR21 0LP     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: Melanie Hutton     Date: 1 7 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Park House The Parade St Marys Isles of Scilly TR21 0LP 01720422699 01720422699 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Lesley Catherine Burrows Type of registration: Number of places registered: Council of the Isles of Scilly care home 14 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is 14. The registered person may provide the following category of service only: Care home providing personal care only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following caegories: Old age, not falling within any other category - Code OP - maximum 14 places Physical disability Code PD - maximum 2 places Date of last inspection Brief description of the care home Park House provides long-term care to older people and is situated in the town of St. Marys and very close to the sea front. The home has a progressive attitude to community contact, which they actively encourage at every opportunity. The style of care provided is based upon residents individual needs within which empowerment; dignity, rights and maximising independence are central features. The Home is also Care Homes for Older People Page 4 of 29 Over 65 14 0 0 2 Brief description of the care home committed to ensuring that changing needs are recognised and that the care provided is adjusted accordingly. There are strong links with the carers and friends of residents and the setting has a flexible approach to visiting arrangements. Day Care and shortterm residential care are also available if the resources permit. The bedrooms are for single occupancy and the home is comfortably furnished. There is limited outdoor space for people who use the service, however there is a park immediately opposite the home and a beach close by. People who use the service are offered a financial assessment by the Isles of Scilly Social Services to determine their contribution. Fees are based at 451.70 pounds per week. Care Homes for Older People Page 5 of 29 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: This was an unannounced key inspection of Park House which took place on the 16 and 17 October 2008 by one inspector. We sent out surveys prior to the inspection to people who use the service, staff and visiting professionals. We received 4 completed staff surveys and 2 from visiting professionals. At this key inspection we met and talked with people who use the service, relatives / representatives, registered manager, care staff and visiting professionals. We looked at records, care documentation, policies and procedures and inspected the environment. Case tracking and direct observation were used. Care Homes for Older People Page 6 of 29 Care Homes for Older People Page 7 of 29 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 8 of 29 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 9 of 29 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 are not provided with sufficient information to enable them to make an informed choice about the care home. Each resident is assessed to make sure the provider is able to meet their needs, preferences and choices. Evidence: The certificate of registration is displayed clearly within the hallway of the home. A service users guide and statement of purpose is given to residents. People we spoke with, including residents and a visitor to the home, were aware of these documents. Some further information must be included within the statement of purpose e.g. specific information about the activities within the home, more detail about the fire precautions, the number and size of the rooms. The service users guide is informative and the registered manager told us it could be provided in a format suitable for the reader e.g. large print, if required. The service users guide should inform people about Care Homes for Older People Page 10 of 29 Evidence: the views of the service users and also provide further information on the communal space within the home. The most recent inspection report is available within the entrance area of the home. Each person is issued with a contract when moving into the home. The registered manager told us that this is due to be updated to provide more detailed information. She also said that a specific contract for people moving into the home for a trial or respite period is to be developed. Prior to moving into the home the registered manager obtains a summary of the persons care needs from the referring agent e.g. health or social services. A care needs assessment is undertaken by the registered manager or her deputy to ensure that peoples care needs, choices and preferences can be met. A written record is kept of this detailed assessment. Care Homes for Older People Page 11 of 29 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. Staff are provided with information within the individual plans of care that tells them of the action they must take to meet peoples assessed care needs. Privacy and dignity of people who use the service is respected and promoted. Systems and practices that are in place regarding peoples medication do not fully protect them. Evidence: Care plans are in place for each person who uses the service that detail their needs, preferences and choices. The care plans are regularly reviewed on a monthly basis and updated following a routine review or as care needs change. The care plans are in sufficient detail to inform and direct staff of the action they must take to meet peoples assessed care needs. Limited evidence is available to show that the person and / or their representative was involved in planning the care or their agreement to the care plan. Good arrangements are in place to meet residents health needs and medical services are accessed when required. During the inspection we observed Community Nurses, Care Homes for Older People Page 12 of 29 Evidence: General Practitioners and the chiropodist visiting. People who use the service are supported to access appointments at the local hospital. People who use the service that we spoke with appeared satisfied with the care that they receive. We were told by individuals: I am very well looked after, They take good care of me, I am very happy with the care I get and This must be the best care home in Britain, they take very good care of me and make sure that I have what I need. We spoke