Inspection on 17/03/09 for The Beeches (Wath)

This inspection was carried out on 17th March 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Beeches (Wath) 27/02/08

The Beeches (Wath) 06/11/07

The Beeches (Wath) 13/09/06

The Beeches (Wath) 02/02/06

The Beeches (Wath) 13/09/05

The Beeches (Wath) 14/12/04

The Beeches (Wath) 18/05/04

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: The Beeches (Wath) The Beeches Residential Care Home Carr Road Wath-Upon-Dearne ROTHERHAM South Yorkshire S63 7AA     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: Valerie Hoyle     Date: 1 7 0 3 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 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: The Beeches (Wath) The Beeches Residential Care Home Carr Road Wath-Upon-Dearne ROTHERHAM South Yorkshire S63 7AA 01709761803 01709761804 paulhulbert@ntlworld.com www.winniecare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Winnie Care (Highgrove) Ltd Type of registration: Number of places registered: care home 44 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of users who can be accommodated is 44 The registered person may provide the following category of service: Care Home: Care Home only - PC 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 catergory - Code OP Dementia - Code DE Date of last inspection 22 0 Over 65 0 22 Care Homes for Older People Page 4 of 26 Brief description of the care home The Beeches is registered to provide residential care and accommodation for up to forty-four older people with dementia. The home is purpose built and is located on the main road in the town of Wath Upon Dearne area of Rotherham. There are community amenities close by which includes local shops. The Beeches is owned by Winnie Care (Highgrove Ltd), who also own other homes in the surrounding area. The home is built on two floors with access via a passenger lift or stairs, and accommodation is provided in two units, each with its own lounge and dining room. Both units have twenty-two single bedrooms, each with en-suite facilities. Two of the single bedrooms have adjoining doors in order to provide two double rooms if they are requested. There are assisted baths, which helps people with physical limitations to bathe more easily. There are also showers on each unit. There is a small, enclosed garden with a patio area for people to use and car parking spaces are provided at the side of the building. Fees are 397 pounds per week, as at 17th March 2009. Additional charges are made for hairdressing, chiropody and taxis. For further information contact the home. Information about the service was available for people and their families in the Statement of Purpose and the Service User Guide. This information was available in the reception area including the last published inspection report dated 31st March 2008. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality for this service is 1 star. This means that the people who use the service experience adequate quality outcomes. This unannounced inspection took place over 7.5 hours starting at 09:30 finishing at 17:00. Steve Baker the Pharmacist Inspector accompanied the visiting inspector Val Hoyle. During the visit we examined the homes medication procedures, 23 current medication administration record (MAR) charts and we were told about recent medication training provided for senior staff. We also looked at the storage and handling arrangements for medicines including controlled drugs. The inspection included a partial inspection of the building. Two people who use the service, four staff and three relatives were spoken to during the inspection: their views are included throughout the report. Two district nurses were contacted to gain their views on how staff meet the healthcare needs of people. Care Homes for Older People Page 6 of 26 We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Occupancy at the home was 23, and the home had closed the first floor until occupancy increases. Four peoples care plans were looked at. Policies relating to medication, complaints, protection of vulnerable adults and handling of peoples monies were looked at. Three staff recruitment and training records were looked at to assess how people were protected. Procedures and risk assessments relating to health and safety were looked at and discussed with the manager. The manager is Jill Stanley who was appointed temporary manager in April 2008. She has there required skills and competencies which includes a nursing qualification. She was available throughout the inspection and assisted with the process. The AQAA was sent to the home and returned to us on time, which demonstrates responsiveness and cooperation. An Annual Quality Assurance Assessment is a selfassessment and a dataset that is filled in once a year by all providers whatever their quality rating. It is one of the main ways that we get information from providers about how they are meeting outcomes for people using the service. The AQAA also provides us with statistical information about the individual service and trends and patterns in social care. The inspectors would like to thank everyone who agreed to being interviewed as part of the inspection process, and the friendliness of staff. What the care home does well: What has improved since the last inspection? 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. