Enter and View Report

Roshini Care Home 25-26 Villiers Road, Southall, UB1 3BS.

Healthwatch Ealing

5th November 2018

Service visited: Roshini Care Home

Address: 25-26 Villiers Road, Southall, UB1 3BS.

Care Home Manager: Beemlah Ramjeeawon

Date and time of visit: Monday 5th November 2018 11.30am – 1.30pm

Status of visit: Announced

Enter and View Authorised

Representatives:

Imojen Jean, Francis Ogbe

Lead Authorised

Representative:

Imojen Jean

Healthwatch Ealing contact

details:

Healthwatch Ealing, 45 St Mary’s Road, W5 5RG

Tel: 020 3886 0830

Email: info@healthwatchealing.org.uk

Healthwatch Ealing has the power to Enter and View services in the borough of Ealing. Enter and

View visits are conducted by teams of trained Enter and View Authorised Representatives.

Background to the visit

The Health and Social Care Act allows Healthwatch Ealing (HWE) Enter and View Authorised

Representatives to observe service delivery and speak to patients, residents, staff, relatives,

friends and carers. The visit can happen if people tell us there are concerns, but equally, the visits

can take place when services have a good reputation. We can therefore learn from shared

5th November 2018

Healthwatch Ealing

Enter and View Report

Roshini Care Home

25-26 Villiers Road, Southall UB1 3BS

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Service visited: Roshini Care Home

Address: 25-26 Villiers Road, Southall, UB1 3BS.

Care Home Manager: Beemlah Ramjeeawon

Date and time of visit: Monday 5th November 2018 11.30am – 1.30pm

Status of visit: Announced

Enter and View Authorised

Representatives:

Imojen Jean, Francis Ogbe

Lead Authorised

Representative:

Imojen Jean

Healthwatch Ealing contact

details:

Healthwatch Ealing, 45 St Mary’s Road, W5 5RG

Tel: 020 3886 0830

Email: info@healthwatchealing.org.uk

Healthwatch Ealing has the power to Enter and View services in the borough of Ealing. Enter and

View visits are conducted by teams of trained Enter and View Authorised Representatives.

Background to the visit

The Health and Social Care Act allows Healthwatch Ealing (HWE) Enter and View Authorised

Representatives to observe service delivery and speak to patients, residents, staff, relatives,

friends and carers. The visit can happen if people tell us there are concerns, but equally, the visits

can take place when services have a good reputation. We can therefore learn from shared

examples of what they are doing well from the perspective of the people who experience the

service first hand.

Enter and View visits are not intended to specifically identify safeguarding issues. However, if

safeguarding concerns arise during a visit, they are reported in accordance with the HWE

Safeguarding Policy. If at any time an Authorised Representative observes a potential

safeguarding concern, they will inform their lead. The lead Authorised Representative will then end

the visit. In addition, if any member of staff wishes to raise a safeguarding issue about their

employer, they will be directed to the Care Quality Commission (CQC) and Ealing Council’s

Safeguarding Team.

On this occasion, two Enter and View Authorised Representatives attended the visit. The

Authorised Representatives spoke to residents and staff. Suggestions have been made on how to

improve the service and good practice has been highlighted.

HWE liaises with the CQC, Clinical Commissioning Group (CCG) and the Local Authority (LA) to

create an Enter and View Programme, as well as the information that it collects about the

experiences of local people. A number of health and social care providers are selected to be

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visited to provide a sample of different services. We did not have a reason for selecting Roshini

Care Home for a visit.

Acknowledgements

We would like to thank Beemlah Ramjeeawon (Care Home Manager), the residents and staff at

Roshini Care Home for making us welcome, facilitating our visit and for taking the time to talk to us

on the day. We would also like to thank Healthwatch Ealing Enter and View Authorised

Representative Francis Ogbe for his contribution.

Methodology

This was an announced Enter and View visit. Healthwatch Ealing approached the manager at

Roshini Care Home before the visit to find out more about the home and any factors we should be

aware of. During the visit, Authorised Representatives spoke to three residents, the Manager,

Deputy Manager, a member of care staff and the chef.

