Inspection on 20/01/09 for The Rowans

This inspection was carried out on 20th January 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Rowans 02/02/07

The Rowans 14/03/06

The Rowans 27/09/05

The Rowans 08/02/05

The Rowans 17/09/04

The Rowans 29/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor 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 Rowans 31 Goonown St Agnes Cornwall TR5 0UY     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: Melanie Hutton     Date: 2 0 0 1 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. 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 28 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 28 Information about the care home Name of care home: Address: The Rowans 31 Goonown St Agnes Cornwall TR5 0UY 01872552147 01872552147 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Ian Hirsch Type of registration: Number of places registered: Mrs Rosemary Joy Hirsch,Mr Ian Hirsch care home 9 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Service users to include up to 9 adults of old age (OP) Total number of service users not to exceed a maximum of 9 Date of last inspection Brief description of the care home The Rowans is registered to provide care for 9 elderly residents. The home is a large Victorian house set in a well-maintained secluded garden, at Goonown, St Agnes. The registered providers Mr and Mrs Hirsh live next door to the care home. The accommodation comprises 9 single bedrooms on two floors, 2 of which have en suite toilets and hand basins. There is a chair lift to the first floor. The ground floor is wheel chair accessible. There is a pleasant lounge /dining room. The home operates a no smoking policy. Care is provided within a relaxed and friendly atmosphere. Socialising and visitors are actively encouraged. A copy of the full inspection report is available in the hallway, and it is suggested a copy is requested from management or CSCI if Care Homes for Older People Page 4 of 28 Over 65 9 0 Brief description of the care home required. The range of fees at the time of the inspection is from 308 to 450 pounds per week. There are additional charges e.g. for hairdressing, chiropody, and newspapers etc. Care Homes for Older People Page 5 of 28 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: This unannounced key inspection took place on 20 January 2009 with one inspector spending eight and a half hours in the home. All of the key standards plus some additional standards were inspected. The methodology used during the inspection was discussion with 6 residents and 2 relatives, discussion with 2 members of staff, discussion with the registered manager, observation of staff interacting with residents, inspection of records and the environment. We also case tracked the records of 4 residents, additionally meeting with them to clarify information provided to us. Further detailed information was provided to us in the form of the Annual Quality Assurance Assessment (AQAA), completed by the registered provider prior to the inspection. Other evidence gathered since the previous inspection, such as notifications Care Homes for Older People Page 6 of 28 received from the home (e.g. regarding any incidents which occurred) was used to help form the judgments made in the report. 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.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 8 of 28 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 28 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 who use the service and / or their representatives are provided with sufficient information to make an informed choice about the care home. Evidence: Terms and conditions are provided to each resident and / or their representatives. These were detailed and informative and signed by the registered provider and the resident and / or their Representative. An addition should be made to these to identify the room that is to be occupied and who is responsible for paying the fee. We discussed with the registered provider that some terms and conditions inspected did not accurately reflect the current fee. The registered provider said that this will be addressed. Detailed care needs assessments are undertaken for new and prospective residents by the registered provider. These were inspected for a number of residents and were Care Homes for Older People Page 10 of 28 Evidence: detailed, informative and form the basis of the care plan. It was noted that two did not include information on history of falls as per the national Minimum Standards (NMS) Residents were able to tell us their experience of being admitted to the home and that the registered provider visited them prior to admission and discussed their care needs. Residents told us that they were able to visit the home prior to admission. One person said I came to stay for a couple of weeks to see if I would like it here and never left another said my daughter and I visited for a day and decided we like it here so I came to live here. Care Homes for Older People Page 11 of 28 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. Care plans are not sufficiently detailed to inform and direct the staff of the action they must take to meet peoples care needs. The privacy and dignity of the residents is respected by the staff. Residents are protected by the homes policies, procedures and systems regarding medication. Evidence: Each resident has an individual plan of care, that is developed from information obtained from the care needs assessment. The care plans are dated and signed by the registered provider and resident and / or their representative. The care plans must be reviewed and developed to consistently set out in detail the action that staff must take to meet the residents care needs. Information was not consistently available to identify residents health and social needs. We discussed this with the registered provider who stated that she plans to develop all of the care plans and include more detail. Care plans are reviewed on a monthly basis, sometimes changes are noted within the review but the care plan not updated. Residents told us I am very well cared for, the Care Homes for Older People Page 12 of 28 Evidence: staff are excellent and look after me well, It is excellent here, everybody is so good and they do anything for you that you need. Residents told us that they are visited by the district