Care Home: Curtis Weston House

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What the care home does well People living at Curtis Weston House and their relatives were all positive about the care they received. Typical comments included: `The staff have been very good with xxx, we`ve no complaints at all, the way they talk with her, and look after her - they treat her with respect` `the food is excellent, you can have as much or as little as you like...if you`ve got to be anywhere this is the best place` `if you feel you need to see a doctor, you just tell your carer and the doctor comes` `On the whole the staff are good, sometimes people ask to go to the toilet but they don`t come`. `the clothes are nicely laundered` `you are made to feel very welcome as a visitor`. We found that the personal and health care needs of people living at Curtis Weston House were well supported. We saw that people enjoyed the food provided, they liked the range of menu options and the choices on offer each day. We saw that staff were sensitive and knowledgeable about the people who they cared for. We found the home to be clean and tidy, and people living there have personalised their own bedrooms. There is a good range of `organised` activities for people living at the home. What has improved since the last inspection? Single glazed windows have been replaced with double glazed windows making the home warmer and less drafty as well as improving appearance. Some areas of the home have been redecorated - The Meadows (the respite unit for people with dementia) has had its corridor redecorated with colours suggested by dementia care experts. The bathrooms have been refurbished with Arjo Malibu baths. This has reduced the amount of moving and handling needed to support a resident in getting into a bath. New sofas have been bought to encourage people using Fir tree lounge at Curtis Weston to sit together and talk with each other. In this lounge there is now a fireplace which has created a focal point. What the care home could do better: Although staff have a very good understanding of the needs of people living at the home, this is not reflected in the care records. The daily notes written by staff do not link in with the care plans, and do not give information about how the care plan is being followed. The cook does not puree the different food groups separately. This should be done to ensure that people who have a pureed diet can still distinguish the different food groups on the plate and enjoy the different smells and tastes. The provider could improve activity planning for people with dementia, and other complex needs, and look at addressing their needs on a more one to one basis. The provider should consider whether the laundry facilities adequately meet the needs of the people living at Curtis Weston House and address any shortfall in provision. The garden for people using the respite facilities at The Meadows could be improved to provide a more sensory experience for people using the service. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Curtis Weston House Aylestone Lane Wigston Leicestershire LE18 1AB     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: Fiona Stephenson     Date: 1 4 0 5 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 28 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 28 Information about the care home Name of care home: Address: Curtis Weston House Aylestone Lane Wigston Leicestershire LE18 1AB 01162887516 01162887799 Telephone number: Fax number: Email address: Provider web address: www.leicestershire.gov.uk Name of registered provider(s): Leicestershire County Council Social Services care home 40 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia learning disability mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability sensory impairment Additional conditions: Curtis Weston House care home is registered to provide personal care to male and female service users who fall withn the following categories:- (DE) 8 (DE(E) 20, (LD) 4 (LD(E)) 4, (MD) (MD(E)) 8, (OP) 40, (PD) 8 (PD(E) 10, (SI) 4 (SE(E) 4. No person falling within the category DE can be accommodated at Curtis Weston House when there are 8 persons who fall within this category residing at the home. 8 4 8 0 8 4 Over 65 20 4 6 40 10 4 Care Homes for Older People Page 4 of 28 No person falling within the category MD(E) can be accommodated at Curtis Weston House when there are 6 persons who fall within this category residing at the home. No person falling within the category PD can be accommodated at Curtis Weston House when there are 8 persons who fall within this category residing at the home. No person within any of the following categories; SI, PD, DE, LD, MD may be admitted unless they are aged 55 years or older. No persons falling within the category DE(E) or DE can be accommodated at Curtis Weston House when 20 persons who fall within these categories/combined categories are already residing at the home. No persons falling within the category LD(E) or LD can be accommodated at Curtis Weston House when 4 persons who fall within these categories/combined categories are already residing at the home. No persons falling within the category MD(E) or MD can be accommodated at Curtis Weston House when 8 persons who fall within these categories/combined categories are already residing at the home. No persons falling within the category PD(E) or PD can be accommodated at Curtis Weston House when 10 persons who fall within these categories/combined categories are already residing at the home. No persons falling within the category SI(E) or SI can be accommodated at Curtis Weston House when 4 persons who fall within these categories/combined categories are already residing at the home. Old age, not falling within any other category (OP) 40. Date of last inspection Brief description of the care home Curtis Weston is a care home providing personal care and accommodation for up to 40 older people, who may have associated conditions including dementia, mental health issues, learning disability, physical disability and sensory impairment. Curtis Weston has a respite facility called The Meadows and