Care Home: Abelard Care Centre

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What the care home does well People that are admitted to the home have their needs assessed prior to admission which means staff will be able to plan for their individual needs and know how to care for them. We looked at the files of two members of staff working in the home and we found that they were well organised and contained evidence that all of the required recruitment checks had been made prior to employment commencing. Staff that we spoke with confirmed that these checks had been completed prior to them working in the home. When we asked people living in the home what the home did well, one person said, "It provides me with a feeling of security". What has improved since the last inspection? The registered manager now sends in the required notifications to the Commission. Safeguarding incidents are now dealt with appropriately, in line with the current local procedures for the safeguarding of vulnerable adults. Medication administration and storage procedures have been improved and are now safe. What the care home could do better: Care plans must be reviewed at least monthly in consultation with the service user and representative if appropriate. Individual life profiles could be introduced to care plans for people living in the home to make the care plans more person centred. Activities could be improved to ensure that individual preferences are responded to. Key inspection report Care homes for older people Name: Address: Abelard Care Centre 116-120 Musters Road West Bridgford Nottingham NG2 7PW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Lynda Dyer     Date: 2 0 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Abelard Care Centre 116-120 Musters Road West Bridgford Nottingham NG2 7PW 01159816069 01159816487 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Kalbro Care Uk Limited Name of registered manager (if applicable) Mrs Emelita M Hurboda Type of registration: Number of places registered: care home 36 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: 36 OP ( old age not falling into any other category ) including 5 PD aged 55 and over Service Users shall be within categry OP Date of last inspection Brief description of the care home Abelard is an adapted property situated in West Bridgford providing personal and nursing care for up to 36 older people. The accommodation is over three floors, in 30 single and three double bedrooms. All except two bedrooms are en suite. A passenger lift gives access to all floors. There is a secure, peaceful and well-maintained garden to the rear, with access via patio doors from the lounge come dining room, where service users can sit comfortably in good weather. At the front of the property is limited car parking space for staff and visitors cars. The home is close to the centre of West Bridgford (around a 15 minute walk for someone with good mobility) and there Care Homes for Older People Page 4 of 27 2 5 0 2 2 0 0 9 0 5 Over 65 36 0 Brief description of the care home residents can access a number of shops, cafes, banks, churches and public houses. The Manager told us on the day of the inspection that the fees range from £294 to £375 per week. Care Homes for Older People Page 5 of 27 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 focus of inspections undertaken by the Care Quality Commission is upon outcomes for people who live at the home and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. The last time we visited this service was February 25th 2009. We, as it appears throughout the Inspection Report refers to The Care Quality Commission. One inspector carried out an unannounced site visit to the home, which took place over a period of six hours. The Registered Manager and the administrator assisted us during the site visit to the home. Care Homes for Older People Page 6 of 27 We have introduced a new way of working with owners and managers. We ask them to fill in a questionnaire about how well their service provides for the needs of the people who live there and how they can and intend to improve their service, this is called an AQAA (Annual quality assurance assessment). We received the AQAA back from the manager in good time. The form was completed well and gave us all the information we asked for. We also sent out surveys called, have your say, to people who use the service, staff that work there and relatives. This meant we could get an idea of what people thought about the way the home was run. We had 24 completed surveys back and we have included some of the comments in this report. We have not included comments that could identify the writer as we want people to feel they can be open about the way they feel the service is run. We also reviewed all of the information we have received about the agency since we last made a visit to them and we considered this in planning the visit and deciding what areas to look at. The main method of inspection we use is called case tracking, which involved us choosing two people who use the service and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. We spoke with the manager, five members of staff, four people who use the service and two visitors to help us to form an opinion about the quality of the service being provided to people. We read documents as part of this visit and looked at the environment and facilities of the home to form an opinion about the health and safety of people who use the service. Care Homes for Older People Page 7 of 27 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 27 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 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that are admitted to the home have their needs assessed prior to admission which means staff will be able to plan for their individual needs and know how to care for them. Evidence: The manager told us in the homes Annual Quality Assurance Assessment that prior to admission each person is assessed by the manager or other suitably qualified person working in the home, to ascertain whether the home can meet their individual