Care Home: Lindisfarne Residential Home

What the care home does well People are supported by a caring staff team. The activities coordinator works hard to provide appropriate activities for people. Also the home has its own transport to enable people to go out. A good range of healthy foods are provided. Those people who choose can personalise their rooms with items of furniture and memorabilia. Residents and visitors commented that staff provide good care. Comments included; Staff look after my welfare. The home is always clean and staff are all helpful and caring. Staff are caring and considerate. Home is clean and bright. Food is very good and there is plenty of it. Staff arrange regular activities and always try to involve the residents. What has improved since the last inspection? Some improvement has been made to care planning although further work is required. The medication system has been improved with a new dispensing trolley purchased and a new system of dispensing introduced. Some redecoration and repair has taken place. What the care home could do better: Several requirements made at the last inspection a year ago have not been fully addressed. For a home that specialises in the care of people with a dementia, the home has no access to support organisations in this field and staff awareness of current good practice is not good. Care planning has improved but further work is needed to provide a more person centred care package. Specific fire training must be more frequent so that in the event of fire staff are better able to support people in the home. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Lindisfarne Residential Home Durham Road Birtley Chester le Street Co. Durham DH3 1LU     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: Allan Helmrich     Date: 3 0 0 9 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 28 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 28 Information about the care home Name of care home: Address: Lindisfarne Residential Home Durham Road Birtley Chester le Street Co. Durham DH3 1LU 01914920738 01914921373 cis@gainfordcarehomes.co.uk CLS@gainfordcarehomes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Janet Helen Wright Type of registration: Number of places registered: Gainford Care Homes Ltd care home 66 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users who can be accommodated is: 66 The registered person may provide the following category of service only: Care home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Dementia Code DE, maximum number of places: 66 Date of last inspection Brief description of the care home Lindisfarne Care Home is a large, purpose-built home that is registered to accommodate people over the age of sixty-five years with dementia who need personal care. The home is also registered to provide nursing care. Care Homes for Older People Page 4 of 28 Over 65 0 66 Brief description of the care home The home has three floors, each containing lounges, dining rooms, bathrooms and either 17, 24 or 25 bedrooms. All rooms are single occupancy with en-suite facilities. Bedroom doors are generally locked, however people are offered a key to their room. There is level access into the home. Wide corridors, spacious toilets and bathrooms allow good access for people who use a wheelchair. The home is equipped with aids and adaptations to help more physically dependent people in the home. A passenger lift serves all three floors. Access to staircases between each floor is controlled by a coded keypad. The home is located in the centre of Birtley, with local shops and amenities close by and there are views of the local countryside to the rear. Transport links are good and there is ample car parking at the front of the building. A Statement of Purpose and service user guide are available at the home. The guides describe the services and facilities provided by the home and how staff are trained to meet service users care and support needs. Inspection reports are available at the home detailing the quality of care provided. The homes fees are between £438-£449 per week. Additional charges are payable for personal newspapers, private chiropody, toiletries and hairdressing. Care Homes for Older People Page 5 of 28 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: The quality rating for this service is 2 star. This means the people who use the service experience good quality outcomes. 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 that 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. How the inspection was carried out. Before the visit we looked at: Information we have received since the last inspection on August 4th 2008. How the Care Homes for Older People Page 6 of 28 service dealt with any complaints and concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service, their relatives, staff and other professionals. During the visit we: Talked with people who use the service, relatives, staff, the manager and visitors. Looked at information about the people who use the service and how well their needs are met. Looked at other records that must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last inspection. We told the provider what we found. Surveys were provided for residents, staff and professional visitors. Six surveys completed by people in the home supported by family members were returned and three from staff. Information from these sources is used in the report. 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 Care Homes for Older People Page 8 of 28 7535. Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. While sufficient information is made available to enable people to make an informed choice about the service, assessment records do not contain the necessary information to ensure peoples needs and wishes are met. Evidence: The Home provides a glossy brochure with information and pictures of the home and contact details for the company. A Statement of Purpose and Service User Guide are also available containing information as required by the Care Homes Regulations 2001. These are written in a way that might support people with dementia care needs and are available to any enquirer about the service. The case record for a recently admitted person was reviewed. Details of the information obtained before admission and a copy of the local authority assessment were in place to assist the manager in determining if a suitable place could be offered. However this information although dated did not record where the assessment took place or who was involved in providing the information. Also although the form provided the opportunity to record Care Homes for Older People Page 11 of 28 Evidence: issues relating to equality and diversity the area for religious beliefs was not completed. Assessments to determine dependency following admission were produced and contained useful information to inform staff about health and personal care needs but again a social profile was incomplete including the information related to personal beliefs. The manager has introduced a Life History Book that supporters are requested to complete to add to the information currently collected. This information and the care managers assessment of the persons needs will be essential to help ensure the needs of the resident can be met by staff. Although the home is registered to provide care to people with dementia the home is still not involved or associated with any local, regional or national dementia care groups that provide current best practice information. Some work has been done recently to identify individual bedrooms but further improved signage and meaningful pictures/photographs to aid orientation should be provided. Some staff spoken with had received training related to dementia but were not aware of current good practice promoted by the various organisations associated with dementia care. People have the opportunity to visit the home as often as they need in order to decide if they want to live there. A resident may come for meals, have overnight stays and be introduced to other residents at the home at a pace suitable to the individual. People who responded to a survey all stated they received enough information before moving in. A copy of the Service User Guide and a welcome letter are placed in each persons room before admission and confirmation of this was seen in the case record reviewed. A rehabilitation service is not provided but respite places are available. Care Homes for Older People Page 12 of 28 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. While the delivery of care is reasonably well met, it is not always person centred. Evidence: The manager has worked to improve the care plans in the home and has introduced a life story book to obtain a view of the individual before they entered the home. However some of these contained little detail and were not dated. Care plans describing to staff how care is to be provided are written and risks in daily living are assessed. Four care plans were reviewed. They all contained a social assessment, although two plans did not identify peoples religious beliefs. The plans were generally updated regularly although one plan to provide stimulation had not been reviewed for several months and a behavior monitoring chart was stopped without explanation. Where a risk is identified, assessments are written with how these can be reduced. Each residents health is assessed. Residents, weights are regularly recorded and care plans are generally reviewed by the manager. An audit sheet is not used to demonstrate to key workers how the plans should be improved to ensure the care provided meets the individuals needs. Care Homes for Older People Page 13 of 28 Evidence: Systems are in place to meet the needs of any resident with a pressure sore and people at risk are provided with the equipment to support them. The system for the administration of medicines was checked. Staff who dispense medicines are trained. Ordering, receipt and disposal systems are in order.Medicines are safely stored and room temperatures are checked regularly. Medical administration records contained no gaps in recording. An issue with one medication was resolved before the inspection concluded. Residents seen were dressed appropriately in their own clothes. Staff were seen to treat residents respectfully and deal with any personal issues with dignity. Locks on bathroom and toilet doors checked during a tour of the building worked smoothly to enable people with less mobility to use them. A pay phone situated in a corridor does not provide much privacy, however, the manager stated for anyone requiring this, a cordless phone is available to them. Residents and their visitors spoken to during the inspection all said that staff provided good care and were respectful. This was confirmed in the returned questionnaires. Comments made included; In the general area of care the home does well and has noticeably improved this year. They look after my welfare. Staff are caring and considerate. Care Homes for Older People Page 14 of 28 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. Daily routines are flexible and a range of activities are available for people to choose. People are provided with wholesome foods. Evidence: The current recording of peoples interests is not well detailed. However a new way of collecting information is being introduced. Residents and their supporters are being requested to complete a life story book identifying peoples preferences. This will be further developed by staff and used when developing activities for the individual. The activities coordinator who has worked in the home for many years was positive about this system and felt it would assist her. Currently the activities coordinator divides her time between each floor in the home and has an activities menu. The activities record showed that people have been involved in; quizzes, board games, sing a longs and light physical exercises. The home has its own transport for up to six residents but this has not been used recently as they have been without a driver. The new handyman will now do this job. The records also showed that entertainers are brought in, coffee mornings are held and that people are taken to shows and other events in the community. The home has a purpose built hair salon. The activities coordinator has not received specific training related to supporting people with a dementia and is not aware of the organisations providing this information. Care Homes for Older People Page 15 of 28 Evidence: Each