CARE HOMES FOR OLDER PEOPLE
Batchfoot Country House 181 Church Street Upwey Weymouth Dorset, DT3 5QE Lead Inspector
Mike Dixon Unannounced 8 September 2005 10:30
th 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 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Batchfoot Country House D55 S26763 Batchfoot Country House V248218 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Batchfoot Country House Address 181 Church Street, Upwey, Weymouth, Dorset, DT3 5QE Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01305 812143 01305 812143 Mrs M Taylor Mrs J Johnson CRH PC - Care Home Only 16 Category(ies) of OP Old age (16) registration, with number of places Batchfoot Country House D55 S26763 Batchfoot Country House V248218 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 9th March 2005 Brief Description of the Service: Batchfoot Country House residential home is established in a large detached Georgian listed building set in its own grounds and mature gardens. It is situated in the village of Upwey, half way between the seaside town of Weymouth and County town of Dorchester. The home is close to the local church, wishing well and other village amenities.The home is registered to accommodate a maximum of 16 service users in the category of old age, not falling within any other category.Mr & Mrs Taylor and Mr & Mrs Cake have been the registered owners of the home since 1985 and Mrs Jacqueline Johnson became the registered manager in March 2002: Mrs Margaret Taylor plays an active role in the management of the home.The service users accommodation is arranged over three floors, with three bedrooms at ground floor level, six at first floor level and four bedrooms on the second floor. For service users with limited mobility there is a stair lift fitted to the back staircase, which accesses the first and second floors.There is a large communal lounge and separate dining room on the ground floor. At basement level there is a storage area, office, laundry room and a staff toilet/shower room.A driveway leads to the home and a car parking area is available to the side of the house. The home is set in its own grounds with large landscaped front and side gardens which boast mature trees and shrubs and is abundant with wildlife, deer, foxes, badgers, squirrels and birds. Batchfoot Country House D55 S26763 Batchfoot Country House V248218 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted by the Commission as part of its regulatory duty to inspect all care homes twice a year. The purpose was to assess the home’s compliance with some of the key national minimum standards for older persons and to review the requirements and recommendations from the previous inspection report. The inspection took seven hours during which time the inspector spoke with five service users, two staff members, the manager and the registered provider. He visited all communal areas and a sample of bedrooms. He looked at the laundry room, medication storage room and a variety of records and documentation relating to the running of the home. Following the visit the inspector received comment cards from three service users, six relatives/representatives, three health care and one social care professionals; no matters of serious concern were raised in these cards. Further comment on responses received appears in the main body of the report. What the service does well:
The home provides useful information about the facilities and services offered to prospective service users. The manager conducts comprehensive preadmission assessments. New service users are assisted to settle at the home in the weeks following admission. For the most part staff have a very good understanding of service users’ care needs and there is an effective system of reviewing service users’ needs on a daily basis. “I’m very well looked after….the staff is marvellous”; “the staff are pretty good on the whole”; “they are lovely girls” are comments received by the inspector which reflect the views expressed by several service users. Staff members monitor the health care needs of service users who receive visits from doctors and community nurses when necessary. Service users are encouraged to retain control over their lives and to remain as independent as feasible. One service user told the inspector: “its like home”. Visitors are made welcome and the home encourages service users to retain links with the local community. There is a comprehensive complaints procedure and staff are made aware of adult protection procedures to safeguard service users from abuse.
Batchfoot Country House D55 S26763 Batchfoot Country House V248218 Stage 4.doc Version 1.40 Page 6 The premises are generally well maintained, equipped and clean and entirely free of un-pleasant odours. The rooms and areas that are accessed by service users provide a pleasant and comfortable environment. Bedrooms have sufficient light, they are well ventilated and stay warm in cold weather. Service users are happy with the laundry provision. Staffing levels and arrangements are very good; staff members are well supported and supervised. There is an open style of management at the home which enables service users and staff members alike to participate in decisionmaking. The management adopts a proactive approach towards health and safety and most of the necessary measures are in place. What has improved since the last inspection? What they could do better:
Care plans must be updated to reflect the current circumstances of service users and a care plan must be drawn up following a service users admission as soon as practicable. Evidence of consultation with service users regarding the content of the care plan must be held on record. An accurate record of the administration of controlled medication must be kept at all times. When staff handwrite details of prescribed medicines on to the MAR chart a second competent person should check and countersign to confirm that all the details are correct. A note recording nil known should be included on the MAR chart for service users receiving medication who do not have a known allergy. The risk assessment for the service user who currently self-medicates should be updated to take account of the situation regarding storage arrangements.
