Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Prospect House Care Home Blundells Lane Rainhill Merseyside L35 6NB 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: Michael Perry
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: Prospect House Care Home Blundells Lane Rainhill Merseyside L35 6NB 01514931370 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) : maureen@malkhandy.com Ms Maureen Bromley,Mr Neil Malkhandi care home 24 Number of places (if applicable): Under 65 Over 65 0 dementia Additional conditions: 24 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: Dementia - Code DE The maximum number of service users who can be accommodated is: 24 Date of last inspection Brief description of the care home Prospect House is a care home for 24 older people with dementia, and the registered manager is Mrs. Maureen Bromley. The home is a large converted dwelling house, which has been extended. Prospect House is set in its own grounds a short car journey from local amenities and bus routes. The home provides single accommodation and is staffed throughout the day and night. All residents are registered with a local G.P. and the service includes personal care, home cooked meals and a laundry service. The grounds include a car park, paved areas and gardens with views of the countryside. The fees in the home are 409 pounds per week. Care Homes for Older People Page 4 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: Before we visited the home the manager filled out a form ( called the Annual Quality Self Assessment, or AQAA) we sent and returned this. It had a lot of information about the home and how the people are supported to live their lives. We visited the home without telling the staff we were coming so that we could see how things work normally. We spoke with many people who live there and observed how they spend their day and how the staff support them. We also spoke with relatives. We looked at the records kept on people who live in the home and other records that show how the home is run. Care Homes for Older People
Page 5 of 30 We looked around the home to see if it was clean and a nice place to live and some of the people living in the home showed us their bedrooms. As part of the inspection we were accompanied by a person who has had previous experience of care services. This person is called an expert by experience and assists the inspector by making observations and speaking to staff and people in the home and then providing some feedback. Comments by the expert are included in the report. What the care home does well: What has improved since the last inspection? What they could do better: We would recommend that copies of the homes written guide [service user guide] is made more readily available so that anybody calling at the home or making an inquiry can be given sufficient information. The care plans and records should record any health support. This will ensure that all health care is supported and monitored appropriately. Care Homes for Older People Page 7 of 30 We looked at the way staff manage medication and found that people living in the home are receiving a safe service. We would, however, recommend that if a person is prescribed a variable dose of medication the records should indicate what dosage has been given. This will ensure a consistent approach. We found that the social life in the home is relaxed and welcoming and staff do interact and encourage residents to be alert and involved. We feel that this can be further developed with more stimulation in the general environment for people with dementia so that they are assisted and encouraged to orientate themselves and to be able to access all areas such as the garden. This will improve the quality of life for people in the home. We spoke to staff in charge and other care staff in the home. We felt that they could be more aware of how the home need to be protecting people by reporting concerns or allegations of abuse through the right channels. The homes polices should be reviewed and made more accessible. Most areas in the home have now been upgraded and were comfortable for people to live in. The dining area is where most people congregate and needs to be decorated and made comfortable in line with the rest of the home. We observed a resident being moved in a wheelchair. The wheelchair had no footrests in place. We observed other wheelchairs stored also without foot rests. This practice presents risk of injury to residents. Wheelchairs must have footrests in place unless for specific reasons which should be included in the individuals care plan. We looked at staff records to see how staff are recruited. We found that some checks that are required such as written references are not being accessed consistently. The management do not always therefore have sufficient information to make a judgment about the suitability of a staff member. This may be putting people at risk. We have made a requirement that this practice must be improved. The managers of the home have shown that they can work at improving standards in the home and have met some of the requirements and recommendations previously made. We found however that the approach is still inconsistent and there are some areas that still need to be addressed as well as other issues [such as recruitment of staff] that now also need to be addressed. We have made some further recommendations following a review of some of the health and safety reporting in the home. Consistency in the area of overall management is important so that the service can continue to improve and support the best interests of people living in the home. 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 Care Homes for Older People Page 8 of 30 240 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 admitted appropriately and assessed so that care needs can be identified. Evidence: The home have produced some information for anybody who wishes to look around or is admitted. This is called the Service User Guide [SUG]. We asked for a copy of this and the staff produced a single copy from a folder in the office. There were no others available. This was discussed as when the managers are not available staff would not be able to access a copy if needed. We would recommend that the guide is more easily accessible. We looked at the admission process and the assessments that are made at this time. We saw a recent care file of a person who had been admitted as an emergency. There were copies of professional assessments such as social work and health care workers. Following admission the staff had completed a series of their own assessments to a