The Enter and View Team used a checklist to collect their observations of the home, which was

based on Healthwatch England’s eight indicators of a good care home1;

1. Have strong, visible management

2. Have staff with time and skills to do their jobs

3. Have good knowledge of each resident and how their needs may be changing

4. Offer a varied programme of activities

5. Offer quality, choice and flexibility around food and mealtimes

6. Ensure residents can see health professionals such as GPs and dentists regularly

7. Accommodate residents’ personal, cultural and lifestyle needs

8. Be an open environment where feedback is actively sought and used

Information about Roshini Care Home

Roshini Care Home is an 11-bed home offering residential care to adults with mental health

conditions. The home is found on a residential street - the ground floor contains a kitchen, office,

restrooms with a walk-in showers, and a dining room, as well four residential rooms and a large

communal area which opens into the garden.

There is a lift that can be used to access the first floor which has six bedrooms, as well as a staff

room and a bath and shower facility. The second-floor sports an office, conference room and a

toilet.

1 ‘What’s it like to live in a Care Home’ Healthwatch England (2017)

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There is an outhouse at the back of the garden with a kitchen, lounge area, toilet and two rooms,

one of which is an en-suite. There is also a laundry room and storage space. Residents who were

deemed fit, were able to reside in the outhouse, offering more independence. Authorised

Representatives were informed that the most recent outhouse resident was able to reach a level of

independence allowing her to leave the home.

First Impressions

Authorised Representatives were welcomed at the door by the deputy manager and asked to sign

in. We were given a tour of the home and shown three emergency exits. The interior and exterior

of the home was clean, well lit, spacious and warm. The overall feel of the home was quite homely

with pictures of flowers and other decorations added throughout.

The communal area was an open space on the ground floor with a lounge area, a dining area and

a table where activities took place. Although there was no specific quiet area, there was a lounge

area in the building at the back of the garden, which residents could utilise if they wished. The

garden was adequately sized and could be easily accessed by residents. The rooms viewed were

all clean and tidy.

HEALTHWATCH ENGLAND QUALITY INDICATORS

1. Strong, visible management

Authorised Representatives were able to speak with the manager and the deputy manager at

Roshini Care Home. They informed us that they both started out as carers and had been with the

home for 12 years. This meant that they knew the roles of the staff well, any challenges that staff

faced and had created a culture that allowed staff to advance their careers. Furthermore, their

years of experience within Roshini Care Home gave them a very comprehensive understanding of

how the home is run from all perspectives. Authorised Representatives were given the

impressions that the management and staff were a close-knit team with good communication.

We met with the owner who stated that he had confidence in the managers and is doing a level 5

certificate in Care to understand more of the workings of care homes since his background was in

childcare. There are two senior support workers at the home that do day shifts and three that do

night shifts.

There are weekly checks carried out for electrical installations, health and safety and medication.

The resident’s medications are stored by the management who told us that they keep the records

up to date and make sure all medications are ordered on time. We were told that the manager or

the deputy manager oversee the administration of all medicines. There is a folder with detailed

medication information for each resident. Medications are kept locked in the office with 28 days’

worth of prescriptions stored at a time. Staff consistently check if anything within the home needs

fixing or improving. For example, there was a recent problem with a resident’s wardrobe that was

considered a hazard which was raised and fixed immediately.

The manager and deputy manager conduct interviews and inductions and newly trained staff are

employed on a trial basis. The manager told us that she had a good relationship with the staff, this

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was corroborated by the staff we spoke to on the day. A staff member told us, “If I have any issues

I can speak to the manager” and “the manager and staff are all really good and work as a team. I

would recommend working here. I have learnt a lot.” We were also told by a resident that the

manager did their clothes shopping for them and that she was good at choosing things that they

liked. They were very happy with the relationship they had with the manager and told us that she

was always friendly.

2. Staff have the time and skills to do their jobs

Currently, there are ten members of staff at the home. There are two members of staff and either

the manager or deputy manager on duty during day shifts. During the night shift there is one

member of waking staff on duty and another member of staff on call. We were informed that there

are four different shifts available for staff: 8am – 2pm, 8am – 9pm, 2pm – 9pm.

The night shift is then 9pm – 8am. Shifts overlap in the day allowing for a smooth handover

process. The handover book is updated at every shift, but information is also passed on verbally.

The chef at the home told us that his daily shift is usually 10am – 2pm, leaving when residents

have finished their lunch. Management described the shifts as a “24-hour service”.

We were told that all staff do mandatory training such as health and safety and adult safeguarding.

There is also various in-house training offered with a specific focus on mental illness care. Staff

told us that they held NVQ certificates in Care and had had training in mental awareness,

schizophrenia, dietary needs like diabetes, dementia, end of life care and first aid. Training is done

through long distance courses and some video training is also offered.

