Care Home: Keb House

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What the care home does well The service continues to ensure the needs of people who are thinking about moving into the home are assessed to make sure it can meet them appropriately. The home provides health and personal care to people using the service in a way to ensure their individual needs are appropriately met and relatives confirmed they are involved in decisions about this and that staff listen to them well to ensure their wishes and feelings about these are respected. A relative told us "My mum has often commented on how much she likes living at Keb House…The staff always try to look after (her) in the Keb House DS0000002886.V376744.R01.S.doc Version 5.2 way myself and family have asked. ". People living in the home are supported by a friendly staff team who are provided with training to help them do their jobs good links are maintained with community professionals to ensure their needs can be met. Friends and relatives are encouraged to be involved in the life of the home and tell us they are confident their concerns will be listened to and acted upon. What has improved since the last inspection? A good amount of work had been carried out to improve the environment with new flooring laid, flat screen televisions installed in the lounges, new kitchen units installed and some bedrooms had been decorated. Further consultation about choices of meals had taken place to ensure the nutritional needs of people living in the home are better met. Staff training had been developed to ensure they can do their jobs. An administrator for the home had been employed to ensure office systems are better developed. What the care home could do better: Recruitment of staff must be improved to ensure they are safe to work with people living in the home. Staff must follow safe moving handling techniques better to ensure people living in the home are not placed at potential risk of harm. The home must be kept free from unpleasant smells and staff should follow good practice guidelines for the management of continence to ensure the dignity of people using the service are promoted and they are provided with a pleasant environment in which to live. The variety of activities should continue to be developed and specialist training provided to staff about these to ensure the individual needs of people living in the home can be better met. Staffing levels should continue to be developed to ensure there are enough staff on duty to meet the individual needs of people using the service. The supervision of staff should be further developed and more meetings held with them to ensure a clear sense of direction and leadership is provided. The quality assurance systems for the home should continue to be developed to ensure it can monitor its effectiveness in meeting its aims and objectives.Keb HouseDS0000002886.V376744.R01.S.doc Version 5.2 Key inspection report CARE HOMES FOR OLDER PEOPLE Keb House Haytons Lane Appleby Scunthorpe North Lincolnshire DN15 0AP Lead Inspector Rob Padwick Key Unannounced Inspection 20th July 2009 12:30 DS0000002886.V376744.R01.S.do c Version 5.2 Page 1 This report is a review of the 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. 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. Keb House DS0000002886.V376744.R01.S.doc Version 5.2 Page 2 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 Keb House DS0000002886.V376744.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Keb House Address Haytons Lane Appleby Scunthorpe North Lincolnshire DN15 0AP 01724 733956 01724 734800 kebhy@aol.com Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Helen Elizabeth Young Mrs Helen Elizabeth Young Care Home 18 Category(ies) of Dementia - over 65 years of age (18), Old age, registration, with number not falling within any other category (18) of places Keb House DS0000002886.V376744.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st July 2008 Brief Description of the Service: Keb House is a care home situated in the village of Appleby near to the town of Scunthorpe. It comprises of an older Victorian style house and an annexe of a single storey purpose built extension. There is a courtyard used for parking and domestic needs and a garden and sitting area to the front of the home. The newer part of the home has its own kitchenette, dining area and lounges. There are no retail providers in the village, but residents can access a nearby church and public transport is available. The home has 14 single bedrooms and 2 shared bedrooms, 7 of which have en suite facilities. Information provided by the homes management at the time of our visit identified the weekly fees charged range between £352.00 and £402.00 with additional charges are made for chiropody, hairdressing and toiletries. Information relating to the home is available from the manager upon request. Keb House DS0000002886.V376744.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This inspection report is based on information received by the Care Quality Commission since the last key inspection of the home that took place on 21st July 2008, together with information gained during a site visit to the home. As part of the inspection process, we sent a self assessment document to the service that the manager completed and returned to us. This document should show how well the home is meeting regulations and national minimum standards and what has been done to improve it and what still needs to be done. The self assessment was completed by the owner manager for the service and information from this used as part of the inspection process. Other information used included feedback from people living in the home and their relatives, together with official notifications sent to us by the home. This information helps us to reach judgments about the service provided. This site visit took place on 20th July 2009 and as well as talking with people living in the home; we spoke with the owner manager and staff who were on duty. As part of the visit we looked round the home including the shared areas, together with personal bedrooms, and inspected the records of people’s care, some staff files, the health and safety documents and other records kept in the home. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the service does well: The service continues to ensure the needs of people who are thinking about moving into the home are assessed to make sure it can meet them appropriately. The home provides health and personal care to people using the service in a way to ensure their individual needs are appropriately met and relatives confirmed they are involved in decisions about this and that staff listen to them well to ensure their wishes and feelings about these are respected. A relative told us My mum has often commented on how much she likes living at Keb House…The staff always try to look after (her) in the Keb House DS0000002886.V376744.R01.S.doc Version 5.2 Page 6 way myself and family have asked. . People living in the home are supported by a friendly staff team who are provided with training to help them do their jobs good links are maintained with community professionals to ensure their needs can be met. Friends and relatives are encouraged to be involved in the life of the home and tell us they are confident their concerns will be listened to and acted upon. What has improved since the last inspection? What they could do better: Recruitment of staff must be improved to ensure they are safe to work with people living in the home. Staff must follow safe moving handling techniques better to ensure people living in the home are not placed at potential risk of harm. The home must be kept free from unpleasant smells and staff should follow good practice guidelines for the management of continence to ensure the dignity of people using the service are promoted and they are provided with a pleasant environment in which to live. The variety of activities should continue to be developed and specialist training provided to staff about these to ensure the individual needs of people living in the home can be better met. Staffing levels should continue to be developed to ensure there are enough staff on duty to meet the individual needs of people using the service. The supervision of staff should be further developed and more meetings held with them to ensure a clear sense of direction and leadership is provided. The quality assurance systems for the home should continue to be developed to ensure it can monitor its effectiveness in meeting its aims and objectives. Keb House DS0000002886.V376744.R01.S.doc Version 5.2 Page 7 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. Keb House DS0000002886.V376744.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Keb House DS0000002886.V376744.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 People using the 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 needs of people using the service are assessed to ensure the home is can meet them appropriately and up to date information is available to help those thinking about using the service make a decision about it. EVIDENCE: The files of people living in the home contained information about their assessed needs completed by the Local Authority or home manager to ensure the service could meet them appropriately. People living in the home told us they were generally happy with the service received and since the last time we visited, updated information had been developed to help those thinking about moving into the home to make a decision about it as was previously recommended. The formal statement of purpose for the service was in the final Keb House DS0000002886.V376744.R01.S.doc Version 5.2 Page 10 stages of being completed, with details of new staff who are employed. The manager confirmed the home does not accept placements for intermediate care. Keb House DS0000002886.V376744.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst staff training had been provided to ensure the health and personal care needs of people living in the home are appropriately met, further attention to the delivery of support provided would ensure their safety is better promoted. EVIDENCE: People living in the home said staff were Friendly and caring and indicated their individual health and personal care needs were being generally well met. A relative told us Staff always try to look after my mum in the way myself and family have asked and another confirmed her mother was Always clean and had Opportunities for lots of baths. The case files belonging to people using the service contained support plans developed from their assessment of needs which provided good information about their individual strengths and personal preferences to ensure wishes and feelings about the way they are supported was respected. Interactions between staff and people living in the Keb House DS0000002886.V376744.R01.S.doc Version 5.2 Page 12 home were observed to be positive and friendly and feedback from people using the service and their relatives indicated their rights were promoted and the service was responsive to need. Information about the health needs of people living in the home were contained in their case files, together with regular monitoring of these and assessments about the management of risks. Feedback from health staff in the community was generally positive and a GP was visiting on the day of our visit. However, whilst District Nurses told us care provided was Very good they indicated staff were sometimes slow to act on their recommendations about the use of wheelchairs with footplates not attached. Whilst we saw evidence staff had received training on moving and handling techniques, a requirement is made about this as this places people at risk of potential harm. The last time we visited we made a requirement concerning the use of medication in the home. We saw evidence that action had been taken on this and that further in house training and visits from a local pharmacist had been arranged, with staff responsible for this aspect of the home enrolled on a College course about the safe use and handling of medication. We made a random check of the medication records and found these to be appropriately maintained. Keb House DS0000002886.V376744.