Care Home: Sutton Lodge Nursing & Residential Home

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What the care home does well People who live at the home are able to take part in developing good assessments and care plans, which means that they get the right support from the start, and they receive their care in the way that they want it. Staff look after them in a respectful way, and make sure that their privacy is maintained. They can make their own choices about what they do with their time and how they live their lives, and staff listen to what they have to say about the services they receive. There are good systems in place to make sure that people are protected, including staff training, risk assessments and policies; and people who use the service told us that they feel safe living at the home. What has improved since the last inspection? During the last inspection we suggested that the home put more details into the records they keep about care plan reviews, and we saw that they have now done this. There are now clear plans in place to hold meetings for people who live at the home, and for staff. This is so that everyone can have more say in how the home is run, and get information in a better way. Since the last inspection the home has made changes to the way they provide activities, and although there was a period of time when not many activities were available to people, there is now an improved programme that people enjoy. Also since the last inspection many of the bedrooms have been decorated, and a new boiler has been installed. What the care home could do better: Although we found that improvements have been made to the service people receive, we said that there are still things that the home could do. These are called recommendations and may help to make things even better for people. We have suggested that care plans should show how new laws about people making their own decisions, effects the lives of the people they support. This so that the home can show how people`s rights and choices are protected. We have also suggested that the home carries out more monitoring of the quality of the service they provide. For example, although the records for keeping people`s money are clear, and care plans are in place, we suggested that the home could do regular audits of these things to make sure that everyone is following the right procedures. We suggested during our last inspection that a regular audit of medication records would help to make sure that staff consistently signed for the medication they gave out, and we are leaving that recommendation in place for this inspection. We have made a suggestion that staff supervision is carried out more regularly, although we do recognise that the acting manager has already begun to plan for this. We have said that there should be an up to date copy of the Local Authority guidanceabout safeguarding people, and a risk assessment for the use of hand disinfectant dispensers. This is so that people`s health and safety needs are protected. The owner has told us that he and the acting manager will talk to people living at the home about having more outings, and having a greater choice of vegetables with their meals. The owner also said that he would talk to the local Environmental Health Officer about the arrangements for for taking food from the main kitchen to another building where people live, to make sure that the current arrangements are satisfactory. Lastly, we said that although the owner makes daily visits to the home, and people can talk to him whenever they want, he should keep records to show how he monitors the quality of the service provided, and what actions he takes to improve the service. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Sutton Lodge Nursing & Residential Home Station Road Sutton On Sea Lincs LN12 2HR     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: Wendy Taylor     Date: 2 3 0 3 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Sutton Lodge Nursing & Residential Home Station Road Sutton On Sea Lincs LN12 2HR 01507441905 01507443322 info@wyngatecarehome.co.uk 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) : Mr Stephen John Croudace care home 34 Number of places (if applicable): Under 65 Over 65 32 0 old age, not falling within any other category physical disability Additional conditions: 0 2 Restriction The additional bed in the category of Physical Disability is for persons aged 45 years and over. Restriction The category of Physical Disability is for one named person only (As per letter dated 28.6.02). The registration for Physical Disability will be revoked when the named person no longer lives in the home. Date of last inspection Brief description of the care home Sutton lodge is situated in a residential area of Sutton on Sea. The home comprises a large older building that has been renovated, and now has a passenger lift. This part of the home has accommodation for 9 residents who require personal care, and 3 of the 9 beds are in converted stables that provide semi independent accommodation with a linked call bell system. There is also a large purpose built single storey building that can accommodate up to 25 older people who require personal and nursing care. There are well-maintained gardens and parking areas surrounding the homes. The providers also run a domiciliary care agency from the top floor of the older building. Care Homes for Older People Page 4 of 27 Brief description of the care home The owner has informed us that the current fees for the service are £351:00 to £516:00 per week. Information about these costs and the day to day operation of the home are available from the main office. 