Care Home: Eastlands

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What the care home does well People living at home have told us that it is a very happy and well-run home. Residents and staff were smiling and welcoming throughout the day and the atmosphere was relaxed. Laughter that was frequently heard during the day. People told us they enjoyed the quality and variety of food available. Menus were varied and nutritious, with plenty of fresh and some home-grown produce being provided. There was appreciation expressed for the activities available both inside the home and also in the local community. The service has listened to the views of people living at the home and tried to include more local interaction, especially with the local church. People receive good healthcare support and visiting health professionals told us they had confidence in the ability of the staff to provide good care. The deputy manager has demonstrated her understanding of best practice in the way she has arranged medication matters. What has improved since the last inspection? Care plans have improved and give good information about most elements of people`s lives and the kind of support needed from staff. There has been significant improvement to the environment. The areas redecorated and improve include corridors, entrance hall, lounges and dining room. There have been improvements outside also, with a new patio and gazebo area that can be accessed from the newly fitted French doors in the main lounge. Staff now receive regular supervision. Some staff have told us this makes them feel well supported. What the care home could do better: The service has met the requirements made at the last inspection. However, with a view to maintaining continuous improvement, some good practice recommendations have been made at this inspection. Staff need to check regularly to make sure that all elements of the care plans are up to date. For example, the record for monitoring people`s weight states it should be completed each month and this is not always the case. It would also be good practice to develop better care plans about the social and emotional needs of each person in addition to the records kept by the activities coordinator. This will mean that staff will have information available to support residents in their hobbies and activities when the activities coordinator is not working. The service keeps a record of complaints and concerns in a folder that also contains complements. This folder is kept in the entrance hall. This document is not protecting people`s confidentiality and the complaints and concerns element should be kept in the office. There is clearly a storage problem at the home and this has resulted in wheelchairs being stored in the main lounge. This is unfortunate, as it detracts from the attractiveness of the room and therefore thought should be given to an alternative storage area. Currently, residents have their hair done in the airing room of the laundry. It would be good for an alternative area to be put aside for hairdressing so that residents can relax and enjoy the experience of having their head done. The service is urged to continue with the high standard of refurbishment to include both shower rooms. It is good practice for staff to countersign supervision records but this is not happening at the moment. By countersigning, staff are showing they understand the contents of the supervision record and agree to the responsibilities this places on them. Key inspection report Care homes for older people Name: Address: Eastlands Beech Avenue Taverham Norwich Norfolk NR8 6HP     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: Geraldine Allen     Date: 0 3 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 26 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 26 Information about the care home Name of care home: Address: Eastlands Beech Avenue Taverham Norwich Norfolk NR8 6HP 01603261281 01603869995 eastlands@fshc.co.uk Noneprovided County Healthcare Ltd, a wholly owned subsidiary of Four Seasons Health Care Ltd care home 35 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Thirty-five (35) Older People, not falling into any other category, may be accommodated. Date of last inspection Brief description of the care home Eastlands is a care home providing personal care and accommodation for 35 older people. The home is a single storey detached building, situated in the village of Taverham. The accommodation consists of six double and twenty-three single bedrooms, twenty-five of which have en suite facility. Various communal areas are available for service users. A drive way leads to the property with car parking facilities and gardens to front and rear of the premises. Email eastlands@fshc.co.uk Fees #398 - #600 0 Over 65 35 Care Homes for Older People Page 4 of 26 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 inspection was unannounced and took place during the day of 3 August 2009. We looked at all the information we had received about the service. Before the inspection the manager sent us a completed annual quality assurance assessment (AQAA) when we requested it. The AQAA is a self assessment that considers how well the outcomes for people living at the home are being met. We also received completed surveys from five residents and two members of staff. On the day of inspection we gathered information from various sources. We looked at records and documents, toured the premises, had a meal with residents, observed staff practice and spoke with residents, the manager, staff at the home, visitors to the home and visiting health professionals. Care Homes for Older People Page 5 of 26 What the care home does well: What has improved since the last inspection? What they could do better: The service has met the requirements made at the last inspection. However, with a view to maintaining continuous improvement, some good practice recommendations have been made at this inspection. Staff need to check regularly to make sure that all elements of the care plans are up to date. For example, the record for monitoring peoples weight states it should be completed each month and this is not always the case. It would also be good practice to develop better care