Care Home: South View

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What the care home does well People told us that they enjoy living at South View and that the staff are very good and they are well looked after. They consider the service to be well managed and that the manager is open and approachable. They felt the service does the following well: "We get good food, the accommodation is comfortable and the staff are nice" "I am always made welcome when I visit and am totally satisfied with the care my mother receives. This place is 10 out of 10 and my mother is very happy here" "We keep the residents happy and well fed" "The staff work very hard" "There are good relationships between staff and residents and we work very well as a staff team...communication is good and we are kept updated with new rules and regulations" People using the service are supported by a trained and committed staff team, which benefits their care. Staff on duty were confident and competent in their roles and have developed positive relationships with the individuals in their care. Staff retention is very good; this helps with continuity of care. Staff spoken with demonstrated a clear understanding of the people we case tracked and were familiar with their individual needs and preferences. What has improved since the last inspection? The last key inspection of this service was undertaken on 21st June 2007. We did an annual service review on 12th June 2008. This did not involve a visit to the home but is a summary of new information given to us, or collected by us, since the last inspection. The report is available at the home. All of the required checks are now undertaken on new staff to make sure they are suitable to work with vulnerable people before they start employment. This helps safeguard people who use the service. Some areas have been redecorated and residents are able to choose the decor of their bedrooms and encouraged to personalise their own space. The gardens are now maintained better and provide a pleasant area for residents to enjoy. The care planning format has changed to make it easier for staff to record the health, personal and social care needs of the individuals they support. This helps ensure people living at the home receive the care in a way that they prefer. Comments about what has improved include the following: "We have been given training that improves our skills in good caring and working safely" "Opportunities for staff training has improved" What the care home could do better: Overall the service is performing well and continues to provide positive outcomes for the people living at the home. Residents and staff spoken with told us that they are satisfied with the service provided and consider there are no areas required for improvement. People are provided with basic but comfortable accommodation however some areas of the home look tired in appearance and would benefit from redecoration and replacement of furniture and fittings, this was fully acknowledged by the manager who committed to develop a planned programme of renewal. Improvements would enhance the environment and provide people with a more pleasant and homely place to live. Overall the arrangements in place for the management of medication is satisfactory however the manager agreed to implement some minor improvements such as placing photographs on medication records, obtaining specimen staff signatures and undertaking competency assessments on staff responsible for administrating medication. These measures would provide greater protection for people receiving support with their medication. Staff would benefit from attending training in the mental capacity act and deprivation of liberty safeguards so that they are aware of their responsibilities regarding this legislation. Key inspection report Care homes for older people Name: Address: South View Sandford Avenue Church Stretton Shropshire SY6 7AB     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: Sue Woods     Date: 1 8 0 6 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 26 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 26 Information about the care home Name of care home: Address: South View Sandford Avenue Church Stretton Shropshire SY6 7AB 01694723525 01588672664 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Catherine Elizabeth Vine care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 15 The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 15 Date of last inspection Brief description of the care home South View is a privately owned Care Home registered with the Care Quality Commission to provide personal care and accomodation for up to fifteen older people. It is a well-established home set in its own private grounds and is conveniently located on the edge of Church Stretton close to local facilities and public transport routes. The home has been operating since 1986 and has become an integral part of the local community. The building has been extended and improved with the emphasis always being to avoid an institutional environment. The home provides a large lounge/dining area in addition to 10 bedrooms; 6 rooms are single and the rest are double. A passenger lift is not provided therefore people with mobility difficulties are Care Homes for Older People Page 4 of 26 Over 65 15 0 Brief description of the care home accommodated on the ground floor only. South View makes its services known to prospective residents in The Statement of Purpose and Service User Guide. Fees for South View as of 1st April 2009 are £430.00 per person per week. The only additional charges are for hairdressing, chiropody and newspapers. Care Homes for Older People Page 5 of 26 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 inspection of South View took place over 5 hours and was unannounced therefore people who live and work at the home did not know that we were visiting. A range of evidence was used to make judgements about this service. We met and spoke with a number of residents, three staff, and a visiting relative. We looked at some parts of the home and sampled a number of records to include care records, complaints and protection, staff