Care Home: Aigburth

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What the care home does well We saw staff at Aigburth being helpful and cheerful to people who live there and treated them with friendliness and care. `Staff are wonderful and take care of us`, one resident said. There is a varied activities programme to provide interest and stimulation for residents. A number of residents said that there were no rules so they could choose to live their lives the way they wished. Residents are involved in choosing which staff are recruited. People are supported to maintain relationships with family and friends. A relative said, `I can come at any time and I am welcomed by staff`. The menu is varied, and the food is liked by the majority of residents we spoke to. The home is clean and tidy, and good standards of hygiene are maintained. `I like that it is never smelly here`,one resident said. Members of staff have received training in different areas of care practice to help them improve their skills. Management are very supportive of staff so that they can produce a high standard of care to residents. There is a system in place to analyse accidents so they can be prevented in future. What has improved since the last inspection? There was evidence in the home`s records that medical services were contacted if a resident had a potentially serious injury. No residents complained that the heating system meant that they were too hot in their bedrooms. What the care home could do better: All aspects of residents lives should be included in the Care Plan, including preferred living routines, action needed to achieve goals in making residents lives better, and how frequently to assist residents with their continence. Assessments need to include the dates of previous health checks so they can be prompted in a timely manner. Food needs to be provided that meets residents expressed wishes. The Provider needs to ensure staff know all the Agencies to refer to if they suspect abuse has taken place and the procedure changed so that complainants go to the Lead Agency responsible. Heating needs to be sufficient for residents comfort. It is recommended that facilities are signed to help residents with dementia etc. Proper minimum staffing levels for care and domestic tasks must always be in place to fully meet residents needs. Staff references regarding previous care experience should be taken up.Staff training on residents conditions and challenging behavior needs to be extended and more staff achieving the NVQ standard to ensure staff skills in all relevant care issues. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Aigburth 21 Manor Road Oadby Leicester Leicestershire LE2 2LL     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: Keith Charlton     Date: 3 0 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Aigburth 21 Manor Road Oadby Leicester Leicestershire LE2 2LL 01162715086 01162714288 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Methodist Homes for the Aged care home 32 Number of places (if applicable): Under 65 Over 65 8 8 32 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: 0 0 0 Service user numbers. No person to be admitted to the home in categories MD(E) or DE(E) when 8 persons in total of these categories/combined categories are already accommodated within the home. Date of last inspection Brief description of the care home The date of the last inspection was on 27/6/08. Aigburth care home cares for thirty-two older people in a purpose built property. It is set in a quiet residential area close to a variety of amenities in Oadby town centre. The premises consist of three floors. Residents occupy the ground and first floor and staff members and volunteers occupy the third floor. Access to all three floors is by use of the passenger lift or stairs. There are a variety of aids and adaptations throughout the home to enable residents to Care Homes for Older People Page 4 of 28 Brief description of the care home be as independent as possible. The home has thirty single bedrooms and one double bedroom all with en-suite facilities. There are gardens accessible to residents at the front and rear of the property. The weekly fees for living at the home range from #459 to #536 per week, dependent on individuals needs. The Deputy Manager supplied this information on the day of the inspection. Residents are supplied with a Service user Guide and the Statement of Purpose, describing the services and organisation of the home, and the last Inspection Report are available on request, thereby giving people information as to whether they wish to live in the home. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection included a visit to the service. We (the CQC) visited Aigburth on the 30th April 2009. The Deputy Manager and staff in the home helped us during the visit. The main method of inspection we used was case tracking. This means looking at the care given to people in different ways. We did this by, - talking to the people who live in the home and relatives, - talking to staff and management, - watching how people are given support, Care Homes for Older People Page 6 of 28 - looking at records. We spoke to eight residents, one relative and a GP at Aigburth during our visit, who told us that staff were very caring and treated residents with respect. One resident said, You could not get friendlier staff and they go out of their way to help you. None of the residents spoken with had any complaints about the attitude of staff. We spoke with three members of staff during our visit to the home who told us about working in the home. They all were enthusiastic about working with the residents and thought there was a good staff team and effective management to ensure residents had a good quality of life. One staff member said: We are encouraged to make sure residents are happy and comfortable. I think they are and its a good home. We checked all the standards that the Care Quality Commission has decided are key standards during this inspection. The information below is based only on what we checked in this inspection. We have kept details about individual people out of the report to make sure we respected their confidences. What the care home does well: What has improved since the last inspection? What