Care Home: Brabyns House

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What the care home does well The management of the home ensure that service users have an appropriate assessment and are offered the opportunity to visit the home before a decision is made that Brabyns House is suitable to meet their needs. Service users have their care needs met by suitably qualified staff who are available in suitable numbers. Similarly staff ensure people`s health and medical needs are met by maintaining appropriate links with community-based medical services. The home and grounds are well maintained and provide a good level of choice in connection with how and where service users wish to spend their time. The provision of food is good, including presentation, choice and amount. People are confident that they are protected from abuse and exploitation and that any complaints will be responded to appropriately. Staff follow safe working practices. Service users and visitors who we spoke to were positive about the attitude of the staff team and of the atmosphere which was created and maintained by them. One visitor told us that their experience of Brabyns House had been "brilliant" and that staff had "bent over backwards" to accommodate their relative`s needs, also saying "it`s like a family really". Another visitor described as among the best things about the home the "homely atmosphere". Comments from service users included " some staff are like old friends"; "[they] treat you very well"; "staff are always very polite to me ... we have a mutual understanding". When asked what the best thing about the home was, comments from service users included "better than living on your own as there is company and sympathy" and "general overall picture of everything being right and proper". What has improved since the last inspection? The new manager had clearly consolidated her leadership role within the home. The good physical environment identified at previous inspection visits had been maintained. Staff have access to more training opportunities. What the care home could do better: Any required amendments, or additions, to medication records should be undertaken more thoroughly to ensure that the reason the change and the date of the change are maintained clearly and that these changes are checked by a second member of staff to ensure accuracy. The recruitment procedures are still not thoroughly undertaken in line with the basic legal minimum requirements. Whilst there is no specific evidence that inappropriate staff are recruited, the management cannot demonstrate fully that all reasonable steps are taken to minimise the risk of employing unsuitable people. Key inspection report Care homes for older people Name: Address: Brabyns House 98 Station Road Marple Stockport Cheshire SK6 6PA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Steve Chick     Date: 1 7 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Brabyns House 98 Station Road Marple Stockport Cheshire SK6 6PA 01614274886 01614274886 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr John Arthur Odell,Mrs. Kathryn Joan Odell Name of registered manager (if applicable) Mrs Angela Griffiths Type of registration: Number of places registered: care home 39 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: 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 categories: Old age, not falling within any other category - Code OP. Dementia - Code DE (maximum number of places: 5). The maximum number of service users who can be accommodated is: 39 Date of last inspection Brief description of the care home Brabyns House is a large, detached property situated adjacent to Marple locks and canal. Local shops, parks, public Houses and restaurants are all close by, enabling service users to independently, and with support from family and staff, visit places of interest. The home is owned by Mr Odell, who takes an active interest in the home Care Homes for Older People Page 4 of 27 5 0 Over 65 0 39 Brief description of the care home and visits each week to undertake an assessment of the building and to consult with the manager. The home is well maintained in both the communal and private parts of the building used by service users. Service users have the use of four lounges during the daytime and evening. There are two dining rooms, one of which overlooks the rear gardens and is enjoyed by service users at all times of the day and evening when, after meals, it is used by service users who play cards and dominoes. Twenty-one of the 31 single bedrooms have en-suite facilities. The home offers four double bedrooms to those service users who prefer to share. The fees for accommodation range from 507 to 640 pounds per week, depending on the accommodation available. Service provision is the same and not dependant on fee structure. Individual fee structures should be discussed and agreed before a decision about accommodation is finally made. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is two star. This means the people who use this service experience good quality outcomes. We (the Care Quality Commission) undertook a key inspection, which included an unannounced visit to the home. This meant that no one at Brabyns House knew that the visit was going to take place. All the key inspection standards were assessed at the site visit. For the purpose of this inspection three service users were interviewed in private, as were two relatives of service users and three staff members. Additionally discussions took place with the manager and a representative of the owner. We also looked at information we have about how the service has managed any complaints, what the service has told us about things that have happened in the Care Homes for Older People Page 6 of 27 service, these are called notifications and any relevant information from other organisations. We also asked the management of the home to fill in a questionnaire, called an Annual Quality Assurance Assessment (AQAA). This is a legal requirement. The AQAA told us what they thought they did well, what they need to do better and what they have improved upon. Where appropriate, some of these comments have been included in the report. We undertook a tour of the building and looked at a selection of service user and staff records as well as other documentation, including staff rotas, medication records and the complaints log. Since the previous inspection we have completed an Annual Service Review (ASR). The ASR does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection. The ASR did not make us change our opinion of the service. We have not received any complaints or allegations about the service since our last Key Inspection. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: Any required amendments, or additions, to medication records should be undertaken more thoroughly to ensure that the reason the change and the date of the change are maintained clearly and that these changes are checked by a second member of staff to ensure accuracy. The recruitment procedures are still not thoroughly undertaken in line with the basic Care Homes for Older People Page 8 of 27 legal minimum requirements. Whilst there is no specific evidence that inappropriate staff are recruited, the management cannot demonstrate fully that all reasonable steps are taken to minimise the risk of employing unsuitable people. 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 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are only admitted to the home after an appropriate assessment, to ensure the home can meet their needs. Evidence: The manager told us in the AQAA that potential service users were encouraged to visit the home before making a decision to move in. We were also told that if they were unable to do that, somebody from the home visited them to ensure that the staff and facilities at Brabyns House could meet their needs. We looked at a selection of service users files, including some relating to people who had moved to the home since the last key inspection. There was written evidence of an assessment having been undertaken before the person moved to the home. Visitors who we spoke to confirmed that their relative had been assessed by somebody from Brabyns House before moving in. One service user who we spoke to Care Homes for Older People Page 11 of 27 Evidence: told us that they had come to have a look round the home before deciding to move in. Brabyns House does not offer intermediate care. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users health, personal and social care needs are met by the implementation of the homes policies and procedures. Staff practices also serve to promote the dignity of the service users. Evidence: We looked at a selection of service users files. Each had a copy of a written care plan together with documentary evidence that the care plan was periodically reviewed. There was also evidence of risk assessments having been undertaken, including in relation to moving and handling considerations for the individual. Relatives who we asked told us that they were involved in discussions about the way in which care is delivered. They also told us that there was good communication from staff to them, and that they were confident they would be told about any problems. Similarly service users who we spoke to told us that their needs were met by the staff team. One person said they bring me a drink if I dont sleep well and anything I want they try to get. Another person said staff are caring and do the right thing by you and really look after you. Care Homes for Older People Page 13 of 27 Evidence: Staff who we spoke to, told us that they were kept up to date about any changing needs of individual service users. They told us that the written care plan was complemented by a verbal handover at each shift change and a communication book which was kept up to date. One visitor cited, as among the best things about the home, the fact that whoever was on duty knew about their relative. Staff who we spoke to also told us that service users were involved in discussion about how their personal needs were to be met. There was very good documentary evidence that service users have access to the full range of medical personnel and services available in the community. All visitors, staff and service users who we asked were confident that medical support was obtained, when necessary and in a timely manner. Medication presented as being stored appropriately and securely. We looked at a selection of medication administration records, most of which presented as being well maintained. Medication administration records are important as they provide evidence that the correct medication has been given to the correct person at the correct time. One example was seen where the time of administration of a particular medication had been changed from night-time to teatime at some point during the period covered by the preprinted medication administration sheet. The way in which this record had been altered, by a member of staff, did not make it clear at which point the change had been made. The effect of this was to make aspects of this important information inaccurate. One example was seen where medication had been recorded as not being given, but the particular tablet (which would be returned to the pharmacist for disposal) could not be found at the time of this visit. One example was seen where the medication administration record had been hand written, but without evidence, usually provided by a second signature, that the accuracy of the information had been checked. Observation and discussion with service users, visitors and staff indicated that people were treated with respect and that their dignity and privacy was maintained. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Appropriate social contacts and activities are facilitated within the home to give service users the opportunity for social fulfilment. Service users are able to maximise their autonomy within the context of communal living. The provision of food to maintain service users health and well-being is good. Evidence: We were told in the AQAA that a full-time activities coordinator was employed at the home. At the time of this visit this post was vacant but the manager told us they were actively recruiting to fill the vacancy. Service users who we spoke to said that there were not many organised activities, but this was not spoken of as a major problem. Two service users we spoke to said that they preferred to read rather than watching TV and that the library service visited once a fortnight. Another person we spoke to said that they liked to sit and talk and appreciated the fact that they could go out. Staff we spoke to confirmed that there were occasional trips out including on the local canal and occasional pub meals. The home benefited from the provision of a quiet lounge where residents could socialise, if they wished, without the presence of a television or radio. Care Homes for Older People Page 15 of 27 Evidence: All visitors and service users who we asked, told us that there were no unreasonable restrictions on visiting. Visitors told that they were made to feel welcome by the friendly and attentive staff. All service users and staff who we asked told us that people were free to get up and go to bed when they wanted, spend time in their rooms or any of the communal areas as they chose. We were also told that service users were able to take their meals in their rooms if they wished. One visitor told us that they particularly appreciated that their relative was not put under pressure to take part in any communal activity. During this unannounced visit to the home lunch was sampled. This was pleasantly presented and tasty. Service users, visitors and staff who we asked all spoke positively about the food provided at the home. One visitor told us that they had been invited to take part in the meals if they wished. One service user said of the food, it is very good, old-fashioned and well set out, whilst another cited the food as amongst the best things about the home. Staff who we asked also told us that people were provided with plenty of food and had a choice. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are protected from abuse or exploitation by the homes policies and practices and are confident that any complaints they may have would be dealt with appropriately. Evidence: Brabyns House has a written complaints procedure which has been found to be appropriate on previous occasions and was not looked at again on this visit. We looked at the record of complaints received at Brabyns House since the previous key inspection. These presented as being appropriately recorded and investigated by the management of the home. All visitors and service users who we asked were confident that any complaints they may have would be dealt with appropriately. Similarly staff who we asked were confident that they, their colleagues and the management of the home would endeavour to resolve any complaints. We were told in the AQAA that all staff had received training in connection with the protection of vulnerable adults. We were given a copy of the training matrix which indicated that any staff who had not attended a relevant training course relatively recently had been identified as needing a refresher. We checked a small sample of staff files which provided documentary evidence that POVA training courses had been attended as per the matrix. Care Homes for Older People Page 17 of 27 Evidence: All staff who we spoke to indicated that they were clear about their responsibilities in connection with being vigilant about the possibility of abuse or exploitation. Similarly, they presented as being clear about their responsibilities to whistle blow if necessary. All service users, visitors and staff who we asked told us that people living at Brabyns House were safe, in so far as they were protected from abuse and exploitation. One visitor said that their peace of mind was among the best things about the home. We had not been made aware of any complaints or allegations made in connection with Brabyns House since the previous key inspection. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is appropriately maintained, decorated and cleaned to enable service users to live in a pleasant, safe and hygienic environment. Evidence: During this unannounced visit a tour of the building was undertaken. This included communal areas and a selection of service users bedrooms. No issues were identified as needing remedial action in connection with the furnishings, fabric or decor of the building. There was a range of different lounges which service users were free to use, including those with a television and one without. The dining areas were nicely repared, including vases of flowers on the tables. Observation indicated a good level of personalisation of peoples own rooms. The home benefits from very nicely laid out and well maintained gardens. The home presented as being clean and tidy throughout with no unpleasant odours. All visitors, service users and staff who we asked, confirmed that this was the usual state of the building. The manager told us that the laundry facilities were appropriate for the size of the home. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The numbers and skills mix of staff on duty promotes the independence and wellbeing of service users. Recruitment and vetting procedures are not thoroughly applied to minimise the risk to service users of inappropriate staff being employed. Evidence: The manager told us that staffing levels were intended to be six care staff in the morning, five in the afternoon and evening and three at night. We looked at the staff rota for the week beginning the 7th September 2009 which provided evidence that these staffing levels were generally maintained. The manager told us that these staffing levels were sufficient given the dependency of the service users resident at this time. Service users who we asked described an attentive staff team. One service user told us that among the best things at the home was that there was always somebody here to help. This person also told us that staff always responded to her buzzer in a timely manner. The manager told us that of the 23 care staff 13 had done NVQ II and one was currently undertaking it. The NVQ (National Vocational Qualification) is intended to improve the skills and