with relatives visiting the home on the day of the inspection and they were able to tell us We are kept informed of our relatives condition regularly, mainly by telephone as we live a fair way away. We think the home does a grand job and are very helpful and supportive to XXXXs individual circumstances. A visiting professional that we were able to speak with during the inspection visit made positive remarks about the home and told us I think they manage well and provide really good care. They are willing to learn new skills and competencies and ask for additional support from other external people appropriately. We also recieved completed from external professionals e.g. community nurses and general practitioners. They said that peoples health care needs are always or usually met by the care service. The privacy and dignity of people who use the service is respected. Staff are provided with information in the care plans relating to individuals wishes. The preferred name of each person is recorded and we observed this being used both in conversations and within written records. People have access to a telephone either within their own room or privately in the office. People are assisted with medication by the staff. Medication Administration Records (MAR)identify the individuals prescribed medicaiton, which is supplied in original containers. The home has a system in place that involves the registered manager and / or her deputies dispensing the persons daily medication into a 24 hour dosette box. The MAR sheet is then signed on the rear of the form, to show that the medication has been dispensed into the dosette box. This is secondary dispensing and is not recommended as good practice due to the potential risk of error. Once administered to the person the MAR sheet is again signed. The procedure within the home is that two members of the staff assist with or administer peoples medication. A specialised medication dispenser has been supplied for one resident by the pharmacist. Medication is stored securely within the home. The policy and procedure relating to medication is available to staff and meets with current legislation. It is possible to audit the medication received in and taken out of the home. Staff have received medication training within their NVQ training and in house from the registered manager who is a registered nurse. Care Homes for Older People Page 13 of 29 Care Homes for Older People Page 14 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service told us that the home meets their social / recreational needs, that they are free to determine their daily lives and that that their is no restriction on receiving visitors. A wholesome diet is provided and people who use the service told us that the standard of food was very good. Evidence: We were told by people who use the service, the registered provider and care staff, that activities are provided within the home. One person said I enjoy going out when the weather is good, the staff take me out in the wheelchair. A coffee club is held on Friday mornings with people from the local community also attending - one person using the service told us how much they enjoy this. We were also told by some people that they prefer their own company and choose to remain in their rooms. One person added the staff often spend time with me, chatting, which I like. Limited written information was observed of activities either within the home or externally and it was not clear of individual peoples participation within the activities. We were told by both visitors and people living at the home, that visitors are always welcomed and encouraged to come. Visitors can be received within the communal areas - there are Care Homes for Older People Page 15 of 29 Evidence: two lounge dining rooms or within private bedrooms. It was noted that not all bedrooms have 2 chairs, but a member of staff said that additional chairs are always provided whenever needed. The visitors book shows evidence of numerous visitors attending the home. People told us that they make choices as to their daily lives e.g. getting up and going to bed. The registered manager told us that financial affairs are managed by the person using the service and / or their representatives. Support from advocates can be arranged if needed through the Isles of Scilly Social Services Department. All of the people who use the service that we spoke with were positive about the meals that they are provided with. The main meal of the day during the inspection was cottage pie, carrots and broccoli. This was followed by fruit meringues. People appeared to enjoy their meals and were given necessary assistance by the staff during the meal time. The dining rooms are spacious and attractively decorated with drinks and cruets located on each table. Two people remained in their rooms for their meal. The menu is based around a 3 week rotation but can be changed if requests are made or supplies alter. There is no formal choice of meal offered but the cook told us that she is aware of peoples likes and dislikes and alternatives are always available. This was confirmed by the people who use the service that we spoke with. One person said The food is excellent, I like all the meals. Another told us the food is good, they know what I like and dont like so all the meals suit me. We discussed with the registered manager the process of offering people a formal choice of meal rather than basing the food provision on peoples likes and dislikes. Care Homes for Older People Page 16 of 29 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 know how to make a complaint should they need to do so. The policies and procedures within the home do not fully protect people who use the service should their be an alleged or suspected safe guarding issue. Evidence: A complaints procedure is in place for people to refer to and this is included within the statement of purpose, service users guide, policy file and contract. The Commission for Social Care Inspection (CSCI) has received one concern since the last inspection which we asked the registered provider to investigate. We received a full and detailed report following their investigation and no further action needed to be taken. A complaints and compliments log is in place within the home. People who use the service told us that they know how to make a complaint but all spoken with, clearly said they had had no need