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst people living in the home are able to make choices about taking part in a variety of activities, further development of these would ensure that their individual needs and wishes about these are better met EVIDENCE: Feedback from people using the service confirmed they were supported to take part in a variety of activities to ensure their lifestyle needs are met. We made recommendations about this previously and there was evidence of work carried out to implement these. Since the last time we visited monthly religious services had been organised to support the spiritual needs of people using the service and we observed a group taking part in a board game of dominoes during our visit. A part time activity organiser is employed in the home and the records inspected showed evidence of regular movement to music, arts and craft sessions and visits from outside entertainers. Some comments received however told us activities could still to be further Keb House DS0000002886.V376744.R01.S.doc Version 5.2 Page 14 developed and although we saw staff taking time to interact with them sensitively, we observed a number of people who appeared somewhat listless and bored. A visitors policy is in place and the service supports the involvement of friends and families. Relatives told us staff listened and involved them well and commented positively on the care provided. Since the last time we visited staff training had been developed with courses on dementia and customer care and comments received confirmed people living in the home are supported to make choices about their lives. There was evidence of a variety of wholesome and nutritious home cooked food provided to ensure the nutritional needs of people using the service are appropriately met. Comments received said the Meals are good and a relative confirmed this stating the Food very good and that XXX is given Lots of extra drinks. The case files belonging to people living in the home contained evidence of nutritional assessments and support with specialist diets. Recent improvements to the kitchen have made it easier to clean and a four star environmental health department rating has recently been awarded for the standard of cleanliness of this area. We saw evidence of work carried out to develop the variety food provided and there were menu boards on display and evidence of consultation with people about these. Keb House DS0000002886.V376744.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People using the 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 concerns of people living in the home are taken seriously by staff who are trained to ensure they know how to safeguard them from potential harm. EVIDENCE: The service has policies and procedures to ensure the concerns of people using the service are taken seriously and they are safeguarded from harm and feedback from them and their relatives was generally positive and indicated they knew how to make a complaint if this was needed. No complaints had been received by us since the last time we visited and the self assessment for the service confirmed none had been received by the home. Staff training had been arranged about the protection of vulnerable adults and discussion with those on duty indicated they were aware of their responsibilities in this regard and would take appropriate action if they had any concerns. We were told relatives are encouraged to look after the finances of people living in the home and the records for these we inspected confirmed that appropriate systems were kept. Keb House DS0000002886.V376744.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst the home was comfortable, safe and generally kept clean, improved management of continence issues would ensure the dignity of people using the service are further respected and that they are provided with a better environment in which to live. EVIDENCE: The home was comfortably furnished and generally clean and tidy and there was evidence it was being appropriately maintained. A considerable amount of work had been carried out to improve the environment as we previously required and non slip flooring had been laid in a number of rooms and drains in the laundry area had been repaired. Some of the bedrooms had been redecorated since our last visit to the service and new units and surface areas had been installed in the kitchen. The home has plentiful areas of communal Keb House DS0000002886.V376744.R01.S.doc Version 5.2 Page 17 space and the homes lounge areas have been equipped with new flat screen televisions. Bedrooms inspected reflected the personalities of people living in the home, however despite a previous requirement to ensure the home is kept free from unpleasant smells; one of these had a strong odour. The manager told us a cleaner was now been employed to keep the home clean and that the service had signed up to an improvement foundation about infection control. Maintenance checks of the building and equipment were being appropriately carried out to ensure the safety of people using the service and a random check of the records for these confirmed up to date certificates were held. Keb House DS0000002886.V376744.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 27, 28, 29 and 30 Whilst people living in the home are supported by a friendly and caring staff group who are provided with a range of training, some recruitment practices meant people using the service are placed at potential risk of harm. EVIDENCE: As indicated elsewhere in this report, feedback about the service was generally very positive. Relatives and people living in the home said staff were Caring and friendly and indicated they worked with them well to ensure their dignity was respected and that support was individually based. A member of staff told us Keb house strives to make it a real home for the residents that live here, the men and women here are someones father, mother, brother, sister and as such deserve to be treated with dignity and respect as we would from our own family. This is their home and I enjoy working for them. The last time we visited, we recommended staffing levels were reviewed and whilst the provider manager told us she had increased these by a further 35 hours a week, we were told staff availability was somewhat limited at times and observed occasions when this could be further improved. A recommendation was made previously about recruitment practices in the home and whilst policies and procedures were in place, there was evidence Keb House DS0000002886.V376744.R01.S.doc Version 5.2 Page 19 these had not always been followed and that practice about this still needed further