Care Home: Bridge House Care Centre

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What the care home does well This service provides residents with a good standard of care which meets their needs. The home is very well maintained and presented, it is homely and residents have been encouraged to personalise their rooms with their own possessions such as pictures photos and small items of furniture. Those people that we spoke with told us " its very nice living here" " staff are always kind" and "I really like the food here". They looked well cared for and people who were having to stay in bed looked clean and comfortable. Appropriate adaptations are in place throughout the home, to help those with limited mobility, and pressure relieving equipment is in use where needed. Residents have access to other health care professionals such as physiotherapists, chiropodists and the tissue viability specialist nurse. The doctor visits regularly. There is a planned programme of activities arranged for those who wish to join in and the views of residents are taken into consideration when planning entertainers and trips out of the home. Spiritual needs are also met, with various church representatives visiting the home. What has improved since the last inspection? We have always considered that residents in this home experience good quality outcomes in relation to their care. However, since we last visited a new manager has been appointed to the service and she has increased the interaction between residents and staff. There has been an improvement in the daily activities that are arranged to interest and stimulate people. There is now an activities coordinator who organises games,exercise and music sessions, visiting entertainers and trips out of the home. A residents association has also been developed and they meet on a regular basis. They discuss items such as other activities they would like arranged and the homes menus. The home has had an extensive redecoration programme since we last visited. Bedrooms are now all single occupancy and additional shower and toilet facilities have been provided. It has also allowed a smaller lounge to be provided which can be used as a quiet room. Residents were involved in choosing the colour schemes for their bedrooms and the garden has been replanted with additional patio and seating areas provided. This provided a good venue for the homes recent barbecue and several residents told us how much they had enjoyed that and were looking forward to another one. What the care home could do better: When we looked at residents care plans we considered that they had improved. They were much more detailed and informative and would give all of the staff clear guidelines about how people should be supported. However, we were not able to see any evidence that residents had been involved when these were compiled. Some of the residents we spoke with would have been able to understand this process and for others a relative or representative should be consulted. This will ensure that residents are able to influence the way that care is given and ensure that it will meet their preferences.Although we believe that residents are receiving their medication as it has been prescribed for them we raised some concerns about the way that it was recorded. The manger agreed to address these issues. We also had some concerns about the way that hoists are stored in the home. In some instances we considered that they might cause an obstruction in the event of a fire and we have asked for alternative storage arrangements to be provided. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Bridge House Care Centre 280-282 London Road Wallington Surrey SM6 7DJ     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: Alison Ford     Date: 0 4 0 8 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Bridge House Care Centre 280-282 London Road Wallington Surrey SM6 7DJ 02086478419 02087739392 h19rsh@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Stella May Bernatek Type of registration: Number of places registered: Ryedowns Ltd care home 35 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 35 The Registered Person may provide the following category of service only: Care Home with Nursing - Code N to service users of the following gender: Either whose primary care need 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: 35) (of the following age range: 55 years and over) Date of last inspection 35 0 Over 65 0 35 Care Homes for Older People Page 4 of 29 Brief description of the care home Bridge House Care Centre is a home registered to provide nursing care for up to thirtyfive elderly people. All of the bedrooms are now for single occupancy and the majority have en-suite facilities. There are 2 lounges, a dining room and a conservatory overlooking the river, plus the usual toilet, bathroom and shower facilities. There is a passenger lift in the home, to ensure total accessibilty, and adaptations have been fitted to help those with limited mobility. The home is on a bus route and opposite a large public park with a car park. At the time of this inspection fees ranged from £585 - £750 per week with some additional charges, which would be discussed prior to admission. A copy of the homes Statement of Purpose and their latest inspection report can be obtained from the them. Inspection reports can also be downloaded from the Care Quality Commission website at: www.cqc.org.uk Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This report follows an announced visit to the service as part of our planned inspection programme. We last visited on 7th August 2007. During our visit we undertook a tour of the home and we spoke with several of the residents who live there, and some of their relatives, to try and find out about their views of the service. We also spoke with the homes manager and some of the staff om duty. We looked at a sample of residents care plans, medication records and storage and various documentation that the home is required to keep as evidence of its commitment to the health and safety of both residents and staff. When writing the report we have also taken into consideration other information that Care Homes for Older People Page 6 of 29 we have gathered such as records of accidents, complaints