Care Home: Ashville Care Home

What the care home does well People told us the staff are kind and welcoming and during the visit we saw that staff were kind and respectful in their interactions with people. Visitors told us the home is friendly and welcoming and said they are happy with the care given to their relatives. People are given information about the service and are encouraged to visit before making a decision about moving in. This helps to make sure the home is the right one for them. The home has a complaints procedure and people told us they know how to make a complaint if they need to. All the required checks are done before new staff start work and this helps to make sure people are protected and only cared for by people that are suitable to work with vulnerable adults. What has improved since the last inspection? There were 6 requirements following the last inspection and the home has taken action to address all of them. Some have been carried forward as recommendations because there is still more to be done to make sure people experience good quality outcomes. However, the level of risk to people has been reduced. Improvements have been made to the way people`s nutritional needs are identified and met. We saw that the home has been consulting other professional for advice on how to improve people`s nutrition and they are monitoring people`s weight more often. They have made changes to the way meals are served and this has helped to make meal times a more social occasion for people. The home has provided the correct storage facilities for medicines classified as controlled drugs and this means these medicines are now stored safely. Improvements have been made to the care plans which means that people`s needs are more accurately recorded and there is clear information for staff on what they should do to meet those needs. This reduces the risk of people`s needs being overlooked. Improvements have been made to the way people`s social care needs are identified and met. The home has asked relatives to provide life history information so that social care plans can be tailored to people`s individual interests. Improvements have been made to the outside areas, one area has been cleaned up so that it provides a safe and pleasant place for people to sit out. Work is still in progress on dealing with the uneven surface in the other outside but it has been tidied and does not looked as neglected. Improvements have been made inside the home. For example, two bathrooms have been converted to shower rooms to make them easier for people to use.One of the owners/directors is now based at the home to provide support to the acting manager and staff to make sure improvements are maintained and developed. What the care home could do better: The home should continue to develop the care plans to make sure they are kept up to date and provide clear information about people`s needs and the action staff need to take to meet these needs. The way people`s dietary intake is recorded needs further improvement to make sure there is a clear record of what people are eating and when. This will help to make sure that people`s nutritional needs are met. The work that has started on improving the way people`s social care needs are addressed should continue. In particular the development of life histories which will make it easier for to develop social care plans that reflect people`s interests and abilities. Staff must be given the training they need to keep up to date with safe working practices and to understand the needs of people using the service. This will help to make sure that people`s needs are properly identified and met. Requirements and recommendations made during this inspection are listed at the end of this report. Key inspection report Care homes for older people Name: Address: Ashville Care Home 58 Sandmoor Garth Idle Bradford West Yorkshire BD10 8PN     The quality rating for this care home is:   one star adequate 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: Mary Bentley     Date: 1 0 0 5 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 26 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Ashville Care Home 58 Sandmoor Garth Idle Bradford West Yorkshire BD10 8PN 01274613442 01274618273 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ashville Care Home Limited Name of registered manager (if applicable) Type of registration: Number of places registered: care home 29 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users who can be accommodated is: 29 The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following category: Dementia - Code DE Date of last inspection Brief description of the care home Ashville Care Home is in Idle, an area about three miles from Bradford City Centre. It is registered to provide care for up to twenty-nine older people. The home is just off the main road and is well served by public transport. There is car parking to the front of the property. There is level access to the main door of the home and a stair lift is fitted to allow people with mobility problems to reach the bedrooms Care Homes for Older People Page 4 of 26 Over 65 0 29 2 0 0 1 2 0 1 0 Brief description of the care home located on the first floor of the building. The home does not have a passenger lift. All the communal areas are on the ground floor of the home. There are three lounge areas and one main dining room. The home had 3 double rooms but one of these has been changed to single occupancy. Many of the bedrooms have en-suite facilities which consist of a toilet and wash basin. There are three communal bathrooms and toilets, which are within reach of bedrooms and lounges. In January 2010 the fees ranged from 397.00 and 463.00 pounds per week. Additional charges are made for hairdressing, private chiropody treatment, reflexology, taxi fares and magazines if purchased by individuals and not provided by the home. