Inspection on 13/11/08 for Spring Bank

This inspection was carried out on 13th November 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Spring Bank 21/05/08

Spring Bank 27/11/07

Spring Bank 04/06/07

Spring Bank 12/12/06

Spring Bank 16/05/06

Spring Bank 11/10/05

Spring Bank 17/05/05

Spring Bank 07/09/04

Spring Bank 05/05/04

Spring Bank 14/01/04

Similar services:

Abbey The

Snydale Care Home

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Spring Bank Howden Road Silsden Keighley West Yorkshire BD20 0JB     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: Mary Bentley     Date: 1 3 1 1 2 0 0 8 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. the things that people have said are important to them: They reflect 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 28 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 28 Information about the care home Name of care home: Address: Spring Bank Howden Road Silsden Keighley West Yorkshire BD20 0JB 01535656287 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Angela Ridley Type of registration: Number of places registered: Mrs Diane Hudson care home 31 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category 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: Either, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Spring Bank is a converted extended property situated in a residential area of the town of Silsden. The town has good road and public transport links. Accommodation is provided on 2 floors. There are double and single rooms. The single rooms with ensuite facilities are in the newer part of the home: shared rooms are in the older part of the building. There are assisted bathrooms and communal toilets on both floors. There is level access to the home and gardens. Inside the home has a passenger lift to the Care Homes for Older People Page 4 of 28 Over 65 31 0 Brief description of the care home first floor. People have a choice of 2 lounges and there is also a dining room. There are attractive gardens and parking is available in the grounds. Information about the service including inspection reports is available on request from the home. 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 last inspection of this home was on 21 May 2008. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspections may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. The inspection process included looking at information we have received about the service since our last visit. Since our last visit we have taken enforcement action because the home was not Care Homes for Older People Page 6 of 28 completing all the required checks before allowing new staff to start work. This has now improved. The purpose of this inspection was to look at how the needs of people living the home are being met and to look at what progress has been made in meeting the requirements from the last inspection. This was an unannounced visit carried out in one day by one inspector. During the visit we spoke to people living in the home, visitors, staff and the owner. The manager was not present at the inspection. We observed staff caring for people, looked at various records including care plans and staff files and looked at some parts of the building. Before the visit we sent questionnaires to the home to give to people using the service. These included questionnaires for people living in the home, visiting health care professionals and staff. In total 14 were returned. We asked the home to complete a self-assessment form (AQAA) which they did in good time. Information from the questionnaires and the AQAA has been used in preparing this report. What the care home does well: What has improved since the last inspection? What they could do better: People using the service are aware of how to make a complaint if they need to. However, the homes systems for recording complaints and providing information to the Commission must be improved. This is to make sure that people can be confident that their concerns are being taken seriously and acted on. The home must make sure they continue to follow the new recruitment procedures to protect people living in the home. The home must continue the work it has started on staff training to make sure that Care Homes for Older People Page 8 of 28 staff have the skills and knowledge they need to meet the needs of the people who live there. The home must keep staffing levels under review and particular attention needs to be given to making sure there are enough staff available at busy times. For example in the morning when most people need staff to help them get up, dressed and ready for the day. The owner has agreed to provide suitable sluicing facilities, which will help to reduce the risk of cross infection. The management team should continue to work together to provide staff with clear leadership and direction so that they are supported in meeting the needs of people living in the home. Improvements are needed to the way staff supervision is done. This is to make sure that all staff get the support they need to carry out their duties and continue with their professional and personal development. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 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. People are given the information they need to help them decide if the home is suitable to meet their needs. Peoples needs are assessed before they move in and whenever possible people or those close to them are involved in this process. Evidence: Six of the seven people who completed surveys for us told us they had been given enough information about the home before moving in to help them decide if it was the right place for them. One person told us his relative had come to look around twice and his care needs had been discussed before he moved in. Another person told us they had not seen the home before their relative moved in but they said they are very happy with the care he is receiving. Care Homes for Older People Page 11 of 28 Evidence: We saw pre-admission assessments in the records and staff told us they get information about peoples needs before they move in. They said the care plan is usually started before someone comes in and is usually completed within the first few days of their stay. The owner told us changes have been made to the way emergency admissions are dealt with. She said the home now always does an assessment before people move in. People told us they have been given contracts setting out the terms and conditions of their stay and we saw evidence of this in the records. The home has produced a leaflet with information about the fees and the owner told us this is given to people when they come to look around. The registration certificate is clearly displayed. This means that people have access to information about who is responsible for the home and the type of care, which the home is registered to provide. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and health care needs are met. People or those close to them are involved in planning how their care needs will be met. Peoples privacy and dignity are respected. Evidence: People told us they usually receive the care, support, and medical attention they need. One person said, it could not be better and another said it is very efficient and attentive. Everyone living in the home has a care plan. We looked at 3 peoples care plans. The care plans have information about peoples personal, health and social care needs. They were up to date and we saw that they are reviewed every month. We saw evidence that people or those close to them had been involved in drawing up and/or reviewing the care plans. People we spoke to confirmed this. There are risk assessments in place to identify if people are at risk for example of Care Homes for Older People Page 13 of 28 Evidence: falling or developing pressure sores. These risk assessments are kept up to date and where risks are identified plans are in place to show how the risk will be dealt with. The home told us they have introduced a more detailed nutritional risk assessment and we saw evidence of this. We saw that a food diary had been started for one person to record what they are eating and drinking because of concerns about recent weight loss. The records showed that people have access to a range of NHS services such as GPs, dieticians, and physiotherapists. Two health care professionals who visit the home told us they are satisfied that people are properly cared for. We looked at the way medicines are managed. Generally they were satisfactory, however there were some gaps on the records of administration. This means that it is not always possible to tell if people have received their medicines as they are prescribed. We saw that the home was holding too much medicine in stock for some people. When there is a lot of medicine in stock there is a risk that people could be given out of date medicines. This was discussed with the owner during the visit and she said she would deal with it. At our last visit we had some concerns that staff were not always aware of how their actions or comments could compromise peoples dignity. These concerns have been discussed with staff both in staff meetings and in one to one supervisions. During this visit we saw that staff treated people with kindness and in a way that showed respect for their dignity. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported in following their interests and are given the opportunity to take part in a variety of social activities. The home is continuing to look at ways in which it can improve daily routines to make more time for social activities. Evidence: Daily routines are fairly flexible, for example people can decide when they want to get up and go to bed and can stay in their own rooms if they prefer. The home offers a range of activities, these include horticultural therapy, visiting entertainers, games, and quizzes. On the day before we visited some staff had brought in their pets and told us people had really enjoyed this. Most people told us there are activities they can take part in and one person said they quite like the games and quizzes. As well as a new fish tank the home now has hamsters. The cages are bright and colourful which helps draw peoples attention to them and they have proved very popular particularly with one person who spends a lot of time in the small lounge. Care Homes for Older People Page 15 of 28 Evidence: During the morning there was music playing in the lounge which people seemed to be enjoying. Some people were playing dominoes, another was looking at magazines, and another was doing a jigsaw puzzle. Staff chatted with people as they went about their duties. Information about peoples social and spiritual needs is recorded and the home told us that representatives from local Christian churches visit. Visitors told us they always feel welcome and are offered refreshments. People told us they usually like the food and one person said it is excellent. One visitor told us they are very pleased that their relative has put on weight since coming to the home. They said he wasnt able to eat without help when he first arrived and is now able to eat without help from staff and enjoy his meals in the dining room with other people. People are offered a choice of meals. At lunchtime staff were available to help and prompt people where necessary. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know how to make a complaint if they have concerns about their care. However, it is not always clear from the homes records whether or not appropriate action has been taken to put things right. More staff training is needed to make sure that people are protected. Evidence: Every bedroom has a copy of the Service User guide, which includes information about how to make a complaint. People told us they know how to complain if they need to and staff told us they know what to do if anyone has concerns about the service. At the last inspection we talked to the home about two complaints they were dealing with. We asked them to provide us with written information about these complaints. Following that visit we were made aware of some other concerns about the service. We asked the home to look into this and provide us with a written response. We have written to the home on a number of occasions to follow up our requests for information. We have not received the information we asked for. We discussed this with the owner during the visit, she said she would get the information and send it to us. Following our visit the owner provided us with