Care Home: Caldene Rest Home

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What the care home does well Visiting to the home is open and people living within the home can maintain relationships that are important to them. People living at the home have access to a range of Health and Social Care Professionals to ensure that any health care needs are met. There are no rigid rules or routines in the home. Money, which is held on behalf of people at the home, was accounted for and there were good systems in place to ensure people`s finances were protected. What has improved since the last inspection? Recommendations made at the previous inspection visit have been met. What the care home could do better: Medication management must improve to ensure people living in the home receive the medication prescribed and they are safeguarded. Record keeping for money held for people living in the home needs to be robust, so that it is clear how much money was spent. The complaints procedure should be reviewed and amended, so that people are aware they can come to the Commission at any point in the process if they wish to inform us of their concerns. Staff need training in a number of areas to ensure they have the competencies and skills to meet the needs of people living in the home. Records need to be available to demonstrate the passenger lift is safe for use. Furniture and other items no longer required by the home should be removed from the garden area, so that people living at the home have a safe and pleasant outdoor space. Key inspection report Care homes for older people Name: Address: Caldene Rest Home 27 Beeches Road West Bromwich West Midlands B70 6QE     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: Karen Thompson     Date: 1 2 0 8 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: Caldene Rest Home 27 Beeches Road West Bromwich West Midlands B70 6QE 01215005664 01215253085 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Richmond Court Nursing Home Ltd care home 27 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: 27 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 (OP) 27 Dementia (DE) 27 Date of last inspection Brief description of the care home Caldene comprises of a traditional property that has a large extension (exceeding the size of the original property) built on. This means the majority of the property is built for the purpose of a care home and offers a number of communal areas. There are a range of adaptations available as would be necessary for the care of older people. The accomodation is spread over the first two floors of the home with bedrooms located on both the ground and first floor. There is a garden to the rear of the property and this provides people living at the home with an outdoor area. Care Homes for Older People Page 4 of 27 Over 65 0 27 27 0 Brief description of the care home The home is sited close to the centre of West Bromwich and is easy to reach by public transport or car, as transport links and main roads are close by. The majority of the accommodation offered is for long term stays although the home has offered short term and emergency care when requested. The home is owned by a company that has a number of other nursing and care homes in Sandwell. The current charges for the home range from £400 to £475 per week. For up to date fee information the public are advised to contact the home. 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: This was an unannounced inspection; so the home did not know we were coming. It was carried out by one inspector over a one day period. The focus of the inspection undertaken by us is upon outcomes for people who live in the home and their views of the service provided. The process considers the care homes capacity to meet the regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. Prior to this fieldwork visit taking place a range of information was gathered to plan the inspection, which included notifications received from the home. We were supported throughout the inspection process by both the manager of the home and a manager from another home within the group of homes. At the time of inspection twenty-two people were living at the home. Information was Care Homes for Older People Page 6 of 27 gathered by speaking to and observing people who lived at the home. Two people were case tracked and this involves discovering their experiences of living at the home by meeting or observing the care they received, looking at medication and care files and reviewing areas of the home relevant to these people in order to focus on outcomes. Case tracking helps us understand the experiences of people who use the service. Staff files, training records and health and safety files were also examined. 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: 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 8 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 9 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. Pre-admission assessments were comprehensive, so staff had sufficient information to allow them to determine if they could meet peoples needs upon moving into the home. People had all the information they needed to make an informed decision about moving into the home. Evidence: The certificate of registration was clearly displayed for people to refer to demonstrating the home is registered to provide long stay and respite care to people. We were given a copy of the Statement of Purpose and Service Users Guide at the inspection, which was dated as having been reviewed July 2009. We observed Service Users Guides in peoples bedrooms which demonstrated that people had access to these guides. The Service User Guide is currently available in larger print than the Statement of Purpose, although it is not currently available in other formats. These