needs. They also told us that people are provided with information about the home including a service user guide prior to planned admission. We case tracked the most recent admission to the home and we found that a full needs assessment had been carried out prior to them moving in and that the information from this had been used to form part of the care plan for this person. Care Homes for Older People Page 10 of 27 Evidence: We spoke with a relative of a person living in the home and also received information from people living in the home via a survey. This told us that people receive information about the home and have chance to visit before they decide to live there. We spoke with staff and they told us that they received up to date information about peoples needs. The home does not offer intermediate care and so standard 6 does not apply. Care Homes for Older People Page 11 of 27 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 living in the home have up to date and relevant care plans to enable staff to deliver the appropriate individual care and people are happy with the care they receive. Medication procedures are safe. Evidence: The manager told us in the homes Annual Quality Assurance Assessment that risk assessments are maintained for pressure areas and nutrition and appropriate action is care planned and implemented. They also told us that a person centered approach to care planning is used. We looked at the care plans of two people living in the home and they contained risk assessments about areas of daily living and health care needs with information for staff on what they needed to do to manage the risks. There was also evidence of people living in the home having access to external health professionals when needed. The last time we visited this home we asked for care plans to include more person centred information about the person it was written for. The care plans we viewed at Care Homes for Older People Page 12 of 27 Evidence: this inspection showed very little evidence of being person centred. There was basic information on peoples likes/dislikes and preferences, with no life history recorded to show staff what the persons life was like before they were admitted to the home. We spoke with the nurse who is responsible for the development of the care plans and they said that they did not have any experience of person centred care planning and were waiting to attend training on this. There was no evidence that people living in the home and/or their representative, where appropriate, were being involved in the development or review of their care plan. We saw evidence that the home are currently developing new care plans and the manager told us that the new plans will be more person centred and include evidence of people being involved in their care planning. The home has started to include assessments around the Mental Capacity Act 2005 in the care plans and the manager has received training in how to apply the act. The manager told us that they will be cascading this training to the rest of the staff. This legislation is aimed at protecting peoples rights and choices. We received surveys from people living in the home and they told us that that they received the medical care and support they needed. We received surveys from the relatives of people living in the home and they told us that the service met the needs of their relative. One relative said, I can leave here knowing my relative is safe and well looked after. We saw evidence that the trained nurses are managing nursing needs such as pressure care and diabetes. We looked at the homes medication storage and administration procedures and we found that these were being managed well by the trained nurses. The nurse spoken with was knowledgeable about the medicines and aware of the requirements for the safe receipt, storage and disposal of medicines. We also observed the nurse administering prescribed medicines and saw that they were following safe procedures. People living in the home told us that staff respected their privacy and dignity and we observed this on the day of the inspection with staff knocking on peoples bedroom doors before entering. Care Homes for Older People Page 13 of 27 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 that live in the home are given the opportunity to participate in recreational activities and maintain social contacts. People receive a nutritious diet and individual needs are met. Evidence: The manager told us in the homes Annual Quality Assurance Assessment that Abelard provides an excellent range of activities and the coordinator is very skilled at encouraging people to participate at whatever level they are able to. The also told us that the home offers three meals per day with choices written in the menu, which is displayed. When we asked people living in the home what the home did well two people said, Cooking and another said, Games and food. The home has just recruited a new activities organiser, who works four days a week in the home. They told us that they played games, did quizzes, bingo, arts and crafts and reading with people living in the home. There was no evidence that people living in the home had their activities tailored around their individual likes and dislikes. Care Homes for Older People Page 14 of 27 Evidence: The manager told us that they were going to be working with the activities organiser to introduce new activities that were tailored around peoples likes and dislikes. Although the home has people living there who have developed dementia, the activities organiser has not got any experience or any training to help her to understand the social needs of people who have dementia or any other cognitive impairment. The home organises trips out for people living in the home, which includes a boat trip and a trip to see the Christmas lights. We received surveys back from relatives and they told us that the home kept them up to date with important issues that affected their relative and helped their relative to keep in touch. We saw relatives visiting the home during the day and they told us that they could