Care Home: Shakti Nursing Home

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What the care home does well Shakti Nursing Home is providing care and support for Asian elders. Staff speak a range of Asian languages, i.e. Gujarati, Hindi, Tamil, Urdu, Swahili. All people using the service and visitors spoken to were very positive about the care and support provided by the home. The home is enabling people using the service to pray and regular Bhajan sessions are organised. One of these sessions is organised by the local temple. It was evident that the home is enabling people using the service to make choices about their lives. Care plans are of good standard and are reviewed monthly, together with the person or their chosen representative. Meals are nicely presented, nutritious and reflect the religious as well as cultural identity of the people living at the home. Staff informed us that they feel supported by the new manager and registered provider, both of whom are available regularly to support staff and people using the service. What has improved since the last inspection? The home has met all five requirements made during the previous key inspection. Issues around the administration of medication has been addressed and people using the service are safely administered medication by registered nurses. The new CSCI contact details have been included in the complaints and safeguarding adults procedure, this ensure people using the service are provided with up to date information about the home. The new manager has introduced a supervisions system which maintains regular supervisions for staff. What the care home could do better: We have made four requirements during this unannounced key inspection. The statement of purpose and service users guide must be reviewed and up dated to ensure that prospective people using the service are provided with current information about the home. People using the service using bedrails must have a detailed risk assessment ensuring that they are safe when in bed. Medication stored in the medicines fridge must be locked away to ensure nobody unauthorized has access to the medication. The new manager must register with the CSCI, ensuring that only a person fit to manage a home is supporting people using the service. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Shakti Nursing Home 11 Forty Lane Wembley Middx HA9 9EA     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: Andreas Schwarz     Date: 2 0 0 2 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 27 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Shakti Nursing Home 11 Forty Lane Wembley Middx HA9 9EA 02089047220 02089031934 shaktihome@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Urvashi Chudasama care home 16 Number of places (if applicable): Under 65 Over 65 16 0 old age, not falling within any other category physical disability Additional conditions: 0 16 The maximum number of service users who can be accommodated is: 16 The registered person may provide the following category of service only: Care Home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Physical disability - Code PD Date of last inspection Brief description of the care home Shakti Nursing Home is a registered care home providing accommodation, personal care and nursing care for up to 16 Asian elders; on the day of the inspection there were 15 people using the service. Mrs Urvashi Chudasama owns the home and a new manager has been employed. The home is situated on a main road in Wembley Park, within easy reach of local facilities. There is parking for four cars on the forecourt. The home is a large converted three-storey house and was first registered under the Registered Home Act 1984 in August 1997. Accommodation for people using the service is provided on the ground floor and first floor, accessed by a through floor passenger lift; there is one shared and 14 single occupancy rooms. On the second floor Care Homes for Older People Page 4 of 27 Brief description of the care home there is an office for the registered provider and a staff room. There is a garden and patio at the rear of the property. The building is Grade 2 listed. The home is providing vegetarian meals for people who are of Hindu faith, but also provides care for people from different religions. Vacant beds can be used for respite care. Fees and charges can be obtained from the registered manager or responsible person. 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: This unannounced key inspection took place in February 2009 and lasted six hours. The registered provider and new manager were available to answer our questions. We spoke to three people using the service, one visitor, one visiting health care professional and three members of staff. Nine service users surveys and three staff surveys have been returned to us prior to this inspection. We looked at care plans and other records relating to people using the service, staff and the home. We would like to take this opportunity thanking everybody, assisting the CSCI during this unannounced key inspection. Care Homes for Older People Page 6 of 27 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 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 8 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. To ensure the home is able to meet the needs of new prospective people the manager is undertaking detailed assessments. People using the service and or their representatives are involved in the assessment process. The home does not providing intermediate care. Evidence: We looked at the homes statement of purpose and service users guide, both documents have been reviewed in September 2007. We noted that changes in management have not been included in the statement of purpose. The residents charter is displayed on the notice board. All surveys received confirmed that the home is providing detailed information to prospective people using the service. The statement of purpose and service users guide is only available in English, the ,majority of people using the home are Gujarati and Hindi speaking. The home should find ways to address this. Care Homes