training, recruitment and health and safety records. Five people completed surveys for us informing us of their views and the feedback gained has been included in our report. Three people who live at the home were case tracked this involves establishing individuals experience of using this service, discussing their care with them and staff on duty, looking at their care files and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. Care Homes for Older People Page 6 of 26 We looked at the outcomes for people living at the home and information to produce this report was gathered from the findings on the day of our visit and also the information that we have received, or asked for, since our last key inspection. The manager completed an Annual Quality Assurance Assessment (AQAA) document for us, as requested. The AQAA is a self-assessment and a dataset that is filled in once a year by all providers. It informs us about how they are meeting outcomes for people using their service and is an opportunity for them to share with us areas that they believe they are doing well. The AQAA provided us with detailed information about the service and helped to determine a judgement about the quality of care the home provides. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? The last key inspection of this service was undertaken on 21st June 2007. We did an annual service review on 12th June 2008. This did not involve a visit to the home but is a summary of new information given to us, or collected by us, since the last inspection. The report is available at the home. All of the required checks are now undertaken on new staff to make sure they are suitable to work with vulnerable people before they start employment. This helps safeguard people who use the service. Some areas have been redecorated and residents are able to choose the decor of their bedrooms and encouraged to personalise their own space. The gardens are now maintained better and provide a pleasant area for residents to enjoy. The care planning format has changed to make it easier for staff to record the health, personal and social care needs of the individuals they support. This helps ensure people living at the home receive the care in a way that they prefer. Comments about what has improved include the following: We have been given training that improves our skills in good caring and working safely Opportunities for staff training has improved Care Homes for Older People Page 8 of 26 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 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 26 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 26 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. Information about the South View is made readily available to help people make an informed choice about whether the service is appropriate for them and able to meet their individual needs. Evidence: Prospective residents and their families are provided with information about South View in the Statement of Purpose and Service User Guide. This provides people with information to help them understand the service provided and enables them to make an informed choice as to whether the home is suitable to meet their individual needs. We spoke with the person most recently admitted to the home and discussed the assessment and admission process with them and the manager. The person stated I visited a few homes before I came here but this is the best, its homely and nice and I really like it. We looked at the persons care records which showed that an assessment of needs had been undertaken prior to admission, which is part of the Care Homes for Older People Page 11 of 26 Evidence: homes admission procedure, as stated in the AQAA. Discussions with a visiting relative indicated that his relative visited the home prior to admission and was offered a trial period to make sure she was happy with the home and that it was appropriate to her needs. He stated Mum thoroughly loves it here. South View does not provide intermediate care therefore we did not assess key standard 6 on this occasion. Care Homes for Older People Page 12 of 26 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. Staff have a clear understanding of how to offer care to residents although care plans should be more detailed to ensure peoples health and personal care needs are met in a way that they prefer. Evidence: We spoke with a number of people who live at the home and a visiting relative about the care provided and their comments were very positive. Comments include: We are well cared for Staff look after us well Im totally satisfied with the care my mother receives We spoke with 3 staff about the needs of the people we case tracked and they all demonstrated a clear understanding of peoples individual needs. They considered that care plans provide sufficient information to ensure peoples needs are met. People are involved in the planning of their care although this needs to be formally documented, which the manager committed to review. Care Homes for Older People Page 13 of 26 Evidence: Records sampled clearly evidence that peoples health is monitored and any concerns are referred to the appropriate healthcare professional and outcomes stated. For example one of the people we case tracked was assessed by both a physio and occupational therapist soon after she was admitted to the home and the necessary equipment obtained to maintain her safety. People we spoke with told us that they are happy with how their medication is managed. The manager demonstrated a clear understanding of the medication procedure and reported that there have been no medication errors since our last inspection. Staff responsible for administering medication receive training. We advised the manager to undertake formal competency assessments on staff responsible for administering medication, provide photographs on medication records and obtain a record of staff signatures as this would provide greater safeguards for the residents at South View. People are able to take responsibility for their medication as long as they have been assessed as safe to do so otherwise all drugs are managed by the staff and