visit when they wished and they were always made welcome by the staff. We observed lunch being served to people living in the home and we saw that there was a choice of meal offered to people and the lunch was well presented and looked nutritious. One person living in the home told us, I like the meals, there is always something different to try. Care Homes for Older People Page 15 of 27 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 using the service know how to raise concerns and complaints and staff know how to safeguard people living in the home from abuse. Evidence: The manager told us in the homes Annual Quality Assurance Assessment that the complaints procedure has been updated and displayed in the main entrance and that it is also supplied on admission and available in the service user guide. They also told us that safeguarding adults procedures are in place to be able to respond to allegations and that staff have undergone safeguarding adults training with the manager attending training on making referrals. We received completed surveys back from people living in the home and they told us that they knew who to speak with if they were not happy and how to make a complaint. Relatives of people living in the home told us that they knew how to make a complaint and staff told us that they knew what to do if someone raised a concern about the home. Since the last time we visited the home an anonymous caller has raised a concern with the Commission regarding the home. Their concern was that there had been a smell of urine present in the main lounge of the home for some months. We looked at Care Homes for Older People Page 16 of 27 Evidence: this as part of the inspection and we found that there was an unpleasant odour in the lounge areas. The manager took immediate action to address this issue and has since written to us to tell us that the odour has been eradicated. The home has an up to date complaints procedure on display in the main entrance and in the lounge. We also saw evidence that the complaints procedures are discussed with people living in the home during meetings. The home has the current local safeguarding procedures in place and we viewed three staff files and they contained evidence that staff are trained in how to safeguard vulnerable adults from abuse. Staff that we spoke with gave a good account of what procedures they needed to follow if they witnessed or suspected abuse and how they would report this to external authorities. The manager has attended training in making safeguarding referrals and has made one safeguarding referral since we last visited. This was dealt with appropriately and the correct procedures followed. When we asked people living in the home what the home did well, one person said, It provides me with a feeling of security. Care Homes for Older People Page 17 of 27 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. Infection control and cleaning procedures may not always be effective. Evidence: The manager told us in the homes Annual Quality Assurance Assessment that the home has undergone improvements since the last inspection such as a new large television in the lounge, new washing machines and tumble driers, all bedrooms and toilets fitted with disposable hand towel dispenser as well as soap dispenser and four bedrooms upgraded. They also told us that all staff had been given training in infection control procedures. We received completed surveys from people living in the home and they all said that the home is always or usually fresh and clean. We viewed the communal areas of the home and we observed that two of the communal toilets had an odour of urine and the floors did not appear clean. The manager took immediate action on this issue following the inspection and has written to us to tell us that the odour has now been eradicated. We viewed three bedrooms of people living in the home and although one was personalised with the persons own possessions, two appeared quite bare and contained very little evidence that anyone was living there. We addressed this with the Care Homes for Older People Page 18 of 27 Evidence: manager and she told us that the relatives of these people had not brought in any personal possessions. We saw evidence that staff are trained in infection control procedures and we saw evidence of them following some of these procedures when delivering personal care. Care Homes for Older People Page 19 of 27 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. The home operates a safe staff recruitment process and staff are trained to safely support people living there. Evidence: The manager told us in the homes Annual Quality Assurance Assessment that any potential employee will undergo the required checks and that an induction period will go on for 26 weeks with a weekly review with the manager or the nurse in charge. They also told us that the manager has assessed the training needs within the home and put in place a training plan which meets the needs of the people living there and supports the staff development. We looked at the files of two members of staff working in the home and we found that they were well organised and contained evidence that all of the required recruitment checks had been made prior to employment commencing. Staff that we spoke with confirmed that these checks had been completed prior to them working in the home. The files also contained evidence that the manager was supporting staff to access training in areas of health and safety and staff spoken with confirmed this. Staff told us that the induction they had received had covered what they needed to know about the role when they started working in the home. Care Homes for Older People Page 20 of 27 Evidence: We spoke with a trained nurse on duty and we found that they had a good level of knowledge of their job role and the needs of the people living in the home. We observed that the nurse has a great deal of areas of responsibility including, developing and reviewing care plans, ordering, administration and storage of medication, directing the care staff in their daily duties and meeting the