Care Homes for Older People Page 11 of 30 Evidence: good standard. This ensures that the persons care needs are identified and a care plan can be drawn up which is used to carry out and monitor the care. Staff were able to talk about some of the residents who had come to have a look around the home before moving in. This helps ensure that people can settle into the home effectivly 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. The management of health and personal care ensures that people are generally well cared for so that their rights and dignity are preserved. Evidence: We spoke to relative and looked at care records and found that health care is accessed and supported in the home. Some of the care records evidenced that people are supported to attend GP appointments and also to attend for other health checks such as dentist and opticians. For example one care record was for a person who had sustained a fracture and had attended hospital. There was also reference to physiotherapy input. This was monitored through the care plan so that the care could be easily traced and monitored. This was not the case with other care records seen, however, and it was difficult to find any reference in some care records regarding any health input. For example one person has diabetes but there was no reference to any medical support. Staff advised
Care Homes for Older People Page 13 of 30 Evidence: us that visiting GP and district nurses are recorded in the daily notes but these are archived and information is therefore not always readily available. We discussed the idea of a recording sheet to record any health care input as well as the care plan. All of the residents have a plan of care so that care staff could follow the care for each resident. They are reviewed monthly and ongoing. The care plans were rather lengthy and it was difficult to be clear about current care needs as some needs had been met but were still on the plan. Some assessed needs did not have any planned interventions for staff to refer to and some care interventions were rather brief. For example one person who had very challenging behavior had a brief statement to reassure that this is his home. We spoke to care staff who are involved in daily recording of the care. The daily notes were generalized and did not always refer to the care plan. There is a risk here that perhaps staff are not looking at care plans regularly and therefore may not deliver care effectively. We looked at the care of one person who has poor mobility and found the care plan supported independence by ensuring the provision of disability aids [hoist and wheelchair]. The home partly meets with current legislation by providing disability access at all internal areas although the grounds are currently not accessible due to health and safety reasons. This shows that the home are considering a diversity of care needs and are trying to meet these although still need to make all areas accessible. We observed a resident being moved in a wheelchair. The wheelchair had no footrests in place. We observed other wheelchairs stored also without foot rests. This practice presents risk of injury to residents. Wheelchairs must have footrests in place unless for specific reasons which should be included in the individuals care plan. [See requirement under environment]. Residents spoken with said that staff where helpful and respectful. We observed staff interacting well and supporting people which maintains their dignity. We saw that people where dressed appropriately and that they were clean and had good standards of personal care. We looked at the medicines and from the records and observations made it is clear that these are generally managed safely. Medication administration records were generally clear and recorded that residents received their medications on time. Staff reported that they are trained in medicine administration by completing an external course and also by being shadowed by the manager for an extensive period
Care Homes for Older People Page 14 of 30 Evidence: before being considered competent to administer medicines so this area of care is carried out by competent staff. One person is prescribed medication to be given when necessary. The recording and instructions for this were unclear. The dosage was variable but the medication record [MAR] did not record which dose was given. There was also no reference to this medicine in the persons care plan. This is important so that all staff can be aware of why the medicine should be given and it can also be regularly reviewed. 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 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 offered a full range of varied activities to meet their needs. Evidence: We saw that residents were involved in making Valentines day cards and there was a party planned for the weekend. We were told that knitting was a popular pastime and there are also board games. There are regular visits from the hairdresser and there is a church service once a week. The relative spoken with told us that the home were always very welcoming and that staff interact well with people living there. We had lunch with the residents and there was a choice available. There were three people being helped by staff . Tables were set with clean cloths, condiments and cutlery. The portions were well presented and warm. One resident commented: The staff are very attentive, they are very good. We observed one of the residents was displaying very antisocial behavior to members