plans about the social and emotional needs of each person in addition to the records kept by the activities coordinator. This will mean that staff will have information available to support residents in their hobbies and activities when the activities coordinator is not working. The service keeps a record of complaints and concerns in a folder that also contains complements. This folder is kept in the entrance hall. This document is not protecting peoples confidentiality and the complaints and concerns element should be kept in the office. There is clearly a storage problem at the home and this has resulted in wheelchairs Care Homes for Older People Page 6 of 26 being stored in the main lounge. This is unfortunate, as it detracts from the attractiveness of the room and therefore thought should be given to an alternative storage area. Currently, residents have their hair done in the airing room of the laundry. It would be good for an alternative area to be put aside for hairdressing so that residents can relax and enjoy the experience of having their head done. The service is urged to continue with the high standard of refurbishment to include both shower rooms. It is good practice for staff to countersign supervision records but this is not happening at the moment. By countersigning, staff are showing they understand the contents of the supervision record and agree to the responsibilities this places on them. 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 7 of 26 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 8 of 26 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. Admissions are only made to the home after a full needs assessment has been completed and if the service is confident they are able to meet the needs of the prospective resident. New residents are provided with a contract setting out the terms and conditions of residence. They receive information about how the home is organised and run. Evidence: People using the service told us they had received a contract setting out the terms and conditions for living in the home. This means they know what will be provided by the home, what they have to pay for or provide for themselves and any rights and obligations they have. People are also given a copy of the service user guide which they keep in their own rooms. We saw evidence that people have a very thorough needs assessment completed Care Homes for Older People Page 9 of 26 Evidence: before they move into the home. This ensures that the service only admits people they know they can care for effectively. Individual care plans are put together on the basis of the needs assessment so that staff know how they need to support the person at the time they move into the home. This home does not provide intermediate care. Care Homes for Older People Page 10 of 26 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. Each person has a care plan reflecting their health and personal care needs. However, in order for these care plans to be fully person centred and holistic, social and emotional needs also need to be considered and recorded. People have access to good health care and staff follow instructions given by healthcare professionals. Good medication arrangements are in place. Medicines are stored safely and good records are kept. Staff attend regular medication training. People are treated with dignity and their rights to privacy are respected. Evidence: We looked at three care plan folders in detail. Each folder included the full needs assessment and it was possible to see how this had informed the care plan for each person. There was information to tell staff what action they needed to take and when, in order to support each person in terms of health and personal care. Requirements Care Homes for Older People Page 11 of 26 Evidence: made at the last full inspection have been met, although a recommendation has been made at this inspection about regular scrutiny of care plans to ensure all elements, such as the recording of the persons weight, is not overlooked. In order that the care plans can be regarded as person centred and holistic, information about each persons social and emotional needs should be included. This should be in addition to the records kept when the person has attended activities with the activities co-ordinator. This will mean that staff are able to support the person when the activities coordinator is absent. The manager told us that she works hard to ensure a good relationship with the local GP surgery and health services. A visiting district nurse told us that the home was well run and people received good care. She said the home notified the surgery if a visit was needed. The care plan folders contained good information about all health care visits and any changes to care or medication as prescribed. We looked at the arrangements for the control, administration and recording of medicines. The home uses a monitored dosage system and the senior member of staff responsible for all medication matters is commended for the good order in which medicines are kept. Concerns were raised with the manager at the time of the inspection because senior staff responsible for administering medicines were also expected to take telephone calls and to direct staff early in the morning. This was unsafe practice and since the inspection the manager has told us that the practice has changed and the senior member of staff is left undisturbed whenever administering medicines. Throughout this inspection the interaction between staff and residents was observed. At all times staff spoke politely to residents and insured all personal care was given in private. People using the service told us that staff always treated them with respect and did everything they could to preserve their dignity when personal care was being given. Care Homes for Older People Page 12 of 26 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 are able to take part in daily activities that reflect their choice and preferences. The service encourages good relationships with the local community so that people feel included in events outside of the home. The choices people make about their lives at the home are respected by staff and support is given to help people maintain