Care Home: Michaelstowe Residential Home

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What the care home does well All those people spoken to said they were happy and felt well cared for. One person in the survey said, "we are well looked after here and staff ask us if we are happy or if we need anything. I do not know of anything the home could do better". The care plans were well written and gave clear instructions to staff about each person`s needs and how to offer care and support. The home provides good quantity and choice of food and meals are well presented and people said they enjoyed them. Daily planned activities offer stimulation and interest and people said how much they enjoyed these, particularly the trips out of the home to local places of interest. Two people said they had enjoyed a recent trip to The Marble House and the acting manager confirmed that a trip was being arranged to The National Marine Aquarium. One person in response the survey question, `what the home does well`, said "keep us occupied, staff are friendly, good attitude". What has improved since the last inspection? No requirements for improvement were made at the previous key inspection, however two were made at the random inspection relating to care plans and access to the front garden. Both these requirements have been addressed and further improvements identified through the AQAA. The owner has continues to invest in the property and upgrade the facilities. Recent staff and management changes have proved to be unsettling for people living in the home and the staff team, and the newly appointed acting manager has a clear idea of how to support staff and provide stable management support. Staff said they looked forward to working with her and confirmed that a staff meeting had been arranged to discuss the running of the home and their own support and development needs. What the care home could do better: The staffing levels must be looked at, particularly in the afternoons, based on the current needs of the people living in the home and the layout of the home and the demands placed on staff at this time. Due to the layout of the home the registered provider must give assurances that all those living in the home can be supervised to ensure their safety and well-being and care and support can be provided in a timely manner. Care plans should be reviewed with the person they have been written for, or their representative as appropriate. Carpets should be replaced where cleaning has not resolved the staining or odour. Bedroom doors should be fitted with door locks, suitable for the needs of the people living in the home, and which can be accessed by staff in a emergency. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Michaelstowe Residential Home 211 Ridgeway Plympton Plymouth Devon PL7 2HP     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: Kim Fowler     Date: 0 1 0 7 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: Michaelstowe Residential Home 211 Ridgeway Plympton Plymouth Devon PL7 2HP 01752339096 01752344733 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) : South West Care Homes Limited care home 24 Number of places (if applicable): Under 65 Over 65 0 24 24 dementia old age, not falling within any other category physical disability Additional conditions: 24 0 0 The maximum number of service users who can be accommodated is 24. The registered person may provide the following category of service only: Care home providing personal care only- CodePC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category- Code OP Dementia- Code DE- maximum of 24 places Physical disability aged 65 years and over on admission- Code PD(E)- maximum of 24 places Date of last inspection Brief description of the care home Michaelstowe is a detached property situated in the residential area of Plympton, within close proximity to The Ridgeway Shopping Centre. Michaelstowe has recently been purchased by Mr Alan Beale of South West Residential Homes Ltd. The home is registered to provide residential accommodation and personal care for a maximum of 24 people over the age of 65, who may also have dementia or a physical disability. The Care Homes for Older People Page 4 of 28 Brief description of the care home home offers all single bedrooms with en-suite facilities over three floors. The home has a large lounge room with access to a conservatory and two dining rooms, one on the ground floor and one on the lower ground floor. The home offers two-assisted bathrooms and an assisted shower room. A shaft lift provides access to all floors, with a stair lift providing further access to the first floor of the older part of the building. There is a call bell system throughout the home. Residents are enabled to access any health or social care services they require and various social activities are arranged by the home. Weekly fees range from 449 to 483 pounds dependent upons peoples care needs and do not include personal items such as toiletries, newspapers and magazines and chiropody. Information about the services provided at Michaelstowe can be obtained directly from the home. 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: This unannounced inspection was undertaken on Wednesday 1st July started at 9.00am. The acting manager and the companys operation manager was present and they and the staff team assisted us throughout the inspection. In July 2008, we undertook a random inspection to look at issues raised following a complaint received over the care of a person living in the home. As a result of this inspection the owner was asked to review the quality of the care planning documentation, access to the gardens, refurbishment of the premises as well as staffing levels. The owner has undertaken this review and improvements have been noted in the care planning process and the issues relating to the environment. Staffing levels however, require further review. Care Homes for Older People Page 6 of 28 Prior to this inspection, the previous manager had completed an Annual Quality Assurance Assessment (AQAA) which provides us with information about what the home does well, how people in the home are listened to and what plans the home has for future development. In relation to the changes made following consultation with the people living in the home the AQAA