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection of this service was carried out on 20 January 2010. At that time we found a number of shortfalls which meant the people were being put at risk. Following the visit the provider sent us an improvement plan telling us what they would do to improve quality outcomes for people using the service. The purpose of this inspection was to check if these improvements were being made and to look at how peoples needs are being met. One inspector made an unannounced visit to the home. During the visit we looked at various records including peoples care plans and we observed staff as they carried out their duties. We spoke to people living in the home, visitors, staff and management and looked around the home. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been Care Homes for Older People Page 6 of 26 deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated it is likely enforcement action will be taken. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? There were 6 requirements following the last inspection and the home has taken action to address all of them. Some have been carried forward as recommendations because there is still more to be done to make sure people experience good quality outcomes. However, the level of risk to people has been reduced. Improvements have been made to the way peoples nutritional needs are identified and met. We saw that the home has been consulting other professional for advice on how to improve peoples nutrition and they are monitoring peoples weight more often. They have made changes to the way meals are served and this has helped to make meal times a more social occasion for people. The home has provided the correct storage facilities for medicines classified as controlled drugs and this means these medicines are now stored safely. Improvements have been made to the care plans which means that peoples needs are more accurately recorded and there is clear information for staff on what they should do to meet those needs. This reduces the risk of peoples needs being overlooked. Improvements have been made to the way peoples social care needs are identified and met. The home has asked relatives to provide life history information so that social care plans can be tailored to peoples individual interests. Improvements have been made to the outside areas, one area has been cleaned up so that it provides a safe and pleasant place for people to sit out. Work is still in progress on dealing with the uneven surface in the other outside but it has been tidied and does not looked as neglected. Improvements have been made inside the home. For example, two bathrooms have been converted to shower rooms to make them easier for people to use. Care Homes for Older People Page 8 of 26 One of the owners/directors is now based at the home to provide support to the acting manager and staff to make sure improvements are maintained and developed. 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 9 of 26 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 26 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 are given information about the service and their needs are assessed before they move in. Evidence: The home has had one admission since January 2010. This was an emergency admission, an initial assessment of the persons needs was done in consultation with their social worker before the person moved in. When we visited in January 2010 people told us they had been given enough information about the home before they moved in. Care Homes for Older People Page 11 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements have been made in the way peoples needs are identified and met and in the way peoples needs are recorded. This needs to continue to make sure peoples needs are not overlooked. Evidence: When we inspected in January 2010 we found shortfalls in the care records which meant that peoples needs were not always being identified and met. We were particularly concerned that some peoples nutritional needs were not being met. We told the home what they must do to make improvements. During this visit we saw that improvements have been made. The home has organised training on care planning and someone is visiting the home every week to work with staff on developing the care plans. We looked at two peoples care records in detail. We saw that peoples needs had been re assessed and this information was used to develop new care plans. In most cases the plans had clear information about how to meet peoples needs, for example one persons care plan about reducing the risk of pressure sores had information about the pressure relieving equipment in use and Care Homes for Older People Page 12 of 26 Evidence: about helping the person to change their position every 3 hours. The home has taken action to improve the way peoples nutritional needs are identified and met. We saw that they have asked for advice and support from other professionals for example from peoples GPs. There are charts in place to record peoples dietary intake, however, the charts we looked at were not detailed enough to give a clear picture of what people are eating and when. The owner had identified this and on the day we visited was introducing a new chart to make it easier to record peoples dietary intake. We discussed the importance of checking the charts to identify areas of concern, for example if people are having long gaps between meals. We also found that some of the nutritional assessments had not been completed properly and talked to the owner about arranging more training for staff. The home has carried out oral assessments for everyone to identify if they have any problems with their teeth or dentures which may be affecting their ability to eat. Where necessary referrals have been made to the NHS dental services. In January we were concerned that the home did not have the correct storage facilities for medicines classified as controlled drugs. This has now been dealt with and these medicines are stored safely. People looked well cared for and visitors told us they are happy with the way their relatives are cared for. We saw that staff were kind and respectful in their interactions with people. Visitors