Care Home: Pinewood Tower

What the care home does well The home carries out a detailed preadmission assessment of need whenever a person is referred to the home, to make sure that the person`s needs can be met at Pinewood Tower. Residents` health and social care needs are met through person centred care planning. Relatives are fully involved and informed about how care is managed in the home. Residents` privacy and dignity is respected within the home. Medication is generally well managed and administered safely to residents by trained members of staff. The home has well publicised complaints procedures. All of the staff have been trained in the protection of vulnerable adults. Staff are deployed in sufficient numbers to meet the needs of the residents. All the staff being recruited in line with best practice and current legislation. Staff receive core mandatory training and also some specialist training to meet the needs of the residents. The home is well managed and run in the interests of the residents. What has improved since the last inspection? All of the staff team have now achieved the standard of level 2 NVQ equivalent or above. The home has been reporting notifiable incidents as required. The home has developed its quality assurance systems. What the care home could do better: Photographs of residents should be placed at the front of both their medication administration records and care plans, to assist new members of staff in identifying residents. For people with a mental health diagnosis, their care plan should provide details of any relapse indicators and a plan for how staff should respond in the event of a person becoming unwell. The home should provide information and a procedure for staff to follow in the event of a resident requiring an emergency admission under the Mental Health Act. The home must purchase a new controlled drugs cabinet to meet new regulatory requirements.The home`s staff application form should be changed to seek information in line with Schedule 2 of the Regulations. Key inspection report Care homes for older people Name: Address: Pinewood Tower 30 Tower Road Branksome Park Poole Dorset BH13 6HZ     The quality rating for this care home is:   two star good 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: Martin Bayne     Date: 0 4 1 2 2 0 0 9 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: Pinewood Tower 30 Tower Road Branksome Park Poole Dorset BH13 6HZ 01202762855 01202762880 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Gene Mangold care home 14 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home Pinewood Tower is a care home providing personal care and accommodation for 14 older people who have mental disorders or dementia. The home is situated in a quiet residential area of Branksome Park. The nearest amenities, including shops, banks, post office, churches and doctors surgeries etc, are approximately half a mile away in Westbourne. Car parking is provided for visitors to the home and further parking is available on nearby roads. A regular bus service goes from Westbourne into Bournemouth (approx 2 miles) and Poole (approx 3 miles). Pinewood Tower is a large detached property that has been adapted to provide residential care. The home is set back from the road in mature secluded grounds with a peaceful, enclosed area of garden where residents may sit and a separate activity area. Accommodation for residents is provided on the ground and first floors. There are Care Homes for Older People Page 4 of 27 Over 65 14 14 0 0 Brief description of the care home ten single bedrooms and two providing shared accommodation. Access to the first floor is via the stairway as there is no passenger or stair lift. The home also has a lounge/dining room with patio doors to the garden. There are two bathrooms with W.C. and washbasin, and two separate W.C.s. Pinewood Tower provides 24-hour personal care, all meals, laundry and domestic services. The home offers stimulation in the form of regular daily activities. Pinewood Tower is owned and personally managed by Mrs Gene Mangold, assisted by an experienced team of staff. 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: 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: We, the Commission, carried out a key inspection of Pinewood Tower between 9:30 a.m. and 5:30 p.m. on the 4th November 2009. The inspection was carried out by one inspector, but throughout the report the term we is used, to show that the report is the view of the Care Quality Commission. The aim of the inspection was to evaluate the home against key National Minimum Standards for older persons, and to follow up on two requirements and one recommendation made at the last key inspection of the home in November 2006. We were assisted throughout the inspection by Mrs Mangold, the Registered Provider, and by members of the staff team on duty that day. We spent much of the inspection within the main lounge so that we could observe interactions between staff and residents. Owing to the mental frailty of the majority of the residents accommodated, they were only able to provide a limited account of what it was like to live at the home, however, we spoke with one resident who was able to tell us of their experience of life Care Homes for Older People Page 6 of 27 at Pinewood Tower. We also had the opportunity of speaking with one visiting relative. We looked at various records that the home is required to keep up to date under the Care Homes Regulations 2001 and we were shown around all of the premises. Additional information that helped form the judgements contained within this report was obtained from the Annual Quality Assurance Assessment document completed by the home. 