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Inspection on 07/07/09 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 their needs, or those of their relatives, were met at the home. They said "I`m very comfortable here" and "My mother...says they look after her well, they are very good, and she is happy". We found that people were referred promptly and appropriately to ensure any healthcare needs were met. People said the staff were "always very good" and "always friendly".

What has improved since the last inspection?

Trips out had been arranged using the home`s own vehicle and people had already enjoyed a visit to Chatsworth, and shopping in the town centre. An acting manager started at the home in March 2009. The acting manager is supernumerary to enable her to fulfill her responsibilities. The 3 requirements made at the last inspection had been met, resulting in improvements to care plans, staff training, and staff recruitment practices.

What the care home could do better:

People in the home, and/or their representatives should be more actively involved in care planning to ensure care provided meets their preferences and expectations. There should always be sufficient staffing and other resources available to allow activities to take place as planned. This will help to ensure the lifestyle in the home meets people`s expectations. 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 people`s rights are understood and fully promoted. The providers and the acting manager should decide the budget available for food. There should be better organisation of meal planning and shopping to ensure menu choices are always available. This will help to ensure that people have meals to meet their need and preferences. When care staff are providing cover for laundry, kitchen or domestic staff, this should not be as part of the care shift. This will ensure that that staffing levels are properly maintained and that care staff are always available to meet people`s needs.