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 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 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were individually assessed prior to moving into the home to ensure their needs could be met. Evidence: A number of assessments were looked at during this inspection. They were comprehensive and covered all aspects of daily living, including personal care, health and wellbeing. The detailed plans were used to formulate the care plan to ensure peoples needs were met. The placing authority had also undertaken an assessment of need and these were seen on the case files looked at. The manager said people could visit prior to moving into the home, and relatives confirmed this arrangement and said staff were very supportive. Care Homes for Older People Page 10 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans provide sufficient information to protect people who use the service, however procedures to promote peoples dignity was only adequate. Medication procedures were generally followed, however more improvements are needed to ensure people receive medication as prescribed. Evidence: Four care plans were looked at to assess how peoples needs were met. The information was sufficiently detailed with peoples needs learly identified. The plans included how their personal, nutritional and health care needs. Risk assessments had been developed to ensure people were supported to maintain their independence within the limits of their capability and capacity. Daily records were brief which means evaluating the plans would be difficult. An example of this was the record to evaluate activities. The record stated no visitors on most of the plans looked at. There was no evidence to support activities had taken place although the activity co-ordinator said people joined in a variety of activities ranging from bingo to baking. The care plan contained good evidence to confirm peoples health needs were met. Care Homes for Older People Page 11 of 26 Evidence: There was evidence that nutritional assessments takes place, and diets and supplements were used to maintain peoples health. Weight and skin care were assessed to ensure people received the necessary assistance fro health care professionals. There were good records to confirm staff keep people hydrated and turning charts to ensure good pressure relieving practices were followed. Two health professionals were contacted and they confirmed staff communicated any skin and health problems to them. They said staff always follow their directions regarding pressure area care and were good at using pressure relieving equipment and monitoring peoples position while in bed using turning charts. People were observed sitting in the main lounge area. Most people were not wearing footwear. A number had no stockings on and some had dressings on their legs and feet that were uncovered. This does not promote good infection control measures, or promote peoples dignity. There are procedures in place for ordering, receiving, administering and disposing of medicines but these documents do not always follow current best practice. The Royal Pharmaceutical Society of Great Britain and CSCI professional advice documents on handling medicines in social care are not available in the home. This means that, despite recent training and ongoing checks, staff in the home do not fully understand what is expected of them when handling and giving medication. We found supporting evidence of this when we examined medication records and checked quantities of medicines in the home. The MAR chart for one person showed that one prescribed medicine was not given for 14 consecutive days as none was available. A replacement supply had not been ordered and none could be found at the time of this visit. Another person was prescribed a painkiller to be taken when needed but none could be found in the home as none had been ordered this month. Sufficient medicines must always be kept in the home to meet peoples needs, otherwise their health and wellbeing may be affected. The quantity of medication brought forward from one monthly cycle to another is not always recorded on the new MAR chart. This means it is difficult to produce a complete record of medication within the home and to check if medication is being given correctly. There are many administration gaps on the MAR charts meaning that people living in the home may not be receiving their prescribed medicines correctly. Handwritten entries of six medicines seen on four MAR charts are not sufficiently clear and detailed enough to be sure that other staff know how to follow the prescribers instructions correctly. Care Homes for Older People Page 12 of 26 Evidence: Most medicines, including controlled drugs, are stored in cupboards in a locked store room. We found two containers of eye drops in the fridge which had passed their inuse expiry date. The opening dates of medicines with a limited use once opened are not recorded consistently, so staff do not know whether these medicines are fit to use. All medicines must be stored securely at temperatures and conditions recommended by the manufacturer so that staff know they are safe to use when needed. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were able to socialise with family and friends. Mealtimes could be more organised to make the dining experience better. Evidence: The home employs a full time activity co-ordinator who has responsibility for developing leisure activities within the home along with outings and outside entertainment. There was little evidence to confirm the activities that take place within the home. There was no notice boards, posters or pictures to enable people to make decisions about activities offered. The home could develop the environment to help orientate people with dementia living at the home. Corridors were dull and the lounges and dining areas could be improved using pictures of events and the display of crafts created by people at the home. Relatives can visit the home at any reasonable time. Two people visiting the home said they were made to feel welcome. One relative