documents provide people with information about the services and facilities in the Care Homes for Older People Page 10 of 27 Evidence: home to assist them in making a decision about moving into the home. Other formats should be explored to ensure it is accessible to everyone. The pre admission assessment was of a satisfactory standard, enabling staff to identify the needs of the person (before admission,) so they could determine if their needs could be met on moving in to the home. This information is used by staff to draw up a care plan, which outlines the action required by staff to ensure peoples needs are met appropriately. Staff spoken to were able to demonstrate they were aware of the care needs of people recently admitted to the home. The home does not provide intermediate care so we did not assess this standard. The home, however, does provide respite care for a number of people on a regular basis. Care Homes for Older People Page 11 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. There were appropriate systems in place to ensure peoples health and personal care needs are met in a way that ensures peoples dignity is maintained. Areas in respect of management of medication need to be improved to ensure peoples well being is maintained. Evidence: The care records of two people living at the home were looked at in detail and other records sampled. We saw that there was also a range of risk assessments that highlighted potential risks and the actions required to reduce the risk, so people could a lead meaningful life with minimum risk. There was clear evidence that people living in the home had their care plans reviewed on a regular basis. Staff spoken to had a clear understanding of the needs of the individuals living in the home and how these were to be met. Everyone living in the home was registered with a local General Practitioner (G.P). People had access to other health and social care professionals as required including Care Homes for Older People Page 12 of 27 Evidence: social workers, dieticians, chiropodists and opticians. This ensures peoples health care needs are being monitored adequately and thier well being promoted. The homes medication system consisted of a blister and box system with printed Medication Administration Records (M.A.R) sheets being supplied by the dispensing pharmacist on a monthly basis. The home had copies of the original prescription (F.P 10s) for repeat medication, so they were able to check prescribed medication against the MAR chart when it entered the home. On inspection of the medication for the current month it was found that all audits were correct for medication that was in the blister packs. However, some of the audits for boxed medication were not correct indicating that people had not received their medication correctly. We found one person had been receiving a variable dose medication, which had not been prescribed and this may have accounted for being unable to audit the medication. We observed one member of staff dispensing medication without checking the Medication Administration Chart and then signing for the medication as given when they had not given the medication to the person. Handwritten MAR charts contained the initials of two staff receiving medication into the home but it is recommended that signatures of staff are obtained for handwritten medication records, as signatures allow for easy recognition if there is a query about medication. Medication fridge temperatures were within range, which ensures that medication to be stored at low temperatures is done so correctly. Good interaction was observed between staff and people living in the home such as staff talking to people at mealtimes whilst assisting them with their meal and chatting generally to people living at the home Care Homes for Older People Page 13 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. Arrangements for visiting the home were flexible, so people are able to maintain important relationships. People are consulted about their wishes and a range of activities are available if they choose to join in enhancing peoples well being. There is a choice of healthy meals that meets peoples dietary requirements. Evidence: There was no evidence of any rigid rules or routines in the home and people who live there can go outside on their own or with friends and family as they choose, depending on their abilities. On discussion with people living in the home they stated they were happy living there. People are able to bring personal items of small furniture, pictures, ornaments and so forth into their bedrooms, providing a home from home atmosphere reflecting their personality. Visiting was flexible enabling people to visit at a time that suited them, so people living in the home could maintain contact with friends and family. The home employs an activities co-ordinator who works across the three homes owned by the company. The activities co-ordinator spends approximately twelve hours a week providing activities for people living at this home. On the day of inspection bingo was being played by a number of people living in the home. The activities coCare Homes for Older People Page 14 of 27 Evidence: ordinator informed us that each person living in the home had an individualised activities programme. They were able to give us examples of these individual activities. Feedback from people included; All friends here, have little concerts. No complaints about food. Go out if I want to Home in one word, wonderful. There is a four week rotating menu, based on peoples preferences. The menu demonstrated a variety of nutritious meals with choice at each meal time and people confirmed that they are offered a choice each day. Special diets can be arranged for reasons of health, taste, and cultural/religious preferences and these were