Care Home: Kevlin

Similar services:

• Claremont House
• Oak Ridge
• Sun Court Nursing Home
• Ashville House
• Bilney Hall
• Hill Barn
• Mabbs Hall Nursing Home
• Henrietta House

What the care home does well The atmosphere, as you spend time in the home is calm and relaxed. Residents are smiling and interaction by staff is considerate, courteous and at a pace that is right for the resident. The comments received give praise to a team who communicate well and who have full knowledge of the needs of each resident. Visits and requests, especially for the GP is timely and informative. The comments talk of `excellent communication`. The training and support for staff to carry out their role is always available and specialist training for the understanding of dementia is regularly updated. The staff team appear to work well together and carry out the tasks required to keep this service as homely as possible. What has improved since the last inspection? Since the last inspection the home has been rewired and some bedrooms have been decorated and a new carpets have been fitted. The home now employs a part time cleaner who can do the more intense cleaning, giving the care staff more time for the growing needs of the residents who are now being admitted. What the care home could do better: The home needs to develop more stimulation/activities with prompts around the home to encourage more interaction with residents. The Annual Quality Assurance Assessment completed prior to the inspection could be more detailed to give a better picture of the service delivered and the plans to develop and improve could be clearer by providing a quality monitoring system for inspection. The recruitment procedures for employing staff should be followed to ensure that all the required paperwork such as two written references are held in the personnel files in the home. The home needs to ensure the correct fire door closures are in place if the need to keep the door open is required for residents own rooms. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Kevlin 66-68 Norwich Road North Walsham Norfolk NR28 0DX     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ruth Hannent     Date: 2 7 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Kevlin 66-68 Norwich Road North Walsham Norfolk NR28 0DX 01692402355 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) : Mrs Diana Tripp,Mr Derek Tripp care home 14 Number of places (if applicable): Under 65 Over 65 14 14 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 0 Kevlin is a care home providing personal care and accommodation for 14 older people. Mr Derek and Mrs Diane Tripp own the home. The home is located on the outskirts of North Walsham and is close to shops, pubs and local amenities. The home is a three-storey building, with service user accommodation located on the ground and first floors. Communal areas are located on the ground floor and service users bedrooms are on both the ground and first floors. A stair climber provides assisted passage to the first floor. The fees are 425 pounds per week. Care Homes for Older People Page 4 of 27 Brief description of the care home There are twelve single bedrooms and one shared bedroom. There is easy access to the rear gardens from the main lounge and dining room. On-road parking is available outside of the home. 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 inspection visit took place over 6 hours and the report has been completed using evidence and details taken from a completed Annual Quality Assurance Assessment submitted to the Commission prior to this visit. Also received before the visit were comment surveys returned by residents, a staff member and the GP who has patients registered. Throughout the visit records were looked at, observation took place and time was spent discussing the day to day running of the home. A meal was taken in the dining room with the residents and conversations about their care support took place. Care Homes for Older People Page 6 of 27 Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: 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 8 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 9 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. Residents are appropriately assessed and the home does not appear to have residents who are not suitable for the service offered. They can visit with families prior to making a decision as to the suitability of the service and a contract will be issued. Evidence: The information written on a pre assessment form and seen in the individual folders were a little basic but a picture of need was in place and no resident at the home appeared inappropriately placed. The home does have one place available for respite, block purchased by the local authority and emergency placements are sometimes made to this room. This sometimes means, according to details discussed with the owner, an assessment has not been completed but a visit to the person will have been made with documentation completed on arrival to Kevlin. The information at the home gives any potential resident a picture of the home and Care Homes for Older People Page 10 of 27 Evidence: the service offered. The families are invited in to see the home and talk to the Manager or owner about the service provided. There is a copy of the statement of purpose and service users guide that is available to any interested people. In the surveys received from people who live in the home and who have had help from their families in completing the form they state they have received a contract. One person stated they had not, who on discussing with the Manager is someone who has lived in the home for over 10 years when the home was owned by someone else. 