development. The file of a newly recruited member of care staff indicated they had started work without a new Criminal Records Bureau check being applied for, whilst in another; a second reference was still needed. This means it was not possible to check staff are safe to work with people living in the home and a requirement is therefore made about this. There was evidence of good progress to develop the staff training programme as previously required and staff files provided confirmation of an appropriate induction and mandatory training. The self assessment for the service told us 70 of care staff had achieved a level 2 NVQ qualification and the provider manager told us that others had taken courses in Customer Care, Dementia and Safe handling of medication. However there was evidence staff development could be further improved and no staff training matrix was available which meant it was difficult to tell when staff training was needed and staff supervision records were somewhat brief and lacking in detail. A member of staff told us I do the training and find it difficult to ensure all staff will attend, so now I do lots of small groups. A recommendation is made about this. Keb House DS0000002886.V376744.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst management systems have been developed to ensure the service can monitor its effectiveness, further development of these and closer supervision of the staff team would enable clearer direction and leadership to be provided. EVIDENCE: The provider manager is a trained nurse and both she and her deputy have recognised qualifications to run the home. Relative feedback was generally very positive about the service and staff told us the manager was supportive and open in her approach. A staff member told us I dont think there is anything any one thing they could do better as suggestions and ideas are Keb House DS0000002886.V376744.R01.S.doc Version 5.2 Page 21 being used all the time…Its an ongoing thing and everyone is involved. There was some evidence however further efforts were still needed to develop the staff team and that more direction and leadership was needed with this. Only two formal staff meetings had been held during the past year and whilst staff supervision records indicated this aspect of the service was being carried out on a regular basis, the records for these were brief and hard to tell what had been covered. Recommendations are made in this respect. A part time administrator has been recently appointed to help develop the homes management systems and although some progress had been made in regard to these, some information we needed was a bit hard to find. The owner manager had completed the home’s self-assessment document as required, however whilst evidence to support the comments were generally satisfactory, there were limited details about the areas where they needed to improve. The ways that they were planning to achieve this were only briefly explained. Whilst surveys had been sent to enable the views of people with an interest in the service to be heard and participate in its development, a recommendation is made that quality assurance systems continue to be developed to ensure the service can monitor its effectiveness in meeting its aims and objectives. Records of finances kept on behalf of people using the service were being accurately maintained and satisfactory checks were being carried out of the building and equipment to ensure their health, safety and welfare were promoted and protected. Keb House DS0000002886.V376744.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 N/A DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 1 STAFFING Standard No Score 27 2 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 3 Keb House DS0000002886.V376744.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP8OP8 Regulation 13 Requirement The Registered Person must make sure staff follow safe moving handling techniques and that wheelchairs are used only with footplates properly attached. This is to ensure people living in the home are not placed at potential risk of harm. The Registered Person must ensure the home is kept free from unpleasant smells and that staff follow good practice guidelines for the management of continence. This is to ensure the dignity of people using the service and that they are provided with a pleasant environment in which to live. The Registered Person must ensure robust recruitment policies and procedures are followed and that Criminal Records Bureau clearance and two references are received for all staff employed. This is to ensure staff are safe to work with people living in the home. Timescale for action 01/01/10 2. OP26OP26 16(2)(k) 28/02/10 3 OP29OP29 19 01/01/10 Keb House DS0000002886.V376744.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP12OP12 Good Practice Recommendations The Registered Person should continue to develop the activities and ensure specialist training about these is provided to staff to ensure the individual needs of people living in the home can be better met. The Registered Person should continue to review staffing levels to ensure there are enough staff on duty to meet the individual needs of people using the service. The Registered Person should develop the staff training programme to ensure it is possible to tell when refresher training is needed. The Registered Person should ensure the programme of team meetings are developed to ensure further leadership and direction is provided to staff. The Registered Person should develop the programme of supervision for staff to ensure they can do their jobs safely. The Registered Person should continue to develop the quality assurance systems for the home to ensure it can monitor its effectiveness in meeting its aims and objectives. 2 3 4 5 6. OP27OP27 OP30OP30 OP32OP32 OP36OP36 OP33OP33 Keb House DS0000002886.V376744.R01.S.doc Version 5.2 Page 25 Care Quality Commission Care Quality Commission Yorkshire & Humberside Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.yorkshirehumberside@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. Keb House DS0000002886.V376744.R01.S.doc Version 5.2 Page 26 Keb House DS0000002886.V376744.R01.S.doc Version 5.2 Page 27 - 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. 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