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Inspection on 19/11/08 for Woodlands Nursing Home

Also see our care home review for Woodlands Nursing Home for more information

This inspection was carried out on 19th November 2008.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

People told us they had the care and support they needed at the home. They said "the staff understand my needs", "they treat you well here", and, "I have always found the level of care to be very good". Relatives said that the person was "well cared for". One relative was pleased that the person`s health had improved since coming into the home and said that the person "smiles a lot". People told us that staff listened to them and acted on what they said. People said, "they`re very kind here", and, "they do listen to you and try to be helpful at all times". Relatives told us the staff always spoke to the person, and other people in the home, in a friendly and courteous way. People said, "All the staff are friendly and cheerful; there are many of them I consider my friends", "I personally find all the staff very pleasant, friendly, despite always being busy they always address any concerns I have", and, "staff very friendly and efficient nice atmosphere".

What has improved since the last inspection?

Most staff had received training about the care of people with dementia. Special `profiling` beds had been provided in some rooms to ensure the safety and comfort of people with limited mobility. A sensory garden had been provided since the last inspection. There was a raised bed with a water feature and scented plants with level paths all around for easy access. There was a greenhouse provided for people to use and the manager said that they had grown tomatoes during the summer.

What the care home could do better:

The activities programme could be further developed in consultation with people living in the home to ensure their needs and preferences were catered for. The organisation of meal times could be improved in consultation with people in the home to ensure that they are not waiting too long at the table before the meal is served. The decor of the home was `tired` and dated in places and could be improved by redecorating and refurbishing.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Woodlands Nursing Home Wardgate Way Holme Hall Chesterfield Derbyshire S40 4SL     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: Rose Moffatt     Date: 1 9 1 1 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: Woodlands Nursing Home Wardgate Way Holme Hall Chesterfield Derbyshire S40 4SL 01246231191 01246231193 jane.tinsley.woodlands@googlemail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs B Tinsley Type of registration: Number of places registered: Midland Healthcare Ltd care home 50 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: No one falling within category DE(E) to be admitted into Woodlands Nursing Home when there are already 3 persons under category DE(E) accommodated in the home No one falling within category OP to be admitted into Woodlands Nursing Home when there are already 50 persons already accommodated within the home The maximum number of persons to be accommodated at Woodlands Nursing Home is 50 To allow one service user under category PD to be accommodated for the period of their stay in Woodlands Nursing Home on a named person basis Date of last inspection Brief description of the care home The Woodlands is a purpose built two-storey home, which provides residential and nursing care for up to 50 older people. The service is also registered to accept three people who have dementia related needs. The home is situated on a housing estate Care Homes for Older People Page 4 of 28 0 Over 65 50 Brief description of the care home and shops and community facilities are close by. The home provides forty-four single and three shared rooms. Three rooms have en-suite facilities. Bedrooms are located on two floors and a lift is available to provide access to those with mobility difficulties. A range of communal areas are available including a small smoking area for service users to use. The home has a garden accessible to people who live there and a car park. The fees charged at the home range from £395 to £525 per week. There are additional costs for hairdressing, chiropody, none urgent escorts to hospital and personal newspapers. This information was provided by the manager on 19th November 2008. Information about the home, including CSCI inspection reports, is available in the main entrance area of the home, and from the manager. 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 quality rating for this service is 2 star. This means the people who use the service experience good quality outcomes. The focus of our inspection is on outcomes for people who live in the home and their views on the service provided. The inspection process looks at the providers ability to meet regulatory requirements and national minimum standards. Our inspections also focus on aspects of the service that need further development. The last key inspection was on 12th December 2007. We looked at all the information we have received, or asked for, since the last key Care Homes for Older People Page 6 of 28 inspection or annual service review. This included: the annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also has some numerical information about the service; surveys returned to us by people using the service and from other people with an interest in the service; information we have about how the service has managed any complaints; what the service has told us about things that have happened - these are called notifications and are a legal requirement; the previous key inspection and the results of any other visits we have made to the service in the last 12 months; relevant information from other organisations; and what other people have told us about the service. We carried out an unannounced inspection visit that took place over six hours on one day. The inspection visit focused on assessing