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: The quality rating for this service is 2 stars. This means that the people who use the service receive good outcomes. This unannounced key inspection was carried out on one day during the month March 2009. We started the process by looking at all of the information held by us, such as surveys sent to us by people who use the service, and staff who are employed within the home. We then used a method called case tracking to find out more about how the home provides support to people. We spoke to people who live at the home, we looked at their care records, and we spoke to staff who were supporting them when we visited. Care Homes for Older People Page 6 of 27 We spoke to the owner of the home during his daily visit. The acting manager was not available in the home on the day of the visit but we spoke to her by telephone. We also looked at things like staff records, complaints and protection records, and policies. Through discussions and surveys people who live at the home told us things like there are wonderful caring staff here. Relatives and other visitors said things like everything is spot on, and the care is very good here. Staff said that working at the home feels like being part of the family. Other comments from people who use the service, and from staff are mentioned in the rest of this report. What the care home does well: What has improved since the last inspection? What they could do better: Although we found that improvements have been made to the service people receive, we said that there are still things that the home could do. These are called recommendations and may help to make things even better for people. We have suggested that care plans should show how new laws about people making their own decisions, effects the lives of the people they support. This so that the home can show how peoples rights and choices are protected. We have also suggested that the home carries out more monitoring of the quality of the service they provide. For example, although the records for keeping peoples money are clear, and care plans are in place, we suggested that the home could do regular audits of these things to make sure that everyone is following the right procedures. We suggested during our last inspection that a regular audit of medication records would help to make sure that staff consistently signed for the medication they gave out, and we are leaving that recommendation in place for this inspection. We have made a suggestion that staff supervision is carried out more regularly, although we do recognise that the acting manager has already begun to plan for this. We have said that there should be an up to date copy of the Local Authority guidance Care Homes for Older People Page 8 of 27 about safeguarding people, and a risk assessment for the use of hand disinfectant dispensers. This is so that peoples health and safety needs are protected. The owner has told us that he and the acting manager will talk to people living at the home about having more outings, and having a greater choice of vegetables with their meals. The owner also said that he would talk to the local Environmental Health Officer about the arrangements for for taking food from the main kitchen to another building where people live, to make sure that the current arrangements are satisfactory. Lastly, we said that although the owner makes daily visits to the home, and people can talk to him whenever they want, he should keep records to show how he monitors the quality of the service provided, and what actions he takes to improve the service. 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 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A comprehensive assessment system means that people are able to receive the right support when they move into the home. Evidence: Records show that people have their needs assessed before they move into the home, and that this process continues after they are admitted. Pre admission assessments contain information about things like funding levels, advocacy arrangements, end of life arrangements, how the person makes decisions, how they communicate, and how they like to be supported with their personal care. We saw that on going assessments are regularly reviewed by staff, and they cover things like psychological and social needs, religion, relationships, moving and handling, pressure area care, and personal equipment lists. We saw that the assessments are detailed and they are signed by the person or their representative to show that they have been involved. Care Homes for Older People Page 11 of 27 Evidence: The owner confirmed that the home does not provide intermediate care. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs and wishes are met in an individualised and respectful way, and they benefit from being involved in developing and reviewing their own care plans. Evidence: The home continues to use a standardised care planning system, and all of the care plans we looked at had been personalised. The plans cross reference with assessments, and they cover issues such as continence, social support, reassurance, mobility, personal care, sleep, and maintaining a safe environment. Risk assessments are also in place and cover issues such as falls, skin integrity, and uncovered radiators. There is no information about decision making in the care plans, however staff told us that there are plans in place to include this information. During our last visit we suggested that care plan review records contain more detail, and this has now been done. We saw that the plans continue to be reviewed regularly, and are signed by the person or their representative to show that they are involved in developing the plans. People also told us that staff talk to them regularly about their care plans. Care Homes for Older People Page 13 of 27 Evidence: Medication records are generally well kept, but there was one signature missing from one administration record. Staff took action straight away to resolve the issue. We made a suggestion about this during our last visit, and we have decided to leave the suggestion in place. We saw that some people have medication care plans, with guidance for giving medication required only when necessary, but not all, and staff said that this would be done in the near future. People told us that they can see their GP whenever they want, and that staff are very good at helping them to stay well. They also told us that staff make sure that they have privacy whenever they need it, and listen to them when they have something to say about their care. We saw staff taking people to private areas when they needed personal care, and being discreet when talking to them. Health professionals told us that the care is excellent and there are very high standards within the home. Staff told us that they are given lots of information about peoples needs so that they can help people in the right way. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People currently enjoy a range of activities, and a flexible menu that suit their needs and wishes. However they would benefit from wider range of activities outside of the home. Evidence: The home no longer employs an activity co-ordinator, and information we received before the visit suggested that there were no activities being provided. We told the owner about this and he said he would take action to resolve the situation. During this visit people told us that the arrangements had improved a lot and there was now a good activity programme, which is run by the staff team in general. People told us they liked things like the exercise classes, and taking communion, and we saw that some people were able to independently use local social facilities like bingo halls. However information from surveys that we received before we visited suggested that in general people do not get the opportunity to go out very often. Again the owner said that he would look into this issue. The timetable for March 2009 was displayed around the home so that everyone could see what was on offer. The programme contained things like chair aerobics, slide shows, Easter bonnet decorating, church services, and musical afternoons. There was also an Easter raffle display in the reception area. Care Homes for Older People Page 15 of 27 Evidence: People have their own activity records now. The records show what activity the person has enjoyed doing, and what their social likes and dislikes are. People told us that they are able to make choices about what they do with their day, and how they are looked after. For example whether or not they join in with activities, what and where they want to eat, where they spend their time, and what time they get up. We saw that staff encouraged people to make their own choices and decisions. Visitors were welcomed into the home throughout the visit, and people told us that they could have visitors whenever they wanted. Flexible three weekly menus are available, and they show that a good range of foods are available. People told us that they choose what they want from the menu, but they can change their minds at meal times if they want. They also said that they can choose things that are not on the menu. We saw that when they did this during the visit their choices were met, and records showed us that this is usually what happens. People told us that the food is very good, and it is presented nicely on the plate. Some people told us that they would like more variety of vegetables, and the owner said that he would look at this issue. The owner also said that he will talk to the local Environmental Health Officer about the arrangements for taking food from the main kitchen to another building where people live, to make sure that the current arrangements are satisfactory. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Clear systems and knowledgeable staff continue to protect residents. Evidence: The complaints policy is available in the service user guide and is also displayed in the reception area of the home. People told us that they know how to make a complaint, and who to speak to if they are not happy with anything. They said that staff help them to sort things out quickly. Records show us that three complaints have been received since the last inspection, and they have all been managed in the right way see also (Standards 27 to 30). There is also a book kept in the reception area that contains visitors comments about the home. We saw that there are some very nice comments about the good standards of care for people. Staff were able to tell us the right things to do if they saw or suspected abuse, and people said that they feel safe living at the home. We saw that there are policies about keeping people safe, including one that protects staff if they need to speak out about an issue, but the copy of the Local Authority guidelines was not an up to date one. We know that the service provider has made one alert to the Local Authority Safeguarding Adults team since the last inspection, and this was managed in the right way. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is comfortable and well maintained, and suits peoples needs. Evidence: We saw that the home was clean and tidy on the day of the visit, and people who live there told us that this is always the case. They, and some relatives, also told us that since the last inspection the dinning room has been moved so that a second sitting room could be available. They said that they thought this was a good idea and liked the arrangement. They also said that there was a homely feel about the place. All of the communal areas and private bedrooms are comfortably furnished, and we saw an on going decorating plan for peoples bedrooms. People showed us that they are able to personalise their rooms as they wish. Staff talked to us about the maintenance arrangements and showed us records for the jobs that are reported and carried out. Since the last inspection the owner has told us when there have been any problems with maintenance issues, and how they have been managed to make sure that people who live there have not been effected. We saw that the home does things to help control the spread of infections. Staff were using gloves and aprons whenever they needed to, and following hand washing procedures. There are dispensers for hand disinfectant around the home and we saw Care Homes for Older People Page 18 of 27 Evidence: staff and visitors using them appropriately. There is a notice about infection control next to each dispenser, but there are no risk assessments in place about their use. Substances that can be harmful to people were stored in a locked cupboard. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by safely recruited, and well trained staff, who are available in sufficient numbers to meet their needs. Evidence: At the last inspection we suggested that staffing levels were monitored closely as some people told us that on occasion staff were very busy. Since the last inspection we also received a complaint about staffing levels not being adequate. At the time of the complaint the owner told us that there were issues with things like sickness levels but agency staff were being used to cover shortages. During this inspection people told us that there are now enough staff on duty to meet their needs, and staff told us that they now have time to support people with social activities as well. Rotas show that where there are absences, they continue to use agency staff to cover, however this is not very often. We saw that call bells were being answered in a timely manner, and people were being given support at the times that they asked for it. People who live at the home, visitors, and other health professionals told us that staff are friendly and welcoming, and know how to do their jobs well. We looked at the staff recruitment and training files. The files contained all of the information to show that staff had been recruited in a safe way, such as criminal record bureau checks, identification, and written references. Staff described a Care Homes for Older People Page 20 of 27 Evidence: thorough recruitment process and said that their induction training had helped them to feel confident to do the job. Records show that induction training includes things like how to promote privacy and dignity, the homes procedures, and peoples care needs. Staff also told us that there is a very good training programme, and records show us that they have had training in subjects like infection control, keeping people safe, managing behaviours, fire safety, and new laws about how people make decisions. Some staff have also had training about dementia care. The acting manager has told us that she is currently carrying out a review of the training arrangements so that she can make sure that everyone has the right training. We also saw that although staff meetings had not been taking place, the acting manager has now made arrangements to hold them on a regular basis. 