states, extended the daily menu based on residents five favourite dinners and teas; improved the garden area to be resident and wheelchair friendly; increased number of trips out; increased variety of in-house activities based on residents preferences. Future plans include improving the care planning processes further and the number and variety of planned activities both in and out of the home. Also prior to the inspection we had sent surveys to people living in the home, staff and health care professionals who visit the home on a regular bases, such as District Nurses. These surveys allow people to comment anonymously about their views of the care and support provided at the home. Six were returned from people living in the home and all six commented favourable about the home, although two people felt staffing levels could be improved upon. Four surveys were returned from staff: all four confirmed that staff were well supported in their role. One staff member indicated more practical training as necessary for new staff and two recognised the improvements being made by the owner to the environment and by the new acting manager. One survey was returned from a health care professional who agreed management needed strengthening and staffing levels could be improved. On the day of the visit to the home, the inspector made a tour of the building and spoke to most of the people living in the home as well as the staff on duty. Documentation relating to the care planning process and the management of the home were examined. 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. Care Homes for Older People Page 8 of 28 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that a full assessment will be completed before admission to ensure the home can meet their individual needs. Evidence: Three care plan files for people living in the home were examined and showed that each person had their needs assessed prior to their admission.The acting manager confirmed that she visits people in their own home or in hospital to provide them with details about the home and to undertake an assessment of their needs. These assessments are important for people considering moving to the home to assure them that not only can their health care needs be met but also their emotional, social, cultural or religious needs. Files also contained the placing authority care plans to support the pre admission assessments. Those people spoken to said that they had been able to visit the home prior to making Care Homes for Older People Page 11 of 28 Evidence: a decision and one person confirmed that her family had visited the home on her behalf. One visitor confirmed their relative had recently been admitted to the home and had settled in well; she confirmed she had confidence in the staff to meet their relatives needs. All six surveys from people living in the home indicated they had received sufficient information about the home prior to moving in. Michaelstowe does not offer Intermediate Care. 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. The personal and social care needs of the people living the home are being met and people are treated with respect. Medication practices are safe. Evidence: Time was spent in the main communal areas of the home talking to people and observing staff in their daily duties. The majority of people living in the home were spoken with and all confirmed they felt well cared for and supported. Many of the people living at Michaelstowe have a diagnosis of dementia, and these people were seen to be treated gently and in a very friendly manner by the staff. In the AQAA, it stated, we have been training staff to move from a task orientated care plan to a person centred approach using the model provided by Alzheimers Society based on the clients strengths and abilities. Improvements have been made to quality of documentation. The care plans for three people who had been identified by the staff as having Care Homes for Older People Page 13 of 28 Evidence: significant care needs were examined. All contains detailed information about the persons care needs and how staff should offer care and support. Risks to the persons well-being, such as from restricted mobility and the risk of falls, or from the risk of developing pressure sores due to fragile skin, where clearly identified. Evidence was recorded that the care plans were updated regularly, but only one person had signed their review to demonstrate their agreement with the content of the care plan. The acting manager was advised to include all people who are able to comment about the content of their care plan and/or their relatives as appropriate to demonstrate this information is shared and agreed. All six people returning a survey said they always or usually receive the care and support they need. People have access to all health care services and this information was recorded onto the care plans and the designated District Nurse files held in individual bedrooms. Information was recorded on peoples files that there was input from other professionals including GPs, chiropodist and the mental health team when needed. People were also supported by consultants based at the local hospital. Five of the surveys retuned by people living in the home answered always to the question, do you receive the medical support you need: one person said usually. The Commission received a survey from one health care professional, who said, the staff were caring and friendly and that care planning processes had improved. The home uses a blister pack system pre-prepared by the local pharmacist for medication administration to reduce the risk of medication errors and staff confirmed they had undertaken medication training. Staff members were spoken with about the medication procedure and it was evident from this discussion that these staff members were aware of the policy and procedure for handling, administrating and recording medication. There is currently no controlled drugs in the home, however the acting manager was familiar with the procedure for storing and dispensing controlled medication and there was safe storage for future use if necessary. The acting manager confirmed that should someone develop a terminal illness they may remain at home as long as the staff supported by the district nursing service can continue to meet their needs. 