Care Home: Oakleigh Lodge

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What the care home does well The atmosphere in the home was comfortable, homely and relaxed and staff were seen to be kind and caring towards people living in the home. People moving into the home are able to bring in their personal possessions to personalise their bedrooms and the home has a well maintained and accessible garden to the rear of the property, which is secure and secluded. There is an open-house policy, which welcomes visitors at all reasonable times and complaints are handled well ensuring that residents feel listen to and their views acted upon. There are sufficient staff on duty to meet the care needs of residents. What has improved since the last inspection? The requirement made at the last inspection now becomes part of the requirement for controlled drugs due to changes in legislation. What the care home could do better: There were shortfalls in records relating to care plans, risk assessments and the preadmission assessments. Not all bedroom doors have locks fitted nor do they all have carpet provided. The Registered Manager has yet to enrol on an appropriate care management course and not all staff underwent a POVA first check prior to starting work in the home. The home needs to inform the Commission of any adverse events that affect residents. Each of the shortfalls impinge on the well being of residents and employing staff with out the required checks puts them at risk. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Oakleigh Lodge Oakleigh Lodge 36 New Church Road Hove East Sussex BN3 4FJ     The quality rating for this care home is:   one star adequate 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: Gwyneth Bryant     Date: 1 5 0 6 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 25 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 25 Information about the care home Name of care home: Address: Oakleigh Lodge 36 New Church Road Oakleigh Lodge Hove East Sussex BN3 4FJ 01273205199 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) : Mr Lockwood,Mrs Lee Lockwood care home 15 Number of places (if applicable): Under 65 Over 65 15 old age, not falling within any other category Additional conditions: 0 The maximum number of service users to be accommodated is 15 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category ; Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Oakleigh Lodge is a private care home registered to provide care and accommodation for up to fifteen older people who generally do not have a high level of need. The property is a large detached house with bedrooms located over two floors. A passenger lift is available to the first floor. Communal areas include a lounge/dining room and a very pleasant conservatory and garden. A ramp has been installed to provide access to the rear garden area. The home is situated on a main road in Hove and local transport, shops, parks, the seafront and other amenities are located close by. Copies of previous inspection reports are available and are usually located in the lobby area of the home. The fees at the inspection carried out in 2007 ranged from £358.00 to £526.00 per Care Homes for Older People Page 4 of 25 Brief description of the care home week. Extra charges are for chiropody, newspapers, hairdresser and some toiletries. Care Homes for Older People Page 5 of 25 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: one star adequate 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 reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report those living at Oakleigh Lodge will be referred to as residents. This was an unannounced inspection and took place in just under six hours hours, starting at 8:50 and ending at 14:35. The purpose of the inspection was to check compliance with key standards and other standards. There were thirteen people in residence on the day of which one was in hospital. Nine residents were spoken individually and residents were also spoken with as a group during lunch. In addition all aspects of the service were discussed with the Deputy Manager and a senior carer. Care Homes for Older People Page 6 of 25 The last key inspection was carried out on 13 July 2007 and an Annual Service Review carried out on 20 June 2008. A number of documents and records were viewed; including personnel files, medication charts and care plans and a tour of the premises was also carried out during which the communal areas, bathrooms and individual bedrooms were visited. An Expert by Experience accompanied the inspector on the day. An expert by experience is a person who, because of their shared experience of using services, and/or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service and their comments and findings are included in this report. Prior to the site visit we asked the Registered Providers to complete an Annual Quality Assurance Assessment (AQAA). The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. This was completed well and provided when we asked for it but the information included in this report as necessary. Residents told the expert by experience that they felt safe in the home and that there was a lovely, friendly atmosphere. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 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 moving into the home benefit from an admission process that ensures their individual needs and wishes are assessed and identified as being able to be met prior to moving into the home. Evidence: Pre-admission documentation was viewed for recent admissions and there was some inconsistency with one including good details but two others where not all parts had been completed and nor did they include how the home will meet assessed needs. It would be good practice to ensure all staff who carry out assessments receive training to ensure consistency in the records. However, residents spoken did feel that their needs were met in full. Care Homes for Older People Page 10 of 25 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. Care planning systems are generally good but more detailed recording would ensure all staff provide consistent care. The handling, recording and administration of medication is good. Evidence: Five care plans were viewed and it is clear that they have been developed from the information in the pre-admission assessments. The plans were satisfactory in that they included clear information on the care needs of people living in the home. While the scoring system identifies the level of dependency they are not always expanded with details of action staff need to take to meet needs. For example, one plan indicated that the resident is of heavy dependency for moving and handling but does not include the action staff need to take to meet this need. Daily notes were variable, with some giving good information as to how the person spent their day but for others comments were limited to washed and dressed, had a good day or slept well. Daily records when well written, help ensure a consistent approach and good quality of care for residents. It is in the homes interests to be able to show what they have done, along Care Homes for Older People Page 11 of 25 Evidence: with providing the evidence on which to base the monthly review and to record that they are following the assessment of needs. Care plans included information on meeting healthcare needs and visits from District Nurses and GPs. Residents are encouraged to remain independent within a risk-assessed framework. Risk assessments had been carried out and they clearly identified the hazards but did not include detailed information as to the action staff need to take to reduce the risk. Information on the need for eyesight tests and dentists has been included in the care plans and good practice suggests that there is a system to remind staff of the date of the next appointment. Although there were shortfalls in the recording of needs, residents spoken with said they felt well cared for and one comment was I feel safe here. The medication administration charts were viewed and were found to be clear, accurate and up to date. The home has a medication trolley in which they also store controlled drugs, however the latest legislation requires the home to have an approved controlled drugs cupboard. A handwritten note for one residents medication found that staff were to give a tablet as two half doses, one of which was not witnessed by staff. This was discussed with the deputy manager who agreed to treat it as a self medicating situation and carry out a risk assessment. Residents are enabled to administer their own medication, however two plans showed that relatives had requested that the resident did not do so. This was discussed with the deputy manager as relatives do not have the right to make such decisions. The deputy manager agreed to carry out risk assessments and seek a best interest assessment if required. There are policies and procedures on respecting residents dignity and privacy and staff were seen to treat residents with care and respect. One resident told the expert by experience they would like a bath but there werent sufficient aids for them to do so. The Management need to explore this to ensure the home can meet the needs of all residents who are accommodated. Following the site visit the Registered Provider informed the Commission that the home has a walk-in hydrotherapy bath and an inflatable chair to aid access to a conventional bath. Care Homes for Older People Page 12 of 25 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People in the home do not always have the opportunity to experience a lifestyle that matches their expectations, choice and preferences in respect of leisure activities and meals. Evidence: There is a daily programme of activities for each afternoon and care plans included information on encouraging residents to participate, however there did not appear to be activities provided based on residents preferences. The expert by experience spoke to eight residents and the responses were varied. There was agreement that some activities were enjoyed but overall there was not a lot to do and one comment was apart from meals there wasnt a lot to come down for. While some residents were happy to watch television or spend time in the garden there was agreement that generally activities were not stimulating enough and more Tai Chi, singing and cabaret would be appreciated. The inspector also found that not all residents enjoy the activities provided and one person found them too childish. The expert by experience observed a game of dominoes but was disappointed that the carer organising the game barely spoke or interacted with the residents. There was evidence of arts and crafts being provided as there were Easter bonnets and paintings in the lounge that Care Homes for Older People Page 13 of 25 Evidence: had made by residents. The activity records showed that for most activities only one or two residents participated and this needs to be addressed to ensure that all residents have an activity each day that is stimulating and enjoyable. Menus were viewed and although an alternative is not advertised, a vegetarian option is always available and residents spoken with were aware there was a choice. The expert by experience joined residents for lunch and found the meal to be tasty and nicely presented and everyone enjoyed it. The dessert was strawberries with cream or ice cream and it was disappointing that the resident who is allergic to strawberries was not offered an alternative fruit. Following the site visit the Registered Provider informed us that the resident is not allergic but just prefers a few and that they are often asked if they would like the dessert bulked out with anything but they like just a few with the cream. The expert by experience was surprised that it was very quiet during the lunchtime meal and none of the staff sat with residents to initiate a conversation. Following the site visit the Registered Provider informed us that it was quiet because there was a stranger at the table with them. Also staff do not habitually sit with the residents at lunch time as it is their mealtime and residents