they could do better: All aspects of residents lives should be included in the Care Plan, including preferred living routines, action needed to achieve goals in making residents lives better, and how frequently to assist residents with their continence. Assessments need to include the dates of previous health checks so they can be prompted in a timely manner. Food needs to be provided that meets residents expressed wishes. The Provider needs to ensure staff know all the Agencies to refer to if they suspect abuse has taken place and the procedure changed so that complainants go to the Lead Agency responsible. Heating needs to be sufficient for residents comfort. It is recommended that facilities are signed to help residents with dementia etc. Proper minimum staffing levels for care and domestic tasks must always be in place to fully meet residents needs. Staff references regarding previous care experience should be taken up. Care Homes for Older People Page 8 of 28 Staff training on residents conditions and challenging behavior needs to be extended and more staff achieving the NVQ standard to ensure staff skills in all relevant care issues. 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.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 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. People living at Aigburth have had their needs properly assessed before moving into the home. Evidence: Residents said they had been provided with sufficient written information prior to admission to make up their minds about the home. I remember being supplied with information about the arrangements in the home so it gave me a good idea as to what to expect, one resident said. We case tracked a person living in the home who had moved into Aigburth in the past. We checked that her family had received information to help with the choice of home, and she said she thought her relative had received enough information. We also checked that this person had her needs properly assessed prior to moving in, to ensure that the staff at the home could meet their needs and we found that the assessment system was detailed regarding residents needs though past health checks Care Homes for Older People Page 11 of 28 Evidence: had not been included, which is useful to prompt these checks and improve the health and daily quality of life for people. 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. People at Aigburth receive good health and social care practice. Evidence: Residents and a relatives said that staff provided friendly and sensitive personal care: Staff cannot be faulted. They go out of their way to make sure you are happy, and My mother is really well cared for. Staff know how to talk to her and encourage her, were some of the many very positive comments that were made. Residents spoken with could recall having a care plan and said that staff went through it with them to check the care supplied to them was right. We checked the care plans of three people living at the home who were case tracked. Plans showed detail regarding the support required by staff to ensure the physical health of people living at the home, and there was information to inform staff of the residents personal history, though no information of preferred daily living routines of residents to ensure their social and emotional well being is fully supported. Some Plans showed residents needs had been identified, e.g. promote independence, but then no action plan for staff as Care Homes for Older People Page 13 of 28 Evidence: to how to do this. Continence information was recorded though some assessments had not been completed. It was recommended that a referral to a specialist nurse is done to work out the individual needs of a resident, especially those with dementia, who usually cannot ask staff for assistance when they need to go, so staff can prompt before they needed to go to the toilet. There were gaps on health check recording insofar as appointments for sight and teeth had not been recorded so that residents could have waited too long before having these appointments. A relative confirmed that staff contacted her if there were any health issues regarding her mother. Staff said they were asked by management to read Care Plans and there was evidence that staff signed to state they had done this, so that they can fully understand and act on residents needs. Accident records were checked and medical services were contacted when a resident had a potentially serious injury.There was also a monthly audit in place to review why accidents happened so that preventative steps could be put in place, thus protecting residents health. A GP confirmed that the service had improved in health matters in the last year, though there was a problem with a minority of staff not always passing on important information. The Assistant Manager said she as aware of this and it was being followed up by management at present. We checked the medication records, and found that there was good recording of the administration of the medicines in the home, with no gaps. There was good information on medication sheets regarding allergies, as needed medication etc so that residents health is protected. Staff and management said that only senior staff issued medication and that they had to pass the approved in house and pharmacy training before they could do this. Controlled medicines storage was in a secured cabinet. The Assistant Manager said they were currently waiting for an up to date storage cabinet which conformed to the latest legal requirements. We spent time watching staff interaction with people living at Aigburth. We saw staff being friendly and caring to people throughout the day with residents and relatives confirming that staff respected the dignity and privacy by knocking on bedroom doors, supplying preferred same sex care staff for personal care etc. Staff were seen to assist residents in various ways - giving choices for breakfast, encouraging residents in activities etc. 