to complain. Staff know what to do should anyone make a complaint to them. There is an adult protection policy and procedure in place. This should now be reviewed and developed to include the procedure of the action staff and the registered manager will take should there be any suspected or alleged abuse. Staff have received training regarding safe guarding adults from external trainers during 2007. Care Homes for Older People Page 17 of 29 Care Homes for Older People Page 18 of 29 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. The environment provided is generally well maintained and is clean, pleasant and hygienic. Evidence: The care home is a two storey building. Access to the first floor is by means of the stairs or a stair lift. The registered manager told us that all of the current people who use the service can access all parts of the building. The home was observed to be comfortable and homely. Outside space accessible to people who use the service is limited but immediately across the road is a public park which we were told that people frequently use when the weather is good. Recent visits have been carried out by the fire and environmental health officers. There are two lounge dining rooms that are comfortably furnished and lighting provided is of a domestic nature. Equipment and adaptations were observed throughout the home to promote the mobility and independence of people e.g.grab rails, raised toilet seat, bath hoists, turn table, stand aids and hoists. A call bell system is in place but this is due to be replaced shortly. The registered manager has been given a date that work will start within 3 weeks of the inspection. This was a previous requirement identified in the last Care Homes for Older People Page 19 of 29 Evidence: inspection report. Individual bedrooms were seen to be personalised with peoples own possessions. People told us that their rooms were comfortable. One person said I like my room and own company. I spend a lot of time in my room and am happy. The bedrooms can be locked from inside the room and accessed in an emergency from outside. Not all rooms currently have lockable storage space within them. The bedrooms were observed to be carpeted and all were clean and tidy. Some of the built in furniture is dated in appearance. A new heating and hot water system has been recently installed within the home. The plumber is addressing the issue of thermostatic controls being fitted to all hot water outlets. The registered manager agreed to inform us when this work is complete. As the water systems have recently been installed, there has been no legionella test carried out to date. Radiators and hot surfaces are guarded. It was observed that some windows did not have window restrictors fitted, work was taking place during the inspection to address this. The home was observed to be clean and tidy during the inspection and mainly odour free. There are laundries located on both floors and provide industrial washing machines. Tumble driers are also located in the laundry areas. Care Homes for Older People Page 20 of 29 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. People who use the service are cared for by trained and competent staff. The recording system regarding staff recruitment does not evidence that people who use the service are fully protected. Evidence: On the days of the inspection there were two care assistants and either the registered manager or her deputy on duty from 07.30 - 22.00. At night there is one waking and one sleeping member of staff on duty. We discussed with the registered manager the procedure of how peoples needs are met during the night, particularly for people who need the assistance of 2 care staff. The registered manager agreed to review the levels of staffing at night, comparing the levels with the dependency needs of the current residents. The room provided to staff on a sleeping night is currently in an annexe of Park House. We were told that this is due to revert back to the main house shortly. People who use the service made many positive comments about the care they receive and all agreed that the staff were reliable, supportive and skilled in the way in which they undertake their duties. Staff told us that they are generally satisfied with the staffing levels. One member of staff completed a survey and said we are usually covered fully with staff, but being where we live it does have its difficulties. We were also told that when there is a shortage of staff e.g. holiday or sickness, agency staff from the mainland are used. Due to the travelling issues, agency staff are Care Homes for Older People Page 21 of 29 Evidence: usually booked for more than one shift and are accomodated on the island. The same agency staff usually come which helps with continuity and stability of the staff team. New staff are required to complete an induction training. This has been developed to reflect the skills for care foundation standards. A training programme is in place that includes in house and external training. Records of the training attended by the staff are held on personnel files by the registered manager. Further training has been booked in the near future for staff regarding food hygiene, safeguarding adults and 1st Aid. Staff are encouraged to undertake NVQ training. Staff who completed surveys prior to the inspection told us that their induction covered everything that they needed to know to the job when they started. They also confirmed that the training they are given is relevant to their role, helps them to understand and meet the needs of individual service users and keeps them up to date with new ways of working. One member of staff added training is readily offered to all staff on all aspects of the job. Staff recruitment records are held by the personnel department of the Isles of Scilly Social Service. We were able to see these records at the town hall. We discussed the need for staff records to hold all relevant documentation and to be available in the care home as per Regulation 17 and Schedule 4. One staff record did not identify that a CRB check had been obtained and another held only 1 reference. Care Homes for Older People Page 22 of 29 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 is run in the best interests of people who use the service. Evidence: The home is well run and managed. Comments from people who use the service and the staff in