Care Home: Hilton Rose

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What the care home does well People like living at the service. Most people say that they get on with the staff and that they provide them with the care they need. Comments include:`staff good`, `care excellent`. The service provides people with information about the service so that they will know whether they wish to move there. An assessment is completed before people move to the service. This makes sure that the service is able to meet people`s needs. The service makes sure that its care plans are person centred and provide staff with the information they need to provide people with care. Most staff are qualified and all staff receive training relevant to the work they do. Staff have training to support people with dementia care needs. People receive the medical care they need including having eye and dental checks. The service works with health professionals such as District Nurses to provide people with support. The service has systems in place to monitor and review the service they provide. This includes consulting with the people that live there and thier relatives. What has improved since the last inspection? The service has updated and revised its care planning process giving staff better information to provide people with the care they need. The service has continued to upgrade its accommodation. Several bedrooms have been decorated and have had new flooring fitted. The exterior has been upgraded to provide a pleasant sitting area, a vegetable garden and a greenhouse that is accessible to people the use a wheelchair. What the care home could do better: There are some areas that the service needs to address to improve the outcomes for people living there. There are some medication practices that the service needs to address to ensure that a robust system is in place. This will reduce the likehood of any errors occurring. The service needs to ensure that its recruitment process includes all the necessary preemployment checks including obtaining and checking references and checking any gaps in people`s employment history. Also when using agency staff, the service must be confident that they have been subject to the required pre-employment checks. This will improve the protection of the people that live at the service. We also recommended that people have access to more activities they want to do and that people are made aware of all the choices available at meal times. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Hilton Rose 30 Broadway North Walsall West Midlands WS1 2AJ     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: Jane Capron     Date: 2 0 0 7 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 30 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 30 Information about the care home Name of care home: Address: Hilton Rose 30 Broadway North Walsall West Midlands WS1 2AJ 01922622778 01922645960 helenbs@hotmail.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) : Mr John Rose,Mr Hilton Thomas Smith care home 23 Number of places (if applicable): Under 65 Over 65 0 23 dementia old age, not falling within any other category Additional conditions: 5 0 The maximum number of service users who can be accommodated is 23. The registered person may provide the following category of service only: PC Care Home only to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age (OP) 23 Dementia (DE) 5 Date of last inspection Brief description of the care home Hilton Rose Retirement Home is registered to provide care for up-to 23 elderly persons. Situated near to Walsall Town Centre the home benefits from easy access to all local amenities; a variety of shops, library, post office, and art gallery. Being adjacent to the famous Arboretum this attraction can be enjoyed at any time of year. Accommodation is provided on two floors, which can be accessed via stairs or passenger lift, and comprises 19 single and 2 double bedrooms, all fitted with washhand basins and 2 with ensuite toilet facilities. There are 3 communal lounge areas, and a dining room/conservatory, which overlooks garden and is also used for social Care Homes for Older People Page 4 of 30 Brief description of the care home and leisure activities. There is car parking to the rear of the property. The service currently charges form 355 pounds per week, with additional charges for hairdressing, chiropody, newspapers, toiletries, outings, and day centres. Care Homes for Older People Page 5 of 30 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: This inspection took place over an seven hour period and the service did not know we were visiting. The information used as part of this inspection includes: The annual quality assurance assessment (AQAA) that the service sent us. The AQAA is a self assessment document that focuses on how well outcomes are being met for the people using the service. It also gives us some numerical information about the service. Five surveys provided by people living at the service. Information we have about any complaints and safeguarding received about the service. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. Care Homes for Older People Page 6 of 30 Discussions with people living at the service. Discussions with staff and the manager. Observation of staff supporting people. An examination of records relating to care practices, staff recruitment and training and health and safety. What the care home does well: What has improved since the last inspection? What they could do better: There are some areas that the service needs to address to improve the outcomes for people living there. There are some medication practices that the service needs to address to ensure that a robust system is in place. This will reduce the likehood of any errors occurring. The service needs to ensure that its recruitment process includes all the necessary preemployment checks including obtaining and checking references and checking any gaps in peoples employment history. Also when using agency staff, the service must be confident that they have been subject to the required pre-employment checks. This will improve the protection of the people that live at the service. We also recommended that people have access to more activities they want to do and that people are made aware of all the choices available at meal