When new staff are employed at the home, the management explained that the induction process

begins with the staff member being shown how the home operates. They then meet the residents

and have a chance to familiarise themselves with resident’s care plans. Staff told us that the

inductions last about 4-5 hours. After the induction, staff start a shadowing period which lasts until

they feel confident and can show they are capable of working alone. Staff told us that there had

been some staff hired after doing work experience at the home as students. Since the students

worked well and residents liked them, they were hired.

We were informed that no agency staff was needed since the home has stable staffing numbers.

Numbers were also contributed to by the work experience students they often have at the home

doing NVQ level 2 or 3 in Care. In the last two years the deputy manager stated that they have

only needed cover for 2 days. Staff told us that they felt that the level of staff was appropriate for

the needs of the care home.

A staff member told us: “I feel supported and they always look out for me. The manager and staff

are all really good and work as a team. I would recommend working here, I have learnt a lot. They

teach you step by step and give you an appropriate workload. I am happy I work here.”

Residents told us that they felt supported and that they got on well with the staff. One resident told

us, “I love it. They have been good to me; my key worker is an angel... They are like family. They

can always have a laugh with you. They are so friendly and are there for me.”

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3. Staff have a good knowledge of each resident and how their needs may be changing

Management told us that care plans are well detailed in order for staff to have a comprehensive

understanding of resident’s medical histories, cultural backgrounds and lifestyles. Staff told us that

they found handovers to be good and information such as any appointments, laundry and

shopping needs are all given verbally. All residents have folders with their information and needs

recorded. A resident told us that they always take my medication on time. One resident who had

mobility problems had been given a room on the ground floor to accommodate them. Staff told us

that residents were asked throughout the day if they are ok and that they approach residents

whose behaviour is not normal for them. If a resident looks down staff will ask how they are doing.

A resident corroborated this, telling Authorised Representatives that staff always spoke with them

on days when they weren’t feeling good and consistently checked on how they were feeling.

Residents may be helped to wash if needed or encouraged to wash if they avoid it. An Authorised

Representative witnessed a resident being encouraged to shower by a staff member explaining

that it was needed because of a health condition. Staff members will therefore intervene if

residents are not taking appropriate care of themselves.

During the visit, one of the residents informed us that they had been subjected to abuse at their

previous place of residence. 2

4. The home offers a varied programme of activities

The daily activities are run by one of the members of staff and while

we were there the residents were playing bingo. There is an activity

every day from 11-11.30 pm and all residents are asked to join at first

but can choose to leave. Activities included bingo, book clubs, card

games, discussing the news, colouring and puzzles. One Authorised

Representative was told by staff that residents are sometimes

allowed to lead the activity sessions and witnessed this happening

with the bingo. Residents we spoke with mentioned that they enjoyed

the variety of activities available at the home and seemed well aware

for what was on offer. Residents are also free to use the colouring,

games and puzzles throughout the day. There are some incentives

for residents to join in with activities such as there being a £1 winning

for bingo and competitions for painting that carry prizes for the winner

and two runners up.

Residents are free to venture outside the home with supervision, unless they are deemed able to

go alone. This might include visits to shops or the local park. There are BBQs held in the garden in

the Summer and residents can visit the manicurist or hairdressers on Saturdays. There are trips to

the seaside in Summer, although there had been no trip in 2018. Management explained that this

2 Healthwatch Authorised Representatives have reported this safeguarding issue to the appropriate authorities in Croydon,

where the previous place of residence is located.

Figure SEQ Figure \* ARABIC 1- Pottery display made by residents

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was because the company who organises the trips had no available trips to the seaside

destinations that the residents requested.

Authorised Representatives were able to view photos of various outings, like a trip last winter to

see the Christmas lights in Central London and residents enjoying fish and chips at the seaside.

We also saw photos and videos of residents playing musical instruments, celebrating birthdays

and attending a New Year’s dinner at a restaurant. Residents looked like they were enjoying

themselves and had dressed up for the dinner. Religious and cultural celebrations like Diwali,

Christmas and Easter are also celebrated at the home.

5. The home offers quality, choice and flexibility around food and mealtimes

We were able to speak with the chef at the home, who comes in every weekday to make lunch for

the residents. All lunch meals are freshly made from scratch on the day. The residents have their

breakfast and dinner made for them by a member of staff or can do it themselves with the staff’s

help. All meals on the weekend are made by staff.

