Inspection on 11/02/09 for Pavilion Court

This inspection was carried out on 11th February 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Pavilion Court 28/01/10

Pavilion Court 23/11/09

Pavilion Court 16/05/08

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Pavilion Court Brieryside Cowgate Newcastle Upon Tyne NE5 3AB     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: Janet Thompson     Date: 1 1 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 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 30 Information about the care home Name of care home: Address: Pavilion Court Brieryside Cowgate Newcastle Upon Tyne NE5 3AB 01912867653 01912865794 pavilioncourt@cshealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Southern Cross BC OpCo Ltd care home 75 Number of places (if applicable): Under 65 Over 65 0 75 dementia old age, not falling within any other category Additional conditions: 75 0 The maximum number of service users who can be accommodated is: 75 The registered person may provide the following category of service only: Care Home with Nursing - Code N 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 75 Dementia Code DE, maximum number of places 75 Date of last inspection Brief description of the care home Pavilion Court is a 75-bedded care home situated in the Cowgate residential area of Newcastle. The home opened in August 2005 and provides residential and nursing care to older people over two floors, including those with dementia care needs. All bedrooms are single and have en-suite facilities. There is a range of communal space including seven dining rooms and lounge areas. The home is attractively decorated and furnished. A range of aids and equipment has been provided. People who use wheelchairs can access all areas of the home. Off road parking is available and the home is close to local bus routes. Care Homes for Older People Page 4 of 30 Brief description of the care home Fees for the home vary. Further information about fees can be found in the homes statement of purpose and service user guide. A copy of the last inspection report has been appended to the service user guide a copy of which is available in the main reception area. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 the people who use the service experience adequate quality outcomes. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations. This will only happen when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Before the visit we looked at information we have received since the last inspection Care Homes for Older People Page 6 of 30 visit, including how the service dealt with any complaints or concerns. We also looked at any changes to how the home is run and asked for the managers views of how well they care for people. We always seek the views of people who use the service, their relatives, staff and other users of the service. This is usually given to us in the form of questionnaires. At the time of writing this report we had received seven responses from questionnaires. During the unannounced visit we talked with people who use the service and some of the staff. We looked at the information about people who use the service and how well their needs are met. We looked at other records the home is required to keep and checked that staff had the knowledge, skills and training to meet the needs of the people they care for. We looked around the building to make sure it was clean, comfortable and safe. and we checked what improvements had been made since the last inspection visit. Feedback was given to the manager at the end of the visit. We were accompanied on this inspection by an expert by experience. This is someone who has an interest and some knowledge of care of the elderly. They are not employed by us and work as a volunteer. We asked that expert by experience to look at social care in the home. The comments of the expert by experience are reflected throughout this report. What the care home does well: What has improved since the last inspection? What they could do better: The care standards varied throughout the home. Residents and relatives told us that Care Homes for Older People Page 8 of 30 not all staff gave good care. In the dementia unit we saw that people were not properly dressed in that they had bare legs or socks instead of tights or stockings. Staff did not give person centered care to these residents in that they did not ensure that everyone had a nurse call, an accessible drink or something to occupy themselves. A second activities person has been employed. There is an activities organiser on duty seven days a week for six hours per day. When we inspected, the activities person was accompanying someone to hospital. We noticed that residents, particularly in the dementia unit were unoccupied and sitting asleep. Residents social needs were not adequately planned for and records of activities not good enough. At mealtimes residents in the dementia units were not assisted to eat in a discreet manner. Some were not given the correct food choice and options were changed with no consultation. The expert by experience said that a resident spilled her drink in her food. Staff noticed this but did not change the meal. The expert by experience noticed that medication was given to some people on the dementia unit with their meal and, in one case, in a drink. No-one supervised the residents to make sure the medication was taken. Relatives said that medication was sometimes found on the floor in the home. Staff have received training in this area but are obviously not following the policy. Some staff training was still not up to date though progress has been made in this area. The health and safety checks on fire systems, hot water and bed rails had not been carried out. The manager said this was due to the absence of the handyman. However, these checks are vital for the safety of residents and should have been allocated to someone else. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are properly assessed, taking account of their needs and wishes, so that they can be assured this is a suitable home and receive an individual care service. Evidence: Three pre-admission assessments were seen. They contained enough information to enable staff to assess if they could meet the individual needs before admission. Information from other health professionals and carers was included in the assessments. We spoke to residents about the admissions procedure but they could not remember the details. One relative described how she had looked around the building before her mothers admission. She said she had been given enough information about the home at the time. Care Homes for Older People Page 11 of 30 Evidence: Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal care that is well planned but does not take full account of their diverse needs. Evidence: Three care plans were examined and case tracked. This means that we spoke to the individual residents or observed their care then matched our observations to what was written in the care plan. All three case tracked care plans did reflect the actual care needed by the residents. Care plans took account of peoples diverse and differing needs. Other health professionals contributed to the planning of care. These contributions were clearly recorded. In questionnaires a relative told us that they would like to have a review of the care plan with staff. The manager could not understand why this was said as he stated that care plans are reviewed with relatives every six months, if care needs are complex this is increased to every three months. The manager agreed to change the system to be more flexible if relatives wanted more frequent reviews. Care Homes for Older People Page 13 of 30 Evidence: We talked to residents about their care needs and they told us they were well cared for. Residents had clean finger nails and lots of female residents had manicured nails. Residents on most units looked clean and well cared for. We noticed that residents in the Dementia unit had bare legs or socks on their feet. In questionnaires residents and their relatives told us that most staff were attentive and willing to help. They also said the home had good links with Doctors and other health professionals. One resident had been receiving nursing care, she had been treated by a private physiotherapist and was ready to be discharged from the home. Two residents in the home are suffering from pressure sores. One was acquired outside of the home and the other was minor. Records relating to the treatment of these were satisfactory. Medication ordering, administration, storage and disposal were examined. The dispensing pharmacist checks all medicines once per month. All medicines are audited by the nurse every week. All medicines were accounted for and all those administered were signed for. Three amounts of controlled drug were checked and were correct. All staff with responsibility for administering medication have recently undergone a pharmacy test. This checks their knowledge and understanding of the procedure and drugs in use. We talked to a senior carer who gives out medicines on one unit. She demonstrated a very good knowledge of the system and was confident in her abilities. The expert by experience did see residents on the Dementia unit given medication without adequate supervision. She said. Medication was given throughout the meal. Two residents who were given pills did not take them straight away and no staff observed whether or not they actually took the pills, there was the possibility of dropping them or leaving them in the food left on the plates. One resident, whose hands were bandaged, had difficulty holding her glass of juice and spilt some onto her food. Staff noticed this but did not ask her if she wanted her food replaced. She was given some liquid medicine in the same glass but staff did not observe whether or not she was drinking or spilling it. Staff were seen to treat residents politely and respectfully. One of the questionnaires received said that care standards varied among carers. Two said that they felt that the carers did not all respond well to residents needs and one said staff seemed disinterested. The majority of comments received were positive. The expert by experience talked to one resident who did not have her call bell near to hand. When questioned staff said this was because she would be unable to use it to ask for assisstance. The manager agreed with this assessment, however, any limitations as such should be documented in the care plan as an assessment of capacity. Similarly we noticed htat some drinks in peoples rooms were not within Care Homes for Older People Page 14 of 30 Evidence: reach. We concluded that the care was not consistent between units and not always person centered. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are not fully supported to lead a healthy and fulfilling personal lifestyle which takes account of their wishes and diverse abilities. Evidence: Before the inspection we received questionnaires that told us the social activities were not adequate. Residents and relatives said that there were too few activities and they were not advertised. They also said that a promised newsletter was seldom seen. Relatives told us that most large group activities happened in the Dementia unit and not all residents wished to go there. The manager agreed with all of the comments. He told us that activities had not been good in the home. To address this he has taken on another activities co-ordinator. This means that there are now two people working on activities. The provision is for six hours seven days per week. This has only been in place for a week. On the day of inspection the activities co-ordinator