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: Photographs of residents should be placed at the front of both their medication administration records and care plans, to assist new members of staff in identifying residents. For people with a mental health diagnosis, their care plan should provide details of any relapse indicators and a plan for how staff should respond in the event of a person becoming unwell. The home should provide information and a procedure for staff to follow in the event of a resident requiring an emergency admission under the Mental Health Act. The home must purchase a new controlled drugs cabinet to meet new regulatory requirements. Care Homes for Older People Page 8 of 27 The homes staff application form should be changed to seek information in line with Schedule 2 of the Regulations. 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. Residents benefit from the home ensuring that their needs can be met before offering a placement at the home. Evidence: Throughout the inspection we used a sample of three residents personal files to track the records maintained on behalf of residents. Two of the personal files we looked at concerned residents admitted to the home since the last key inspection in November 2006. We saw that detailed preadmission assessments had been carried out by Mrs Mangold prior to the residents being offered a placement at the home. The assessments covered all of the topics detailed within the National Minimum Standards for Older Persons. We also saw that the residents and their relatives had been invited to view the home and had been provided with information about the home by means of a brochure and the homes Service User Guide. Once it had been determined that the persons needs could be met at the home, a letter had been sent to inform of this with an offer of a trial placement at the home. Care Homes for Older People Page 11 of 27 Evidence: The home does not provide an intermediate care service. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents health care needs were being met through person centred care planning and risk assessment. Residents are treated with respect and dignity and benefit from their medication being administered safely. Evidence: We looked at the care plans for the three residents we tracked through the inspection. As found at previous inspections, care plans were of a good standard and person centred. Care planning is divided into two main sections, one section, Aid to Daily Living, focuses on how personal care needs are to be met and the other provides details on how to meet peoples psychological and emotional needs. We recommend that the home has information and procedure to follow in the event of a resident requiring an emergency admission to hospital under mental health legislation. We saw that relatives were very much involved in care planning with their providing detailed social histories and photographs of people and things that were important to the resident concerned. We saw that relatives were always sent a copy of the care plan. We also saw from returned quality assurance surveys that relatives felt that they Care Homes for Older People Page 13 of 27 Evidence: were fully informed of what was happening within the home. We saw that risk assessments of how to minimise risk of harm were recorded and included within the care planning system. We saw that residents nutritional, skin-care and moving and handling needs were assessed and monitored within a risk assessment framework. We recommend that a photograph of each resident is placed at the front of their individual care plan, as this can be useful for new members of staff in identifying residents. As well as looking at the care plans, we looked at daily recording notes completed by the staff. We saw that at the end of each week the residents key worker summarises how residents needs were being met in relation to their care plan. This process ensures that care plans are kept up to date and reflect changing needs. Through looking at the care plans and daily recording notes we saw examples of how residents health care needs were identified and then met. We saw examples of where the home had worked with GPs, district nurses and the community mental health team. Throughout the day we saw that staff were attentive to residents needs and interactions with residents were positive and supportive. We saw that the returned quality assurance surveys from relatives supported that residents privacy and dignity were maintained at the home. We looked at the medication administration records for all of the residents. We saw that medication was only being administered by members of staff who had received training in safe medication administration. We found that there were no gaps in the medication administration recording with staff making appropriate entries when medication had been refused. We saw good practice of a second member of staff checking and signing where hand entries had been made to the medication administration records. We also saw that any known allergies of residents were recorded at the top of their medication records. We recommend that a photograph of the resident concerned is placed at the front of their medication administration records, so that new members of staff can readily identify the appropriate resident. One of the residents we tracked through the inspection was having to have their medication covertly administered. We saw that the home had complied with best practice guidelines of involving the GP, social worker, pharmacist and relatives in making this decision. Records were available that documented the process. We looked at how medication was stored. The home uses a unit dosage system with these being securely locked in a cupboard with the senior member of staff responsible for medication administration holding