nursing needs of people living in the home. We spoke with people living in the home, visiting the home and working in the home and they told us that staff were very stretched in carrying out their duties. We received surveys back from people living in the home and when we asked if the staff listened and acted on what they said, three people said that they usually did and two said they sometimes did. We received surveys back from staff working in the home and two members of staff told us in the surveys that there was never enough staff on duty to meet the needs of the people living there. When we asked what the home could do better, one member of staff said, Communication could be improved a little. Sometimes there could be a language problem when passing on messages or instructions. Another member of staff said, The home is not doing very well because of short staffing. There are not enough staff as some of the residents are not mobile. We spoke with the manager about the incident in the lounge and about staffing levels and she told us that she is currently recruiting more staff. She told us that there are usually four care staff on duty with a trained nurse during the day. The manager provided us with an assessment that showed how the staffing levels were decided to ensure individual needs of the people living in the home were met. Care Homes for Older People Page 21 of 27 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. There is evidence that the home is run in the best interests of the people that live there although staffing levels may be having an impact on the quality of service delivered. Evidence: The Manager has been working in the home for almost six years, was appointed as the manager in 2007 and maintains continuous development by attending regular training that is relevant to her role. We made some requirements following our last visit to the home and we found that the manager had met these requirements at this inspection. We also made some recommendations for good practice following the last inspection. The manager has met some of these. We observed that the manager, as with the rest of the staff, was very busy on the day of the inspection. Care Homes for Older People Page 22 of 27 Evidence: We saw that the home carries out an annual quality survey in order to measure the quality of the service being provided and we saw the results of this survey on display. Some people had not rated the home very highly on involving them in their care planning and the activities provided by the home. There was no evidence that an action plan had been produced to address any areas on concern identified in the quality assurance survey. There is a monthly meeting held in the home for the people living there and an action plan is produced as a result of issues raised in the meetings. Staff that we spoke with felt that they worked hard to try and meet the needs of the people living there and one member of staff said, Personal care and happiness are things that Abelard does very well. We are well supported by our manager and senior staff We looked at the personal spending money of two people living in the home, which are managed by the administrator. We found that although receipts showed the required signature, the personal allowance sheet did not have a signature and witness signature to verify transactions. We looked at the audit trail and there was evidence that the money was being managed appropriately. We received information since the last time we visited the home that told us that some health and safety checks in the home, such as the safe water temperature testing had not been carried out regularly for a short period of time. We asked the manager to tell us what she was doing to address this and she produced an appropriate action plan. We viewed the records of these checks at this inspection and found that the required safety checks were now being carried out regularly and records kept of this. We have asked the manager to provide the Commission with a detailed risk assessment of how they have determined the amount of staff that needs to be on duty at any time. This will tell us how the home intends to ensure the needs of the people living in the home are being met. Care Homes for Older People Page 23 of 27 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 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Care plans must be reviewed 01/04/2010 at least monthly in consultation with the service user and representative if appropriate. This will ensure people receive care in the way they wish. 2 38 13 Records must be 01/03/2010 consistantly maintained that show that regular checks are being made on water temperatures and fire testing. To ensure the environment is safe. 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 7 Continue to develop the new care plans to include individual life profiles. This will make the care plans more Care Homes for Older People Page 25 of 27 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 person centred 2 3 7 12 Staff should receive training in the Mental Capacity Act 2005 and the Deprivation of Libery safeguards. An activity profile should be produced for each person with their likes and dislikes around social activies documented. This should be made available to the activity organiser. The activity organiser should have training in how to support people with dementia in relation to activities. Cleaning processes should be looked at and ongoing action taken to ensure the home is kept clean and free from odours. Ongoing assessments of the staffing levels should be maintained to ensure there are adequate staff to meet the changing needs of the people living in the home. Following the annual quality assurance survey, an action plan should be produced to show what the home will do to address issues raised in the surveys. There should be a signature and a further witness signature in place on individuals personal allowance records for all transactions carried out. 4 5 12 26 6 27 7 33 8 35 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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!