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. There are are great deal of opportunities for residents to have a relaxed lifestyle of their choosing. Evidence: Residents said that they were satisfied with the current activities. A resident said There are loads of activities. J (the Activities Organiser) is always very enthusiastic and encourages everyone to get involved and enjoy themselves. We spoke to the full time Activites Organiser and we saw that there is a current list of activities. We saw the Activities Organiser organising May Day poles for May Day and residents said that Easter activities were provided to celebrate Easter. Residents said they had lots of games and quizzes, there were trips out, a shop every Friday, weekly bible reading classes, they watched TV, we witnessed age appropriate music being played in the lounge and residents said staff took them out to the garden in good weather. The Activities Organiser stated that there is a regular five times weekly activities - this was displayed on a noticeboard with pictures of the activities. We saw that the home produces a regular newsletter to keep people up to date with Care Homes for Older People Page 15 of 28 Evidence: relevant news about the home and that residents had their stories published in it. The relations between staff and residents were observed to be relaxed. Residents said there were no rules though one resident said he thought he had to get up for breakfast. The Assistant Manager said this was not the case and residents would be reminded they could get up when they chose. There was evidence that residents are involved in the recruitment of staff, which shows respect for residents views on the running of the home. The home supports residents with dementia with staff training on this having taken place and there was displayed information on dining tables for reference to what food is being served that day etc. Visitors are welcomed at Aigburth and we were informed by a visiting relative that she could come at any reasonable time and she was always greeted in a friendly way by staff and offered a drink, meal etc. Residents largely said they enjoyed the food: The food is good and we get a choice, one resident said. There were a small number of comments that the food had become blander since the full time cook was off. Whilst the chicken did taste bland the Assistant Manager said that seasoning was not used in the food due to some residents health conditions and that this could be added by residents at the table. It is recommended that medical advice is sought regarding whether any seasoning can be added to the food, with residents views also sought. Some residents said they would like the choice of having a cooked breakfast every day. The Assistant Manager said that this was available and residents would be reminded they could ask for this. We recommend that a cook take part in residents/relatives meetings to answer queries regarding the food. Lunch was a choice of two hot dinners and a resident said she was offered an alternative to these choices as well. Food was well presented and looked appetising, and was followed by a choice of dessert. Two vegetables were served with a good variety of different fruit in the fresh fruit salad for dessert - this choice showed a commitment to healthy eating. Food records showed a good variety of traditional food served. There were displayed menus on tables to provide information to residents about what food they were getting. A residents Care Plan stated that this person ate only vegetarian and fish dishes. However menus did not show this choice each day. Care Homes for Older People Page 16 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. Residents are listened to and protected from abuse. Evidence: Residents said if they had a complaint they were confident that Liz, the Manager, would sort it out. The relative said she never had cause to complain but thought the staff or the management would quickly get the issue resolved. A resident said, I am not afraid of speaking about anything that bothers me and I know it would be properly looked into. We saw that there had been one minor complaint since the last inspection in the complaints book, which was resolved by management, though another complaint regarding missing clothes was found in staff meeting minutes, which needed to be entered into the complaints book to show how it was resolved. The Complaints procedure needs to be altered so that complainants can refer their complaint to the Lead Agency, the Social Services Department, not the CQC. We talked to staff to find out how much they knew about protecting people in the home from abuse. Records showed they had received training about safeguarding adults from abuse, and they knew the in house procedure, and Agencies to whistle blow to if the in house procedure failed, except one staff spoken to. Care Homes for Older People Page 17 of 28 Evidence: We looked at the staff recruitment records to see whether all the proper checks had been made on staff before they started employment at Aigburth and legal checks were in place to help management reach the judgement that people were safe to start employment. Care Homes for Older People Page 18 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. People living at Aigburth live in a homely and well maintained environment. Evidence: All residents spoken to said they liked their bedrooms: Domestic staff keep my bedroom spotless and I can have my things the way I like, one resident said. Some residents said they were cold in the main lounge at times as doors were not shut so there were draughts, and that night staff sometimes forgot to boost the heating just before residents came down in the morning. The Assistant Manager said this would be followed up. We saw people at Aigburth living in a clean and well maintained environment. The furnishings in communal areas are homely, and people said that they were encouraged to bring their personal possessions into their bedrooms. The service needs to review signs around the home to improve the environment to further help residents with dementia, e.g. colour coding toilet doors, pictures of residents favourite scenes on bedroom doors etc to make facilities clearer, and orientate residents to go to their own bedrooms etc. Care Homes for Older People Page 19 of 28 Evidence: Records show that the home is well maintained, and good measures are in place to keep the home hygienic. There were no odours in general apart from a low level odour in one bedroom. There are radiator covers fitted throughout to ensure that residents are protected from burn risks. Residents said they loved sitting or walking in the large gardens and appreciated it when the garden was kept in good order. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are met by a competent staff group though staffing levels need to be reviewed and increased as needed and staff training extended to ensure residents needs are always met. Evidence: There were some comments from residents there were not enough staff to meet their needs: There are a lot of people here that need a lot of care and that means that sometimes I have to wait for up to half an hour to get assistance. The home is good and staff are wonderful but this is disappointing, one resident said. The staff rota showed three care staff plus a member of management on duty throughout the day/evening with two awake staff members on at night, plus another care staff member on duty in the morning period. As the staff have to deal with a number of high dependancy residents who need two care staff to help one resident this means that care staffing for the remaining residents can be low. We spoke with the Asstant Manager about the staffing and asked her to ask the Manager to review this situation. As regarding domestic staff they are shown in the staff rota six days a week though only for the morning period. This needs to be reviewed as it means that care staff have to deal with accidents/spillages in the afternoon/evening when care staffing levels are not of a high level, and cover is not seven days a week. Care Homes for Older People Page 21 of 28 Evidence: A staff member said that although she had only been working at the home for a short time she had been encouraged by management to do further training and was looking forward to doing a NVQ 3 course in the future and had already completed a number of training courses and a thorough induction. From information obtained from the Asstant Manager we saw that there are not 50 of staff with NVQ training, needed to ensure a good range of knowledge to meet residents needs. We found that staff have been on a number of training events to help update their practice on areas such as Moving and Handling, Fire Safety, Infection Control etc though some issues regarding residents health conditions were missing from the Training Matrix we saw - e.g. Dementia, Sight and Hearing Impairment, Stroke, Mental Health conditions, Diabetes etc. We asked that these topics be added to the training programme. Staff records showed that proper checks had been carried out to protect residents from unsuitable staff though references from staffs previous care experience had not always been taken up, which would have shown their capability to carry out care tasks etc. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are management systems in place to protect the health and safety of residents. Evidence: Elizabeth Grognet is the Registered Manager of the home, who has completed the NVQ 4 Award in management skills. Residents were very positive about Elizabeth and her management skills: Liz is very efficient and runs everything smoothly, one resident said. Satisfaction questionnaires were sent around the home last year, and the results were seen to be generally very positive, though they did not contain an analysis of the results to see if improvements in the service were needed. Written records regarding finances for residents are properly in place, and monies were checked for two residents and totals were found to be correct. Care Homes for Older People Page 23 of 28 Evidence: There was evidence of residents meetings discussing relevant issues - activities, food etc, which showed their involvement in the running of the home. Safe working practices were observed as we went around the home - e.g. e.g. instruction for staff to wash hands in the staff wc to prevent infection, proper transfer of residents from wheelchair to easy chair etc. Staff informed us that they were able to tell management of the problems they were facing and there were regular meetings and supervision to support them, which we saw as being detailed and well kept. There are proper Health and Safety systems in place in the home. We saw risk assessments for safe working practices and COSHH assessments to keep residents and staff safe. Proper fire records were in place with regular fire drills. Staff were asked about the fire drill procedure and they all knew what to do. There was a Health and Safety folder with Risk Assessments completed in a systematic preventative way. We tested the hot water and found it met the National Standard so that residents are not scalded. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 3 The admission sheet needs to include when health checks have occurred so that there is prompt referral if needed for dental, optical etc checks, so that steps are taken to improve residents health. All aspects of residents lives should be included in the Care Plan, including what steps to take if action is needed to improve residents quality of life, preferred living routines and how frequently to assist residents with their continence. Food needs to be suitable for all residents at all times. All complaints need to be detailed in complaints records to show what the complaint was and show it was dealt with and the procedure needs to be altered so that complainants can refer their complaint to the Lead Agency, the Social Services Department, not the CQC. The Provider needs to ensure all staff know the Agencies to refer to if they suspect abuse has taken place to fully safeguard people living at the home from poor and abusive practice. Heating needs to be monitored to ensure residents are comfortable. Page 26 of 28 2 7 3 4 15 16 5 18 6 19 Care Homes for Older People The Provider is recommended to undertake an environmental audit of the home to determine how the service can best meet the needs of people with dementia living at Aigburth. 7 33 The Quality Assurance survey needs to include an action plan as to what needs to be in place to improve residents quality of life. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or 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) 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. 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