Care Home: Heathlands

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What the care home does well People who use the service do not move into the home until an assessment has been completed and they have been assured that the home has the skills and experience to meet their needs. We found that people who live in the home are supported to make decisions about their daily lives. People tell us they are treated with respect. People who live in the home are able to keep in touch with family and friends, they are also able to maintain choice and control in their lives as much as they are able. Food is carefully considered to ensure the nutrition needs of the people living in the home are met. People living in the home know who to speak to if they are unhappy with the service and know that their concerns will be listened to and acted upon. The home is clean and the laundry system works well ensuring that people have nicely laundered clothing. The number of staff in the home meets the needs of the people living there at the moment. Staff receive the training they need to do the job well. The recruitment practice ensures that people are supported and protected. Training is in place to ensure that all staff are competent to do their job. the home is run by someone who understands their role and responsibilities. There is a quality assurance system in place which ensures the views of people who use the service are listened to and acted upon. Systems are in place to safeguard the financial interests of people living in the home. What has improved since the last inspection? At the last inspection there were five requirement and two recommendations. People are consulted about their interests and activities which they want to participate in within the home. Staff receive training in safeguarding which means they know how to recognise and report their concerns of abuse. Recruitment practice has improved which protects the people living in the service. Regular monthly visits are completed by senior managers in the organisation which means they are able to support the care and management of the service. All health and safety checks are completed according to regulation and ensure the health, safety and welfare of the people living and working in the service. What the care home could do better: At the end of this inspection there is one requirement and five recommendations. People living in the home must be safe at all times and this means that any unguarded radiators might jeopardise that safety. To ensure that all staff understand the actions which need to be taken to meet the needs of people living in the home care plans must be clear and specific in all aspects of health, personal and social care. To ensure that health care needs are fully met recording has to be consistent. It is important that the medication policy and practice in the home is followed especially with regard to homely remedies where current practice in the home differs from the providers policy.It is important that individual`s living in the home have their privacy maintained, no documentation should be left in communal rooms. Protective clothing such as gloves should not be left in waste paper bins in people`s rooms after use as this is unhygienic and unpleasant for the individual whose room it is. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Heathlands Constitution Hill Road Parkstone Poole Dorset BH14 0PZ     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: Tracey Cockburn     Date: 1 9 0 1 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 27 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Heathlands Constitution Hill Road Parkstone Poole Dorset BH14 0PZ 01202676858 01202684643 heathlands@care-south.co.uk 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) : Care South care home 51 Number of places (if applicable): Under 65 Over 65 6 6 45 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: 0 0 0 One named person (as known to CSCI) who is under the age of 65 and whose primary care needs are due to a physical disability may be accommodated for periods of respite care. Date of last inspection Brief description of the care home Heathlands is situated at the bottom of Constitution Hill Road. The home has pleasant gardens and provides for some off road parking. The land is leased from the Borough of Poole and is shared between Heathlands and a day services centre run by the Borough. Heathlands was built as a care home approximately 40 years ago. It is registered with the Commission to provide care for 51 service users, 45 in the category of old age and 6 in the category of either dementia or mental disorder. The care home is registered to Care Homes for Older People Page 4 of 27 Brief description of the care home accommodate people over the age of 65. Bedrooms are provided on the three upper floors of the home. Care South, a not for profit company are the Registered Providers of the home. The bedrooms are for single occupancy and there is sufficient communal space of a large lounge and dining room, smaller lounge areas, staff office space and utility services of main kitchen and laundry. There are shops within half a mile of the home and the main town centre of Poole is one and a half miles away. Bus and train routes serve the main shopping areas of Poole and Bournemouth. A short drive to the top of Constitution Hill Road reaches the viewpoint from which there are views over Poole Harbour and the Purbeck Hills. Weekly fees range from #450 - #545. Care Homes for Older People Page 5 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: We began the key inspection without warning, because of the size of the home we used two inspectors. We spent a total of six hours on the site visit and a further two hours in planning and preparing for the visit. We sent out survey forms to people who live in the service as well as those who work in the service and other health professionals. We received ten surveys back from staff who work in the home. We received five surveys back from health professionals. We received seventeen surveys back from people who live in the service. We spoke to people who live and work in the service. We toured the building and we looked at a variety of records, care files, recruitment files and health and safety records. We observed staff