Care Homes for Older People Page 16 of 30 Evidence: of staff who dealt with this in a very calm manner and supported the person and others present very well so that people could feel safe. The cook informed us that the menu was planned and that there is fresh vegetables and fruit from a local farm shop. This is an improvement from the previous inspection when there was reliance on all frozen vegetables. We spoke to the managers about the need to plan activities in advance and to advertise these as this gives people in the home something to look forward to and lends some orientation to their day and week. [There is an orientation / menu board but this was observed to be out of date]. The activities program we were shown was dated 1999. There are activity assessments in care files but no recording of activities actually undertaken. All reported activities are indoor with little access to the garden or outside facilities. The access to the garden is still unsafe and remains a requirement [see environment]. 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. Although there are policies and procedures and staff are trained so that peoples concerns are listened to and reported these need to be reviewed and updated so that people living in the home are fully protected Evidence: There is a complaints procedure available for people in the home. Those people observed were very relaxed around staff and were reassured by them so that they felt safe. A relative spoken with said that the managers were approachable so that any concerns could be addressed. The complaints procedure is available in the guide for the home. We looked at the complaints recorded. There were no complaints recorded since the last inspection visit. The Commision did recieve a concern from a person who contacted us directly. The areas of concern where around the provision of meals, support for staff and training, cleanliness of the home and the condition of the wheelchairs. All of these areas have been addressed on the inspection. We were shown policies and procedures around the recognition and management of allegations of abuse. Copies of the locally agreed procedures were not available so they could not be referenced. The homes policy was not clear in that it did not reference the locally agreed procedures and was not therefore clear about who any
Care Homes for Older People Page 18 of 30 Evidence: allegations should be referred to. It therefore needs reviewing and updating. Staff spoken with have received training in how to recognize and report abuse and were knowledgeable about identifying abuse and said were confident about this to the manager. Staff were not really aware of the wider picture in terms of understanding how investigations are conducted and the role of statutory agencies such as social services. They were also unclear about where to look for the locally agreed procedures and policies [as further evidenced by the above lack of availability]. It would be recommended that future training includes these elements so that staff are more aware of the broader picture in terms of safeguarding of vulnerable adults. Managers did display some understanding of what to report through the safeguarding process and have completed appropriate referrals previously and liaised with social services so that people in the home are protected. There have been no referrals to safegaurding since the last inspection. 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. The home is maintained and clean so that people living there enjoy comfortable surroundings but there needs to be continued upgrading and development with reference to removing barriers for people with dementia so that they can move around the home more freely. Evidence: We toured the home and found the entrance, visitors lounge and TV lounge to be clean bright and well furnished. There were no offensive odours. A passenger lift is available so that there is level access to both floors. We were shown several of the bedrooms and here again they were clean and bright with evidence of peoples own past lifestyles and personalization. For example photographs and furnishings. Most of the people living in the home congregate in the dining area and this room remains in need of refurbishment. The carpet was in a worn condition, the walls needed repainting. There remains little evidence of orientations aids [to help people with dementa to find their way around the home and to recognise the time and day] and the walls were rather bare. The orientation board available showed the wrong date and gave wrong information regarding the meal time menu as it had not been
Care Homes for Older People Page 20 of 30 Evidence: updated. This can further confuse people living in the home who have dementia. We had further discussion with the managers around the need to further remove the barriers that disable people with dementia such as making facilities like toilets and bathrooms more accessible with appropriate signage for example. Also the external grounds are an area that remains inaccessible for people due to lack of safety and the upgrading of this area remains a requirement. There are suitable bathrooms and toilets available to meet the needs of disabled people. We did observe residents being moved in wheelchairs without footrests which can present as a risk of injury [see health and personal care]. 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. Staff numbers are consistent and they are receiving training so that care needs can be met but there needs to be tighter recruitment practice so that people living in the home are fully protected. Evidence: The staffing in the home has improved overall since the last inspection in April 2008. At that time the home had very limited care staff and ancillary staff cover and the standard of care suffered because of this. On this inspection we found that the staffing numbers are now consistent and that there is now a regular core of ancillary staff such as domestic staff and a cook. There have also been some key care staff in post for most of the last year. We had some discussion around the need to maintain the current level of staffing as this will help ensure a more consistent standard of care. Currently the managers working hours are not listed on the duty rota and we would recommend that this is made clear so that there is an accurate record. We found evidence of ongoing training for staff. For example all new staff who have previously lacked experience have been referred to an induction program run by the local authority. Staff spoken with had clearly benefited from this as it prepared them for working with vulnerable people. Some of the senior staff in the home have also attended training courses in dementia care over the past year so that they are better