and comments made by people visit the home. In addition the home sent us their Annual Quality Assurance Assessment ( AQAA). This is a self assessment that they send us to tell us how well they believe that they are meeting the aims and objectives of the home and about their plans for the future. We have not received any complaints about the service during the las year and we consider that it still providing good care for the people who live there. What the care home does well: What has improved since the last inspection? What they could do better: When we looked at residents care plans we considered that they had improved. They were much more detailed and informative and would give all of the staff clear guidelines about how people should be supported. However, we were not able to see any evidence that residents had been involved when these were compiled. Some of the residents we spoke with would have been able to understand this process and for others a relative or representative should be consulted. This will ensure that residents are able to influence the way that care is given and ensure that it will meet their preferences. Care Homes for Older People Page 8 of 29 Although we believe that residents are receiving their medication as it has been prescribed for them we raised some concerns about the way that it was recorded. The manger agreed to address these issues. We also had some concerns about the way that hoists are stored in the home. In some instances we considered that they might cause an obstruction in the event of a fire and we have asked for alternative storage arrangements to be provided. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 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 29 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. No one is admitted into the home without first having an assessment of their health care needs to ensure that these can be met. More information about residents social needs and preferences would ensure that people could feel confident that the daily life there would suit them. The home does not offer intermediate care therefore, standard 6 does not apply. Evidence: We spoke with a number of residents and asked some of them about how they and their families had decided that this home would be suitable for them. In some instances they had been in hospital and a care manager had made the choice on their behalf however, other people were able to tell us how their relatives had visited and liked the home. There is a pre-admission process in place which complies with the standards. The Care Homes for Older People Page 11 of 29 Evidence: home tells us that they would encourage any resident ,who was able, to come and visit for themselves although this is often not practical because of their frailty or ill health. However their relatives would often visit on their behalf. A senior member of the nursing staff would meet with any potential resident to ensure that the home would be suitable for their needs. In addition, for those people who are admitted under care management arrangements, we were were able to see that an assessment had been obtained from the local authority prior to admission. We looked at some of the homes own assessments and they gave us basic information about the people they had visited. we saw that information about the home, in the form of a Service User Guide, and the residents contract have already been produced in a large print format and a folder is being compiled, about the home, which can be taken out to show potential residents. Although we were confident that peoples health care needs will be met there was little evidence to show that their social preferences had been considered or or that daily life in the home will suit them. We discussed how more emphasis could be put on gathering this information and also about planning how people will need to be supported when they move in. Care Homes for Older People Page 12 of 29 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. The home is generally meeting the care needs of the people who live there although they must be given the opportunity to influence the way that they are being supported. The home will need to make sure that medication storage and administration processes are in line with current guidelines in order to ensure the protection of residents. Evidence: All of the residents in the home have an individual care plan and we looked at four of them during this inspection. We found them to be well organised, reflective of the care and support that people need and considered that they had improved since our last visit. They now contain more information about how residents prefer to be supported and they are reviewed regularly so that any changes can be identified and addressed. We could see that other health care professionals are involved as needed, such as the doctor and tissue viability nurse. Care Homes for Older People Page 13 of 29 Evidence: However, we were concerned that there was no evidence to show that residents have been involved in the compilation of these plans even when we could see that they would have had the ability to do this. Residents or, if they are not able, their relatives or representatives must be given this opportunity to influence the way that care and support is provided. Factors which may indicate declining health are monitored regularly such as skin integrity and nutritional scoring. Where these raise any concerns appropriate interventions have been made. People who may be at risk of developing pressure sores have been given pressure relieving mattresses and cushions and risk assessments are all in place. There are hoists and wheelchairs available to help those with limited mobility. Personal care is delivered in residents bedrooms and those people who we spoke with were all very complimentary about the staff and told us that they were treated kindly. There are both male and female care staff in the home in order to respect peoples wishes. We saw that personal profiles have been developed for some people and were told that this work is ongoing. We discussed with the homes manager how important this work is in order for care staff to understand about the people that they are supporting and to be able to engage with them and also in