dispensed and ordered for residents under the instructions of the GP. The Statement of Purpose states It is policy of South View to respect the unique character and personal needs of each individual regardless of circumstances. Throughout our visit the residents seen were very well presented and staff on duty were observed providing and promoting privacy, dignity and respect. They interacted with people they care for in a professional and sensitive manner. Care Homes for Older People Page 14 of 26 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 are provided with opportunities for social activity. Important relationships are maintained and people are provided with a choice of meals in accordance with their own preferences and dietary needs. Evidence: Records seen and discussions held evidence that routines are flexible, people are able to rise and retire as the wish and contact with friends and family is promoted. Although no structured activities were observed during our visit people told us that they are satisfied with the social activities provided such as musical events, coffee mornings, hairdressing, church services, quizzes, birthday celebrations and the occasional trips out. Activities were documented on the daily records of the individuals we case tracked. One resident said that arrangements are being made for a trip to Shrewsbury Quarry shortly. One individual we case tracked attends day services provided by the local authority and it was reported that she very much enjoys accessing this provision. A Getting To Know You document was available on one file sampled which includes information about a persons life, employment, relationships, major life events, likes and preferences. This tool provides staff with important information about new people coming into the service. Care Homes for Older People Page 15 of 26 Evidence: Residents are encouraged to maintain relationships with people important to them and told us that their relatives and friends are made welcome when they visit the home. This was evident in the observations made during our visit and the positive feedback that we gained in discussions with a visiting relative. He reported he is always made welcome and stated that he is totally satisfied with the care his mother receives. People we spoke with told us they like the food provided and that they are offered a choice of meals, as observed during our visit when the cook spoke with individuals to request their preferences prior to lunch. Meals appeared balanced, nutritious and were well presented. The cook demonstrated a clear understanding of the dietary needs and personal preferences of the residents and has obtained a recognised qualification in catering. Lunch was a social occasion and staff offered assistance to individuals requiring support in a sensitive manner. Care Homes for Older People Page 16 of 26 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. People living at South View and their representatives have access to a complaints procedure, which is accessible and ensures the views of people are listened to. Staff have an understanding of safeguarding adult procedures so people they support are protected from abuse, ensuring their well being. Evidence: People living at South View are provided with information about how to make a complaint through the Statement of Purpose, Service User Guide and complaints procedure displayed in the homes reception area. Discussions held indicate that people know who to approach if they have any concerns about the service. Neither the home or the commission have received any formal complaints or concerns since our last inspection, which indicates peoples continued satisfaction with the service the home provides. Staff spoken with demonstrated an understanding of safeguarding adults and whistle blowing procedures. Some staff have received training in this area which is also covered in staff induction where they learn about understanding the nature of abuse and recognising signs and symptoms. No referrals have been made under local safeguarding procedures since our last inspection. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People feel safe, enjoy living at the home and are provided with clean and comfortable accommodation but improvements would enhance residents enjoyment of the facilities. Evidence: People we spoke with told us they like living at the home and that they are happy with their rooms. We looked at some parts of the home and at the rooms of the people we case tracked. These were basic but comfortable and were personalised with family photos, ornaments and were appropriately equipped to meet their individual needs. Some areas of the home look tired and would benefit from investment, which was fully acknowledged by the manager and stated in the AQAA as an area for improvement. We advised the manager to develop a programme of renewal and replacement. The floorcoverings in the bathroom and toilet areas remain carpeted due to financial constraints, however the manager is aware that these should be replaced with washable floorcoverings, as identified at our previous inspection. A passenger lift is not provided therefore people with mobility difficulties are accommodated on the ground floor, which has posed some difficulty in filling vacancies on the first floor. The gardens are now attended to by a Gardener/handyman who was on site at the time of our inspection. Care Homes for Older People Page 18 of 26 Evidence: The home was clean during this unannounced inspection. Care staff are responsible for maintaining cleanliness and discussions with them and observations made indicate this does not infringe on their care duties. An infection control audit has recently been undertaken by Shropshire PCT Infection Control Officer and matters arising are currently being addressed by the manager. Training in infection-control procedures has been sourced and staff are due to attend this shortly. Care Homes for Older People Page 19 of 26 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 at South View are cared for by an established, trained and committed staff team who have a good understanding of their individual