this offers accommodation for up to seven people with Dementia. It is a self contained unit within the home. The home is situated in the town centre of Wigston, close to shops, pubs, the post office and other amenities with local transport facilities being easily accessible. The forty single bedrooms are without en-suite facilities. The building is two-storey, and people can get to the first floor either by using the stairs, or by using a passenger lift. There is a pleasant garden area for people using the main part of the home; and there is also a garden for those using The Meadows. The maximum weekly fee is £499.80. There are extra costs such as chiropody, optician Care Homes for Older People Page 5 of 28 Brief description of the care home and hairdressing services, and the fee will depend on the services received. Care Homes for Older People Page 6 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: This key inspection included a visit to the service. This is the first key inspection to the home since the 21st May 2007. We (the CQC) visited Curtis Weston House on Thursday 14th May 2009. The registered manager ,and the staff in the home helped us during the visit. The visit started at 08:45 and finished at 16:50. The main method of inspection we used was case tracking. This means looking at the care given to people in different ways. We did this by, - talking to the people who live in the home and their relatives, - talking to staff and management, - watching how people are given support, Care Homes for Older People Page 7 of 28 - looking at records. We looked at the Annual Quality Assurance Assessment (AQAA). This is a document the provider (the person who owns the service) sends to us at the CQC, and it tells us what the provider thinks about the service they deliver to people who live at Curtis Weston House. We also looked at the surveys called Have your Say About.. which are sent out to people who live and work at Curtis Weston House. We received no surveys back from people who live at the home, and six from staff. We spoke with five people who live at Curtis Weston House during our visit, and three relatives who were visiting the home during the inspection. Everyone we spoke with was very positive about the care being given at the home. We spoke with six members of staff during our visit to the home who told us about working in the home and gave us their views. All staff spoken with were happy working at Curtis Weston House, and felt well supported by management. The staff who responded to the Have Your Say questionnaires also were positive about the support and training they received, which they felt gave them the skills and knowledge to do their job properly. Two of the six felt that the service could improve by: staff having more time for activities and to spend with the residents we are key working for Curtis Weston could do with more staff to be able to spend more time with the residents e.g. go out for walks, shopping, out for a drink at the pub, sitting and chatting/reading the papers on a regular basis. We checked all the standards that the Care Quality Commission has decided are key standards during this inspection. The information below is based only on what we checked in this inspection. We have kept details about individual people out of the report to make sure we respected their confidences. What the care home does well: What has improved since the last inspection? Single glazed windows have been replaced with double glazed windows making the home warmer and less drafty as well as improving appearance. Some areas of the home have been redecorated - The Meadows (the respite unit for people with dementia) has had its corridor redecorated with colours suggested by dementia care experts. The bathrooms have been refurbished with Arjo Malibu baths. This has reduced the amount of moving and handling needed to support a resident in getting into a bath. New sofas have been bought to encourage people using Fir tree lounge at Curtis Weston to sit together and talk with each other. In this lounge there is now a fireplace which has created a focal point. Care Homes for Older People Page 9 of 28 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 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 10 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 11 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 looking to move to Curtis Weston House are provided with enough information to help them make an informed choice. Evidence: We looked at the written information given to people who are moving into Curtis Weston House, and their relatives, and saw that it gives them the information they need to make an informed decision as to whether Curtis Weston House or The Meadows is the right place for them to live. We checked that new people moving into the home had their needs assessed to ensure that Curtis Weston House could meet their needs. We saw that there were good, clear needs assessments undertaken and that staff were providing the required support and care. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Curtis Weston House have their health and personal care needs met well. Evidence: We talked to people who live at Curtis Weston House, and to their relatives. The people we spoke to were happy with the quality of personal care being given to either themselves or their relative. They felt that staff knew the needs of the person very well, and acted on their needs to ensure they were given the care needed. We spoke to staff who were either the key workers to the people we case tracked, or who were known to have an in depth knowledge of their care. What they told us about the care needs of each individual corresponded with what the relatives told us. We saw that care notes are kept on each person. These include care plans, risk assessments, medical notes, and daily notes. We saw that the written documentation did not reflect the good care being given to people living in Curtis Weston House. There were care plans in place and they had been signed to say they had been reviewed, but by talking to the relatives and staff we saw that some areas of care had Care Homes for