times. Care Homes for Older People Page 8 of 30 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 30 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 30 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 considering moving to the service have suitable information to decide if the service can meet their needs. An assessment of need is completed by the service before a decision is made over whether the service can meet a persons needs. Evidence: The services AQAA states that it has updated the information provided to people considering moving to the service. The service user guide provides people with information about what the service offers. Examination of the records of people most recently admitted confirms that the service completes an assessment of peoples needs before agreeing to offer them a place. The assessment includes peoples general and mental health, their dietary needs, mobility, medication and spiritual and cultural needs. Care Homes for Older People Page 11 of 30 Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the service are treated with respect and are provided with the care in the way they wish. People within the service are receiving their medication but a more robust system would lessen the likelihood of errors occurring. Evidence: The services AQAA gave us little information about how the service supports people to have their health and personal care needs met. We examined a sample of files and these show that peoples needs are identified. People have a person centred plan that includes their general and mental health needs, any needs relating to their mobility, communication and any dietary needs. Plans also include information about peoples social network. Care plans are evaluated monthly. Records confirm that the service is completing assessments relating to nutrition, the risk of falls, bed rail assessments and of the risk of pressure sores. We saw that people are provided with pressure relieving equipment including mattresses and cushions. Records tell us and people confirm that they are having eye and dental checks. People Care Homes for Older People Page 13 of 30 Evidence: are receving nail and haircare. The hairdresser was present on the day we visited. People are wearing appropriate clothing and have good footwear. Records confirm that people see the GP when they are ill and that the service receives the support of the District Nursing service. Discussions with staff and examining relevant records confirms that the service works with specialist palliative care staff to support people. Staff also confirm they have received training in palliative care. All the responses from our surveys tell us that people get the medical care they need but people were slightly less positive when asked if they received the care and support they need. Speaking to staff confirms they know the needs of each person and how to meet them. People we spoke said that the staff give them the care they need. The service provides care to people with dementia care needs. There are pictorial notices on doors to assist people to orientate themselves to the premises. Staff have received training in this area. When we spoke to staff they could describe how they support people with dementia care needs including the need to communicate clearly, always to introduce themselves, to explain the action they are taking and to treat them as an individual and to understand them. We observed staff with people that live there and saw that they treat people with respect and uphold their right to privacy. All bedrooms and toilets and bathrooms are lockable. Staff say that they always knock on bedroom doors, close curtains and doors when doing personal care. They also say that they try and keep people as independent as possible. For example one person is safe to be left alone in the bath so the staff wash their back and then leave them and this person shouts when they wish to come out of the bath. One staff memeber said that she treats people as she would want her parents to be treated. We looked at the medication practices at the service. Medication is kept in the office in a trolley that is secured to the wall. A medication fridge was available. The temperature of the medication room and the fridge are not being kept and the service needs to address this. Controlled Drugs (CD) are kept securely in a safe attached to the wall. The service maintains a CD register and this is being filled in and double signed. We noted a recording error in the CD records when medication had been returned and some received but this was not been recorded in the CD record. Staff need to ensure that any CD medication returned or received is recorded in the register to ensure that an accurate record of stock is kept. We also saw that some medication was not recorded on the Medication Adminstration Records Chart (MAR) and this must be addressed. There was also some medication in the office and in peoples bedrooms that was not stored securely. An examination of the MAR sheet shows that there are no gaps and when medication is not given the reason is recorded. We observed Care Homes for Older People Page 14 of 30 Evidence: medication being administered and saw that the person administering the medication is not signing the MAR. A second staff member who is observing is signing the record. This is not an accepted practice and the person administering medication must sign the record to confirm they have administered the medication. If a second person is involved their role is observational and an added safeguard to ensure medication is given correctly. The manager did state that the arrangements for medication have been externally assessed and no recommendations have been made. Staff and records confirm that staff are trained in medication and that the manager undertakes assessments of their competence. Care Homes for Older People Page 15 of 30 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 that live at the service have the opportunity to take part in some activities but there is scope for this area to be developed. There is a varied diet and people have choice over what they eat. Evidence: The services AQAA did not provide us with much information about the lifestyle people experience at the service, although it did tell us that they provide at least one activity a day. We did see that when