Inspection on 14/10/08 for St John`s Nursing Home

This inspection was carried out on 14th October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

Extracts from inspection reports are licensed from CQC, this page was updated on 05/12/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: St John`s Nursing Home Rownhams Lane Rownhams Southampton Hampshire SO16 8AR     The quality rating for this care home is:   two star good 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: Ian Craig     Date: 1 4 1 0 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 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 John`s Nursing Home Rownhams Lane Rownhams Southampton Hampshire SO16 8AR 02380732330 02380735859 info@saintjohns.uk.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Elaine Evans Type of registration: Number of places registered: Mrs Elizabeth Kitchen,Mr Richard Edward Kitchen care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users to be accommodated is 34. The registered person may provide the following category/ies of service only: Care home with nursing - (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 (OP) Physical disability (PD). Date of last inspection Brief description of the care home The home is a detached building on the outskirts of Southampton. There is car parking for visitors and ramped access to the home for those with mobility needs. The gardens include a paved area, seating and tables for residents and visitors. There is a ground floor living/dining room with an adjacent quiet room/library and a first floor lounge. Care Homes for Older People Page 4 of 29 Over 65 34 0 0 34 Brief description of the care home The home has a hairdressing salon. Twenty six bedroom sare single and 9 shared doubles. Four of these have an en suite toilet. There are 5 communal toilets and 3 bathrooms with hoists or a walk in shower facility. There is an activities programme for the residents which includes a range of arts and crafts and entertainment. The home is staffed 24 hours per day and a Registered General Nurse is always on duty. Care and nursing staff have access to a training programme. 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: two star good 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 inspection consisted of a site visit of 5.5 hours to the home. A tour of the building took place, which included communal areas and bedrooms. Staff were observed working with the residents. Discussions took place with the registered manager and the cook. Polices, documents, care plans and records were seen. Four residents were case tracked. This means that the records and care plans for these people were looked at, and that they were each interviewed about their life at the home. Surveys were sent to the home for distrubtion to residents, relatives and the staff to ask for their vierws on the home. Seven surveys were returned by staff but Care Homes for Older People Page 6 of 29 unfortunately none were returned to the inspector from residents or relatives. Care services are required to complete an Annual Quality Assurance Assessment (AQAA). The home completed and returned this document which as also been used for the purposes of this report. The homes weekly fees range from 449.00 to 720.00 pounds sterling. What the care home does well: What has improved since the last inspection? What they could do better: The home needs to ensure that it obtains information from the referring social services care managers about the needs of those referred for possible admission. Medication procedures need to improve so that staff have clear guidance of the circumstances and symptoms of when medication as needed should be administered. Instruction from medical practitioners of any changes to prescribed medication needs to be recorded. The homes pro forma for risk assessing the use of bed rails for individual residents needs to be completed to ensure any risks are minimsied. Improvements are needed to the way staff assist residents with their meals to ensure this in done in a dignified way and that residents receive help to eat. Clearing away of cleaning liquids, used crockery and food needs to improve. Care Homes for Older People Page 8 of 29 Residents records must be securely stored whn not being used. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents are able to make an informed decision about moving in. The home ensures it accommodates only those whose needs it can meet although some improvements are needed so that the homes assessments are more thorough. Evidence: The home has a Statement of Purpose, which gives information about the home including the complaints procedure. The document is available for residents and visitors on display in the hall. The manager explained that prospective residents are given a copy of the homes brochure at the pre admission assessment stage. This was also confirmed by residents. When the home receives a telephone enquiry regarding a referral for admission, the home completes an enquiry form. Completed copies of these were seen. Personal and Care Homes for Older People Page 11 of 29 Evidence: medical details are entered on the form. The form is used to determine whether or not the referral should progress to an assessment by the manager. The manager explained that she assesses the persons needs by visiting them at hospital or at their home. Copies of completed assessments were seen and include the following: breathing, continence, eating/drinking, sight, skin, pain, mobility, washing/ dressing, hearing and speech, pain, mental state, oral health, chiropody, history of falls, medication, social activities, religion, cultural needs and family involvement. In one case the home was unable to see the person before so completed the assessment by contacting other professionals and relatives of the person. It was noted that the home does not routinely obtain a copy of a social services care managers assessment and care plan for those referred to the home by the local authority. This was discussed with the manager who stated her intention to ensure that this is done in the future. In certain instances the home also obtains copies of hospital discharge summaries. A record is also made to show that the person was supplied with a brochure, and whether or not a visit by the resident or a relative to see if the accommodation meets their needs. Copies of contracts between the home and residents were seen. These give details of the terms and conditions of residence. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents health and personal care needs are met although improvements are needed in the recording of medication needs and the storage of residents records. Residents are treated with dignity. Evidence: Assessments and care plans were looked at for 4 residents. Each of these 4 residents was also spoken to. Care plans are comprehensive and include each relevant area of need structured as follows: Abilities, Needs, Aims of Care and Method. These are evaluated each month. Care plans are also devised for more specialist care such as catheter care and for dressings. A variety of assessment tools are used including nutrition screening, score matrix assessments, mobility, continence, skin integrity, waterlow assessments and Care Homes for Older People Page 13 of 29 Evidence: environmental risk assessments. It was noted that the home has a risk assessment pro forma when the use of bed rails is considered. These had only been completed by involving the residents relative in agreeing to the need to use them. The remainder of the pro forma had not been completed which includes an assessment of the risks in using the bed rails. This was discussed with the manager who agreed to address this. The manager explained how residents relatives are consulted about the care plans. Records show that health care needs are addressed. This includes health checks by the nursing staff for blood pressure, pulse, breathing and body temperature. The home has policies and procedures regarding the care of those with a terminal illness and has working links with a local hospice who provide support, training and guidance to the staff team. Where relevant, care plans also refer these needs. Daily running records are completed for each person detailing significant events and care needs. These are signed and dated by the person completing them. Specialist equipment is provided for care needs. These include pressure relieving mattresses and lifting aids. Residents state that they are satisfied with the care they receive and that the staff are kind and helpful. Two residents said how the staff are prompt and responsive when a request for assistance is made. One person said, Nothing is too much for them. They are marvellous. Screens are available in shared bedrooms. Residents bedroom doors do not have privacy locks. The manager stated that this could be provided if the resident requested this. It was suggested that the home asks each resident about this and records whether or not the person wishes to have a lock or if it has been assessed that the person is not able to deal with this facility. Care staff report that care plans are available for staff to use and that the residents care needs are met. It was noted that residents confidential records, including medication records, are not securely stored when they are not being used. The homes medication procedures were looked at and staff were observed dispensing medication. Staff with responsibility for dispensing medication sign a record in the Care Homes for Older People Page 14 of 29 Evidence: medication administration recording sheets. Stocks of medication show that medication is dispensed as prescribed. For 3 residents who have medication on an occasional basis there was no record in the care plans to show the circumstances and symptoms of when this is needed. Daily running records have not been completed detailing why the medication was needed when it had been given. From discussion with the manager and a staff member it was understood that the frequency of this medication had been changed on a number of occasions by the general practitioner for 2 people. A record had been made in the daily running records for one of these changes but not for the remaining amendments. Controlled medication is stored and administered as advised by the Royal Pharmaceutical Society. This includes 2 staff who sign and record that the medication has been given and the remaining balance of medication. 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. Residents benefit from a range of activities and stimulation. The home promotes residents in having choice in how they spend their time and in the food they eat. Food is nutritious and of a good quality. Residents who need help with eating are not given sufficient and dignified assistance from the staff. Evidence: The home maintains a record of activities provided to the residents. These include arts and crafts, games, celebratory meals such as cream teas and barbecues. Four of the homes care staff have completed a training course in activities for older persons. A staff member was observed involving 3 residents in a quiz which each of the residents was enjoying. Residents were seen watching television and reading newspapers in the lounge. A notice board in the hall gives details of forthcoming events which includes a visiting singer every 2 weeks and a theatre company performance in the home every 4 weeks. Care Homes for Older People Page 16 of 