Inspection on 21/01/09 for Troutstream Hall

This inspection was carried out on 21st 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Troutstream Hall 26/03/07

Troutstream Hall 25/01/06

Troutstream Hall 15/07/05

Troutstream Hall 20/09/04

Troutstream Hall 28/06/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Troutstream Hall Chorleywood Road Rickmansworth Hertfordshire WD3 4EX     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: Jeffrey Orange     Date: 2 1 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: Troutstream Hall Chorleywood Road Rickmansworth Hertfordshire WD3 4EX 01923772703 01923770486 karensteffe@troutstreamhall.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Karen Steffe Type of registration: Number of places registered: Troutstream Hall Trust care home 21 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: This home is registered for 21 people with old age. Date of last inspection Brief description of the care home Troutstream Hall is a residential home for 21 people over 65 years of age. It is owned and run by Troutstream Hall Trust, a Christian Charitable Trust. The building is a large detached house that has been converted into a care home. It is situated in a quiet residential area near to the village of Rickmansworth. The M25 and M1 motorways are a few minutes drive away. There is a driveway with parking spaces to the side. The spacious entrance hall leads to the dining room and kitchen. The administrative office, staff room and the laundry room are all on the ground floor. The bedrooms, of varying sizes, are on all three floors. Each bedroom has a hand basin with toilet and bathroom facilities in close proximity. Two rooms have been converted to ensuite bedrooms. The communal rooms include two well proportioned lounges. There is an attractive front and back garden, surrounded by mature trees and bushes. The patio areas have Care Homes for Older People Page 4 of 28 Over 65 21 0 Brief description of the care home garden furniture and potted plants. The home has a lift to all the floors. All the rooms and gardens are accessible to wheelchairs. The managers office and an equipped training room is on the top floor and there is a large room on the ground floor where medication and records are stored. The weekly fees range from £531 to £600 according to the size of the room and the facilities in the room. (Correct at January 2009). Fees are subject to review where the dependency level of people living in the home is assessed as having changed significantly. Full details are set out in the service user guide available in the home. Charges for additional services such as hairdressing and chiropody are priced individually and set out in the individual service contract. Copies of the latest inspection report from the Commission for Social Care Inspection (CSCI) are available in the home. 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: The last Key Inspection on this service was completed on the 30th March 2007, we also carried out an Annual Service Review on the 7th January 2008. This inspection was carried out by one inspector, where this report refers to we it recognises that it is written on behalf of the CSCI. The inspection started early in the morning and this enabled the routine of the home to be observed as those people who live in the home were getting ready for the day ahead. During the inspection we spoke to people who live in the home and to members of the care, ancillary and administrative staff. We also had very useful discussions with the registered manager and one of the homes trustees and were able to look at some key records, including those for staff recruitment, care plans and medication administration. We also sent surveys to both staff and people living in the home and where these have already been Care Homes for Older People Page 6 of 28 received we have drawn on them in writing this report. Any surveys received after this report is written will be recorded and assessed and used to determine the future regulation of the home. We have also made use of the information provided to us by the home in their Annual Quality Assurance or AQAA. The AQAA is a self assessment document that assesses the care outcomes for people living in Troutstream Hall, it also includes some useful statistical information, for example on complaints and staff training. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are only admitted to Troutstream Hall after an assessment process has determined their care needs can be appropriately met. The assessment process could however be improved by including more detail about the persons life history and interests so that the initial care plan can reflect these more fully in the way that care is provided to meet their assessed needs. People considering Troutstream Hall as their home are provided with a good level of detailed information about fees and facilities and are encouraged to visit the home to help them make a well-informed decision. Evidence: When we looked at the information provided for people who may be considering Troutstream Hall as a home for themselves or someone for whom they are responsible, we found that it was reasonably comprehensive and clear and included a very good level of detail about fees including those additional charges that apply where Care Homes for Older People Page 10 of 28 Evidence: people living in the home subsequently require a higher level of care because of a significant change in their assessed needs. This means that people can make a well informed decision about a prospective move into Troutstream Hall based on up to date and detailed information. When we spoke to people who live in Troutstream Hall or to their relatives, they told us that they had been able to visit the home before any decision was made about admission and that they had been provided with the information and advice that they needed during that decision making process. When we looked at assessments of the care needs completed for people being considered for admission to Troutstream Hall we found that they were reasonably detailed so as to ensure that only those people whose care needs can be met are admitted. We found however that the detail of individual circumstances, interests and life history could be fuller in order to provide a better basis for drawing up a genuinely person centred, individual care plan. 