Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Tenlands Care Home Wood Lane Ferryhill Durham DL17 8JD 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: Elsie Allnutt
Date: 1 7 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: Tenlands Care Home Wood Lane Ferryhill Durham DL17 8JD 01740657200 01740656262 tenlands@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 Home Properties Limited care home 40 Number of places (if applicable): Under 65 Over 65 40 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who may be accommodated is 40. The registered provider may provide the following category of service only: Care home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP, maximum number of places 40. Date of last inspection Brief description of the care home Tenlands Care Home is purpose built. The home can accommodate up to 40 people in single or double, personalised bedrooms provided on two floors catering for service users who require general nursing and residential care There are a number of communal lounge / dining areas available for residents use. There is a social and recreational programme for those who wish to participate. Fees charged are between #390:50p and #600. Hairdressing, chiropody, newspapers and toiletries are not included. Care Homes for Older People Page 4 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: Before the visit we looked at, information we have received since the last visit, how the service dealt with any complaints and concerns since the last visit, any changes to how the home is run, the providers view of how well they care for people and the views of people who use the service, their relatives, staff and other professionals. An unannounced visit was made on 17th February 2009. During the visit we, talked to people who use the service, relatives, staff, the manager and visitors, looked at information about the people who use the service and how well their needs are met, looked at other records which must be kept, checked that staff had knowledge, skills and training to meet the needs of the people they care for, Care Homes for Older People
Page 5 of 29 looked around parts of the building to make sure it was clean, safe and comfortable, checked what improvements had been made since the last visit. We told the manager what we found. What the care home does well: What has improved since the last inspection? The one requirement and both recommendations made at the last inspection have been fully addressed. The medication procedures have been reviewed and improved practices put in place. When medication has a limited shelf life once they are opened the date of opening is now recorded on the label. This means that service users receive medication that is appropriate. The care plans now include the service users cultural needs. For example if they have a particular religion that they practice, this is recorded in their care plan. The management arrangements in the home are currently being addressed and interviews are taking place to appoint a permanent manager who can manage the home in the best interests of service users. Since the inspection process took place the home has informed CSCI that a new Care Homes for Older People Page 7 of 29 permanent manager has been appointed. The person appointed has worked as deputy manager in the home for several years and knows the home, the staff and service users very well. What they could do better: 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. Care Homes for Older People Page 8 of 29 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. Preadmission assessments demonstrate service users needs and assists the home to make informed judgements as to whether they can meet these. Evidence: The home receives comprehensive information from referring agencies and other people involved in an individuals care, prior to making a decision that they can meet their needs. Recently a high volume of referrals to this home have come from a local Primary Care Trust which consists of an integrated team that covers two local areas. The home is provided with comprehensive assessments that highlight areas of risk and it is from this information and that gathered by the home during a visit to the prospective service user, that an informed decision is made to offer a service to the person. Care Homes for Older People Page 11 of 29 Evidence: A care plan, with risk strategy plans in place, is developed that reflects the assessed needs. The home has developed good relationships with the PCT team who following any admission offers excellent support to the home. Two members of the team were visiting the home at the time of the inspection to discuss a recently admitted persons care. Positive comments were given from both the PCT members of staff and the care home staff in relation to the way information/advice is given and received. When the home is happy that the persons needs can be addressed appropriately, a letter is sent out to the person to confirm this. This home does not provide intermediate care. 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. Suitable and effective arrangements are in place to meet service users healthcare needs and good procedures are in place for the safe administration of medicines. However more detail in some care plans could further promote the health and welfare of service users in a more consistent way. Evidence: A care plan document that reflects the corporate image of the company is in place and staff are aware of the importance its use in relation to an individuals assessed and changing needs. The care plans are comprehensive and cover all aspects of service users health and social care needs. They relate to the assessed needs identified in the assessment process while at the same time they address any identified risks. Risk strategy plans guide staff to reduce the risk and in doing so keep them safe, comfortable and promote their independence. For one service user a care plan was in place to reflect the assessed risks of pressure sores developing. Guidance for staff to follow was in place regarding regular position