should be able to enjoy it amongst themselves. The provider added that at supper time when there are fewer at the table staff do sit with them. Staff regularly take residents out for walks and those residents spoken with said how much they enjoyed the walks. Three visitors were spoken with and they were very happy with the care given and felt staff were kind and caring. The visitors confirmed they were always made welcome and offered refreshments. Residents agreed that they are able to get up and got to bed at times of their choosing and cups of tea and drinks provided on request. The expert by experience concluded that on the whole residents were happy enough to be living at Oakleigh Lodge. Staff were pleasant and respectful with residents when they delivered routine tasks. Levels of stimulation and engagement did appear to be lacking which created, for a lot of the time, a very quiet atmosphere with the telly as background noise. Most of the residents spoken with would really appreciate and benefit from a more person centred approach where tasks are delivered as real experiences and like minded residents were able to have more appropriate stimulation akin to their own needs. Care Homes for Older People Page 14 of 25 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. The home has a satisfactory complaints procedure with evidence that those living in the home feel that their views are listened to and acted upon. People living in the home are further protected by satisfactory adult protection systems. Evidence: The AQAA demonstrated that the home has policies and procedures on both complaints and safeguarding adults. The complaints log was viewed and the home has received three complaints in the last six months, each of which was investigated and all outcomes and actions taken recorded in full. All staff have received some training in Safeguarding adults as it is covered as part of the induction programme, with full training booked with the local authority at a later date. The Deputy Manager said she is due to attend a training course on the Mental Capacity Act and Deprivation of Liberty Safeguards to ensure she is up to date with current legislation. Care Homes for Older People Page 15 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Most parts of the home are maintained providing a homely and comfortable environment for people living in the home; improvements need to be made in respect of fitting locks to bedroom doors and providing carpets in bedrooms. Evidence: A tour of the premises was carried out and a random selection of bedrooms inspected, in addition to bathrooms, the garden and communal areas. Generally, the premises are clean, tidy and well maintained. Individual bedrooms are well maintained, clean and pleasingly decorated and it was evident that people are able to bring in their own possessions in order to personalise their bedrooms. All residents are provided with a lockable space in their rooms to store medication and valuables. Three bedrooms were not carpeted and the care plans did not show that the carpets were removed due to continence issues. One resident told the inspector that there was no carpet when they moved in. When carpets are removed for the benefit of residents with continence problems, they must be replaced for new occupants. This was discussed with the deputy manager agreed to explore continence management and cleaning techniques in future rather than just removing the carpets. Following the site visit the Registered Provider informed us that the individual was offered a carpet but stated that they were happy with the flooring. One resident told the expert by experience that they were not consulted about the change of carpet to washable Care Homes for Older People Page 16 of 25 Evidence: flooring. The deputy manager said this person was consulted but there were no detailed records to support this and it was agreed to provide supporting evidence in future. It was of concern that not all bedroom doors had locks fitted and this needs to be addressed to ensure that all residents are offered keys to their rooms, within a risk assessed framework. It was disappointing that heating is not provided in the conservatory as it is not suitable for use in the winter. Given that neither the lounge or dining room have windows the conservatory is the only access to natural light and fresh air for residents. Therefore this needs to be addressed. Following the site visit the Registered Provider informed us that heating is provided in the conservatory with an electric radiator. People spoken with said they were happy with their rooms and many have brought in their own furniture. The rear garden is well maintained and is accessible for all residents. The laundry facilities are satisfactory and washing machines are able to wash clothes at temperatures that control the risk of infection. Information in the AQAA showed that most staff are trained in infection control and there were plenty of gloves and aprons available for staff use. Not all waste bins in communal bathrooms and toilets had lids and this needs to be addressed to reduce the risk of cross infection. It was of concern to note that doors had been wedged open and one door sticks. These issues were raised as part of the fire safety risk assessment and the deputy manager confirmed that appropriate self closing devices have been ordered, in addition to a chair to facilitate the evacuation of residents accommodated on the top floor. Care Homes for Older People Page 17 of 25 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. There are sufficient staff with the skills and competency to meet the needs of people living in the home but recruitment practices are not robust which puts people at risk Evidence: The staff rota indicated that there are three carers, including the deputy manager, on duty for most of the day time shifts. The deputy manager also carries out care duties and staff also do laundry tasks and the cooking. The staff rota needs to accurately reflect the care hours provided as the time staff spend on other duties impinges on their time for