order to arrange activities that will interest them. In some care plans we noted that entries were some what generalised as in duly cared for and spent the day satisfactorily . It is recommended that staff should be encouraged to be more specific about what they write in order to provide evidence of the care that they are providing. Medication procedures in the home were generally well organised. We discussed some issues regarding storage of medication with the manager and have asked her to ensure that a thermometer is purchased for the clinical room. This will ensure that medication is being stored at the temperature recommended by the manufacturer. There were also some concerns with regard to the recording of administration of controlled drugs which she agreed to address. We noted that administration sheets did not state whether residents were allergic to any drugs. There is an assumption that this is because there are known allergies, so we have asked the home to ensure that this is documented in some way to reduce the Care Homes for Older People Page 14 of 29 Evidence: risk of any adverse reactions happening. They also need to ensure that record sheets include a photo of the resident to minimise the risk of any errors occurring. The home has recently introduced a process whereby the nurse administering the medication wears a red tabard during this time. Everyone is then aware of what she is doing and will try not to disturb her unless it is absolutely necessary. Staff are currently undertaking training with regard to The Gold Standard Framework. This is about ensuring the best possible care for people who are nearing the end of their lives and to their relatives. It includes working with the homes doctors, the out of hours doctors and the local hospice. It is hoped that accreditation for this will be achieved by the end of the year. Care Homes for Older People Page 15 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents find that the daily life in the home suits them, there are activities arranged for them to join in with and they enjoy the food that is served to them. Evidence: People have always told us that they enjoy the daily life in this home and that they are able to choose how the spend their days. However, previously some people have told us that they would enjoy more organised activities. Since we last visited this has improved enormously. There is now a dedicated activities person for the home and she organises games,reminiscence, exercise sessions and musical events. There have been parties held in the home and several people told us about the recent barbecue and how much they were looking forward to having another one. The home organises trips out for those who wish to go, there is a minibus that can be used, and some residents told us that they were going out the next day to see the Mary Rose Exhibition. The manager told us how much residents look forward to coming down to the lounge now to participate in the days events. For those people who have too, or choose to, stay in their rooms their are individual sessions arranged. Care Homes for Older People Page 16 of 29 Evidence: We particularly liked the fact that a residents association has been formed and we met the lady who chairs this. They have been able to meet to discuss issues such as menu changes and the activities that they would like to see included. People told us that the food that is served in the home is very good. We observed the lunchtime meal, there was chicken in mushroom sauce or macaroni cheese. One resident is a vegetarian and she told us that the chef is very good and she always enjoys her meal. There were tablecloths and flowers on the tables in the dining room, everyone had a drink and the menu was on a board on the wall. The meal is served from a heated trolley and a similar trolley is taken upstairs to people who are in their rooms, so that their meal is hot when it is served to them. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are confident that any concerns that they might raise will be taken seriously and addressed promptly. Evidence: The home has a complaints procedure which complies with the regulations and a copy is displayed in the entrance hall. There is a book there for people to write in and when we looked we could see that any issues had been addressed promptly. Since our last inspection there had been some concerns that had been referred to the local authority to be investigated under their safeguarding procedures. These investigations were completed and recommendations made at that time have been put in place. The home is now on the local authority list of preferred providers. There have not been any further concerns raised over the last year and The Commission has not received any complaints about the service during this time either. The manager of the home operates an open door policy and would actively encourage people to report any concerns that they might have, seeing them as a way to improve service delivery. Residents that we spoke with said that if they had any issues they were confident that she would deal with them swiftly. All staff have had training with regard to recognising and reporting any suspected Care Homes for Older People Page 18 of 29 Evidence: abuse. Those we spoke with were able to explain how they would go about ensuring that any concerns were taken seriously and acted upon. To help protect residents, no new staff members are employed without full and satisfactory information being obtained about them including clearance from the Criminal Records Bureau and the Protection of Vulnerable Adults Register. Care Homes for Older People Page 19 of 29 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 is is a well appointed and maintained home which suits the needs of those who live there. Evidence: As a part of this inspection we walked around the home. Accommodation is arranged over three floors and there is a lift to ensure accessibility. It has always been pleasant and well maintained and adaptations are in place which help those with limited mobility. Residents have been encouraged to personalise their bedrooms with their own possessions and many of them have photos and pictures and small items of furniture. The lounge downstairs is a particularly attractive area