Inspection on 18/02/09 for Rosegarth

This inspection was carried out on 18th February 2009.

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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rosegarth 03/12/07

Rosegarth 31/05/06

Rosegarth 11/10/05

Rosegarth 27/04/05

Rosegarth 13/10/04

Rosegarth 13/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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: Rosegarth 40 Moseley Road Cheadle Stockport Cheshire SK8 4HJ     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: Fiona Bryan     Date: 1 8 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 29 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 29 Information about the care home Name of care home: Address: Rosegarth 40 Moseley Road Cheadle Stockport Cheshire SK8 4HJ 0161-4853349 01614858466 rosegarth@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Rosegarth Limited Name of registered manager (if applicable) Mrs Elaine Reid Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Service users to include up to 25 OP. Date of last inspection Brief description of the care home Rosegarth is a Victorian building situated at the end of a quiet cul-de-sac in an area between Cheadle and Cheadle Heath. The home is set in gardens, surrounded by mature trees. Rosegarth provides care and support for up to 25 service users who are older people. Single bedroom accommodation is provided for all service users on the ground and upper floors. People are able to bring small items of furniture and personal possessions with them. A call system is installed in all rooms to summon support or assistance from staff. The home has a Statement of Purpose and Service User Guide which were reported to Care Homes for Older People Page 4 of 29 care home 25 Over 65 25 0 Brief description of the care home be given to prospective people or their families when they visit the home to look round. Copies of these are also in bedrooms. Fees for accomodation and care at the home range from 340 - 425 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 key unannounced inspection, which included a visit to the home, took place on Wednesday 18th February 2009. The staff at the home did not know that this visit was going to take place. All the key standards were assessed at the site visit and information was taken from various sources, which included observing care practices and talking with people that lived at the home, the manager and other members of the staff team. Key standards refers to those standards we feel are particularly important in ensuring the health, safety, welfare and quality of life of people living at the home. The care and services provided to three people were looked at in detail, looking at their Care Homes for Older People Page 6 of 29 experience of the home from their admission to the present day. A selection of staff and care records was examined, including medication records, training records and staff duty rotas. Before the inspection, we asked for surveys to be sent out to people living at the home and staff asking what they thought about care at the home. Seven people that used the service and seven staff returned their surveys. Comments from these questionnaires are included in the report. We also asked the manager of the home to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This helps us to determine if the management of the home see the service they provide the same way that we see the service. The manager provided only basic information and did not tell us whether all the things we said must be done at the last inspection had been acted on. We discussed the sort of information we need with the manager so she can complete it in more detail the next time we send one. What the care home does well: What has improved since the last inspection? What they could do better: Although people living at the home and those that returned surveys felt that they were Care Homes for Older People Page 8 of 29 well looked after and that their personal and health care needs were always or usually met, lack of proper assessments and care planning by staff at the home leads to a risk that some peoples needs may not be fully identified and planned for. There was also a risk that changes in peoples health or personal care needs would not be recognised and acted on. Staff did not have access to clear information and policies about safe guarding adults. This meant that if they suspected abuse or had concerns that people may be at risk of harm they may not take appropriate action to protect people. Although the home was clean and quite comfortable, parts did look worn and shabby. A programme of redecoration should be implemented. More robust checks had been undertaken when new staff were recruited but there was still room for further improvement. Gaps in employment histories should be explored so the manager can be sure about where people worked previously and why they left. No improvement was seen in the induction arrangements for new staff, which did not meet current standards. Long standing staff had also only received training in a limited number of topics and further training needs should be identified and provided for. Lack of relevant training means staff may not always have the required skills and knowledge to meet peoples specific needs. The need for further training also extends to the manager who needs to be updated on key topics such as care planning so she can ensure staff are working in line with current best practice. At the last inspection we said that the manager should develop a system to check that policies and procedures were being followed correctly and that staff practices were safe and meeting peoples needs. This had still not been done and meant that some shortfalls within the service had not improved. 