Care Home: Greenacre

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What the care home does well Greenacres was a home that provided the people living there with a clean, homely environment in which to live. One resident told us that he had visited friends and colleagues in the home and knew this was where he wanted to live when he needed care and support. A variety of training was offered to the staff to ensure that collectively, they had the skills and experience, to meet the needs of the residents, and it was very noticeable that the staff were happy and enjoyed their work. The manager understood the importance of continually auditing and evaluating care in order to ensure that the best possible care was provided People who may use the service were correctly assessed to ensure that the environment of the home, and the staff team, could meet their needs before they were admitted. Care plans were written for all aspects of the care provided to ensure continuity of care. People were encouraged and supported to retain as much independence as possible. For example residents could self medicate if they wished. Residents were treated appropriately and those residents with a learning disability were integrated into many of the activities. A variety of activities were organised that helped to keep the people living at Greenacre interested and stimulated. A robust complaints procedure and staff awareness of safeguarding ensured people were kept safe at all times. What has improved since the last inspection? Since the last inspection people being admitted into the home for care were assessed prior to their admission to ensure that the staff team had the necessary training and experience to provide the care and that the environment was suitable. It was clear that where possible people using the service were consulted regularly and the care provided met their needs. All staff files included two written references before a person started work at Greenacres however the reference was not always from their last place of employment. What the care home could do better: There were few requirements made as a result of this inspection and the AQAA indicated that on the whole the manager was aware of the improvements that needed to be made. It is necessary for the home to keep he Statement of Purpose under review and make alterations as necessary. The service must ensure that all residents have a statement of terms and conditions or a contract. This document should include details of the fees.Care should be taken that each residents care plans is kept under review. Care should be taken that there is a record of all medication held by the home so that an audit could be undertaken at any time. All staff should have six recorded supervision sessions every year. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Greenacre Brewers Hill Road Dunstable Bedfordshire LU6 1UU     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: Sally Snelson     Date: 0 9 0 4 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 29 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 29 Information about the care home Name of care home: Address: Greenacre Brewers Hill Road Dunstable Bedfordshire LU6 1UU 01582603029 Telephone number: Fax number: Email address: Provider web address: BERRYNIC@bupa.com Name of registered provider(s): BUPA Care Homes (Bedfordshire) Ltd care home 42 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia learning disability old age, not falling within any other category physical disability Additional conditions: The home may provide care for 2 service users less than 65 years and have a learning disability. This condition applies only to the 2 service users who have been identified to the Commission for Social Care Inspection. The home may not admit any other person under this category. The Commission must be informed when either service user ceases to live in the home. Date of last inspection 0 2 0 0 Over 65 33 7 33 40 Care Homes for Older People Page 4 of 29 Brief description of the care home Greenacre is a large purpose-built home for older people, situated in a residential area on the outskirts of Dunstable. It is close to local amenities such as schools local shops and places of worship, but too far from the town centre for service users to be able to walk there. The home is on a bus route. The registered provider is BUPA Care Homes (Bedfordshire) Ltd. The home is organised around a central quadrangle that has an enclosed garden area that is well maintained and contains a bird aviary and a fishpond. The building is laid out to provide five separate living units. The home is currently registered to provide services to forty people over the age of sixty-five who may have dementia and/or physical disabilities or learning difficulties and two temporary arrangement for service users with learning difficulties under this age range. The fee for accommodation at this inspection was £644.00 per week. There were additional costs for chiropody, hairdressing, toileteries and newspapers Care Homes for Older People Page 5 of 29 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 carried out in accordance with the Care Quality Commissions (CQC) policy and methodologies, which requires review of the key standards for the provision of a care home for older people that takes account of residents views and information received about the service since the last inspection. Information from the home, through written evidence in the form of an Annual Quality Assurance Assessment (AQAA) has also been used to assess the outcomes within each standard. Evidence used and judgements made within the main body of the report include information from this visit. Prior to the inspection six service user surveys were sent out, three were returned to us. Sally Snelson undertook this inspection of Greenacre It was a key inspection, was unannounced, and took place from 07:30hrs on 9th April 2009. Care Homes for Older People Page 6 of 29 Nicola Berry, the manager, was present throughout the inspection. Feedback was given throughout and at the end. During the inspection the care of four people who use the service (residents) was case tracked in detail. This involved reading their records and comparing what was documented to what was provided. In addition to sampling files, people who lived at the home, visitors, and staff were spoken to, and their opinions sought. Any comments received from staff or residents about their