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Inspection on 26/01/09 for Rydal House Nursing Home

Also see our care home review for Rydal House Nursing Home for more information

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

People told us the staff were aware of their needs and were "nice and friendly". Relatives told us "the staff are lovely with her, they talk to her all the time, they`re very caring", and, "I can`t fault the staff - they know how to look after her". We observed that staff had a friendly and courteous approach to people in the home. People told us they liked the activities offered. One person enjoyed having their fingernails manicured by the activities coordinator and told us "it makes me feel better". Another person said they enjoyed the reminiscence session as this involved old photographs of the local area the person was familiar with. The improved staffing levels noted at the previous inspection in July 2008 had been maintained, ensuring there were enough staff available to meet people`s needs.

What has improved since the last inspection?

All of the requirements made at the previous key inspection in July 2008 had been met. This meant there were improvements in many areas - care plans, medication records, social activities, quality assurance, staff recruitment, induction and training, and health and safety. An activities coordinator had been appointed and so the range and variety of activities offered to people in the home had improved. The activities coordinator was also the assistant manager and provided support to the acting manager.

What the care home could do better:

Care plans did not have enough detail of the person`s individual preferences, of their family, life, and work history, and of the action staff should take to ensure the person`s privacy and dignity were maintained. People in the home, or their representatives, were not actively involved and consulted in planning care. The acting manager continued to work 4 shifts per week as the nurse in charge, reducing the time she had available for management responsibilities. The acting manager, or any permanent manager, should be allowed sufficient supernumerary time to allow them to run the home effectively with a proactive approach. This will ensure that improvements made are sustained and further developments are made to ensure the home is run in the best interests of people living there. There should be information provided for people in the home, and their representatives, about local advocacy services and about the Mental Capacity Act 2005. Staff in the home should have training about the Mental Capacity Act 2005 and the implications for people living in care homes.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Rydal House Nursing Home 21 Somersall Lane Chesterfield Derbyshire S40 3LA     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: Rose Moffatt     Date: 2 6 0 1 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: Rydal House Nursing Home 21 Somersall Lane Chesterfield Derbyshire S40 3LA 01246569511 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) : hitch_d@yahoo.com Mr D Chand,Dr. Anjuman Diwan Chand care home 31 Number of places (if applicable): Under 65 Over 65 31 0 old age, not falling within any other category physical disability Additional conditions: 0 1 The maximum number of service users who can be accommodated is: 31 The registered person may provide the following category of service only: Care Home with Nursing - Code N To service users of the following gender: Both whose primary care needs on admission to the home are within thw following categories: Old age, not falling within any other category - Code OP Physical disability Code PD (maximum number of places - 1) This relates to the application to vary the conditions of registration dated 09/09/08 in regards to a named service user. Date of last inspection Brief description of the care home Rydal House is situated on the western side of Chesterfield in a pleasant residential area, close to local amenities and within easy access of a main bus route. The home is a converted building, with an extension, set in its own grounds. There are separate lounges and dining rooms on the ground floor. A conservatory has been added. The Care Homes for Older People Page 4 of 30 Brief description of the care home home provides personal and nursing care for up to 31 people. Information about the home, including CSCI inspection reports, is available in the main hallway of the home, or from the acting manager. Fees charged at the home range from £333.85 to £498.30 per week. This information was provided by the acting manager on 26th January 2009. 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 1 star. This means the people who use the service experience adequate quality outcomes. The focus of our inspection is on outcomes for people who live in the home and their views on the service provided. The inspection process looks at the providers ability to meet regulatory requirements and national minimum standards. Our inspections also focus on aspects of the service that need further development. We looked at all the information we have received, or asked for, since the last key inspection or annual service review. This included: information we have about how the service has managed any complaints; what the service has told us about things that Care Homes for Older People Page 6 of 30 have happened - these are called notifications and are a legal requirement; the previous key inspection and the results of any other visits we have made to the service in the last 12 months; relevant information from other organisations; and what other people have told us about the service. The previous key inspection was on 15th July 2008 and we carried out a random unannounced inspection on 24th November 2008. For this key inspection, we carried out an unannounced inspection visit that took place over 7.5 hours on 26th January 2009. This inspection visit focused on assessing compliance with requirements made at the previous inspection and assessing all the key standards. There were 20 people accommodated in the home on the day of the inspection visit. People who live in the home, visitors and staff were spoken with during the visit. The acting manager was available and helpful throughout the inspection visit. Some people were unable to contribute directly to the inspection process because of communication difficulties, but they were observed during the visit to see how well their needs were met by staff. Case tracking was used during the inspection visit to look at the quality of care received by people living in the home. 3 people were selected and the quality of the care they received was assessed by speaking to them and / or their relatives, observation, reading their records, and talking to staff. At the last key inspection in July 2008 the overall rating for the home was poor and so the home was included in the CSCI improvement strategy. A management review was held with the inspector and regulation manager, and then a meeting with the providers of the service. The providers were required to produce an improvement plan detailing how they were going to make the necessary changes to comply with the regulations and improve outcomes for people living in the home. The improvement plan was produced in the required timescale and all the requirements made were addressed. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get Care Homes for Older People Page 8 of 30 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. The assessment process and staff training were sufficient to ensure that peoples needs could be met at the home. Evidence: We looked at the care records for three people living in the home. Each one had an assessment of their needs that included information obtained by the home during a pre-admission visit to the person. These assessments had brief details of the persons needs and abilities. In addition, there were copies of the social services assessments and / or assessments by hospital or Primary Care Trust staff as appropriate. One person told us they had initially come to the home for a short stay and then decided to move in permanently - and Im pleased I did!. Relatives we spoke with said they felt the persons needs were usually well met at the home. Care Homes for Older People Page 11 of 30 Evidence: Staff we spoke with and observed were aware of peoples individual needs and preferences. Staff training records showed that staff had received training to enable them to meet peoples needs, such as manual handling training, and training about the needs of people with dementia. At our previous inspection in July 2008, we found that a person had been admitted who was not within the homes registration category. We made a requirement that the home must make the appropriate application to us to ensure the home was suitably registered and able to meet the persons needs. The providers made the application and their registration was changed accordingly as they were able to demonstrate the persons needs were met at the home. Standard 6 did not apply as there was no-one in the home receiving intermediate care. 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. Although improvements had been made, the care plans did not have enough detail to ensure a person centred approach. Evidence: The three care records we looked at all included an individual care plan. The care plans covered all the assessed needs of the person and had all been reviewed monthly. The care plans did not have sufficient detail of how the privacy and dignity of the person should be ensured. There was not enough information about the personal preferences of the person. There was no evidence that the person, or their representative, had been involved in care planning. Staff spoken with and observed were aware of the individual needs and preferences of people. The daily records were completed by staff on each shift and showed that people received care and support according to the care plans. The entries made about night Care Homes for Older People Page 13 of 30 Evidence: times tended to be repetitive and uninformative. There were appropriate risk assessments in place and these had been reviewed regularly. There were records to show people had access to appropriate healthcare services, such as their GP, the district nurse and the chiropodist. One person told us my GP comes when I need to see him. Relatives told us they were kept up to date with any concerns about the persons health. Medication was securely stored and there were satisfactory systems in place to ensure safe handling and administration. Improvements had been made since the previous inspection to ensure a more robust system for recording all medication received into the home. People told us the staff were aware of their needs and were nice and friendly. Relatives told us the staff are lovely with her, they talk to her all the time, theyre very caring, and, I cant fault the staff - they know how to look after her. People told us the staff respected their privacy and maintained their dignity when carrying out personal care. We observed that staff had a friendly and courteous approach to people in the home. Care Homes for Older People Page 14 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 in the home had the opportunity to take part in a variety of activities. The meals were of satisfactory quality, well presented, and met the dietary needs of people in the home. Although attempts were made to provide a flexible and individual service, the approach was not sufficiently person centred to ensure this. Evidence: Since the previous inspection an activities coordinator had been employed at the home. Records showed that people were offered a range of activities including arts and crafts, games, reminiscence, music, gentle exercise, and visiting entertainers. The four-weekly programme of activities was displayed in the main hallway, though there was no indication which week was the current one. There was a monthly religious service at the home. There were few opportunities for involvement with the local community, other than the regular church service. The activities coordinator said they planned to take people out to local places using the homes own vehicle, when suitable insurance had been Care Homes for Older People Page 15 of 30 Evidence: arranged. People told us they liked the activities offered. One person enjoyed having their fingernails manicured by the activities coordinator and told us it makes me feel better. Another person said they enjoyed the reminiscence session as this involved old photographs of the local area the person was familiar with. People told us they could get up and go to bed when they wanted to. One person told us they preferred to spend time in their own bedroom during the day and staff respected this choice. People could have a key for their bedroom door if they chose to. People were able to bring in their own furniture and possessions to personalise their bedrooms. One of the care records we looked at had details of the persons life, family, and work history. The other two records did not have this information. There were few details in any of the records about the persons individual preferences regarding routines and activities. There was information displayed about a national advice service