We found that the meals were not set in a rigid schedule. We were informed that residents are

offered a choice of 3-4 dishes the day before or in the morning when the chef arrived. Residents

can then make suggestions of what they will prefer to eat on the day. The chef is happy to make

different food if a resident requests it. The chef makes dishes to meet the varied culinary and

dietary needs of the residents. We were told that there is always a vegetarian option as some

residents do not eat beef or pork and diabetic needs are considered when making deserts. Certain

diabetic residents may have smaller portions and sweetener is used instead of sugar.

The residents that Authorised Representatives spoke to said they liked the meals and that they

were happy with the variety of options. Residents told us that they felt that they were free to

choose what food they wanted. Food shopping lists are made for residents so that staff can buy

what they prefer. Residents are encouraged to have their meals at the dining table together but

can eat where they want apart from in their rooms. For example, one resident preferred to eat in

the garden.

There was a list of example meals on offer at the home with pictorials. The photos used were

actual meals that the chef had cooked previously. Authorised Representatives thought that this

was a great resource that would be a fantastic addition to other homes in the borough.

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Figure 2 - Starter Examples

Figure 3- Main Menu Examples

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6. Residents can see health professionals such as GPs and dentists regularly

All residents at Roshini Care Home are registered at the same GP practice. Residents have

annual check-ups and can request appointments when needed. There are annual dentist check-

ups or every six months for some residents with dental problems. Optician check-ups are also

yearly or when needed. Staff make appointments for residents and will accompany residents if

they need help. There is a book of appointments that staff check each morning. A resident we

spoke with told us that they see a physiotherapist and are accompanied by staff who also assist

them with the exercises. A number of residents told us that they are taken to doctors, opticians

and hospital appointments whenever they need to go.

7. Residents’ personal, cultural and lifestyle needs are accommodated

The manager stated that resident’s religious, personal and cultural lifestyles were catered for. A

resident we spoke to told us that they were religious and that the home respected their right to

practice. We were told that various religious holidays were celebrated such as Diwali and Easter.

The residents we spoke with told us that they are able to furnish their rooms with their belongings

and decorate how they please. Authorised Representatives were invited to see a resident’s room

who had hung paintings they had painted and displayed large puzzles they had completed. We

saw that residents were free to display their religious symbols and statues.

In general, residents seemed to have a lot of freedom within the home where appropriate.

Residents told us that they can choose what clothes they want to wear and what they want to buy.

Staff told us that residents can get up in the morning when they wish but are usually checked on at

8am and encouraged to get up for breakfast or if they need to take medication. Residents who

have been assessed to be capable are allowed to go out as they please. Some of the residents we

spoke with told us that they go out regularly and some may spend a few days with family. A

resident who needed support told us that they go out when they want. Staff will accompany them,

book a cab for travel and will often do shopping for them on their behalf if asked. There is a daily

allowance given to residents if they want to shop, staff told us there is no specific curfew but that

residents usually return before 6pm. A resident told us, “I like to cook my meals once a week and

shop in Lidls and Iceland.”

Staff told us that they motivate residents to do things by themselves and support them where

needed. Residents are encouraged to do tasks like helping to set-up and clean the tables at lunch

time. A resident confirmed that a different resident does this each day. This is done to help

residents feel more involved and independent. The chef informed us that previously there was a

resident who helped in meal preparations before leaving the home to live independently.

Residents are helped when doing their laundry which we witnessed during the visit.

Residents can host visitors either in their rooms or in the lounge. Visiting times are 8am - 8pm but

visitors are discouraged at mealtimes. Residents commonly also go to visit their family and friends.

A resident who had had a recent bereavement stated that the home had helped them as much as

possible during this period and had offered to take them to visit the place of rest of a relative. All

residents at the home consented to their care. We were informed that residents who had left the

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home still came to visit occasionally which attested to the level of care and the satisfaction of

residents.

8. There is an open environment where feedback is actively sought and used

The manager has an open-door policy for staff, residents and relatives who are welcome to

approach any of the senior staff. There is a survey sent out yearly for relatives and residents and a

resident’s meetings three times a year. There was a complaint form available in the corridor so

that residents or visitors could submit anonymous feedback. We were told that there is a

comprehensive complaints procedure at the home and when a complaint is made, the senior staff

on duty try to deal with it immediately, if this isn’t possible, the management are informed, and

they handle it accordingly. We were told that if the complaint raised is a safeguarding issue, the

safeguarding procedure is conducted, and the necessary authorities are informed.