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 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 10 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 thinking of moving into the home received sufficient information to help them to make a decision and an assessment was undertaken of their needs to ensure they could be met at the home. Evidence: A statement of purpose and service user guide were provided in each persons room. We sent surveys to people living at the home and all 7 people who returned them confirmed they had received enough information about the home to help them decide if they wanted to move in. We spoke with one person who had only arrived at the home the previous day. They said they had been helped to settle in and everything is fine so far. We looked in detail at the care provided to 3 people living at the home. We looked at the records for these people and although they had assessments available from social Care Homes for Older People Page 11 of 29 Evidence: services there was very little information recorded about how staff at the home had assessed each persons needs. A recommendation was made at the last inspection that all information gathered and assessed prior to a persons admission be clearly recorded and used in the decision making process when offering a person a place at the home. There had been no improvement in this area. Care Homes for Older People Page 12 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 provided support to people to make sure their individual personal and health care needs were met but a lack of adequate care planning presents a risk that changes to needs will not be identified and addressed. Evidence: We looked in detail at the care provided to 3 people. We looked at their care files and the records relating to them were very limited. Care plans and single assessments were available from the local authority that was funding each person, but there were no care plans in place that had been developed by staff at the home. A short profile was provided in each case giving some information about the persons general abilities, preferred routine and medical history, although in one case some important details had not been included. Risk assessments were not carried out properly to accurately assess the risk to people in respect of nutrition, falls, pressure areas or moving and handling. Care Homes for Older People Page 13 of 29 Evidence: Daily records referred to toileting programmes for individuals to maintain continence but there were no care plans to explain what the programme entailed. Each file had a care plan evaluation form stating that care plans had been evaluated, when in fact there were no care plans actually in place to be evaluated. Lack of proper care plans and risk assessments meant that staff did not have access to information about the care they needed to provide or how it should be monitored and changes to peoples conditions were not properly reflected. We made a requirement at the last inspection that care plans plans must fully reflect peoples holistic needs and set out clearly the support and interventions used to help people to meet those needs and this had not been met. Care files in general were untidy and lacking in any order making them difficult to read and find relevant information. People living at the home had access to other health care services such as the district nurses. The district nurses kept their own records of treatment they were giving to people and when we looked at the records for one person it showed that the condition they were receiving treatment for was improving. People we spoke to said staff were very good and knew what help they needed with their daily routine and personal care needs. We watched staff interacting with people living at the home and noticed a friendly and inclusive atmosphere. People said they were treated with respect by staff and that staff were polite and courteous. Staff told us they had a handover at the start of each shift where they had a verbal update on the condition of each person. As the home and the staff team are quite small a lot of information appeared to be communicated by word of mouth, so although the records were poor staff were aware of peoples needs and the help and care they needed. All the 7 people that returned surveys said they always or usually got the care, support and medical attention they needed and staff listened and acted on what they said. People looked clean and well cared for and were dressed appropriately. We looked at a small sample of medicines records and in general these were well maintained and accurate. Staff need to make sure that where a dose of medicine is variable, for example the person receiving it could have 1 or 2 tablets, that the actual number of tablets given is recorded. Care Homes for Older People Page 14 of 29 Care Homes for Older People Page 15 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 were provided with activities and a variety of home cooked food, which they enjoyed. Evidence: A designated activities organiser is not employed at the home, as it is seen as part of the role of the carers to identify and meet peoples social care needs. Six of the seven people that returned surveys said there was always or usually activities arranged that they could join in with if they wished. One person we spoke to during our inspection said, the time soon passes. We looked at the care provided to 3 people in detail. Records in their care files showed that they had taken part in a range of activities such as in-door games and exercises, films, music and beauty treatments such as foot spas and manicures. Photographs displayed in the reception area showed people enjoying sitting in the garden in summer and relaxing at a candlelit Christmas meal. Staff were seen chatting with people living at the home about their families and it was clear a good rapport was established between them. One staff member told us they had included people living Care Homes for Older People Page 16 of 29 Evidence: at the home in their hen night by having a drink with them and had called at the home on their wedding day to show everyone their wedding dress. People said that routines within the home were flexible. One person told us that it depends on the person entirely when asked about what time people got up, had breakfast and went to bed etc. This person said they usually went to bed at about 9pm but if there was football on television they would stay up later to watch it. People we spoke to during the inspection said the food provided at the home was very good. We looked at the menus, which showed a choice was provided at each mealtime and a varied diet was available. All the people that returned surveys said they always or usually liked the