was accompanying someone to hospital instead of doing activities. The manager stated the dementia unit is used a lot for activities because it has the only lounge big enough to accommodate a large number of people. Residents told us that there were not enough outings from the home. There was not a lot of evidence of good social links within the community and this is something the manager hopes to improve. Care Homes for Older People Page 16 of 30 Evidence: In questionnaires residents and relatives said the food choices were limited and repetitive. They said the people in the dementia unit did not get their food on plates in the evening. The manager was not aware of this and agreed to investigate why this happened. We were told that the new NUTMEG menu started two days before the inspection. NUTMEG is a menu system based on a nutritional tool. The system takes some time for catering staff to get used to as it introduces a lot of different menus. It does provide residents with greater variation of food and should address some of the complaints made in questionnaires. We asked residents what they thought of the menu so far, they told us they liked it. One resident said she was enjoying trying new things. We ate the food at the home and tried to observe the lunch being served in as many dining areas as possible. The food we ate was Risotto, followed by Rhubarb Crumble and Custard. The food was hot enough, tasty and well presented. A number of residents tried the risotto and enjoyed it. We did notice that there was a difference in the dining areas between the residential or nursing unit and the dementia unit. The people in the dementia unit were not offered biscuits with their coffee. There was no ice-cream and they were all given yogurt without explanation or choice. We also noticed that none of the dining areas displayed menus, this is important to remind residents of the choices they ordered. The expert by experience told us that in the Dementia unit the place mats were dirty, there were no napkins used, only plastic aprons, and the food was late to be served because the choices sheet had not arrived. She said that staff noticed, after serving the soft meals that they were not the correct choices. No attempt was made to change them. Care Homes for Older People Page 17 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate 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 not properly protected from harm through thorough policies, procedures or staff training. Evidence: Staff follow the homes policies and procedures relating to the management of complaints and allegations of abuse. Staff spoken to were clear about their role in whistle blowing and complaints. The training for staff in relation to adult protection had fallen due to staff turnover. The training is a thirteen week accredited course, therefore not all staff can attend immediately. The manager confirmed that twelve staff are booked onto the next available course. Residents are told how to complain through the complaints procedure. This was clearly visible within the home. The procedure needs to be updated to reflect that CSCI does not investigate individual complaints, information about the Local Authorities procedures should be included . Residents spoken to said they would complain if they needed to but none of them had any current complaints. One relative told the expert by experience that she had raised complaints and was dissatisfied with the outcome. We discussed this with the manager who is taking appropriate action. In questionnaires most relatives told us that the home had improved slightly since the appointment of the manager. The number of complaints received since his Care Homes for Older People Page 18 of 30 Evidence: appointment has fallen. Care Homes for Older People Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a safe comfortable home that is generally clean but not fully odour free. Evidence: We walked around the building and looked at residents bedrooms, sitting areas, bathrooms and toilets. The home was generally clean, however there were areas of the home that did not smell fresh. Some areas of the home were also untidy, there was a lot of old equipment such as walking frames and wheelchairs that were no longer needed. These were cluttering up bathrooms and store cupboards. The expert by experience noticed that the sitting areas in the dementia unit looked institutional. Chairs were placed around the walls making small group conversation difficult. We also noted that the dementia unit was not adapted to help people with confusion as the doors were all the same, there were no directional signage indicating sitting areas and handrails did not stand out. The manager does have plans to redecorate this unit. The expert by experience voiced concerns that this would be done without consultation with dementia experts. The manager stated that he has consulted various dementia authorities about his plans. Some of the walls in the nursing corridor and dining room were scuffed. Care Homes for Older People Page 20 of 30 Evidence: Residents bedrooms were clean and comfortable, though some did have odours. Residents told us they liked their bedrooms. One lady was adjusting her heating when we arrived to talk to her and staff helped her with this. The resident told us that the rooms are cleaned every day, she was able to bring things from home that she liked to have around her and she was very happy with the home. Toilets and bathrooms were clean enough but in some there were no guardrails on the toilets. These are important to keep residents safe and develop or maintain some Independence. Staff generally practiced good infection control techniques. The laundry was clean and well equipped to deal with soiled or infected linen. Some of the bins in the home were not foot operated. This is essential to contain and limit the