During the daily activity session residents all come together and are welcome to share any

feedback during this time. Residents told us that they were comfortable to approach management

with any issues or feedback. Authorised Representatives also witnessed staff asking residents

whether they liked to food during lunch.

Conclusion

Healthwatch Ealing was given a good impression of Roshini Care Home, it came across as strong

on all Healthwatch indicators of a good care home. There seemed to be a particular focus on the

quality of life of residents which was refreshing and created a culture where residents seemed

comfortable and content. The staff member we spoke with was appropriately trained and was

happy with all aspects of their role and the support they received.

Recommendations:

1. Authorised Representatives found that residents were happy with the activities and outings

that were offered. During the visit, management showed us their activity files, which

included timetables and pictures of residents partaking in past activities. The home might

consider displaying this material in the form of an activities board.

2. A safeguarding concern was raised by a resident to an Authorised Representative. It was

not about Roshini Care Home but a previous place of residence. Management may want to

revise their responsibilities around safeguarding where incidences have taken place in

other settings.

In reference to the safeguarding concern, management stated that they believe the incident should

be excluded from the report as it did not occur under the home’s care.

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Provider response

Although the Care profession is full of controversy, it has not stopped me (Kelly Marashi,

Manager) from entering it recently.

Clearly the valuable, time and attention we had from Healthwatch Ealing can only assist us in not

only progressing towards a higher level of quality in care but also makes our job easier.

I have been an advocate for professionals in every field working together for the benefit of our

service users.

Our doors will always be opened for such programs where we will be happy to participate in any

ongoing of future supportive work you may present whenever possible.

Next Steps

This report has been shared with the management at Roshini Care Home who have had the

opportunity to comment on our findings. The report will be published on the Healthwatch Ealing

website https://healthwatchealing.org.uk/what-we-do/our-reports/ and will be circulated to the

provider and the commissioners of care home services in Ealing.

This report is based on our observations and the views of residents, staff and relatives that

Healthwatch Ealing spoke to on the day of our visit, and we appreciate it does not necessarily

represent the views of all the relatives and staff members at Roshini Care Home.

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Appendix I

Healthwatch Ealing Enter and View Checklist

Based on the Healthwatch 8 Quality Indicators for Care Homes

Date of visit

Authorised Representatives

1. Home details

Name

Address

Website

Registered number of residents

CQC Regulated activities at the home

Last CQC inspection

Actual number of residents on the day of the visit

Split between LA/NHS funded and self-funded residents

Other notes

2. First impressions

How was the reception process?

Does the home feel welcoming?

How is the environment e.g. temperature, ventilation, odours?

Do communal areas offer a chance for

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residents to socialise as well as having quiet time?

How easily can residents move about the home?

Residents rooms – do they have to share, can they bring their own possessions?

Is there an outside space where residents and relatives can go when they want to?

Other notes

3. Healthwatch England Quality Indicators

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a. Strong, visible management (Management)

The manager should be visible within the care home, provide good leadership to staff and have

the right experience for the job.

How long has the manager been at the home?

What is their background?

What other senior staff are there at the home?

How do the management team ensure good teamwork and communication amongst the staff team?

How does the management team deal with any staffing issues at the home?

How does the management team communicate with residents and relatives?

Other notes

b. Staff have time and skills to do their jobs (Staff)

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Staff should be well-trained, motivated and feel they have the resources to do their job.

What is the breakdown of staff at the home?

What induction do staff receive?

What training do staff receive?

What support do staff receive?

What is the turnover of staff?

How do staff communicate and handover between shifts?

Other notes

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c. Staff have good knowledge of each resident and how their needs may be changing

(Staff)

Staff should be familiar with residents’ histories and preferences and have processes in place for

how to monitor any changes in health and wellbeing.

How do staff find out about a resident’s history, likes and dislikes?

Are residents able to make choices about their daily routines/are their routines based on a knowledge of their likes and dislikes?

How do staff know about the needs and preferences of residents who cannot communicate verbally?

How do staff communicate about residents’ needs and preferences and any changes they observe?

Other notes

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d. The home offers a varied programme of activities (Residents and Staff)

Care homes should provide a wide range of activities (and ensure residents can access these)

both in the home and outside the home.

Is there a programme of activities?

If yes, how is the programme put together? How are residents’ needs and likes included in the programme?

Are residents offered physical activities?

Do residents regularly use any local facilities, such as parks, pubs and cafes, shops etc.?

How are residents told about what activities are on offer?

How are residents encouraged to take part in activities?

Are residents encouraged to do as many things for themselves as they can?