views of the home, plus all the information gathered on the day was used to form a judgement about the service. The inspector would like to thank all those involved in the inspection for their input. What the care home does well: What has improved since the last inspection? What they could do better: There were few requirements made as a result of this inspection and the AQAA indicated that on the whole the manager was aware of the improvements that needed to be made. It is necessary for the home to keep he Statement of Purpose under review and make alterations as necessary. The service must ensure that all residents have a statement of terms and conditions or a contract. This document should include details of the fees. Care Homes for Older People Page 8 of 29 Care should be taken that each residents care plans is kept under review. Care should be taken that there is a record of all medication held by the home so that an audit could be undertaken at any time. All staff should have six recorded supervision sessions every year. 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 9 of 29 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 10 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who may use the service are correctly assessed to ensure that the environment of the home, and the staff team, can meet their needs. Evidence: The service had a statement of purpose that covered all the areas required by the National Minimum Standards and residents were provided with copies of a Service Users Guide. These documents outlined what the home provided and information about any additional costs, such as hairdressing and chiropody costs. The welcome pack given to new residents included a description of the home written by one of the current residents. We noted that the information about us was out of date as it included a contact address from which we had moved 18 months previously, and the name of an inspector that no longer worked for the commission. We advised the manager that the documents should also be reviewed to reflect our new title. We asked to look at contracts for the residents who care we were case tracking. The Care Homes for Older People Page 11 of 29 Evidence: administrator told us that for the past two or three years contracts had only been given to those residents who funded the placement themselves. Other residents did not have a statement of terms and conditions. It is expected that the residents who are funded by the Local Authority also have an agreement between themselves and the home to ensure for example, that they can not be moved from their bedroom to another without agreeing a move. Prior to moving in all of the people using the service, whose care we tracked, had been assessed by the manager, or a senior carer. The assessments were in detail and the information gathered was used to build the care plans. The manager was clear about the needs that the staff team were able to provide care for. For example the staff team did not have the experience or training to care for those people who presented with challenging behaviour. Residents spoken with confirmed that they, or someone on their behalf, had visited the home prior to moving in. One resident told us that he had visited friends and colleagues in the home and knew this was where he wanted to live. At the time of the inspection the home did not offer intermediate care. Care Homes for Older People Page 12 of 29 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. Wherever possible people using the service, or someone on their behalf, were consulted about the care they received. Care plans were written for all aspects of the care provided to ensure continuity of care. Evidence: We looked at four care files of residents who we had randomly chosen to case track. All the files were neat and tidy and the information was easy to find. Each file had a photograph of the resident and clear information about next of kin and who and when to contact in the event of sudden illness. Plans of care had been written for all aspects of the care provided. In three of the four files, plans had been reviewed monthly and altered as necessary. In the fourth file the plans and other documentation had not been reviewed for seven weeks and it was clear from the daily log that care needs had altered in that time and were therefore not reflected in the care plans. However the outcomes for the resident was not compromised as staff were able to discuss their current needs. We were also concerned that a resident who was having her legs dressed by the community nursing Care Homes for Older People Page 13 of 29 Evidence: service was not wearing a dressing. Staff told us that the community nurses had made this decision. We could not find any documentation to support this decision, and we did find a entry in a care log that stated No stockinette available, so were left unsure. Care plans were written in detail and in a person centred way. For example a plan for the provision of personal care detailed how to provide the verbal prompts to encourage and support the residents independence, information as to where the toiletries were kept, and how more toiletries could be obtained. The goal was clear, and it was easy to establish how staff were supporting this resident to achieve her goals and move forward. Each file included areas of risks taken during daily life. With the exception of the one already mentioned they had been kept under review. Monthly reviews and assessments included monthly weights, nutritional screens, skin integrity and moving and handling plans. Daily records of the care provided were clear and well written. We did advice the manager that if staff did not complete a sheet in the care plan that indicated when a resident had a bath or a shower it appeared that people were not being bathed or showered regularly, even though the daily log may dispute this. Records on case files indicated that people living in the home had been supported to access healthcare specialists for routine treatment such as chiropody and optical check ups. Referrals had been made to doctors, district nurses, for continence services, physiotherapy and in relation to mental health needs as necessary. The manager confirmed that the home had a good relationship with G.Ps and the community nursing service. Community nurses were visiting the home twice a day to support a resident who needed to have regular insulin injections. We checked the Medication Administration