for Older People Page 9 of 27 Evidence: We viewed an assessment of a person being admitted to home recently. The assessment has been undertaken by the newly appointed deputy manager. The deputy manager is a qualified registered nurse. The assessment is detailed and provides information about the persons needs, likes and dislikes. Information from the assessment is included in the persons care plan. It was refreshing to see that the home is doing a Mental Capacity Assessment and Deprivation of Liberty assessment during the initial needs assessment process. People using the service confirmed that they have been assessed by the homes manager. The home does not provide intermediate care. Care Homes for Older People Page 10 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. Care plans are written with the individual, or their representative, and include a range of information that is important to them. People receive personal and healthcare support using a person centred approach with support provided based upon the rights of dignity, equality, fairness, autonomy and respect. People using the service have access to healthcare and remedial services. The home has a medication policy which is accessible to staff. Medication records are up to date for each person and medicines received, administered and disposed of are recorded to ensure people using the service are safe. Evidence: We looked at three care plans during this inspection, care plans are detailed and provide information about the persons likes, dislikes, preferred language. Care plans have been reviewed and updated if any changes to the care of the person is required. Care plan goals provide care staff with information and guidelines to ensure care is provided in a person centred way. One person told us that he has seen his fathers care plan and is very happy how the home is providing care. Six surveys confirmed that the Care Homes for Older People Page 11 of 27 Evidence: home always provides care and support based on the assessment of their need. We viewed individual night care plans for people who present challenges during nighttime or have specific needs such as changing of incontinence pads or needing to be turned due to the risk of developing pressure sores. People using the service told us that their family is dealing with the care plans. People using the service told us that staff is helping them with their personal care. We observed staff assisting people to use the bathroom and to eat. This was done unrushed and staff interacted with people professionally and with respect. We viewed a number of manual handling assessments, falls assessments, pressure sore assessments in peoples care plans. The assessments have been reviewed regularly and updated if necessary. We observed staff supporting people using the service with a hoist. Staff communicated with each other and the person and followed individual manual handling guidance. We discussed with the deputy manager weight loss of one of the people using the service. The deputy manager told us that the person has been referred to a dietitian and food supplement drinks have been prescribed. The GP visits the home every other week and visits are documented in peoples care plans. During the day of this inspection the dentist visited the home to provide treatment to two people using the service. Staff encouraged the person to go into her room to receive treatment from the dentist. The home is visited regularly by an optician for sight test if they choose to do so. We observed people using the service at risk of developing pressure sores using appropriate equipment such as mattresses and cushions. We viewed in one care plan a consent form from a family member to use bedrails, there was however no risk assessment, which is required. The new deputy manager has re-organised the medication system since starting in the home, a new pharmacist is dispensing medicines. The medicines storage was of good standard. Controlled drugs are safely stored and records viewed are of good standard. Medication is administered by a registered nurse. We noted that the medication fridge was not locked and ice is building up. Temperature recordings are up to date and within the legal limit. One of the liquid medication bottles was opened, but not dated. This was discussed with deputy manager who told us that she will address this with staff. During the day of this inspection a person received a private call. Staff gave the person the phone in the lounge not offering to receive the call in a more private setting. The person however did not appear uncomfortable with using the phone in the lounge. We recommend to find alternative ways for people to receive private calls. Service users were dressed in culturally appropriate saris. One person told us that she is wearing her own clothes. Staff told us and induction records demonstrated that staff are informed to ensure people using the service are treated with respect. Care Homes for Older People Page 12 of 27 Evidence: Care Homes for Older People Page 13 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 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 have the opportunity to develop and maintain important personal and family relationships. People using the service are involved in meaningful daytime activities of their own choice and according to their individual interests. The meals are balanced and nutritious and cater for the varying cultural and dietary needs of individuals. Care staff are sensitive to the needs of those people who find it difficult to eat and give assistance with eating their meals. Evidence: The home is providing a range of activities based on peoples interest and cultural background. Activities such as Bhajan, listening to music, exercise, watching of religious videos, massage are recorded in the weekly activity plan. People using the service confirmed that this activities are offered and they are attending them if they wish. Daily activities are displayed on the notice board in the living room. We observed staff encouraging people using the service to take part in table top activities such as puzzles, dominoes