caring. There is one night waking staff on duty, but other staff provide an rota of on call. Residents said they would like staff to spend more time with them but as staff were always very busy this is not possible. It would be good practice to ensure that a cook and laundry staff are employed to free up time for carers to be with residents. The recruitment files for the last four people to be employed were viewed and it was of concern that three had begun working in the home before a POVA first check was obtained. This needs to be addressed as this puts people in Oakleigh Lodge at risk, particularly as one person works alone at night. Although all staff provided two written references, none had supplied a full employment history. There is a staff training programme which includes dementia care, nutrition and infection control. The AQAA showed that of the ten care staff, seven have already achieved National Vocational Care Homes for Older People Page 18 of 25 Evidence: Qualifications in care at level 2. Not all staff have had up to date manual handling training and this needs to be addressed and the individuals must not provide this type of care until their training is complete. Care Homes for Older People Page 19 of 25 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff need to be provided with sustained leadership and direction and systems need to be put in place to ensure all aspects of service users health, welfare and safety are protected and promoted. Evidence: While the Registered Manager has many years of experience in managing a care home she still does not have the required qualifications. This shortfall has been raised in inspection reports in 2005, 2006 and 2007. Although the deputy manager has the required management qualifications it is the registered manager who must have this qualification. People spoken with on the day believed that the deputy manager was the manager and said they would go to her if they had any concerns. The staff rota shows that the registered managers regular hours in the home are from 10 to 2pm at weekends only. The deputy manager explained that the registered manager does pop in during the week, however the registered manager needs to be in charge of the home on a day to day basis, particularly as staff are working in the home prior to the Care Homes for Older People Page 20 of 25 Evidence: provision of a POVA first check. Following the site visit the Registered Manager informed us that that weekend hours are a temporary arrangement due to personal issues and once they are dealt with she will resume full time responsibility for the home. All residents spoken with by the expert by experience agreed that the deputy manager was approachable and they would be happy to raise any concerns with her, however, it is important that they are aware that there is a registered manager who should be dealing with complaints. The home does not manage any residents finances but does hold money on behalf of one resident. The records relating to this were accurate and receipts had been provided as necessary. The deputy manager carries out the quality monitoring system and staff and resident meetings are carried out in addition to regular surveys. The minutes of one staff and one residents meeting were viewed and indicated that only one topic is discussed at each meeting. It is good practice to ensure an agenda is compiled to encourage consultation with residents on a range of topics. Following the site visit the Registered Provider told us that that residents meetings have an open agenda and a range of topics discussed. Records viewed showed that there have been incidents that affect the well being of residents that the Registered Manager has not informed the Commission about as she is required to do and this needs to be rectified. The AQAA showed that regular checks are made on all electrical and gas appliances and systems In addition checks are carried out on call bells, water delivery temperatures and emergency fire systems. All staff have been trained in fire safety and a fire safety risk assessment has been carried out for all parts of the premises. These systems ensure the safety of people living in the home in the event of fire. Accident records were viewed and found to be accurate and maintained in line with the Health and Safety Executive guidance. Care Homes for Older People Page 21 of 25 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 22 of 25 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 7 15 That care plans and risk assessments include direction to staff in meeting care needs and reducing risks. To ensure service users receive consistent care. 15/07/2009 2 9 12 That all service users are given the opportunity to self medicate within a risk assessed framework. To promote their dignity. 15/07/2009 3 9 13 That a suitable controlled drugs cupboard be purchased and the existing trolley be fixed to the wall. To ensure controlled drugs are stored safely. 15/07/2009 4 12 16 That service users are consulted on the activities provided. To ensure they are based on service users preferences. 15/07/2009 Care Homes for Older People Page 23 of 25 5 19 12 That all bedroom doors have 15/09/2009 locks fitted. To promote service users privacy. 6 31 37 That a system is devised for 15/07/2009 informing the Commission of adverse events in the home. To ensure the Commission has regular information on the home. 7 31 10 That the Registered Manager 15/07/2009 is in day to day control of the home. To ensure the home is run in the best interests of service users. 8 31 9 That the Registered Manager 15/09/2009 enrols on a suitable care management course. To ensure they have the knowledge and skills to effectively manage the home. 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 26 33 That all waste bins in communal areas have lids fitted to reduce the risk of cross infection. That staff and service user meetings include a range of topics at each meeting. Care Homes for Older People Page 24 of 25 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. 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