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. People living at Michaelstowe can be confident that the home offers good wholesome meals. Daily activities provide stimulation and interest. The home welcomes and encourages families and friends to visit. Evidence: People said how much they look forward to the activities each afternoon and confirmed that trips to local places of interest take place regularly. Two people said how much they enjoyed a recent trip to The Marble House and future trips have been arranged for Dartmoor Wildlife Park and the National Marine Aquarium. One of the care staff has the added responsibility to work with the acting manager to develop an activities programme. There is a notice displayed on the homes notice board showing what activities are arranged and future dates. The home also has a designated activities file and evidence was recorded on the activities undertaken and included aromatherapy, music and exercise. One service user spoken with confirmed that the home had recently had some people in the home singing and playing music. People living in the home as well as a visiting relative confirmed visitors are welcome at any reasonable time and are encouraged to become involved in the activities. Care Homes for Older People Page 15 of 28 Evidence: During discussion with people about food they said it was very good, and people confirmed there is always a choice. Five of the six people who returned a survey said they always or usually enjoy the meals: one person said sometimes. The menus were displayed on the notice board and people were each given a copy of the weekly menu as well: it was clear alternatives to the main meal were available. The meal of roast pork and vegetables being served at lunchtime was home-cooked using fresh products: the meal was well presented and freshly prepared. During the tour of the building fresh fruit and vegetables were found being stored in the laundry room. This is not acceptable due to the risk of contamination from soiled articles and the acting manager was asked to store these elsewhere. Several staff and people living in the home felt that a review was necessary regarding the preparation of the evening meal as currently the care staff on duty were responsible for this task: the acting manager said that she would review this. 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 and relatives can be confident that any complaints or concerns raised will be listened to, acted upon and well managed by the home. Evidence: The home has a complaints procedure and this was displayed on the homes notice board and is also available in the Service Users Guide. A complaints register records concerns or complaints raised by people living in the home or their relatives. The home had received four complaints since the previous inspection and these are well documented and included the action taken by the staff to resolve the matter. All those people spoken with, and who could comment directly about the actions they would take if they had any concern, said they had confidence in the newly appointed acting manager and her staff team to deal with matters efficiently. All six people living in the home who returned a survey said they knew how to make a formal complaint. It was evident from discussions with staff and from training records that staff had received training in the protection available adults, and the acting manager was aware of her responsibilities should she suspect someone was at risk of abuse. Care Homes for Older People Page 17 of 28 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. Michaelstowe provides a comfortable home. Refurbishment continues to ensure it is maintained in safe and pleasant order. Evidence: Michaelstowe is situated on a main road in a residential area and near local amenities including a shopping centre. A full tour of the premises was undertaken. This showed that the home is safe and suitable for its stated purpose: it is a comfortable, warm and light home. Bedrooms were personalised and it was evident people had been able to bring personal belongings and furniture with them. Several bedrooms were currently being decorated and people said they had been involved in colour choices etc. Door were not fitted with locks and some people said they wished to have a lock fitted to protect their belongings and to prevent people with confusion from entering their room by mistake. This information was passed to the acting manager and she agreed to discuss this with the owner and prioritise the fitting of locks to those people who had requested one. Two people said they had no hot water in their bedrooms: the acting manager confirmed that a plumber was undertaking work to restore this as soon as possible and Care Homes for Older People Page 19 of 28 Evidence: the problem related to the age of the building. The gardens to the front and rear of the property are attractive and some areas are more easily accessible for people with restricted mobility than others. The conservatory leading from the main lounge room provides additional attractive seating and pleasant views of the garden: on the day of the visit to the home this was being well used by people. The home was found to be clean, hygienic and free from offensive odours, with the exception of one bedroom which had an odour of urine: the acting manager said the owners had agreed to a change of carpet in this room and in the meantime the domestic staff confirmed they clean the carpet regularly. The acting manager said the carpet in the lower ground hallway was to be replaced as well as this was very heavily stained. The laundry facilities were suitable for its stated purpose also the washing machine has a sluice facility to clean soiled laundry and reduce the risk of cross infection. As noted in the outcome group for daily life and social activities, fruit and vegetables were being stored in the laundry room and this was not acceptable due to the risk of contamination. Staff had completed infection control training and this course was provided by a DVD training package purchased by the owner. Staff confirmed, and it was evident through observation, that the home provided disposable aprons and gloves for protection. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by kind and caring staff. Ongoing training ensures staff receive the information they need to support the people living at Michaelstowe. Improvements in staffing levels in the afternoons would improve the care and support people receive and protect them from the risks that come with being unsupervised. Evidence: People said they were supported by kind and caring staff and on the whole they were provided with care and assistance promptly. However people living in the home and the staff said the staffing in the afternoons could be improved as one of the care staff had responsibility for preparing the evening meal. This resulted in one care staff and the team leader caring for all 21 people currently living in the home. Due to the layout of the building, with accommodation over all three floors, this caused some concern over the level of supervision provided by the staff and their ability to meet peoples needs and respond to emergencies quickly. These concerns were shared by two of the people living in the home, three care staff and the healthcare professional who returned a survey. Those staff spoken with said they felt well supported and received the training necessary to care for people living at home. All said that they had confidence that the management of the home would improve with the recent appointment of the acting Care Homes for Older People Page 21 of 28 Evidence: manager. One member of staff who returned a survey said, since new manager has been here improvements in choice of menu, alternatives are in place. Activities within the home and outings have improved. Another staff member in response to what does the home do well?, said care about the residents, give the residents a home they can be proud of and a great sense of security. The staff were observed throughout the inspection to be patient and helpful when assisting people. Ongoing training ensures staff receive the information they need to support the people living at Michaelstowe. Improvements in staffing levels in the afternoons would improve the care and support people receive and protect them from risks that come with being unsupervised. Three staff recruitment and training files were examined. All files examined contained the required pre-employment checks, including two written references and a Criminal Record Bureau Disclosure, ensuring as far as possible unsuitable staff are not employed. Training certificates and a written training programme indicated staff received training in subjects relating to the care of older people and those with dementia. Forthcoming training included dementia care, fire safety, infection control, medication and deprivation of liberty and the Mental Capacity Act. The acting manager confirmed all staff either have obtained a National Vocational Qualification in care or are in training, a qualification for which they must demonstrate their skills and knowledge in care of older people. 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. Michaelstowe is a well-managed home. The acting manager has a clear idea of her responsibilities in the action she needs to take to ensure stability within the staff team. Evidence: The acting manager has been in post for two weeks although has had several months experience working in the home prior to her appointment. She has a NVQ 3 in care, is undertaking NVQ level 4, and has worked in the care professional for the current owner for a number of years. The acting manager is supported in her role by the companys operations manager, also newly appointed, who is an experienced nurse and has worked in developing services for people with dementia many years. People living in the home and staff said they had confidence in the acting manager and her ability to provide management support after a period of unsettledness following the previous manager leaving the home. The home has a formal consultation process to consult with people living in the home Care Homes for Older People Page 23 of 28 Evidence: and their relatives regarding the quality of the service provided. The results of last years survey were available and demonstrated peoples satisfaction with the home. The acting manager confirmed that this years survey is still to be sent. Residents and relatives meetings occur every two months and the acting manager confirmed that she had reintroduced staff meetings: these meetings are important for people to meet with the manager, to discuss the running of the home and to share their views regarding the quality of care and support provided. Equally important is individual staff supervision to discuss work performance and identify training and development needs, and once again the acting manager confirmed that she had reintroduced these. Health and safety matters are well managed and evidence was available that equipment, including the fire safety system, was serviced regularly to ensure it was maintained in good working order. The accident records were accurate and files examined showed that information is recorded onto accident forms and also written into peoples daily records with appropriate action taken when needed. None of the people currently living at the home were able to manage their own finances and the home holds money for people who do not have anyone to assist them with this. The money was held safely and records relating to each persons balance was available: those checked were found to be correct. 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 19 13 The registered person shall 31/08/2009 ensure that the necessary risks to their health or safety of service users are identified and so far as possible eliminated. This relates to the level of supervision provided by the care staff during the afternoon period when the evening meal is being prepared. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 The person for whom the care pan has been writtien, or their representative, should be involved in its development and review. Those carpets that are stained or odorous should be replaced. Bedroom doors should be fitted with locks suited to the needs of the people living in the home and accessible by staff in an emergency. Page 26 of 28 2 3 24 24 Care Homes for Older People 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. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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