Care Home: Hambrook Meadows

What the care home does well The home finds out about the needs of people before they move into the home. This means new residents can be confident that staff can support them in the areas they require. Residents are happy with the support they receive to manage their health. For example one resident stated, "they are very good, make sure we get the proper attention" and another "they sorted free eye glasses for me and arrange doctor if needed". The way staff talk to residents promotes their dignity. As one resident explained, "To be spoken to in proper manor, to be spoken to in way like a child would be wrong, being shown respect is all we ask, staff are very good here like that". The home provides a range of activities that meets the current residents needs. Visitors are made to feel welcome. As one person explained, "visitors can come anytime, they always offer cup of tea and biscuit". Residents are confident that their complaints will be listened to, taken seriously, and acted upon. All nine residents questionnaires that we received state the home is always fresh and clean. All staff apart from one person hold a National Vocational Qualification (NVQ) at either level 2 or 3. This means residents can be confident staff have a level of knowledge appropriate to meet their needs. Equipment in the home is regularly serviced making it safe for residents to use. What has improved since the last inspection? The registered manager has implemented new risk assessments for the moving and handling of residents. These are detailed and inform people how risks to residents can be reduced. The homes AQAA informs us of improvements that have been made to the environment since our last visit. It states that security door locks have been fitted, equipment including an adjustable bed purchased and one bedroom redecorated. Weekly meetings take place between the registered manager and the proprietor. These allow for the needs of residents to be discussed and prompt action taken where needed. What the care home could do better: A record of all prescribed medication entering the home must be maintained. Without this information effective medication audits cannot take place. Controlled drugs must be stored in a facility that complies with Misuse of Drugs (SafeCustody) Regulations 1973 as these were amended in 2007 and now require care homes to have the same facility as a nursing home in order to offer greater protection from theft. POVA first disclosures must be obtained prior to any member of staff commencing work and even if a member of staff has a CRB disclosure from a previous employer the home must still apply for and obtain a new one. This must happen to ensure the homes recruitment practises offer safeguards to residents. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Hambrook Meadows Broad Road Hambrook Chichester West Sussex PO18 8RF     The quality rating for this care home is:   one star adequate 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: Lesley Webb     Date: 2 2 0 6 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: Hambrook Meadows Broad Road Hambrook Chichester West Sussex PO18 8RF 01243572922 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) : macullen@easynet.co.uk Mr Myles Antony Cullen,Mrs Brigid Teresa Cullen care home 15 Number of places (if applicable): Under 65 Over 65 15 old age, not falling within any other category Additional conditions: 0 The maximum number of service users to be accommodated is 15. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home Hambrook Meadows is a privately owned care home, registered to provide personal care and accommodation for 15 persons in the category of OP (Old Age). The proprietors are Mr. & Mrs. Cullen, and the registered manager is Mrs Elaine MacAskill. Hambrook Meadows is a large detached property located in the village of Hambrook, which is a few miles from the County town of Chichester. Accommodation comprises of 11 single rooms, three of which have en-suite facilities, and two doubles. A stair lift is available for the upstairs bedrooms. There is a lounge, dining room, sun lounge and mature garden. There are parking facilities available at the front of the premises. Fees Care Homes for Older People Page 4 of 29 Brief description of the care home charged for living at the home are 410.00 per week. Extras are charged for hairdressing, chiropody and personal items. 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: one star adequate 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: We visited this home on Monday 22nd June 2009, arriving at 10.00am and staying until 3.30pm. The purpose of this inspection was to assess how well the home is doing in meeting the Key National Minimum Standards and Regulations. The registered manager was present, offering assistance throughout the visit. During our visit to the home we had conversations with four residents and two care staff. We examined the care records of three residents and recruitment records of two staff. We also looked at other documentation maintained in the home such as medication records, staff training and supervision records and health and safety records. Care Homes for Older People Page 6 of 29 Prior to our visit the home supplied us with a copy of its Annual Quality Assurance Assessment (AQAA) and nine residents completed questionnaires and forwarded them to us. Information from all of the above sources was assessed and used to help us form judgements on the quality of service provided to people living at the home. What the care home does well: What has improved since the last inspection? What they could do better: A record of all prescribed medication entering the home must be maintained. Without this information effective medication audits cannot take place. Controlled drugs must be stored in a facility that complies with Misuse of Drugs (Safe Care Homes for Older People Page 8 of 29 Custody) Regulations 1973 as these were amended in 2007 and now require care homes to have the same facility as a nursing home in order to offer greater protection from theft. POVA first disclosures must be obtained prior to any member of staff commencing work and even if a member of staff has a CRB disclosure from a previous employer the home must still apply for and obtain a new one. This must happen to ensure the homes recruitment practises offer safeguards to residents. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents have their needs assessed before moving into the home so that the home can be confident that it can meet their needs. Evidence: The home sent us the Annual Quality Assurance Assessment (AQAA) prior to our visit. With regard to pre admission processes it states Pre admission we liase with social workers, GPs, prospective residents and their families. Preliaise admission we visit the resident in their home if possible or at appropriate venue to get to know them. They fill in a questionnaire. We offer invitation to view, to have tea and meet staff and other residents. We explain our ethos, care plans and policy of keeping home from home ethos. During our visit to the home we spoke with residents and the registered manager. We also looked at the admission records for three residents. Conversations with people Care Homes for Older People Page 11 of 29 Evidence: and examination of records confirm the contents of the AQAA as accurate. For example pre admission assessment forms were found to be completed in full, identifying the potential residents individual health and social care needs. The home uses a proforma assessment sheet, which takes into account peoples level of mobility, self help skills, medical history, health care needs and emotional needs. Nine residents completed questionnaires and returned them to us before our inspection. All state they received enough information about the home to help them decide if it would be the right place for them. The home does not provide 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal and health care needs of residents are being met consistently and safely. Medication systems offer some safeguards to residents although improvements to storage and some recordings of Controlled Drugs must take place to enhance this further. Residents are treated with respect and their rights to privacy upheld. Evidence: With regard to health and personal care the homes AQAA states we draw up a comprehensive care plan. We monitor the resident daily and change the care plan as appropriate. During our visit to the home we spoke with residents and staff, indirectly observed care practises and examined care records. Evidence from all of these sources confirms the contents of the AQAA as accurate. For example each person records that we examined contained individualised plans of care for specific needs such as hygiene, pressure care, mobility and mental health. Care Homes for Older People Page 13 of 29 Evidence: We did note that one resident is receiving palliative care and that an end of life plan is not in place. Records demonstrate that the home has liaised with the GP on a regular basis and that the persons medication has been reviewed as a result. The registered manager agreed to contact the district nursing team and to seek advice regarding the implementation of an holistic end of life plan. Since our last inspection the registered manager has implemented new risk assessments for the moving and handling of residents. These appear detailed and informative. We noted that not all residents have the new assessments in place. The registered manager informed us she had prioritised those already identified at greater risk and would ensure the new assessments are completed for everyone. All residents that we spoke with expressed satisfaction with the support they receive to manage their health care needs. For example one resident stated, they are very good, make sure we get the proper attention and another they sorted free eye glasses for me and arrange doctor if needed. Residents were also very satisfied with the staffs approach to privacy and dignity. As one person explained, we can come and go when we please, independence is important. To be spoken to in proper manor, to be spoken to in way like a child would be wrong, being shown respect is all we ask, staff are very good here like that. Nine residents completed questionnaires and returned them to us before our inspection. All state they always receive the care and support they need. Additional comments recorded include it cannot be faulted and they will ring the doctor when needed. We looked at the systems for management of medication. Since our last key inspection the home has changed to a monitored dosage system for the administration of medication. A record is maintained of medication being administered. We found no records of medication entering the home. The registered manager confirmed medication is checked when delivered by the supplying pharmacist but that this is not recorded. We saw a quantity of medication for pain relief. The registered manager confirmed a stock record is not maintained but said that she would implement this to aid monitoring systems. Controlled drugs are stored in a separate facility to that of other medication. We informed the registered manager that the current facility does not comply with Misuse Care Homes for Older People Page 14 of 29 Evidence: of Drugs (Safe Custody) Regulations 1973 as these were amended in 2007 and now require care homes to have the same facility as a nursing home. We directed the registered manager to CQC website and the guidance Safe Management of Controlled Drugs in Care Homes. We informed the registered manager a requirement would be made in respect of this. There are currently three residents who are prescribed controlled drugs. Each has an individual book for recording these. For two we found these to include a running total and two signatures for every instance of administration. The third did not. The registered manager informed us that eight of the ten staff working at the home have received medication training. Competency assessments are not undertaken. We directed the registered manager to the CQC website and the guidance Medication Training for Care Staff. She informed us she would implement this for all staff. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can participate in activities as per their expressed wishes and are able to maintain contact with family and friends. Residents are supported to exercise choice and control over their lives, which assists them in leading fulfilling lives. In the main meals meet residents expectations, however greater choices of main meals should be explored to ensure all residents are satisfied in this area. Evidence: As at the previous inspection Hambrook Meadows does not operate a formal activity programme. They very much prefer to provide more individual activities. Music, television, games and jigsaws are available and staff confirmed that they have sufficient time to sit and talk with residents or to play a board game with them. Residents can spend time in the garden and this can be easily accessed and has sturdy garden furniture and umbrellas. The conservatory provides a pleasant area to sit in and personal plants given to residents are kept there so they have a good display of plants and residents can water them and watch their growth. All residents that we spoke with confirmed their satisfaction with activities provided by the home. For example one person explained, we have exercise man, he is very nice Care Homes for Older People Page 16 of 29 Evidence: and another I have newspaper delivered, my son pays for it and we have one that the staff bring in, we pass that one around. Nine residents completed questionnaires and returned them to us. Three state activities are always, three sometimes and two they are usually arranged by the home. One person did not respond to this question. Residents confirmed that they are free to spend their time as they wish and visitors are welcome any time and made to feel welcome. As one person explained, visitors can come anytime, they always offer cup of tea and biscuit. As at the previous inspection all meals are prepared and cooked by the staff team. Each member of staff will have a dedicated role during their shift so they are not continually moving from personal care tasks to food preparation. Most members of staff have received training in food hygiene. We received nine residents questionnaires before our inspection. Six state they always and three they usually like the meals provided. During our visit to the home the majority of residents that we spoke with confirmed their satisfaction with meals provided. Some did comment that they do not have a choice of a main meal. We discussed this with the registered manager who agreed to explore further. We indirectly observed the lunch time meal being served. Residents appeared to enjoy this time of day, with lots of laughter heard. 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. People living at this home are confident that their complaints will be listened to, taken seriously, and acted upon. Arrangements are in place whereby people can expect that they will be safeguarded from harm. Evidence: All residents that we spoke with confirmed they would feel confident to raise concerns both formally and informally. Comments include you complain to the ones in charge and I would talk to my family. Nine residents completed questionnaires and returned them to us before our inspection. Five state they always and four they usually know who to speak to if not happy. All state they know how to make a complaint. We saw the complaints procedure on display in the home. The registered manager informed us that there have been no formal complaints received by the home. Policies and procedures for safeguarding adults are in place and the registered manager informed us most staff have received training in this area. All staff that we spoke with during our visited demonstrated understanding of their responsibilities with regards to safeguarding. Care Homes for Older People Page 18 of 29 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. People live in a safe, well maintained environment which meets their needs. Evidence: With regard to the environment the homes AQAA state the residents are given their own rooms which is their private space, these are personalised and homely. They enjoy access to communal rooms and the conservatory and patio are well used and popular. We ensure the home is well maintained, odourless, safe environment which complies with all rules and regulations of our governing authorities. We looked around communal areas and viewed some residents rooms, all of which reflected the contents of the AQAA. For example residents rooms had been personalised and the dining area, lounge and conservatory appear clean and homely. The front garden where residents sit is well kept. The homes AQAA informs us of improvements that have been made to the environment since our last visit. It states that security door locks have been fitted, equipment including an adjustable bed purchased and one bedroom redecorated. Care Homes for Older People Page 20 of 29 Evidence: Members of staff working in the home are responsible for cleaning, laundry and cooking. The members of staff spoken with confirmed that they have sufficient time to do this. The laundry is done at night as the laundry is sited through a downstairs toilet near the lounge that the residents use during the day. The current laundry room does not meet the National Minimum Standards for Older People as the walls are not impermeable and access is via a toilet. The registered manager produced plans that have been approved to extend the building and these will include the building of a new laundry. Staff have received training in the prevention and control of infection. All nine residents questionnaires that we received state the home is always fresh and clean. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are met by the numbers and skill mix of staff. Residents are not always protected by the homes recruitment practises. Evidence: At our visit the registered manager informed us there are three staff on duty of a morning and two of an afternoon. During the night we were informed there is one wake night person and a sleep in person in case of emergencies. The home does not employ separate ancillary workers with all kitchen and domestic tasks undertaken by the care staff on duty. The homes AQAA informs us that it is the intention of the home to employ a cleaner and that additional care staff will be recruited to provide holiday and weekend cover. Nine residents completed questionnaires and returned them to us before our inspection. All state staff always listen and act on what they say. Seven state there are always staff available when needed and one they are usually available. One person did not respond to this question. Additional comments were recorded including the staff are always friendly and helpful and the home is well run. The staff are all very friendly and kind and always willing to help, it is always warm and friendly and the girls make it a happy place to be. Care Homes for Older People Page 22 of 29 Evidence: All residents that we spoke with during our inspection also praised the staff working at the home and the support they receive. We examined the recruitment records of the two newest members of staff to commence employment at the home. Application forms and references were in place for both. We did note that the homes application form only asks for the past five years employment history and it does not state one reference must be from the most recent employer. The registered manager said she would amend the form immediately. Neither of the files we examined included evidence that a POVA first had been obtained prior to the member of staff commencing work. One of the files contained evidence of a Criminal Records Bureau (CRB) disclosure but this was from a previous employer. The second file did not contain evidence of a CRB disclosure having been obtained. The registered manager confirmed the member of staff has commenced employment without this but was supervised at all times. We directed the registered manager to the CQC website and Department of Health guidance with regard to staff working without a full enhanced CRB disclosure having been obtained and informed her a requirement would be made in relation to this. There are currently ten staff employed at the home. The majority have received training in areas including fire, first aid, moving and handling and cross infection. Nine staff hold a National Vocational Qualification (NVQ) at either level 2 or 3. Sampling of staff records indicates that induction training is in place which assists new staff in getting to know the service and how they are expected provide safe care. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management practices fail to ensure that residents are safe at all times by not following expected practices for the recruitment of staff and storage and recording of some medicines. Quality monitoring systems are in place that allow the home to measure if it is meeting its aims and objectives. Staff are receive supervision that supports them to understand their roles and responsibilities. Evidence: Since our last inspection the deputy has been promoted to manager and completed her registration with us in 2007. The registered manager was present throughout our visit and demonstrated an understanding in providing a quality service to older people. As mentioned earlier in this report some medication and recruitment practices are not safe and do not comply with the law. The registered manager said she would discuss these with the registered provider and arrange for remedial action to be taken. The home sent us its AQAA when requested. The contents of this are detailed, informative and demonstrate quality monitoring and reviews undertaken by the home. The home Care Homes for Older People Page 24 of 29 Evidence: obtains the views of residents via annual surveys. These were last completed April 2009 with no issues identified. We discussed obtaining the views of others such as GPs, district nurses and relatives with the registered manager. She said she would explore this. Residents meeting do not take place. The registered manager informed us the views of residents are obtained informally. She said she thought it would be a good idea to hold residents meetings twice a year. We sampled a number of health and safety records, finding all to be in good order and up to date. The registered manager informed us that the home does not manage the finances of anyone living there, and does not hold cash for anyone. All staff files that we looked at contained written evidence that staff receive formal, one to one supervision. Staff meetings do not take place. The registered manager informed us issues are discussed in hand overs but records are not maintained. Since our last inspection weekly meetings take place between the registered manager and the proprietor. 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 9 13 In line with Regulation 13(2) 22/07/2009 a record must be maintained of all prescribed medication entering the home. This must happen to ensure medication recording systems are safe. 2 9 13 In line with Regulation 13(2) 22/07/2009 the storage of controlled drugs must comply with the Misuse of Drugs (Safe Custody) Regulations 1973. This must happen to make sure medication is stored safely. 3 26 19 In line with Regulation 19 and Schedule 2 the registered person must not allow anyone to work in the home before a POVA first declaration has been obtained and a CRB disclosure applied for. 13/07/2009 Care Homes for Older People Page 27 of 29 This must happen to ensure residents are protected by the homes recruitment practices. 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 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. 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