week people are invited to a Catholic service held in the home and each month a Church of England minister provides communion. Visitors are welcome in the home although a protected mealtime was introduced so staff could better support people around this time. Visitors spoken with were happy with the visiting arrangements and said they are always made welcome when they visit. Of the people surveyed whether activities were suitable for them; 3 stated always 2 usually and 1 sometimes. One person commented; staff arrange regular activities and always try to involve residents. A picture book has been produced to assist people to decide on a choice of meals but this was not seen to be used. The cook has a catering NVQ and is aware of foods likely to promote some independence for people with a dementia, however she has not had any training in this area. People spoken to were complimentary about the meals and the lunchtime viewed by the inspector was well supported by staff and appeared a very calm and enjoyable affair. During the day people were offered hot and cold drinks and the cook said that snacks between meals would be provided if requested. Care Homes for Older People Page 16 of 28 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 can feel confident their complaints will be addressed. They are also supported by a well trained staff team to ensure they are safe. Evidence: The homes complaints procedure is given to new residents as they move into the home and a copy is posted in the reception area for the benefit of visitors. The home keeps a record of complaints. There have been three complaints received since the last inspection which have been investigated by the home and appropriately recorded with any outcomes. The activities person also meets with people each week and any issues identified are recorded and brought to the attention of management. The manager who has received basic safeguarding training has been involved in three safeguarding referrals since the last inspection. Some of these have involved people without capacity who have been supported by outside professionals. The majority of staff have received safeguarding training and appropriate policies are in place to support them. Staff spoken to were aware of there responsibilities related to this area of care. Care Homes for Older People Page 17 of 28 Evidence: Most staff have also completed a twelve week Dementia Care course to give them more understanding of the needs of people with memory loss. Everyone who completed a survey recorded they were aware of who to speak to if they have a concern and a visitor commented that although they had not needed to complain, some areas of dissatisfaction brought to the attention of management were addressed immediately. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although some works of maintenance and repair are required, the home is generally comfortable and safe with a reasonable standard of hygiene. Evidence: The home that was purpose built, is close to local shops and is on a bus route to the nearby town centre. Outside there is a large car park and level access into the home. The home has three floors served by a passenger lift and each floor has a keypad control on the exit doors. A maintenance person works 25 hours each week and was seen during the inspection attending to various issues of maintenance around the home. There is an ongoing programme of decoration and refurbishment around the home however there were some areas of the home that required attention as the home were without this support for some time. Some air extractors were not working, some ceiling tiles stained by water needed replacing and some minor redecoration work is required due to general wear and tear. Some air extractors were dirty and those not working would limit effective odour control. However generally the home was clean and little malodour was noted. The housekeeper is aware of infection control measures and has a NVQ in support services. She inducts all new domestic staff that are employed. Care Homes for Older People Page 19 of 28 Evidence: Many bedrooms were locked, however the manager stated that those people who requested had keys and some people were seen using their rooms.Several en-suite bedrooms were seen. Some of these were stark and contained no television or radio for entertainment. Others were pleasantly decorated and contained personal items of furniture, wall hanging, ornaments and family photographs. The manager has recently started to identify bedrooms with photographs or memorabilia specific to them. Laundry facilities appeared well organised. The washing machines have the specified programme to meet disinfection standards. People commented; the home is clean and bright. The home is always clean. Everyone recorded in a survey the home is always fresh and clean. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care staff are employed in sufficient numbers to care for people in the home. However staff awareness about dementia is not sufficient to promote the well being of all people using the service. Evidence: On the days of inspection and from staff rotas the normal staffing levels in addition to the manager who works in a supernumerary capacity from Monday to Friday are; 8.00am - 8.00pm a nurse, two senior care staff and six care staff. These staff are supported by an activities coordinator, administrator, handyman, kitchen, domestic and laundry staff. Between the hours of 8.00pm and 8.00am people are supported by a nurse, two senior care staff and three care staff. The survey returns identified staff are always or usually available when they are needed. Some comments made were; Staff are caring and considerate but the home could do with more to allow more time for one-to-one contact with residents. The staff are all helpful and caring. Care Homes for Older People Page 21 of 28 Evidence: From information obtained before the inspection and in conversation with the manager it was ascertained that 28 staff have obtained a National Vocational Qualification (NVQ) in care, 14 at level 3 and a further 3 staff are working towards NVQ level 2. This demonstrates an ability to provide support to people in the home. Staff were spoken with and observed during the inspection and were seen generally