compliance with requirements made at the previous inspection and assessing all the key standards. We sent out ten surveys to people living in the home and received six completed responses. We sent out ten surveys to staff employed at the home and received one completed response. There were 48 people accommodated in the home on the day of the inspection visit. People who live in the home, visitors and staff were spoken with during the visit. The manager was available and helpful throughout the inspection visit. Some people were unable to contribute directly to the inspection process because of communication difficulties, but they were observed during the visit to see how well their needs were met by staff. Case tracking was used during the inspection visit to look at the quality of care received by people living in the home. Four people were selected and the quality of the care they received was assessed by speaking to them and / or their relatives, observation, reading their records, and talking to staff. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 Care Homes for Older People Page 9 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 10 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. There was a thorough assessment process so that people were confident the home could meet their needs. Evidence: People told us they had the care and support they needed at the home. They said the staff understand my needs, they treat you well here, and, I have always found the level of care to be very good. Relatives said that the person was well cared for. One relative was pleased that the persons health had improved since coming into the home and said that the person smiles a lot. Staff told us they had training to help them meet the needs of people in the home, such as training about caring for people with dementia. Staff said they had sufficient information about people coming into the home and were kept updated about any Care Homes for Older People Page 11 of 28 Evidence: changes in needs. We looked at the care records of four people in the home. All the records had assessment information from hospital and / or social services staff prior to the admission of the person. There was also an assessment carried out by the home on admission. The AQAA said, there is always a twelve week assessment / trial period for all new service users. Standard 6 did not apply as there were no people receiving intermediate care in the home. Care Homes for Older People Page 12 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. There was a consistent, purposeful approach to care planning and delivery so that people received care and support to meet their individual needs and preferences. Evidence: People told us they had the care and support they needed, including medical support. They said, if we need a doctor the staff are very good at getting us one. A relative said the person in the home always receives attention and medical support when necessary and I am always telephoned on these occasions for my information, which I appreciate. The care records we looked at all had a care plan addressing the persons individual needs. Two of the care plans had been signed by a relative of the person to indicate their involvement and agreement. Two were not signed. All the care plans covered the assessed needs of the person and gave good details of the action required by staff to meet those needs. The care plans had all been reviewed monthly and updated if there were any changes. Care Homes for Older People Page 13 of 28 Evidence: There were assessments of the persons risk of developing pressure sores, their nutritional state and needs, and their manual handling needs and any associated risks. These assessments had all been reviewed regularly. People had appropriate risk assessments in place, such as their risk of falling, or risk of choking. There were records of the input of other health care services. People had been referred appropriately to other services, such as chiropodist, dentist, optician, speech and language therapist, dietician, and physiotherapist. Staff spoken with were knowledgeable about the individual needs and preferences of people in the home. Staff were able to give examples of how they ensured privacy and dignity for people, and were clear that personal choice should be respected. The AQAA said that care plans had been comprehensively enhanced in the last twelve months, and the home planned to introduce a new person centred approach in the next twelve months. Medication was stored securely in two rooms in the home. The floor in one of the rooms had been replaced as required at the last inspection. Medication administration records seen were correctly completed. There were records of the receipt and disposal of medication. The disposal records were signed by one member of staff. Staff who administered medication had received appropriate training. People told us that staff listened to them and acted on what they said. People told us, theyre very kind here, and, they do listen to you and try to be helpful at all times. Relatives told us the staff always spoke to the person, and other people in the home, in a friendly and courteous way. Relatives were pleased that the person was always dressed in clean, matching clothes. We observed that staff usually showed respect for peoples privacy and dignity, for instance, knocking on doors before entering, and using appropriate language and tone of voice with people. However, we did observe staff discussing personal information about a person in the home in the lounge where other people could hear what was being said. Care Homes for Older People Page 14 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. People were generally satisfied with the range of activities offered, the flexibility of routines, and the meals provided. Evidence: People told us about the activities offered at the home. They said, we play bingo and were knitting squares to make a blanket, and, we sometimes bake cakes and scones. A relative said, Great emphasis is put on arranging events for the