Care Homes for Older People Page 13 of 29 Evidence: changes and to ensure that the bedding and clothing did not cause pressure on the skin. Visiting healthcare professionals commented how well staff in the home take on board the advice and information that they give and how effective this becomes in practice. Recently this home has particularly developed recognition from healthcare professionals and service users families regarding the sensitive and skilled care given in relation to terminal care. The care plans include service users and their families/friends wishes with regards to this. Generally there is good information available in the care plans for staff to follow when it relates to clinical guidance, however some other care plans do not include such detail. For example one care plan describes how 2 carers are needed to assist a person with personal hygiene and dressing and although it is recorded that some anxiety noted and can be resistent to intervention, these statements are not expanded on. Neither is there further detail to say, how the persons independence is to be promoted, what their preferences in relation to how they like to dress are and what measures should be taken to reduce the persons anxieties. If clear guidelines relating to the persons preferences and examples of triggers that might cause anxiety were in place, a consistent approach by staff may help to alleviate some anxieties and fears. This sort of information could be collected during the assessment process and as part of developing information about an individuals social and life history that could become an invaluable resource to use when supporting people with memory loss related to older age and dementia. Many of the people currently living at this home have some form of memory loss or dementia and although staff demonstrate patience and tolerance when supporting service users, they have not received any in depth training regarding current good care practices related to dementia care. This should be addressed as soon as possible. Care Homes for Older People Page 14 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. So that service users do not become bored and socially isolated they are encouraged to make choices and to take control over their lives by being offered a range of activities and stimulation, while also maintaining contact with family and friends. Their individual dietary needs are met by being offered food that is appropriate, healthy and nutritious, however improved dining resources could enhance and further promote service users dignity and autonomy. Evidence: A part time activities coordinator is employed to organise the activity programme throughout the home and a volunteer, a person who worked at the home for many years as a carer prior to retiring, also supports this role. The activity programme is advertised on the homes notice board. The activity coordinator attends training in relation to her role and from this feels that she has developed more ideas and offered more opportunities to service users. Outside entertainers come into the home every month and every 3 months an old film, using old film equipment is shown creating an atmosphere of the 1940s cinema with
Care Homes for Older People Page 15 of 29 Evidence: an usherette serving drinks and ices. The companys mini bus which has a tail lift is accessed every six weeks and short trips out are organised to local places of interest and two different religious services take place every month. The activity programme is regularly reviewed to ensure that individual service users interests are accomodated. Service users are encouraged to discuss what activities they would like to see in the home at Residents Meetings and these are recorded. Service users care files include activity care plans, however these could be enhanced if they were more person centred and focussed. Individual service users daily routines could be included in these, for example the time they prefer to retire and start their day, where they prefer to sit during the day and the people they enjoy being with. Individual details about family/friends visiting arrangements, past hobbies and employment, important events in their lives and interests in general could be recorded in individual social histories and this valuable and useful resource could be used to develop individual activity programmes. Visitors are welcomed to visit the home and are given a friendly greeting on arrival. Good information about what is going on in the home is displayed on the walls of the entrance hall along with recent photographs of acitivities enjoyed. This informs service users, their families and friends of what future activities are planned. The cook who is assisted by a kitchen assistant is aware of the diverse dietary needs of service users, however the choice of meals on a daily basis is limited. Staff are allocated to the dining rooms at mealtimes in numbers that reflect service users needs. Where it has been identified that a service user may have a risk of not eating or drinking effectively a care plan is in place to monitor food and liquid intake and also their weight. Service users were joined for a midday meal and although the meal was nutritious and tasty the tables were set without conidments or matching crockery. Tea was served in a variety of styles and coloured mugs and if service users wanted salt or pepper they had to ask for it to be handed to them. So that the dignity, individual choice and autonomy of service users is promoted discreetly, tables should be set attractively and with the necessary condiments. Care Homes for Older People Page 16 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. Effective procedures are in place to help protect service users from abuse and to address concerns and complaints about the home seriously. Evidence: The home has a comprehensive complaints procedure of which service users and their representatives are aware. Any concerns that are brought to the homes attention are addressed directly and this often avoids them escalating to complaints. The homes complaints file demonstrates that complaints have been taken seriously and addressed appropriately and the outcomes demonstrating the changes that have been made to improve the service delivered. Two safeguarding issues reported since the last inspection were referred to the local authoritys safeguarding team following the appropriate procedures. Although the local authority did not take one of the issues down the safeguarding route the issues raised had been appropriately addressed. The home has worked closely with the local authoritys safeguarding team in relation to these. The home follows the local authoritys safeguarding adults policies and procedures and staff receive training in relation to these. Staff are aware of the action they would take if abusive practice was observed or if abuse was reported to them. A copy of the