and building bricks. We observed family members visiting people using the service and the visitors book confirmed that residents receive regular family visits. People using the service told us Care Homes for Older People Page 14 of 27 Evidence: that they could meet visitors in their rooms, but prefer to meet them in the lounge. We spoke to one visitor during this inspection who confirmed that the home is keeping them informed about changing needs and issues relevant to the home and the service provided. The visitor spoke very positive about he home and told us that he is very happy how his mother and father are cared for at Shakti. Volunteers from the local temple visit the home regularly for prayer meetings. The home is not handling service users finances and benefits. The manager told us that all financial affairs are either handled by the service user or a family member. The home is keeping a small amount of finances for some of the people using the service, which is used for daily expenditures such as toiletries, hairdresser, etc. The money is safely kept in a locked a cabinet and records are of good standard and up to date. We were invited by two people using the service to view their rooms, rooms are spacious and people using the service brought in personal possessions such as pictures, religious ornaments lamps, etc. Records are stored safely in an office space in the main lounge and can only be accessed by staff or individual family members on request. The home is providing a vegetarian Asian diet, food is freshly prepared and people using the service told us that they are happy with the menu. One person told us that she eats chicken, which is brought to her by her family. The service users guide states clearly that Shakti Nursing Home is a Vegetarian home. We viewed in the kitchen a list of special diets required by people using the service due to health or religious beliefs. We spoke to the home cook, who was fully aware of this and explained to us that the home will provide alternatives for people. We observed breakfast time and staff assisted people using the service to eat, which was done with dignity and unrushed. The registered provider told us that the home has recently changed the menu and information from service users have been obtained in service users surveys. Care Homes for Older People Page 15 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. The home has an open culture that allows people using the service to express their views and concerns in a safe and understanding environment. The service has a complaints procedure that is clearly written and easy to understand. The policies and procedures for safeguarding adults are available and give clear specific guidance to those using them. Evidence: The home has received four complaints since the lat key inspection. Complaints have been well recorded and the Commission for Social Care Inspection (CSCI) has been contacted and informed about one complaint. The home has a complaints policy, which is available in Gujarati and English. The complaints procedure has been updated and the new CSCI contact details have been included. People using the service confirmed in surveys that they are happy how the home deals with complaints and are confident that all complaints are addressed. People using the service told us that they would complain to the manager or registered provider, but have no problems at the moment. The home has a safeguarding policy, which has been updated in September 2007, the CSCI contact details have been changed. The home did not make any safeguarding adults referrals since the last inspection. Brent safeguarding adults guidelines are available. We found in care plans forms for Mental Capacity and Deprivation of Liberty assessments. Staff have received safeguarding adults training and new training is Care Homes for Older People Page 16 of 27 Evidence: arranged for 11/03/09. Staff spoken to demonstrated good understanding of safeguarding adults procedures and expressed confidence that the provider would deal appropriately with any safeguarding adults allegation. 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 provides a physical environment that is appropriate to the specific needs of the people who live there. People using the service are encouraged to personalise their bedrooms. All fixtures and fittings meet the needs of individuals and can be changed if their needs change. The shared areas provide a choice of communal space with opportunities to meet relatives and friends in private. The home is well lit, clean and tidy and smells fresh. Evidence: The home has a large lounge, which is used as a dining room. People using the service informed us that they could meet visitors in their room, but prefer to meet them in the shared lounge. The home has a large well-maintained garden, which can be accessed by people using the service. The communal rooms are airy and well lit. The lounge has been completely refurbished since the last key inspection. The staff base has been relocated, which is creating more space for the people using the service. Furnishing is of good standard and was partially replaced following the redecoration. Two people using the service allowed us to view their rooms. All rooms were spacious and nicely decorated. Pictures and other personal possessions were on display and all rooms were clean and tidy. Care Homes for Older People Page 18 of 27 Evidence: The home has refitted the kitchen new appliances such as fridge, freezer, microwave oven, dish washer, cooker, etc. have been purchased. The kitchen was clean and well organised. The home was clean, tidy and free from any offensive odours. Two domestic staff are employed during the morning. The domestic staff is also responsible for washing laundry. The home sluice room is clean. There is a washing machine and dryer in the laundry room. The flooring and walls can easily be cleaned. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The recruitment of good quality carers is seen as integral to the delivery of an good service. The service is proactive rather than reactive in its staffing, recruitment and training, with planning for the potential needs of people who use the service. Management priorities training and facilitate staff members to undertake external qualifications beyond basic requirements. The service ensures that all staff within its organisation receives relevant training that is targeted and focused on improving outcomes for people using the service. Staff has the skills to communicate effectively with all people. Evidence: The home has three early, three late and two night staff on duty every day. On certain days the home has additional staff on duty, to facilitate hospital appointments or planned activities. We observed staff interacting with people using the service and we never had the impression that staff is rushed of their feet, or people using the service had to wait long for support. People using the service told us that there is enough staff on duty, but during busy periods in the morning or during the evening they have to wait a little longer for staff. The home has two domestic staff and four cooks employed. The registered provider informed us that all but one staff hold a National Qualification Care Homes for Older People Page 20 of 27 Evidence: in Care Level 2 or 3. The home does not employ staff under the age of 18. We assessed five staffing records, staff have received a detailed induction about the home, people using the service, policies and procedures. Staff confirmed in surveys having received an induction. We assessed five staffing records, which have been of good standard and all required documentation was in place. Staff confirmed of having to provide documentation for Criminal Records Checks and for the employer to take references. The training plan is up to date., staff receive basic training such as Manual Handling, Fire Safety, Safeguarding, First Aid and Food Hygiene. Regular refresher training courses are offered to staff. Staff confirmed of having received training. We received two surveys, which confirmed that regular training is provided by the home. Some staff have attended Dementia training provided by Harrow College. 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. The new manager is experienced and supportive to people using the service and staff. Regular audits are undertaken enabling people using the service and relatives being involved in the service. Appropriate Health and Safety checks and procedures protects people using the service from accidents. Evidence: The home has employed a new manager since September 2008. Staff and people using the service spoke very positive about the support received from the new manager. New changes in medication procedures, care planning and supervision have been introduced by the manager. The manager is a registered nurse, with experience working in England and abroad. The manager has not been registered with the CSCI, which is required. The home has an annual development plan for 2008/09 in place. The development plan is addressing issues around the maintenance of the home, areas such as Care Homes for Older People Page 22 of 27 Evidence: activities, menus, etc. are not addressed in the plan. This is recommended. The home undertook service users surveys in December 2008. Comments made by people using the service and relatives have been very positive. For example, the home is very presentable and clean, Staff is very friendly and polite, the residents are well looked after, this is a clean and friendly place to visit. Staff informed us of having attended staff meetings, the last meeting was held on 12/02/09. The home is not acting as an appointee for people using the service, finances are managed by relatives, court of protection or the service user. The home is storing a small amount of money for people using the service. This money is used for day to day expenses, such as hairdresser, toiletries, etc. The money is kept in a lockable cabinet and all monies is stored in individual pouches. We checked financial records of three people using the service and found that records were up to date and correct. We looked at supervision records, an annual supervision planner is displayed on the office wall. Staff confirmed since the new manager has started regular supervisions are provided. We viewed the homes safety certificates such as Portable Appliance Test, Landlords Gas Certificate, etc. All required certificates are in place and up to date. The homes fire records are in place and are in order. The fire risk assessment has been reviewed in January 2009. Signs to direct people to fire exits are in English and Gujarati. 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 1 6 The responsible person must 01/04/2009 review and update the statement of purpose and service users guide. This ensures prospective people using the service are provided with up to date information about the care and service provided by the home. 2 8 13 The responsible person must 15/03/2009 ensure that people using bedrails are risk assessed. This is to ensure people using the service are protected from injuries when bedrails are provided. 3 9 13 The responsible person must 01/04/2009 ensure to lock the medication fridge. This ensures that medication is only accessed by people authorised to do so. 4 31 9 The new manager must registered with the CSCI. 01/05/2009 Care Homes for Older People Page 25 of 27 This ensures only a fit person is managing the home and support people using the service 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 1 The responsible person should find ways to make the service users guide and statement of purpose available in Gujarati and other languages spoken by people using the service. The home should defrost the medicines fridge regularly, this will ensure that the fridge is in good working order. The responsible person should find alternative ways for people using the service to receive private telephone calls. We recommend to address issues such as activities, menus, etc. in the annual development plan. 2 3 4 9 10 33 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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. 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