Inspection on 12/02/09 for St George`s Residential Home

This inspection was carried out on 12th 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 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

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 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: St George`s Residential Home Brickhills Broughton Brigg South Humberside DN20 0BZ     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: Theresa Bryson     Date: 1 2 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 29 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 29 Information about the care home Name of care home: Address: St George`s Residential Home Brickhills Broughton Brigg South Humberside DN20 0BZ 01652657459 01652659273 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) : Stamford Enterprise Limited care home 22 Number of places (if applicable): Under 65 Over 65 22 old age, not falling within any other category Additional conditions: 0 1 The registered person may provide the following category of services only: Care Home only - Code PC To service users of the following gender: - Either Whose primary care needs on admission to the home are within the following category: Old Age not falling within anyother category - Code OP The maximum number of service users who can be admited to the homes is: 22 Date of last inspection Brief description of the care home St Georges Care Home is set on the edge of a small village in North Lincolnshire and near the larger market town of Brigg and the industrial town of Scunthrope. These are easily accessible by road and all areas have bus links. The home is an older style house set in extensive grounds and is on two floors. Upper floors are accessed by a lift and stair ways. The house has retained many of its original features, but also has a more modern conservatory room and entrance hall. There are ample rooms available, some which are shared rooms and different communal areas and a dining room. Details of the services the home can provide are in the Statement of Purpose and Care Homes for Older People Page 4 of 29 Brief description of the care home Service Users Guide which are available on request and are in display in the main entrance. Fees are reviewed annually and extra charges detailed for such events as outings and hairdressing. Care Homes for Older People Page 5 of 29 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 site visit for this home took place over one day in February 2008. Prior to this the service history for this home was checked to see what the home had told us they were doing in the last year. During the course of the visit we were able to speak to 7 people who were resident in the home, some relatives and 5 staff. The Registered Provider was present for part of the inspection. This home has new owners since the last inspection and CSCI Registration Team for the North Eastern Region had looked at the new owners application prior to giving them a new certificate. We were also able to look at a number of records and documentation during the visit Care Homes for Older People Page 6 of 29 and tour the home and grounds. Some health professionals were spoken to by telephone prior to the site visit. The home was able to submit their Annual Quality Assessment Audit which gave us information about how they perceive the home and lots of statistical data. What the care home does well: What has improved since the last inspection? What they could do better: More care needs to be taken to ensure that accurate records are kept at all times for events which occur to each individual. This includes accident records where follow through needs to be recored when injuries have occurred. Events need to be recorded when other health care professionals have been involved in a persons care to ensure all parties are aware of the care which has been delivered. The Responsible Person also needs to ensure that where an event takes place which is reportable to The Commission this happens. We can then make a judgment as to whether the correct course of action has occurred. The management team need to check all records to ensure people are not put at risk and ensure staff keep the dependency levels up to date. This will then be used to help determine the amount of staff who are on duty to meet peoples needs. The social, religious and cultural expectations of people living in the home should be met and a varied program put in place. This should also involve events and people in the community so people do not feel isolated in the home. Work had already commenced with a refurbishment program in the home and must continue. Some areas needed particular attention such as covering of the radiators to ensure they are not hot to touch, replacement of equipment which is not fit for purpose such as commodes. And to ensure some floor coverings are replaced to make a more homely and safe environment in which to live. To aid the maintenance program the current maintenance plan should be prioritized to ensure it is a safe place. Care Homes for Older People Page 8 of 29 To ensure all staff are safe to work with people in the home a full audit of the staff personal files should take place to ensure all safety checks have taken place. They then should be supervised to ensure they can do their jobs. So the management team can see what training has taken place and to ensure mandatory training has occurred it is recommended that a training matrix be developed to keep abreast of suitable topics. When the dependency levels of people living in the home have been updated these can then be used along with details about the configuration of the home to ensure sufficient staff are always on duty to meet peoples current needs. 