Batchfoot Country House D55 S26763 Batchfoot Country House V248218 Stage 4.doc Version 1.40 Page 7 Safety precautions must be undertaken in all instances where identified by risk assessment with regard to service users vulnerability to the hot surface temperature of radiators. All staff must receive training in first aid. The manager should carry out a session with the staff member who has not undergone POVA training, familiarising her with the homes policies/procedures and No Secrets guidance. A programme of fitting approved door locks to service users bedrooms should be commenced. Commode pots should be dried and not left to dry on shelves in the laundry room. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Batchfoot Country House D55 S26763 Batchfoot Country House V248218 Stage 4.doc Version 1.40 Page 8 DETAILS OF INSPECTOR 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) Scoring of Standards Statutory Requirements Identified During the Inspection Batchfoot Country House D55 S26763 Batchfoot Country House V248218 Stage 4.doc Version 1.40 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3 and 5 The home has compiled a comprehensive statement of purpose and service user guide, which enables prospective service users to make an informed decision about going to live at the home. The home ensures that it only admits service users whose care needs it can meet by carrying out a thorough pre-admission assessment. The arrangements in place for the admission of new service users ensure that they have the opportunity to settle in the first few weeks after their arrival. EVIDENCE: The home has a statement of purpose and service user guide, which complies with regulations and national minimum standards. The document contains useful information about the home, which is periodically updated. A copy is provided to prospective service users and/or their representative and is made available to current service users. Each service user and/or their representative is given the home’s terms and conditions of residence following admission; a signed copy is retained with each service user’s records. Batchfoot Country House D55 S26763 Batchfoot Country House V248218 Stage 4.doc Version 1.40 Page 10 The manager conducts a pre-admission assessment on all prospective service users and makes a record of her findings. Information is obtained from the service user, relatives and external professionals, where appropriate. A record of her findings is made and kept. Prospective service users are offered the opportunity to visit the home, to meet the current service users and staff, prior to making a decision about admission. In some cases relatives visit the home on behalf of the service user. A trial period of six weeks takes place following which the placement is reviewed. The inspector spoke with one service user who had recently arrived at the home; she was very pleased with the way she had been assisted to settle by the staff. Batchfoot Country House D55 S26763 Batchfoot Country House V248218 Stage 4.doc Version 1.40 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 and 10 Care plans are informative but do not consistently reflect the current circumstances of service users. Service users receive the health care input from external professionals which they require to help sustain their quality of life. Staff enable service users to retain their independence, promoting service users’ feelings of worth as valued members of the household and community. The arrangements for the administration of medication are mainly good but are in need of adjustment in order to comply with professional guidance. EVIDENCE: The inspector looked at the care plans and risk assessments for four service users. There is a lot of detailed and clearly set out information which demonstrates that the home takes account of a wide range of care issues. The weakness in the documentation is that care plans are not consistently updated to reflect the current situation and there is no recorded evidence that service users are consulted regarding the content of the care plan. From discussion with five service users, the registered persons and two staff members it was evident that for the most part staff had a very good understanding of service users’ care needs and that there was an effective
Batchfoot Country House D55 S26763 Batchfoot Country House V248218 Stage 4.doc Version 1.40 Page 12 system of reviewing service users’ needs on a daily basis. With one exception service users praised the manner in which staff members assisted them and took steps to make their lives as comfortable as possible. The following comments reflect the views of the majority of service users: “I’m very well looked after….the staff is marvellous”; “the staff are pretty good on the whole”; “they are lovely girls”. One service user commented adversely to the inspector on the manner a staff member had spoken to her; the matter was reported to the manager by the inspector who followed it up immediately. Staff members monitor the health care needs of service users who have ready access to the primary health care team. Doctors call on service users when necessary and the community nurses visit to carry out any nursing tasks that may be required. Arrangements are made to ensure that service users receive the health care input that they need, e.g. in relation to sight, hearing, dentistry. There is liaison with external health and social care professionals; advice is sought and acted upon in the interests of improving service users’ quality of life. One such example was noted where the home pursued alternative options to improve a service user’s mobility. Views expressed through comment cards