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 do have information in a care plan that will give a guide to the personal and health care needs of the residents but more information on the social support could be more detailed. The health support required for each person is offered timely and fully to ensure their health needs are met. Medication is handled and and administered correctly but more secure storage would improve further safe practice. Evidence: The residents all have a care plan that gives some details of the care needs of the individual. The home Manager and Owners told us that gathering information is sometimes difficult due to the limited information given by Social Workers and families. The residents who have been at the home for some time have a pen picture written telling the staff their individual backgrounds and the life they had before Care Homes for Older People Page 12 of 27 Evidence: requiring care. Although the care plans are in place the individual detail is not clear for all the needs and are limited in the individual aims and goals for the social support required. Dates throughout the care plan were noted as to when areas of parts of the care had been reviewed. Although not all details are written in the care plans the staff at the home appear to know the residents well. The staff are aware of the needs of the residents but time is required to work one to one with some people to allow tasks such as nail cleaning and cutting to take place. On discussing this with the staff it was evident that some residents will not allow these tasks to be done and patience and tactics to encourage the resident takes time. The home does have a good relationship with the health professionals. The CPN is actively involved in the home and is a good contact via the Julian Hospital with any concerns the home may have. The Manager talked of the support from the Continence Advisor who visits regularly and will support the individual needs of the residents with the correct pads and equipment. A survey form was received back at the Commission from a GP who has commented on the home in a very positive manner. The staff are excellent, communication is excellent and the home always call for advice and visits requested from them are appropriate. The medication is stored in a utility/office room on the ground floor in a wooden locked cabinet. The room is easy access to all visitors and residents and although the cupboard is locked at all times it would be recommended that a purpose metal cabinet be used for the safe storing of medication. The contents within the cabinet were discussed with the Manager who is the responsible person for ordering and monitoring the medication. The Senior staff and Manager are the staff trained to administer medication. Each person has a blister pack for their medication. Some medication is not suitable to be in a blister pack and these are stored separately. The eye drops are stored in the cabinet and are replaced every month regardless of the amount left. The medication administration records were looked at as the lunchtime administration process began. The staff member wore disposable gloves, popped the pill into a plastic pot, offered it to the person to put in their mouth and observed the person swallowing the medication. The MAR chart was then completed. The process was carried out calmly and after the lunch was eaten. Care Homes for Older People Page 13 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 activities and stimulation for residents could be improved with more time allocated to meet the social needs of the individuals. Contact with relatives and friends is encouraged for the well being of the residents. The meals are wholesome and choice is offered in surroundings chosen by the residents. Evidence: The home owner shared a record book with us on the activities that had taken place and how some residents had been involved and how some had refused. On the day of this visit although residents were calm and the home had a relaxed, comfortable feeling throughout there did not appear much stimulation or activity happening. There was nothing around the home to show what the day of the week was or any notices in the hall of special events. The Owner had also reported in the AQAA received prior to this visit that it is difficult to get many of the residents involved in activities. A few residents were asking what day it was but there were no prompts to show them. Care Homes for Older People Page 14 of 27 Evidence: Comments received from the owner tells us that residents do not like having notices up and some pull them down again. Reminders are verbally given by the staff which triggers conversation with the home trying to look personal and not institutionalised. The television was on but on walking through the lounge on a number of occasions it appeared to be playing to itself with residents chairs at the wrong angle to be able to sit and watch comfortably. Staff were very kind and always gave the residents time and encouragement when they came to find someone. Comments received prior to the inspection talk of residents being contented but more staff would give residents more individual time for activities. The Manager and Owner gave examples of when time has been offered to individuals. One gentleman goes out for a walk regularly with the lady who volunteers with the PAT dog. Time is spent painting the nails of ladies who would like it and board games are played on occasions. Relatives can come and go as they so wish. The Manager told us of the families that want to can be involved, can do so, as much as they like. One relative has a meal regularly with his wife and another resident has their husband visit on most days. The meal on the day of this visit was offered, according to the choice of the resident, in the dining room, bedroom and lounge. It was toad in the hole with mash, beans or spaghetti. The alternative choice was cheese omelette that was chosen by half of the residents. One person was not happy when the choice arrived and asked for cold meat and bread and butter. No problem was made of the need to change the food and all residents appeared to enjoy their meal. The Owner showed us the menu but said it was rarely stuck to as the residents usually changed their minds. The fridge and freezer has a stock of choices to ensure all tastes can be met. A home made cake was cooling on the kitchen side for tea and a rhubarb crumble was fresh out of