told us the staff are always kind and friendly. Care Homes for Older People Page 13 of 26 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. Some improvements have been made however more needs to be done to make sure people are given the support they need to follow their personal interests and make the most of their abilities. Evidence: During the visit we spent some time observing staff as they carried out their duties. We saw that staff treated people with respect, for example when helping someone to move with a hoist they talked to her all the time about what they were doing. In one of the lounges staff were playing ball games with people during the morning. In another lounge where there were 5 people we saw that staff missed a lot of opportunities to engage people in conversation. For example, they came into the room to get something and left again without speaking to anyone. During the afternoon staff worked with a group of people in the dining room making sandwiches. People appeared to be enjoying this, making and eating the sandwiches. In one persons records we saw that there was information about their past life and their interests. Having this information available helps staff to talk to people. The home is in the process of getting more information about peoples past lives and where people are not able to provide this information themselves relatives have been Care Homes for Older People Page 14 of 26 Evidence: asked if they can provide it. Visitors told us they are always made welcome and we saw evidence of this during our visit. The home is making changes to the conservatory to provide a place where visitors can help themselves to tea and coffee. The home told us they have employed another cook and this will free up some time for the current cook to do activities with people in the afternoon. They have also identified a member of care staff who will be responsible for doing activities in the morning from the end of May. Since January the home has engaged the services of a reflexologist. One visitor told us they thought this was a good way of making sure people have some one to one time and said they feel it is beneficial to their relative. Since the inspection in January changes have been made to the dining arrangements and meals are now served in two rooms. The food is served from a hot trolley and this means people can see and smell the food which can help to stimulate peoples appetites. Photographs of food have been put on the walls to help people associate the dining areas with food. They are planning more changes which include having a breakfast bar where a variety of food will be available for people to choose. We observed the meal service at lunch time, the tables were set properly before people sat down and the meal service was well organised. People were shown the different meals to help them choose what they wanted and staff helped people discreetly where necessary. Drinks were served with the meal and pureed food was available for people who needed it. The cook told us that she is working on a new menu which will run for a trial period of two weeks to see if people like it. She confirmed that staff have access to the kitchen at all times and snacks such as sandwiches, cakes, biscuits and flapjacks are always available. However, we did not see any snacks or finger food around for people to help themselves to and this was discussed. Care Homes for Older People Page 15 of 26 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 are suitable systems in place to make sure that complaints are taken seriously and acted on and to make sure people are protected. Evidence: When we visited in January 2010 the home told us they had not had any complaints in the last 12 months and they have not had any since then. No complaints have been to us. Information about the complaints procedure is available in the home and was sent to everyone using the service in December 2009. There is a suggestions/comments box in the entrance which people can use if they prefer. Staff have received safeguarding training (the protection of vulnerable adults) and are aware of how to report any concerns they might have about peoples welfare. Care Homes for Older People Page 16 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and improvements have been made, however work needs to continue to make sure the home is suitably equipped and maintained to meet the needs of the people living there. Evidence: When we visited in January 2010 we were concerned that there was no safe outside area for people to use. There is a fairly large enclosed area at the back of the home but the surface is uneven because of tree roots. During the visit in January we saw that this area was neglected and untidy, overgrown with weeds and littered with discarded cigarette butts. During this visit we saw that improvements have been made and the area was clean. The tree roots are still causing a problem but the owner told us they are getting quotes to have the area resurfaced and garden furniture was delivered while we were in the home. There is another small outside area which people could use, in January we found this in a state of neglect but it has since been cleaned up and is now available for people to use. When we looked around we saw that the home was clean and people had personal belongings in their rooms. Some people have photographs on their doors to help them identify their bedrooms. In many bedrooms the call bells were not accessible to people, either because the Care Homes for Older People Page 17 of 26 Evidence: cords were not attached or they were located too far away from the beds. There were no risk assessments to show that people had been assessed as not being able to use the call bells or to show that alternative measures had been put in place to make sure people are checked at regular intervals if they are unable to use the call bell. The owner told us she had already identified this as an area that needed to be addressed. Two new showers have been fitted and this has made washing facilities more