respect of the registered manager were positive. All felt that they could approach her with any concerns or issues and that they would be dealt with appropriately. The registered manager was observed spending time with people who use the service and their relatives. One relative said We ring and speak to Lesley often, she keeps us up to date and we always feel able to ring. Staff told us This is a very friendly and happy place to work. Lesley is brilliant, she is always there for us and we can go to her at anytime with anything. We have a staff meeting every week and we all come to it. We can discuss anything there. We were able to see completed quality assurance survey forms on peoples individual files. The registered manager told us that everybody plus their relatives is given a Care Homes for Older People Page 23 of 29 Evidence: survey to complete, and following the survey any concerns are addressed. We discussed the need to audit and publish the results of the quality surveys. People we spoke with were satisfied that they felt in control of their lives. The providers will assist people who use the service to manager their personal allowances if they do not have relatives / representatives to do this. The money is held securely. We audited the records and money for a number of people who use the service and found these to be accurate and up to date. Staff told us that they feel very well supported by the registered manager and the deputy managers. However, written records do not evidence that staff are supervised regularly. Further comments were made within surveys completed by the staff including I meet with the manager most days, she is very supportive in both work and personal life. She is very approachable and is contactable whenever needed - day or night. A range of measures are in place to promote safe working practices and this includes a number of policies and procedures. Risk assessments have been developed to positively manage risks that people who use the service may experience living at Park House e.g. fire and environmental risk assessments. The equipment and services at the home are regularly serviced and maintain and this includes the fire detection arrangements. The local fire brigade carry out a full fire drill twice a year involving staff and people who use the service. Further training should be provided to the night staff during the year. Care Homes for Older People Page 24 of 29 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 18 12,1a,b,2,5b, Adult protection policy and 30/04/2007 13,6 procedures must be amended to meet the national minimum standards. 2 38 23(4)c-e Fire training and drills must 30/12/2006 be undertaken on a regular basis that reflects good practise standards. (Previous timescale of 30 April 2006 not met). Care Homes for Older People Page 25 of 29 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 4 It is required that the 16/01/2009 statement of purpose contain all of the information detailed in Regulation 4 and Schedule 1. This is to ensure that people are provided with information to enable them to make an informed choice about the home that they live in. 2 1 1 It is required that the service users guide be reviewed and developed to provide the information as detailed within Regulation 5 and standard 1. This will enable people to make an informed decision about the home they live in. 16/01/2009 3 9 14 The registered provider shall 19/12/2008 make arrangements for the recording, handling, safekeeping , safe administration and disposal Care Homes for Older People Page 26 of 29 of medicines received into the care home. It is required that medication is dispensed from original packaging or as dispensed by the pharmacist to reduce the risk from errors associated with secondary dispensing. 4 15 17 It is required that a record of the food provided for service users is maintained. This is to enable any person inspecting the record to determine whether the diet is satisfactory, in relation to nutrition and otherwise, and of any special diets prepared for individual service users. 5 18 13 The registered person shall make arrangements to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. The policy and procedure should identify the action that staff and the registered manager will take if any suspected or alleged abuse is identified. 6 29 17 It is required that a record of all persons employed is available within the care home. Records must include copies of two written references and a CRB check. 19/12/2008 19/12/2008 19/12/2008 Care Homes for Older People Page 27 of 29 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 2 It is recommended that the contract be reviewed and developed to include the fees payable and by whom, who is liable if there is a breach of contract and the period of notice to be given. It is recommended that the person using the service and / or their representative sign the care plan to show their agreement with the planned care package. It is recommended that further written evidence is maintained of activities provided to people who use the service and their participation and enjoyment of the activity. It is recommended that a formal choice of meal is offered to people who use the service. It is recommended that the complaints procedure be developed to show the correct address for the Commission for Social Care Inspection. It is recommended the registered provider inform CSCI when the contracted work to install a call bell system is completed. It is recommended that the registered provider inform CSCI when the contacted work to install thermostatic valves is completed. It is recommended that the registered manager undertake a review of the staffing levels, particularly at night, when one waking and one sleeping member of staff is on duty. It is recommended that the annual surveys are audited and made available to current and prospective service suers, their representatives and other interested parties, including CSCI. It is recommended that written records evidence that staff are provided with formal supervision at least 6 times a year and that the supervision covers all aspects of practice, philosophy of care within the home and career development needs. It is recommended that staff receive adequate fire training. 2 7 3 12 4 5 15 16 6 22 7 25 8 27 9 33 10 36 11 38 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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