at work and we observed activities during the day. Care Homes for Older People Page 6 of 27 Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: At the end of this inspection there is one requirement and five recommendations. People living in the home must be safe at all times and this means that any unguarded radiators might jeopardise that safety. To ensure that all staff understand the actions which need to be taken to meet the needs of people living in the home care plans must be clear and specific in all aspects of health, personal and social care. To ensure that health care needs are fully met recording has to be consistent. It is important that the medication policy and practice in the home is followed especially with regard to homely remedies where current practice in the home differs from the providers policy. Care Homes for Older People Page 8 of 27 It is important that individuals living in the home have their privacy maintained, no documentation should be left in communal rooms. Protective clothing such as gloves should not be left in waste paper bins in peoples rooms after use as this is unhygienic and unpleasant for the individual whose room it is. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 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 10 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. People have their needs assessed before the decision is taken to move into the home so everyone is clear that the home has the skills to meet individual needs. Evidence: The annual quality assurance assessment says: An assessment of individuals needs are undertaken prior to a decision being made whether the home can meet their needs. Monthly Audits are being completed, which shows us areas which need improvement and many of the improvements have been made. It also shows us what we do well and we can build on these We looked at five files for people who use the service. We looked at the information on two files about the pre admission assessment. We found that an assessment had been completed before the person moved into the home. At the time of the site visit someone moved into the home in the afternoon. He told us that the manager had Care Homes for Older People Page 11 of 27 Evidence: visited him in the hospital and completed and assessment several days before he was discharged. In one file we looked at the information in the pre admission assessment was detailed and thorough and provided a good basis for the care plan. One person told us they were very happy , they knew the home locally before they were admitted and were able to visit. They told us they enjoy the activities and the activity co-ordinator. One person wrote: staff were excellent during the assessment of my mother Care Homes for Older People Page 12 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 have individual plans of care which provide information on how their health, personal and social care needs should be met. More detail and consistency in recording would enhance the quality of information and provide clearer instruction for staff. Medication practice in the home should follow the policy and guidance to ensure peoples needs are fully met. To ensure the dignity of people living in the home is maintained care should be taken with personal information. Evidence: The annual quality assurance assessment says: During the latter stages of a persons life, the care given by the staff and community nurses is of a particularly high standard. We also liaise with the family and formulate a priority needs care plan which includes their views.At Heathlands there are no service users who are capable of managing their own medication. The management team have undergone the safe handling of medicines training course. We have a comprehensive medication policy that the care team managers are fully compliant with. Care Homes for Older People Page 13 of 27 Evidence: We found that not all care plans are signed and dated. One care plan makes no mention of the mental health needs of the individual. We found evidence in two files of monthly reviews being completed. We found that care plans are task focused. In several care plans there was very little mention of mental health needs and no mention of diet intake or appetite. The care plan for another person gives clear instruction on how to meet someones needs, however there is a lack of information on how to fully support there mental health. Risk assessments in place as are medical contact information and a monthly summary. We looked at a chart for one person, which stated that staff must sign once they have completed the task. This task was to be completed in the morning and evening. Over eighteen days the chart was only signed six times. The care plan for another person states maintain correct level of mental health and prevent deterioration there is no details of how this should be achieved by staff. We looked at medication and found that there was a clear audit trail although variable dosage was not indicated and the number of tablets was not brought forward. We found any hand written entries on the medication chart was countersigned. Items stored in the controlled drugs (CD) cabinet were stored and recorded correctly. The medication policy states that a limited stock of homely remedies should be held in the home. We were told that the home doesnt have any homely remedies. Staff have recently had training from a new pharmacy supplier. We observed staff talking to people respectfully, assisting them to the privacy of their rooms when necessary. We observed in one communal bathroom a book which records when people who live in the home have a bath. This information was not maintained in a way which would maintain an individuals confidentiality and personal information could be seen by other people. This was brought to the managers attention. Care Homes for Older People Page 14 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to lead the life they want to and are encouraged to see those who are important to them. People living in the home are offered a varied and appealing diet which Evidence: The annual quality assurance assessment says: A more proactive activities organiser has been employed who enables as many service users to access activities throughout the week.A care assistant recently attended a