their individuality. People enjoy a well balanced and nutritious diet. Evidence: During the course of the day people living at the home, visitors and staff were spoken with in addition to observations being made about what was happening in the home. People were seen taking part in various activities and they told us that these were the choices they had made. People said that staff listened to what they say and always acted on it whenever they could. They told us they felt in control of their lives and were confident staff would respond positively and support them as needed. People told us they could choose how, where and with whom they spent their day. During the course of the afternoon the activities coordinator arranged a session playing hangman. This was very well attended, with 11 residents present 10 of whom were actively engaged in the game. People seemed to be enjoying themselves and there was plenty of laughter. Care Homes for Older People Page 13 of 26 Evidence: Most people had lunch in the main dining room, although they could have it in their own rooms if they preferred. The dining room was light and spacious and the tables attractively laid. The catering manager had spoken with all residents during the course of the morning to see what they would like for lunch. In addition to the choices available on the main menu, a wide range of further alternatives were available. People enjoyed their meals and there was very little waste seen being disposed of. Residents said they enjoyed their meals and appreciated the variety on offer. Plenty of staff were available to provide help if needed. The catering manager spoke about special diets being provided at the time of inspection. Care Homes for Older People Page 14 of 26 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 a complaints procedure that is clearly written and easy to understand. People know how to make a complaint and are confident it will be dealt with effectively. current practice does not ensure confidentiality. The service has appropriate policies and procedures in place regarding the safeguarding of adults. Staff receive training to ensure they understand what is abusive practice. Evidence: There was a complaints procedure displayed in the entrance hall of the home so that all residents and visitors know how to make a complaint. Details about any complaints or concerns received need to be recorded in a folder kept in the office rather than the entrance hall so that people will be able to voice their concerns knowing they will be treated confidentially. Residents and visitors to the service knew about the complaints procedure and said they felt confident that the manager would deal quickly and appropriately if they voiced concerns. The Commission has not received any complaints or concerns about this service in the last 12 months. Staff receive training about safeguarding people and how to alert managers when they have a concern. Staff had a good understanding about what was abusive practice and what they should do if they witnessed or heard anything that could be abusive. Recruitment practices at the home include criminal records bureau checks and a Care Homes for Older People Page 15 of 26 Evidence: minimum of 2 written references obtained before people begin working at the home. This helps to protect people from abuse. Care Homes for Older People Page 16 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is well maintained, clean, hygienic and free of unpleasant odours. Residents are encouraged and supported to personalise their bedrooms. Thought needs to be given to the storage of items such as wheelchairs so that they do not spoil the appearance of communal areas. Evidence: A requirement was made at the last inspection about keeping the home in good decorative order and evidence was seen during the course of the day that this requirement has been met. A tour of the premises was conducted with the manager during the course of the morning. All areas of the home were clean and tidy and there were no unpleasant odours detected. The communal areas that have been decorated appeared bright and airy. Unfortunately, the main lounge is used to store wheelchairs and this practice spoils the appearance of the room. On the day of inspection, a new assisted bath was being installed in one of the bathrooms. In addition, there is a further bathroom and two shower rooms available for residents use. However, both shower rooms and in particular shower room two needs to be upgraded and the tiles replaced. Care Homes for Older People Page 17 of 26 Evidence: One resident showed us their bedroom and this appears to be highly personalised and reflected her interests and hobbies. The laundry room was seen and the opportunity was taken to speak with the laundry person. The equipment in the laundry room provides sluicing facilities and foul laundry washing temperatures. Unfortunately, the area is shared with the visiting hairdresser and thought needs to be given to providing a more appropriate location so that residents can enjoy having their hair done in a pleasant and hygienic room. Externally, a new patio area and gazebo have been built. Once matured, the planting in this area will provide a delightful place for people to sit. We talked with the manager about ways in which the area can provide more sensory stimulation. This area is surrounded by grass that has been allowed to grow unchecked and it was agreed this would make a delightful wildflower meadow. There are also two areas of the garden which are used to grow fruit and vegetables, some of which have already been enjoyed by residents. Care Homes for Older People Page 18 of 26 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. The service employees sufficient staff to ensure the needs of people are met. The service follows a robust recruitment procedure that helps to ensure residents are safeguarded. Staff receive training appropriate to their roles. Evidence: Four staff files were looked at and these showed us that the service follows good recruitment practice. All potential staff have criminal records bureau check completed before they start work in addition to a minimum of two written references from previous employers and/or people who know