How do staff assess if activities are successful and if residents have enjoyed them?

Other notes

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e. The home offers quality, choice and flexibility around food and mealtimes (Residents

and Staff)

Homes should offer a good range of choices and adequate support to help residents who may

struggle to eat and drink. The social nature of eating should be reflected in how homes organise

their dining rooms, and accommodate different preferences.

Do residents have a choice of food and drink?

How does the home meet different dietary needs?

How often is the menu changed?

Can residents choose where to eat their meals?

Can residents prepare their own drinks or snacks?

What help is offered to residents who need support at mealtimes?

Other notes

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f. Residents can see health professionals such as GPs and dentists regularly (Residents

and Staff)

Residents should be able to see a health professional promptly, just as they would when living in

their own home.

Does each resident have a named GP?

What happens if a resident needs to see a dentist?

What happens if a resident needs to see an optician?

What happens if a resident needs to see an audiologist or needs a hearing aid adjustment?

What arrangements are in place to ensure that residents receive the correct medicines?

Other notes

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g. Residents' personal, cultural and lifestyle needs are accommodated (Residents, visitors

and staff)

Care homes should be set up to meet residents’ cultural, religious and lifestyle needs, as well as

their care needs, and shouldn’t make residents feel uncomfortable if they are different or do things

differently from other residents.

Can residents choose when they get up and when they go to bed?

Do residents chose what they are going to wear?

Is there any restriction on when visitors can come in and how many there are?

Where do residents meet their visitors?

Are children welcome?

How are residents’ religious and cultural needs met?

What happens if residents do not speak English? Are there members of staff who can speak different languages?

Other notes

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h. There is an open environment where feedback is actively sought and used (Residents,

visitors and staff)

There should be mechanisms in place for residents and relatives to influence what

happens in the home, such as a Residents and Relatives Committee. The process for making

comments or complaints should be clear and feedback should be welcomed and acted on.

Is information about how to make a complaint easily available?

Are residents and relatives encouraged to give feedback?

Is there are residents/relatives committee?

Are residents and relatives provided with information about the home?

Are residents and relatives provided with information about external inspections and audits and copies of any reports?

Other notes

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Appendix II

Questions for Management Name of Home:

Date and time of visit:

Name of Staff Member:

Position:

Staff Member Since:

Audits and checks Do they carry out their own checks and audits? (E.g. care records, nutrition, medicine management etc.) Were there any recent concerns/improvements to the service through these checks and audits? How are concerns/improvements made aware to staff?

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Views collected How are residents’/visitors views collected about the service? (E.g. satisfaction surveys, resident and relative meetings etc.) If views are collected, how is the feedback circulated to relatives/residents?

Relationship with staff As management do you have a good rapport/relationship with staff/relatives/residents? How have you come to establish a good rapport/relationship staff/relatives/residents? (E.g. regular meetings, social gatherings etc.)

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Complaints procedure What is the complaints procedure? Are ALL complaints recorded and investigated?

Activities Are social activities initiated by staff? (E.g. do staff ask or encourage people what they want to do during their leisure time?) If yes, how? How do you find out about your residents’ history, likes and dislikes and how does this information inform your planning? How do you plan activities for the week/month ahead? Is there a planned programme of activities? What do you do to encourage your residents to engage in activities? How do you provide stimulation to those residents who often say ‘no’ to most activity suggestions? How do you overcome barriers such as physical access e.g. confined to their room?

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How do you know if your residents enjoy the activities on offer? Give an example of an activity that worked well/didn’t work well and what you did about it?

Activity Coordinators How many activity coordinators are employed? What are their duties? Question for activity coordinator What are your duties?

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Meals Are residents’ religious and cultural needs and preferences taken into consideration? (E.g. Access to food, religious places etc.)

Training What kind of training is provided for staff? (E.g. is it a mix of training – online, shadowing, classroom) How long do newly recruits shadow staff members for?

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Resident’s care Do residents consent to the type of treatment and care they receive?

Recruitment What is the recruitment process? Do you use any agency staff?

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Time management Do you think there are enough staff members on each floor to support all the residents? Is there enough time to dress, wash, feed and help all the residents?

How do you ensure residents are well-hydrated throughout the day? Is there a protected drinks time? Are foods with high fluid content considered when developing the daily menu? How are staff made aware of residents’ preferred drink choices? Is there a drinks menu available? For residents who are confined to their rooms, are special measures taken to ensure they remain hydrated e.g. more offers of drinks?