being provided. Drinks and snacks were available between meals. On discussion with catering staff they were aware of peoples dietary needs. The kitchen was clean and very orderly. There are two dining areas in the home. The dining tables at breakfast and lunchtime were well presented with table cloths, condiments, cutlery and so forth. Staff had also obtained specialised equipment where necessary to enable people to maintain their independence. Meals were nicely presented and staff provided assistance appropriately where necessary. Care Homes for Older People Page 15 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. There were systems in place for dealing with complaints and concerns and people living at the home felt listened to. There were systems in place to protect people living at the home. Evidence: A complaints procedure was on display in reception area. Some people were not aware of the procedure, but stated they would go to the office or speak to the manager if they had any concerns. One relative commented that they were Happy with home, no concerns, people nice, looked after. We have not received any complaints about the home and their complaints record demonstrated three complaints had been received since the last key inspection. The management team provided us with a copy of the response to the complaints, which covered all the areas raised by the complainants. Since the last inspection they have introduced a complaint procedure in another language to ensure everyone living in the home had access to the procedure in a format accessible to them. The complaints procedure in the Service User Guide and Statement of Purpose does not make it clear that people can raise concerns with us at any stage in the complaints process and they do not have to wait for the outcome of the homes investigation. The complaints procedure should be updated to reflect this. Care Homes for Older People Page 16 of 27 Evidence: Records indicate that most care staff had undertaken training in respect of safeguarding and on discussion with members of staff they had a satisfactory knowledge of the procedure within the home. Staff had not received training in respect of the Mental Capacity Act 2005 and Deprivation of Liberty safeguards. This is an important piece of legislation that protects and promotes the rights of people with varying levels of capacity to make decisions. Staff need to be aware of their responsibilities in supporting people with varying levels of capacity to make decisions. Care Homes for Older People Page 17 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. People live in a homely, clean and comfortable environment that meets their needs but improvements are needed in the outside space to ensure it meets peoples needs Evidence: The building is a large detached three storey home. The first two floors are devoted to people who live in the home. There is off road parking to the front of the building. The home is maintained internally and externally with level access to the building for wheelchair users. The home originally comprised of two properties, which are now linked. Our observations on walking around the home were it was warm, clean and maintained to a good standard. The garden area, however, contained a variety of discarded items such as furniture and oxygen cylinders, which need to be removed, to ensure the garden is safe and pleasant for people living at the home to enjoy. The atmosphere in the home was calm, relaxed and friendly and there were no unpleasant odours. Bedrooms were personalised and reflected individual tastes, gender and cultural preferences. People are encouraged to bring in their own possessions to create a home from home environment. A call bell facility was available in each bedroom so people can call for assistance if required. Lights in the corridor areas of the home come on automatically when they sense movement. This means people living in the home getting up during the night to use the bathroom dont have to search for a light Care Homes for Older People Page 18 of 27 Evidence: switch. People living in the home told us they like this facility and found it helpful. A passenger lift enables people to access all areas of the home and the home has a range of equipment to assist people with reduced mobility for example, portable hoist, hand rails and raised toilet seats. One bath hoist had not been working for a number of months and this will be commented upon in the management and administration section of the report. There are two main communal areas on the ground floor of the home. They consist of two lounge/dining areas. This allows people a choice of areas to sit and dine, but also provides people living at the home with a change of environment if they want to move around the home. The main kitchen was clean, well organised and adequately equipped for its purpose. The laundry equipment was adequate to allow sluice and pre-wash cycles. Staff were observed in the laundry from the home next door using the tumble dryer. Whilst we were informed that this was only a temporary arrangement staff are advised to discuss the arrangements with the Environmental Health Department and ask for advice as to any potential hazards this arrangement may present. 