the key. We saw that medicines requiring refrigeration were being stored correctly. Concerning controlled drugs, none had been prescribed to any resident at the home at the time of our inspection however we require that the home purchase a new controlled drugs cabinet that meets new Care Homes for Older People Page 14 of 27 Evidence: regulatory requirements. Care Homes for Older People Page 15 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. Residents benefit by the social needs being met through a range of individual activities, by being able to maintain contact with friends and family and being provided with those a good standard of food. Evidence: When a new resident is admitted to the home, their assessment of need looks at their abilities, strengths and aptitudes in the context of their life history. The home then tries to provide individual activities matched to residents assessed needs. We were told that the home does not engage external entertainers for communal activities, as activities are provided on a one-to-one personalised basis. We saw that the home had a range of memory boxes, musical equipment, arts and crafts equipment, books and games. We saw that some residents were provided with comfort toys is and we observed staff engaging appropriately with residents throughout the morning. There were various photographs of activities undertaken with residents on display on the walls. We spoke with a resident who did not suffer from dementia. They told us that they had got used to living with people with memory loss and that they enjoyed playing card games with staff members, going into the garden and reading. We were told that the visiting the library called at the home. Care Homes for Older People Page 16 of 27 Evidence: We spoke with a relative who was visiting and they told us that they were made welcome and could visit at any time. We saw that residents spiritual needs are assessed as part of the admission procedures with action taken to support residents with any assessed needs. We were told that a member of the Church of England visited the home each month to conduct a Holy Communion service. One Roman Catholic resident is visited by a priest bimonthly and one person is taken out by relatives to attend the Baptist Womens Guild. The home does not employ a dedicated cook. The staff take it in turns to cook and there is one person on dedicated cooking duties each morning. We talked about how staff are trained to cook, as all of the staff were from overseas may not be used to english cuisine. We were told that less experienced staff shadow more experienced staff once they have completed basic food hygiene training. The home works to a two week menu cycle and we were shown recipes that the staff work to, together with information as to what condiments should go with particular meals. The menus also provided an analysis of each meals nutritional content which was matched against guidance on nutritional intake of food served to older people in residential care. We saw that residents were weighed every month and that should they lose weight, the Malnutrition Universal Screening Tool (MUST) is used to make sure that residents nutritional needs are met. We looked at the records of food provided and saw that one could determine what each person had been provided with. Care Homes for Older People Page 17 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from their being a well-publicised complaints procedure and through the staff being trained in the protection of vulnerable adults. Evidence: We saw that a copy of the complaints procedure was displayed in the reception area of the home, with this providing information on how to make a formal complaint. We also saw that the correct address for the Commission was displayed within the procedure. We were told that relatives are given a copy of the complaints procedure when a resident is admitted to the home. Since the last key inspection in November 2006 there have been no formal complaints made to the management of the home and and none had been brought to the attention of the Commission. There have also been no safeguarding alerts raised in respect any resident living at the home. The home has copies of all relevant policies and procedures relating to the protection of vulnerable adults and we found that all of the staff had received training in the prevention of adult abuse. Care Homes for Older People Page 18 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. Pinewood tower provides a homely, safe and well maintained environment of the residents. Evidence: As part of the inspection we carried out a tour of the premises. The home was clean, warm, in reasonable decorative order with furniture and fittings in a good state of repair. Mrs Mangold told us that when the home is redecorated she was going to use colour schemes and signage better suited to the needs of people with dementia. This will be followed up at future inspections. Residents have access to in enclosed garden at the rear of the home. A swimming pool, no longer in use, is fenced so as not to cause a risk of harm to residents. We were told that the swimming pool was to be filled in, which would completely eliminate any risk. In the hall reception area we saw photographs of the staff team and other information such as the complaints procedure and menus. During the inspection we were able to look within some residents bedrooms and saw that residents could personalise their rooms with their own furniture. We saw that a screen had been provided in the bedroom where two people were sharing to maintain Care Homes for Older People Page 19 of 27 Evidence: privacy and dignity. We saw that all the radiators in the home had been covered so as to eliminate the risks of residents getting