Care Home: Royal Manor

Similar services:

• Byars Care Home
• St Marys Nursing Home
• Bramble Lodge
• Parkmanor Residential Home
• Thornham Grove
• Hunter`s Lodge
• London Road Neurological and Specialist Care Unit
• Carlton Care Home

What the care home does well Individual written needs assessments were in place before people were admitted to the Service so that their diverse needs were identified and planned for. Each person had an individual plan of care which demonstrated that their care needs were being met. They were being treated with respect and their right to privacy was upheld. The Service provided activities and services that benefited people living here and meals were varied and enjoyed by people. Good procedures for handling complaints and abuse were in place ensuring that people were fully protected. People were living in a comfortable and homely environment. The Service had a good level of well trained staff to ensure that the people were safe and their needs were met. The Service was well managed so that people living here were protected and their best interests were promoted by the systems in place. What has improved since the last inspection? A number of environmental improvements had been made within the last 12 months. These included replacement flooring, redecoration and the fitting of suitable locks to approximately half of the bedroom doors, following consultation with the people living here. Staff recruitment practices had improved and quality monitoring measures had increased. Staff training had attained far improved levels. What the care home could do better: Recorded risk assessments on individual people must be reviewed consistently and at a frequency that reflects the assessed level of risk. Uneven slabbed and tarmac paths, in the rear and side garden, must be given attention. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Royal Manor 346 Uttoxeter New Road Derby Derbyshire DE22 3HS     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Anthony Barker     Date: 2 7 0 5 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 24 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 24 Information about the care home Name of care home: Address: Royal Manor 346 Uttoxeter New Road Derby Derbyshire DE22 3HS 01332340100 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Sandra Beech,Mr N Beech care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Royal Manor is a 25-bedded care home that provides both nursing and personal care and is located in a residential area close to the centre of Derby. Bedrooms are located across two floors and all floors can be accessed via a passenger shaft lift or staircase. Eight single rooms and one shared room have ensuite facilities. There are a number of lounges and one dining area. There is a large garden area to the front and side of the property which can be easily accessed. 0 Over 65 25 Care Homes for Older People Page 4 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The time spent on this inspection was 8.5 hours and was a key unannounced inspection. Survey forms were posted to people living at the Service, their relatives, staff and external professionals before this inspection and 12 people responded. We spoke to several people living at the Service - one of these in more depth - and, briefly, to one relative who was visiting. We also spoke to the Manager and one care assistant. Records were inspected and there was a tour of the premises. Three people living at the Service were case tracked so as to determine the quality of service from their perspective. This inspection focussed on all the key standards and on the progress made towards achieving the requirements and recommendations made at the last key inspection on 21 April 2008. The pre-inspection, Annual Quality Assurance Assessment (AQAA), questionnaire was reviewed prior to this inspection. The Manager informed us that the Services fees ranged from £366 to £515 per week. The last inspection of this Service was on 21st April 2008. Care Homes for Older People Page 5 of 24 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 6 of 24 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 7 of 24 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. Individual written needs assessments were in place before people were admitted to the Service so that their diverse needs were identified and planned for. Evidence: The Services Residents Guide had been improved since the last inspection and now includes reference to the Services environmental facilities. However, it did not include the views of people who live at the Service. One of the people case tracked had been recently admitted and their file was examined. A pre-admission written assessment of this persons needs was on file and provided staff with information about the individuals particular needs and preferences so these could be met. People who completed a pre-inspection survey were positive about their decision to choose Chestnut View for them or their elderly relative to live. One relative commented, My (elderly relative) is well cared for... their needs are met consistently. Care Homes for Older People Page 8 of 24 Evidence: The Service was not providing intermediate care. Care Homes for Older People Page 9 of 24 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 who use the Service had individual plans of care which demonstrated that their care needs were being met. They were being treated with respect and their right to privacy was upheld. Evidence: Three people living at the Service were case tracked so as to identify the standard of care provided from their own perspective and from individual records and discussions with the Manager and staff. The files of these people were examined and these included care plans that clearly set out how peoples health needs should be met by staff. Although, in one file, the persons religious needs were recorded in a care plan there was no other evidence of peoples psychological, social or emotional needs being recorded with associated care plan goals. With care plans generally limited to meeting peoples health needs staff may find it difficult to proactively meet peoples holistic needs. Care plans were up to date, though file entries were not being consistently dated and this could limit the monitoring process. The care planning