nurses, general practitioners, chiropodists, opticians and records supported this. Further information and guidance should be available regarding the management of continence. Some residents and the care plans told us they have problems with continence and use incontinence pads. It was not clear that continence assessments have been undertaken or the type of pad used. Residents are encouraged to mobilise throughout the home with support as needed and some residents told us that they go on trips with the home or for walks locally when the weather permits. Records are made on admission of the residents nutritional needs and preferences. One visitor told us that their relative enjoys the food at the home and that their weight has increased since becoming a resident here. A satisfactory medication policy and procedure is available within the home. Medication administration records (MAR) were inspected and were completed fully and up to date. A record is available to show the medicines received into the home and returned to the pharmacy. The controlled drugs (CD) register was inspected and found to be completed appropriately. Staff files inspected showed that these members of staff had completed medication training. The registered provider told us that this will be updated and is currently seeking a training provider for this - she is hopeful that the local pharmacy will be able to provide this training. The community pharmacist visits the home twice a year to check the systems in place in the care home and to review and speak with residents. Residents told us that staff are kind, caring, polite and respectful. Comments included we are like a family here, they are so kind and know just what I like, the staff help me if I need it but they know I like to do things myself if I can so only help when necessary Residents preferred forms of address are recorded and staff were observed to use these names. The privacy of residents is respected and staff were seen to knock and wait to be asked to enter before going into individual bedrooms. Residents made positive comments about the laundry system within the home and told us that their own clothes are looked after well when sent for washing and returned speedily. It was evident that some residents have installed their own telephones. Another resident told us that they have used the homes telephone when needed. Care Homes for Older People Page 13 of 28 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. Routines and activities are such so that residents can live a lifestyle that meets their needs. Visiting times are flexible. Residents are provided with a nutritious, varied and wholesome diet. Evidence: Residents told us that they feel able to make choices regarding their daily routines e.g. when they get up and go to bed and how they spend their day. Bedrooms were seen to be personalised with ornaments, photographs and furniture belonging to the residents. Limited information about residents leisure activities was available for inspection. The registered provider said that she and the staff try to arrange different activities but often the residents do not wish to take part. Residents told us that they enjoy the outings arranged by the home, examples given to us were shopping, both locally and further afield, prior to Christmas. An outing is being arranged to a local pantomime and residents were able to discuss this with us. The registered provider told us that often activities are arranged spontaneously as oppose to planned events. We heard from residents that they had a body shop pampering party recently, baking afternoons and we were told that on a Sunday, there is often a craft activity and bingo Care Homes for Older People Page 14 of 28 Evidence: / beetledrive taking place. Several residents told us that they enjoy retiring to their rooms after lunch rather than remaining in the lounge socialising. Visitors are welcomed to the home by the registered provider and staff. On the day of inspection we were able to speak with visitors to the home who were very positive in their comments about the home and staff. The main meal on the day of inspection was gammon with either parsley sauce or pineapple, potato wedges and green beans followed by a desert. All of the residents we spoke with expressed their great satisfaction with the food provided. It appears that currently the residents do not know what they are to be given for their main midday meal. All of the residents that we spoke with did not see this as a problem and comments included It is a lovely surprise, I like all the food here and They know just what I like and dislike and never give me anything I cant eat. This was supported on the day of inspection as alternatives to gammon were given to 2 people. The evening meal provides a vast choice, records show that up to 4 different meals are provided. Residents told us that they enjoy a variety of sandwiches, soup, cheese, tomatoes or mushrooms on toast and sometimes choose an egg for their tea. Residents also told us that supper is also provided and can include more sandwiches, cake or biscuits. Breakfasts vary between residents with cereals, porridge, fruit, toast and eggs on the menu. Care Homes for Older People Page 15 of 28 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 registered person has suitable procedures regarding complaints and adult protection so that residents can be assured that there are appropriate procedures to deal with any concerns or bad practice. Evidence: The registered provider has satisfactory procedures regarding complaints and adult protection. Staff and service users showed some awareness of the procedures and were able to tell us who they would approach and the action they would take should they have a complaint. Staff sign a form to say that they have read and understood the complaints procedure. The registered provider told us during the inspection and within the AQAA that the home has received no complaints. Residents and two visitors who we spoke with told us that they were satisfied with the care and services provided within the home. Several residents said that they would feel able to approach the registered provider with any concerns and had total confidence that these would be addressed appropriately. Staff files inspected showed that these members of staff had attended adult protection training, either with Cornwall County Council or internally