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 is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Rose Moffatt     Date: 0 7 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 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): hitch_d@yahoo.com Mr D Chand,Dr. Anjuman Diwan Chand Name of registered manager (if applicable) Type of registration: Number of places registered: care home 31 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 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 2 6 0 1 2 0 0 9 0 1 Over 65 31 0 Care Homes for Older People Page 4 of 28 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 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 £353.92 to £527.24 per week. This information was provided by the acting manager on 7th July 2009. Care Homes for Older People Page 5 of 28 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: the annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also has some numerical information about the service; surveys returned to us by people using the service and from other people with an interest in the service; information we Care Homes for Older People Page 6 of 28 have about how the service has managed any complaints; what the service has told us about things that 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. We carried out an unannounced inspection visit that took place over 8 hours on 07/07/2009. The inspection visit focused on assessing compliance with requirements made at the previous inspection and assessing all the key standards. We sent out 10 surveys to people living in the home and received 2 completed responses. We sent out 10 surveys to the relatives or representatives of people living in the home and received 2 completed responses. We sent out 10 surveys to staff employed at the home and received 4 completed responses. There were 20 people accommodated in the home on the day of the inspection visit. We spoke with 5 people who live in the home, 4 visitors and 4 staff 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. Care Homes for Older People Page 7 of 28 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Older People Page 8 of 28 You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 28 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 28 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. There was a satisfactory assessment process and sufficient information provided so that people were confident their needs could be met at the home. Evidence: People told us their needs, or those of their relatives, were met at the home. They said Im very comfortable here and My mother...says they look after her well, they are very good, and she is happy. We looked at the records of 3 people in the home. All had satisfactory assessments of their needs and relevant information from social services, hospital and Primary Care Trust staff as appropriate. The Statement of Purpose had been updated and revised to include all the required information. The acting manager said that a copy of the Statement of Purpose, together with a copy of the most recent inspection report, was provided to anyone Care Homes for Older People Page 11 of 28 Evidence: thinking of coming to live in the home. The AQAA said that people thinking about coming to live in the home could visit the home and have a meal, join the activities and stay overnight if they wish prior to making a decision. The home planned to improve by providing training for staff about equality and diversity issues. Standard 6 did not apply as there were no people in the home receiving intermediate care. Care Homes for Older People Page 12 of 28 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. Improvements had been made to some care plans so that people usually received care to meet their needs. However, the lack of involvement in care planning and the inconsistent approach to the review of care plans and assessments meant that peoples preferences and expectations were not always fully met. Evidence: People told us they usually had the care and support they needed and expected. They said they look after us very well. Some people were pleased with the medical support provided. They said the GP was always called in promptly when needed, and they confirmed they received other health care services, such as the chiropodist, optician and dentist. Since the last inspection in January 2009, the acting manager had introduced new care plan documentation. We looked at 3 care plans, 2 with the new documentation. The care plans covered all of the persons assessed needs. The new style care plans had good details of the persons needs and preferences in all daily activities. There were clear details of the action required by staff to meet those needs. The care plan in Care Homes for Older People Page 13 of 28 Evidence: the previous documentation was not as clear and detailed as the new style care plans. The acting manager said that all care plans would be changed to the new style documentation as soon as possible. There was an inconsistent approach to the review of care plans. Some had been reviewed monthly, most had not been reviewed for 2 or 3 months. None of the care plans seen had been signed by the person, or their representative, to indicate their involvement and agreement. People told us they had not seen their care plan, or that of their relative. We found relevant risk assessments and other assessments of health care needs in place. These included assessments of the persons manual handling needs, nutritional needs, risk of falls, and risk of developing pressure sores. Again, there was an inconsistent approach to the review of assessments and risk assessments. Where necessary, people had a risk assessment in place for the use of bed rails and these had been signed by the persons relative. We saw records of the involvement of other health care professionals, such as GP, District Nurse, optician, dentist and chiropodist. We saw from the daily records for each person that prompt and appropriate action was taken to address health concerns. We found that medication was securely stored and there were satisfactory records of the receipt, administration and disposal of medicines in the home. The acting manager had recently carried out an audit of medication practices in the home and had already taken action to address most of the issues found. People told us that staff were always friendly, polite and kind. There were few details in care plans of how peoples dignity and privacy should be maintained. The care records did not include the persons preference about the gender of carer to give personal care. We observed that staff knocked on doors before entering and people confirmed this usually happened. The AQAA said that the home had improved by introducing new care planning documentation and implementing falls risk assessments. The AQAA recognised that the home could improve by more involvement of people and their relatives in care planning. Care Homes for Older People Page 14 of 28 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. The lifestyle offered did not always meet the needs, preferences and expectations of people living in the home. Evidence: The 2 people who returned our surveys told us there were usually activities arranged that they could take part in. During the inspection visit, people and their relatives told us there were not always enough activities offered. Trips out had recently been arranged and people told us they were looking forward to a trip to Carsington Water later in the week. The activities for the week were displayed in the main hallway. People told us the activities did not always take place as shown. The list of trips out was also displayed and people confirmed these had taken place. People told us they could follow their preferred routines at the home, such as getting up and going to bed when they wanted to. We observed that people could move freely around the home, sitting in the lounges or in their bedrooms as they wished. Visitors told us they were always made welcome and were able to visit at any Care Homes for Older People Page 15 of 28 Evidence: reasonable time. There were regular meetings for people in the home and their relatives. The payphone for people to use was situated in the main hallway where there was no privacy for anyone making a call. Menus were displayed in the main hallway for 4 weeks with no indication of the current week. As noted at the previous inspection, the menus were in small print and too high to be read by someone sitting in a wheelchair. There were no menus displayed in the dining room. The menus showed a choice of main meals and puddings at lunch and tea time and people were asked about their choices the day before. We found that choices made were not always available, the quantity and quality of food was not always what people expected and preferred, and the standard of cooking was variable when the main cook was not at work. A relative said When it is anyones birthday they make a cake and do a special tea for everyone, and, I would like to see a bit more fresh fruit in bowls for residents to eat. The AQAA said the home had improved in the last 12 months by providing a structured activity program in consultation with service users. The home planned to improve by making better links with the local community and providing opportunities for people to be more involved. Care Homes for Older People Page 16 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were suitable systems in place and good staff awareness so that people were generally well protected and their concerns effectively dealt with. Evidence: People told us there was someone at the home they could talk to informally if they were unhappy about anything. Most people knew how to make a complaint and said they were confident that the acting manager or other senior staff would take appropriate action. The complaints procedure was displayed in the main hallway and was in the Service User Guide. The home had received 1 complaint since the last inspection in January 2009. They had let us know about this complaint and appeared to have taken appropriate action. We had not received any complaints or concerns directly about the home since the last inspection. There were appropriate policies and procedures in place about safeguarding vulnerable adults. More than half of the staff had received training about safeguarding vulnerable adults and further training was planned. Staff were aware of the procedures to follow if abuse was suspected. 