Inspection on 16/02/09 for St Augustines Court Care Home

This inspection was carried out on 16th February 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

St Augustines Court Care Home 15/05/07

St Augustines Court Care Home 19/04/06

St Augustines Court Care Home 12/12/05

St Augustines Court Care Home 21/06/05

St Augustines Court Care Home 06/01/05

St Augustines Court Care Home 20/09/04

Similar services:

Trevayler Residential Care Home

Thornham Grove

Thistle Hill Hall

Conifer Lodge

Westwood Lodge

Egerton Lodge Care Home

Alfred Minto House Care Home

St Matthews Unit

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: St Augustines Court Care Home 105 - 113 Wells Road Nottingham Nottinghamshire NG3 3AP     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: Meryl Bailey     Date: 1 6 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: St Augustines Court Care Home 105 - 113 Wells Road Nottingham Nottinghamshire NG3 3AP 01159590473 01159412079 staugustines@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Southern Cross Care Homes No 2 Ltd care home 40 Number of places (if applicable): Under 65 Over 65 40 40 dementia mental disorder, excluding learning disability or dementia Additional conditions: 3 0 Within the total number of 40 beds 3 beds maybe used for clients under the age of 65 years in the category of DE Date of last inspection Brief description of the care home The last inspection was carried out on 15 May 2007. St Augustines Care Home provides 40 places for older people with Mental Disorder and Dementia who require nursing care. Accommodation is provided in double and single rooms without en-suite facilities. A passenger lift is installed to provide access to the first floor. All areas are accessible for people in wheelchairs. The home is two miles north of Nottingham and on a regular bus route to the city centre. There is also a range of local stores close by. The fees at the home range from £326.00 to £500.00 per week according to needs. People pay extra for their personal toiletries, taxi fares, confectionery and cigarettes are extra. Care Homes for Older People Page 4 of 30 Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The Quality rating for this service is 1 star. This means that the people who use this service experience adequate quality outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for people who live at the home and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice. In planning our visit we reviewed all of the information we have received about the home since we last visited and we considered this in planning the visit and deciding what areas to look at. Care Homes for Older People Page 6 of 30 We did this inspection with one inspector and an expert by experience who observed and spoke with people who are using this service. An expert by experience is a person who either has a shared experience of using services, has specialist knowledge or understands how people in this service communicate. The expert visited the service with us to help us get a picture of what it is like to live in or use the service. This is important because the views and experiences of people who use services are central to helping us make a judgement about the quality of care. Another method of inspection we use is called case tracking which involves us choosing people who live at the service and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. We observed staff working with people, spoke to two members of staff, six individual people who live at the service and a visiting relative to form an opinion about the quality of the service being provided. We read documents and records as part of this visit and observed how nurses handle medication to help us form an opinion about the health and safety of people who live at the service. What the care home does well: What has improved since the last inspection? What they could do better: Arrangements must me in place to enable people to wear their own properly fitting clean clothes at all times. This is to promote and maintain the dignity of the people living in the home. Medical treatment, including the application of creams, should always be provided in private in a persons own room or bathroom so that privacy and dignity are respected. Keep a record of interactions with people who spend their time isolated from others in the home. The activities worker should plan activities for the care staff to engage in with people. Display the food menu clearly in the dining room with photographs so that people can more easily understand what meals are available each day. Provide and display a clear complaints procedure to include contact details, together with stages and timescales for the process. This is so that people know who to speak to and can be confident that their complaints will be taken seriously and dealt with. Retain full details of outcomes of complaints within the complaints management file. Produce a programme for routine maintenance and renewal, which includes the Care Homes for Older People Page 8 of 30 replacement of damaged ceiling tiles. This is so that the home is always well maintained for people who live there. Repair or replace damaged or worn bedroom furniture. This is so that each persons bedroom is furnished and equipped to assure comfort and meets the assessed needs of the individual. Review the cleaning processes to ensure all areas are thoroughly cleaned. This is so that the home is kept free from offensive odours for the benefit of people who live there and their visitors and to protect people from risks of infection. Arrange for clothing to be laundered, ironed and returned to people as quickly as possible. This is so that people always have a sufficient choice of clean clothes ready to wear. Where rooms are shared, they should be occupied by two people who have made a positive choice to share with each other. When a shared place becomes vacant, the remaining person should be given the opportunity to choose not to share. Provide a choice of carpeting in bedrooms to give more comfort to people. Provide training for the activities worker specific to the work to be performed. This is to develop the skills of the worker in providing appropriate activities in a safe way. The acting manager must make an application to the Commission to be assessed for registration. This is so that the she can demonstrate her fitness to manage the service for the benefit of people that live there. When accidents and injuries are recorded an assessment must be undertaken and recorded to ensure follow up action is taken and risks of recurrence are diminished as far as possible. This is in order to promote and protect the safety and welfare of people who live at the home and staff. Arrange 1:1 supervision meetings with each staff member at least six times each year so that they are appropriately supported in their work in caring for people at the home. Review the accidents and injuries procedure to direct staff to complete the accident record form, remove the form from the book and submit it to the person in charge for assessment. This is so that each persons personal data is protected and appropriate follow up action is taken to safeguard health. 