with windows which overlook the garden and the river. We could see that an extensive amount of redecoration and refurbishment has taken place since we were last there. Bedrooms are now all single occupancy in line with current standards and additional shower facilities have been provided. A new small lounge has been created to be used as a quiet room and there is a new nurses station. The garden has been redesigned with a patio and additional seating. The majority of the home has been redecorated and residents told us how much they liked the new pictures that had been put up on the walls. Care Homes for Older People Page 20 of 29 Evidence: We did notice that hoists are in some of the corridors, due to limited storage facilities, and they caused an obstruction which could be hazardous in the event of a fire. Alternative storage arrangements must be made for these. On the day that we visited the home was very clean and residents told us that this was always the case. There are protective gloves and aprons available for staff and also alcohol hand cleansers are sited around the home including the entrance hall for visitors to use as well. Care Homes for Older People Page 21 of 29 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 always enough appropriately trained staff on duty to meet the needs of the people who live there. Robust recruitment checks ensure that people are protected from those who have been judged as being unsuitable to be working with vulnerable adults. Evidence: The home is staffed by both trained nurses and care staff, supported by domestic and ancillary staff. The day that we visited there were enough of them on duty to meet the needs of the residents and the rotas showed that this was generally the case. Residents spoke highly of staff telling us they are really kind and I find them lovely. There is a board in the hall which has letters from relatives which also reflects how kind and caring they have found them. Information from the home tells us that majority of care staff have been trained to at least NVQ level 2 and some are undertaking a level 3. Some trained nurses are completing a level 4. This group of homes employs an in-house trainer and he visits Bridge House every other week. This has helped to give staff training a high profile and the training matrix shows that they are up to date with all their mandatory sessions. Other sessions are Care Homes for Older People Page 22 of 29 Evidence: arranged which focus on the diseases and problems that are experienced by the residents in the home. These have included Equality and Diversity, Wound Care and Infection Control. There are plans to provide more training in palliative care and dementia care in the near future. The day that we visited staff were receiving training about helping and managing residents who may be exhibiting challenging behaviour Robust recruitment procedures are in place to ensure the protection of the people who use the service. No new members of staff are employed with out all of the necessary checks being done including clearance from the Criminal Records Bureau and the Protection Of Vulnerable Adults Register. Care Homes for Older People Page 23 of 29 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 home is being managed by a person who is fit to be in charge and in the best interest of the people who live there. Evidence: Since our last inspection a new manager has been appointed to the service. The process for her registration is currently being completed. She was previously employed as the deputy manager in another home owned by this group and displays an understanding of working with this client group. We have noted that there have already been improvements in the running of the home: people find that their daily lives have improved and they tell us that they enjoy all of the activities that are now being arranged for them. We can also see that they are more engaged with staff. In order to gain the views of those who use the service surveys were sent out earlier this year. Over 75 were returned and were generally very positive in their comments. The home is now addressing areas where people felt improvements could be made. Visits are made by a company representative every month in line with Care Homes for Older People Page 24 of 29 Evidence: Regulation 26 and we were able to see the records of these. Some money is kept on behalf of residents mainly for services such as chiropody and hairdressing. This is checked by the manager and her deputy on a regular basis and they are the only ones who have access to it. The service does not manage the financial affairs of any of the residents. The home has provided dates to show that equipment is serviced and maintained appropriately. Other records that they are required to keep as evidence of their commitment to the health and safety of those using the service were all in order. We are always informed of any adverse incidents that occur which might affect the health and welfare of any one in the home. The home complies with fire safety guidance and there are regular fire drills held. The last kitchen inspection by the environmental health officer resulted in a 3 star rating being given. Care Homes for Older People Page 25 of 29 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 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 There must be evidence to 30/10/2009 show that care plans have been drawn up in conjunction with residents or their representatives. In order to give them the opportunity to influence the way that care and support is provided. 2 9 13 Medication records storage and administration must be in line with current Royal Pharmaceutical Society guidelines. In order to provide protection for the people who use the service. 30/08/2009 3 19 23 Alternative arrangements 30/09/2009 must be made for storage of hoists. To make sure that they do not constitute a hazard in the event of a fire. Care Homes for Older People Page 27 of 29 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 It is recommended that staff entries in care plans should be made more specific in order to provide evidence of all of the care that is being given to residents. Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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