29 Evidence: A Christian church service takes place in the home every month. Visits are made to the home from other community groups such as the Girl Guides. Residents were observed receiving visitors in their bedrooms and in the lounge. One resident said that he/she can have visitors at any time. Two residents confirmed that activities are provided and these include ball games, quizzes and cards. The manager said that occasional outings take place which a resident confirmed. These include visits to the church and to day centres. A resident described how he/she is able to spend his/her time as he/she wants. Choice is available for food. The days menu was displayed in the lounge/dining room. On the day of the visit this was: liver casserole or turkey mushroom pie with mashed potatoes, swede and cauliflower. Dessert was steamed treacle sponge pudding with custard. The manager and cook described how meals are home made including the steam sponge pudding. The cook described how improvements have been made by pureeing individual food items compared to the previous routine of pureeing altogether. This is done to improve the appearance and taste of the pureed meals. Fresh fruit and vegetables are provided. The serving of the midday meal in the ground floor lounge/dining room was observed. Each of the residents ate at small tables in their armchairs. The majority of residents were independent and could feed themselves. Two people needed help. One persons meal was placed in front of him/her and it was clear that he/she either didnt like it or needed help. After 15 minutes a member of staff asked if he/she liked the meal, placed a spoon in the residents hand and walked away. The resident tried to use the spoon. After 20 minutes a staff member said, Your food has gone cold. After 22 minutes a dessert was placed alongside the main course. At 25 minutes the residents sat with his/her eyes closed. After 26 minutes a staff member approached the resident who now had his/her eyes open and without saying anything to the residents placed a spoon full of food in the residents mouth. The staff member asked if the resident liked the food and if he/she wanted it and then removed it. The staff member then helped the resident to eat ice cream by lifting spoonfuls of ice cream without any verbal communication. Another resident was helped by another staff member to eat his/her ice cream. The staff member stood upright whilst the resident was sat in an armchair and did not speak to the resident whilst feeding him/her. It was noted that the area around the trolley and dining tables was busy. Two bowls of porridge were left on the trolley between 10.58 and and 1pm. A resident commented that the lounge was too busy and noisy. Care Homes for Older People Page 17 of 29 Evidence: This issues regarding the organisation of the delivery and serving of food was discussed with the manager who expressed her concern and stated that it would be addressed. Residents described how they liked the food. Care Homes for Older People Page 18 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. the home has an accessible complaints procedure and protects residents from possible abuse. Evidence: The homes complaints procedure is displayed in the hall. There is a procedure for dealing with any complaints which includes the home recording the details of the complaint and how it is investigated. The home has not received any complaints. The home has a copy of the local authority adult protection procedures. Each staff member attends a training course in the protection of vulnerable adults. This was confirmed from discussions with the manager, from staff surveys and training records. Care Homes for Older People Page 19 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 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 generally clean, well maintained and homely environment for the residents. Evidence: A tour of the home was undertaken. A number of bedrooms and the communal areas were seen. The home has a ground floor lounge/dining room and a first floor lounge. Residents were seen sitting watching television in the ground floor lounge and taking part in a quiz in the first floor lounge. There is a smaller lounge area adjacent to the ground floor lounge. A hairdressing room is situated on the first floor. The lounges are decorated in calm colours or wall paper. There is also a sitting area in the entrance hall. Residents bedrooms contain items of personal belongings which residents are encouraged to bring into the home. One person said how he/she likes to spend time in his/her room and another person said that the home is comfortable with good quality furnishings. Each person has lockable storage space in their room. Privacy screens are provided in double bedrooms. Care Homes for Older People Page 20 of 29 Evidence: The home has a passenger lift. There are 3 specialist bathing facilities consisting of a walk in shower room and two bathrooms with hoists. The home has two mobile hoists and two stand aids. Two of the seven staff who completed a survey stated that there should be new lifting equipment. This was raised with the manager who stated that this is being looked into. There is a laundry with washers and driers. Staff and administrative facilities include an office, staff room and an office in a separate garden building. The home was found to be clean and free from any odours, with the exception of the area near the trolley in the gground floor lounge. Breakast plates had not been cleared away and a disinfectant cleaning spray was left on a sideboard during the morning. Care Homes for Older People Page 21 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a well trained staff team provided in sufficient numbers to meet their needs. Residents are protected by the homes recruitment procedures. Evidence: The home aims to provide the following staffing levels: 7.30am to 2.30pm, 6 care staff plus 2 Registered General Nurses. 