using a training DVD whilst waiting for a place on the external course. The registered provider informed us that adult protection is included within the induction training for new members of staff. The policy and procedure should now be developed to clarify that any suspected abuse Care Homes for Older People Page 16 of 28 Evidence: would be reported to the Department of Adult Social Care even if the residents consent could not be obtained. Care Homes for Older People Page 17 of 28 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 Rowans provides a pleasant, homely, clean and well-maintained environment for people to live and feel at home in. Evidence: The building presented as accessible, safe and well maintained and residents told us that their needs are met. One person commented that they were waiting for a ground floor room to assist their mobility around the home. This was confirmed to us by the registered provider. We were able to observe areas that had been refurbished since the last inspection. There is a pleasant front garden that is accessible with seating for residents. There is a large lounge dining room, we were told by one resident that the dining room table and chairs has recently been renewed. Residents were observed to gather in the lounge prior to lunch and eat together at the midday meal. This appeared a lively and social occasion. Residents are able to eat their meals in their rooms if they so choose and on the day of inspection it was observed that one person remained in their room. Most residents appear to choose to stay in their rooms during the day rather than use the lounge. One resident likes to spend time in the lounge and told us it was a nice and comfortable place to spend time. The private accommodation is all within single occupancy bedrooms, two of which are ensuite, the rest have hand basins. Curtaining has been used to create a private area within the bedrooms when using the handbasin. Commodes are available if needed and toilets and assisted Care Homes for Older People Page 18 of 28 Evidence: bathing are in use on both floors. There is both an assisted bath and a wet room so that residents can choose whether to shower or bathe. We spoke with residents about this and were told that they are offered a choice of which facility to use and how frequently they wish to bathe. Throughout the home we observed aids and adaptations to assist with mobility and independence. Access to the first floor is by means of the stair case or stair lift. Raised seats, pressure relieving equipment, hand and grab rails were observed in use. A call bell system is in operation, residents told us that when they need to ring the bell the staff respond promptly. During the inspection this was confirmed. Residents we spoke with told us that they were satisfied with their rooms, these were all seen to be personalised and individually decorated. The doors are able to be locked by a bolt from the inside, in an emergency situation the staff would be able to access the room. Doors are able to be locked by the resident on leaving the room if they wish, currently nobody holds a key for this purpose. Not all rooms currently have a lockable space within it but the registered provider told us that this could be arranged should the resident require it. Some residents confirmed to us that they did have a lockable space in their room for their personal belongings or medication. During the tour of the premises, it was observed that a number of radiators are not guarded or of low surface temperatures, both within the communal and individual rooms. The radiators are adjustable so that residents can alter the temperature should they wish to. Risk assessments clearly identify the hot surface temperatures within the home and the perceived risk to people. Portable heaters were observed within some areas, again these were included in the environmental risk assessments. The hot water outlets do not appear to have thermostatic temperature controlled valves in place. The environmental risk assessments detail the action taken by the registered provider to reduce the risk e.g. colour changing plugs, bath thermometers and policies and procedures for staff to follow. The registered provider was able to demonstrate that the water storage system in the home has been tested for Legionella. The laundry is located on the ground floor and was clean and tidy on the day of inspection. There are two washing machines and a tumble drier. A system is in place to ensure that soiled laundry does not contaminate the clean laundry. Hand washing facilities and protective personal equipment e.g. gloves, aprons and hand gel are located within this area. The home has a policy and procedure relating to infection control and some staff have undertaken training in this area. It was noted that staff change their gloves and aprons when working between the kitchen and providing care, it may be a more robust system of infection control if different coloured equipment is used for each task e.g. blue for food preparation and white for care work. Care Homes for Older People Page 19 of 28 Care Homes for Older People Page 20 of 28 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. Staffing levels seem satisfactory to meet the needs of the current residents. Residents are protected by the homes recruitment and training practices. Evidence: Residents told us that there are enough staff on duty to meet their needs. The duty rota is recorded within a diary and amendments made that showed changes to the planned rota. The rota shows that two members of staff are on duty in the morning, one for part of the afternoon and two staff in the evening. One carer works during the night, the registered provider told us this person would sleep from midnight using a portable bed that is made up in the lounge. Based on the information given to us by the residents and the registered provider the staffing levels are currently satisfactory. However, it is suggested that this is reviewed regularly to ensure that residents needs have not changed and that they do not require more assistance at night. The use of the communal lounge as a sleeping room for the night staff could compromise residents who may wish to use this area. We discussed these issues with the registered provider who agreed to undertake a review of the staffing arrangements. There are 5 care staff currently employed at the