Care Home: Elizabeth House Care Home

What the care home does well Peoples needs are assessed before they move into the home so that staff know how to meet their needs. People are offered a range of information before they choose to move into the home. The manager has a training plan in place for staff and there is a high number of staff who have completed a recognised training qualification. This shows the manager has a commitment to developing the staff working in the home. We spoke with one visitor on the day of the inspection and they told us that they and other members of the family visited daily and always felt welcome. Another visitor told us in a completed survey, "The home makes visitors very welcome and they can come and go as they please". What has improved since the last inspection? Following the inspection in April 2009 we asked the manager to provide us with an improvement plan telling us how she was going to improve the service. She completed this plan and sent it to us detailing action being taken to address issues we raised at the inspection. The manager has worked hard to put improvements in place and has met all of the requirements that we set. These improvements were evident when we visited the home as part of this inspection. The medication procedures in the home have been improved. The home has introduced nutritional assessments for people needing assistance with their meal and these have have been approved by external health care professionals. We observed lunch being served and saw that people living in the home who need assistance with their meal are now provided with plate guards and staff told us they felt that this had improved the way that people can be supported to eat independently. What the care home could do better: The home could offer more activities around peoples individual needs and preferences. All staff should complete training in the Mental Capacity Act 2005 and the deprivation of liberty safeguards. Where staff have left previous employment that involved working with vulnerable people, the Commission asks that this reason is documented. Although the manager told us that she always asks this question at interview, it is not recorded and this would further enhance the homes recruitment procedures. Key inspection report Care homes for older people Name: Address: Elizabeth House Care Home 2 Church Hill Avenue Mansfield Woodhouse Mansfield Nottinghamshire NG19 9JT     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: Lynda Dyer     Date: 2 7 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Elizabeth House Care Home 2 Church Hill Avenue Mansfield Woodhouse Mansfield Nottinghamshire NG19 9JT 01623657368 01623631720 d.ramnarain@btinternet.com RAMNARAIN9@aol.com Mrs Vijay Ramnarain,Surendra Dev Lutchia,Mr Vivek Obheegadoo care home 16 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: Date of last inspection Brief description of the care home Elizabeth House is a care home providing personal care and accommodation for 16 older people. The home is located in Mansfield Woodhouse, in a quiet residential area and close to shops, pubs, the post office and other amenities. The home is an older style domestic property with a more recent two-floor extension. There are 14 single, and 1 double bedroom, which are located on both floors and there is a passenger lift. There are a variety of lounge areas. There is a garden that is only accessible people who have good mobility. There is limited car parking available on the homes driveway and further parking is available on the street. The manager told us on the day of the inspection that the current range of fees are between £1,420 to £1,460 per month. There are additional costs for newspapers, chiropody and taxis. 2 2 0 4 2 0 0 9 0 Over 65 16 Care Homes for Older People Page 4 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of inspections undertaken by the Care Quality Commission is upon outcomes for people who live at the home and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. The last time we visited this service was April 22nd 2009. After this visit we asked the home to provide us with a plan of how they planned to improve the service due to our concerns in some areas of service delivery. The manager produced the improvement plan and worked well with us and we looked at the areas identified in the improvement plan as part of this inspection. We, as it appears throughout the Inspection Report refers to The Care Quality Commission. Care Homes for Older People Page 5 of 27 Two inspectors carried out an announced site visit to the home, which took place over a period of six hours. The Registered Manager assisted us during the site visit to the home and we found her and her staff to be helpful and hospitable. We have introduced a new way of working with owners and managers. We ask them to fill in a questionnaire about how well their service provides for the needs of the people who live there and how they can and intend to improve their service, this is called an Annual quality assurance assessment (AQAA) We received the AQAA back from the manager in good time. The form was completed well and gave us all the information we asked for. We also sent out surveys called, have your say, to people who use the service, staff that work there and relatives. This meant we could get an idea of what people thought about the way the home was run. We had six completed surveys back and we have included some of the comments in this report. We have not included comments that could identify the writer as we want people to feel they can be open about the way they feel the service is run. We also reviewed all of the information we have received about the agency since we last made a visit to them and we considered this in planning the visit and deciding what areas to look at. The main method of inspection we use is called case tracking, which involved us choosing one person who use the service