this information. At the last inspection we were concerned that the home was not following the correct Care Homes for Older People Page 17 of 28 Evidence: procedures when dealing with safeguarding (protection of vulnerable adults) issues. The owner told us that they are clear about the procedures and will if necessary contact the local Adult Protection Unit for advice. The owner told us that there have not been any new allegations or suspicions of abuse and none have been referred to us. The manager has attended training on safeguarding run by the Local Adult Protection unit. The owner said she has not attended this training, we recommend that she does. At the last inspection we identified that staff had not attended safeguarding training and discussed this with the home. They have not yet received this training, however, the owner said it is being arranged. We saw in the staff files that staff are given some information about the protection of vulnerable adults and whistle blowing procedures as part of their induction. Staff told us they know what to do if they have concerns about peoples safety or wellbeing. Information about local advocacy groups in provided in the home. The owner told us that the manager has attended training on the Mental Capacity Act but that this information has not been cascaded to staff. It is important that staff have an understanding of the implications of the Mental Capacity Act because some of the people living in the home suffer from dementia. 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 provides a clean and comfortable place for people to live. Suitable equipment should be provided to protect people from the risk of cross infection. Evidence: The home was clean and tidy when we visited and people who live there told us it is always fresh and clean. The home has provided a fish tank. This is located in the entrance hall and during our visit we saw a number of different people enjoy sitting and watching the fish. The standard of decor throughout the home is good and there is an ongoing programme of refurbishment. New curtains have been fitted in the bedrooms since our last visit. The bedrooms we saw were warm and clean and suitably equipped to meet peoples needs. We saw that most people have personal belongings such as pictures or ornaments in their rooms. The home does not yet have a mechanical sluice for cleaning and disinfecting equipment such as commode pots. This potentially increases the risk of cross infection although alternative measures are in place to deal with the risk. This has been discussed with the owner at previous inspections. She agrees this equipment is Care Homes for Older People Page 19 of 28 Evidence: necessary and said she hopes to be able to provide it in the near future. The environmental health department has awarded the home a 4 star rating (5 is the best) for its standards of food hygiene and safety. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough staff to keep people safe but not always enough to make sure peoples needs are met in timely way. The way new staff are recruited has improved and this helps to make sure people are protected. More needs to be done to support staff in gaining the skills and knowledge they need to meet the needs of people living in the home. Evidence: People living in the home told us staff are usually available when they need them. One person said there is always someone ready to help night and day. Another person said their relative is unable to use the call bell but staff check on them at least every hour, sometimes more often. However, the duty rosters showed that there are not always enough staff first thing in the morning to help people get up and dressed. There are a number of care staff who do not start work until 9.00am, the number varies on different days, between one and three. Staff said this could create problems and make it difficult for them to give people the help they need when they need it. Some staff also expressed concerns about the staffing levels at the weekends, again they were concerned that there are not always enough staff available. Care Homes for Older People Page 21 of 28 Evidence: At previous inspections we have been concerned that the home was not following the correct recruitment procedures and was therefore putting people at risk. On this visit we found that improvements have been made. We looked at the files of 4 newly appointed staff. In all cases we saw that checks against the PoVA (Protection of Vulnerable Adults) register had been carried out before people started work in the home. We saw evidence that when people started work pending completion of the full CRB (Criminal Records Bureau) check arrangements were in place to make sure they worked under supervision. In 3 of the files we saw that 2 written references had been obtained before staff started work, in the fourth file we saw that the references had been obtained after they had started work. This was discussed with the owner as the law requires all these documents to be obtained before new staff start work in the home. We saw that one member of staff who was employed to work in the kitchen is now doing some work as a care assistant. Although this person had a CRB check it was not the level required for care work. The owner said she would complete another CRB check at the correct level. At the last inspection we were concerned that staff were not receiving the training they needed to meet peoples needs. The home has started to address this. The majority of staff have completed moving and handling training since our last visit and the manager is training to be a moving and handling coordinator so that she will be able to provide this training in house. We saw evidence that a number of staff have attended training on caring for people with mental health problems and dementia and more training on this subject is planned. Some of the nursing staff have attended training on end of life care (The Liverpool Care Pathway). Most staff said they did not get enough training to help them meet the individual needs of people living in the home. Some expressed frustration that training which is promised does not materialise. The information provided by the home (AQAA) showed that 35 of care staff have completed an NVQ (National Vocational Qualification) at level 2 or above. The home continues to support staff in getting this qualification. Staff told us that the induction training they received when they started work covered most of what they needed to know to do the job. The way training is recorded has improved. 