the oven on our arrival. Comments from three surveys from residents and one from the GP all rate the food as excellent. Throughout the day residents were given drinks at timely intervals with fluids encouraged. It was noted that only orange squash was available at lunchtime but comments from the owner state that people may have whatever drink they prefer. Care Homes for Older People Page 15 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the home have the opportunity to complain if and when they so wish and know they will be listened to. Residents are protected from abuse. Evidence: The home has not received any complaints directly. The Commission has received one complaint that was forwarded to the home and the Owner was asked to investigate. A detailed report was returned to the Commission with the investigation recorded thoroughly. The home has a complaints procedure and details of how to complain is in the homes information booklet. The home has a good record of staff who have attended training on the protection of vulnerable adults and each staff handbook (seen) that is issued to all staff has a section detailing the responsibility of reporting any concerns that may affect the well being of any resident. One staff member spoken to understands the whistle blowing policy and would report as necessary any concerns. Care Homes for Older People Page 16 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is serviced and maintained to a good standard but improvements are required to the fire safety within the home. The communal areas are pleasant and homely The home is clean and pleasant with nearly all areas free of unpleasant odours. Evidence: The home is two homes converted into one accommodating 14 residents. The Owners are slowing improving areas as rooms become vacant. Rooms that have recently been improved have bright, light and homely settings with new carpets. The building has been partly rewired and a new kitchen was installed 18 months ago with a new cooker purchased recently. The home has records that were seen of maintenance and servicing. Dates for gas servicing, hoists and stair lift servicing, fire equipment servicing were all seen. The one concern shared with the Owners was of the door wedge that was in a residents bedroom door on the ground floor. A risk assessment had been written in red and placed in the persons care plan. According to the Owners the Fire Officer who recently visited the home was happy that the wedge could stay as long as the risk assessment Care Homes for Older People Page 17 of 27 Evidence: was in the persons care plan. This is not deemed safe by the Commission and as the Fire Officer had not signed the risk assessment nor was there a letter to say this wedge was permitted then a requirement needs to be made for a door closure to be placed on the door. The gardens are safe and suitable for residents to walk around with a large gate to the side of the property making the area secure. There are two assisted bathrooms with the larger being on the first floor. This is a nice bright room that is large enough to accommodate a hoist. On the shelf in the bathroom were personal creams and toiletries belonging to a variety of people. It is good practice to have creams in peoples own rooms and toiletries kept separate and out of sight ensuring only the bottles belonging to the person who is having the bath is available at the time required. The home has some bedrooms that have an odour due to continence difficulties. According to the Owner the home has a carpet shampoo machine and these carpets are cleaned regularly, but as some carpets are quite old the odour is not always removed. The communal areas are clean, tidy and free from any unpleasant odours. The laundry was not seen on this occasion but folded laundry was in the utility/office room and each resident has a named compartment for their clean clothes. Care Homes for Older People Page 18 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 home is staffed at an adequate level by a good skill mix of staff who are qualified but could improve the individual needs of residents with more staff time. Recruitment procedures do need to improve to ensure residents are cared for by safe hands. The training and induction of staff is to be commended who are competent in carrying out their duties. Evidence: With one person in hospital this left 13 residents needing support for their care needs on the day of this inspection. The Manager arrived shortly and the home appeared to be managing the personal needs of the residents. The rota, discussed with the Manager and Owner, is three care staff on duty in the morning and two in the afternoon with two waking staff over night. The two owners take a very active role in the home and support and carry out any tasks to ensure the home is running smoothly. The home does now employ a cleaner for two days a week when all the deeper cleaning is done. All the other tasks are for the care staff do do. Cooking, cleaning, laundry and care. The residents were calm, content and dressed appropriately. No-one appeared rushed. Although the staffing levels appeared suitable Care Homes for Older People Page 19 of 27 Evidence: the extra support for activities, stimulation and extra grooming would improve the care even further. The home has lost a few staff in the last year and the quota of qualified staff has gone down. At present the home has 3 staff with NVQ 3 and another 4 staff in the process of gaining the qualification of either NVQ 2 or 3. The owner, in both the AQAA and in discussion, stated the home is having difficulty in recruiting suitable staff. The process should be robust with all staff interviewed and the relevant paperwork gathered to ensure residents are cared for safely and appropriately. On checking personnel files it was noted that only one reference had been obtained for a staff member who had been in post for 6 months. The Owner explained that obtaining references has been very difficult and even though a stamped addressed envelope is sent a reply has not been returned. As stated in the National Minimum