home. Three of these have NVQ level 2, with 1 also having achieved NVQ level 3. The remaining 2 members of staff have registered to commence the NVQ level 2 training. The registered provider told us that Care Homes for Older People Page 21 of 28 Evidence: one member of staff has been given responsibility to develop the training programme for all staff. It was evident that a number of training sessions have been provided, with records held on staff files to show which they attended. A programme identifying the forthcoming training was provided. Training that people have undertaken includes dementia care, infection control, moving and handling, medication, food hygiene, fire training, catheter care and adult protection. Further update training that has been planned includes moving and handling, fire safety, health and safety food hygiene, first aid, medication, moving and handling, adult protection. Two members of staff are booked to attend the metal capacity act training provided by the Department of Adult Social Care. Staff records inspected showed that a robust recruitment procedure is followed when appointing new staff. This includes the checking of employment history, CRB (criminal records bureau) check, obtaining 2 written references and other relevant checks. Care Homes for Older People Page 22 of 28 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 registered provider is suitably experienced and skilled to manage the home and has completed the Registered Managers Award. The management of health and safety is satisfactory so residents can be assured they live in a safe environment. The home is run in the best interests of the residents. Evidence: The registered providers have the experience and skill to manage the home with Mrs Hirsh being responsible for the care in the home and supervision of the staff. Mr Hirsh undertakes the business administration for the service. Mrs Hirsh told us that she completed the Registered Managers Award in September 2008 and is awaiting the certificate to evidence this. Staff and residents made positive comments regarding Mrs Hirsh as the registered provider. Staff said she is very supportive, it is a great place to work and they are good to work for. Residents said Joy [Mrs Hirsh - registered provider] is a joy, nothing is too much trouble for her and she is always smiling, Joy Care Homes for Older People Page 23 of 28 Evidence: is of just the right disposition, unfailingly cheerful and obliging and It was a joy to come here to Joy and her staff, they are so kind, always smiling and so helpful. One resident told us the home has a family feel and we are included in all that is going on. The last quality assurance survey that was sent out to all residents, relatives / representatives and other stakeholders was in December 2007. The registered provider told us that the survey has been developed, is due to be sent out imminently and will be audited and the outcome of this survey will be made available to residents and other interested parties (including CSCI). All of the current residents manage their own finances, some supported by relatives. The home does not hold any money for residents but can store valuables securely for a short period of time. Records are stored securely within either the home or the registered providers home office that is on site. If the registered provider is away from the home for any period of time she informed us that her daughter (who manages The Rowans Domiciliary Care Agency) would be able to access any required records. Records were brought to the care home for the purpose of the inspection immediately when requested. The registered provider has a detailed health and safety policy and procedure. Records kept of checks required by regulation are to a good standard. For example there are suitable records for the testing of fire and moving and handling equipment. Servicing records for the equipment used in the home were provided for inspection. The electrical hard wiring is currently being tested by an electrician. Environmental risk assessments are in place for areas where there are identified hazards. It is recommended that these are reviewed on a regular basis. Care Homes for Older People Page 24 of 28 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 28 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 15 It is required that the 02/03/2009 registered person shall, after consultation with the service user and / or their representative, prepare a written plan as to how the service users needs in respect of his health and welfare are to be met. The care plans must set out in detail the action that care staff must take to ensure the residents assessed care needs are met. 2 27 18 It is required that the registered provider shall having regard to the size of the care home, the statement of purpose and the number and needs of service users ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the 16/03/2009 Care Homes for Older People Page 26 of 28 health and welfare of service users. A staffing review should be undertaken to ensure that sufficient numbers of staff are on duty at all times to meet residents needs. 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 2 It is recomemnded that the terms and conditions accurately reflect the current fee charged. It is recommended that the terms and conditions identify the room number that is to be occupied. It is recommended that information is collated and included in care planning documentation of residents interests, hobbies and leisure activities. It is recommended that the registered provider consider informing residents of the planned meal of the day and an alternative should they so choose. It is recommended that the policy and procedure regarding safeguarding adults be amended to clearly state that any suspected abuse will be reported to the Department of Adult Social Care regardless of whether the resident gives consent. It is recommended that thermostatic temperature valves are fitted to hot water outlets, particularly where there is full body immersion, to ensure that the water does not exceed 43 degrees centigrade. It is recommended that the gloves and aprons used for food preparation and care work are differentiated by colour. 2 12 3 15 4 17 5 25 6 26 Care Homes for Older People Page 27 of 28 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. 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