said they visited regularly and assisted at meal times. She said it helped her feel still involved in her husbands care. People personalised their bedrooms to their own taste and some people enjoy spending time watching TV. A number of rooms looked at had two wheelchairs which Care Homes for Older People Page 14 of 26 Evidence: were stored in the room. This meant that moving around the room was difficult and could pose a hazard to people. Wheelchairs must not be stored in bedrooms unless they are used by the individual. This was discussed with the manager. Mealtimes had been changed since the last inspection. The main meal is now served at tea time. A lighter lunch of soup and sandwiches was served and the cook was aware of peoples dietary needs and the use of supplements. Lunch was observed and it was disorganised and chaotic. People who were quite disruptive were taken in to the dining room first and then people were transferred from their wheelchair. At one point there was a que of wheelchairs waiting along the corridor and into the dining room. People seated early were quite agitated about having to wait for their meal, which meant the atmosphere was not conducive to enjoy their meal. Some thought must be given to improve the dining experience. A small lounge next to the dining area could be utilised more as it would declutter the main dining area allowing movement of wheelchairs more easily. Care Homes for Older People Page 15 of 26 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. People who use the service could access the complaints procedure and the manager ensures complaints were recorded and investigated appropriately. Adult safeguarding policies and procedures ensure people are safe and protected. Evidence: The home has robust complaints procedure and the AQAA confirmed that five complaints had been received since the last inspection. A number of complaint documents were looked at. They had been resolved to the satisfaction of the complainant, although letters and investigation notes were not always attached to the original complaint. The home has robust safeguarding adults procedures and the manager operates to those standards. Staff had received training to recognise the signs of abuse and the manager holds regular discussion with staff to reiterate the procedures. Care Homes for Older People Page 16 of 26 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 using the service were provided with generally good, clean, and comfortable environment, anthough some refurbishment would improve communal areas. Evidence: A partial tour of the environment found the first floor of the home unnocuppied. The manager confirmed that due to changes in registration and occupancy, the first floor was not currently in use. The home was generally tidy and clean however the small quiet lounge was untidy and the carpet and furniture was in poor condition. The room was quiet dark and was obviously used for dining as the floor was littered with food from the previous meal. Consideration should be given to replace the carpet and put dining room furniture in the room so that people can eat sat at the table. One of the bathrooms was untidy and was used as a store for equipment and incontinence wear. Staff said it was not currently used for bathing. Wheelchairs were stored in bedrooms adjacent to the dining area, although the bedrooms were occupied. The wheelchairs were dirty and required deep cleaning to prevent cross infection. Some wheelchairs did not have footplates and some were in poor condition. Care Homes for Older People Page 17 of 26 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. Staff have the skills and knowledge to fulfill their roles within the home. Recruitment policies are followed ensuring the safety and protection of people who live at the home. Evidence: Training records looked at show that staff had the required skills and competencies to deliver a service to people. The training plan identified gaps in staff knowledge and the manager was proactive in arranging training for staff. Health and safety, and infection control training needs to be added to the training plan and dates for training identified. The manager said some staff were working to complete a distance learning course on infection control. Staff were attending a behaviour management course and the manager said if successful the training would be made available for other staff to attend. Staff had the required skills to meet the needs of people. They have achieved above fifty percent NVQ level two qualified staff. The AQAA confirmed that sixteen of the twenty five staff had achieved the award in care. There was a comprehensive induction and probationary package. It meets the skills for care standards and the manager said induction takes place over two days and then staff were mentored until competent. The manager confirms permanent employment Care Homes for Older People Page 18 of 26 Evidence: when satisfied they had reached good competency levels. Staff rotas and observation during this inspection confirmed there were sufficient staff to meet the needs of people who live in the home. The manager said they had been able to retain staff and some staff had worked at the home for a considerable length of time. There were robust recruitment and selection procedures that ensured people who use the service were safe and protected. A number of staff recruitment files were looked at and there was evidence that all the required employment checks had been undertaken prior to commencing employment at the home. Files contained Criminal Record Bureau checks, references and proof of identity. The manager should check the date on all existing CRBs as good practice suggests that a new CRB check should be carried