Care Home: Philip Cussins House

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What the care home does well Checks are in place including the use of questionnaires to monitor the standards of care provided. The home is well managed and run in the best interests of residents. There is a stable staff team of experienced mature carers that provide a good standard of care for residents. There is clear detailed care planning to meet assessed needs. The home is very welcoming to visitors. There is good support from the committee, the local community, families and friends. Health care needs are fully met and people are treated with great warmth and respect. Comments from questionnaires completed by people in the home and their visitors included; The home is comfortable, caring and clean. Every aspect of my Mother`s needs are catered for. I cannot speak too highly of the way the home is operated. It is friendly and comfortable. I have lots of friends who visit and they are always looked after by the staff. The home is very caring. What has improved since the last inspection? This home was assessed as excellent at the last inspection and many of the systems in place ensure this continues. Maintenance and renewal works are ongoing. Training of staff to ensure that care practices are good continues and the Manager and committee constantly look at how care can be improved. What the care home could do better: To ensure peoples needs are well met, a system should be introduced to ensure a completed induction programme is followed by new staff. The home`s pre admission checklist must be completed to ensure peoples needs are identified before a place in the home is offered. Ensure that staff are aware of how care plans are developed and consider suggestions from them for any improvements they may identify. The oral health of people living in the home should be promoted and any appointments and professional opinion recorded. Ensure the recording of medicines is in accordance with current pharmacist guidance. Consider providing a specific shower facility in the home using an underutilised bathroom.Review the home`s recruitment processes and ensure that a photograph for identity purposes is obtained, proof of qualifications is seen and recorded, gaps in employment history are identified, investigated and recorded and that a General Social Care Council code of conduct is provided to each staff member. Key inspection report Care homes for older people Name: Address: Philip Cussins House 30-33 Linden Road Gosforth Newcastle Upon Tyne Tyne & Wear NE3 4EY     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Allan Helmrich     Date: 0 2 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Philip Cussins House 30-33 Linden Road Gosforth Newcastle Upon Tyne Tyne & Wear NE3 4EY 01912135353 01912135354 pcussins@gotadsl.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Carol Eve Lurie care home 26 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 26 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - code OP, maximum number of places: 26 Date of last inspection Brief description of the care home Philip Cussins House is a long established charity that provides residential care for elderly Jewish people. It also warmly welcomes non-Jewish residents. The building is a recently converted large Edwardian terrace, within a reasonably short distance from Gosforth High Street, with its shops, amenities and public transport. The home offers mainly large single bedrooms with en-suite toilet and shower facilities. Philip Cussins House has strong support from the local Jewish community, has a high quality kosher diet, and has the spiritual support of local Rabbis. Inspection reports and information Care Homes for Older People Page 4 of 27 Over 65 26 0 Brief description of the care home about the home are readily available. The weekly fees are £438 - £460. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent 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 3 star. This means the people who use this service experience excellent 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. Before the visit we looked at: Information we have received since the last visit on 4th April 2007. How the 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 Care Homes for Older People Page 6 of 27 residents, their relatives and other professionals who visit the service. This inspection was unannounced and was undertaken by an inspector in one day. During the visit we: Talked with people who use the service and their visitors. Talked with the registered manager, care manager and staff on duty. Looked at information about the people who use the service and how well their needs are met. Looked at case records for four people and other records which must be kept, including medication. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to assess if it was clean, safe and comfortable. Checked what improvements had been made since the last visit. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: To ensure peoples needs are well met, a system should be introduced to ensure a completed induction programme is followed by new staff. The homes pre admission checklist must be completed to ensure peoples needs are identified before a place in the home is offered. Ensure that staff are aware of how care plans are developed and consider suggestions from them for any improvements they may identify. The oral health of people living in the home should be promoted and any appointments and professional opinion recorded. Ensure the recording of medicines is in accordance with current pharmacist guidance. Consider providing a specific shower facility in the home using an underutilised bathroom. Care Homes for Older People Page 8 of 27 Review the homes recruitment processes and ensure that a photograph for identity purposes is obtained, proof of qualifications is seen and recorded, gaps in employment history are identified, investigated and recorded and that a General Social Care Council code of conduct is provided to each staff member. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home obtains sufficient information to limit the possibility of admitting someone whose needs cannot be met. However this information is not always recorded. Evidence: Before anyone is admitted, the homes care manager obtains information about them. This is used to determine whether the individuals needs can be met. The preadmission assessment of the most recent admission was reviewed and some information necessary to form a judgment was not obtained. The registered manager agreed that the full pre-admission form was not used in this instance. Other case records reviewed did contain fuller information. When an individual is referred through a local authority a care managers assessment is also obtained. Shortly after admission a plan of care is produced and these were observed in peoples Care Homes for Older People Page 11 of 27 Evidence: individual records. Each of the responses to a questionnaire confirmed that they received sufficient information before moving in and that a contract is provided. One person and their relative spoken to stated the home offered a months trial stay before having to decide on a permanent move into the home. The home does not provide intermediate care to rehabilitate people to return home, but respite places may be made available. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to maintain their health needs and to consult medical professionals, although oral health could be better promoted. Evidence: Following admission, the care manager or senior care staff ensure that any problems are identified and that the home has appropriate equipment to meet the residents needs. Standard health assessment forms are completed for; nutrition, mobility and mental health. Then risks associated with daily living are identified and recorded. People identified as at risk from pressure sores are provided with appropriate equipment to limit this occurring. Within four weeks of admission each person is given information by senior staff about their care plans and to ensure their care needs are being met. People then have the opportunity to sign the care records. Three case records reviewed were clear and easy to read. Each persons health is assessed regularly and where appropriate health care professional are involved. The Care Homes for Older People Page 13 of 27 Evidence: records demonstrated that people regularly see their GP, podiatrists and opticians. The files did not demonstrate people are provided with the opportunity to see a dentist. People are regularly weighed and a record of this is maintained. People spoken to said that they are well cared for and their health needs are met. Surveys returned all stated they Always receive the care and support they need and that they receive the medical care they need. One person commented every aspect of my relatives needs are catered for. I cannot speak too highly of the care provided. Staff spoken to stated they are involved in care planning as key workers and use the care plans daily, although some had received no training related to risk assessment and were unsure how to develop these. The system for administration of medicines was reviewed. The home has a dedicated medicine store where the dispensing trolley is fixed to the wall when not in use. Staff who dispense medicines are trained and the care manager periodically checks their competence in understanding the systems. Records are maintained for ordering, receiving, administering and disposal. These were generally of a good standard, although, hand written notes are not countersigned by someone checking the detail is correct and the medical administration records do not contain a photograph for identity purposes. These are both considered good practice issues. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home meets peoples social, cultural, religious and recreational needs. There are very good links with the local community, and family and friends are encouraged to visit regularly. Evidence: The homes provide an appropriate lifestyle for its Jewish residents, having very strong links with and support from, the local Jewish community. Religious, cultural and social needs are met. The local orthodox and reform rabbis visit regularly. The home also has non-Jewish residents, who respect the culture of the home, but who are free to live their own lives within a warm and tolerant community. An activities programme shows that a different activity is offered each morning and afternoon. Arts and crafts are very popular, residents have previously been awarded first prize at the Gateshead Garden Festival arts and crafts section and are currently working on a model to present in this years show. Peoples daily involvement in social activities are recorded and during the inspection a class for light exercise was in progress. Later people spoken to stated they really Care Homes for Older People Page 15 of 27 Evidence: enjoyed this activity and others provided by the home. Everyone who responded to a survey recorded they are always provided with activities they can take part in. The home provides a strict Kosher diet. A cooked breakfast is offered daily. There is a three-course lunch, with choice of each course. There is a choice of soup, and hot and cold dishes for high tea. The menus are wholesome and nutritious, containing a variety of vegetables and fruit. The lunchtime meal was observed. It was unhurried with adequate staff numbers supporting people in a quiet dignified way. Most people spoken with said that the food was either good or excellent. One person said the food was bland and another recorded in a survey that the food could be tastier sometimes. The cook said that he obtains regular feedback from people in the home and demonstrated the range of meals he could provide on request. He did accept this is slightly limited by the kosher diet, however salads and sandwiches were provided by request, in addition to the menu choices on the day of inspection. Most people have good family support. Representatives of the homes committee are in the home each day and talk with all of the residents and their visitors. People are encouraged to be as independent as possible and were seen during the day, leaving the home with family support and alone for short walks. Other people were seen walking in the homes grounds. People spoken to stated that they choose what to do and when. One person who recently moved into the home stated they could not be more content. Sensible risk taking is encouraged. Special equipment for bathing has been installed to increase independence. There are regular house meetings with minutes taken. Residents are encouraged to give their opinions about the running of the home, and these comments are taken seriously and acted upon. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A well trained staff team ensures people are safe and well protected in the home. Evidence: The home has a complaints procedure and this is given to each new admission. A copy of the complaints procedure is also displayed in the home for the benefit of visitors. Everyone who responded to a survey confirmed they were aware of the complaints process and felt confident to raise any issues they may have. Each person that commented said they would speak with the manager or staff if they were discontent. The home has not received a complaint or recordable concern since the last inspection. However a log is maintained to record any issues of this nature. Staff are provided with training related to protecting vulnerable adults and procedures are in place regarding this. Staff spoken to understand how to protect vulnerable people. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is safe, clean and well maintained. Evidence: The home is converted from two Edwardian terrace houses. The grounds are well maintained with paved areas making them accessible for people in the home. The home is refurbished to a good standard, It was warm, well ventilated and well decorated and has good levels of natural and artificial light in all areas. The communal areas are clean, bright, attractive, homely in appearance, domestic and varied in style. Recently new seating was provided in lounges and new carpets are to be fitted in communal areas above the ground floor. Peoples bedrooms are individually styled and contain many personal possessions. Bathrooms and toilets are located around the home in appropriate numbers. Two bathrooms fitted with equipment to assist people with poor mobility are mainly used. The home does not currently benefit from a walk in style shower although some bedrooms contain personal shower cabinets and one is fitted with a medi style bath. There is a dedicated hairdressing facility. People spoken to during the inspection are happy with the standard of appointment and decoration in the home. Care Homes for Older People Page 18 of 27 Evidence: A programme of cleaning is in place, the home is clean and no odours were detected. The kitchen is well equipped and a good standard of hygiene was observed. The laundry contains appropriate equipment to meet disinfection standards and laundry staff are provided with information and instruction regarding laundry. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by a well trained staff team, employed in sufficient numbers. The homes recruitment policies and practices are generally sound, but care should be taken to ensure all employment criteria are met and that initial induction training is promoted. Evidence: In addition to the manager, who normally works from Monday to Friday, staffing levels are maintained at; four carers including seniors between 8.00am and 2.00pm, three carers including seniors between 2.00pm and 8.00pm, then one senior and one carer between 8.00pm and 8.00am. This level of staffing enables the home to provide a good standard of support to people in the home. Additional staff are brought in to support hospital appointments or outside activities. Most staff have worked in the home for several years. The latest member of care staff was recruited over one year ago. This persons file and those of two others were reviewed. Each persons information has held separately in a folder and information was easy to find. Each file contained an application form, suitable references and proof that criminal records checks have been made. What was not clear was that gaps in employment are checked, that a code of conduct is provided to new staff or that a full induction to ensure staff are appropriately skilled before providing care is given. Induction books are available but those seen were only partially completed. Also one Care Homes for Older People Page 20 of 27 Evidence: file did not contain a photograph for identity purposes and another did not contain a copy of the persons National Vocational Qualification (NVQ) certificate obtained in a previous employment. Staff are well trained and the manager maintains a system to identify when training updates are required. Regular supervision takes place and the care manager conducts periodic competency assessments to monitor the quality of care provided. Currently all care staff employed have NVQ in care at level 2 or above with the deputy care manager achieving NVQ level 4. People spoken to in the home were very complimentary about the standards of care provided and everyone who completed a survey stated they always receive the care and support they need. Three of the four staff who responded to a survey recorded they always have enough support to meet the individual needs of people in the home, one staff recorded this is usually the case. However staff also said their views about how care is provided were not considered. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from the way the home is managed. The home has good systems in place to ensure people live in a safe, comfortable environment. Evidence: The manager has been in charge of the home for over ten years. She has the Registered Managers Award which demonstrates her ability to manage a home for vulnerable people. Recently she has attended courses related to deprivation of liberty and the mental capacity act as part of her development. She is supported by a care manager who directs the care staff in their duties. There is also a committee of people who are regularly in the home monitoring the quality of care provided. Quality monitoring system are also in place that involve company representatives, the use of questionnaires and a proprietary system for quality monitoring that has recently been used. This has identified some small areas for improvement. Care Homes for Older People Page 22 of 27 Evidence: People spoken to during the inspection stated that the manager is always available to discuss matters relating to the running of the home. A visitor commented that the manager is approachable and listens and reacts to any concerns. Five staff were spoken to during the inspection. Most felt well supported and stated that supervision occurred regularly. Some felt confidentiality could be improved and others that meetings were not useful and a better format would be to organise smaller meetings between the domestic team, seniors and care staff. Many people are supported by their relatives in controlling their own monies. A system is in place to hold small amounts of money for people should they require this service. Transactions are recorded and evidenced by two signatures, receipts are kept and regular audits are done by management. Systems are in place to ensure the home is safe. Certificates were seen to demonstrate maintenance tasks carried out by external contractors were done. Portable electrical appliances are checked, gas servicing is dome and hoists are regularly checked. A fire risk assessment has been produced and regular fire checks are recorded and staff training provided to ensure residents are safe. The care manager is charged with promoting infection control and obtains current best practice information from the Health Authority. The homes housekeeper also checks the quality of service provided each day. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 28 18 New staff must undertake a 31/03/2010 certified training programme to demonstrate they are able to provide appropriate standards of care. People must be supported by well trained staff to ensure their well being is maintained. 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 3 Ensure that staff undertaking pre-admission assessments, of people who intend to move into the home, are provided with a comprehensive aide-memoir identifying all those issues detailed in Standard 3.3 of the National Minimum Standards. This will ensure a fuller picture of the individual is identified. Ensure staff are aware of the development of care plans and how risk assessments are produced. Ensure people in the home have access to regular dentistry to maintain good oral health. 2 3 7 8 Care Homes for Older People Page 25 of 27 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 4 9 Ensure hand written entries in the medication administration records are signed by the transcriber and signed by the person checking their accuracy. Consider utilising an underused bathroom to provide a shower room suitable for people with reduced mobility. Ensure staff files contain a photograph for identity purposes. Gaps in previous employment history should be identified and recorded in the pre employment information. Proof of qualifications obtained previously, must be retained in the home. Record that the General Social Care Council (GSCC) code of conduct is provided to new employees. 5 6 21 29 7 32 Consider the views of the staff team and ensure that any decisions made by management in relation to staff comments are clearly presented either in team meetings or in individual supervision sessions. Continue to use the homes quality monitoring document to measure and improve the standards provided in the home. Where potential improvements are identified provide associated action plans. 8 33 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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