Inspection on 16/09/08 for Westlands Care Home

This inspection was carried out on 16th September 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Westlands Care Home 04/12/09

Westlands Care Home 15/09/09

Westlands Care Home 26/09/07

Westlands Care Home 07/06/06

Westlands Care Home 06/12/05

Westlands Care Home 03/06/05

Westlands Care Home 10/02/05

Westlands Care Home 12/07/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 06/12/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Westlands Care Home 48 Oxford Street Wellingborough Northants NN8 4JH     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: Louise Bushell     Date: 1 6 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Westlands Care Home 48 Oxford Street Wellingborough Northants NN8 4JH 01933274430 01933275882 westlands@regalcarehomes.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Tracy D`Arvigigny Type of registration: Number of places registered: Regal Care Homes Ltd care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Westlands is a care home providing personal care and accommodation for 28 older people over the age of 65 years. The home is currently registered to provide care for up to 28 older people with up to 22 older people with dementia. The home is owned by Regal Care Homes Ltd. The Home is situated close to Wellingborough town centre and local amenities, shops and the local park. There is a small courtyard area outside the Home and a garden with seats. Peoples rooms are situated on all three floors of the building. A passenger lift provides access to part of the home. There are twenty single rooms with four having en-suite facilities and four shared rooms. A copy of the most recent inspection report is also made available. 0 0 Over 65 22 6 Care Homes for Older People Page 4 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: 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: Standards identified as key standards and highlighted throughout the report were inspected. In addition to the key standards a number of other standards were inspected to assess the services ability as part of case tracking people that use the service from the admission stage to placement stage. The key standards are those considered by the Commission to have a particular impact on outcomes for people who use the service. Inspection of the standards was achieved through review of existing evidence, the Annual Quality Assurance Assessment, pre inspection planning, an unannounced inspection visit to the service, any information sent to us from the service and other professionals, collating information received in person from relatives and the people who use the service, and drawing together all of the evidence gathered. Care Homes for Older People Page 5 of 28 The service has received one formal written complaint since the last inspection and there have been two referrals to the Sustaining Adults Team. The pre inspection planning was carried out over the period of a day and involved reviewing the service history, which details all contact and correspondence with the home and previous inspection reports. The last key inspection occurred on the 26th September 2007. This unannounced inspection visit was carried out by one inspector and covered the morning and afternoon of a weekday. The inspection was carried out by case tracking, which involves selecting samples of residents records and tracking their care and experiences. Observations of the homes routines and care provided were made and views on the care provided were sought from people who use the service, visitors and staff. The management of medication was checked through reviewing prescribed medication for a sample of people as part of case tracking A sample of staff files were reviewed to check the adequacy of the recruitment procedures in protecting people who use the service. Communal areas and a sample of bedrooms were viewed and observations were made of peoples general well being, daily routines and interactions between staff and people who use the service. Verbal feedback was given to the Area Manager and the Manager of the service at the end of the inspection. The fee range for the service is dependant on need. The range is between 365.00 Pounds and 600.00 Pounds per week. Excluded from the fee is personal items, toiletries and news papers. 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 Care Homes for Older People Page 7 of 28 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. The service obtains information about peoples needs before admission to ensure the service has the capacity to provide individual care as per the persons needs. Evidence: Written information is provided in the form of a statement of purpose and a service user guide. These documents provide prospective residents and their families with clear information about the facilities, staff, and the care provided. The statement of purpose was available in the entrance of the building. The manager confirmed that they are looking at ways to ensure that this information remains in the foyer and available to all. There are two versions of the service user guide. One of these is a simplified version, which includes pictorial prompts to aid understanding. The information is individual to Westlands and helps to give some idea about the routines of the home. There is also Care Homes for Older People Page 10 of 28 Evidence: information about what is included in the fee and what is not. This helps people who use the service make informed choices about their care. Review of the records for one newly admitted person identified that prior to admission an assessment of needs is carried out. The assessment is carried out by a senior person with the appropriate skills to conduct the assessment. The assessment included gathering, where applicable information in the form of an assessment from social services. The assessment was detailed and covered numerous areas to ensure that the needs of the person could be met by the service.The assessment details personal preferences and choices for the individual, including religious needs and choices, food preferences and care support preferences. The assessment conducted is then used as a tool to complete the initial care plan for the person who uses the service. The care plan detailed the specific support needs of the individual ensuring that the care provided is person centred. Feedback from one person who uses the service determined that they had enough information made available to them and that a contract is in place. 