to attend to peoples needs appropriately. The manager is assessing the training needs within the staff team and although many have received training related to; challenging behaviours, dementia awareness, mental capacity and deprivation of liberty, she is aware that further training is required in a home registered to provide care specific to people with a dementia. Staff spoken to were also aware of their shortcomings related to this area of support. The manager promotes training and senior staff have been involved in team leader training and have done a course related to care planning. Two staff files reviewed contained appropriate information to safeguard people from harm. Two references were obtained and criminal records bureau checks received before employment. Each new staff receives a comprehensive company handbook and a Care Council code of conduct. Some information related to induction was seen but the manager could not demonstrate that a full induction to national standards was provided. This is necessary to demonstrate staff are competent before they are left to provide unsupervised care. Care Homes for Older People Page 22 of 28 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 manager is qualified and competent to manage a home for vulnerable people but quality reviewing systems do not provide a thorough assessment of the service provided. Evidence: The manager who is a registered nurse and who obtained the Registered Managers Award in 2004 has been in management for over thirteen years. She has worked hard to improve standards in the home and was praised by staff and visitors during the inspection for her efforts. To date she has not had access to organisations that specialise in dementia care such as The Bradford Dementia Group but has used her basic knowledge to change and improve the home for the benefit of the people who live there. Quality monitoring systems are in place but to date these have been superficial. Regulation 26 visits by the provider were last recorded in July. Questionnaires sent out Care Homes for Older People Page 23 of 28 Evidence: in July that were returned were all positive but feedback has not been provided in any form. A quality monitoring document is in place but non of the issues recorded at this inspection were identified. Although some action plans have been produced that are to be reviewed during the next visit by the provider. A system is in place to hold monies for those people who require this service. Full detail is recorded by the homes administrator but a company audit for each person is not regularly done. To monitor safety in the home water temperatures are regularly checked by the handyman although some bathrooms did not have a thermometer to allow staff running baths to check water temperatures. These were replaced before the inspection concluded. Accidents in the home were well recorded and copies are forwarded to head office and analysed to identify any issues. Hoists are regularly checked and the gas heating system has been serviced appropriately this year. A certificate to demonstrate the homes wiring is safe was not found. Fire checks are carried out at the correct frequencies and a risk assessment of the building associated with fire is in place but staff training to ensure people are safe in the home is not regularly recorded. The homes kitchen is clean and hygienic. Appropriate equipment is in place and a system of self audit is in place. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 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 29 18 A record of induction to identify staff have been trained prior to working unsupervised should be available in the home. Staff competency must be assessed to ensure people are maintained safely in the home. 30/11/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 3 3 3 4 Ensure that equality and diversity issues are identified and can be met before a place is offered in the home. Obtain a recent photograph as soon as possible for people admitted to the home. The manager must ensure that specialist services offered for people with dementia are demonstrably based on current good practice and reflect relevant specialist and clinical guidance. The manager should continue the improvement in care planning and ensure staff are aware of how these should be Page 26 of 28 4 7 Care Homes for Older People 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 improved. 5 12 Provide the activities coordinator with the information and opportunity to develop activities specific to people with a dementia. Continue with the development of the life story books to promote a more person centred care package. Provide the cook with the information and opportunity to develop the menu to take account of the needs of people with a dementia. Ensure the system of ensuring maintenance work is done in a timely way is more robust and attend to those issues of maintenance identified throughout the inspection and in the report. Ensure the system for ensuring the home is clean is more robust and clean air extractors identified during the inspection. Access to current information related to dementia awareness should be available to the staff team to promote specialised dementia care. Use the homes quality monitoring tools to identify areas for improvement. Produce action plans and timescales for implementation. This process should be ongoing. Company Representatives should audit the system used to hold service users monies on a more frequent basis. Signed audits should be available in the home for inspection. Staff should receive fire training at the intervals specified by the fire authority. That is twice annually for day staff and four times annually for night staff. This must be recorded and signed by staff receiving the training. A certificate to demonstrate the homes wiring is safe should be available for inspection in the home. A copy of the latest certificate should be forwarded to The Commission. Ensure thermometers are available in each bathroom to enable staff to measure the water temperatures of each bath. 6 7 12 14 8 19 9 26 10 30 11 33 12 36 13 38 14 38 15 38 Care Homes for Older People Page 27 of 28 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. 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