residents days are long in a nursing home! Singers, pantomime, choirs, services by a priest, etc. Special days are celebrated with appropriate meals and drinks. As far as possible residents are encouraged to make their own contributions. Excellent work is done here. Another relative said the person was taken out on country visits...which she enjoys. Three people told us they were not always offered suitable activities. One of these people said, sometimes we have activities which I usually take part in, but I think the home has difficulties finding people to do the work, so there are periods when we dont have them. Another person said the activities offered were not stimulating enough. Activities staff were employed at the home and we saw records of activities offered. Care Homes for Older People Page 15 of 28 Evidence: There was a range of activities including games, gentle exercises, walks to the local shops, manicures, baking, making cards, visiting entertainers, and trips out. There were photographs of activities, and posters advertising forthcoming events. Since the last inspection the home had improved the garden to provide a sensory garden with a water feature and scented plants. Relatives said people had enjoyed using the garden in good weather. There was also a greenhouse and the manager said that people had used it to grow tomatoes in the summer. The AQAA identified that the home could improve by offering a wider range of activities. The AQAA said the home was hoping to use local community transport to increase the number of trips out. People told us they could generally follow the routines they wanted to. One person preferred to spend time in their own room and said staff respected this choice. People were encouraged to bring in their own possessions and photographs to personalise their bedrooms. There were regular meetings held for people living in the home and their representatives to attend. The manager said the meetings were not well attended as people preferred to come directly to her with any issues or concerns. People were encouraged to complete satisfaction questionnaires as part of the quality assurance system. There were several visitors in the home on the day of the inspection visit. They told us they could visit at any reasonable time and they were always made welcome. They said they could share a meal with the person in the home if they wanted to. People told us they usually enjoyed the meals provided in the home. They said, meals are very nice and theres always plenty, and, they do some very nice meals, good variety. A relative said the person enjoys her food. Another relative said I have had meals occasionally as a visitor and they seem good to me. There were two dining areas in the home, and some people ate in their rooms or in the lounges. The dining areas were pleasant and bright with artificial flowers on the tables. The menu for the day was displayed in the main dining area. There was no alternative to the main meal indicated on the menu, but staff said that people were given other choices if they did not want what was on the menu. The meal served during the inspection visit looked appetising and some people told us they had enjoyed it. Two people said the portions were too big for them. We observed that people who needed help with eating and drinking were given appropriate assistance by staff. Care Homes for Older People Page 16 of 28 Evidence: As at the last inspection, we observed that people were brought to sit at the dining tables approximately thirty minutes before the meal was served. People told us they did not like sitting and waiting for so long. We observed that there was a very quiet atmosphere while people were waiting for their meals, there was no background music. Care Homes for Older People Page 17 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. There were satisfactory policies in place and good staff awareness so that people were protected and their concerns effectively dealt with. Evidence: Most people we spoke with or who returned surveys to us told us they knew how to make a complaint. People said they would go the manager with any complaints and were confident that she would take appropriate action. They said, Little problems are easily sorted out by the senior staff, and, not a complainer, but whenever I find it necessary the staff are always cooperative. The complaints procedure was displayed in the home and people confirmed they had received a copy of the complaints procedure with the Service User Guide when they came to live in the home. The complaints records showed that appropriate and prompt action was taken for any complaints received. No complaints about the home had been made directly to CSCI since the last inspection. Most staff had received training about safeguarding vulnerable adults. Staff spoken with were aware of the correct procedures to follow if abuse was suspected or alleged. There were suitable policies and procedures in place. Care Homes for Older People Page 18 of 28 Care Homes for Older People Page 19 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 home was clean, suitably equipped, and generally well maintained so that people lived in a pleasant environment that met their needs and expectations. Evidence: People told us the home was usually clean and fresh. They said, Theres always someone cleaning, It has improved in cleanliness and freshness over the years that I have been here, and, No smell - everything neat and tidy. People told us the home was homely and comfortable. We looked at the communal areas of the home, some of the bedrooms, some bathrooms and toilets, the laundry, and the rooms used for storage of medication. The lounges and dining rooms were pleasant and comfortably furnished. Some of the ceiling tiles in the main dining room were cracked, loose and discoloured. As found at the last inspection, the lounges, dining rooms and corridors remained in need of redecoration. A relative said, The corridors, walls and paintwork look a little tired in places. People said they were pleased with their