knowledge base of the care workers. We looked at a small selection of records relating to staff who we were told had the NVQ II, and appropriate Care Homes for Older People Page 20 of 27 Evidence: certificates were seen to confirm this. There was good documentary evidence that staff have access to a range of appropriate training opportunities. This was confirmed by staff who we spoke to, including confirmation that several were attending a course on dementia care the following week. Staff who we spoke to confirmed that new staff have a period of induction and then shadow more experienced staff. A selection of records relating to the recruitment and vetting of staff was looked at. These records did not provide sufficient evidence that the legally required minimum information in respect of potential staff had been obtained before a decision was made for them to work at the home. Specifically, this related to two areas. The failure to obtain a full employment history and the failure to record any explanantion of conflicting information provided in references. The homes application form asked for details of employment in the last 10 years whereas the information required by legislation is a full employment history together with a satisfactory written explanation of any gaps in employment. An example was also seen where a referee had made reference to having been the persons employer, but it was not clear on the application form which job this refered to. This does not mean that any of the care staff employed at Brabyns House were unsuitable, but that the registered person could not demonstrate that the decisions to employ were made reasonably. Similar issues had been identified at the last key inspection, which did not appear to have been adequately addressed. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is competent to run the home, use the quality audit systems and implement the health and safety procedures are the benefit of service users and staff. Evidence: Since the previous key inspection the registered manager at that time has retired. The responsible person had recruited a replacement for her, who has been registered with the commission as a person who is fit to undertake this role. Discussion with the manager throughout the unannounced visit indicated that she had a good understanding of the service users and Brabyns House. Staff who we spoke to told us they were confident that their colleagues and the management structure was supportive to them. The manager told us that they were aware of the new Deprivation of Liberty safeguarding protocols, and that no application had been needed to be made for any servic euser at Brabyns House. Care Homes for Older People Page 22 of 27 Evidence: A quality assurance exercise had been undertaken by the home in 2008, including questionnaires being sent to service users and other interested parties. There was documentary evidence of detailed action regarding individual comments having been undertaken. There was no summary report available for service users to see. We looked at a small selection of records relating to money held by the home on behalf of service users. These presented as being appropriately maintained to protect the interests of the service users. This included keeping receipts for any items purchased on behalf of service users. Training in records indicated that that a high proportion of staff had received specific training in health and safety issues and food hygiene. The cooks use a recognised system for maintaining records of safe food practices in the kitchen, which presented as being appropriately maintained. We had been told in the AQAA that the necessary servicing and maintenance of equipment was undertaken. We looked at a small selection of records relating to the maintenance of equipment at the home which presented as being appropriately maintained. All staff who we asked told us that personal protective equipment, such as disposable gloves and aprons, was always available and used when necessary. This is to help to minimise the risk of cross infection. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 29 19 The registered person must ensure that the vetting of staff is undertaken with reference to the most up to date legislation, to minimise the chances of employing staff who may pose an unacceptable risk to service users. In particular this relates to obtaining a full employment history and the nature of references which should be sought. 01/10/2007 Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 29 19 The registered person must 13/11/2009 ensure that the vetting of staff is undertaken with reference to the most up to date legislation. In particular this relates to obtaining a full employment history and clarifying any conflicting information. This is to minimise the chances of employing staff who may pose an unacceptable risk to service users. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 9 The registered person should ensure that any amendments to a preprinted medication administration record provide clarity about why the record was being changed and when the change is made. The way in which the record is amended must allow for the original information to be clearly read. Page 25 of 27 Care Homes for Older People 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 2 9 The registered person should ensure that if a new medication has to be added to a medication administration record, the accuracy of the information relating to the medication the dose and the frequency of administration is checked by a second member of staff who signs the record to confirm they have done this. The registered person should ensure that following any quality assurance exercise which involves asking service users or other interested parties their views on the running of the home, a written report is made available. This report should summarise the outcome of the quality assurance exercise and identify any action which the management was proposing to take a consequence of the information received. 3 33 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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