them. The manager told us that they receive full induction training and work initially beside experienced staff. A copy of the staff duty roster for the week of inspection was provided and this showed that sufficient staff were on duty to meet the needs of the residents effectively. In addition to care staff, the service also employs ancillary staff to deal with catering, cleaning, laundry, gardening and maintenance. There is also an activities coordinator employed 3 half days a week. A copy of the staff training plans in 2009 was provided. This showed us that staff receive training that is appropriate to the needs of the people living at the home. Much of the training, such as manual handling, fire safety, health and safety, and Safeguarding vulnerable adults are mandatory. Care Homes for Older People Page 19 of 26 Evidence: We talked to 4 members of staff during the course of the inspection. They told us about some of the training they have undertaken and also demonstrated a good understanding about safeguarding matters. Staff told us they receive supervision from senior staff. Staff also told us they receive regular training updates and feel well supported. They also told us they worked in a happy and contented atmosphere. Visitors to the home told us that staff were knowledgeable and hard-working and were always cheerful. One visitor spoke of her admiration for the staff and appreciated how well they treated her relative. Care Homes for Older People Page 20 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager has the required qualifications and is experienced and competent to run the home. There are effective quality assurance and quality monitoring systems in place and the views of people living at the home are sought and listened to. The service has robust processes in place where they look after peoples personal allowances. The health, safety and welfare of service users, staff and people visiting the home are protected. Evidence: The manager told us she has been in charge of the home for the last nine years. We saw copies of her qualifications displayed in the entrance hall and these confirmed that she is suitably qualified to undertake her role. People living at the home told us there was a happy atmosphere and they felt it was a well-run home. Staff told us they get plenty of support from the manager and felt communication with her was very good. The manager told us a customer survey is sent out from the companys head office each year. She receives feedback and develops an action plan with the regional Care Homes for Older People Page 21 of 26 Evidence: manager based on the findings of the survey. The last survey had been done fairly recently and the manager undertook to send us a copy of the findings, although this had not been received by the time this report was completed. People living at the home told us the manager consulted with them. They said the manager and senior staff listened to their views and opinions and acted on them when they could. We looked at the arrangements for looking after and recording personal allowances belonging to people living at the home. Good, clear records were seen, with plenty of checks in place to ensure the risk of errors were reduced and people were protected from financial abuse . Monies held were checked against records and found to be correct. The arrangements for staff supervision were discussed with the manager. Formal supervision takes place regularly and is well structured. However, it was noted that the supervision record was only signed by the senior member of staff and not by the supervised person and it was recommended they should do so to ensure they are clear about their responsibilities within this process. In addition to formal supervision, group supervision also takes place on a regular basis. Staff confirmed they received supervision and appreciated the support this provided. We looked at a variety of records in respect of health, safety and welfare of people at the home. These included the maintenance records completed on a daily, weekly or monthly basis. These records were clear and up-to-date. Other records seen included portable appliance testing, hot water temperatures, fire safety equipment, fire training, health and safety and control of substances hazardous to health. In all cases records were up-to-date. Practices observed during the course of the day confirmed staff were aware of the various policies and procedures in place in respect of health and safety matters. Care Homes for Older People Page 22 of 26 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 23 of 26 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 It is recommended that a care plan is written detailing the persons preferences regarding their social and emotional needs. This should be in addition to the records kept by the activities coordinator. This will mean that staff will be able to support people with preferred activities when the activities coordinator is not working. It is recommended that staff regularly scrutinise care plans to ensure all entries such as weight records are up to date. It is recommended that full details of all complaints and concerns are kept in a file and stored in the main office. This will ensure that confidentiality is maintained for people who wish to make a complaint or raise a concern. It is recommended that wheelchairs are stored in an alternative location than the main lounge. This will ensure that the appearance of the lounge is enhanced. It is recommended that the two shower rooms are upgraded and the wall and floor tiles replaced so that residents can have a shower in a pleasant environment. It is recommended that an alternative location is found for the hairdresser to use so that residents can enjoy having Page 24 of 26 2 3 7 16 4 20 5 21 6 26 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 their hair done in a pleasant and hygienic area. 7 36 It is recommended that staff also sign their supervision records. This will help to ensure they understand what has been agreed and what their responsibilities are within the process. Care Homes for Older People Page 25 of 26 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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