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 29 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 29 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. Adequate information is available to ensure people can make informed choice about whether the home can meet their needs and each person receives an assessment prior to admission to ensure their current needs can be met. Evidence: The records of the latest admission to the home were seen and contained adequate information to show that an assessment had been completed prior to the persons admission. This is then used as a basis to plan a program of care for that person. People are accepted into the home on a trial basis and the home will accept people on a rolling respite program to see if they like the home and it meets their needs. People spoken to said they had found it comforting that staff knew a lot about them before they became resident which had given them confidence in the staff to look after them. Care Homes for Older People Page 11 of 29 Evidence: Since the last inspection the home has new owners and the Statement of Purpose and Service Users Guide, which was on display in the main reception area, reflected this change. Both documents gave basic information about the services the home can provide, which is helpful in enabling people to make informed choice about the home. The Company also tries to ensure that staff have been trained in specific needs of people using the service, which needs expanding upon to ensure they have the knowledge base to deliver good care to individuals. The home does not provide intermediate care so Standard 6 is not applicable. Care Homes for Older People Page 12 of 29 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. All records kept on individuals must be a true reflection on the care being delivered and be accurately written to ensure individual needs are being met and people are free from harm. Evidence: During the course of the site visit we were able to speak to 6 people who live in the home, who made mainly positive comments about the care they receive. Saying such as the girls look after me and can have a bath when ever I like which is a real treat for me. Another said if I want anything they will get everything for me. 3 care plans were tracked in depth and showed that basic information is kept on each individual. This included, where necessary falls assessments, manual handling assessments and individual risk assessments. Some sections, for example the personal cleaning charts had been only spasmodically completed, which, when speaking to staff and individuals did not necessarily reflect the actual delivery of care to people. This was also reflected in other documentation such as where people are needed to be Care Homes for Older People Page 13 of 29 Evidence: weighed, these records were incomplete: some records had photographs others did not. In some cases people were able to tell us that they had had input into developing their care plans, but where people could not make informed decisions there were no records to show other advocates had been involved. Care plans generally had most sections evaluated on a regular basis, but this needs to be so for everyone to ensure staff are aware of peoples current needs and can document accurately that they have been met. The individual and overall dependency levels through out the home must be kept up to date to enable there to be sufficient staff on duty to meet peoples needs. There was some input recorded by health care professionals who were helping staff to deliver the correct care for peoples needs, but this needs to be more accurately recorded to reflect actual care given. For example where an accident had occurred staff and people in the home were able to tell us when a district nurse had been involved and when they had attended hospital, but this was not always reflected in the documentation. To assist this process the management staff should ensure that these records are audited regularly and kept up to date, are legible and accurate. This will ensure people are free from risk. During the course of the visit staff were observed assisting people with personal care and at a meal time. They completed each task calmly and with dignity and respect to each individual, taking into consideration their personal needs. For example where a person was a little hard of hearing staff did not shout but approached the person where they could be seen and spoke clearly and calmly. Where a person with some memory loss needed direction again the approach was one of calm but simple instructions were given. The storage and administration of drugs was checked. The administration sheets appeared to be correct and staff were observed completing a medication session where they appeared to be using safe practice. The storage area was very cramped and should only be used for medication. All other items should be removed. The controlled drug cupboard was particularly full and should only be used for the storage of certain classes of drugs. Records are also kept in each persons file of their wishes when their life is drawing to a close. During the course of the site visit a person was being removed by a funeral director and staff ensured that this was completed out of the eye range of other residents and treated the person with courtesy and respect. The care plan documentation seen was completed on the day and appeared to be accurate. Care Homes for Older People Page 14 of 29 Care Homes for Older People Page 15 of 29 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. More variety needs to be offered to ensure peoples social, religious and cultural expectations are being met. Evidence: During the time of the site visit there was little activity to suggest peoples social needs were being addressed. A poster was on display listing different activities to be done on a daily basis and we were informed that a member of staff would be allocated to complete those events. The poster listed topics such as bingo, quiz and residents choice. There were very few staff on duty at the time of the site visit and no obvious signs during our observation and walking around the home that events were taking place that day. When speaking to people in the home some said they were happy to stay in their rooms and one person had a special radio to enable them to choice between a radio or cassette tape being used, as they were visually impaired. Another person said I read a lot. A relative stated that they were concerned that their loved one was left for long periods on their own, due they felt to not enough staff to do the quality time. People had been allowed to bring in personal possessions to enhance the look of their rooms, Care Homes for Older People Page 16 of 29 Evidence: which those spoken to said had helped them settle in. In the care plans seen not all social needs assessments had been completed and events only spasmodically recorded. It was inconclusive whether enough was being put in place to ensure peoples social, religious and cultural expectations were being met. There was little evidence recorded that access to community activities were being sought. A tour of the kitchen took place and food appeared to be prepared in a clean and safe environment. The last environmental health officers visit had been in May 2008 and there were no outstanding issues to be resolved. Since the new ownership new suppliers were being used but staff spoken to appeared to be satisfied with the quality being provided to cook the 3-week cycle of menus and provide for the diabetic diets. There was ample evidence of home baking and the use of fresh vegetables and fruit. People resident in the