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 and the management of medicines is suitable to ensure that the specific care and support needs of the people who use the service are supported. Evidence: Three care files were assessed. The care plans seen were based on detailed assessments of need. Plans covered peoples personal, physical, health, recreational, social and emotional needs. Assessments of need and corresponding care plans had been reviewed on a regular basis and updated as needs had changed. Documents listing peoples preferences for their daily lifestyle had been completed. These listed preferred times for getting up and going to bed, preferred meals, beverages, hairdressing and food choices. Observation of the daily lifestyle and conversations with staff showed that personnel were familiar with peoples needs and how these were to be met. It was noted that the service provides a number of shared bedrooms. Evidence was not in the care plan that the people who were sharing a room had consented to this. Care Homes for Older People Page 12 of 28 Evidence: People who contributed to the inspection commented that the service was a nice place to be and that the staff look after us well and are kind and caring. Indirect observations of staff practise was respectful and dignifying to the person at all times. There was evidence to show that people had been supported to access health care appointments for routine treatments such as chiropody, optical tests and had been referred to their doctors and other specialists as need be. It was noted that in one care plan that the chiropodists would attend every six weeks but the last entry visit made was for February 2008. This was brought to the attention of the manager. Risk assessments had been completed for the risk of people who use the service in relation to falls, bedsides and manual handling and had been reviewed. Any change in need was recorded on the care plan. Medicines were only administered by members of the team who had received training in safe practise. Medication systems at the service were well maintained, with audits being completed by the service manager routinely. Medicines were being stored in a very small room with hot water pipes located in the room. The temperature of the room was high and exceeded the storage requirements of the medicines. The manager stated that she would be relocating the medicines cupboard to another larger room. Temperatures where not being taken of the room. The service has compiled a comprehensive information folder containing all of the information including side effects of all medicines held at the service. Controlled drugs were randomly inspected and good systems were seen to be in place to ensure that the management of medicines is effective. Appropriate records had been maintained for the receipt of medicines and those returned to the pharmacist. It was also noted that the medicine cupboard was not securely bolted and appeared to be unsteady in its structure. The Area Manager stated that there is another medicines cupboard that the service could access to ensure further security. No poor outcomes for the people who use the service were identified. The service did not have The Royal Pharmaceutical Guidelines on site. 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 use the service Evidence: A high percentage of the people in living in the service had some form of cognitive impairment / short term memory loss. The arrangements for the day to day lifestyles in the service therefore were required to be extremely flexible. It was noted that daily routines varied according to need. Meals were served at set times but these could be varied for individuals who wished to eat at other times. Some people were also observed eating meals whilst seated in comfortable relaxing chairs. The manager also stated that the people who use the service can if they choose eat their meals in their rooms but they re encouraged to socialise in the main areas. Similarly, getting up times and bedtimes were individual. The building does not enable all people who use the service to have access to all parts of the service and thus there are some restrictions for the health and safety of the individuals. People can not access the garden area freely and would require support. This is due to the back door leading onto the car park and laundry area of the service with a side path leading around to the garden. During the inspection the main gates to the car park and laundry area were not closed. This was brought to the attention of the manager. A number of Care Homes for Older People Page 14 of 28 Evidence: people who use the service also shared a bedroom. Consent by the individual and or representative was not evidenced. Arrangements for activities for stimulation and recreation had taken account of abilities. Activities included organised events such as sing a longs, dominoes, arts and crafts, quizzes and talk sessions. The service has a new computer in the foyer of the building which people who use the service can access as they wish. There was old time music playing during the inspection and people were singing along. The computer also provides a visual slide show of photos which engages people. There is an activities board on display however this did not contain any planned activities. The manager stated that she had not added the forthcoming planned activities for that month. The service did not have an activities coordinator in post and was actively recruiting. One person who uses the service commented that I liked it when we had an activities lady here, it would be good to have some one else soon. Another person commented that I enjoy the company of others, we have a good laugh here and a chat. In addition to this one person described their daily lifestyle as, I can do as I like. A small group of people who use the service were in one of the lounges chatting with each other, drinking tea and reading the newspapers available. A relative was on site and commented that the staff always are kind and care well for my mother, I come here every day and am offered drinks, I like to chat with other people who live