out every three years. Care Homes for Older People Page 19 of 26 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. People who use the service were protected by sound management practises, and their views were actively sought to improve the service. The financial interests of people were safeguarded although records could be improved. Good health and safety procedures ensured people were safe. Evidence: The manager was appointed in April 2008. She has commenced the process to be registered with CSCI. She holds a nursing qualification and has also achieved the Registered Manager Award. The manager was supported by three deputy managers who are working towards NVQ level four in management and they take lead responsibility for different aspects of the service. There was evidence that the home actively seeks the views of people who use the service. There was a quality assurance audit which included surveys from people who use the service and their representatives. The last audit was undertaken in October 2008 and the published results show overall good satisfaction levels. Some comments Care Homes for Older People Page 20 of 26 Evidence: from people said improvements were needed in areas of shift organisation and some relatives said some staff were better organised than others. The area manager undertakes quality assurance audits (Regulation 26 reports) on behalf of the organistaion. She reports on the outcomes for people who use the service which includes speaking to people that live at the home, and looking at records. People who use the service were able to manage their own finances, although some prefer to the manager to assist. Records were looked at and they were an accurate reflection of the accounts held on peoples behalf. One person also had a second account held at the home. A seperate record should be used to record all transactions and consideration should be given to set up and transfer some of the money to a higher interest account. Maintenance and service records were looked at. These were up to date with relevant certificates. The required Health and Safety policies and procedures were displayed throughout the home. Accident and incident records were looked at and the manager has responsibility to analyse the information and develop risk assessments where required. Care Homes for Older People Page 21 of 26 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 22 of 26 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 9 13 Arrangements must be made to ensure that accurate records are kept of all medicines received, administered and leaving the home or disposed of. This helps to confirm that medication is being given as prescribed and facilitates accurate checking of stock levels. 30/04/2009 2 9 13 Arrangements must be made to ensure that all medication is stored securely at the correct temperature & conditions recommended by the manufacturer. This makes sure staff know that medicines are fit to use when needed. 30/04/2009 3 9 12 Arrangements must be 30/04/2009 made to ensure that there is an effective system in place to request, obtain and retain Page 23 of 26 Care Homes for Older People 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 adequate supplies of prescribed medicines for people living in the home. So that they can be given them as and when prescribed. 4 10 12 Peoples dignity must be observed by ensuring they are dressed appropriatley. This means they must wear appropriate footwear, including stockings and slippers, unless stated in their care plan for medical reasons. 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 30/04/2009 1 7 Care plans should reflect the activities that people take part in, which should include peoples likes and interests assessed on admission to the home. Social activities must be clearly recorded on peoples care plans. The outcomes must be reviewed monthly. Professional guidance documents on handling medicines in social care should be available for staff to use in support of the existing medication policy and procedures. Handwritten entries on MAR charts should should be accurately recorded and detailed. This makes sure that the correct information is recorded so that all staff understand and follow the changes correctly. The environment could be improved by creating notice boards and display boards which will inform people of the Page 24 of 26 2 3 7 9 4 9 5 12 Care Homes for Older People 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 activities and entertainment available. This could also be used to orientate people to the time and date, and special events throughout the year. 6 15 Mealtimes must be improved to create a better atmosphere for people. The dining area could be improved as it was cluttered and not suitable for people who depend on the use of a wheelchair. The carpet and furnishings in the small lounge adjacent to the dining area need to be deep cleaned or replaced, to ensure it is fit to be used as a second dining area. Wheelchairs throughout the home must be thoroughly cleaned and kept clean to ensure they are fit for use. Footplates must be used at all times to prevent accidents and the wheelchairs must not be stored in peoples bedrooms unless they are used by the person. The manager should check the date on all existing CRBs as good practice suggests that a new CRB check should be carried out every three years. A separate record should be used for the person that has two accounts at the home, to record all transactions. Consideration should be given to set up and transfer some of the money to a higher interest account. 7 19 8 26 9 29 10 35 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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. 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