meals provided at the home. One person wrote Food excellent and enjoyable. Whilst we were speaking to one person a member of staff asked her what she wanted for lunch. Lunch on the day of our inspection was either meat and potato pie or salad. Lunch was served at 12.30pm. Most people came to eat in the dining room, where the tables were set with cloths, cutlery and condiments, including beetroot to accompany the meat and potato pie. Several people had chosen the salad for lunch. The salad was substantial and included cheese, ham and hard boiled eggs as well as salad vegetables and bread and butter. Everyone that ate the salad said they enjoyed it. Other people had the meat and potato pie, which they said was tasty and hot, although the presentation would have been improved by an accompaniment of vegetables, as none, other than the beetroot was served. Staff were observed helping people to eat and some people had aids such as plate guards to enable them to eat independently. Care Homes for Older People Page 17 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 knew how to complain and were confident that their concerns would be listened to but policies lacked detail which meant staff did not have access to clear information about action to take to ensure people were protected from abuse and harm. Evidence: The complaints policy was available in the Service Users Guide and Statement of Purpose. All the people living at the home that returned surveys said they knew how to make a complaint should they need to. All the staff that returned surveys confirmed they were aware of the complaints procedure. People that we spoke to on the day of the inspection said if they had any concerns they would speak to the manager and they were confident she would deal with any issues appropriately. The manager reported that she had not received any complaints since the last inspection and no concerns have been made known to us. Staff that we spoke to said they had undertaken training in safe guarding. Certificates of training in this topic were available in the staff files that we looked at, although the training in some cases had been as long ago as 2005 and may require updating. Care Homes for Older People Page 18 of 29 Evidence: Staff were aware of the procedures to follow and a basic policy was provided in the homes policy file. However, the manager was unable to locate the Stockport multi agency policy that should be readily accessible for staff to refer to. The manager also said she did not have a copy of the Department of Health guidance No Secrets. It is recommended that both this guidance and the Stockport safe guarding policy be obtained for use in the home. Care Homes for Older People Page 19 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. Rosegarth is clean and homely but would benefit from some refurbishment and redecoration as parts of the home looked tired and worn. Evidence: In the AQAA the manager confirmed that the environment of the home was maintained to a good standard and reported that a new commercial clothes drier had been bought since the last inspection. All the people living at the home that returned surveys said the home was always fresh and clean and an audit in respect of infection control undertaken by the PCT had shown that staff were meeting the required standards of hygiene. We carried out a partial tour of the home. The lounges and conservatory areas were generally pleasant and homely. One person told us he really enjoyed sitting in the conservatory as it was bright and spacious. A number of the bedrooms were quite cluttered with several frames and wheelchairs, some of which did not belong to the person whose room it was. It is recommended that a review is held of all equipment at the home and equipment removed where it doesnt belong to people. Care Homes for Older People Page 20 of 29 Evidence: Some rooms were nicely personalised with photographs and ornaments but we noticed that wall clocks in several rooms showed the wrong time. Staff should be more attentive to such details, as this may be disorientating for people, especially if they already have some confusion. Liquid soap was available in the staff toilet but the container was not fixed to the wall so it was difficult to dispense. Tablet soap and cloth towels were also provided but staff should always use liquid soap and paper towels to reduce the risk of cross infection. The carpets in a number of rooms were discussed with the manager. These should be replaced as they were quite old and stained. The flooring in the dining room and basement corridor would also benefit by being replaced. Care Homes for Older People Page 21 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at Rosegarth are supported by a team of staff who know them well, but induction training does not meet current standards and a limited range of training means staff may not always have the knowledge and skills to fully meet peoples needs. Evidence: On the day of our inspection the manager and 5 care staff were on duty to care for 19 people. The manager said there was normally herself and 4 carers but an extra person was on duty as someone needed a member of staff to escort them to attend a hospital appointment. Staff that returned surveys and those that we spoke to during the inspection said there was always or usually enough staff. People living at the home said there were enough staff on duty to meet their needs. We looked at the personnel file for one staff member who had started working at the home since the last inspection. Recruitment procedures had improved since the last inspection in that references and criminal disclosure records had been obtained before they started working at the home. However, the persons employment history had some gaps where it did not state where or if they were working. Within the record of the interview that was conducted with this person there was no evidence that the gaps in their employment history had been explored. The manager should make sure that a Care Homes for Older People Page 22 of 29 Evidence: full employment record is obtained and discussed to ensure she has complete information about where prospective staff have previously worked and their reason for leaving. The manager said that the deputy manager was responsible