Inspection on 02/09/09 for Saffron House

This inspection was carried out on 2nd September 2009.

CQC 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Saffron House 22/12/09

Saffron House 17/10/07

Saffron House 10/04/06

Saffron House 22/09/05

Saffron House 10/05/05

Saffron House 26/01/05

Saffron House 11/06/04

Saffron House 20/03/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Saffron House 2a High Street Barwell Leicestershire LE9 8DQ     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: Keith Charlton     Date: 0 3 0 9 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 27 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Saffron House 2a High Street Barwell Leicestershire LE9 8DQ 01455842222 01455841222 saffronhouse@dsl.pipex.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Downing (Barwell) Limited care home 42 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: No person under 55 years of age who falls within categories PD or DE may be accommodated in Saffron House Persons who fall within either category DE or DE(E) may only be accommodated within Saffron House on the ground floor Service User Categories DE & DE(E) No person who falls within categories DE or DE(E) may be admitted to Saffron House when 20 persons of those categories/combined categories are already accommodated within the home Service User Categories PD & PD(E) No person who falls within categories PD or PD(E) may be admitted to Saffron House when 10 persons of those categories/combined categories are already accommodated within the home To be able to admit to Saffron House the named person of category LD 55 named in Care Homes for Older People Page 4 of 27 Over 65 20 42 10 20 0 10 variation application number 56181 dated 18th September 2003 Date of last inspection Brief description of the care home The last key inspection of the service was on 17/10/2008. Saffron House is a purpose built care home situated in the centre of Barwell, Leicestershire. It is registered for forty-two service users within the categories of old age, dementia and physical disability. The home is not registered to provide nursing care. The home is situated on two floors and these are accessed by a passenger lift. The home has a dining room and lounge on each floor and a further five lounges throughout the home. The home has forty-two single bedrooms, which have ensuite facilities. Close to the home are a number of hotels and restaurants and is within close proximity of Mallory Park Race track and Market Bosworth. The home has a sensory garden for residents to enjoy at the back of the property and a circular walkway. The home has electric gates fitted to the exterior of the home for safety and to prevent intruders. The weekly fees are from #341 to #525 - this information was provided by the Manager on the day of the inspection. There are additional costs for individual expenditure such as hairdressing, toiletries, etc. A Statement of Purpose and Service Users Guide to the services the home offers can be supplied to applicants and the last Inspection Report is available in reception, to enable prospective residents to make an informed choice as to whether they wish to live at the home. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is One Star. This means the people who use this service experience adequate quality outcomes. We, as it appears throughout the Inspection Report, refers to The Care Quality Commission (CQC). The inspection process consisted of pre-planning the inspection, which included reviewing the Annual Quality Assurance Assessment (AQAA), which is self assessment tool completed by a representative of the service, We have sent surveys to people who use the service along with staff and their comments are reflected in this Report. The unannounced site visit commenced on the 2nd September 2009 and was carried out by Keith Charlton. Care Homes for Older People Page 6 of 27 The focus of the inspection is based upon the outcomes for people who use the service. The method of inspection was case tracking. This involved identifying people with varying levels of care needs and looking at how these are being met by the staff at Saffron House. Four residents were selected. Discussions were held with six residents, though this was limited as most residents had difficulties with communication due to their dementia, three relatives, the Manager, the Area Manager, and three members of staff. What the care home does well: What has improved since the last inspection? What they could do better: Residents welfare could be more effectively met by ensuring that: Assessments are detailed and contain all aspects of individual needs to make sure staff can meet those needs from day one of a persons admission. Residents must not be admitted where the home is not legally permitted to do this, which is the first floor of the home. All aspects of care e.g. proper toileting programmes, stated dates of health checks, etc need to be detailed in Care Plans to assist staff to meet all residents needs. Management need to ensure that staff respect residents at all times and respond to their needs as per the action stated in the care plan. More outings, based on residents wishes, are needed. The food supply needs evidence that it is appropriate to peoples needs and that drinks are regularly provided to prevent dehydration. The Complaints Procedure needs to be clearer for residents and their representatives so that complainants can go to the Lead Agency to reach a proper resolution. An environmental audit is recommended to make facilities better signed for residents with dementia etc. Maintenance issues need to be attended to quickly to provide an attractive, odour free and safe home for residents. Care and domestic staffing levels need to be raised now that management have identified this as needed to meet the increasing needs of residents. The staff training programme needs to become more comprehensive through ensuring all staff receive thorough training to increase their skills in delivering good quality care for residents. Care Homes for Older People Page 8 of 27 Issues of concern must be reported to the Commission to ensure these can be monitored to ensure residents needs are met. Management need to evidence that action has been taken if issues are identified through resident and staff surveys, meetings etc. Residents must have a safe environment through effective fire safety being observed. 