home made such comments as food is nicely served and plenty enough to eat. Another person said how much they now enjoyed my food since coming into care. Care Homes for Older People Page 17 of 29 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. A robust system is in place to protect people from harm and they are confident concerns will be dealt with efficiently. Evidence: Our records showed that there had been no concerns raised to us since the new ownership of the home. This was also supported by reading the complaints/concerns book in the home. The policy was on display near the main entrance and people spoken to said they would be happy to approach the management team if they had any concerns. Staff appeared to be aware of how the safe guarding adults policy was operating locally and training for staff was in place. This will ensure that people are free from harm if staff know how to recognize abusive situations. There were no people in the home that the management team were aware of who need special advocates to speak on their behalf. The care records indicated that those with memory impairment had relatives or friends to speak on their behalf and staff appeared to understand the need to keep this information up to date. This will ensure that peoples legal and civic rights are protected at all times. Care Homes for Older People Page 18 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in an adequate standard of accommodation but further work needs to be carried out to ensure it is comfortable and safe. Evidence: We were able to tour the home during the site visit. The new owners are putting a lot of work into the home to try and bring the standard of the environment to an acceptably comfortable place to live. Due to the low occupancy one wing on the first floor had been taken out of commission and was seen to have been made safe from intruders. Some areas of the home were looking very tired and care will need to be taken to ensure that each individual bedroom and all communal area furniture is fit for purpose. Each of the areas seen were clean and some bathrooms had already been refurbished. Attention to detail by staff needs to take place to ensure peoples personal care and needs are being addressed, For example in some bathroom and toilet areas communal toiletries were in use which could be a source of infection and disrespectful to individual tastes. In bedroom areas some commodes were not fit for purpose and could be a cause of infection if they remain in use. Also some bedroom carpets were in need of attention, Care Homes for Older People Page 19 of 29 Evidence: looking worn and soiled. Each bed room had a different type of bed but the bases, in some cases were worn and would benefit from valances to make the area more comfortable to look at. Some fire door guards were in place, which react to the fire alarm and close a door in the event of a fire. In most general areas the radiators were not covered, which could cause harm to people if they touched them. This must be completed as a priority. All other areas of the home and gardens appeared to be free from hazards. The day of the site visit was a very cold winters day but no area of the home felt cold or uncomfortable to move around or sit in. People spoken to said they felt warm. Due to the layout of this large older style house each room is very different in both communal areas and individual rooms. This makes for a very homely and comfortable looking environment. The conservatory room overlooks a well kept garden area which is accessible for all wheelchair users. In the laundry and kitchen areas all equipment was in working order and staff were working in a clean and safe environment. When deciding on the number of staff to be on duty through a 24-hour period the configuration of the home must be taken into consideration to ensure staff can respond to peoples needs quickly. The maintenance plan was seen which did detail work to be completed in each area of the home but it had no dates and the management team could not give us any indication when work would be completed. The team need to ensure they prioritize the long list of items and address areas which could be a hazard to people currently living in the home Care Homes for Older People Page 20 of 29 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. A more robust system must be in place to ensure sufficient staff are on duty to meet the needs of people and that safety checks have been made to ensure they are safe to work with people in the home and then trained to do their jobs. Evidence: During the site visit there did not appear to be the correct deployment of staff available to meet the needs of people resident. The configuration of the building means that staff have to travel long distances between bedroom and bathroom areas and communal areas to address the needs of individuals. People spoken to who are currently resident made such comments as they say they will be on the end of a buzzer but it isnt always so and I like to stay in my room and when I press my call bell they will come, but it seems a very long time sometimes. Another person said I know they are busy so thats what I put down to them not always being able to do things when I want them. We were also informed by staff that those designated to do caring roles within the home also have to complete other tasks such as laundry and some domestic duties at night. This takes them away from satisfying the needs of those living in the home. The Responsible person and management team must ensure that there are sufficient staff on duty at all times to meet peoples needs to prevent them from being put at Care Homes for Older People Page 21 of 29 Evidence: risk. Certificates were seen which showed staff had attended a variety of training courses and staff spoken to confirmed they had attended some sessions. This included manual handling, safe guarding adults and safe giving of medication. The management team need to ensure they keep on top of everyones needs by developing a yearly matrix so they can more easily see when mandatory courses are due for renewal and where individual staff require more in depth topics 3 staff personal files were tracked in depth. There was sufficient evidence in two of the files to support safety checks had been obtained prior to their employment but not on the third file. This persons name was given to the manager. To ensure that all staff are safe to work with the people in the home the manager must audit all the files and obtain evidence where it is lacking. This will ensure that people are protected from unworthy staff. Care Homes for Older People Page 22 of 29 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. More