for carrying out induction training with new staff. Examination of the training materials used showed that the induction was not in line with Skills For Care. We made a recommendation at the last inspection that the manager should update the induction programme to reflect the Common Induction Standards but this had not been done. Records showed that staff had undertaken fire safety and moving and handling training. Some staff had also done food hygiene training. However, there was little evidence that staff were provided with other specific training to ensure they had the skills to meet the needs of people currently living at the home, for example in the care of people with epilepsy, and the manager should consider accessing further training in relevant topics. In the AQAA the manager reported that 12 out of the 17 care staff had successfully completed NVQ training. Care Homes for Older People Page 23 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. Effective quality assurance systems were not in place, so there was no consistent programme for improving weak areas and developing the service provided to people living at the home. Evidence: The registered manager has a number of years experience in working in the residential care sector. She has completed the NVQ Level 4 in Care Management and the Registered Managers award. People living at the home told us there were residents meetings, where they discussed meals and food they would like on the menu and where to go on trips out. One person we spoke to said he felt the manager and staff took notice of peoples suggestions and said Rosegarth was a very good home. Another person said you couldnt get anywhere better. The manager said she tried to include everyone living at the home although some people were more able to voice their opinions than others. She also Care Homes for Older People Page 24 of 29 Evidence: said that she got good feedback from some relatives. We made a requirement at the last inspection that the manager develop a quality assurance system to ensure that the staff and management working practices are in line with current guidance, regulation and legislation. The manager did not provide any details in the AQAA about whether this requirement had been met and we did not see any improvement in this area. There was still no formal system for checking staff working practices, although the manager said that the deputy manager checked the medicines each week; however there was no record of what checks had been made. There were major shortfalls in key areas of the service such as record keeping and care planning that should have been addressed. The manager needs to make sure that staff are aware of and consistently following the homes policies and procedures and a system of audit would inform her of how staff were performing. We looked at how people who lived at the home were helped to manage their money at the last inspection and the manager said the system remained unchanged. We did not look at any records in respect of peoples money but were told that receipts were kept of all transactions. Records were available to show that health and safety checks had been carried out in the building and equipment had been regularly serviced. We had to remind the manager to return the AQAA that we had requested as she had misunderstood what we asked for. The information supplied in the AQAA was very basic and did not always tell us if the requirements and recommendations we made at the last inspection had been acted on. Care Homes for Older People Page 25 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 7 15 (1) Individual care plans must 30/01/2008 fully reflect peoples holistic needs and set out clearly the support and interventions used to help people to meet those needs. To find out how people feel 30/06/2008 about the quality of the service they receive and to ensure that the staff and management working practices are in line with current guidance, regulation and legislation, a quality assurance system must be developed and implemented. 2 33 24(1) Care Homes for Older People Page 26 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 7 13 Risk assessments must be 15/04/2009 carried out to assess the risk to people in respect of nutrition, pressure areas, falls and moving and handling as well as other risks specific to individuals. This will help staff identify where people are at high risk so they can plan their care accordingly. 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 3 All information gathered and assessed prior to a persons admission should be clearly recorded and used to develop a care plan to address the persons needs. The manager should ensure that staff have access to the Stockport multi agency safeguarding procedures and the Department of Health guidance No Secrets. This will make sure they have clear information about the actions they should take if they suspect abuse. A review should take place to ensure that people only have Page 27 of 29 2 18 3 19 Care Homes for Older People equipment belonging to them stored in their rooms so they have space to move around and their rooms are pleasant for them to spend time in. 4 19 Consideration should be given to replacing the carpets in the rooms discussed during the inspection, replacing the flooring in the basement and beginning a programme of redecoration to brighten and freshen up the decor and enhance the environment for people living at the home. Liquid soap and paper towels only should be used in staff toilet areas to prevent the risk of cross infection. Gaps in employment histories should be fully explored so the manager can satisfy herself about where and when people have worked and their reasons for leaving previous employment. The Induction Programme be reviewed and updated to ensure that it reflects the mandatory Skills for Care Common Induction Standards. Consideration should be given to accessing some further training for the manager in key areas such as person centred care planning, so she is able to direct and support staff to develop meaningful care plans for people. 5 6 26 29 7 30 8 31 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 © (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 29 of 29 - 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!