people move to the service they are asked about their preferences including their preferred time for getting up and going to bed and the food they prefer. We did not see that social histories have been completed. The manager did tell us that people are reluctant to get involved with activities and that its usual activity staff member has been absent from work for some time and that a care staff member has taken on some of this role. Due to this the service has not been able to offer any trips out this year. We did see a schedule of activities but no records to confirm that these activities are taking place. The records did show that people have recently taken part in bingo and gentle exercises and the manager said that there has been a flower arranging session. Some people say that they sit in the garden and have been involved in growing vegetables in the garden and in the greenhouse. The service Care Homes for Older People Page 16 of 30 Evidence: provides a religious service for people that wish to attend. We had a mixed response to our surveys. One person said that activities are always available and another one said they are never available. Comments made include provide more activities, at the moment only bingo is played sometimes. Perhaps outings would be nice for residents and provide activities to keep guests occupied. We would recommend that the service considers how it can develop this area to provide people with activities they wish to take part in. Throughout the day we saw a number of visitors and people say that visitors can visit whenever they want. The service provides a varied menu and flexible mealtimes. People can choose to eat in their bedroom or in the dining room. The menu is displayed on the wall and this gave a choice of main course but not sweet although we saw a choice of sweets being provided. People tell us they are given a choice of meals. The service did tell us that people could have further choices if they asked but these additional choices are not displayed. We would recommend that people are made aware of all the choices available. People we spoke said that the meals were good but the responses to our surveys gave a mixed view with comments including meals need to improve. Dinners I dont much care for although something else is always given in place and food is excellent. The service can provide a soft diet and a diabetic diet. Care Homes for Older People Page 17 of 30 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 the service are listened to and any complaints they raise are addressed. People can be confident that staff know about the signs of abuse and know what action to take if they have concerns about peoples welfare. Evidence: The services AQAA states that they are proactive in dealing with complaints. We saw that there is a complaints procedure in place and that this is included in the service user guide and is displayed around the service. The service has received one complaint this year and the records confirm that it has been responded to. We, the commission have not received any complaints. Our surveys confirm that people know about the complaints procedure and know who to raise issues with. The service told us that it intended to put a comments book in place and we saw this has been done. Staff are aware of issues relating to safeguarding people. A sample of staff we spoke to could tell us of the signs that may indicate someone is being abused. They also told us that if they have any concerns they would report them to the manager who they are confident would take action. We spoke to the manager who also was aware of safeguarding issues. We did however advice her to be more fully aware of the referral process. The manager also told us that all staff have been provided with information about the whistle blowing procedure. Care Homes for Older People Page 18 of 30 Care Homes for Older People Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service provides people with suitable private and communal accommodation that is kept satisfactorily maintained. Evidence: The services AQAA gave us limited information about the environment of the service. It did state that they try to provide a homely and friendly environment. We saw that the service has made improvements to its accommodation. A number of bedrooms have been decorated and have had new flooring fitted. The exterior has been altered to provide a good area for sitting and this includes a small vegetable garden and a greenhouse accessible to people that use wheelchairs. We looked at a sample of the accommodation including a number of bedrooms. Bedrooms are all lockable and provided suitable accommodation. Two rooms have en suite toilet facilities. Shared rooms have privacy screening. Bedrooms provide adequate storage facilities including a lockable drawer in which to keep valuables. The service provides suitable communal rooms including three lounges and a large dining room. These are suitably furnished and decorated. There are two bathrooms with hoists and one level access shower room. These are somewhat clinical in appearance but the manager states that there are plans for the upgrading of these Care Homes for Older People Page 20 of 30 Evidence: areas including the provision of another shower. The service was seen to be clean throughout. The AQAA informs us that most of the staff have received training in infection control. We observed staff using protective equipment when undertaking personal care tasks and using different ones when serving meals. Four of the surveys we received were positive about the cleanliness of the service. One person commented the room is kept beautifully clean and tidy. Care Homes for Older People Page 21 of 30 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. The service provides staff in sufficient numbers to provide the care people need. The current recruitment process is not adequately protecting the people that live at the service. Evidence: The service provides three care staff on duty throughout the day and evening and two waking night staff overnight. There are also two cooks and two cleaning staff. The manager tells us that they have had some staffing diffuculties this year due to long term ill health and maternity leave. The other staff have taken on extra hours and the service has used a bank staff member. Through this the service