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 30 Care Homes for Older People Page 10 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Assessment processes are comprehensive so that people considering moving to the home are assured that staff will have full information about how to meet their needs. Evidence: We looked at the files of six people and found evidence that a manager or other nursing staff had visited each person before they were admitted. They had undertaken a comprehensive pre-admission assessment on each person. The assessment included all areas relating to personal and social care as well as nursing. Full body mapping was used to determine any skin or limb problems prior to admission. A draft care plan was in place immediately so that staff were informed of how to meet the peoples needs as soon as they were admitted. All pre-admission documents had been signed by the person admitted or a representative showing they had been fully consulted on all aspects of the care Care Homes for Older People Page 12 of 30 Evidence: required. Care Homes for Older People Page 13 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care is well planned and appropriate provision is made to meet health needs, but current practices and arrangements do not ensure that peoples rights to privacy and dignity are always upheld. Evidence: We saw detailed plans of care that specified action needed to meet needs and reduce or eliminate risks. There were comprehensive risk assessments for each person regarding moving and handling, nutrition (including malnutrition screening), falls and possibility of developing pressure sores. Specific risks were also assessed for individuals affected by other risks due to diabetes or their behaviour. There were weekly progress reports and each plan had been reviewed at least monthly. There was evidence of signatures of people or their relative showing they agreed to the way care was provided. There were daily notes written by staff, but accident records remained on the Accident Record Notepad and it was not clear if action had always been taken following accidents (See Management section of this report). Care Homes for Older People Page 14 of 30 Evidence: There were records of visits from doctors and other health professionals showing that when specific health needs were identified attention was sought. There were two nurses on duty during the day and one through the night. Medication was handled by the nurses. We saw the room which was kept locked, but window openings were not restricted (See Management section). There was added security within the room with locked trolleys and cupboards and all medication has stored at appropriate temperatures. There were photos on the medication records to help nurses identify people. The previous four weeks of records had been well maintained. We observed nurses giving oral medication to people at lunchtime in the dining room and saw that they were following procedures correctly. However, at teatime we saw one nurse was trying to apply cream to a persons legs at the dining table. This was not respecting the persons privacy and dignity and on seeing this the manager directed the nurse not to carry out the procedure in public. We also noted that some of the clothes worn by the residents appeared to need washing. Some people had spilt food on their clothes and had not been helped to change. There were generally spillages on the floor that were not attended to and we saw one man, who had no slippers or shoes, walking through spilt tea that had not been cleaned up (see standard 26 in the Environment section). A relative commented that one person was wearing trousers that were not his own and were too big. The relative feared the trousers might fall down in public. Another man was seen trying to fasten trousers and some staff were watching without offering any assistance. 22 people were sharing double bedrooms, but there was no evidence that people had known each other before coming to the home (see standard 23 in the Environment section). We saw some of the shared rooms and there were curtains that could be drawn between beds to provide some privacy. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Some appropriate activities are offered to people, but not all people have the benefit of regular stimulating activities to meet their needs relating to Dementia. Visitors are made welcome. People enjoy varied nutritious meals, but are not made fully aware of their choices. Evidence: The current activities worker has been employed at the home since June 2008. We saw her working with people at one table in the dining room, using touch to identify objects in feely bags and she accompanied one person out to lunch. Another person went out in the afternoon with a Care worker to visit a friend. She told us she does this every week. There was a list of activities planned for each day, but we saw several people sitting unoccupied and some were wandering. One person never came into the communal areas. One relative told us it would be better to see more activity at the home instead of people sitting around all day. The activities worker told us she had tried to engage people, but many were not interested. She had not had any training in providing activities for people with Dementia (See staffing section of this report). A team leader told us of a party held at the previous weekend for Valentines Day. We Care Homes for Older People Page 16 of 30 Evidence: saw a team leader interacting well with people and encouraging them to sing. There was music playing in the dining room, but other staff were not so involved in social interaction. Some outside entertainers come to the home. There had been a Rock and Jive session in January, a dog visit every Thursday and Motivation once a month. There were several