Vitalyz,workshop to enable her to work with service users on a seated exercise programme.During the,Breath of Fresh Air Week. All service users were given the opportunity to access fresh air and this has continued.More trips have been organised using a minibus hired via social services.External entertainment has been sourced on a regular basis.The homes quality assurance survey indicated that the majority of service users felt that there was a good choice of food to eat and the enjoyed the food provided. A requirement was made at the last inspection about consulting with the people living in the service to develop more activities to engage people living in the home. We found more information being recorded about peoples interests in their care plans. Care Homes for Older People Page 15 of 27 Evidence: We spoke to the activity co-ordinator who told us about the activities taking place in the home and how they were trying to encourage people to participate if they wanted to. We observed a group in the afternoon who were talking about transport and engines. There were also people in the home who were very interested in the Living Egg project. The project supply the home with eggs which are about to hatch and are in a special container and over the course of three or four weeks the people living in the home are able to watch the chicks hatch and they feed them and watch them grow. Several of the people in the home said they thought it was marvelous. The activities co-ordinators are planning to over the year to introduce cooking activities for the people living in the home. There are no restrictions on visiting times to the home and residents confirmed that visitors were made welcome at the home. A returned comment card from one relative also reported the same. People are able to receive visitors in the communal lounges or in the privacy of their room or one of the small quiet rooms. Generally, people we spoke with said that they were happy with the level of activities provided in the home, although one person informed that they did find it difficult to occupy their time. One person said that she enjoyed books provided by the visiting library and another said that they knit. Some people said that they preferred to occupy themselves. Late morning we observed very little activity in the main lounge, there had been musical bingo earlier. We observed lunch and found that it was relaxed and people who needed assistance were given help in a sensitive manner. Where someone needed support to eat their meal the carer was able to sit down beside them and there was no rush. A small dining room was used for those people who needed more support. The chef told us about how food is ordered and how they listen to what people want on the menu and provide it. The chef understood the needs of people who are diabetic and provides puddings which they are able to eat. Care Homes for Older People Page 16 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 who use the service should be confident that their worries and complaints will be listened to and acted upon. Staff working in the home should understand how to protect people from abuse. Evidence: The annual quality assurance assessment says: We respond promptly to all complaints received, when required work with other agencies in a transparent and collaborative way.The complaints procedure is clear and concise, a copy (large print) is available for all to see.All complaints are taken seriously.The majority of staff have now attended a safeguarding of vulnerable adults workshop.All staff have had the statutory employment checks undertaken to safeguard our service users. The complaints procedure is detailed within the Service User Guide and within the Terms and Conditions of Residence and everyone has access to these documents. The home has a policy and procedure to respond to allegations of abuse or neglect and has copies of all relevant policies and procedures relating to adult protection. A requirement made at the last inspection regarding staff receiving training in safeguarding has been addressed. 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 adequate 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 comfortable home which would be safer in action was taken to guard radiators which are hot to the touch and are a potential risk to the safety of the people living in the home. Evidence: The annual quality assurance assessment says: The contracts and routine maintenance are kept up to date.Specialist service users equipment is maintained.We keep the home homely and welcoming as well as being hygienic.The home is kept clean and free of unpleasant odours.Dining room carpet is cleaned monthly.Decoration is accessed via the organisations decorators to ensure areas are kept looking fresh, including bedrooms and communal areas.Service users are encouraged to personalise their room.We encourage the service users to use the gardens. The home had planned to close in late 2008 however this planned closure is not taking place and painting and decorating has been taking place in the communal halls of the home. We found that many of the radiators in the communal areas are covered but there are other radiators around the home in individual bedrooms and in some of the small lounges which are uncovered and on the day we visited, which was cold, were very hot to the touch. This was brought to the attention of the manager. We found risk Care Homes for Older People Page 18 of 27 Evidence: assessments in place for all unguarded radiators but they had not been reviewed in several years. In one sluice room we noticed that the paint work is peeling both on the pipes and the ceiling. We observed that protective clothing such as gloves and aprons were always available and it was noted that alcohol gel sanitisers were available in key areas of the home. The home has dedicated cleaning staff and also a laundry assistant who works seven days a week. The home provides sluicing facilities for the cleaning of commodes. We found no soap dispenser or paper towels in one toilet but there was in another one. The laundry room was tidy and items suitably stored. We found personal information about one person living in the home in one of the bathrooms this was brought to the attention of the manager. There are some rooms which have profile beds