Older People Page 13 of 28 Evidence: changed and this had not been changed in the care plan. We also saw that staff write daily notes on each person, but these notes are brief and dont accurately show the care being given each day. We looked at the way medicines are given to people and how they are recorded as being given. We observed staff giving medicines to people living at the home during breakfast time. We saw that they were given safely and hygienically to people living in the home. We looked at how staff recorded what medicines have been given and we saw that staff record this well. We checked how medicines are stored, and saw that all medicines were stored in the correct way. For example, controlled medicines were stored in a Controlled Drugs cabinet, medicines that require being stored somewhere cool were stored in a medicine fridge, and general medicines were stored in other safe cupboards. We checked that the ordering and disposal of medicines was done in a timely way to ensure people get their medicines when they need them, and that they are disposed of safely. We found this was done well. We checked that people living at Curtis Weston have access to other health care services when they need them. We were told by people living at the home that they can see their GP when they want, and we saw that other health care practitioners such as district nurses, chiropodists, dentists and opticians provide health care support to those who need it. We watched how people living at Curtis House were being treated by staff and management. We saw many instances of staff treating people well and with dignity and respect. We saw one member of staff talking to a person living in the home with dementia who was anxious, who gently and patiently re-assured the person that everything was going to be OK, and why it was going to be OK. We saw staff check that it was OK to enter a persons room by knocking and waiting at the door. We were told by people who live at the home, and by people who visit that staff treat people at Curtis Weston well. 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 living at Curtis Weston House have a good daily life, although those with more complex needs would benefit from more one to one activities to support their social and emotional needs. Evidence: We saw that people living at Curtis Weston House had flexibility in their daily routines, and staff tried to accommodate their personal preferences as much as possible. We spoke with visitors at Curtis Weston House who told us they were able to come at any time during the day and evening, and were made to feel welcome by staff working in the home. We saw organised activities taking place during our visit (a game of ball with residents), and saw evidence of other activities being organised for people living at Curtis House. We didnt see as much information about how those with dementia and more complex physical care needs have their social and emotional needs catered for in terms of more one to one support. We saw people living at Curtis Weston House having their breakfast. There was a Care Homes for Older People Page 15 of 28 Evidence: range of breakfast options available, including a cooked breakfast. We spoke to the cook and looked at the menu, and saw a good range of menu choices available to people living at the home. The residents we spoke with said they thought the food was very good. One said the food is excellent, you can have as much as you like, if youve got to be anywhere this is the best place. We asked how pureed food is given to those who require it, and we were told that all the different items of food for the persons dinner are pureed together. We asked the relative of the person this is served to whether they thought their relative would prefer the food pureed separately, and they said they thought it would be better served separately as this would look and taste nicer. The manager told us they were in the process of buying molds to make pureed dinners look more appetising. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has good systems in place to listen to, and act upon the concerns of people living at Curtis Weston House. Evidence: We spoke with relatives and people living at Curtis Weston House. They told us that they felt able to talk to staff and management if they had any concerns regarding the home or staff. They felt that staff listened to what they had to say and would act on it. We saw that the complaints procedure had been talked about at the last residents meeting to ensure that people living in the home knew how to make a formal complaint. We looked at the records, and spoke with the manager, and saw that there have been no formal complaints made about the service since the last key inspection of Curtis Weston House. Our information also told us that there had been no referrals made under the Safeguarding Adults polices and procedures (these are made if there are concerns that a person living at the home has been abused in any way). We were told that staff are reminded in staff supervision sessions of their responsibilities to report to management if they are concerned about the wellbeing of residents; and we saw by looking at the AQAA that this issue will be talked about in residents meetings also. We saw by looking at the AQAA that staff are having training to understand how the Mental Capacity Act, and the Deprivation of Liberty Act impacts on how they should be Care Homes for Older People Page 17 of 28 Evidence: providing care to people who live at Curtis Weston House. 