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.cqc.org.uk. 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 27 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 27 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 living at Saffron House do not have their needs assessed in sufficient detail before moving into the home. Evidence: The AQAA stated that prospective residents are invited to the home and can stay for the day and have a tour of the home, relevant information is provided and assessments are carried out by the management. One person who used the service confirmed that the Manager had assessed him in hospital: Yes, the Manager assessed what care I needed when she came to hospital. Residents were not able to confirm that they had been provided with sufficient written information about the home due to their dementia conditions but relatives spoken with said they had enough information at the time of the admission to make up their minds about the home. However some surveys said that residents had not received any information. The Manager said she would follow up this issue. Care Homes for Older People Page 11 of 27 Evidence: We case tracked a person living in the home who had moved into Saffron House in the past. We also checked that this person had his needs properly assessed prior to moving in, to ensure that the staff at the home could meet their needs, and we found that the assessment system had information regarding residents needs though some sections had not been properly completed - e.g. past health checks had not been included, which is useful to prompt these checks and improve the health and daily quality of life for people, and there was no information regarding hobbies. Some residents had been admitted to the 1st floor which is not registered to admit residents with dementia. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People at Saffron house receive adequate health and social care practice. Evidence: My care plan has been discussed with me, one person who used the service said. Residents and relatives spoken with recalled having a care plan and being invited to reviews. We checked the care plans of three people living at the home who were case tracked. Plans showed detail regarding the support required by staff to ensure the physical health of people living at the home, information to inform staff of some of the residents personal history and some information of preferred daily living routines of residents, which ensures their social and emotional well being is fully supported. Continence information was recorded though this assessment needed more detail to work out the individual needs of a resident so staff could prompt before they needed to go to the toilet. Staff said they had read the Care Plans - this is needed so that they can fully understand the needs of people who use the service. Care Homes for Older People Page 13 of 27 Evidence: Accident records were checked and medical services were contacted when people who use the service had a potentially serious injury. A monthly audit is in place to review why accidents happened so that preventative steps could be put in place, thus protecting residents health. We checked the medication records, and found that there was generally good recording of the administration of the medicines in the home, though there were some gaps that the Manager said she would follow up and put a system in place so these could be checked on a daily basis. There was a picture of residents on medication sheets to ensure the medication is given to the right residents and the Manager said that there will be information on medication sheets regarding other important information - allergies etc so that residents health is protected. Controlled medicines storage was in a secured cabinet, which appeared to conform to the latest legal requirements. Medication was checked and one medication was wrongly recorded, which the Manager said would be followed up. We spent time watching staff interaction with people living at Saffron House. We saw staff being friendly and caring to people throughout the day doing their best to meet the needs of people living at the home and relatives confirmed that staff were friendly to residents, though there was reference on survey forms that not all staff are friendly and respectful towards residents: Satisfaction questionnaires were sent around the home this year, which were seen to be positive in general though there were remarks about: Some staff are not so polite and caring towards residents. Attitude of certain staff. Residents left too long after meals and sitting on commode. General cleanliness amongst service users need to be improved. The Manager said that these issues had been raised with staff and would be closely monitored. Care Homes for Older People Page 14 of 27 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. There are opportunities for people at Saffron House to take part in activities and have a relaxed lifestyle. Evidence: Residents said that in general the activities provided were good. Yes, theres something going on most days, one resident said. The AQAA stated that there is a flexible routine, individual and group activities and outside activities, church involvement etc. An Activities Organiser is employed for five days a week and described the activities for