has managed to maintain its staffing levels. People we spoke to are overwhelmingly positive about the staff with comments such as staff good, and staff alright, Im happy here, although one relative said that they thought that the more mature staff were more understanding. Through talking to staff and through examining the records we could confirm that staff receive a range of training including induction training and ongoing training both in Health and Safety issues and training specific to peoples care needs. The AQAA tells us that the service has a high number of staff with a qualification in care. Care Homes for Older People Page 22 of 30 Evidence: A sample of staff files was looked at and these confirm that the service is obtaining Criminal Records Bureau and Protection of Vulnerable Adult checks for the staff it employs. We did however see that there is only one reference for one staff member and two others have references that have not been obtained by the service. There is no evidence that their genuineness has been checked. We also noted that application forms are not always properly completed and that there are gaps in peoples employment records. One of the cleaning staff is from an agency and the service could not confirm that the necessary pre employment checks have been completed. Care Homes for Older People Page 23 of 30 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. The service is generally well led in the interest of the people that live there. The service has systems in place that promote the welfare of the people that live there. Evidence: The manager has worked at the service for many years and has lengthy experience of working in the field of care. She undertakes ongoing training to keep up to date with current practices. Although providing some good outcomes for people the service does need to address the issues we have highlighted in relation to medication practices and to the way it recruits its staff. The service provided us with an AQAA when we asked for it. It did not give us sufficient information about the service. This was the first AQAA that the service has completed. We gave the manager advice on how to complete it more effectively. The service monitors and reviews the service to check on the quality of the service it Care Homes for Older People Page 24 of 30 Evidence: provides. This includes a number of audits and surveys of people living at the service and of relatives and professionals. The service also seeks the views of people through resident meetings and staff meetings. We did see evidence of changes that have resulted from talking with the people that live there. This includes providing a better outside area including purchasing a greenhouse. The service undertakes general and individual risk assessments to ensure safe working practices. We did notice that two people were using wheelchairs without foot plates and informed the manager of the need to complete risk assessments to ensure that people are safely moved around the service. Records confirm that the service provides staff with Health and Safety training including infection control, fire safety, moving and handling and food safety. The service is not appointee for anyone living there although the manager does collect the personal allowances of two people. In both cases the money is not held by the service either being given to the person concerned or their relative. The service does maintain records of the receipt of this money. An examination of the records shows that the service is undertaking fire safety checks on the fire alarm system and emergency lighting. There were a few gaps in the records and the manager was advised to ensure these are always kept up to date. A fire risk assessment is in place and regular evacuation practices take place. Care Homes for Older People Page 25 of 30 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 30 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 The service must ensure that medication is stored at the correct temperature through recording the temperature on a daily basis. This will ensure that medication is stored correctly and action can be taken if the temperature is not appropriate. 10/08/2009 2 9 13 All prescribed medication should be stored securely. This will ensure that medication cannot be accessed by someone other than those responsible for administering medication. 10/08/2009 3 9 13 When medication is administered the staff member responsible should always sign the record to show that the medication has been administered. 10/08/2009 Care Homes for Older People Page 27 of 30 This will confirm that medication has been administered as prescribed. 4 31 19 The service must ensure that they undertake all the appropriate preemployment checks including obtaining two references. This will improve the protection for people living there. 5 31 19 Where staff are using agency staff they must make sure that the person has been subject to the necessary pre employment checks. This will improve the protection of people living there. 6 38 13 Where people are using wheelchairs without foot plates risk assessment must be in place. This will make sure that risks are assessed and that people are moved safely. 10/08/2009 23/08/2009 23/08/2009 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 9 When tamezepan is being recorded as a Controlled Drug, any medication returned or received at the service should be recorded in the register. This will ensure that an accurate record is kept. Care Homes for Older People Page 28 of 30 2 9 When medication is prescribed this should be recorded on the MAR sheet. This will lessen the likelihood of errors occuring. A range of activities should be provided after consulting with people about wha tthey wish to do. People that live at the service should be made aware of all the choices available at mealtimes. All staff at the service should have information about the multi-agency agreed safeguarding referral process. The service should ensure that application forms are properly completed and that any gaps in employment are checked out. The service should ensure that its Health and Safety records are kept up to date. 3 4 5 6 12 15 18 31 7 38 Care Homes for Older People Page 29 of 30 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 30 of 30 - 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!