Care Home: Laglin House

What the care home does well It is a homely welcoming place for people to live. The premises are attractive and very well maintained and contribute positively to individuals’ state of well being. The home benefits from the presence of an experienced and capable manager. The home facilitates good communication with mental health professionals, recommendations made are responded to accordingly. What has improved since the last inspection? The service has improved and following this key inspection is now rated as good. Needs assessments are kept under review with appropriate support plans developed to respond to these needs assessments. The outcomes of CPA meetings are recorded in personnel files and used to inform risk assessments and support plans. Recruitment procedures are much improved with all new staff fully vetted before they are employed at the home. Staff are receiving relevant training to meet training needs, more attention is needed to specialist areas. What the care home could do better: Staff are generally experienced and competent in the majority of areas in their role as support workers. However not all staff have received the relevant medication training. The service must provide support staff with appropriate medication training. ItLaglin HouseDS0000022801.V375022.R01.S.doc Version 5.2 should ensure that a verifiable method is introduced to assess staff competencies in this field. Key inspection report CARE HOME ADULTS 18-65 Laglin House 168 Leigham Court Road London SW16 2RG Lead Inspector Mary Magee Unannounced Inspection 21st April 2009 09:30 Laglin House DS0000022801.V375022.R01.S.doc 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 home adults 18-65 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. Laglin House DS0000022801.V375022.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 Laglin House DS0000022801.V375022.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Laglin House Address 168 Leigham Court Road London SW16 2RG 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) 020 8769 8655 Mr Hussain Modile Mrs Elizabeth Modile Mrs Elizabeth Modile Care Home 4 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (4) of places Laglin House DS0000022801.V375022.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Mental Disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 4 7th May 2008 Date of last inspection Brief Description of the Service: Laglin House is a small care home registered to provide care and accommodation for a four people. The premises a mid-terraced house is located on a residential road in Streatham. Public transport links are very good. Bedrooms are single occupancy and located on the ground, first and second floor. Communal areas include a spacious lounge, a kitchen/ diner and a conservatory on the ground floor. Fees range from £850 to £950 per week. Laglin House DS0000022801.V375022.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 2 star. This means the people who use this service experience Good quality outcomes. While carrying out this unannounced key inspection we made two visits to the home. We received information from a range of sources to inform the evidence in this report. We met and had discussions with the registered manager and a support worker. We contacted the mental health team and received comments verbally from the care coordinator assigned to residents at the home. We met informally with one person currently using the service. A number of records were observed and used to inform this inspection evidence. A completed AQAA was supplied, we examined a selection of personnel records relating to persons using the service and to support staff. What the service does well: What has improved since the last inspection? What they could do better: Staff are generally experienced and competent in the majority of areas in their role as support workers. However not all staff have received the relevant medication training. The service must provide support staff with appropriate medication training. It Laglin House DS0000022801.V375022.R01.S.doc Version 5.2 Page 6 should ensure that a verifiable method is introduced to assess staff competencies in this field. 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. Laglin House DS0000022801.V375022.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Laglin House DS0000022801.V375022.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1 2 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. People using the service experience positive outcomes. Assessments are completed to determine the support requirements of individuals admitted and support plans are developed in response to these. EVIDENCE: The home has not admitted any new residents since the last inspection. The Statement of Purpose states that a full assessment of need is completed prior to admission in consultation with the prospective resident. We observed the needs assessments recorded for the current resident. It covers all areas where support and assistance is required. The assessments focus on achieving positive outcomes for the person. It includes information from mental health professionals. The assessment ensures that the facilities, staffing and specialist services provided by the home meet the ethnic and diversity needs of the individual. We spoke to the care coordinator. He meets regularly with the person using the service currently, he also holds CPA meetings and medication reviews. He tells us that he finds that the placement is appropriate and that the resident’s needs are well met at the home. Further reports too confirm that the manager’s experience of working with people in mental health settings has a Laglin House DS0000022801.V375022.R01.S.doc Version 5.2 Page 9 positive contribution to the good communication and relationship with the resident. The home displays a current correct registration certificate, a current insurance liability certificate is also on display. Laglin House DS0000022801.V375022.