needs. Recruitment checks ensure the right people are employed to support the residents safely. Evidence: People living at South View are cared for by a well established staff team who appear committed to their work. Staff on duty demonstrated a good understanding of the individual needs of the people we case tracked. Staff retention is excellent, providing continuity of care for people living at the home. Discussions held and observations made clearly evidence that staff enjoy their roles, work well as a team and have developed positive working relationships with the people they support. People felt that staffing levels are appropriate and effective to meet the individual needs of the people living at the home. Staff told us that they provided with good training opportunities to include training in safe working practices, such as fire, first aid and moving and handling. The manager agreed to update the staff training matrix so that it is an accurate reflection of training undertaken. There has been a deterioration in one residents mental health needs therefore the manager has sought professional input and arranged training in order to equip staff with the skills and knowledge to effectively support the individual concerned. Six of the 14 care staff employed hold a nationally recognised care qualification known as NVQ at 2 and above Care Homes for Older People Page 20 of 26 Evidence: and two told us they are due to commence the award shortly. Staff told us: We are kept well updated with new rules and regulations and opportunities to do courses has improved We are given training that improves our skills in good caring and safe working We looked at the recruitment records for the one member of staff employed since we last visited the home. With the exception of a photograph and health declaration, the necessary paperwork was in place including references and a criminal records bureau check. This means that residents can be confident that the right people are supporting them. We spoke with the member of staff recruited who considered the homes recruitment practices to be robust and confirmed that she had completed her induction, as evidenced on records seen. She was also given the opportunity to shadow existing staff until she was familiar with peoples care needs and confident in her practice. Care Homes for Older People Page 21 of 26 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 management and administration of the home is based on openness and respect. People have confidence in South View because it is managed in the best interests of the people living and working there. Evidence: The AQAA states The home is run in the best interests of the residents and staff at the forefront. The manager has worked at South View for a number of years and has obtained the qualifications required of her role. People we spoke with stated that the manager is approachable, supportive and considered the service well-managed. The manager acknowledged areas for improvement however she does not hold responsibility for the management of finances and resources to deliver any business plan. The manager considered record-keeping systems could be improved which is acknowledged in the AQAA which states Continuing issues will be addressed and resolved, time will be allowed for the manager to complete administration and review Care Homes for Older People Page 22 of 26 Evidence: standards of care. This should therefore be given priority. The manager has recently undertaken training in the Deprivation of Liberty Safeguards and confirmed that no restrictions are in place but agreed to formally assess individuals and document the findings. The home has a system in place for the management of residents finances and records evidence two signatures are obtained for all transactions in addition to receipts. The home provides a main safe for storing valuables and small quantities of money however one resident said It would be nice if I had somewhere in my bedroom to store small private items. Residents and staff spoken with indicated they were happy with health and safety arrangements in place. We looked at a variety of health and safety records and the checks that staff do to prevent people from being placed at risk of harm. We found that checks are generally undertaken at the required frequency to ensure the safety of residents and staff. Staff on duty confirmed that they are in receipt of training in safe working practices for example moving and handling, food hygiene, health and safety and fire and are due to receive training in infection control procedures shortly, which helps to keep people safe. An audit of fire safety arrangements has recently been undertaken by the Fire Officer and this was found satisfactory. The manager confirmed that there are no outstanding requirements made by the Environmental Health Officer following an inspection of the home in February 2007. The manager is currently in the process of reviewing the homes policies and procedures and implementing new ones in relation to infection control procedures to ensure residents are better protected. Care Homes for Older People Page 23 of 26 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 26 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 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 9 Medication Administration Records should contain a recent photograph of the individual, specimen staff signatures obtained and competency assessments undertaken on staff responsible for administering medication. These measures would provide greater safeguards for people receiving support with their medication. A planned programme of routine maintenance and renewal of the fabric and decoration the premises should be developed incorporating replacement of floorcoverings in bathrooms and toilets. This will assist in future planning and prioritising areas for improvement for the people accommodated. The manager should be provided with dedicated management hours to review record-keeping systems and fulfil the aims and objectives of the home. 2 19 3 31 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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