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 living at Curtis Weston House live in a comfortable, safe, and well maintained environment. Evidence: We looked at the communal areas of the main part of Curtis Weston House, and of The Meadows, as well as looking at the bedrooms of those we case tracked. We saw all areas as clean, tidy and odour free. We saw that as well as a large communal lounge, there are smaller lounges in the home that have been furnished to create a homely environment. Bedrooms have been personalised by the people who live in them. There are no en-suite facilities and people living in the home use communal toilets and bathroom facilities. We saw that specialist aids and equipment is available for people living at Curtis Weston House who need them, e.g. pressure relieving mattresses, hoists etc. We saw that equipment is checked regularly to ensure it remains safe for the use of people living at the home. We checked that staff used gloves and aprons when undertaking personal care, and that laundry was washed at the correct temperatures to ensure that infection is not spread. We saw that the service took infection control seriously and had all the correct measures in place. Care Homes for Older People Page 19 of 28 Evidence: We spent time in the laundry and spoke with the laundry worker. We saw that the two washing machines (one of which is smaller than the other) do not always have the capacity to take the large amount of laundry that is now required. We were told that the machines are not always reliable and there have been problems with them breaking down. We saw that there has been some refurbishment and redecoration at Curtis Weston House. New double glazed windows have replaced single glazed windows; the corridors, main lounge and entrance hall have been redecorated, and there are have been improvements made in the main garden. The garden for those living in The Meadows is not as pleasant, being mainly a slabbed area. We were told by the manager that this is going to be improved in the near future. 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. There are sufficient staff, who have been suitably trained to meet the needs of people living at Curtis Weston House. Evidence: All the people we spoke with on the day of our visit were very complimentary of the staff and management. Staff know the needs of each person living at the home, and have developed good relationships with their relatives. The staff rota shows that there are enough staff on duty during the day and evening to support the current health and personal care needs of people who live at the home. There are only two waking night staff on duty during the night, and they also support the care needs of people in the Dementia Care respite service. The manager informed us that if needed, more staff can be rotad to ensure the needs of people are met during the night time as well as day time. We were told that the majority of people working at Curtis Weston House had achieved their National Vocational Qualification in Care (NVQ) to level two. Some had achieved NVQ 3 in care, but had paid for this themselves as the County Council would not fund this. We saw that staff had undertaken job specific training in areas such as health and safety, to ensure people living at the home were kept safe. Care Homes for Older People Page 21 of 28 Evidence: We looked at the recruitment procedures and saw that the service had ensured all the relevant checks had been carried out on staff before they started work at Curtis Weston House. These procedures help to keep people living at the home safe. We also checked that staff receive on-going supervision, and saw that staff have regular supervision sessions, as well as participating in team meetings. 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. Management and administration at Curtis Weston House is good. Evidence: By talking to people who live at Curtis Weston House and their relatives, by talking with staff, and by looking at records, we saw that Curtis Weston House provides a good quality of life for people who live there. The manager leads and supports a strong staff team who want to provide good quality care and support to people at Curtis Weston House. Both staff and people living at the home have a good relationship with the manager and feel he works well with them to keep standards of care high. The manager is well qualified, and has a National Vocational Qualification in Care to level 4, and the Registered Managers Award. He is also an NVQ assessor. During our visit we saw that the service has paid good attention to health and safety issues such as infection control, food hygiene, and the maintenance of equipment. We saw that the service undertakes quality audits through a variety of ways. It has an Care Homes for Older People Page 23 of 28 Evidence: annual quality assurance questionnaire that is sent out to people living at the home and their relatives. We were also informed and saw the notes of meetings with residents on a group basis, and were told that one to one meetings are held to check that residents and their relatives are satisfied with the care and support they receive. Relatives also informed us that staff are responsive to any ideas or queries they may have about their relatives care. 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 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 The care plans should include information about the care of pressure areas and risk assessments should be in place. They should also include information abut the medication people take, and the reasons why they take it. The daily care notes should be linked to the care plans so they can be used effectively when undertaking monthly reviews of the care plan. The care plans and risk assessments must be reviewed and updated more effectively to accurately reflect the changing needs of the person and how care staff are to meet their needs. The provider should look at how it can improve opportunities for people with complex needs such as dementia, for social and emotional stimulation. The cook should ensure that food groups are pureed separately so people can distinguish the different flavours of each food group. The garden for people using the respite facilities at The Meadows could be improved to provide a more sensory experience for people using the service. Page 26 of 28 2 7 3 7 4 12 5 15 6 19 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 7 19 The provider should consider whether the laundry facilities adequately meet the needs of the people living at Curtis Weston House and address any shortfall in provision. Care Homes for Older People Page 27 of 28 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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