for people in care homes and their relatives. There was no information about local advocacy services. None of the staff at the home, including the acting manager, had received training about the Mental Capacity Act 2005 and the implications for people living in care homes. Visitors spoken with said they were always made welcome and were able to visit at any reasonable time. We observed that visitors were greeted warmly by staff. Relatives told us that they were informed by staff of any changes in the persons condition or any concerns about the persons health. A four-weekly menu was displayed in the corridor outside the kitchen. It was not clear which was the current week. The menu was in small print and was too high on the wall to be read by a person in a wheelchair. There was no menu displayed in the dining room. Most people ate their meals in the dining room which was pleasant and spacious. The meal served at lunchtime on the day of the inspection visit looked appetising and well presented. Some people chose alternatives to the main menu. Staff gave appropriate assistance to people who needed help. People at the home had recently been consulted about the menus and changes had been made. Care Homes for Older People Page 16 of 30 Evidence: The care records all included a nutritional assessment and a care plan about the assistance the person needed with eating and drinking. There was little information about the persons preferences regarding food and drink and mealtimes. One person told us they preferred not to have a cooked meal in the middle of the day and was pleased that staff always offered a lighter alternative. 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 improvements had been made, not all staff had received appropriate training and some were not fully aware of the external procedures for safeguarding vulnerable adults. Evidence: The complaints procedure was displayed in the main hallway and included all the required information. The acting manager said there had been no complaints recorded since the previous inspection. No complaints had been received by CSCI since the previous inspection. The acting manager said they planned to put a comments and complaints box in the main entrance area for people to use. The acting manager said that people were able to bring any concerns or complaints to the residents and relatives meetings in the home. There were no minutes available of recent meetings to substantiate this. The people we spoke with in the home told us they were aware they could complain if they needed to, but none of them ever had. Relatives said they had taken minor concerns to the acting manager or the nurse in charge and action had usually been taken to sort out the issue. People in the home and their relatives told us they had confidence in the acting manager to take appropriate action on any concerns or complaints. Care Homes for Older People Page 18 of 30 Evidence: Since the previous inspection, most of the staff had received training about safeguarding vulnerable adults. The acting manager said that further training was planned to ensure that all staff had received this by the end of February 2009. The safeguarding vulnerable adults policy had been updated to include all the required information. Staff supervision records showed that the policy had been discussed at recent supervision sessions and staff had signed to say they had read and understood the policy. Most of the staff we spoke with were aware of types of abuse and said they would report any concerns to the acting manager or the nurse in charge. They confirmed they had read the updated policy. They were not sure about who safeguarding issues should be referred to outside the home. Staff more recently employed had not received training and were not so aware of safeguarding procedures. At the time of this inspection there was one safeguarding vulnerable adults allegation that had been referred to social services and was being investigated. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was well maintained and suitably equipped so that people lived in a clean, pleasant environment that met their needs and expectations. Evidence: The home was a large, domestic property that had been extended and provided accommodation on two floors. The home had several lounge areas for people to use including a large conservatory. Some of the lounges did not have a television so that people could choose to use a quieter area. People could bring in their own furniture and possessions to personalise their bedrooms. They could have a key to their bedroom door if they wanted to. New bedding had been provided since the previous inspection. One person was pleased to have a bird table outside their bedroom window and said they had many hours of enjoyment watching the birds and squirrels. There was a payphone for people to use situated in the main hallway. This did not allow any privacy for people using it. People could choose to have a private telephone installed in their bedrooms. The home was suitably equipped with lifting hoists and other manual handling Care Homes for Older People Page 20 of 30 Evidence: equipment, bath hoists, handrails, and some height adjustable beds. The acting manager said they would like to have an accessible shower installed in one of the bathrooms to improve choice for people in the home. We found that maintenance and repairs were usually carried out promptly by the homes maintenance person. Some parts of the home had been redecorated since the previous inspection. All the areas of the home seen during the inspection visit were clean. There was an odour in one bedroom, but otherwise the home was free from offensive smells. People we spoke with told us the home was usually clean and fresh. We observed that staff used disposable gloves and aprons as necessary. Staff we spoke with were aware of the importance of infection control procedures, such as proper hand-washing and cleaning equipment. 