Care Home: Bedewell Grange

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What the care home does well Bedewell Grange is a purpose built home and provides a caring homely environment in a pleasant setting. Everyone spoken to enjoys living in this home and many positive comments were received about the good support provided by the staff team. There is a varied range of activities for residents to enjoy. All complaints are taken seriously and addressed. Staff are well trained to enable them to support residents appropriately. The views of residents and their visitors are encouraged with the use of meetings and questionnaires. What has improved since the last inspection? The manager is recently registered by The Commission and has demonstrated her ability to care for older people. The manager and her staff team have worked hard to address the requirements and recommendations made at the last inspection. Improvements have been made in all areas of care. Systems are in place to measure the quality of care provided. Record keeping is improved and with the appointment of an activities coordinator a range of appropriate activities are being put in place. Dining rooms are pleasant places to eat and a range of good quality food is served with sufficient staff on duty to address the needs of those who require some support. Health and safety of residents and the promotion of privacy and dignity has been improved. Staff numbers and quality through training and supervision has been improved. Quality monitoring has been introduced to identify practices that can be further improved. What the care home could do better: The manager has a clear plan for improvement that will directly benefit people who live in Bedewell Grange and these are being put into an action plan for the future. Items include making more use of outdoor space and improving care standards generally. The safe handling of medicines must be further improved to ensure the wellbeing of people who live in the home. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Bedewell Grange Campbell Park Road Hebburn Tyne And Wear NE31 2SL     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: Allan Helmrich     Date: 2 2 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Bedewell Grange Campbell Park Road Hebburn Tyne And Wear NE31 2SL 01914838000 01914833000 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Maria Susan Scott Type of registration: Number of places registered: Barchester Healthcare Homes Ltd care home 52 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Bedewell Grange provides personal care for up to fifty-two older persons, with care staff available at all times over the twenty-four hour period. Nursing care is not provided at the home. The building has two-storeys. The first floor being accessed by stairs and a passenger lift. There are 48 single bedrooms and two double bedrooms all of which have their own en suite toilet facility. Car parking is available to the rear of the home. A large grassed area is available to the rear and side of the building, which has a pleasant seating area. Bedewell Grange is situated in a central area of Hebburn, close to the shops, bus route and local amenities. The home was originally opened in 2001 and during this time it has changed ownership the most recent change being February 2007. 0 0 Over 65 10 42 Care Homes for Older People Page 4 of 28 Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection was unannounced and was undertaken by the link inspector for the service. The inspection took place over two days and lasted 10.5hrs. During the visit we: Talked with people who use the service. Talked with the home manager and staff on duty. Looked at information about the people who use the service and how well their needs are met, Looked at case records for three residents and other records that must be kept, including medication. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to assess if it was clean, safe and comfortable. Checked what improvements had been made since Care Homes for Older People Page 6 of 28 the last visit. Also surveys were sent to residents and staff. Responses were received from six residents supported by relatives and five staff members. Information from these sources is used in this report. What the care home does well: What has improved since the last inspection? What they could do better: The manager has a clear plan for improvement that will directly benefit people who live in Bedewell Grange and these are being put into an action plan for the future. Items include making more use of outdoor space and improving care standards generally. The safe handling of medicines must be further improved to ensure the wellbeing of people who live in the home. Care Homes for Older People Page 8 of 28 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 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. Comprehensive pre admission assessments and clear pre-admission information for residents are in place. This is so management can make an informed choice and know the care needs of people can be met before they move into the service. Evidence: Everyone is given the opportunity to spend time in the home prior to admission. The company has recently improved the information available to prospective service users, which gives people information about the home and the service it provides. There is a statement of purpose, service user guides and a copy of the most recent inspection report available to anyone who visits the home. One resident who had recently moved into the home stated that they were made to feel welcome and that their needs are being met. All of the respondents to a survey stated they received sufficient information prior to moving to Bedewell Grange and they receive the care and support they need. Care Homes for Older People Page 11 of 28 Evidence: Staff commented the home is a really friendly place to live and work in and the home provides a happy, clean environment. The home receives an assessment from the persons care manager prior to admission. This information is looked at by the manager and a pre admission visit is made by senior staff when other information is collected to ensure the home can meet the persons needs. Each of the case records reviewed contained an assessment of the persons needs and other appropriate supporting information. Within a short time of admission each resident has a plan of care constructed by senior staff in the home. These plans identify fourteen areas of care which include any special needs the individual may have such as religious or cultural requirements as well as personal care needs. In the file of a recent admission the information reviewed was comprehensive and well written although a life history and activity form were not completed. The manager stated these areas were currently being addressed by the recently employed activities coordinator. The manager stated the home does not provide a rehabilitation service but short-term respite beds are available. Details of this service are included in an information pack that can be requested from the home. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs are well supported by good care planning, regular involvement from other professionals and clear recording. However, medication recording is not always consistent and prevents an accurate audit of medications. Evidence: Shortly after admission a range of assessments to determine the physical and mental needs of residents are carried out and any identified needs are included in the persons plan of care. The plans of care reviewed contained a good standard of information to describe to care staff how appropriate individualised care is to be provided. Where an assessment tool had identified a need, a care plan was produced to reduce any risk to the person assessed. As mentioned previously, the homes standard information includes an assessment of fourteen areas of care, these include; communication, personal hygiene, mobility, social needs, nutrition and mental state. Further work is required in the areas of social history and activity preference. This is currently being addressed by the recently appointed activities coordinator. Care Homes for Older People Page 13 of 28 Evidence: The care plans are reviewed by key staff each month and generally the files were up to date. The managers attention was brought to one file were a major change to a person had occurred and the review of their file was outdated. In one other file a medical condition had not been reviewed for two months. Care plan reviews ensure that staff are considering the individuals needs and wishes on a regular basis. The returned surveys each confirmed residents always receive the care and support needed. Positive comments included; staff are professional and treat my mam with dignity and, overall I get good support. However this respondent also said that the level of care fluctuates when the home is understaffed because of holidays or sickness. Records demonstrated that residents regularly see health care professionals to promote their good health with details of health checks, visits to their GP and hospital appointments were recorded in the individual files. The files are regularly reviewed by the manager and other senior staff for quality. Three residents spoken to all stated the home provides a good standard of support and staff were observed throughout the inspection talking to residents and attending to issues discreetly. The manager is concerned that all residents are treated individually. She and her deputy are aware of equality and diversity issues and this is passed on to other staff. Other staff are being given training to ensure residents are well supported to live a life of their choosing. Residents stated they choose where to go and what to do. All senior staff that dispense medicines have had training in the safe handling of medication. The following areas of practice were identified to ensure residents health and well-being is maintained. Medicines that have a limited life should be dated when opened. A medication of this type was in use but was within date. Hand written entries in medical administration records should be signed and countersigned to ensure the accuracy of the recording. Staff should be reminded of the need to be consistent in recording details in the medication administration records and to follow the homes comprehensive procedures. Storage of medicines was appropriate, the temperature of the store is regularly monitored and storage facilities are good and safe. Appropriate procedures that promote the safety and well-being of residents are in place. These should be re-introduced to staff administering medicines. A current medication reference book is available to the staff team. 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. The home operates flexibly to enable people to have choice and meet their expectations. Evidence: A social activities coordinator has been recently engaged to promote activity for older people. This person is currently reviewing life histories and social preferences of people who live in the home. Also other staff are being provided with training called yesterday, today and tomorrow by The Alzheimers Society to increase their understanding of working with people with a dementia. A new mini bus has been purchased that can be driven by the majority of carers. This will enable people in the home to visit local places of interest more frequently. Prior to any trip, the suitability for wheelchairs is checked so that all residents in the home can enjoy the same facilities. The atmosphere in the home was relaxed. Staff were seen talking to individual residents and groups. Residents were seen in conversation with each other and some were sitting quietly in areas of the home designed for this purpose. In the morning after breakfast was completed, one resident was arranging cups and pots on a dresser Care Homes for Older People Page 15 of 28 Evidence: and another resident was arranging a cloth on a table. A third resident appeared to be directing the others in the tasks they were involved with. A member of staff was nearby providing supervision. People spoken to during the day confirmed that activities take place regularly. The home has started a project called memory lane. This is for residents with a dementia and is intended to stimulate and provide a sense of purpose. A weekly activity schedule is in place and details of activities are posted around the home. In response to