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 17 of 28 Evidence: The home had notified us of most required events, such as deaths or injuries of people in the home. We found that 1 event had not been notified to us and the acting manager took approriate action as soon as this was discussed with her. The AQAA said that the home had improved in the last 12 months by having up to date policies in place and by relevant staff training. They planned to improve by more staff training, including training about the Mental Capacity Act 2005. Care Homes for Older People Page 18 of 28 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 safe, clean, pleasant environment that met their needs and expectations. Evidence: People told us the home was usually clean and fresh. A relative told us The security is very good as you cannot get in unless someone lets you in. The lounges, conservatory and dining room were bright and pleasant with suitable furniture. The bedrooms seen were personalised with peoples own furniture and other possessions. The home was suitably equipped with lifting hoists and other manual handling 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. Since the last inspection, an additional fixed bath hoist had been installed. The acting manager had recently completed an audit about the environment of the home and had formulated an action plan to address the issues found. Some issues had already been resolved. Care Homes for Older People Page 19 of 28 Evidence: Most of the staff had received training about good practice in infection control. Staff were aware of procedures to follow to minimse the risk of spread of infection. The AQAA said the home offers a warm and homely environment. They planned to improve by developing a formal program of maintenance, redecoration and refurbishment. Care Homes for Older People Page 20 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were satisfactory recruitment practices, a good staff training programme and adequate staffing levels so that people were protected and generally well supported. Evidence: People told us staff were usually available when they were needed. People said that staff usually had the right skills and experience to meet their needs. They said the staff were always very good and always friendly. The staff rotas showed that there were 3 care assistants on duty for the morning and afternoon shifts, and 2 at night. There was a registered nurse on duty for each shift. From looking at the rotas and discussion with staff, we found that staffing levels had been maintained with very little use of agency staff. The acting manager told us she was in the process of recruiting a laundry assistant and teatime kitchen assistant. In the meantime, care staff were helping with the laundry and the preparation of the teatime meal, although no additional care staff were provided to cover the extra duties. We looked at the records of 3 members of staff, all recruited since the last inspection in January 2009. The records had all the required documents and information in place, except for photographs of the staff. Care Homes for Older People Page 21 of 28 Evidence: New staff had started an induction program that met Skills For Care standards. Staff confirmed they had a period of shadowing experienced staff when they first started at the home. Staff training records showed that most staff were up to date with required training, such as fire safety and manual handling. The acting manager had carried out an audit of staff training needs and sessions were planned to ensure all staff had all relevant training over the next few months. The AQAA showed that nearly 50 of care staff had achieved a relevant National Vocational Qualification at level 2 or above. The AQAA said the home had improved by increasing the staff complement and reducing the use of agency staff. The home planned to improve by introducing a robust system for workforce planning over a longer term. Care Homes for Older People Page 22 of 28 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 so that the home was better organised and people received a more consistent service. Evidence: Since the last inspection in January 2009, the previous registered manager had left the home. An acting manager started at the home in March 2009. The acting manager was suitably qualified and experienced to run the home and was supernumerary to allow sufficient time for her to fulfill her responsibilities. The acting manager said she had started the application process but was not yet registered with CQC. People told us the acting manager was a breath of fresh air and was getting things organised. Staff told us they had confidence in the acting manager to take appropriate actions on issues they raised. The acting manager was supported by a deputy manager, although the deputy manager had been covering for other staff shortages and so was not always available Care Homes for Older People Page 23 of 28 Evidence: to give management support. The acting manager had no other administrative support and was frequently having to answer and deal with telephone calls on the day of the inspection visit. The quality assurance system had been further developed by the acting manager and included monthly audits of accidents, the incidence of pressure sores, and the use of bed rails in the home. The acting manager had also carried out recent audits of medication and of the environment of the home. Action plans had been devised as a result of these audits and some actions had already been completed. There were meetings for people in the home and their relatives every 2 months. The acting manager said that quality assurance surveys would be sent out in July and a report would be produced to inform people of the results and of any action taken to address issues raised. The AQAA was completed by the acting manager. The AQAA contained clear, relevant information supported by a range of evidence. The AQAA let us know what changes had been made and where they still needed to make improvements. The data section of the AQAA was fully completed. We found problems with the organisation of food shopping and menu planning, as noted in the Daily Life and Social Activities section of this report. The acting manager had not been given a budget to work to for provision of meals in the home. The personal money for some people in the home was managed for them. The money was stored securely and satisfactory records were kept. The AQAA showed that all required maintenance and servicing of equipment and systems in the home was up to date. Also, that all relevant health and safety policies were in place. Staff training records showed that most staff had received relevant training, such as fire safety, food hygiene, manual handling, and infection control. Care Homes for Older People Page 24 of 28 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 25 of 28 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 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 evidence of the active involvement of people, or their representatives, in care planning to ensure their needs and preferences are fully met. Care plans and risk assessments should be reviewed and updated at least monthly, or more often if there is a change in the persons condition or circumstances. This will ensure the person receives care to meet their current needs. It should be noted in their care records if a person has a preference about the gender of carer to help them with personal care. This will help to ensure the persons dignity and privacy are maintained. There should always be sufficient staffing and other resources available to allow activities to take place as planned. This will help to ensure the lifestyle in the home meets peoples expectations. 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 Page 26 of 28 2 7 3 10 4 12 5 12 Care Homes for Older People 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 providing suitable activities and also that routines are based around individual preferences. 6 14 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. 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. When care staff are providing cover for laundry, kitchen or domestic staff, this should not be as part of the care shift. This will ensure that that staffing levels are properly maintained and care staff are always available to meet peoples needs. Staff records should include a recent photograph. This will help to protect people in the home as part of a robust recruitment system. The acting manager should have sufficient administrative support to enable her to focus her time on improving systems and standards in the home. The providers and the acting manager should use available research and guidance, such as the Caroline Walker Trust Eating well for older people, to ensure better organisation of meals and shopping. This will help to ensure that people have meals to meet their need and preferences. 7 15 8 27 9 29 10 31 11 33 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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) Care Quality Commission (CQC). 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