Care Homes for Older People Page 17 of 29 Evidence: procedures is available in the home to which the staff can refer. Service users are encouraged to look after their own finances when appropriate and when support is needed with this comprehensive procedures are followed. The records kept by the home are audited monthly by the regional administrator and monitored by the manager and a monthly reconciliation report is carried out and submitted to the head office. 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. Service users live in an environment that is comfortable and that encourages their independence and autonomy, however the environment could be improved by addressing the identifed hazards and giving consideration to how the communal areas are arranged. Evidence: The home is kept clean and tidy, however signs of wear and tear are showing throughout. To address this there is a planned refurbishment and redecoration programme in place that should enhance the home when complete. Individual bedrooms are adequately furnished and nicely decorated and personal possessions reflect service users individual personalities. Some of the bedrooms have en suite facilities and those without are within close reach of toilets and bathrooms. However although there have been some measures taken to enhance these areas, some of the bathroom facilities look uninviting and would benefit from redecoration and refurbishment. One of the bathrooms has been converted into a shower room but is rarely used as service users prefer to use a bath, this room is currently being used for storage. The wooden panel around the bath in the bathroom on the ground floor is broken in several places and this needs to be renewed. There is one electronic bath
Care Homes for Older People Page 19 of 29 Evidence: that provides a high/low facility, however service users who are physically frail and experiencing very poor health could benefit from having more improved bathing facilities that are adapted to meet their needs. The home has plans to address this. Equipment used to assist service users with their mobility is regularly serviced, however two of the slings used with hoists were condemned when recently serviced. The home has ordered new slings and is awaiting delivery of these. When not in use, wheelchairs are stored in a walk in cupboard, however this area is not big enough to safely store all of them. Some wheelchairs were sticking out of the cupboard and causing a hazard in the passageway. This manager agreed to address this. A separate small lounge on the first floor is used as a smoking lounge and those service users who need support or observation for safety reasons, are accompanied by a member of staff. At one point of the day it was very evident that smoke from this room was infiltrating into the downstairs area causing a smokey atmosphere. When this was brought to their notice the manager immediately addressed this by activating the extractor fan and this soon dispelled the smoke. The lounge and dining areas are open plan providing a large communal area and when not in their rooms service users use the lounge area to sit and relax. There is a large screen T.V. at one end of the lounge and easy chairs are arranged around the walls of the room facing it. Although many service users enjoy watching T.V. this arrangement does not provide the opportunity for service users to sit in small groups to chat or to take part in any other activity. A discussion took place with the manager in relation to this and it was agreed that consideration would be given to how the chairs in this area could be grouped in different ways. It was noted that some doors throughout the home were wedged open and this includes that of a service users bedroom. When brought to their attention the manager he removed the wooden wedges. Although it is acknowledged that some doors need to kept open for mobility reasons and at times service users choose this, this must be achieved by following fire regulations and following the advice given by the fire service. During their last visit the fire service gave the home advice on this issue and stated this in a letter to them. Advice regarding this must be discussed again with the fire officer. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Robust recruitment and selection procedures and training opportunities ensure that service users are appropriately supported and protected by a competent and qualified staff team. Evidence: The home employs a staff team that is diverse in experience and qualifications, 90 per cent have qualified in NVQ 2 or above and others are working towards it. This is a good achievement. Due to the home experiencing a period of low occupancy the staffing ratio needed is regularly reviewed to reflect the number of service users living in the home and the level of their needs. The number of staff on duty included the manager, a qualified nurse and 4 care assistants. In addition to this a domestic, a cook and a kitchen assistant were also on duty. The number was adequate and effective, all staff worked hard and with enthusiasm, supporting service users in a competent and respectful way and staff were allocated to different areas of the home in numbers that addressed service users needs effectively. Staff work competently, interacting with service users in a sensitive and skilful way and this reflects the effective guidance and training received. A training programme that reflects the homes and individual staffs needs has been established and a training matrix demonstrates the various training programmes arranged and the dates