a survey asking if sufficient activities are arranged in the home, two stated always three usually and one sometimes. One resident commented they would like more 1-1 activities. Several staff would like to extend the Memory Lane project. A weekly activities programme is in place and details of future events are posted around the home. The manager has used framed old photographs of Hebburn, its local football teams and local industry to form a corridor to stimulate memory and conversation. Another corridor contains pictures of famous personalities. The manager is promoting the use of doll therapy in the home. This is a recognised technique used with people whos behavior may be challenging to help in reducing their anxiety. Raised beds have been built in the garden to enable residents to be more involved in horticulture. One resident who used to enjoy gardening before moving into the home is supported by staff to enjoy this hobby. The person responsible for activities stated there is a budget for activities and that this is added to with some in-house fund raising. There is a store of activities that are currently being reviewed to develop the current activities schedule. It is intended that each resident is re-assessed to develop activity programmes that are more individualised. The manager is aware of diversity issues and has introduced systems to find out about residents specific needs and wishes. She stated that currently people in the home are from the local area and have no needs that cannot be met within the community. A trip to Lourdes was recently undertaken by one resident, supported by a member of staff. Each resident survey stated they either always or usually like the meals provided. One person said they are happy with the meals they get and another said the meals have improved recently, however a little more variety for supper would be nice. The lunchtime meal was overseen. Residents were supported by staff as necessary and lunchtime was a pleasant relaxed affair. The tables were nicely dressed with a cloth, Care Homes for Older People Page 16 of 28 Evidence: condiments and a centre decoration. Everyone spoken to said they enjoyed their meal. Choices are available for each mealtime and details provided to new residents explain the variety of choices available and that should anyone require a different meal they should just see the cook. Currently one resident has a separate meal of their choice each day. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home takes complaints seriously and staff are well trained to ensure everyone is protected from abuse. Evidence: The home provides a copy of the complaints procedure to new residents in the Service User Guide and copies are displayed in the home for the benefit of visitors. Five complaints received by the home were recorded in a log. Each was dealt with appropriately and to the satisfaction of the complainants. The six residents who responded to a survey all stated they were aware of how to complain and who to complain to. One resident commented that my complaints are always addressed efficiently and another stated that staff take the time to listen to residents and their families. The manager and all staff have been trained in an awareness of issues that affect vulnerable people and staff spoken to were confident they would always support the rights of residents in the home. The home has policies and procedures to protect residents and the Department of Health guidance (NO SECRETS) dealing with the protection of vulnerable adults. This guidance is available to all staff to promote abuse awareness. Care Homes for Older People Page 18 of 28 Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a modern clean and pleasant environment to live in. Evidence: Bedewell Grange is modern and purpose built. There is level access from the car park into the home and a lift to assist residents in moving between floors. Many of the bedrooms seen were personalised with items of furniture brought from residents previous homes. This is encouraged in the homes brochure provided to all residents before they come to live in the home. Everyone spoken to was happy with their accommodation and five of the returned surveys confirmed the home is always fresh and clean. One respondent felt that sometimes there can be a strong smell of urine in the corridor and the carpet in their room does not look clean and sometimes feels sticky underfoot. During a tour of the communal areas and some bedrooms the home was found to be clean and well maintained. No odours were detected. There are sufficient bathrooms and toilets around the home with equipment to assist residents to bath should this be necessary. Some bathrooms did not contain thermometers to monitor the water temperatures but these were replaced before the inspection concluded. Care Homes for Older People Page 20 of 28 Evidence: There is a specific room designated for hairdressing. This is used by the regular visiting hairdresser and other hairdressers that come to the home for specific residents. The laundry is a good size to meet the needs of the home. Washing equipment meets current disinfection standards and information is posted to ensure staff wash items at the correct temperatures. The home has several lounges and a conservatory. Residents were seen during the day using all areas of the home. The gardens that have been made secure with fencing are well tended and contain raised beds to encourage less mobile residents to work in them. There is also a garden seat donated by the family of a resident no longer in the home. The manager hopes to upgrade the external areas of the home to enable residents to make better use of the outside space. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient staff to meet the needs of each resident and recruitment procedures ensure people who live in the home are safe. Staff get regular training and supervision to ensure the necessary skills are available to provide the people who live at the home with good care. Evidence: Information provided by the home manager before the inspection shows that of 30 permanent care staff, 16 have an appropriate vocational qualification and 13 are working towards this. The staffing rota shows that in addition to the manager who normally works from Monday to Friday, the home try to maintain seven care staff during the day reducing to six in the afternoon and into the evening. During the night five care staff are on duty. The manager feels recent staffing problems have been resolved and although 15 staff have been replaced over the previous six months, a stable staff team is now in place. Currently there is a vacancies for a senior care assistant at night. This means that on some shifts a senior is not on duty. The manager has arranged for senior support in an emergency but this has not been formalised to ensure safe systems are in place for Care Homes for Older People Page 22 of 28 Evidence: residents wellbeing. Also this can put pressure on day staff having to extend their working day should evening medications be required. The manager is also supported by an able deputy, an administrator, an activities coordinator, a handyman and domestic and catering teams. During the inspection sufficient staff were on duty to ensure the needs are residents were addressed. All staff who responded to a survey stated they receive up to date information from good effective hand overs and that a vast amount of training is available. All stated there is usually or always enough staff to meet individual needs. Comments from residents included this home has good, caring, hardworking staff, this is probably the best home in the area and has a reputation for the care the staff and management give, the staff provide excellent care. The records showed that a regular training programme is in place to ensure staff receive the training they need to care for older people and people with a dementia. The range of training provided this year includes; first aid, fire, infection control, mental health, equality and diversity, caring for people with a dementia and training dealing with the safeguarding of vulnerable people. The files of recent recruits were reviewed and found to contain appropriate information in the form of application forms, references and Criminal Record Bureau (CRB) checks to ensure residents can live in a safe environment. It was however unclear from the audit forms used whether CRB issues are identified and reviewed with the decision to employ. A system of induction for new staff is in place and should staff be employed without a care background they are enrolled on a full induction course to support them in providing good care. The files checked did have some information relating to induction but these were not fully signed off to demonstrate a level of competence was achieved. Also each new staff member is provided with a handbook providing information regarding codes of practice for care workers. Each resident spoken to during the inspection that made a comment praised the quality in the staff team. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Bedewell Grange is a home that is well run for the benefit of the people who live there. Evidence: The manager has worked in the home since it opened in 2000 and has managed the home for the last four years. She is recently registered by The Commission and has demonstrated her awareness and ability to manage a home providing care and support for older people. Since the last inspection there has been many changes and improvements to systems in a structured way to ensure sustained benefit for the people who live and work in the home. Staff spoken to during the inspection stated they feel well supported by management, that staff meetings are regular, as is supervision and appraisal sessions to promote good practice. There is a quality monitoring system in place that is used throughout the company. Issues identified for improvement are recorded and as the manager is involved in annual budgetary meetings any costs associated with these improvements can be Care Homes for Older People Page 24 of 28 Evidence: requested. Questionnaires are used to obtain opinion from residents and visitors to the home. Guest questionnaires are available in the home, although these appear to be designed for short term nursing clients. Also the manager could not demonstrate an analysis of any returns made to the company. The home has procedures in place that make sure resident’s finances are safeguarded. Currently no monies are held for residents. The manager demonstrated that regular servicing of equipment takes place, that staff, through training, promote safe working practices to ensure the safety and welfare of people who live in the home. The certificate demonstrating the gas heating system has been maintained and that electrical tests are done were reviewed and found to be in order. The home has a machine, used by the handyman, to test electrical equipment brought into the home by residents. This ensures that unsafe electrical items that may compromise the safety of people living in the home are not accepted. A fire risk assessment has been produced. Staff have received fire instruction and fire drills take place to ensure residents are maintained in a safe environment. Good hygiene systems and standards are maintained by the homes housekeeper. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 Encourage members of staff involved with activities to produce individual care plans and social histories. Review these regularly to ensure the social needs of residents are identified and promoted. Ensure that staff are aware of the importance of fully reviewing plans of care each month and detailing any changes to ensure the well being of the individual. Ensure of staff are aware of the need to follow the homes policies and procedures relating to medication to ensure an audit can be conducted at anytime. Also hand written records must be signed by the transcriber and by the checker to confirm accuracy of recording. Limited life medicines should be dated when opened. Record details discussed with staff when employing staff with CRB disclosures. Ensure that staff in charge in the home at any time have written details of their responsibilities. Ensure the induction process for new staff is signed off by all parties to confirm an appropriate standard of training is achieved. 2 7 3 9 4 5 6 27 27 30 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). 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