to assist with moving and handling. We found that rooms were personalised. People told us that their rooms are comfortable. One person told us: the decor is tired and old but the home has a pleasing smell and Xs room is always clean and tidy 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. People working in the home are properly trained and recruited which ensures that people living in the home are supported by staff who know how to care for them. Evidence: The annual quality assurance assessment says: Recruitment procedures are rigorous to ensure suitable staff are employed and statutory checks are completed. Training is of a high standard in excess of 65 percent of the care staff have or are working towards an NVQ in care. Sufficient staff are on duty to meet service users needs. Staff retention is good. Regular staff meetings which are well attended and staffs views are encouraged. We looked at four staff files to find out if procedures are robust and protect people living in the service. We found that two written references are taken up and returned before the person starts work. We found that in all four files the criminal records bureau checks are completed and returned before the person starts work in the home. We found that the requirement at the last inspection was met. The manager explained that the use of agency staff has decreased recently, we looked at the records for January 2009 between the 16th - 18th January the home used bank staff from Care South for a total of twenty seven hours and used agency staff from three agencies totaling forty eight hours. Care Homes for Older People Page 20 of 27 Evidence: We were shown the staff training records, which demonstrated that the organisation had a good commitment in developing the staff team. Staff are trained in core areas such as induction, health and safety, manual handling, infection control, basic food hygiene and fire safety. Training is also available in first aid, loss and bereavement, catheter and stoma care pressure area care, healthy bowel and constipation and dehydration. On the day of the site visit there were six care staff on duty one care team manager, one chef, one laundry assistant and one dining room assistant. One person told us: the staff are always most accommodating and very pleasant Another person wrote: Not always enough staff to meet the individual needs of all the people in the home Another person wrote: more staff would be helpful in assisting with those who are more dependent One member of staff wrote: we work well as a team 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 service is managed by a competent and qualified person who understands how to meet the needs and aspirations of the people living in the home. Systems are in place to listen to people and run the home in their best interests and safeguard their finances. Systems are in place to ensure that the health, safety and welfare of people living and working in the home are protected. Evidence: The annual quality assurance assessment says: The home manager has 15 years care experience, including 8 as manager and holds his RMA and NVQ 4 in Care qualifications, plus other relevant OU qualifications. We have a committed team of staff who work well together.We listen to comments given at reviews and continually up date our practices.Service users finances are accurate and only managed by the management team.An annual quality assurance takes place using an outside agency to compile the findings.Investors In People, has once again been accredited to the Care Homes for Older People Page 22 of 27 Evidence: organisation.Completion of statutory notifications promptly.Records are maintained and audited for accuracy. At the last inspection the following was noted in the report: One area of concern however, was in respect of unannounced visits by a representative of the organisation under Regulation 26. The responsible individual or one of the partners of the organisation should carry out these visits unannounced each month. A report should also be available on the conduct of the home resulting from these visits. We found at this inspection that these visits were taking place monthly and a record of the report kept in the home. The requirement made at the last inspection has been addressed. The last key inspection report noted: We saw the fire log book and found that inspections of the emergency lighting and of the fire fighting equipment had not been carried out to the required timescale. A requirement was made that these tests be carried out. We found that home completes regular audits. covering professional practice, health and safety, activity and documentation. We found that the actions plans are followed through. We found at this inspection that the fire log book was up to date and all inspections and checks on equipment were up to date. The requirement made at the last inspection has been addressed. Staff told us: the manager is always prepared to listen I like the way the home is run by the manager 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 25 13 The registered person shall ensure that unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. Unguarded radiators pose a risk to people living in the home and could cause injury a number are hot to the touch. 31/03/2009 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 The registered manager should ensure that information in care plans give clear and specific instruction for the action to be taken. The registered manager should ensure that records are maintained consistently when recording information. The registered manager should ensure that the medication policy is the same as the practice within the home. Specifically if the policy states that homely remedies can be stored then this should be the practice. Page 25 of 27 2 3 8 9 Care Homes for Older People 4 10 The registered manager should make sure that information about individuals living in the home should not be left in communal areas such as the bathroom. The registered manager should ensure that the home is hygienic at all times and that staff follow the homes procedure for the disposal of used gloves. 5 26 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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. 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