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. People who live in Troutstream Hall can be confident that they will receive effective health and personal care support, that they will be treated with respect and that systems and records for medication are efficient and accurate. Evidence: When people living in Troutstream Hall replied to our surveys they all agreed that they either always or usually received the medical support they needed. When we spoke to people living in Troutstream Hall they told us that they were well cared for. They are very caring and attentive and I can see the doctor when I need to were some of the comments received. When we looked at care plans of people who live in Troutstream Hall we found that they were adequately clear and set out the basic health and care needs of the people concerned. They included records of the involvement of people living in the home with GPs and other health care services and this supports the comments of people living in the home shared with us. Care Homes for Older People Page 12 of 28 Evidence: Throughout this inspection, wherever we saw care staff helping people who live in the home or when they were talking or referring to them, they always did so with appropriate respect and courtesy. When we looked at medication records we found a generally good standard of medication administration and recording, with no gaps in records identified. We observed one instance where a person had been left their medication to take and although the care worker had not actually seen the medication taken, the administration record would show that it had been. As in some cases people might conceal or hoard medication instead of taking it, it is important that those responsible for administering medication monitor it being taken, in a sensitive and discreet way. As we were told that the temperature of the medication storage room is not routinely recorded, it was not possible to tell if it had ever exceeded the appropriate level. Temperature records are however kept for the medication fridges and these were seen. When we looked at the records for controlled drugs, we found that these were satisfactory. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in Troutstream Hall can be reasonably confident that they will be provided with regular opportunities to undertake a variety of activities and they can be assured that they will receive a high standard of catering. They can be confident that they will be able to maintain contact with their family, friends and the community and that they will be consulted in a meaningful way about the activities and routines of daily life. Evidence: When we spoke to or received survey comments from people living in Troutstream Hall, we found a mixed view of the frequency of organised activities in the home. One person told us that we did oil painting last week but that we dont have activities every day. Some surveys said there were always activities arranged by the home for them to take part in and others said only sometimes or usually. On the day of our visit there were no obvious activities in the morning until a brief session just before lunch. In the afternoon there was a musical entertainer in the larger lounge and there were notices in the home about a sing along Sound of Music due to take place soon. In their AQAA, the home inform us that they; hope to be able to offer more arts and Care Homes for Older People Page 14 of 28 Evidence: crafts other than just games and have identified that they need to employ additional activities staff. As the care plans we saw did not include any really meaningful or detailed information about the personal history, interests, hobbies or social care needs of people living in the home, beyond comments such as born in London, has three daughters and encourage to join in activities it is hard to see how staff responsible for providing activities can tailor these to the individual. It is understood that activities are discussed in service user meetings and figure in the homes own quality assurance process. It would enhance the care experience of people living in the home if this information could be analysed and used to inform the development of future regular activities provided. This has been raised with the manager and was also a requirement made following the previous inspection. It is understood that this work, which we were told has already begun, would now be given a higher priority. The provision of activities was discussed with the manager and the name of an organisation that can provide support and resources for care homes in providing activities was given, so that the trustees of the home could perhaps consider following this up in order to support the manager and activities staff. When we spoke to people living in the home about the standard of meals and food, we were impressed by the overwhelmingly positive views expressed. I go to some good restaurants, but they are not as good as we enjoy here was one comment, and many additional favourable comments were received. When we spoke to the homes chef he demonstrated a commitment to meeting not only the nutritional needs of people living in the home, but to provide a varied and attractive choice of menu throughout the year, making use of seasonal produce wherever possible and experimenting with new dishes in order to provide new experiences for people living in the home. The chef made it clear to us that he spoke to individuals about the choice of food and sought to meet peoples preferences and tastes as far as he was able to. When we spoke to people living in the home, they told us that they are able to have visitors at almost any time and that they can access the community subject to the availability of transport. 