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. There are adequate staff on duty to meet peoples needs. The staff were both capable and enthusiastic but were not being sufficiently supported with regard up to date training to meet peoples needs. Evidence: On the day of the inspection we were assisted initially by the care manager from another servie belonging to the owner. The Care Managers for the three homes in the organization recently swapped homes for a trial period and we were informed of this in writing. We were informed the manager for the home works during the week and the duty rota indicated there were three care staff on duty during the day and two care staff overnight. Ancilliary staff such as domestic, laundry, catering and maintenance staff support the care staff. The recruitment records for a new staff member were sampled and showed that appropriate recruitment checks had been made. Staff informed us they may move around the three homes within the organisation. We asked the management team the reasons for this and were informed that if it was felt that someone was better suited to residential or nursing care they would move them to the home more appropriate to their skills. The training records for staff indicated which staff had completed training in respect of Care Homes for Older People Page 20 of 27 Evidence: safeguarding, first aid, infection control, health and safety, but there had been lapses in the training provided. The majority of staff required updated training in manual handling and fire prevention. Fourteen of the twenty four members of staff had completed a National Vocational Qualification (NVQ) level 2 in care. Training provides staff with appropriate skills and knowledge to care for people living in the home. New staff undertake induction training when commencing employment to the home, so they are familiarised with the homes policies and procedures and so forth and this was evidenced at the time of the inspection. 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 home is run in the best interests of people living there. Systems are in place to ensure the health, safety, and protection of people living in the home. Evidence: The care manager works on a full time basis, is registered with us and has almost completed the Registered Managers Award, ensuring she is appropriately qualified for the post. Individual records and receipt were kept for people where the home holds money on their behalf and receipts. Receipts were available to confirm expenditure on hairdressing. We looked at four individuals records, the balances of monies were checked and we found one was not correct. The management team were advised to look at the records and establish where the error had occurred. The home has a quality assurance system in place. We were also told by the management team that regular staff meetings were taking place. We were also told Care Homes for Older People Page 22 of 27 Evidence: that questionnaires were sent out on a regular basis to people living at the home, relatives and professionals in order to gain feedback about the quality of the services. There was evidence that health and safety maintenance checks had been undertaken in the home with the exception of a thorough examination of the passenger lift. The management team were unable to find a certificate to demonstrate this had been carried out. A bath hoist had not passed its safety check and had not been in use for several months, which is concerning as this impacts on the choice people have in relation to bathing. This hoist needs to be repaired or replaced to ensure peoples choice, dignity and independence is maintained and upheld. Checks were completed for gas, portable hoists, fire systems and equipment and were deemed safe. The accident records held by the home complied with data protection and there were records to demonstrate monitoring of peoples conditions following accidents, in case of any further complications. Care Homes for Older People Page 23 of 27 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 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 9 13 The quantity of all medicines 20/11/2009 received into the home and any balances carried over from previous cycles must be recorded. This is to enable audits to take place to demonstrate the medicines are administered as prescribed. 2 9 13 All staff must check the prescription prior to dispensing and check the dispensed medication and the medicine charts. This is to ensure that people living in the home receive their medication as prescribed. 20/11/2009 3 38 23 The passenger lift should have a thorough examination carried out every six months and records must must be available to demonstrate this. 13/11/2009 Care Homes for Older People Page 25 of 27 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 To ensure the lift is working correctly and does not place anyone at risk. 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 Handwritten Medication Administration Charts should contain the signatures of the staff receiving and recording the medication in the home, to ensure an accurate record. The Complaints procedure must be amended to reflect that people can contact eh Carfe Quality Commission, to ensure that people using the service are aware that their voice their concerns us. It is recommended that the home obtain a copy of the Department of Health guidance Mental Capacity Act 2005 residential accommodation published 2007 The garden area should be cleared of unwanted items such as furniture and oxygen cylinders, so that it is suitable for use. The home should seek advice from Environmental Services in respect of the current arrangements for drying cloths from Richmond Court to ensure hygiene procedures are not breached. Shortfalls identified in staff training such as Mental Capacity Act, Deprivation of Liberty, Manual handling and fire training should be addressed through the appropriate learning style, so that staff fully understand their roles and responsibilities. This will ensure knowledge and practice mirrors and meets the needs of people living in the home. Systems for holding the money of people living in the home should be reviewed to ensure they are held safely and can be accounted for in all cases. 2 16 3 18 4 19 5 26 6 30 7 35 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. 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