us and we saw her and other staff providing activities to residents. The Area Manager said that memory boxes were going to be provided for residents which will be useful for reminiscence one to one sessions with residents with dementia. Staff said there were activities - playing ball, playing skittles, watching TV, listening to music and staff said they took them out to the garden in good weather. There were some suggestions to have more frequent outings and staff having more time to speak to residents and for a resident to be provided with a raised flower bed Care Homes for Older People Page 15 of 27 Evidence: so he could still grow things. The Manager said these issues would be followed up. The relations between staff and people who use the service were observed to be relaxed. Staff said there were no rules. People can get up when they like, choose their clothes and food. The home supports residents with dementia though only half the staff had received training on this. There was no displayed information for day, weather, menu etc on a noticeboard. Staff said visitors were always welcome and three relatives were spoken with on this visit who confirmed that staff welcome them and they thought the care the staff supplied was of a high standard. Residents said that food was good in general though there were some comments in surveys that the food was not always good. The cook said that menus had been expanded and issues were being followed up. People at the home have a choice of meal at lunch time. Food records indicated this. On the day of inspection the meal was a choice of chicken or liver with five fresh vegetables and mashed potato, followed by a choice of dessert. All the food was well cooked and tasty with an emphasis on healthy eating. Satisfaction questionnaires were sent around the home this year, which were seen to be positive in general though there were remarks about: More cups of tea needed. More cups of tea, more diabetic food. Care Homes for Older People Page 16 of 27 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. Complaints are taken seriously and residents are protected from abuse at Saffron House. Evidence: I have never needed to complain but I am sure Becky would do something about it if needed, one person said. The AQAA stated that staff have been trained in protecting residents from abuse. A relative said that when she had a complaint she took it to the Manager and it was sorted out. There have been a number of complaints since the last inspection and all were properly followed up by management. Spoke with staff and asked what they would do if it was reported that a member of staff had been seen abusing a resident. They were clear that this was unacceptable and needed to be reported to the Manager and they knew to contact the right outside agencies if this was needed. The Complaint Procedure was seen but found not to be in line with the need to refer such matters to the Lead Agency - the Adult Care Department. The Area Manager said this would be followed up. Staff were found to have proper checks - written references and CRBs to protect staff from unsuitable staff. Care Homes for Older People Page 17 of 27 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. People living at Saffron House live in a generally homely environment but odours need to be eliminated and maintenance improved so that facilities are fully accessible to residents. Evidence: All residents spoken with said they liked their bedrooms: I like my bedroom and it is the way I want it to be, one resident said. We saw people at Saffron House living in a maintained environment though there were comments in the surveys that maintenance has taken to long to do - for example taking ten days to fit a rail and the lift being out of order for three weeks without proper chase up, (though there is an alternative smaller lift so residents were not confined to the first floor). We discussed the need to sign the environment to further help residents with dementia, e.g. pictures on residents doors to orientate them to their bedrooms, colour coding toilet doors, pictures of residents favourite scenes on bedroom doors etc to make facilities clearer, e.g. orientate residents to go to their own bedrooms etc. The Area Manager said this would be followed up. There were some low level odours to some corridors and easy chairs which need to be Care Homes for Older People Page 18 of 27 Evidence: eliminated, which did not promote the homeliness of the service. The Manager said these issues had been looked into with more domestics to be on covering every day of the week. Care Homes for Older People Page 19 of 27 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. Residents needs are not fully met as staffing levels are not adequate to deal with them and some training for staff has not been provided so residents needs cannot be fully met. Evidence: Speaking to residents and relatives we found that there were a lot of positive comments about the staff: Staff are great. They would do anything for you, one resident said. However the satisfaction questionnaires sent around the home this year had remarks about: Some staff are not so polite and caring towards residents. Staff dont always work together and night staff treat day staff wrongly. We should be nice to one another. Attitude of certain staff. Not enough staff when hospital appointments occur. More staff needed. There were comments in surveys that staffing was short and there was a need to have at least four care staff on each unit with two staff on each unit at night. The Manager said that staffing is to be increased to at least four care staff on each unit in the day and evening time periods to deal with the increasing needs of residents. Domestic staff stop work at 2.00pm so care staff then have to do these tasks - it Care Homes for Older People Page 20 of 27 Evidence: means that care staff