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 home is generally well managed and there are systems in place to help keep people safe. However improvements to the quality assurance system would ensure that people have more say in how the service runs. Evidence: Since the last inspection, the registered manager has left and an acting manager has been recruited. People who live at the home, and their relatives have been informed of this in writing, and there is a clear notice about the same in the reception area. We have sent a new registration certificate to the home to reflect this. The acting manager is a registered nurse who has worked at the home for approximately two years so she is familiar to people who live there, the staff team, and visitors. She has told us that she is in the process of completing her application to register with us. Staff told us that the communication systems in the home work very well, and they get enough information to help them do their jobs well. We are kept informed of Care Homes for Older People Page 22 of 27 Evidence: anything that happens in the home that may effect peoples care, by the acting manager and the owner. Staff said that they are well supported by the acting manager, and they feel able to express their views to both her and the owner. The owner visits the home on a daily basis and showed us that he is aware of what is happening in the home and what needs attention. We also saw people who live there, staff, and visitors are able to speak to him whenever they wish to. However he does not keep records to show how he monitors the quality of the service provided, and what actions he takes to improve the service. The acting manager told us that she has developed new audit tools for things like meal satisfaction, and recruitment processes, and a general satisfaction survey was carried in 2008 with people who live at the home. Staff told us that although there have not been regular meetings for people who live in the home, the acting manager has now arranged for this to happen, and we saw that a date has been set for the very near future. We spoke to the acting manager and the owner about developing more audit and survey tools so that they can better monitor the quality of service that people receive. For example, we saw that where the home supports people with their personal money, there are clear records showing what is received and what is spent for each person, and the money is kept in a secure place. However there is no formal system to monitor that procedures are consistently followed. Supervision records show that formal sessions are carried out but not in a regular way. The acting manager told us that she has now set out a regular supervision programme, and those staff who supervise others are booked to attend training about how to carry out the role effectively. Staff said that they get lots of support from the acting manager and senior staff, and they can get help and advice whenever they need it. Risk assessments are in place for subjects such as fire safety, food hygiene, substances that could be harmful to people, and moving and handling. There are also information sheets available about substances that could be harmful to people so that staff know how to use them safely.Up to date maintenance records were seen, as well as records for regular safety checks on things like hot water temperatures, and fire safety equipment. 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 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 It is recommended that care plans contain information about the Mental Capacity Act 2005, and the effects it has upon peoples lives. This is to make sure that their rights and choices are protected. It is recommended that arrangements for the administration of medication taken only where necessary are incorporated into the care planning process. This is so that this medication is given consistently. It is recommended that a regular audit of medication records be carried out. This is to ensure that medication given to people is consistently signed for by the member of staff administering it. It is recommended that the activity programme is reviewed with people who live at the home in regard to including trips out of the home. This is to make sure that the activities provided reflect their wishes. It is recommended that the home has an up to date copy of the Local Authority safeguarding adults guidelines. This is to ensure that people know about the correct procedures for reporting abuse. It is recommended that risk assessments be carried out for Page 25 of 27 2 9 3 9 4 12 5 18 6 26 Care Homes for Older People the placement of for hand sanitisers around the home. This is to make sure that peoples health and safety needs are monitored and protected. 7 33 It is recommended that the service provider keeps a formal record of at least one monthly monitoring visit to the service, in accordance with Regulation 26 of The Care Homes Regulations, 2001. This is so that the service provider can demonstrate how they monitor the quality of the service provided, and what actions are taken to improve the service. It is recommended that there be more quality monitoring arrangements in place, for example care plan audits, audits of personal money kept by the home, and satisfaction surveys for relatives and visiting professionals. This is so that the quality of the service provided can be monitored more closely, and people can have more say in how the service is run. It is recommended that staff have access to regular supervision, at least six times per year. This is so that staff are adequately supported to do their job. 8 33 9 36 Care Homes for Older People Page 26 of 27 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. 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