records did not reflect a person centred approach so as to ensure that peoples preferred lifestyles are identified, though individual files did contain peoples photographs. Files showed Care Homes for Older People Page 10 of 24 Evidence: that care plans were being reviewed regularly to ensure monitoring to reflect peoples changing needs. Recorded risk assessments covered areas such as peoples risk from falling, Moving and Handling, tissue viability, and nutrition and provided a means of measuring and minimising these risks. These risk assessments were not always being regularly reviewed on a consistent basis. For example, one person had three recorded pressure sore assessments - one dated 7/10/08, one undated and one dated 27/2/09. The scores indicated this person was at high risk of developing pressure sores and the infrequency of these assessments potentially placed this person at risk. Additionally, this persons Manual Handling Assessment/Plan did not indicate the sling type/size that staff should be aware of when using the hoist. However, in discussion with this person, we were told, I always feel safe when hoisted...the carers are wonderful. Another case tracked persons pressure sore assessments had been recorded at regular intervals that reflected that persons high risk and a Hoisting Plan did contain details of sling type and size. We met a relative of this person who confirmed that they had had no pressure sores and added that the nursing was, A1...super. The inconsistency between the records completed by staff was discussed with the Manager who was recommended to improve her monitoring of such records. Peoples health needs were being met by appropriate contact with external health professionals and evidence of this was seen on records examined. The administration of prescribed medicines was being recorded accurately and medicine records contained a photograph of each person living at the Service in order to minimise mistakes. Medicines were being securely and appropriately stored. No controlled drugs were in use at the time of this inspection though a necessary secure storage facility was in place for such items. People living at the Service were well dressed and one case tracked person spoke of being, very happy with my personal laundry. This person also confirmed that their privacy needs were met by staff and felt respected. The care assistant spoken with described how she meets the privacy needs of people living at the Service and also how staff listen to people and give them choices, of teatime meal for example. She added, We ask them politely. One staff member, who responded to the postal survey, said that, staff are polite and approachable. Staff were observed talking and assisting people with meals and in the Services lounge. This was seen to be done very positively and within a relaxed atmosphere. Care Homes for Older People Page 11 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Service provided activities and services that benefited people living here. Meals were varied and enjoyed by people. Evidence: The Service was providing a range of activities, for the people living here, by visiting entertainers. The Manager estimated that six or seven entertainers visit each month. One person visits for two hours every one or two weeks, she said, to lead a singsong activity - an increase from last year. In the pre-inspection questionnaire the Manager said she had, arranged with a College Beauty Department for trainees to manicure nails of people living here. At the last inspection the Manager was recommended to consider providing an Activities Coordinator. With no staff actually dedicated to this role this is likely to lead to staff mostly prioritising personal care tasks over recreational activities. The Manager told us that this was not a viable proposition and said there was no interest within the staff group to taking on this role. She was encouraged to continue considering how staff may provide a daily programme of activities. She did add that staff do spend time talking to the people living at the Service. The care assistant spoken with said that staff do occasionally lead an activity that includes dominoes, skittles or cards and spoke of a group of singers visiting sixweekly and trips out. One case tracked person spoke of being quite satisfied with the Care Homes for Older People Page 12 of 24 Evidence: level of activities provided. This person also described a daily routine that reflected their personal preferences. The Services Map of Life record sheet provided details of peoples interests and preferred activities. However, this had not been completed on one case tracked persons file although the Manager showed us one partially completed for another person. This suggests that a more pro-active and person centred approach to activities should be taken. There was evidence, in the Visitors Book, of frequent visitors to the Service and this was observed on the day of this inspection. One case tracked person spoke of family members visiting and confirmed they could stay as long as they like. The Manager said in the pre-inspection questionnaire that, We have involved service users in the decoration of their rooms. She also referred in the questionnaire to the Mental Capacity Act having, brought about important changes. She told us, at the inspection, that Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS) forms are ready to complete and was hoping to have staff on a Derby City SS training course on MCA/DoLS in July 2009. This indicates that the Service has started to consider the assessment of vulnerable peoples mental capacity and, in this context, their right not to be deprived of their liberty. The Manager explained that one of the case tracked people has two informal advocates who are social workers. She also said another person has a distant relative acting as the persons advocate. The Manager added that she has put relatives in touch with Care Aware: an information and advisory service specialising in elderly care funding advice in the UK. One relative commented in their completed pre-inspection questionnaire that, meals are home cooked and appetising. One case tracked person told us that the food was, marvellous and was able to describe what there was for lunch. The person confirmed that two choices of main meal are provided. We