Standards Care Homes Regulations Schedule 2 the information and documents of people working in the home must be in place. The home is to be commended on the amount and quality of the training that staff have attended. The workbooks, DVD and courses discussed show a high level of dementia training is in place. The staff spoken to talk of the quality of the training and in practice, on the day of this inspection it was evident that staff had the correct approach to people with dementia. The comments received from residents, staff and the GP prior to this inspection all talk of knowledgeable and experienced staff who understand the needs of the residents. Care Homes for Older People Page 20 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 home is run by people fit to be in charge who have good leadership skills and management approach but they do need to register the Manager with the Commission. The home is run in the best interests of the residents but clearer monitoring and recording would evidence this in a more detailed manner. The residents personal money would be safeguarded even better if the personal money was locked in a safe. The health, safety and welfare of service users are protected but records could be improved. Evidence: The home has a Manager who is not yet registered with the Commission but the service has the full time support by the owners Mr and Mrs Tripp, who work alongside Care Homes for Older People Page 21 of 27 Evidence: the person aiming to be the registered Manager. The qualifications of the Manager are being achieved so that registration of this person can take place shortly. Throughout the day the conversations that took place show the experience and capabilities of the management team. Comments received prior to this inspection from a GP, staff and residents, and by staff members on the day of the inspection say the management team is very supportive and easy to approach. Training is always available and concerns are listened to. According to the owner the home does not have a robust quality monitoring system that effectively measures quality as they have tried questionnaires in the past but do not get them returned. The home does listen to people and improvements and development are made such as staff training that is moving on to understand the Mental Capacity Act and the improvements made with the homes environment. The Owner explained that the home does not take responsibility for any residents money other than the weekly personal allowance. The records and individual money is kept in a box in the office that is locked when the Owner is not there. The money is not in a safe and should be locked in a metal strongbox/safe and not left on the side in a file box. A name was picked at random and that persons money was counted and the amount balanced with the amount recorded. Noted were transactions for hairdressing and chiropody being the biggest outgoings. The Manager discussed the procedure of staff supervision that is more one to one time spent with a staff member and overseeing the work practice of that person. Records of supervision were not seen on this visit. The Owner also told us that staff meetings occur about three times a year. The staff spoken to said that the support offered is good even if notes are not taken of actual meetings together the team communicate well together. The health and safety of the home is mainly carried out by Mr Tripp, the joint owner, who showed us records of equipment serviced in the past year. The fire alarm checks were noted to be recorded weekly and tested in different zones of the home. The hoists (the home has two) were both up to date with the 6 months service. The fire extinguishers were dated 14.01.09 and the stair lift service 13.03.09. The staff are trained well in all health and safety areas and new staff have a comprehensive induction pack to complete. Only one new staff member has joined the team recently but a copy of her induction process was seen. The one area that does need improvement on is the records to show that hot water thermostatic valves are being checked regularly. The Owner tells us that valves are in place and two taps tested by hand ran at a hand hot temperature but the home has no record keeping of regular Care Homes for Older People Page 22 of 27 Evidence: testing. The home has a very detailed fire risk assessment that has been seen by the Fire Officer and is suitable for the home. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 23 The Owners must ensure that correct and safe procedures for fire door closures are in place to contain fires To ensure that all residents are protected from fire. 01/06/2009 2 29 18 The procedures for recruiting staff must be followed and 2 written references must be in place. To ensure the residents are cared for safely by someone of good character. 01/06/2009 3 33 24 It is required that the home has recorded review of the quality of care. To ensure the reviewing and improving of the care is taking place. 01/07/2009 4 38 13 The home needs to ensure all areas of risk such as hot water thermostatic valves are regularly checked. 01/07/2009 Care Homes for Older People Page 25 of 27 To ensure that the valves are working correctly and not putting anyone at risk of scalding. 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 2 9 12 It is recommended that storage of medicines is more secure. Stimulation and individual activities should be considered that occur thoughout the day and are readily available and on display to prompt people to take part. Creams and toiletries should be stored in the persons own room with a cream administration chart available for staff to sign when the cream has been applied. It is recommended that the Manager is registered as soon as possible. It is recommended that the money belonging to the residents is held in a secure safe/locked box for safe keeping. 3 21 4 5 31 35 Care Homes for Older People Page 26 of 27 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 27 of 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. 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!