here. There is a large garden to the rear of the service and recent works have been commenced to aid people who use the service to have access safely. A new gazebo area is also provided with a raised seating area. Currently safe access for all people who use the service is not in place as the pathway is not fully completed. The manager stated that this work is outstanding and would soon be completed. People described the catering service as good, I get enough to eat and I always have a choice. Records indicated that nutritional needs had been assessed. Special diets were catered for as required. The menus seen showed a nutritious choice throughout the day. Lunch was observed and appeared to be appetising. The meal took place at an unhurried pace and was an enjoyable social experience. The carer serving the meal were aware of peoples needs and appetite, so that those who preferred smaller portions were not put off by larger servings of food. A large menu board was on display at the service but was blank and therefore did not allow people to refer to this as they wished. 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 service has a robust policy and procedure for complaints and concerns, this ensures that the people who use the service are supported to complain and are protected. Evidence: People who use the service confirmed that they are happy. One person commented that I would always talk to a member of staff if I had any complaints to make. In addition to this another person using the service commented that the staff always ask what you would like, there is nothing to complain about. The Annual Quality Assurance Assessment (AQAA) states that the service has a complaints box in place and that all complaints are taken seriously. The service also states that staff have been made aware of the Mental Capacity Act and Independent Mental Capacity Advocates. The AQAA determines that one complaint has been received in the last twelve months and this was managed within the services policy time frame. Records of the complaint were held on site. There have been two referrals to the Sustaining Adults Team and investigations have taken place as required. Evidence of these were recorded at the service. Records of complaints were maintained with correspondence held on file. The service Care Homes for Older People Page 16 of 28 Evidence: did not have a current log of the actions taken and the progress to date for the complaints. 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. The home presents as clean and comfortable however several areas currently compromise the health and safety of the individuals using the service. Evidence: The service provides a homely, comfortable feel for individuals to use as their own home. The service was clean throughout. The AQAA determines that the building has undergone some changes, this includes a new garden seating area, a new shower room, and replacement windows to parts of the building. Following an Environmental Health Inspection requirements were made to refit the kitchen with stainless steal units throughout. The manager confirmed that this will be completed. The AQAA also refers to the service having a new cooker and hood as well as replacement of all carpets in the communal areas within the next twelve months. Some of the paint work in the service looks worn and tired and the work on the shower remains incomplete. A small number of bedrooms were observed and contained furniture to meet the needs of the individual. Some rooms were very personalised and others were not. The manager stated that this is their choice. One bedroom was observed and had a very strong mal odour. This was discussed with the manager who stated that action would Care Homes for Older People Page 18 of 28 Evidence: be taken. A number of the bedrooms at the service are shared accommodation and no evidence was observed to determine that the individuals had made a positive choice to share with each other. A number of fire doors were observed to be propped open using items or wedges and not those considered to be safe by the Fire Authority. This was brought to the attention of the manager and action was taken immediately. One person who uses the service commented that I like it here. The garden access pathway had not been completed and did not enable people to freely access the area. Risk assessments were in place for the environment but the garden was not sighted on the assessment. The laundry system at the service is outside the main building in a separate area. Suitable equipment was observed to ensure laundry facilities complied with infection control requirements. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Recruitment procedures ensure that all individuals are kept safe, however some of the staff did not have training in safeguarding and dementia care to ensure that the support people were receiving was suitable to their individual needs. Evidence: The AQAA determines that the service provides compulsory training and National Vocational Qualifications (NVQ). Information provided by the service shows that a total of 15 staff have completed their NVQ with a further two staff currently working towards this qualification out of a total staff team of twenty one. The service is in the process of introducing a new induction standards programme to ensure all staff are suitably inducted to the role. This will ensure that there is suitable evidence in place to determine that staff have received an induction suitable to needs. Over the last twelve months the service has identified improvements through audits which are being completed during the Regulation twenty six visits, an increase in staff trained to NVQ level and greater staff involvement in their own development. A training matrix is on place and shows that staff have recently received an update in Fire Safety, Manual Handling and Infection Control. The training matrix shows that there is a need for staff to receive training in Safeguarding of Adults, and Dementia. Care Homes for Older People Page 20 of 28 Evidence: Four recruitment files were checked to ensure they contained all information required to ensure the safety of the people who use the service. One file did not contain a second reference, however the manager stated that this staff member had transferred from another service. All other files contained the required information to ensure that suitable recruitment measures and checks are in place for the safe keeping of the people who use the service. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a manager who is qualified to run the service, however shortfalls in the management of health and safety do not ensure that the people who use the service are kept safe at all times. Evidence: The manager is qualified and competent to complete her role and has been registered previously with the Commission. During the inspection a number of staff were spoken with. The ethos within the service appeared relaxed and all staff appeared content within their role. One staff member confirmed that there are staff meetings and supervisions on a regular basis. Records of supervision were viewed and were being completed within the requirements. Staff meeting records were viewed and further discussed with the manager. The manager stated that there are three - four staff meetings per year. The service provides effective quality assurance and quality monitoring systems which Care Homes for Older People Page 22 of 28 Evidence: is based on seeking the views of the people who use the service, relatives / representatives and other relevant professional. The service had on display the recent findings from the last quality assurance process. This determined that most people who live at the service are happy. Discussions occurred with the manager regarding systems that are in place to feedback to the individuals the findings and the actions that will be taken in response of the quality assures process. The manager stated that this is something that she is working towards. People who use the service are supported and protected by the services policy and procedures for the management of finances. The AQAA determines that there are suitable and secure facilities for the safe keeping of money and valuables. Individuals rights and best interests are safeguarded by the services record keeping polices and procedures. It was observed that all records were being stored confidentially. A number of records were observed in relation to the management of Health and safety at the service. It was found that a number of Heath and Safety checks had not been completed. The weekly fire alarm test had not been completed for the month of August until the inspection was conducted. It was also found that the water temperature checks had not been completed for the month of August. The services fire risk assessment was observed. This had not been reviewed and did not contain all of the information required. The fire risk assessment did not contain person specific needs in the event of a fire. This was discussed with the Area Manager and the Manager of the service. The fire safety audit was last completed in 2006. Care Homes for Older People Page 23 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 24 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 14 15 Consultation must occur with the person using the service and or their Representative in relation to their consent to share a bedroom. To ensure that the person using the service is supported to exercise choice and control over their lives. 01/11/2008 2 19 16 The service must be kept free of offensive odours. To ensure that the people who use the service live in a comfortable environment. 29/11/2008 3 19 23 Suitable equipment must be in place to keep doors open that complies with the Fire Authority. To ensure that people who use the service are safe at all times. 01/12/2008 4 21 23 The ground floor walk in shower must be completed and fully functioning 21/11/2008 Care Homes for Older People Page 25 of 28 To ensure that the people who use the service can access the shower and make positives choices over facilities to use. 5 23 15 Consultation must occur with the persons using the service and or their Representative in relation to their consent to share a bedroom To ensure that the person using the service is supported to exercise choice and control over their lives. 6 27 18 Staff must receive training in Safeguarding of Adults and Dementia. To ensure that the people who use the service are in safe hands at all times and that the staff are suitably qualified to provide the care and support required. 7 38 13 Fire Safety Risk assessments 29/11/2008 must be reviewed. To ensure that the health, safety and wellbeing of the people who use the service is maintained at all times. 8 38 13 Health and Safety checks must occur for the water tempertaures and weekly fire alarm testing. To ensure that the health, safety and wellbeing of the people who use the service is maintained at all times. 29/11/2008 18/12/2008 01/11/2008 Care Homes for Older People Page 26 of 28 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 medicine cupboard should be replaced to ensure an up to date secure trolley is used for the safe keeping of medicines. The medicine room should be located to area that is more suitable to ensure safe keeping and stotage at all times. A record of the temperature of the room where the medicines are stored should be maintained to ensure that medicines are stored at the desired temperatures, not exceeding the guidelines from the manufacturer. The service should ensure that the revised and up to date Royal pharmaceutical Guidelines are available for all staff to refer to as required. The activities board should display the activities available in order to provide current information for the people using the service. An activities coordinator should be employed to ensure that suitable stimulation and activities are provided for the people using the service. Any restriction imposed on a person using the service should be detailed clearly with appropriate assessments conducted to assess the reasons for the restriction. Menus should be displayed in order to encourage, support and enable people with dementia to use visual recognition and make active choices over the foods they consume. A log should be maintained for all complaints so the date of receipt, response, action and closure is clear. The kitchen should be replaced as stipulated by the Environmental Health officer. 2 3 9 9 4 9 5 12 6 12 7 14 8 15 9 10 16 19 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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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!