spoke to several people in the dining room during lunch time and they were all happy with the quality of food. Tables were attractively laid with clean cloths, condiments and drinks. Two staff plus the Manager were helping people to eat. Food stocks were at a good level and included fresh fruit and vegetables. The four-week rolling menu indicated that people were being provided with nutritious and varied meals. The specialist dietary needs of three people living at the Service were recorded on display in the kitchen. Files contained peoples food likes and dislikes. A notice was displayed in the entrance hall showing the days menu. Care Homes for Older People Page 13 of 24 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. Good procedures for handling complaints and abuse were in place ensuring that people who live at the Service were fully protected. Evidence: The Service had a satisfactory and up to date complaints procedure that was displayed in the entrance hall. The Manager stated in the pre-inspection questionnaire that there had been two complaints received by the Service within the past 12 months. We examined the documents relating to these and they indicated that matters had been dealt with in a satisfactory manner using an appropriate complaints record. People who responded to the postal survey said they knew how to make a formal complaint. One case tracked person told us they would speak to the Manager if unhappy and had never made a formal complaint. The Manager stated that all staff had been provided with training on keeping adults safe from abuse. The Service had satisfactory Safeguarding Adults and Whistle Blowing procedures. The care assistant spoken with showed understanding of how to safeguard vulnerable people and of whistle blowing. The Manager told us she plans to provide staff with, training in all aspects of potential restraint...in the next 12 months One person living at the Service commented in their completed preinspection questionnaire that, I feel safe and happy here...the staff look after me very well. Care Homes for Older People Page 14 of 24 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. People were living in a comfortable and homely environment. Evidence: We noted at this inspection that the premises were well decorated and furnished inside and those bedrooms we visited were of a pleasant appearance. Nine bedrooms have an en-suite facility. The Manager told us in the pre-inspection questionnaire of a range of areas within the premises that had been improved in the last 12 months. The two requirements, in this section, made at the last inspection had been met and suitable doors locks had been fitted to those bedrooms where people had indicated an interest in having them. The Manager said she planned to eventually fit all bedroom doors with locks. As well as asking people about door locks she had asked about their preference for further easy chairs in bedrooms. She added that nine people sit in their own chairs in lounges. A strip light in one ground floor toilet took an excessive time to light and this was pointed out to the Manager. Both slabbed and tarmac paths, in the rear and side garden, held potential trips hazards and needed repair. Other environmental matters that needed attention were... * the area outside the front door was full of weeds and rather unsightly, * the lawn grass was long and needed mowing, * white paint was peeling from wooden windows at the side of the premises. At this inspection the interior of the premises was clean and there were no unpleasant odours. One relative of a person living at the Service, who responded to the postal Care Homes for Older People Page 15 of 24 Evidence: survey, commented that the premises were, always very clean and smelling fresh. The Manager confirmed that all staff had completed Infection Control training within the last 12 months. The care assistant spoken with described good practice regarding the transportation of soiled articles of clothing and bedding within the premises. Care Homes for Older People Page 16 of 24 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. The Service had a good level of well trained staff to ensure that the people living here were safe and their needs were met. Evidence: The staffing rota was examined and indicated sufficient staffing levels. The care assistant spoken with confirmed that there were adequate numbers of staff on duty. One case tracked person we spoke with said there are, enough (staff) to meet my needs. The Manager told us that all care staff had now achieved a National Vocational Qualification (NVQ) in Care at least to level 2. Additionally, one member of care staff had achieved an NVQ in Care at level 3 and five were undertaking this level of qualification. This exceeded the minimum level required by the National Minimum Standards and is commendable. The file of the most recently appointed member of staff was examined. Matters relating to her recruitment were satisfactory except that... * the person had not been asked to provide details of any criminal offences in respect of which she had been cautioned by a constable and which, at the time the caution was given, she admitted, * there was no written explanation of the two gaps in the persons employment history. Care Homes for Older People Page 17 of 24 Evidence: The Services staff training matrix was examined. All staff had completed mandatory training within the past three years. The Manager said that she personally completes all the training provided to her staff and this has included a course on Dementia, which six staff have attended. One relative of a person living at the Service, who responded to the postal survey, commented that the person cared for has dementia and, is well catered for. The care assistant spoken with confirmed she had attended a range of mandatory training courses over the past 12 months. The Manager said that Age Concern has recently started to provide induction to new staff at Skills for Care Common Induction Standards level. The Manager showed that she recognises the importance of training for the staff group. Care Homes for Older People Page 18 of 24 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 Service was well managed so that people living here were protected and their best interests were promoted by the systems in