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. There were improvements in staffing levels, recruitment procedures, induction and training so that there were enough competent staff to meet the needs of people in the home. Evidence: There were 20 people living in the home on the day of the inspection visit and 8 of these were assessed as needing nursing care. The staff rotas showed that there was a registered nurse on each shift with 3 care assistants for the morning and afternoon shifts, and 2 care assistants at night. In addition, there were domestic, laundry and kitchen staff, plus the activities coordinator/assistant manager. People in the home and visiting relatives told us there were usually enough staff available to meet peoples needs. Staff told us the staffing levels were sufficient to meet the current needs of people in the home. We looked at the records for three members of staff. One record had all the required documents and information in place. Two records did not have a full employment history as there were unexplained gaps. The acting manager obtained this information from the staff during the inspection visit. One record did not have proof of the staff members identity or a recent photograph. Care Homes for Older People Page 22 of 30 Evidence: New staff had started an induction programme that met Skills For Care standards. Staff training records showed that all the staff were up to date with manual handling, fire safety, infection control, health and safety, and food hygiene training. Staff spoken with confirmed they had received this training. As noted previously in this report, most staff had received training about safeguarding vulnerable adults, and no staff had received training about the Mental Capacity Act 2005. Of 13 permanent care staff, 5 had already achieved a National Vocational Qualification (NVQ) at level 2 or above. The acting manager said that another 7 staff had just started working towards NVQ. 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. Improvements had been made in the organisation and management of the home so that the health and safety of people was better promoted. Evidence: The registered manager for the home was on long term leave and the acting manager had been in place for several months. The acting manager had worked at the home for many years as a registered nurse and had also managed the home previously. The acting manager continued to work 4 shifts each week as the nurse in charge. This reduced the amount of time she had available for management responsibilities. There was evidence that this was affecting the management of the home as the acting manager worked extra hours to try and fulfil her management responsibilities. Also, the temporary nature of the management arrangements did not allow the acting manager to have a proactive approach to running the home. The acting manager was supported by the assistant manager who was responsible for Care Homes for Older People Page 24 of 30 Evidence: some non-clinical areas, such as housekeeping and staff rotas. People in the home and their relatives said they had confidence in the acting manager to run the home and to sort out any problems. Staff said they found the acting manager easy to get on with. The quality assurance system had been further developed since the previous inspection. People living in the home had completed surveys about food and menus at the home and the menus had been changed in response to their comments. Relatives of people in the home had also been sent surveys to complete. A meeting had been held for people in the home and their relatives. The acting manager had started to complete internal audits of accidents, health and safety, and care records. The personal money of people in the home was kept securely with access only by the acting manager. Satisfactory records were kept of all transactions. Since the previous inspection, a programme of staff supervision had been introduced. Most staff had been involved in one to one supervision with the acting manager and further sessions were planned. Since the last inspection, health and safety records had been brought up to date, such as the gas safety certificate and the testing of portable electrical appliances. Accident records seen were fully completed and the acting manager had started an audit of accidents in the home. The fire safety records were up to date. There were monthly fire drills for staff, though the records of these did not have enough detail of who had taken part and if there were any training issues or concerns arising. 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 7 15 Care plans must include more detail about the persons individual preferences regarding their daily routine and the way that care is provided, and the person, or their representative, must be more actively involved in planning care. This will ensure a more person centred approach to care planning and delivery. 31/03/2009 2 18 13 All staff must have appropriate training to recognise and report the abuse of vulnerable adults. This will help to protect people living in the home. 28/02/2009 3 29 19 The required documents and 28/02/2009 information must be in place for each member of staff before they commence employment. Care Homes for Older People Page 27 of 30 This will help to ensure people living in the home 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 7 There should be more detail in care plans about how staff should ensure the persons privacy and dignity are maintained and promoted. The care records should include details of the persons life, family and work history, their previous interests and hobbies, and their preferences regarding routines. This will help to ensure a more person-centred approach to providing suitable activities and also that routines are based around individual preferences. There should be information available for people living in the home, and their representatives, about the Mental Capacity Act 2005. All staff in the home should have training about the Act and the implications for people living in care homes. This will help to ensure that peoples rights are promoted. There should be information available for people living in the home, and their representatives, about local advocacy services. This will help to protect people and ensure they have access to independent advice and support. The current menu should be displayed so that it can easily be seen and read by people in the home. This will ensure that people are aware of the choices available to them. The payphone should be moved to a quieter area to allow more privacy for people using it. The acting manager, and any permanent manager, should have sufficient supernumerary time to ensure they can complete their managerial responsibilities and run the home effectively. The quality assurance system should be further developed to include an annual report of the findings of surveys and the action taken to address issues raised. This will help to ensure people are consulted about the home and their views are taken into account in the running of the home. 2 12 3 14 4 14 5 15 6 7 19 31 8 33 Care Homes for Older People Page 28 of 30 9 38 Records of fire drills should include the names of staff who took part and should note any issues or concerns that could require further training. This will help to promote the safety of people in the home. 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!