bedrooms. Some of the bedrooms had been redecorated since the last inspection. New furniture had been provided in one Care Homes for Older People Page 20 of 28 Evidence: bedroom. Special profiling beds had been provided in four bedrooms to ensure people could be safely and easily moved in bed and to improve their comfort. A sensory garden had been provided since the last inspection. There was a raised bed with a water feature and scented plants with level paths all around for easy access. There was also a greenhouse provided for people to use. The laundry was suitably equipped. The manager said they were about to have a new tumble dryer and a sheet press to improve the laundry facilities. Most of the staff had received training about the control of infection. Staff spoken with were aware of the procedures to follow to reduce the risk of spreading infection in the home. We observed staff using disposable aprons and gloves appropriately. Care Homes for Older People Page 21 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. There were satisfactory recruitment practices, a good staff training programme and sufficient staff available so that people were protected and their needs met by a competent staff team. Evidence: Three people who returned our surveys told us that staff were always available when needed and two said they usually were, (one did not respond to the question). Most people we spoke with said there were usually staff available when they needed them. Two people said they sometimes had to wait because staff were busy. We looked at the staff rotas. There were usually 7 care assistants on duty for the morning shift with a qualified nurse, 5 care assistants and a nurse for the afternoon shift, and 4 or 5 care assistants and a nurse for the night shift. The home used agency staff for cover when necessary. Staff told us that the staffing levels were usually sufficient to meet the needs of the people in the home. People said, All the staff are friendly and cheerful; there are many of them I consider my friends, I personally find all the staff very pleasant, friendly, despite always being busy they always address any concerns I have, and, staff very friendly and efficient nice atmosphere. Care Homes for Older People Page 22 of 28 Evidence: We looked at the records of three members of staff, all recruited since the last inspection. The records included all the required documents and information, such as a Criminal Records Bureau disclosure (CRB) and two written references. The induction programme for new staff was in line with Skills For Care standards. New staff had a short period of shadowing a more experienced member of staff. Staff training, such as manual handling and fire safety, was up to date for nearly all of the staff. The AQAA said that eight out of sixteen care staff had already achieved National Vocational Qualification (NVQ) in care at level 2 or above, and another six staff were working towards the qualification. Care Homes for Older People Page 23 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 home was well managed and there were good systems in place so that the health, safety and welfare of people was promoted and protected. Evidence: The manager had been in post for over ten years and was suitably qualified to run the home. People told us the manager was very professional, well organised, and, has everything under control. Staff were pleased that the manager had a hands on approach and that she regularly worked as the nurse in charge of a shift. The AQAA was completed by the manager and returned to us by the date required. The AQAA contained clear, relevant information supported by a wide range of evidence. The AQAA included information about what changes had been made in the home, and where they still need to improve. The data section of the AQAA was fully completed. Care Homes for Older People Page 24 of 28 Evidence: The quality assurance system included surveys given out once or twice a year to people in the home and their representatives. A report was produced of the findings of the surveys with details of action taken to address any issues raised. There were meetings for people in the home and their representatives once or twice a year. The manager said these meetings were not well attended as people preferred to come directly to her with any concerns. We observed during the inspection visit that the manager was available to talk to visiting relatives, and also to talk to relatives by telephone. The home held personal money for some people in the home. The money was kept in a safe with access limited to the administrator and manager. Satisfactory records were kept of all transactions. The AQAA showed that the maintenance and servicing of all equipment and systems in the home was up to date. We looked at accident records and these were satisfactory. The manager carried out a monthly audit of accidents to spot any trends or health and safety issues. The fire safety records were up to date and showed that all checks of equipment and systems had been carried out as required. Care Homes for Older People Page 25 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 26 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 19 23 The cracked ceiling tiles in the dining room must be replaced, and the loose ceiling tiles repaired or replaced. This will help to ensure a safe, well maintained and pleasant environment for people in the home. 28/02/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 Records of the disposal of medication should be signed by two members of staff. This would ensure a more robust system with better protection for people. There should be more consultation with people living in the home about the activities they would like. This will ensure that the range of activities offered meets the needs and preferences of all people in the home. People in the home and staff should be consulted about how mealtimes could be reorganised so that people do not have to sit and wait too long before meals. 2 12 3 15 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!