accessible to people. Staff told us people like the showers. There was no bath thermometer in the main bathroom meaning that staff cannot check the temperature of the water before people get into the bath. This could put people at risk of scalding. Many of the bedrooms have been redecorated and new carpets have been fitted. When we looked around we saw that some of the bedding was in a poor condition. The owner told us that new bedding had been provided, however, it appears some of the old bedding had not been removed and was still being used. This was discussed. When we visited in January we were concerned about the conditions in the laundry. The ventilation has been improved since then. When we looked around we saw that peoples clothing was properly laundered and put away neatly in their rooms. Care Homes for Older People Page 18 of 26 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. There are generally enough staff to meet peoples needs. Staff need more training to make sure they have the right skills and knowledge to meet peoples needs. Evidence: There are usually 4 care staff on duty in the morning, 3 in the evening and 2 overnight. The acting manager works from 08:00 to 17:00 Monday to Friday and is not usually counted in the care staff numbers. The home also employs separate staff for housekeeping and cooking. People did not raise any concerns about the availability of staff and during the visit we saw staff going about their work in a calm and organised way. Feedback from staff about training varied, some said they get plenty of training but others said they had not done any training for a while. Some had completed training on the care of people with dementia and others said they were booked on this. The owner told us that staff had been signed up for training on nutrition but staff we spoke to said they had filled in the forms but not heard anything since. The owner said she would look into this as it had been organised by one of the other directors who has now left the company. When we visited in January this year we looked at two staff files and they showed that Care Homes for Older People Page 19 of 26 Evidence: all the required checks are completed before new staff start work. The home has not had any new staff since then. The home is in the process of recruiting a new cook but is waiting for the CRB (Criminal Records Bureau) check to be returned before he can start work. Care Homes for Older People Page 20 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management team are clearly committed to continuing to make improvements to make sure people experience good quality outcomes in all areas of the service. Evidence: The home has an acting manager who has been in post since January 2010. She is aware that she is required to apply for registration with the Commission. One of the owners/directors has been based in the home since January 2010 to make sure the acting manager is getting the support she needs. The owner is also overseeing the implementation of the improvement plan which the home prepared for us following the inspection in January 2010. The home sends quality assurance questionnaires to people every year to give them the opportunity to share their views of the service. They have also started to having meetings with the relatives and friends of people living in the home. There ave been two meetings since January they are planned to take place every six weeks. This is a good way of giving people the opportunity to put forward ideas for improvements. A Care Homes for Older People Page 21 of 26 Evidence: visitor told us they were pleased that the home has started these meetings. They said they have seen improvements in the service in the last couple of months. The home does not hold any money on peoples behalf. Any additional services that are provided are charged on the monthly invoices. Some of the staff we spoke to said they had not done any moving and handling training for some time, the owner said she would organise this. When we visited in January we saw that there were suitable systems in place to make sure equipment and installations are serviced and maintained in line with manufacturers guidelines. This helps to make sure the home is a safe place for people to live and work. Care Homes for Older People Page 22 of 26 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 23 of 26 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 13 People must have access to 30/07/2010 the emergency call systems. If people are not able to use the emergency call systems risk assessments must be carried out and linked to the care plans to inform staff how often they need to have safety checks when they are in their bedrooms. To make sure people are safe. 2 30 18 Staff must receive training on safe working practices and related to the needs of people living in the home. Records of all training undertaken must be maintained. To make sure staff have the knowledge and skills they need to meet peoples needs. 30/07/2010 Care Homes for Older People Page 24 of 26 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 The home should continue to improve the care records to make sure peoples needs are identified and met and to make sure care is given in a way that takes account of peoples abilities and preferences. Food and fluid charts should be checked to make sure peoples dietary intake is being recorded accurately so that shortfalls can be identified and acted on. Snacks and finger food should be made available in the communal areas so that people can help themselves. The work that has started to improve the outside areas should continue to make sure people have access to a safe outside space. A bath thermometer should be available to check the temperature of the water before people get into the bath, this will reduce the risk of scalding. The acting manager should apply for registration with the Commission. 2 8 3 4 15 19 5 19 6 31 Care Homes for Older People Page 25 of 26 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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