2.15pm to 9.15 pm, 4 care staff plus 1 Registered General Nurse. The registered managers working hours may be in addition to these numbers. Night time staffing consists of the following waking staff: 1 Registered General Nurse and 2 care staff. The following ancillary staff are also provided each week: housekeeper for 18 hours, 4 cleaners working 80 hours, a laundry assistant for 36 hours, a cook for 35 hours, a kitchen assistant for 35 hours and a further 14 hours catering staff. The home also employs a maintenance staff member. Care Homes for Older People Page 22 of 29 Evidence: Observation and the staff rota showed that these staffing levels are maintained. Residents state that the staff are kind, helpful and always responsive when assistance is asked for. The staff surveys comment that the staff work as a team and are supported by the homes management, which helps the residents to receive the care they need. 10 of the 16 care staff are trained at National Vocational Qualification (NVQ) level 2 in care. Two of these staff have NVQ level 3 in care. The home has an induction procedure, which involves newly appointed staff completing a period of shadowing another more experienced staff member as well the completion of the Common Induction Standards for Social Care. Each of the 7 staff surveys confirmed that an induction was provided. 3 staff said that the induction mostly covered everything that is needed to know to do the job. The remaining 4 surveys said the induction is very good. The home has introduced a system of formal supervision. Records of supervision show that this takes place every 10 weeks. The staff member and supervisor sign the record. Each staff member completes mandatory training in moving and handling, infection control, first aid and adult protection. Recruitment procedures were looked at for two staff who have recently started work at the home. Records show that criminal record bureau (CRB) and protection of vulnerable adults (POVA) checks are carried out and 2 written references are obtained before the person starts work. Care Homes for Older People Page 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and run in the best interests of the residents. The health and safety of residents is promoted. Evidence: The manager has worked at the home for more than 10 years and is a Registered General Nurse. She has also attended the following training: supervision and appraisal, the care and prevention of pressure sores, promoting continence and is a key trainer in moving and handling. Staff state that the manager is supportive and open to discussing matters regarding the running of the home. One staff member said: Our matron/manager gives us the support we need and assesses us on how we do our jobs and if we are doing them correctly. If we need help in some areas she is there to help us. Care Homes for Older People Page 24 of 29 Evidence: Residents and relatives are given surveys asking for their views on the service provided by the home. These are compiled to give a satisfaction level and to plan for any improvements. There is also a suggestions box in the home. The manager described how the homes owners make frequent visits to the home and that improvements have been made to the environment. The home handles some residents valuables and money for safekeeping. Records are maintained of any amounts held plus any withdrawls or deposits. Residents records are not securely stored when not being used. Staff are trained in first aid, moving and handling, infection control and food hygiene. The homes equipment and appliances are serviced by suitably qualified persons. Records show that the fire alarm system is tested and that fire drills take place. Staff receive fire safety instruction. Residents are protected from hot surfaces by the use of radiator covers and from hot water by temperature controls on taps. Regular checks are also carried out by testing the temperature of hot water. Restrictors are fitted to first floor windows to prevent possible falls. A cleaning disinfectant was not locked away and was left on a sideboard in a lounge for several hours. Care Homes for Older People Page 25 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 26 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 13 Where medication as required is prescribed a record must be made to show the circumstances and symptoms of when this is needed. So that staff have guidance to ensure the person receives medication as instructed by a medical practitioner. 12/12/2008 2 9 13 Where a medical practitioner 12/12/2008 gives a verbal instruction to change a residents medication a record of this must be made. So that the staff are able to know that medication the resident is taking. 3 15 16 For residents that need help at meal times staff must be organised to ensure assistance is provided and that the dignity of the resident is promoted. 30/11/2008 Care Homes for Older People Page 27 of 29 So that residents receive an adequate diet and that they are treated in a manner that is respectful during meal times. 4 37 17 Residents records must be securely stored when not being used. For reasons of confidentiality and to safeguard medication. 5 38 13 Cleaning substances must be securely stored when not being used. To prevent possible injury to residents. 30/11/2008 30/11/2008 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 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 © (2008) Commission for Social Care Inspection (CSCI). 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