Care Homes for Older People Page 21 of 29 Evidence: training needs to be updated. The home has a member of staff who is fully qualified as a moving and handling trainer, the Company also has a Back Care Coordinator, this means that staff are regularly trained and brought up to date with appropriate techniques to be used and recent legislation in relation to moving and handling, while at the same time service users benefit from this knowledge and skill. In addition to mandatory training staff have recently had the opportunity to attend training courses that reflects the needs of the people currently using the service and this inlcudes, Pain Management, Verification of Death, End of Life Pathway, Awareness of Pressure Damage and Level 3 in Palliative Care. However it was noted that not all staff have received recent training in dementia care. As there are many people living at this home with dementia or memory loss related to old age, it is very important that staff receive training in relation to this. A good induction programme that is based on the Skills for Care Induction Standards is followed and staffs personal training records include a copy of this and other training records. Most of the staff who work here have done so for many years, service users therefore know them very well and receive care that is consistent. New staff are recruited following robust recruitment procedures and staff files include, a completed application form clearly demonstrating the individuals work history, two relevant references and Criminal Record Checks (CRB). Staff spoke very positively about working at the home and some comments include, We are like one happy family. We all get on so well. We work as a team. The training is really good. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are appropriate arrangements in place to temporarily manage this home until the plans to recruit a permanent manager are achieved. A competent staff team support the manager to develop and maintain good management routines that deliver a service in the best interests of the service users. Evidence: There has been no permanent manager at this home since October 2008 and the temporary manager who was managing the home since October retired the week prior to this inspection. However another temporary manager is in place and interviews for a permanent manager are to take place later in the week. The person in place as manager has worked in care for 22 years and as deputy manager at this home for many years. He therefore knows the home and the service users and staff very well. He is qualified in NVQ level 3 and is registered to do the Registered Managers Award (RMA), he shows a committment to his role and enthusiasm towards the development of the home. He has developed a good relationship with both service users and staff
Care Homes for Older People Page 23 of 29 Evidence: and he is aware of the homes many strengths and the areas that need further development. The homes policies and procedures that are regularly reviewed are brought to the staffs attention in staff meetings and during individual supervision sessions when 1 to 1 discussions take place in relation to them. An effective quality assurance system is in place. Monthly audits are carried out and validated bi-monthly by the operations manager, they are then sent to the main office where they are collated and a service development plan is produced. Staff generally feel that they are receiving good support and spoke positively about the temporary management arrangements in place. The home has health and safety records in place and appropriate up to date certificates prove good maintenance procedures. Advice was given about the confidential storing of accident records and discussions with the manager addressed the health and safety anomalies found in the body of this report. Good arrangements are in place to safeguard service users monies held in the home and comprehensive procedures monitored by senior management, are followed and recorded appropriately. 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 19 13 The health and safety issues 31/03/2009 found throughout the home regarding, the holding open of fire doors, the storage of wheelchairs, the broken bath panel and the use of the extractor fan in the smoking room must be addressed. So that the evident these areas do not present a hazard to service users and staff. 2 19 13 Staff must remember to activate the extractor fan in the smoking lounge when smoking is taking place. So that the health and safety of service users, staff and visitors is protected. 31/03/2009 3 30 18 All staff must receive 30/06/2009 training in relation to current good practice in dementia care. Care Homes for Older People Page 26 of 29 So that staff develop the appropriate knowledge and skills needed to support service users with dementia. 4 31 8 A permanent manager must be appointed to manage the home and they must register with the CSCI. So that service users live in a home that is managed by a person who is fit to do so and who carries out their responsibilities in the best interests of service users. 31/03/2009 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 7 Care plans should be further developed so that they are more person centred and include more information about their personal and social needs. For example there should be clear guidelines for staff to follow in relation to their preferred way of daily living, dressing and the individual way an individual likes to be supported. When someone demonstrates challenging behaviour related to feeling anxious or frustrated the triggers that can be the source of the behaviour should be recorded and guidance how these are to be addressed should be clearly written in the care plan for staff to follow. So that staff have important information about service users and so that daily activity can be organised to suit their preference and culture, individual social histories should be fully developed starting from the assessment stage. So that staff have important information about service users and so that daily activity can be organised to suit their preference and culture individual social histories should be fully developed starting from the assessment stage. 2 7 3 12 4 13 Care Homes for Older People Page 27 of 29 5 14 So that staff have important information about service users past interests and lives from which they can support them to make choices and decisions about their lives social histories should be fully developed starting from the assessment stage. Service users should have the opportunity of sitting at attractively set tables for their meals that are equipped with matching crockery and the necessary condiments needed when eating a meal. So that the people who are using this service have the opportunity of using bathing facilities that are appropriate to their needs consideration should be given to the refurbishment of the bathrooms with particular attention to the aids and adaptations needed to meet the needs of disabled and physically frail people. Advice regarding the bathing equipment needed should be sought from an occupational therapist. 6 15 7 21 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!