burnt. Within communal bathrooms we saw there were paper towels and liquid soap and bins are provided. We tested the water temperature of one of the baths and found that this was above 50C. We were told that the home had thermostatic mixer valves fitted to the hot water outlets of baths to reduce the risk of residents receiving scalding from hot water. We recommend that the valve is checked as water temperature should be around 43C. We saw that staff were provided with gloves and protective clothing to meet infection control standards. The home has a sluicing area for the cleaning of commodes. The home has a laundry room fitted with machines capable of meeting the laundry needs of the home. Care Homes for Older People Page 20 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. Residents benefit from staffing levels suitable to meet the needs, through the staff being well-trained and being recruited in line with current legislation. Evidence: We were told that between 8am and 6pm there are four care staff on duty in the home and between 6pm and 7pm, three care staff. During the night-time period from 7pm to 8am there are two awake staff members on duty. We saw duty care rosters that reflected the above staffing. In addition to the care staff Mrs Mangold works between 8am and 4pm office hours, and that an administrator works office hours from 9am to 1pm and domestic staff are employed from 9am to midday day seven days a week. We were told that the home has not had to use agency staff over the last year. During the inspection we spoke with members of staff who told us that staffing levels were sufficient to meet the needs of the residents. We also spoke with one resident who was able to give some feedback about what it was like to live in the home and they indicated that staffing levels were satisfactory. We looked at the recruitment records of three members of staff recruited to the staff team since the last key inspection. We saw that each of them had completed an application form. We recommend that the application form be changed to seek information to comply with Schedule 2 of the Care Homes Regulations 2001. (The form asked for the persons previous employer as a reference rather than a reference Care Homes for Older People Page 21 of 27 Evidence: from the persons last place of work involving children or vulnerable adults, the form also did not ask for a full employment history as required under the Regulations). We found however, that all of the required checks and records were in place concerning these members of staff and that they had been recruited in line with the regulations. We also saw that each member of staff had a work permit and were working to the agreed stipulations of their permit. We were provided with a staff training matrix showing us that all of the staff had received core mandatory training as well as specialist training in dementia care to meet the needs of the residents. At the last key inspection a requirement was made concerning NVQ training, in that at least 50 of the staff team should have achieved a level of level 2 or above. We found at this inspection that the requirement had been met as all of the staff team have now achieved this level of training. Care Homes for Older People Page 22 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. The home is well managed and run in the interests of the residents. Evidence: Mrs Mangold has managed the home for many years and has achieved the required qualifications. At this inspection we found that the home was well managed with record-keeping up-to-date, policies and procedures in place and a longstanding staff team in place who had been well-trained. At the last key inspection it was recommended that the home carry out quality assurance questionnaires involving residents, relatives and health and social care agencies involved with the home. We found that the home had complied and that the results of the surveys were used in development plans for the home. At the last key inspection a requirement was made concerning notifications to the Commission of incidents occurring at the home. We looked at the accident book and saw that all accidents were being recorded, analysed for any trends and that Care Homes for Older People Page 23 of 27 Evidence: notifications had been sent to the Commission appropriately. The home does not look after any monies on behalf of residents. We looked at the fire logbook and saw that tests and inspections of the fire safety system were taking place to the required timescales. The returned AQAA informed us that equipment in the home was being serviced appropriately to the required timescales. Care Homes for Older People Page 24 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 25 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 9 14 You are required to purchase 08/01/2010 a controlled drugs cabinet that meets new regulatory requirements. For safe storage of controlled drugs. 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 We recommend: That the home has information and a procedure for staff to follow in the event of the resident requiring an emergency admission under the Mental Health Act. That photographs of residents are placed at the front of both their care plan and medication administration records to assist new members of staff identifying residents appropriately. We recommend that the thermostatic mixer valve in the communal bathroom is checked to make sure water temperatures are not too hot. We recommend the staff application form be changed to seek information that satisfies requirements of Schedule 2 of the Regulations. Page 26 of 27 2 19 3 29 Care Homes for Older People 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. 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