Care Home: Jasmine Court

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What the care home does well This was a key inspection of a care home for older people, which ended with an unannounced visit to the service. Before the visit we [throughout the report the use of `we` indicates the Care Quality Commission], spent six hours reviewing information received by the Care Quality Commission [CQC] since the last key inspection on the 29th September 2008. The visit took place on the 28th July 2009 and lasted eight hours. During the visit we checked all the `key` standards as identified in the National Minimum Standards. This was achieved through a method called `case tracking`. Case tracking means that we looked at the care provided to four of the residents. To achieve this we spoke with the staff supporting their care and looked at the records relating to their health and welfare. We spoke with the residents and visiting families. With their permission the residents` bedrooms were looked at. We also checked how the home was run and organised. This included looking at staff records, training and how the staff are organised. We looked at health and safety records, menus, minutes of meetings and the quality audit. The policy for handling complaints and how the home dealt with them was seen. We looked at how prospective residents and their families are given information about the services the home can offer and whether they are suitable for them. During the visit we spoke with the manager, the senior manager, the residents, the staff and families visiting the home. We checked the Annual Quality Assurance Assessment (AQAA) that the home had sent to us when we asked for it. We looked at the surveys that we had sent out and had returned to us by the staff, the residents and relatives of the residents. What has improved since the last inspection? The home has improved its` staffing levels and training. there are now enough staff to meet the residents` needs. The care staff are now involved in putting information into the careplans and these are available to them. There is a now a dedicated activities organiser who is providing suitable activities for the residents. There is a complaints policy in place that is accessible and understandable to the residents and their families. The staff in the home are making sure that the residents rooms reflect their personalities. There is a new manager in post who is making sure that she is visible and available to the residents, families and the staff. There is a programme of staff supervision in place to allow the staff time with their line manager to discuss work and training issues. What the care home could do better: They could make sure that when care plans are made or reviewed that the resident or their family sign that they have agreed them or that it is documented that they don`t wish to sign them. That all the staff are made aware of good hygiene practices. That the home finds a hairdresser for the residents. Make sure that the required level of staff achieving a National Vocational Award at level 2 or above is met. Key inspection report Care homes for older people Name: Address: Jasmine Court 38-44 Nottingham Road Loughborough Leicestershire LE11 1EU     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Anthea Richards     Date: 2 8 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Jasmine Court 38-44 Nottingham Road Loughborough Leicestershire LE11 1EU 01509265141 01509236361 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Rushcliffe Care Limited care home 66 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability sensory impairment Additional conditions: No person falling within the category of DE should be accommodated at Jasmine Court when there are already 22 persons within that category accommodated at the home No person falling within the category of MD should be accommodated at Jasmine Court when there are already 22 persons within that category accommodated at the home No person falling within the category of PD or PD(E) should be accommodated at Jasmine Court when there are already 30 persons within that category/combined categories accommodated at the home No person falling within the category of SI or SI(E) should be accommodated at Jasmine Court when there are already 6 persons within that category/combined categories accommodated at the home Care Homes for Older People Page 4 of 27 Over 65 66 66 66 30 6 22 22 0 30 0 No person under 35 years of age who falls within the categories DE, MD, SI or PD should be accommodated at Jasmine Court Rushcliffe Care Limited are registered to provide personal care with nursing at Jasmine Court to male and female service users who fall within the following categories :- Old Age, not falling within any other category (OP) 66 Dementia (DE) 22 Dementia - over 65 years of age DE(E) 66 Mental disorder - excluding learning disability or dementia (MD) 22 Mental disorder - excluding learning disability or dementia over 65 years of age MD(E) 66 Physical disability (PD) 30 Physical disability over 65 years of age PD(E) 30 Sensory Impairment (SI) 6 Sensory Impairment over 65 years of age SI(E) 6 The maximum number of persons to be accommodated at Jasmine Court is 66 Date of last inspection Brief description of the care home Jasmine Court is a purpose built residential care home (with nursing) situated in Loughborough, close to the city centre. It opened in August 2006 and specialises in the care of residents with dementia, providing both long-term and respite care. The home has 66 single bedrooms, all with ensuite facilities, arranged into six units. Each unit has its own large lounge/dining area and kitchen. There is also an activities room, a hairdressing room, and two secluded patio areas at the back of the home. The fees are negotiated dependent on care needs. 