place. Evidence: We saw documentary evidence that the Manager had attained a qualification in Management at NVQ level 4 in July 2008. She has a nursing qualification too and been a Registered Manager for 22 Years. There was evidence of the Manager having a hands on approach - spending time working directly with staff and the people living at the Service to everyones benefit. She showed a very good understanding of the needs of individuals and had good interpersonal skills with staff. One case tracked person spoken with said the Manager, is marvellous and thoughtful. The care assistant we spoke with said there was, good management, of the Service. One relative who completed our pre-inspection survey said the Service is, very well organised...Mr & Mrs Beech always understanding and helpful. We noted that the Service offers work placements to Care Homes for Older People Page 19 of 24 Evidence: apprentices supported by Age Concern - a move that is positive for the people who live at the Service and for the wider social care community. There was evidence of improved monitoring of the Service by the Manager. Her preinspection questionnaire stated, We have started having residents meetings. A record of the first meeting, held in January 2009, was seen. The Manager said these will be held every six months. We noted that questionnaires about the quality of the Service, completed by the people living at the Service, had been received, although they had not yet been audited and summarised. The Manager explained that a Care Advisor supports her in maintaining the Services policies and procedures up to date and in her quality assurance measures. She said this Care Advisor was planning to audit these questionnaires. This person was also holding copies of questionnaires completed by people who had received respite care from the Service. We also saw completed questionnaires from visitors and from two external training officers and one community psychiatric nurse. Staff meetings were being held every six months and we examined a copy of the minutes of the last one from January 2009. A rather brief annual development plan was in place, with no target dates from which progress towards achieving the aims could be measured. The pre-inspection surveys completed by people living at the Service contained positive comments such as, I am well cared for, and, I cannot fault the services provided. One case tracked person we spoke with said the Service is, very good here...wonderful...Im so happy. The Manager stated that the she did not hold any savings on behalf of people living at the Service. The Manager stated that staff receive one to one, formal supervision six times a year, as recommended within the National Minimum Standards, although she could find no documents to support this. The Manager showed she is well aware of good Health and Safety practices. All the staff had completed Health and Safety training in February 2009. Environmental risk assessments had been developed with regard to the laundry and to carpets, but not all areas of the premises. The Manager said that her Care Advisor is currently developing risk assessments on all working conditions for staff. A Fire Risk Assessment dated August 2007 was in place. Cleaning materials were being safely stored in a locked cupboard and Product Information Sheets were in place, the Manager said. Her preinspection questionnaire showed that equipment was being checked and maintained appropriately. Good food hygiene practices were being followed. There were comprehensive and robust accident reporting procedures, with the associated sheets periodically audited by the Manager. This was good practice. The Manager had obtained a copy of the Management of Health and Safety at Work Regulations, 1999, as recommended at the last inspection. Care Homes for Older People Page 20 of 24 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 21 of 24 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 8 15 15(2)(b) Recorded risk assessments on individual people must be reviewed consistently and at a frequency that reflects the assessed level of risk. This will ensure the personal health and safety of people living at the Service. 01/07/2009 2 19 13 13(4)(a) Uneven slabbed and tarmac paths, in the rear and side garden, must be given attention. This will ensure peoples safety in that area. 01/09/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 1 7 The Residents Guide should contain a summary of the views and opinions of the Service from people living there. Every entry in peoples care plans should be dated. Page 22 of 24 Care Homes for Older People Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 3 4 5 7 7 8 Care planning records should take a person centred approach. Care plans should reflect peoples holistic needs. Manual Handling Assessments should clearly indicate the sling type/size that staff should be aware of when using the hoist. The Manager is recommended to improve her monitoring of care planning records to ensure consistency and minimise risk to the people who live at the Service. Peoples interests and preferred activities should be fully and consistently recorded. The Service should continue considering how staff may provide a daily programme of activities. Poorly tended parts of the garden need attention to make it pleasant for people to sit in. Wooden windows, at the side of the premises, should be repainted or otherwise improved in appearance. The strip light in one ground floor toilet should be repaired so it functions properly. There should be a satisfactory written explanation of any gaps in a job applicants employment history. Job applicants should be asked to provide details of any criminal offences in respect of which they have been cautioned by a constable and which, at the time the caution was given, they admit. The Services annual development plan should cover all aspects of the running of the Service and should include target dates. A summary should be made of the questionnaires about the quality of the Service, completed by the people living at the Service, and incorporated into the Service Users Guide. Risk assessments should be developed for all areas within, and immediately outside, the premises. 6 8 7 8 9 10 11 12 13 12 12 19 19 19 29 29 14 33 15 33 16 38 Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!