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. People living in Troutstream Hall can be assured that they are able to make a complaint if they need to and that if they do, it Will be dealt with appropriately without any adverse repercussions for them. They can also be confident that they will be protected from any form of abuse and that were it seen or suspected action would be taken to address it. Evidence: The homes complaints policy and procedure is included in the material provided to all people living in the home and is also clearly displayed in the home. When we spoke to people living in the home or received survey responses from them they told us that they knew how to make a complaint if they needed to. The homes AQAA tells us that there were no complaints received during the past twelve months. When we spoke to staff and looked at staff training records we found that they were familiar with the concept of safeguarding vulnerable adults from abuse and that they were confident they knew what to do if any form of abuse was seen or suspected. When we spoke to the homes administrator and manager they were able to confirm that they would take appropriate action to protect the financial interests of any person living in the home if it appeared they were being deprived of the financial resources to which they were entitled. All of the above should provide all those who live in Troutstream Hall and those responsible for them with confidence that they or their relatives are being protected Care Homes for Older People Page 16 of 28 Evidence: from any form of abuse and that if it were seen or suspected robust and appropriate action would be taken. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living and working in Troutstream Hall can be assured that the environment is safe and comfortable and is reasonably well maintained, although some areas of the home would benefit from decoration and the replacement or refurbishment of furniture in order to maintain the standard of the accommodation and communal areas for people who live or work there. Evidence: When we walked around the home and with their permission went into the bedrooms of people living in the home, we found that the standard of cleanliness was good. This is confirmed in survey responses where everyone who responded said that the home was always fresh and clean. When we arrived in the home, early in the morning, we noted that people were freely accessing the kitchen without protective clothing and some care staff appeared to be moving from care work to the kitchen without always changing their protective aprons, which could compromise the health of people living in the home. This was discussed with the manager during the inspection who undertook to take steps to remind people working in the home of good food hygiene practice. Those bedrooms seen were personalised by the individuals concerned and included pictures, ornaments and photographs reflecting their interests, personal tastes and the Care Homes for Older People Page 18 of 28 Evidence: things that are important to them. When we walked round the home, we noted that comments made in the last report in March 2007 about the need in some parts of the home for redecoration and refurbishment are still true. As indicated then, whilst the home undoubtedly has a homely feel and appearance, in places this homely feel is compromised by the standard of decor and furnishing. When we spoke to the manager and one of the trustees of the home we found that they were well aware of the need for action and had already commissioned a survey of the fabric in order to draw up a priority list of refurbishment and decoration, to possibly include for example rewiring the home. This awareness is positive and suggests that eventually people living in Troutstream Hall will benefit from the renewed focus its fabric. However, as discussed with the manager and trustee, routine maintenance, redecoration and replacement of furniture on a rolling basis must continue alongside any major capital work in order to maintain the fabric of the home at a satisfactory level and promote and maintain the well-being of people living and working there. Care Homes for Older People Page 19 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. People living in Troutstream Hall can be assured that they are protected by the recruitment policies and procedures followed by the home and that there are sufficient numbers of care staff with the training and skills required to meet their care needs. Evidence: When people who live in the home spoke to us or sent in replies to our survey they told us that there were usually or always staff available when they need them and that they always receive the care they need. The care is very good and They are very caring were some of the very positive comments we received during our visit. When we observed the interaction between care staff and people living in the home, when we heard them talk about people living in the home and when we saw them assisting people, for example at meal times, the standard of care was never less than good. When we spoke to care staff they told us that they are supported by the home through training and supervision. We have regular training courses to keep us updated. When we looked at records of training, spoke to staff and from the information included in the homes AQAA, we found that there is a very high level of staff with either NVQ2 or 3, which demonstrates the commitment of the home to enrol staff on recognised courses for the development of good care practice among its staff team. When we looked at training records it was sometimes hard to see when updates of training for Care Homes for Older People Page 20 of 28 Evidence: each member of staff would be due and this was discussed with the manager to see if an overall training matrix could be devised to keep track of this. In the event that staff do not have appropriate level practical training and updates in, for example moving and handling, they should not take part in care that requires this, in order to protect the people receiving care from suffering accidental harm through poor practice. When we looked at staff recruitment records we found that all the checks required to protect people who live in the home from the recruitment of unsuitable care staff were in place and that recruitment policies and procedures were followed robustly. Care Homes for Older People Page 21 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. Troutstream Hall is well managed and has an effective administration support system in place to ensure that people who