2 9 0 9 2 0 0 8 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: This was a key inspection of a care home for older people, which ended with an unannounced visit to the service. Before the visit we [throughout the report the use of we indicates the Care Quality Commission], spent six hours reviewing information received by the Care Quality Commission [CQC] since the last key inspection on the 29th September 2008. The visit took place on the 28th July 2009 and lasted eight hours. During the visit we checked all the key standards as identified in the National Minimum Standards. This was achieved through a method called case tracking. Case tracking means that we looked at the care provided to four of the residents. Care Homes for Older People Page 6 of 27 To achieve this we spoke with the staff supporting their care and looked at the records relating to their health and welfare. We spoke with the residents and visiting families. With their permission the residents bedrooms were looked at. We also checked how the home was run and organised. This included looking at staff records, training and how the staff are organised. We looked at health and safety records, menus, minutes of meetings and the quality audit. The policy for handling complaints and how the home dealt with them was seen. We looked at how prospective residents and their families are given information about the services the home can offer and whether they are suitable for them. During the visit we spoke with the manager, the senior manager, the residents, the staff and families visiting the home. We checked the Annual Quality Assurance Assessment (AQAA) that the home had sent to us when we asked for it. We looked at the surveys that we had sent out and had returned to us by the staff, the residents and relatives of the residents. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? The home has improved its staffing levels and training. there are now enough staff to meet the residents needs. The care staff are now involved in putting information into the careplans and these are available to them. There is a now a dedicated activities organiser who is providing suitable activities for the residents. There is a complaints policy in place that is accessible and understandable to the residents and their families. The staff in the home are making sure that the residents rooms reflect their personalities. There is a new manager in post who is making sure that she is visible and available to the residents, families and the staff. There is a programme of staff supervision in place to allow the staff time with their line Care Homes for Older People Page 8 of 27 manager to discuss work and training issues. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. 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 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. The residents needs are always assessed before moving into the home and they have good information to help them make the right choice about the home. Evidence: The residents and the families spoken with, told us that they had received a Statement of purpose and a service user guide. The residents spoken with confirmed that they had had a visit from someone from the home and had the information that they needed to make a decision. The Statement of Purpose and Service Users Guide gives people the information that they need to know about to help them make a decision about the home. All of the residents case tracked had thorough, completed pre admission assessments in their care plans. These had been completed by the manager or a senior member of staff. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents receive good care from a staff who meet all the individual care needs, with privacy, dignity and respect. Evidence: The case tracked records were found to contain good individual evidence of the care being given to the residents and reflected the care that they needed. There was evidence that the residents and/or their relatives had been involved in planning the care, although they had not all signed the care plans. We spoke with many residents and families who all told us that they received the care that they needed and that they were happy that they received it. The care plans contained all the required information and were clear about the residents needs and how they were being addressed. The care staff were seen to be treating the residents with dignity, respect and consideration when talking to them and giving them care. They were seen to be knocking on the residents bedroom doors before they went into them. Care Homes for Older People Page 12 of 27 Evidence: Comments received included: The home has improved dramatically over the last year She receives excellent personal care in a bright, clean and extremely supportive environment There are records of the involvement of G.P.s, chiropodist, optician, where needed in the care plans, showing that thorough health care is being provided for the residents. There was evidence that the care plans are regularly reviewed and the residents and the families spoken with confirmed that they had been involved and were aware of the care to be given and that they were happy with it. The daily record of care was up to date making sure that the residents receive the right care and the staff know what has happened to them during the day or night. There are records of the residents nutritional needs and weight, which makes sure that they are eating well and are not losing or gaining large amounts of weight. There were records of the dietician and speech and language therapists being involved when the resident had swallowing difficulties. The staff spoken with were aware of the care needs of the residents. The residents and the families spoken with told us that they were happy that all care needs were being met. There were risk assessments in place to cover all the identified risks for the residents and how the