relatives visiting during the inspection and the manager told us some people visit every day. There were no restrictions on times for visiting and various places were available for people to sit with their visitors. People were eating Shepherds Pie and vegetables for lunch and staff said there was also Cornish pasty and chips available. Two people claimed that there was no choice of meals and there was no menu displayed for them in the dining room. There was a varied nutritious menu displayed on the notice board in the reception area, but it was out of date. The acting manager said that the cook asks each person first thing in the morning what they would like for lunch. Care Homes for Older People Page 17 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are not made aware of how to complain, but concerns are taken seriously and people are safeguarded from abuse. Evidence: Two people we spoke with said they did not know how to make a complaint and others did not respond to the question. A relative was also not aware of the complaints procedure. The acting manager said that the procedure was contained in the Service User Guide, which needs updating. There were some records of complaints received and these showed that complaints had been taken seriously and responses had been given. However, not all outcomes were recorded in the complaints file. People told us they felt safe in the home. Recruitment records showed that staff had been thoroughly checked to ensure they were fit to care for vulnerable adults. Records of staff training clearly showed that staff were all given training in safeguarding vulnerable adults during the last 12 months. Those we spoke with confirmed this and said they would report any concerns to the manager or nurse in charge. They were aware of the Whistle blowing Policy and the local procedures. They said they would make sure any abuse was investigated. The acting manager informed us of previous concerns that were appropriately investigated. Care Homes for Older People Page 18 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home have some facilities appropriate to their needs, but some areas have not been fully maintained or kept clean. Evidence: We performed a partial tour of the home, which included some bedrooms, communal areas, the bathrooms, kitchen and laundry. Most people sat in a main lounge and dining room and an additional smaller lounge, both on the ground floor. A room for people who smoke was also available on the ground floor. There was another small lounge available on the upper floor. As at the last inspection, signs and graphics were used to promote orientation for people living in the home. The bathrooms walls were covered in murals of undersea scenes and bedroom doors painted different colours and fitted with a door knocker. There were murals of shops along the corridors and framed tactile artwork including old newspapers. However, most of the decoration had not changed since our previous visit in May 2007. There were 22 people sharing double rooms and 15 people had a room each. Those sharing had not made a positive choice to share with each other. The ceilings were covered with polystyrene tiles and in some bedrooms these tiles were stained from previous water leaks. In one bedroom a drawer front missing was from a wardrobe. The acting manager told us that attempts had been made to repair it, but it needed Care Homes for Older People Page 19 of 30 Evidence: replacing and at least 6 bedside cupboards needed replacing. Floors were mainly hard surfaces and some were stained. Bedrooms were sparsely furnished, but otherwise clean. The shared rooms had curtains that could be drawn between beds for privacy. A senior care worker said that some rooms had been recently decorated since the new acting manager had commenced and this had made some improvement in the premises. We noticed a stale odour throughout the building, which was stronger in some areas. Staff appeared to ignore spillages on the floor of the main lounge and dining room, which made the surface sticky to walk on. There was a domestic worker cleaning other parts of the home during the inspection visit. There was appropriate equipment for washing clothes in the laundry, but we saw a large pile of clothes that needed ironing and sorting for people. Care Homes for Older People Page 20 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared for by sufficient numbers of staff who have been safely recruited and receive training to meet care needs. Evidence: The acting manager told us that a standard formula was used to calculate the number of staff needed to meet peoples assessed needs. The current staff rota showed there were two nurses, a senior care worker and five other care staff on duty during the day shifts and one nurse and three care staff were employed at night. The acting manager, administrative worker, domestic and kitchen staff, a maintenance person and activities worker were employed in addition. Two senior care staff both told us that they felt there were enough care staff to meet personal care needs, which meant that people could choose what time to get up and go to bed. All nurses were experienced and registered with the Nursing and Midwifery Council. Senior care workers held at least level 2 of the National Vocational Qualification (NVQ) in Care and other staff were undertaking this training. NVQ assessors were present during the inspection. We saw an example of induction training for new staff. There were records that showed that staff had been checked through the Criminal Records Bureau and references had been provided to ensure all staff were fit to care Care Homes for Older People Page 21 of 30 Evidence: for vulnerable adults. Records of continuous staff training clearly showed the extent of training given to staff during the last 12 months. Pressure care, care planning, Dementia Awareness and Challenging Behaviour were included in addition to health and safety topics. Staff spoken with confirmed they had received various training. The acting manager told us of further training about Dementia that was planned to start within the next month. However, the activities worker told us that no training had been given specifically about providing safe and appropriate activities for people with Dementia. Care Homes for Older People Page 22 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from someone managing the home, but not all current management systems are effective. The current management of accident records does