have to deal with accidents/spillages. The Manager said that there are to be two domestic staff on duty each day of the week so that care staff have more time to care. A staff member said that although she had only been working at the home for only just over a year, she had been encouraged by management to do the NVQ 2 course and had already completed a number of training courses and a thorough induction. We found that staff have been on a number of training events to help update their practice on areas such as Moving and Handling, Fire Safety, Infection Control though not all staff had Dementia training and no staff had Challenging Behavior training and also training regarding residents health conditions were missing - e.g. Sight and Hearing Impairment, Stroke, Parkinsons Disease, Diabetes, etc. The Manager said that these would be added to the training programme. Staff records showed that proper checks had been carried out to protect residents from unsuitable staff. Care Homes for Older People Page 21 of 27 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. Complete management systems are not fully in place to protect the health and safety of residents. Evidence: Rebecca Woodley is now the Manager of the home and confirmed she will be applying for registration. Rebecca has completed the NVQ4 in management skills. Surveys and comments on the day were very positive about Rebeccas positive management style and how her aim is to promote residents welfare. The Company has not informed the Commission of the change in management arrangements, as needed by the legal requirement. The Area Manager said this would be done. Rebecca has a knowledge of the Mental Capacity act so knows that there would need to be a referral to the relevant Agency if a resident was deprived of their liberty, if this was seen to be in their best interests. Satisfaction questionnaires were sent around the home last year, and the results were Care Homes for Older People Page 22 of 27 Evidence: seen to be generally positive though there were also negative comments about residents care, low staffing levels, lack of teamwork and respect amongst staff etc. There was no analysis of the results or action plan to see show how improvements in the service were to be achieved. There were also comments made in the last staff meeting regarding residents not being toileted at night, and staff ignoring a buzzer for a resident to get help. The Manager said these issues are to be monitored. Written records regarding finances for residents are properly in place, and monies were checked for two residents and totals were found to be correct. There was evidence of a residents/relatives meeting discussing relevant issues -activities, food etc, which shows involvement in the running of the home. Staff informed us that they were able to tell management of the problems they were facing and there was regular supervision to support them. Some staff in surveys said there was a need to have more staff meetings and the Manager said she was arranging this. Safe working practice Risk assessments were in place. Fire records were in not properly place with regular fire drills as a drill had not occurred for over a year and fire bell testing had stopped for over three months - the Manager then arranged a fire drill the next day, and we saw evidence of this, and she said fire drills and fire bell testing would be more frequently done. There was an unlocked store cupboard which was a fire door. The Manager said that would be followed up. Staff were asked about the fire drill procedure and they all knew what to do. Hot water is regularly tested to meet the National Standard so that residents are not scalded. Care Homes for Older People Page 23 of 27 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 27 18 Care staffing levels in the morning period need to be reviewed and increased to ensure residents needs can always be met. 17/12/2007 2 30 18 The staff training programme 17/04/2008 needs to be extended to cover all relevant topics regarding residents care including residents conditions, e.g. stroke care, hearing and sight impairment etc . Care Homes for Older People Page 24 of 27 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 1 27 18 Staffing levels need to be reviewed and increased. To ensure that they are adequate to meet residents needs. 07/10/2009 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 31 37 The Registered Provided needs to inform us of important events such as the change of Manager and the failure of the lift. So we can assess the running of the service and take action if needed. 07/10/2009 2 38 13 Proper health and safety systems need to be in place in respect of regular fire drills, testing of fire bells, and unlocked storage rooms. To protect the health and safety of residents. 07/10/2009 Care Homes for Older People Page 25 of 27 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 3 4 5 6 7 8 3 7 10 12 16 19 26 30 A detailed assessment is needed to ensure that all residents needs are met by the home. Care Plans need to contain full detail of residents needs so that staff are able to meet these needs. Management must ensure staff treat residents with respect at all times. More outings need to be provided, based on the wishes of people who use the service. The complaints procedure needs to be changed so that complainants have the details of the Lead Agency. Maintenance issues need to be followed up swiftly to ensure a safe and attractive home for residents. Odour control needs to be in place at all times to ensure a fresh home for residents. The Training Programme needs to be extended to include residents conditions and how to deal with challenging behavior. Quality Assurance systems need an analysis and action plan to improve the service. 9 33 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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