Record (MAR) sheets for the four residents we case tracked, plus three more. Medications were appropriately stored in a locked trolley that was secured to the wall in a locked room. Monthly deliveries had been appropriately signed in. However there were some instances where medication remaining from the previous month, had not been carried forward. Reconciliation was not possible for these. On the whole charts had been accurately completed with signatures and omission codes where appropriate. The back of the MAR sheet had also been completed when an omission code had been used. Controlled drugs (CDs) were stored appropriately and all administrations had been recorded accurately with two signatures in the CD register. If at all possible residents are supported to self administer their medication. Throughout the inspection we observed residents being treated appropriately and those residents with a learning disability being appropriately integrated into some of Care Homes for Older People Page 14 of 29 Evidence: the activities. Care Homes for Older People Page 15 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A variety of activities were organised that helped to keep the people living at Greenacre interested and stimulated. Evidence: Throughout the home there was evidence that a number of different activities were provided at Greenacres. Each of the five units advertised a number of different activities including regular coffee mornings to which all the units joined together to have their coffee and meet together. Also advertised was a Sunday social club which was a chance for residents to have a sherry before Sunday lunch. Other activities included quiz nights to which staff and relatives were invited and regularly services of worship. The staff providing the activity kept a record of what had been provided, who had participated and the outcome. Staff also took photographs of all events and there was an album showing residents using a wii console, flower arranging, on a theatre trip and celebrating the Chinese New Year with a Chinese buffet. On the day of the inspection the activity co-ordinator had planned for staff to provide an Easter egg hunt for the residents. This had been well advertised and we noted that families and friends, particularly those with children who were on school holidays were taking part and assisting by pushing wheelchairs around the home to search for the Care Homes for Older People Page 16 of 29 Evidence: eggs. The egg hunt followed an Easter bonnet competition. In addition throughout the home we saw a couple seated in the dining room playing dominoes and a gentleman doing a jig-saw in a link area of the home. He told us that residents, staff and visitors would sit with him and add pieces, and that on average he completed two 1000 piece jig-saws a week. One resident told us about the 90th birthday celebrations that had been provided for him and how the home set aside an area so that his family and friends could all celebrate with him. He said it was so successful that his granddaughter wants to hold her next birthday celebrations at Greenacre. Relatives told us that they were welcomed at anytime. One said I visit when I want, it doesnt seem to bother the staff. It was apparent that people using the service were making choices about when they got and up and went to bed and what they did. For example when we arrived at 7.30 some people were up and having breakfast, while we noted others having breakfast in dressing gowns at 10.30am. Residents meeting were held regularly and gave people the chance to comment for example we noted that one person had asked not to be woken with an early morning cup of tea and another had requested more trips out. Residents spoken to had no complaints abut the food, although in the BUPA customer satisfaction survey 2008, satisfaction with the meals had fallen by 10 and residents requested more variety and more nite-bites. It appeared that this had been corrected. Lunch on the day of the inspection was sweet and sour pork or sausages in gravy. One resident said If I want anything special I ask for it. For example on Fridays its fish and chips and I like breaded fish so thats what I ask for. Care Homes for Older People Page 17 of 29 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. A robust complaints procedure and staff awareness of safeguarding ensured people were kept safe at all times. Evidence: Following the last inspection the home had been reminded of the need to hold a central register of complaints, and to record how complaints were investigated. This was now in place and we could see exactly how a complaint had been dealt with. We were disappointed that staff had not identified the need for a change of mattress for a resident, and that the change occurred as a result of a relative making a complaint, but it did confirm that the process was working correctly. Service user satisfaction surveys indicated that residents knew how and to whom to complain to. The home had received a letter of praise from a social worker complementing them on the standard of care they had provided to a client during a respite stay. The training record and training matrix showed that all staff had completed safeguarding training (SOVA) over the year. The manager kept a record of incidents within the home. Discussion with her confirmed that she knew how, and when, to report an incident for investigation by the safeguarding team. Files indicated that residents, or someone on their behalf, had been requested to complete a restraint agreement for the use of bedrails. Care Homes for Older People Page 18 of 29 Evidence: Staff had and were receiving training on the implication of the Mental capacity Act, the use of the IMCA service and Deprivation of Liberty. Care Homes for Older People Page 19 of 29 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 home provided the people living at Greenacres with a clean homely environment in which to live. Evidence: The home was divided into five units, referred to as A,B,C,D,and E unit. This layout promoted small group living and allowed for people with diverse needs to be accommodated. The small units each had their own lounge and dining room and there was communal space at the entrance for joint activities. The home was clean and tidy and appropriately decorated. On the day of the inspection we notes an odour at the entrance to D unit. This was not traced to any one area and may have been due to