robust systems need to be in place to ensure peoples views are taken seriously and whether correct action is taken to prevent them from being harmed. Evidence: Since the last inspection the ownership of the home has changed and the new team has included a new acting manager. This person was in the process of completing their application to become the new Registered Manager and was urged to complete this as soon as possible as it is an offense to run a service without a Registered person. The site visit reports were seen which the Provider makes to the home, showing the input they have in the day to day running of the home which is either by visit or telephone. This ensures they have an up to date view of the establishment to ensure people are safe. As this was a new service the Registration Team of the North Eastern Region of CSCI had checked the business and financial plan of the new owners prior to issuing a new Care Homes for Older People Page 23 of 29 Evidence: certificate. The Company has started to develop its own quality assurance auditing system to ensure the views of people living there are taken seriously and the home is being run for their benefit. This, we were verbally told, will include surveying people living in the home, visitors and other stake holders. The process will also look at all issues involved in running the home. in December 2008 the home obtained the Investors in People award which looks at the training of staff and how this affects care to people using the service. The Local Authority also has a quality development award and when lasted tested the home had an adequate rating. The policy and procedure manual was very basic but gave staff some guidance on how to deal with situations in the home. How staff perform and whether they can do their job roles is normally tested through supervision sessions The records tracked during the visit were very spasmodically written and did not show whether staff understood their roles. There were no observational supervision sessions recorded. To enable the staff to know whether they are performing their job roles correctly guidance sessions must take place and these recorded to ensure we can see whether suitable action has occurred to make people using the service safe. A number of other records and documents were seen which showed the Company is taking care to ensure the building is safe to live and work in. This included records of safety of equipment in use, fire prevention checks and hazard checks in the kitchen. The accident records of 3 people living in the home were tracked but the accuracy of recording was spasmodic. There was no clear follow through when some people had sustained injuries as to whether the advice of other health care professionals had been sought and in some instances events were reportable to us using Regulation 37 notices which had not been forwarded. This would give us the opportunity to see whether the correct action had taken place and whether the safety of some people had been protected. Care Homes for Older People Page 24 of 29 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 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 17 Accurate records must be kept on each individual in the home. This is to ensure that current needs are being met. 30/05/2009 2 7 15 All records must be evaluated regularly and dependence of needs recorded. This is to ensure that suitable numbers of staff are available to meet peoples needs at all times, taking into consideration the total dependency of everyone in the home. 30/05/2009 3 12 16 A varied activities program must be offered in the home. This will ensure individuals social,religious and cultural expectations can be met. 30/06/2009 Care Homes for Older People Page 26 of 29 4 19 23 The Responsible Person must ensure that all radiators are safe. This will prevent people from being harmed if they touch them. 30/06/2009 5 27 18 There must be sufficient staff on duty at all times to meet the needs of people. This will prevent them from being put at risk of harm. 30/05/2009 6 29 18 All staff files must be audited to ensure each person is safe to work with people in the home. This will ensure people are protected from unsuitable staff being employed. 30/05/2009 7 36 18 Staff must be supervised to ensure they can do their jobs. This will ensure people are protected from staff unable to look after them. 30/08/2009 8 38 37 All incidents, accidents and deaths must be notified to us using Regulation 37 formats as laid out in the National Minimum Standards. This will ensure we can make a judgment as to whether the home has taken the correct action with each incident to protect people from harm. 30/05/2009 Care Homes for Older People Page 27 of 29 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 4 Staff should expand their knowledge base to ensure they are working with the latest information to enable them to meet peoples current needs. The management team should ensure that all staff keep accurate records of people living in the home and individual records are audited regularly. This will ensure the team are preventing people from being at risk. The controlled drug cupboard should only be used for storage of medication and not other items, as errors may occur if this area is used inappropriately. More contact should be made with the local community to ensure people are not isolated in the home. All equipment in use in the home should be fit for purpose and not put people at risk. This should include all commodes and beds. The maintenance plan which is in place should priorities areas of work to ensure people currently living in the home are safe and free from risk and harm and their surroundings are comfortable. To enable the manager to see what mandatory and service specific training is required for each staff member a matrix should be developed to ensure training is kept up to date. The manager should ensure that the application is sent to CSCI Regsitration team as soon as possible as it is an offence to run an establishment without a Regsitered Manager. The Registered Provider should ensure they further develop their quality assurance system to take into consideration the views of users of the service and that it is running for the best benefit of people living in the home. The Registered person should ensure that all accidents are accurately recorded and where necessary the follow through of further assistance from other health care professionals is recorded, to protect people from further harm. 2 7 3 9 4 5 13 19 6 19 7 30 8 31 9 33 10 38 Care Homes for Older People Page 28 of 29 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 29 of 29 - 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!