Care Home: Crystal Residential Home

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What the care home does well Crystal Residential Home provides a homely place for people to live in. People living their have done so for many years and consider it home. The staff and manager are welcoming and encourage individuals to visit the home before moving in. Mealtimes are relaxed and a sociable occasion. Staff demonstrate knowledge of each person and protected their privacy and dignity. Care has been taken to make sure that any refurbishment or redecoration involves the people that live in this home. What has improved since the last inspection? No requirements were made at the previous inspection. What the care home could do better: Some improvements are needed to make sure that care plans fully reflect an individuals needs and choices. These covers areas such as choice of toiletries and food preferences. Recommendations have been made in this respect. Only one requirement has been made as a result of this inspection. This concerns induction training that staff receive and the need to make sure that staff are aware of moving and handling techniques and falls prevention. Key inspection report Care homes for older people Name: Address: Crystal Residential Home 97 Woodcote Grove Road Coulsdon Surrey CR5 2AN     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: Janet Pitt     Date: 0 3 0 7 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 28 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 28 Information about the care home Name of care home: Address: Crystal Residential Home 97 Woodcote Grove Road Coulsdon Surrey CR5 2AN 02086608643 F/P02086608643 jaisreenemchand@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Jaisree Nemchand care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users who can be accommodated is: 12 The Registered Person may provide the following categories 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: Dementia - Code DE Date of last inspection Brief description of the care home Crystal Residential Home is registered to care for up to twelve older people. It is owned and managed by the same person. The house is a large detached residence set in the attractive suburb of Coulsdon. The home provides accommodation arranged over two floors; there are eight single bedrooms and two double rooms, which are presently occupied by married couples. All bedrooms have a wash hand basin, while one is ensuite. There is a passenger lift allowing easy access to both floors. The home has a large garden to the rear of the building and off road parking to the front. The parking area has been resurfaced, and a new wheelchair ramp installed to the front of the house. The home provides information about its services in a User Guide, which is made available to people living in the home and anyone considering moving in. Care Homes for Older People Page 4 of 28 Over 65 0 12 Brief description of the care home Additional information can be found in the home?s Statement of Purpose. The current weekly fees (as provided at the time of this inspection) range from #373.60 - #430. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating of the service is 2 star. This means the people who use this service experience good quality outcomes. One inspector undertook this unannounced inspection. The inspector was accompanied by an Expert by Experience. This is a person who has experience of either receiving a care service or caring for an individual. A site visit was made which lasted three and a half hours. During this time we observed the lunchtime meal and toured the premises. We were able to speak with people that live in the home and their visitors. We also had discussions with the manager and members of staff. Records relating to assessment and care planning were examined. Staff recruitment Care Homes for Older People Page 6 of 28 files and policies and procedures were inspected. The home provided us with their Annual Quality Assurance Assessment, which gives an overview of how they consider the service is performing. Information that is held by the Care Quality Commission, such as notifications of incidents and concerns was also used to inform this report. We would like to thank our Expert by Experience for their time and observations during this inspection. Care Homes for Older People Page 7 of 28 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 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who chose to live in Crystal Residential Home will be provided with sufficient information for them to make a choice. They will have an opportunity to visit the home and view what happens on a daily basis. Individuals needs will be assessed and a care plan drawn up from this assessment. Evidence: Crystal residential home states in its AQAA that they offer introductory visits, and prospective clients can come and have a meal if they wish to. A tour of the home is offered, including the room available and the communal area. Our Expert by Experience was informed by the manager that there is a waiting list for the home. In their opinion this is an indication that care is of a good quality within the home. When we looked at assessments we found that they were comprehensive. Information Care Homes for Older People Page 10 of 28 Evidence: from the placing authorities was available. The homes own assessment contained information on the persons past medical history, mental health needs and physical assessment. The physical assessment covered areas such as mobility, dexterity, diet, oral health and input of carers needed to met need. The was also information on peoples behaviours, for example hoarding goods, aggression, agitation and restlessness. Nutrition and falls risk assessments had been completed and gave good indicators of what staff need to put into place to make sure a person is cared for correctly. People we spoke to who live in the home said that they had made a positive choice to move into Crystal and thought they had been given sufficient information to help them make a choice. The manager told us that she had updated the Statement of Purpose, we have requested a copy of this to be send to us. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals can be confident that their assessed need will be addressed in their care plans. Some improvements could be made which will make sure that staff have a fuller understanding of the person. End of life wishes are dealt with sensitively. Medications are handled well and safely. There was good evidence of people having choices within the care plans. Evidence: The AQAA states that the the health and personal care is assessed regularly and all outcomes are documented. we make daily record into the service user individual care plan. Our Expert by Experience made the following observations. The residents were neatly dressed. They were wearing clothes suitable for the weather conditions A chiropodist visits every 6 weeks. A local GP visits when necessary. I was told that there is a laundry on site and clothes are washed daily including staff clothing. The Manager said that the residents could retire to bed at night at the time of their choosing. Care Homes for Older People Page 12 of 28 Evidence: The staff were very polite in their attitudes and they kept calm at all times. One [person]liked to read newspapers and keep to [themselves]. However at no time did I feel [they] was neglected. The staff made sure [the person] had what [they] wanted. The expert by experience also observed that staff are able to provide one to one care if needed, to make sure that individuals are comfortable. We looked at care plans selected at random from people who had come to live in the home since the previous inspection. We found that the plans lead from assessed needs and there was a standardised format. There is a key worker system in place, this makes sure that the individuals care is monitored by one person. We noted that there was information on health needs and social needs. For example an individuals personality and personal circumstances. Each plan had a risk assessment for personal and hygiene needs, getting up, bathing or showering, dressing and eating. The number of carers needed to support a person in the community was detailed. There was some good information on peoples behaviour patterns, such as [they] get a little aggressive, [they] will hold someones hand quite firmly. and gets agitated and restless especially when [they] are unable to express [themselves]. However, although there was some indication of how to manage aggressive behaviour, for example staff need to speak to [the person] in a very gentle manner. More specific information is needed to make sure that staff approach an individual in a consistent manner. Another improvement to plans that could be made which will show a persons choice are details of brands of toiletries that they prefer to use. Each persons plan had details of their bedtime routine, such as the number of pillows they used, whether they wished to have a hot drink and if the individual wanted to be checked by staff at night. For example sleeps from ten pm until 6 am, has two pillows, door open, wants a night visit. Each section of the plan was seen to be reviewed regularly and any changes to meet need were recorded. For example mobility and confident improved since being in Crystal. There was evidence of the person or their representative being involved in the care planning process, but this needs to be consistent. One family member had Care Homes for Older People Page 13 of 28 Evidence: commented, as follows [the person] is improving, very calm, put on weight. and having a laugh [they] are happy here. One plan had an advanced decision for personal wishes on the event of mental incapacity. Peoples wishes for end of life care were documented. One plan had not had this section completed, but there was an entry that indicated that the persons representative had been asked and would provide the necessary information. Staff need to avoid use of Tippex on plans, mistakes should be crossed out and signed and dated. There were records of visits to other health professionals such as the doctors, staff were available to go with an individual if needed. We found good evidence of people being able to makes choices, such as [the person] say [they are] to tired to talk to me and she is fed up of answering the same questions. and [the individual] did not go to bed at all. [they]said [they are]comfortable sitting on the chair and do not want to be treated like a child. Slept for a while with legs elevated. Use of language in the daily records and care plans was noted to be appropriate, for example prompt to eat and speak in a gentle manner. No issues were identified with the handling and administration of medications in the home. Since the previous inspection a new drugs trolley, controlled drugs cupboard and drug fridge have been purchased. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Crystal are able to continue with any hobbies or interests that they have. Mealtimes are a sociable relaxed occasion. Staff are responsive to individuals needs and enjoy a good relationship with people. Peoples privacy and dignity is protected and promoted. Evidence: Information in the AQAA about these Standards was as follows, We ensure that routines of daily living and activities made available are flexible and varied to suit each service users expectations, capacities and performance. Encouragement to continue activities and interests eg hobbies and relationships with others. we discuss social activities with the group... minutes of the meeting is recorded. We were able to confirm this by what we saw on the site visit and examination of plans. Our Expert by Experience focused primarily on the Standards in this section, so that we could make a judgement about peoples experience of living in Crystal. They observed the lunchtime meal and had the opportunity to speak with people that live in Care Homes for Older People Page 15 of 28 Evidence: the home and some relatives. The following comments were noted. a choice of menu. The food appeared palatable as I could see no sings of wastage. One resident remarked that they liked the food and others on the table nodded in agreement. Drinks were available. Fruit was provided if the residents asked for it. They also had a choice of beverages. At the time of inspection, staff sat with three residents, [assisting] them in a caring manner. [People] were not rushed and lunch was a leisurely affair. In the evenings, I was told that the residents were provided with a hot drink before retiring to bed. The manager said that she was thinking of providing pictures of food available on the daily menu so that the residents did not get confused when they made their choice. Social activities are arranged in the afternoon after lunch on the day of the site visit this was - gentle exercise and music. The residents did not appear bored. The Manager told me that the home also organises outside entertainment and families are invited to come and join in on that day. I was told that she arranged trips about three or four times a year. The expert by experience spoke with a visitor who had come to see their relative. [They] felt that [the person] was well looked after and had no complaints. [The relative] said that [they] had to wait for a long time to get a place. Here [the relative] felt the carers were more proactive and [people who live in the home were not just one of a number]. During our conversations with the manager, she said that two married couples live in the home in shared rooms. Peoples care plans detailed their interest such as listening to classical music, walking or reading newspapers. There was information on when an individuals family or friends visited. Some people go out with their families. Individuals can chose whether to participate in church services that are held in the home. Care Homes for Older People Page 16 of 28 Evidence: There was a biography of one person that had been brought in by their family. The biography gave good information on what the person had been like before moving into Crystal and details about where they lived, what jobs they had and significant relationships. Staff had commented on this information we are privileged that [they are] in Crystal where we can give [them] that love, support and a quality of life as far as possible. One person likes gardening and there are plans for them to be able to care for pot plants. The manager said that families are invited to celebrations in the home. One persons plan indicated that they liked to peel potatoes, butter bread etc and they are facilitated to do this in Crystal. Plans could be improved by noting individuals food preferences. We also made observations of the lunchtime meal. We found that people had their own places to sit and staff were seen to interact well with the people that live in the home. For example, one person requested a cup of coffee during the meal and this was brought to them without delay and the person and member of staff shared some good humoured banter. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home can be confident that any concerns they have will be listened to and acted upon. Safeguarding procedures make sure that individuals are protected from harm. Evidence: Crystals AQAA states that, The home listens to the service users complaint and acts upon [it] immediately and take necessary steps and actions to safeguard the service users welfare. Our service user and their representatives have expressed feedback to us on the result of how the complaint was dealt with. Provide a suggestion book regarding our services and have regular meetings to give service users the opportunity to express any concerns. When we spoke with people who lived in the home they said that they did not have any concerns or complaints. Many of them have lived at Crystal for a number of years and were satisfied with the service provision. The Care Quality Commission has not received any complaints about the service. There have been no Safeguarding investigations during the past twelve months. There is an appropriate policy in place that details what actions staff should take. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is comfortable and homely. They are able to decide what colours they wish the environment to be decorated in. There are suitable areas for private time and a large accessible gardens. Crystal is clean and maintained. Evidence: The home states in its AQAA that We also take into consideration decorating ideas from the service user. The service user also has the opportunity to decorate their own room. We have plans to build a conservatory to provide and activity or quiet area. Our Expert by Experience was shown around Crystal by the manager they made the following observations, The Home is clean and tidy. It appears that cleaning is done regularly as there was no evidence of dusts in bedrooms and communal areas. There were no unpleasant smells. The communal area is well equipped with chairs. It leads to the rear garden where there are chairs to sit on the patio. The room temperature was comfortable. Disability equipment [was] placed in a corner and readily available. No hazards [were noted]. Doors to toilets and bathrooms [were] painted yellow. making them stand out in line Care Homes for Older People Page 19 of 28 Evidence: with good Dementia care practises. The kitchen was very clean and tidy and not cluttered by kitchen utensils. We looked at one room that had recently been redecorated. The colour scheme was in pastel shades and made the room homely and comfortable, as well as relaxing. The main lounge has been redecorated and opened up, by incorporating the old conservatory. The manager told us that people who live in the home had chosen the colour scheme. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that live at Crystal can be confident that they are cared for by staff who have been appropriately recruited. Staff receive training and regular supervision. However, the service must make sure that mandatory training is undertaken as part of the induction. Evidence: During our site visit we looked at staff files of people employed at the home. Both individuals had started work since the previous inspection. The files were well organised into differing sections. Each file had an application form, health declaration, two references and a full employment history. Criminal Record Bureau checks had been carried out. Staff are asked about previous convictions, it is recommended that information on any cautions is requested. There was information on a persons permission to work in the United kingdom and proof of identification. One person had been recruited via an agency and there was evidence of competence in the English language. Contracts were in place that detailed the role the person was expected to fulfil. The staff files also contained detail of training attended. Recent courses and study Care Homes for Older People Page 21 of 28 Evidence: days included food hygiene, NVQs, Certificate in Dementia Awareness and infection control. Our expert by experience spoke with members of staff and made the following observations, Crystals AQAA states that I spoke to members of staff who were on duty at the time. One was new having been in the post for two months. I could not find out from them whether they had received any [moving and handling training or prevention of falls]. We will require that all staff receive appropriate training in manual handling and falls prevention as part of their induction. One carer was very knowledgeable and said that they had gone through many training courses although they could not identify all of them. This member of staff had done their NVQ. Staff are supervised regularly at least every two months and records kept. Crystals AQAA states that they plan to Continue to provide further training and carry out two monthly supervision sessions. Set targets and provide more in house training. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Crystal is managed by an individual who is focused on making sure that people are able to have a say in the running of the home. The organisation of information held for inspection has improved and it is clear what further improvements the service wishes to make. There are suitable systems in place for making sure individuals health and safety is protected and promoted. Evidence: Crystal states in its AQAA that An annual development plan for the home is based on a systematic cycle of planning, action and review. Feedback is actively sought from the service user through means such as completing questionnaires, and having individual and group meetings. We found the AQAA to be well completed and gave a good overview of what is happening currently. Care Homes for Older People Page 23 of 28 Evidence: The manager and her staff team have made significant improvements and sustained the work they have with regard to organisation of the home. There are plans to further improve the service provision within the home. The manager told us that peoples finances are managed by their families or solicitors. There is a petty cash fund for small essential items. Records are kept and the person responsible for the individuals finances is involved. Throughout the site visit we noted that all staff were visible within the home and attended to peoples requests promptly. The office was well organised and files were easily accessible. Health and safety and hazardous substance handling information was up to date. Policies and procedures were in place, it is recommended that a policy on Sexuality and relationships is developed. The AQAA indicates that in the next twelve months some of the homes aims are as follows, Aim to continue with good practise and provide a high standard of care. The management approach will aim to create an open, positive and inclusive atmosphere. Quality monitoring systems will also be implemented. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 30 18 All staff must receive training in manual handling and falls prevention as part of their induction. This will make sure that people are protected from harm 30/10/2009 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 2 3 1 7 7 It is recommended that the Care Quality Commission is provided with a copy of the updated Statement of Purpose. It is recommended that Tippex is not used on care plans and mistakes are crossed out and signed and dated. It is recommended that improvemnts to care plans could be the use of more detailed descriptions, for example the brands of toiletries a person uses. It is recommended that the person or their representative is invovled in the care planning process consistently and this is evidenced. It is recommended that specific details on how staff should handle challenging behaviours is included in the plans. Page 26 of 28 4 7 5 7 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 6 7 15 29 It is recommended that individuals food preferences are recorded in their plans. It is recommended that prospective staff are asked about any cautions they may have when applying for a post. Care Homes for Older People Page 27 of 28 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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