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 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): 6 7 8 9 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. Support plans are developed with individuals that are meaningful and that consider any risks associated with living at the home and accessing the community. Individuals make choices about their lives with assistance given as needed. EVIDENCE: We examined the support plans developed for residents. The plans we viewed were found to be individualised for the person they relate to. Staff demonstrate that they are fully committed in supporting individuals to lead purposeful and fulfilling lives. We received further evidence of this in reports we received from the care coordinator. People using the service make their own informed decisions. This right is respected, and have the right to take risks in their daily lives. The support plans are drawn up in simple form and are easy to follow. Risks associated with Laglin House DS0000022801.V375022.R01.S.doc Version 5.2 Page 11 conditions are recognised and recorded and are reflected in support requirements. The information from case histories and health professionals reports are used to inform support plans and risk assessments. We found that goals and targets set are realistic and consider issues such as histories of disengagement and non compliance and reluctance to attend day centre activities. Up to date copies of recently reviewed support plans are held. We viewed copies of CPA meetings and records of visits to care coordinator and mental health professionals. Key workers are allocated to people using the service. This helps with communication. We heard from the key worker the support needed by a resident. Key working sessions are held with one to one time given to focus on personal goals and aspirations; the outcome of each session is recorded on personnel file. Records are maintained of daily progress. Support is available to residents in assisting with managing finances and budgets. Currently the resident manages his own personal allowances and chooses to do so independently. Laglin House DS0000022801.V375022.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: 12 13 15 16 17 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. Individual rights are respected with responsibilities given. People using the service have the opportunity to be involved in meaningful activities and develop valuable independent living skills. Individual choices on whether to participate are respected. The home supports individuals to develop and maintain relationships with families and friends. EVIDENCE: Staff work together with residents to identify and inspire individuals to set goals and aspirations. This is important to encourage and motivate those with a long history of withdrawal from participation in any form of structured activity. However if a resident chooses not to participate in any programme this choice is respected. We found that after much encouragement from staff a resident has achieved some success in following his aspirations, he is now enrolled and attending a gym locally several days a week. Laglin House DS0000022801.V375022.R01.S.doc Version 5.2 Page 13 Currently individuals living at this home access the community independently. They use public transport, and frequent shopping centres and visit family and friends home. (One resident is an in patient at a hospital for some months) Despite difficulties with disengagement by an individual the home offers structure to individuals and residents are aware of the need to comply with times for medication. Individuals have activity profiles in place. Responsibility for household chores and food preparation are part of the activity programme. Where appropriate, residents are involved in the domestic routines of the home. They take responsibility for their own room, menu planning and cooking meals, making sure that they are able to enjoy the food they prefer and like. The menu offers variety and feels personalised. A good degree of flexibility is afforded. We observed that a resident arose earlier for breakfast, took the prescribed medication and went back to his bed for a period. The lifestyle is totally non institutional with a homely family style of living that promotes an inclusive feel. A large kitchen with table and chairs present is where individuals can relax and enjoy their meals. Mealtimes respond flexibly to other commitments people may have in the community. The local community offers a range of therapeutic activities for the client group. The meals are balanced and nutritious and cater for the varying cultural and dietary needs of individuals. Residents are actively supported to help plan, prepare and serve meals. A resident benefits from the presence of a support worker from community mental health team who assists him with developing cooking skills. According to the manager this is progressing well. Staff are currently exploring the possibilities of a resident continuing his higher education course. Laglin House DS0000022801.V375022.