not promote and protect the health, safety and privacy of people living in the home, but people can be assured their money is looked after safely. Evidence: The previous registered manager left the home in October 2008. A new acting manager commenced in December 2008 and told us she intends to make an application to be registered with the Commission. Staff told us that the new acting manager has started to arrange maintenance work to make improvements to the premises. The management of peoples money was examined and there were appropriate safeguards are in place for people who were unable to manage their own money. The acting manager had attended training regarding action needed under the Mental Care Homes for Older People Page 23 of 30 Evidence: Capacity Act. Some cash was looked after for people in a secure facility and we saw that suitable signed records of all transactions were held. Two peoples amounts were checked and correct balances were recorded. There were no recent records of staff supervision meetings with the manager or senior care staff. Staff said they used to have individual meetings, but could not remember the last time this happened. However they said they could discuss any concerns with the acting manager as needed. We looked at all Accident Report Books that were available and found that these had not been used in the way they were designed in order to protect peoples personal information. None of the forms had been removed and filed, but the acting manager had seen most and signed them. Names and addresses of staff as well as people living in the home were available for any other people using the record book. There were details of accidents and resulting injuries in some cases. Some had required follow up action, but it was not always clear if this was taken. The staff training statistics and matrix records assisted the acting manager to ensure staff received training in working safely and keeping people safe within the premises. For example, records showed that most staff had refresher training in fire safety in January 2009. Other staff had the training within the last year. There were records of weekly fire alarm testing and monthly checks on emergency lighting. During the tour of the premises we noticed that the Parker assisted bath was last serviced in February 2008. The acting manager said it was due to be serviced again and a regular contractor will be undertaking all annual safety and servicing checks. Care Homes for Older People Page 24 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 10 12 Arrangements must me in place to enable people to wear their own properly fitting clean clothes at all times. This is to promote and maintain the dignity of the people living in the home. 30/04/2009 2 16 22 Provide and display a clear complaints procedure to include contact details, together with stages and timescales for the process. This is so that people know who to speak to and can be confident that their complaints will be taken seriously and dealt with. 30/04/2009 3 19 23 Produce a programme for routine maintenance and renewal, which includes the replacement of damaged ceiling tiles. 30/04/2009 Care Homes for Older People Page 26 of 30 This is so that the home is always well maintained for people who live there. 4 24 23 Repair or replace damaged or worn bedroom furniture. This is so that each persons bedroom is furnished and equipped to assure comfort and meets the assessed needs of the individual. 5 26 16 Arrange for clothing to be laundered, ironed and returned to people as quickly as possible. This is so that people always have a sufficient choice of clean clothes ready to wear. 6 26 16 Review the cleaning 31/03/2009 processes to ensure all areas are thoroughy cleaned. This is so that the home is kept free from offensive odours for the benefit of people who live there and their visitors and to protect people from risks of infection. 7 30 18 Provide training for the activities worker specific to the work to be performed. This is to develop the skills of the worker in providing appropriate activities in a safe way. 8 31 9 The acting manager must make an application to the Commission to be assessed for registration. 30/04/2009 29/05/2009 31/03/2009 30/04/2009 Care Homes for Older People Page 27 of 30 This is so that the she can demonstrate her fitness to manage the service for the benefit of people that live there. 9 38 13 When accidents and injuries 31/03/2009 are recorded an assessment must be undertaken and recorded to ensure follow up action is taken and risks of recurrence are diminished as far as possible. This is in order to promote and protect the safety and welfare of people who live at the home and staff. 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 10 Medical treatment, including the application of creams, should always be provided in private in a persons own room or bathroom so that privacy and dignity are respected. Keep a record of interactions with people who spend their time isolated from others in the home. The activities worker should plan activities for the care staff to engage in with people. Display the food menu clearly in the dining room with photographs so that people can more easily understand what meals are available each day. Retain full details of outcomes of complaints within the complaints management file. Where rooms are shared, they should be occupied by two people who have made a positive choice to share with each other. When a shared place becomes vacant, the remaining person should be given the opportunity to choose not to share. Page 28 of 30 2 3 4 12 12 15 5 6 16 23 Care Homes for Older People 7 8 24 26 Provide a choice of carpeting in bedrooms to give more comfort to people. Clean up spillages in the communal areas immediately so that people do not have to walk across wet and sticky floors. Arrange 1:1 supervision meetings with each staff member at least six times each year so that they are appropriately supported in their work in caring for people at the home. Review the accidents and injuries procedure to direct staff to complete the accident record form, remove the form from the book and submit it to the person in charge for assessment. This is so that each persons personal data is protected and appropriate follow up action is taken to safeguard health. 9 36 10 38 Care Homes for Older People Page 29 of 30 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). 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. 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