spread of infection. Care Homes for Older People Page 21 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are supported and protected through staff numbers, but skill and ability could be improved. Evidence: Staffing for the home is split into different units. The nursing unit has a nurse at all times with three carers through the day and one at night. The residential unit has a senior carer at all times with an additional carer through the day. Both dementia units have a senior carer at all times with two carers through the day and one at night. We noticed that some staff interacted with residents more than others and that the care given was not always person centered. When we examined staff training records it was apparent that training had lapsed to a large degree recently. The manager has taken steps to address this and it has improved but many areas still need to be addressed. Some of the training courses, such as adult protection and infection control take thirteen weeks to complete. This means that improvement in the training statistics will be slow. We noted that only 44 of staff had up to date moving and handling training but by March the figure would reach 85 . None of the staff had infection control training and only 15 were trained in the protection of vulnerable adults. The manager stated that he had booked staff on the vulnerable adults course as a priority, when they have completed this they would be trained in infection control. Care Homes for Older People Page 22 of 30 Evidence: We agreed with the priority list. All staff with responsibility for handling medicines have been trained to do so, though we did observe that they did not always follow proper procedure. 70 of staff are trained in NVQ 2 or above. Three staff recruitment files were checked. These were for one nurse, one senior carer and one carer. All contained evidence of thorough background checks. All staff had completed an application, provided two references and undergone a criminal records check. Work permits were in place for overseas workers and a registration check had been carried out for the nurse. Care Homes for Older People Page 23 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service are not fully protected through reflective management which takes account of the diverse needs of the service. Evidence: The home is run by an experienced manager who is qualified for the role. The manager has not yet been registered by CSCI for the home. The manager has been in post for a few months and has not yet made all of his planned changes to the home. Staff spoken to said the home has improved since he took over. They have had a period of disruption when different managers have been in post. Staff said things were settling down now and they felt more confident and relaxed. A quality assurance system is in place. Residents, relatives and staff are consulted through meetings and an open door policy. The systems in the home are regularly audited using a measurable tool that gives a percentage score for each section. This reflects a slight improvement in all areas over the last two months. Care Homes for Older People Page 24 of 30 Evidence: Residents money is held in a pooled account. The amounts therefore could not be checked. The records for two accounts were checked and seemed to be in order. The health and safety checks in the home had lapsed due to the absence of the handyman. We advised that someone else should be given responsibility for checking fire systems, window restrictors and hot water systems. There had been no internal fire checks carried out in 2009. External safety checks on gas and electrical appliances were up to date. Care Homes for Older People Page 25 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 Ensure that all staff follow the medicine procedure when administering medication. Residents are fully supervised to ensure they take all of their medication. 01/04/2009 2 18 13 Provide all staff with training 01/04/2009 in the protection of vulnerable adults. This helps to protect residents from abuse. 3 22 13 Provide grab hand rails to all 01/04/2009 toilets. This keeps residents safe. 4 26 16 Address the cause of the odours in the home. Provide bins that are foot operated. This helps to ensure that the home is hygienic and pleasant for residents to live in. 01/04/2009 Care Homes for Older People Page 27 of 30 5 30 18 Proved a training action plan 01/04/2009 indicating the timescales for meeting training targets. This promotes better standards of care for residents. 6 38 13 Ensure that all health and safety checks are brought up to date and continue to be checked at the correct intervals. This maintains the safety of the building for all users. 01/04/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 10 12 Provide staff with training relating to the promotion of person centered care. Develop a full social programme that takes account of residents past experiences and personal wishes. Ensure that residents and relatives are made fully aware of the programme. Develop better links with the local community and support residents to access these. Demonstrate how residents are supported to maximise autonomy and choice. Ensure meal choices and dining standards are the same for all residents in the home. Develop siutable tools to help the people in the dementia unit choose their food. Ensure adeqaute supervision is given to all residents over mealtimes. Update the complaints procedure. Produce a programme of redecoration. Ensure that the home remains tidy at all times. 3 4 5 13 14 15 6 7 16 19 Care Homes for Older People Page 28 of 30 8 31 Provide a registered manager. Care Homes for Older People Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (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 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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