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 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): 18 19 20 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. Individuals receive support that is reliable, consistent and responsive. People are supported to comply with taking prescribed medication. People using the service receive encouragement and support in a sensitive and flexible manner that maximises independence and enables people take control over their lives. EVIDENCE: Staff tell us that none of the people using the service currently require support with personal care. People are supported and helped to be independent and can take responsibility for their personal care needs. Health needs are monitored, and appropriate action and interventions take place as necessary. The home has effective systems in place to monitor, identify changes and respond to the physical and emotional needs of people using the service. Staff are experienced and skilled and quickly identify changes in conditions of an individual. They are aware of the speedy action needed to respond to changes. Laglin House DS0000022801.V375022.R01.S.doc Version 5.2 Page 15 The incidence of individuals experiencing relapse is reduced due to the prompt actions of staff. Communication with health professionals is good. Care coordinators tell us that management keep them informed on all aspects of the welfare of individuals. Residents are encouraged to manage their own healthcare including GP appointments. They have access to all NHS healthcare facilities in the local community. We observed that regular appointments are seen as important and there are systems to ensure they are not missed. The home arranges for health professionals to visit residents at home when necessary. Staff attend CPA meetings and receive all the follow up reports, these are maintained on personnel files. The home understands the need for residents to comply with the administration, safekeeping and disposal of medication. Medication profiles are developed for residents. We observed medication procedures, signed MAR sheets record an accurate record of medicines administered. The current resident is not self medicating. Regular reviews of prescribed medication take place. Individuals find that blood levels are monitored and have frequent blood tests in relation to prescribed medication. The home has a medication policy, and procedures are in place that reflect policies. We are not fully satisfied that medication training is given the priority desired to new staff. According to managers staff are trained and competent in medication procedures. A small number of staff received training at other establishments prior to this employment but have not received training in medication procedures since coming to work at this home. There is no evidence of the system used to evaluate competencies of staff that administer medication. It is recommended that the home introduces a system to ensure the competencies of staff in administering prescribed medication. Laglin House DS0000022801.V375022.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 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): 22 23 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 home has procedures in place that safeguard vulnerable adults from abuse or neglect. Staff are knowledgeable having received training on local authority procedures. The home operates a complaints procedure. EVIDENCE: There is a clear system for staff to report concerns about colleagues and managers which ensures that concerns are investigated in line with local policies and procedures. In the past twelve months staff received training in local authority procedures from the safeguarding coordinator, this also included the procedures adopted by the home. Staff spoken to demonstrate a good knowledge of the procedures. A range of information is displayed at the home on the local authority safeguarding procedures. The manager has also acquired information on other important acts and legislation. Brochures with a cassette tape on the mental capacity act and Deprivation of Liberties Act is supplied to staff to read. The home supplies a copy of the complaints procedure to new residents ate point of admission. No complaints are recorded in the complaints log. We received no complaints at the Commission about the service. We found that not all service related issues raised by residents are logged. A recommendation is made. Laglin House DS0000022801.V375022.R01.S.doc Version 5.2 Page 17 Laglin House DS0000022801.V375022.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 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): 24 25 26 28 30 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service benefit from living a pleasant well maintained environment. They find that their independence is promoted. The homely non institutional style of living people finds to be inspirational in promoting a positive sense of well being. EVIDENCE: The house has a homely feel. It is comfortable, bright airy and very well maintained. Attention is given to maintaining the premises in a good state of repair; decoration is ongoing to make sure that the premises are attractive and pleasant. Communal space is good; it has a lounge, a conservatory and kitchen cum dining area. Cleaning is to a high standard. Furniture and fittings are of good quality. We viewed two bedrooms and all the communal areas. Communal areas include a lounge, dining room/kitchen and a conservatory. Laglin House DS0000022801.V375022.R01.S.doc Version 5.2 Page 19 Bedrooms are suitably furnished and spacious. One of the bedrooms viewed is very spacious. The resident has a sofa provided as well to entertain guests. Laglin House DS0000022801.V375022.