Care Homes for Older People Page 22 of 30 Evidence: able to understand the care needs of people in the home. The AQAA document returned by the manager states that only a small percentage of staff have NVQ qualifications mainly due to a high staff turnover. This needs to be built on so that a solid core of staff have the basic care skills needed to work in the home. We observed the staff interacting with people in the home and found them to be very supportive. We looked at staff records for those staff more recently employed [since the last inspection]. We found that in all three files seen there were anomalies regarding the provision of written references. References seen were not dated or were dated following the start date of staff. One staff only had a single reference on file. These written reference checks are required before staff start work in the home so that managers have a full picture of the persons fitness and can make a decision as to whether to employ. They help ensure that people living in the home are protected. Recruitment processes must be consistent. 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. The management systems at Prospect House do not fully ensure the efficient running of the home and the ongoing improvement of the service. Evidence: The homes proprietor, Mrs Maureen Bromley, is the registered manager. She has many years experience in the home and also has a nursing qualification. The deputy manager plays an important role in the day to day running of the home. There has been progress in some areas of the home and managers have been able to evidence that they have met some of the outstanding requirements. For example The care plans seen were clearer and where being regularly reviewed. Also there has been improved staffing in the home which was a major concern previously and the main barrier to any progress being made with standards of care in the home. The training of staff is now more consistent and some of the maintenance records in the home such as fire records were up to date. These all show that the management are able to work
Care Homes for Older People Page 24 of 30 Evidence: at developing standards and meeting statutory requirements. There are still some areas of concern however and failure to meet some requirements shows that the level of consistency needed still needs to improve. For example the access to external grounds which would be a key element to improving the quality of life for people in the home still needs to be met. Also the registration certificate displayed is not the one updated and agreed in august 2008 and therefore needs to be replaced. Also the AQAA states that portable electrical appliances have been tested in June 2007 but we could find no record of this. We looked at accident records and these are well recorded. One accident reviewed resulted in a fracture and was possible in need of reporting under Health and Safety regulations [RIDDOR] but the deputy manager had no understanding of this. Care Homes for Older People Page 25 of 30 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 19 23134 External grounds which are 01/03/2007 suitable for, and safe for use by service users, are provided and appropriately maintained; therefore the garden area must be made accessible and safe for residents. This is so that the people living in the home who have dementia can experience an improved quality of life. 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 People who are prescribed PRN [give when required] medication must have this monitored through the care plan. This ensures that all staff are consistent in their approach and administration and that the medicine can be regularly reviewed. 13/03/2009 2 22 13 All wheelchairs must have 02/03/2009 footrests in place. If there is reason why a person doesnt have footrests on their wheelchair this must be entered on the care plan. This ensures that people are moved safely. 3 29 19 All staff employed in the 18/03/2009 home must have two written references which are clearly identifiable before they commence work. Care Homes for Older People Page 27 of 30 This is to ensure that staff are fit to work with vulnerable people and that they are protected. 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 3 4 1 7 9 12 Copies of the service user guide should be readily available in the home. The care plans and records should record any health support and how this is monitored and supported. If a person is prescribed a variable dose of medication the records should indicate what dosage has been given. Activities and stimulation for residents in the home should continue to be developed with reference to good practice in dementia care. The homes policy on safeguarding of vulnerable people needs to include reference to the locally agreed social service policy. The St Helens policy should be readily available and known by all staff. Any in house training needs to reference the local policies and the wider picture on terms of how abuse is reported and investigations carried out. 5 18 6 19 The dining area is the part of the home internally that should now receive some upgrading in terms of good practice guidance for dementia care and making it more homely. The carpet is badly worn and needs replacing. The home should ensure that at least 50 percent of care staff are trained to NVQ level to meet this standard. The current certificate of registration should be replaced by the certificate more recently sent to the home. The quality assurance systems in the home should be developed so that managers can assess and evidence continued progress and act in the best interests of people 7 8 28 33 Care Homes for Older People Page 28 of 30 living in the home. 9 38 The portable electrical appliances in the home need to be tested and records maintained. The managers need to update them selves with requirements under Health and Safety legislation with respect to RIDDOR regulations. 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