from a variety of sources indicated that for the most part those people living at the home or who have regular contact with it have a high opinion of the service provision. One health care professional commented that although he/she was satisfied with the overall care provided in his/her opinion the home tried to care for service users with dependency levels that were beyond the skills of the staff. The manager was surprised to learn this comment as it is her understanding that there is good communication and team working between the home and health care professionals; should an occasion arise when a service user requires more help than the home can provide the manager would support the decision to relocate the service user to a more suitable setting. Service users are encouraged to retain control over their lives and to remain as independent as feasible. All service users have their own bedroom and their privacy is respected. Staff members assist service users to make choices as to how they spend their time, the frequency and timing of bathing, what they have to eat etc. During the visit staff members were observed to approach service users in a courteous and friendly manner. Service users were suitably dressed in clean and well-laundered clothing. The arrangements in place for the storage, administration and recording of medication are mainly in accordance with guidance from the Royal Pharmaceutical Society. Medication is stored in a well organised manner and changes have been introduced to the method of recording disposal of unused medication. One recommendation from the previous inspection report had not been addressed in full. An error had also been made by staff with the recording of controlled drugs; no medication was missing. The manager took immediate action following this discovery to minimise the chance of an error
Batchfoot Country House D55 S26763 Batchfoot Country House V248218 Stage 4.doc Version 1.40 Page 13 occurring again. All staff members who handle medication have received externally verified training. Service users confirmed in discussion with the inspector that they received their medication regularly. One service user currently looks after her own medication, in accordance with her wishes; the inspector made a recommendation to update the risk assessment. Batchfoot Country House D55 S26763 Batchfoot Country House V248218 Stage 4.doc Version 1.40 Page 14 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13 The home makes visitors welcome and thereby helps service users maintain contact with the local community. EVIDENCE: Service users receive visitors whenever they wish and their visitors are always made welcome by the staff. It was evident to the inspector from speaking with service users that friends and relatives of service users were encouraged to participate in the life of the home and to maintain contact. Information regarding visiting arrangements is contained in the statement of purpose. Batchfoot Country House D55 S26763 Batchfoot Country House V248218 Stage 4.doc Version 1.40 Page 15 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The home has a comprehensive complaints procedure, which enables service users and/or their representatives to address any concerns they might have. The policies and practices of the home ensure that service users are safeguarded from abuse or harm. EVIDENCE: The home has a complaints procedure, which complies with regulations and meets National Minimum Standards. The procedure is contained in the home’s statement of purpose and in the terms and conditions of residence provided to service users and/or their representatives. The manager reported that no complaints had been received. Service users who spoke with the inspector said that they would feel comfortable about raising concerns either with the registered provider or with the manager. It was evident from speaking with service users that the environment at Batchfoot was one in which issues could be freely discussed. The home has policies/procedures relating to adult protection and prevention of abuse. With one exception all staff members have undertaken training on this topic. The inspector recommended that the manager conduct a short session with the staff member in question, covering relevant issues. There are certificates in staff members’ files, evidencing the attendance at training courses, and the staff members with whom the inspector spoke confirmed that they had received such training. Batchfoot Country House D55 S26763 Batchfoot Country House V248218 Stage 4.doc Version 1.40 Page 16 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19-26 The premises are maintained in a safe and generally clean condition, providing a pleasant environment for service users. The equipment and facilities offered by the home are suited to the needs of the service users, ensuring that their care needs can be met. The bedrooms are furnished in such a way as to promote the comfort and well-being of service users. Laundry facilities are sufficient to provide service users with clean clothing and linen and meet service users’ expectations. EVIDENCE: The inspector saw all communal rooms and areas and a sample of bedrooms. The accommodation is generally well maintained and is suited to the needs of service users who are currently living at the home. Bedrooms are refurbished when they become vacant. Upgrading projects are in place e.g. the imminent replacement of curtains in the communal rooms. The stair carpet is looking “tired” but remains in reasonable condition and does not present a safety hazard. Service users have specialist equipment and items of furniture that