staff should manage those risks. This makes sure that the residents and the staff are protected from any risks that have been identified, without restricting their activities. Medication records for the case tracked residents were in order. Medicines are given by the trained nurses who receive regular updating and supervised medicine rounds. We saw that the medicines were administered individually and the residents were seen to be taking them. Medicines are supplied in a monitored dosage system where each tablet is in a separate pop out card, which is a safe method of administration, helping to make sure that the resident is always given the right medicines. The staff spoken with were knowledgeable about the medicines and where to obtain information. They were also aware of the requirements for the receipt, storage and disposal of medicines. Care Homes for Older People Page 13 of 27 Evidence: All of the residents have a self medicating drug assessment to identify people who are able to look after their own medicines and those who are not. There is a lockable cupboard in the bedrooms for medicines to be stored. There were no residents responsible for their own medicines at the time of the visit. The manager carries out a regular written audit of the medicines and the medicine sheets to make sure that they are correct. There were no controlled [dangerous] drugs in the home at the time of the visit, but the staff were aware of the requirements for the storage and documentation of these drugs. 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. The home provides enough activities for the residents to enjoy and take part in and meets their spiritual and nutritional needs. Evidence: The home employs an activities organiser who, with the staff, provides activities in the home. She regularly documents the activities that the residents have taken part in into the careplans. The care plans describe the residents past life and their interests so that the home can help them continue those interests if they wish to. Activities include craft work, newspapers, nails, hairdressing, card games, board games, discussions and outside entertainment such as singers. The activities organiser was seen to be spending time with the residents in the sensory room that has variable lighting, music and items with different textures to feel. Trips out of the home are arranged and the residents were looking forward to the boat trip that had been arranged. Visitors are welcomed into the home at any time and are invited to attend social Care Homes for Older People Page 15 of 27 Evidence: functions and the regular resident/family meetings. The menus seen gave choices of meals and the cook and the staff were aware of individual needs and choices. We spent time with the residents during their lunch, which was well presented and they told us that they were enjoying. The food is good The staff were seen to be sitting with the residents to help them with their meals. The chef told us that menus were planned with the residents and that each home had individual menus. She also told us that she received regular good quality deliveries of food. Religious needs are catered for by the residents having a regular service in the home or by visits from a local minister. The home does not have a hairdresser at this time and a lot of the residents look as if they could benefit from one. The residents spoken with told us that they would appreciate one. 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. There are good systems in place to support and protect residents and staff are aware of the processes. Evidence: There is a complaints policy in place which gives the details of how to complain and who to complain to in the home if they needed to. The policy could be made available in a large print and other languages if it was needed, which makes that as many people as possible could read it. The complaints form was clear and easily followed. The home has been investigated by Social services following complaints and the home agreed to stop admissions whilst these were investigated. The investigations have been completed and the home may now admit new residents. The residents, the families spoken with and the surveys told us that they were aware of how to make a complaint and were happy that it would be dealt with properly. The staff were aware of how to deal with a complaint and were happy that they would be dealt with correctly. The staff spoken with were able to describe how they would deal with an allegation of abuse, knew the areas where abuse could happen and could describe the process that Care Homes for Older People Page 17 of 27 Evidence: they would go through if they suspected any abuse. They confirmed that they had had training in safeguarding adults and whistle blowing and the manager and the records seen supported this. They were confident that the management would handle any issues correctly. We looked at the accident book, which had been completed correctly. These practices make sure that the residents are safe from any abuse and that any concerns are handled properly. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents and staff are well protected by the policies and procedures in the home that provides a safe and very pleasant environment to live in. Evidence: Jasmine Court is a large, purpose built care home on the outskirts of Loughborough in Leicestershire. It has three floors, with the first and second able to be reached by the stairs or the passenger lift. The home has large lounge/dining rooms on each floor. These were all bright, well decorated and suitably furnished. There were bedrooms on all the floors. The bedrooms of the case tracked residents that were seen, with their permission, were clean, bright, well decorated and some were personalised. The home has encouraged families to personalise the bedrooms with little success. The staff are personalising them for them with items that they like and photographs of activities that they have taken part in. The residents spoken with told us that they were pleased with their rooms and that they were kept clean and decorated. All of the bedrooms have en-suite facilities that includes a shower. I like my room. Care Homes for Older People Page 19 of 27 Evidence: There was evidence of equipment in the home to help the residents, such as wheelchairs, special mattresses and hoists. There was a good provision of bathrooms in the home that were found to be clean and free of any items that could cause a hazard for the residents. The kitchen has had a recent Environmental Health Officer inspection and was given a good rating. There are two patio areas, with tables and chairs, that are accessible for the residents to walk and sit. Fire alarm testing, drills and instruction were found to be up to date, this was confirmed by the records seen, the staff spoken with and the manager. Hot water temperature records were found to be up to date and within recommended levels. The residents and the families spoken with were happy with the cleanliness of the home, and told us that the staff worked hard to keep it clean. There are staff employed to complete the cleaning in the home and they have had training in health and safety. The cleaning products are stored in a locked cupboard, which we saw. This was confirmed by the staff spoken with, the records seen and by the manager. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents are protected by the recruitment and training practices in the home. Evidence: We looked at three staff files and they all contained the documentation that is required. These included two written references, a Protection of Vulnerable Adults check and a Criminal Records Bureau check. The staff spoken with confirmed that they had received recent training in moving and handling, challenging behaviour, safeguarding of vulnerable adults and first aid. This was confirmed by the records seen and the manager. The manager holds a training matrix showing when courses would be held and which staff needed to attend. The residents, the families spoken with all felt that the staff were well trained to do their job and that there were usually enough staff to look after them. Staff spoken with told us that the staffing levels have improved in the last few months and that the staff were much happier at work now. We saw the induction programme, the basic one takes three days to complete and includes fire, health and safety, moving and handling and infection control. The staff then complete a more detailed one over six weeks. Care Homes for Older People Page 21 of 27 Evidence: Only two of the care staff hold a National Vocational Qualification [NVQ] at level 2 or above or are completing the award. The National Standards guidance is that 60 of staff should have achieved this award. The National Vocational Qualification is a qualification for care staff to make sure that they receive training in the needs of the resident group whom they are caring for. Care Homes for Older People Page 22 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 residents views are taken into account and their safety is protected by the practices in a home that is run in their best interests. Evidence: The home has appointed a new manager who had been in post for two weeks at the time of the visit. the senior manager for the home was available throughout the visit. There are regular meetings held for the residents and for their families, to discuss activities and menus in addition as to how the home is meeting their needs. These were confirmed by the residents and their families and by the minutes that we saw. There is an annual quality questionnaire sent to the residents and their families and the questionnaires that we saw on the visit confirmed this. The families and the residents told us that they had completed the questionnaire. We received positive comments from the residents and the families at the visit and Care Homes for Older People Page 23 of 27 Evidence: from the surveys received by us, amongst which were that the staff and the manager were very supportive of them and their relative. They are all very supportive of us The residents accounts were seen and found to be in order and had two signatures on each entry. This makes sure that the resident and the member of staff handling the money are protected. We saw that receipts were obtained for purchases. There was evidence from the staff spoken with and from the records seen with that they are having regular, formal supervision with their line manager. Formal supervision of the staff gives them and their line manager the opportunity to discuss work and training issues and needs. There are regular staff meetings held, confirmed by records held and by the staff spoken with. The manager completes a regular audit of any accidents that have happened in the home to make sure that if at all possible they could be avoided. The areas of health and safety such as hot water temperatures and fire alarm testing were found to be in order. Care Homes for Older People Page 24 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 25 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 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 That the care plans are signed as agreed by the resident or their family, or that it is documented that they are happy with the care but dont wish to sign them. That the manager makes sure that all the staff receive training in good hygiene practices. That the home arranges for a hairdresser to visit the home for the residents. That the home makes sure that the required number of staff with an NVQ at level 2 or above is achieved. 2 3 4 8 12 28 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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