and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. We also looked at the care plan of another person living in the home so that we could see evidence that the requirements we made at the last inspection had been met. We spoke with the manager, two members of staff, a visitor and three people who use the service to help us to form an opinion about the quality of the service being provided to people. We read documents as part of this visit and looked at the environment and facilities of the home to form an opinion about the health and safety of people who use at the service. The Commission have a focus on Equality and Diversity and issues relating to this are included in the main body of the report. Care Homes for Older People Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Older People Page 7 of 27 You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed before they move into the home so that staff know how to meet their needs. People are offered a range of information before they choose to move into the home. Evidence: The manager told us in the homes Annual Quality Assurance Assessment (AQAA) that all service users needs are assessed by social workers before they are admitted to Elizabeth House. They also told us that they ensure that their needs can be met first and foremost before admission. We received information from two people living in the home that told us that they felt they were offered enough information before they decided to live there. We looked that the care plan of one person living in the home and this contained a full needs assessment that was completed prior to them moving into the home. Care Homes for Older People Page 10 of 27 Evidence: We looked at the information available to people to look at before deciding to live in the home. This information includes a service user guide and a statement of purpose and the manager has introduced an updated version. The updated information now contains the required information and is also written in a format that is easy to read with pictures throughout to aid people with communication difficulties. The manager told us that she is looking to condense this information and produce a smaller version for people to read on admission. The home does not offer intermediate care and so standard 6 does not apply. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home have up to date and relevant care plans, which give guidance to staff to deliver the appropriate individual care and medication procedures are now safe. Evidence: The manager told us in the homes Annual Quality Assurance Assessment (AQAA) that all service users health care needs are fully met . They also told us that all service users are treated with respect and dignity and their privacy is upheld at all times. The home operates a designated key working system with clear evidence displayed of which staff is key worker to individuals in the home. We looked at the care plan of two people living in the home and we looked at one in depth. We found that appropriate risk assessments were in place along with a care plan for staff to follow in how to manage that risk. We saw evidence of referrals to external health professionals where needed and saw that appropriate records were being kept of these visits. Where people have been assessed as needing to have their Care Homes for Older People Page 12 of 27 Evidence: meal liquidised, an appropriate assessment has been made and this has been signed by the persons General Practitioner. The care plans were being reviewed regularly and there is evidence of the person that the care plan was written for and/or their representative had been involved in the care plan. The care plans contained a personal profile with information that is important to the person it was written for. Information is included about equality and diversity issues including religion and sexual orientation. The plan also contained information relating to the Mental Capacity Act 2005 with best interest assessments in place. We looked that the medication procedures in the home and found that these had been improved since the last inspection. The requirements we had set had all been met and the medication procedures were now safer. We observed a member of staff administering medication and found that they were following the correct procedures. We observed staff interacting with people living in the home and we found the interactions to be positive with staff being respectful and kind with staff knocking on peoples bedrooms doors before entering. The recent report from the Nottinghamshire County Council quality auditing team states that the staff are due to attend training on maintaining dignity. Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that live in the home are given the opportunity to participate in some recreational activities and maintain social contacts. People receive a nutritious and appetising diet with individual preferences being met. Evidence: The manager told us in the homes Annual Quality Assurance Assessment (AQAA) that they ensure service users lifestyle that they experience in the home matches, their expectations and preferences and satisfies their social, cultural, religious and recreational needs. They also said that they encourage contact with family, friends, and other members in the community. Activities are offered in the home three times a week, there is a hairdresser that visits the home once a week and there are some trips out for people living in the home to go on. We received two surveys back from people living in the home and they told us that there were activities for them to take part in. However, three staff working in the home told us that they felt there could be more trips arranged and a recent visit by the Nottinghamshire County Council quality monitoring team felt that the activities offered were limited. One member of staff said Care Homes for Older People Page 14 of 27 Evidence: they wished there was more time