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. The home has made improvements since the last inspection, however more needs to be done to make sure that the management team convey a clear sense of direction and leadership so that everyone involved with the service can feel confident the home is being managed appropriately. Evidence: The owner and registered manager are responsible for the day-to-day running of the home. At the last inspection it was evident that they have different styles of management and this was causing some tension in the home. We discussed these concerns with the owner and manager at that time. In their self-assessment the home told us that working relationships between the owner and manager have improved. However, our discussions with staff suggest that more work needs to be done on this area. Among the concerns raised by staff were issues about poor communication, for example changes being made to peoples hours of work without consultation and issues about lack of confidentiality. These concerns need to be resolved because staff Care Homes for Older People Page 23 of 28 Evidence: need strong and clear leadership to support them in relating to the aims and purpose of the home and in meeting peoples needs. The home does not have formal meetings for people using the service, however they told us they do try to encourage relatives and friends to become more involved in the running of the home. One way they do this is by having a notice inviting people to share their views. People told us they are kept informed and involved in decisions about the care of their loved ones. At the last inspection we discussed the way the home sends surveys to people. They usually send surveys to people when they have been in the home for a few months and to people who come for short stays. This approach does not make sure that everyone is given the opportunity to share his or her views of the service. Also because of the way information is received it is more difficult for the home to use it to assess the areas where they are performing well and the areas where improvements are needed. This was discussed again during this visit. Following the last inspection we asked the home to give us an improvement plan setting out how they would improve the service for the benefit of the people living there. This information was received after we reminded them that is was overdue. Before this inspection we asked the home to complete a self-assessment form. This was completed and returned to us in good time. However, other information we have asked for has not been provided, specifically information in relation to how the home deals with complaints. The owner confirmed that the home does not hold any personal money for people. There are safes in peoples rooms where they can store money or valuables, on the rare occasions when the home keeps valuables for people they are recorded. Staff told us that the approach to supervision is inconsistent, some staff have had supervision, others have not and the records confirmed this. This was identified at our last visit as an area that needed to be addressed. Information provided by the home showed that in most cases equipment and installations are checked and serviced at the required intervals to make sure they are safe. The current gas safety certificate was not available at the time of our visit. Since our visit the owner has confirmed that the gas appliances have been checked and are safe and a copy of the certificate will be sent to us as soon as it is available. 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 1 16 17 There must be a record of all 23/01/2009 complaints, including details of the actions taken in response to the complaint. So that people can be confident their concerns are taken seriously and acted on. 2 27 18 The numbers of staff on 30/01/2009 duty and the hours that staff work must be kept under review. To make sure there are always enough staff available to meet peoples needs and so that staffing numbers take account of peak times of activity when people need more help. 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 Care Homes for Older People Page 26 of 28 1 9 Nursing staff should make sure they always sign the medicine administration charts so that it is clear whether or not people have received their medicines as prescribed. More care should be taken when ordering medicines to avoid holding excessive stocks as this could result in people receiving out of date medicines. 2 17 Staff should receive training on the Mental Capacity Act so that they understand the legal framework and their responsibilities in relation to assessing peoples capacity and making decisions in peoples best interests. The owner and staff should attend safeguarding training so that they are familiar with the correct procedures for dealing with suspicions and/or allegations of abuse. This is to make sure that people are properly protected. A washer disinfector should be provided in a separate room, with hand washing facilities, to help reduce the risk of cross infection. The home should continue to support staff in gaining the skills and knowledge they need to enable them to meet the needs of people living in the home. The owner and manager should continue to look at ways in which they can address the concerns about the management of the home so that staff are provided with strong and clear leadership to support them in meeting the needs of people living in the home. The home should continue to develop the systems that are in place for evaluating the quality of the service so that everyone using the service is given the opportunity to share their views and contribute to the development of the service. A copy of the current gas safety certificate should be sent to the Commission as soon as it is available. 3 18 4 26 5 30 6 32 7 33 8 38 Care Homes for Older People Page 27 of 28 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 28 of 28 - 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!