poor airflow to first floor areas. We were aware that people using the service could personalise their bedrooms as they wished. One resident told us, I like being where things are happening, but I also like being in my bedroom. I have my own computer and TV. Another said, We can lock our bedroom if we want, but why would we. The AQAA told us that the service was now planning a programme of continuous redecoration, not simply redecorating as rooms became vacant. The laundry area was away form the residential area and robust processes ensured Care Homes for Older People Page 20 of 29 Evidence: that laundry was returned to the correct resident as soon as possible. The home had been awarded four stars by the Environmental Health Officer. Care Homes for Older People Page 21 of 29 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. A variety of training was offered to the staff to ensure that collectively, they had the skills and experience, to meet the needs of the people living at the home. Evidence: At the time of the inspection 38 of the 42 beds were occupied. The vacant beds were on the unit dedicated for older people with a learning disability and there were no plans for these to be filled in the near future. The manager informed us that she worked supernumerary, and that there were eight care staff on duty across the five units in the morning, seven in the afternoon and three or four at night. This was in addition to cleaning and catering staff. The manager told us that there had been no problems recruiting staff and there was only very occasional use of agency staff. There was a clear record of training and a training matrix which could be used to easily identify the staff that needed additional or specialist training. The matrix indicated that over the past year all of the staff had undertaken the mandatory training which included moving and handling, fire safety, infection control, food hygiene and SOVA. The majority of the staff had also undertaken in-house dementia awareness and others had completed a relevant course via distant learning. Other specialist training was not recorded on the matrix but was recoded in individual files. The AQAA informed us that five staff had NVQ level 3 and that 22 of the permanent staff had an NVQ to level 2. Care Homes for Older People Page 22 of 29 Evidence: We examined the personal files of three members of staff. All were well-kept and contained fully completed application forms, references, induction checklists and training records and certificates. Criminal Record Bureau (CRB) checks had been carried out on all staff, and home office paperwork was present where required. However the references in one file did not include a reference from the staff members current place of work. The manager told us that this was because the new staff member was not going to resign from her current, very part-time role until she was sure the new post suited her. We explained that it was necessary to have a reference from her current position, particularly as it involved working with vulnerable members of the society. Care Homes for Older People Page 23 of 29 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 understood the importance of continually auditing and evaluating care practises in order to ensure that the best possible care was provided. Evidence: The manager had been registered as the manager of Greenacres for more than two years. She was supported by a deputy, who was shortly to move on to manage her own home. The processes for consultation and auditing were good, although not foolproof. They included the auditing of care files and medication, by the manager, the deputy manager and the responsible individual during Regulation 26 visits. The company also regular evaluated the service and produced a written report of the outcome and expected the manager to provide an action plan. Monies held on behalf of people were held in accordance with BUPAs corporate systems. These system paid monies received on behalf of people living in the home Care Homes for Older People Page 24 of 29 Evidence: into private savings accounts and billed people or their representatives for purchases not included in costs for the accommodation, such as hairdressing and chiropody treatment. Small amounts of cash were held on site for those who wished to pay for these items directly. The two records seen showed that proper accounts had been maintained of purchases made on behalf of service users. We looked at the supervision records of three staff members. Over the previous 12 months two had received six supervisions and a third only three. We were told this was because this member of staff was doing NVQ and receiving supervision from their assessor, but there were no supervison records from the assessor or any indication that all areas required by standard 36 were covered by the assessor. We looked at health and safety documentation, including the fire log and maintenance book. There was evidence to indicate that fire call points and the emergency lighting were being tested on a regular basis, and that fire drills were carried out periodically. The last fire check had been the 3rd of April 2009 and the last fire drill the 10th of December 2008. Care Homes for Older People Page 25 of 29 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 26 of 29 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 2 5 The service must ensure that all residents have a statement of terms and conditions. This ensures residents have details of their entitlements. 01/06/2009 2 29 19 This refers to regulation 19, schedule 2. Where applicable the two references obtained prior to a job offer must include the persons last place of work This ensures the prospective employee is not currently undergoing any disciplinary procedures. 10/05/2009 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 1 This refers to regulation 4 (1) and schedule 1. Page 27 of 29 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 The Statement of Purpose should be kept under review and altered as necessary. 2 3 4 7 9 36 Care should be taken that each residents care plans is kept under review. care should be taken that there is a record of all medication held by the home so that there is always an audit trail. All staff should have six recorded supervision sessions every year. Care Homes for Older People Page 28 of 29 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. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!