to sit and chat with people living in the home and to play board games with them. The home had also conducted a quality assurance assessment by asking people living in the home and their relatives to complete a survey. The results of this were on display and it was evident that people wanted to be offered more activities. We spoke with the manager and she told us that she was planning to improve the activities offered by trying to tailor activities around personal preferences and link this to the personal profile already in place in individual care plans. On the day of the inspection we observed people moving living in the home moving freely around the home and we saw evidence of people being supported to make choices around what time they got up in the morning and what they did during the day. We observed lunch being served and saw that people living in the home who need assistance with their meal are now provided with plate guards and staff told us they felt that this had improved the way that people can be supported to eat independently. The mealtime was relaxed and staff sat with people and gave assistance in a sensitive and discreet manner. The menu was on display and the cook told us that there was a choice of meal each day and we saw evidence of this on the day of the inspection. The meal looked appetising and nutritious and two people living in the home told us that the meals were always good. We looked at records in the kitchen and saw that the cook had written information about the likes, dislikes and dietary needs of all people living in the home and that specialist diets were provided for. We looked at the care plan of two people living in the home who needed to have their meal partially liquidised and we saw that this was well documented and signed by a health professional. We spoke with one visitor on the day of the inspection and they told us that they and other members of the family visited daily and always felt welcome. Another visitor told us in a completed survey, The home makes visitors very welcome and they can come and go as they please. Care Homes for Older People Page 15 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home know how to make a complaint and staff know how to safeguard them from abuse. Evidence: The manager told us in the homes Annual Quality Assurance Assessment that all service users have opportunities to tell her on a daily basis about any complaint or unsatisfactory issues they have encountered and that service users, their families, visitors and staff are encouraged to disclose any concern they have about any issues including abuse. They also told us that the home has policies on safeguarding people and that all staff staff are aware and have attended safeguarding training. The Commission has received one complaint about the service since the last inspection and the manager responded to this appropriately. The manager told us that the home has not received any complaints since the last inspection and that there have not been any incidents which led to a safeguarding referral being made. People living in the home told us in surveys that they knew how to make a complaint and staff told us that they knew what to do if someone raised a concern. The home now has an updated complaints policy in place and this is displayed in the main reception as well as in every bedroom in the home. The complaints policy now gives the correct contact information for people to be able to contact the Commission Care Homes for Older People Page 16 of 27 Evidence: if they have any concerns. The home has the current local safeguarding procedures in place and we saw evidence that staff are trained in safeguarding procedures. Staff have not yet attended training on the Mental Capacity Act 2005 or the new deprivation of liberty safeguards. However there and there was evidence in care plans that the manager is applying the act by completing capacity assessments. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good housekeeping procedures provide people with clean, pleasant and homely surroundings in which to live. Evidence: The manager told us in the homes Annual Quality Assurance Assessment that they ensure the service users live in a safe, clean, homely and well maintained environment. On the day of the inspection the home was clean, homely and well maintained. We viewed the bedrooms of five people living in the home and found them to be bright, clean and personalised with the persons own possessions. One person living in the home said, The home is always clean. Another told us, The rooms are nice, it is a homely atmosphere and it is always warm. One shared bedroom only had a call bell assessable to one person. The manager told us that the second person would be unable to use the call bell but agreed that a second call bell would be placed in the room for that persons safety. Since the inspection that manager has told us that this had now been addressed and a second call point installed. Care Homes for Older People Page 18 of 27 Evidence: The home has installed a new wet room but it was not being used due to people being more familiar with using the older bathroom. The older bathroom does not have appropriate shower facilities for people who wish to have a shower and so staff were using the over bath shower. This was creating issues with the floor being wet and slippery and there were also issues with there not being an appropriate shower seat. We spoke with the manager about this and she agreed that the new wet room would be introduced to people living in the home over a period of time and that staff would use this room for any person living in the home who wanted a shower instead of a bath. We saw evidence of staff being trained in infection control procedures and observed them following these procedures on the day of the inspection. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has good staff training procedures and staff have a good understanding of peoples needs. Evidence: The manager told us in the homes Annual Quality Assurance Assessment (AQAA) that they have staff of various skills, acquired knowledge and experiences during day and night to ensure that all Service Users needs are met. They also told us that all staff recruited undergo the required safety checks before commencing work and that staff are trained on mandatory courses and that there are sufficient members of staff on duty at all times with extra staff at lunch time whenever needed. On the day of the inspection we found staff to be helpful, friendly and observed them caring for people in the home in a kind and sensitive manner. We asked people living in the home what the home does well and that said, The staff are good and Staff look after us well. We asked relatives the same question and one relative told us, The staff are fantastic. We received surveys from two people living in the home and they told us that staff were available when they needed them and we also received surveys from three staff working in the home and they told us that there was usually enough staff on duty. Care Homes for Older People Page 20 of 27 Evidence: However we spoke with a member of staff and they told us that sometimes if staff were busy, they had to ask people to wait for assistance, particularly at mealtimes. We spoke with the manager about this and asked her to send us an action plan to tell us how she would address this issue. The manager has responded to this and has told us that she is going to use a regular source of volunteers to help over the busy meal periods. The manager has a training plan in place for staff and there is a high number of staff who have completed a recognised training qualification. This shows the manager has a commitment to developing the staff working in the home. We received information from staff working in the home that told us that staff receive training that is relevant to their role and helps them to meet the needs of people they care for. we also saw evidence in staff files of a range of mandatory training and some training relevant to health care needs being completed. There are some people living in the home who have diabetes and although staff have been given written information on this health care need, they have not received any training. Staff told us in completed surveys that the manager had completed the required safety checks on them before they commenced working at the home and we saw evidence in staff files of these checks being carried out. Where staff have left previous employment that involved working with vulnerable people, the Commission asks that this reason is documented. Although the manager told us that she always asks this question at interview, it is not recorded and this would further enhance the homes recruitment procedures. Staff told us, I think the home makes people feel welcome and all the staff are friendly and outgoing and Staff are friendly and helpful to professionals, residents and family members. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed in the best interests of the people living there. Evidence: The manager told us in the homes Annual Quality Assurance Assessment that the Service users benefit from a home which is run efficiently and managed by a person who is fit to be in charge, of exemplary character, compassionate and ensure that all service users welfare are her number one concern. They also told us that the safety and welfare of residents and staff are promoted and protected at all times. Following the inspection in April 2009 we asked the manager to provide us with an improvement plan telling us how she was going to improve the service. She completed this plan and sent it to us detailing action being taken to address issues we raised at the inspection. The manager has worked hard to put improvements in place and has met all of the requirements that we set. These improvements were evident when we visited the home as part of this inspection. Care Homes for Older People Page 22 of 27 Evidence: We found the manager to be open and helpful on the day of the inspection and she gave us all of the information we asked for. We spoke with a person visiting the home and they told us that the manager was very approachable and helpful and staff told us in surveys that the manager met with them often to discuss how they were working and to support them. The home completed a quality assurance survey with people living in the home and their relatives this year and the results of this had been displayed for people to read. We looked at some health and safety records and we found that the manager is having regular fire audits carried along with a range of other health and safety audits. Staff are also trained in health and safety procedures. The home has a track record of consistently safeguarding peoples finances with regard to managing their personal spending monies. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 27 19 Where a person has previously worked with vulnerable people, verification of the reason why the employment ended must be recorded in staff files. This will make sure recruitment procedures are robust. 01/12/2009 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 7 Where sensitive information is recorded about people such as sexual orientation, a signature should be obtained as to whether they are happy for that information to be contained in their care plan or if it should be confidential. The home could offer more activities around peoples individual needs and preferences. All staff should complete training in the Mental Capacity Act 2005 and the deprivation of liberty safeguards. Staff should be given training in diabetes and how to Page 25 of 27 2 3 4 12 18 30 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 recognise and respond to high/low blood sugar. Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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