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 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): 32 34 35 36 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 staff team is made up of a number of experienced support workers that are suitably trained. Recruitment procedures are more robust and EVIDENCE: The home has not had full occupancy since it reopened in 2008. For the past four and a half months only one person has resided at the home. The individual accesses the community independently. As a result of the low occupancy staffing levels required remain low with one support worker needed on duty daily; there is one waking night staff member on duty. Six support staff are involved in working at the home and are on the rota. We spoke to two staff, the manager and a support worker. Fortunately the team of support staff are retained with the employer. The majority work part time at the sister home also in Streatham. A high proportion of staff have achieved relevant NVQ qualifications. The provider has employed the majority for a number of years. Two new members of staff joined this staff team in the past twelve months. Laglin House DS0000022801.V375022.R01.S.doc Version 5.2 Page 21 We examined the recruitment procedures. Staff files for new staff were examined. The recruitment procedures have improved. All the personnel files include the relevant documentation that demonstrates vetting procedures are thorough. We looked at how staff are supported. Records are held of regular one to one supervisions, team meetings also take place for staff. Support staff attended training provided by the local authority in the past twelve months. This training includes POVA training, health and safety, Fist Aid. The home employs a trainer with a background in mental health to deliver training in relation to conditions affecting people using the service. As the resident intake is low the training and development programme is not well developed. A requirement is made in relation to medication training for new staff member. It is recommended that the home focuses on the development of a suitable staff training and development programme. Laglin House DS0000022801.V375022.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 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): 37 39 42 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 home provides a safe environment for people that live and work there. It benefits from the presence of an experienced and competent manager. The views of residents are considered and used as to evaluate, monitor and review the quality of the service delivered. EVIDENCE: The manager is experienced in the mental health field, is knowledgeable on services available in the community. She is calm and reassuring. She demonstrates a good awareness and understanding of equal opportunities issues relating to residents and staff. She promotes and leads a service that focuses on the individual, and takes account of equality and diversity issues. The service is user focused. Laglin House DS0000022801.V375022.R01.S.doc Version 5.2 Page 23 Residents receive the encouragement and support needed to develop independence. Residents take responsibility for managing their own finances but advice and support is available as necessary. Evidence was gained from speaking to mental health professionals that communication with management and staff is good. The experience is that management and staff work well with residents, relatives and health professionals. The views of residents and staff are listened to. This used with effect and translated into a quality assurance process. It is recommended that additional information is included in the quality assurance process to determine the overall outcome for people using the service. The service demonstrates a good level of self-awareness. It recognises some of the areas that it needs to improve and records this in the quality assurance process. The AQQA was well completed and contained supporting evidence for much of the practice. Improvements have taken place in health and safety policies and procedures. Records are held of environmental checks that take place, hot water temperatures in bathrooms are maintained within safe limits. Fridges and freezers are kept clean and checks made regularly of temperatures and reliability of the equipment. Health and safety is promoted generally and the service has a good history in this aspect. The premises are kept in a good state of repair. Records present confirmed that essential equipment is serviced, the premises are well maintained, and fire drills are conducted. Laglin House DS0000022801.V375022.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 x 2 3 3 3 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 3 26 3 27 x 28 3 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 x 3 x x 3 x Version 5.2 Page 25 Laglin House DS0000022801.V375022.R01.S.doc No Are there any outstanding requirements from the last inspection? 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 YA20 YA35 Regulation 13 (2) Requirement Staff assigned to administer prescribed medication must receive appropriate medication training. Timescale for action 30/05/09 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 2 3 Refer to Standard YA20 YA22 YA35 Good Practice Recommendations The home should ensure that a verifiable system is introduced to assess staff competencies in administering medication The complaints procedure should record all quality issue raised by residents The home should ensure that a suitable training and development programme is in place for the staff team. Laglin House DS0000022801.V375022.R01.S.doc Version 5.2 Page 26 Care Quality Commission London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: 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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