live in the home receive a high level of care within a safe environment provided by well trained and motivated staff. Evidence: When we spoke to people living in the home, care staff and people associated with the home in other ways, they were all positive about the way that it is managed and administered. When we spoke to one of the trustees of the home we found that there is a renewed focus on taking the home forward, building on the good standard achieved in the past and developing both the environment and the business model to deliver improved outcomes for the people who live in the home or work there. When we spoke to the manager we found that additional support had been provide, for example by the appointment of an administrator in order to release some the managers time to better concentrate on management of care in the home. There are still some areas of the homes activity, for example staff training records and the Care Homes for Older People Page 22 of 28 Evidence: provision of activities where further sharing of day to day responsibility and increased resources could be advantageous to the manager, staff and indirectly people who live in the home. Although when we spoke to the manager we found that she was very experienced and up to date with current good practice, we did discuss the possible additional benefit to her and to the home from having the opportunity to share information, resources, good practice and experiences with other registered care services through membership, for example of a local or national association of care providers. This is of course entirely a matter for the manager and the trustees to determine as it has a financial implication in terms of membership fees. When we checked the records and system for accounting for monies held on behalf of people living in the home we found that it was essentially sound and robust and should protect their financial interests. When we spoke to one of the new trustees for the home we were encouraged by the positive and realistic view they had for the homes development and for the support shown to the manager in offering a more formal supervision process to her in her demanding role. This should benefit not only the manager but indirectly all staff and most importantly people living in the home. When we looked at the records for staff supervision and talked to care staff, it appears that whilst supervision is taking place regularly, it has not yet reached the required frequency. This was discussed with the manager, who indicated this would be addressed. When we spoke to care staff they told us they felt very well supported by the manager and that she had an open door policy, which, as one member of staff remarked kept the staff fit as the managers office is on the top floor of the home. When we looked at risk assessments in place we found that they are regularly reviewed and are in general well recorded. In seeking to protect the health, safety and well being of people living in the home, it is important that all staff abide by the homes policies and procedures, for example in terms of medication administration and food hygiene. When we discussed specific instances observed during this inspection with the manager she assured us that good practice would be reinforced through staff supervision and training as necessary. The homes AQAA tells us that there are service users meetings held regularly, that self-assessment forms are sent out twice a year and the chef told us how he regularly ensures he hears from people living in the home about any changes they might want in respect of menus and catering generally. This demonstrates that people living in the Care Homes for Older People Page 23 of 28 Evidence: home are asked for their input in decision making, that they are listened to and their views taken into account appropriately. 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 3 14 Any assessment carried out 27/02/2009 before a person is admitted to the home should include adequate information about the persons social interests, hobbies, religious, cultural needs and life history to enable a care plan to be drawn up that can take these into account. This information is needed in order to draw up a person centred initial care plan that takes account of the individual life history, preferences and interests of the person concerned. 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 9 The temperature of the medication storage area should be taken and recorded daily to ensure that it remains within the relevant range for the medication stored, in line with the manufacturers instructions. This will ensure that Care Homes for Older People Page 26 of 28 medication is not adversely affected by being stored above the appropriate temperature. 2 9 Care staff administering medication should be reminded of the need to observe medication being taken, before they record it has been. This ensures that people living in the home are assisted to take the medication prescribed for them to maintain their health and well-being. The manager and trustees of the home should assess the resources currently available for meaningful activities in the home and should consider if additional resources are required including those available from specialist organisations who provide support and advice about activities within a care setting.(Recognising that these are membership organisations with a cost implication for the home). Any developments or proposals should be based upon active consultation with people living in the home and the views expressed. Action should be taken, by means of supervision, training and signage to ensure that people maintain good food hygiene practice when entering the homes kitchen and thus reduce any risks to the health and well-being of people living in the home. All staff should have an individual training and development assessment and profile and an easy to access record should be kept to enable the person with responsibility for staff training to be able to readily see when updates or additional training for each member of staff are due. 3 12 4 26 5 30 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. Care Homes for Older People Page 28 of 28 - 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!