Batchfoot Country House D55 S26763 Batchfoot Country House V248218 Stage 4.doc Version 1.40 Page 17 they require to maintain their independence and they can access the patio areas and garden. The facilities and equipment at the home have been assessed by a qualified occupational therapist; her report states that the home meets the required standard. The registered person has decided not to implement the minor recommendations in the occupational therapist’s report as they are not considered necessary at the present time. The service users are happy with the lay-out of their bedroom and the items of furniture contained within it. Bedrooms have sufficient light, they are well ventilated and stay warm in cold weather. Bedroom doors do not contain the type of lock that is recommended under this standard. Service users are given the option of having a lock fitted following admission. Bathrooms and WCs have the necessary aids to enable service users to use facilities safely. A step ladder was stored in one of the bathrooms; the inspector was informed that this was only a temporary measure. The communal rooms are light and comfortably furnished. The registered persons are reviewing the need to provide protective covers to radiators that are in exposed places, according to the findings of risk assessments. Radiators in the ground floor corridor are “padded”. The home was generally clean and entirely free of unpleasant odours. Service users informed the inspector that their bedroom was kept clean and their bed linen was changed regularly. Service users said that their clothes were laundered efficiently and that items did not go missing. The laundry room was in good order and contained machinery which is suitable for the purpose. There is a facility for cleaning of commode pots (WC and butler sink) in the laundry room and the home has a written policy/procedure for the process. The inspector gave advice on the drying arrangements for commode pots. Batchfoot Country House D55 S26763 Batchfoot Country House V248218 Stage 4.doc Version 1.40 Page 18 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 28 The stable and well-motivated staff group ensure that all duties at the home are carried out efficiently. The home is making progress in establishing a work force that is accredited with nationally recognised qualifications, in the interests of promoting service users’ quality of life. EVIDENCE: Staff members are employed in sufficient numbers by day and night to carry out the care, domestic and catering duties in the home. During the day time there are two carers on duty who are supported either by the manager or registered provider. At weekends in the absence of management one of the carers is a senior carer. At night a wakeful staff member is supported by a second person sleeping in. Support staff include chefs, cleaner and a handyman. A roster is in place which records staff cover each day. The staff group is a stable one with little change in personnel over a long period of time. Staff members informed the inspector that they worked well together as a team and supported each other. Service users confirmed to the inspector that their needs were met with the staffing arrangements that were in place. There are seven care staff members currently in employment at the home. Three senior carers have already attained NVQ level 3 in care; it is anticipated that a further staff member will have achieved this level by the end of the year. The management is looking to put forward another staff member for
Batchfoot Country House D55 S26763 Batchfoot Country House V248218 Stage 4.doc Version 1.40 Page 19 similar assessment in the foreseeable future. Through the NVQ system and other training initiatives the home is building up the competency portfolios of the staff members, the majority of whom already have many years of experience. In most cases service users expressed their confidence in the competence and professionalism of the staff group. Batchfoot Country House D55 S26763 Batchfoot Country House V248218 Stage 4.doc Version 1.40 Page 20 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 36 and 38 There is an open style of management at the home which enables service users and staff members alike to participate in decision-making. Staff members are suitably supervised which assures service users that their welfare is protected. The home is taking steps to implement measures which are designed to promote the health and safety of service users. EVIDENCE: Communication and the sharing of ideas mainly takes place on an informal basis. It was evident from talking to service users and staff members that there was the opportunity to raise and discuss ideas. Both the registered provider and the manager are “approachable” and are available for consultation. The home is efficiently managed and systems are in place to ensure that important information is passed on to relevant parties. A residents’ forum and formal staff meetings take place periodically and notes are taken of the outcome. Staff members receive one-to-one supervision
Batchfoot Country House D55 S26763 Batchfoot Country House V248218 Stage 4.doc Version 1.40 Page 21 every two months, the outcome of which is recorded. The manager is currently devising a format with which to conduct an annual appraisal for staff. The registered persons adopt a proactive approach towards health and safety through the servicing of equipment, the carrying out of risk assessments and staff training. Following an accident or incident, the manager conducts a review of the service user’s situation, records the outcome and implements any changes that are indicated by the review. The inspector recommended a further development to this practice: the periodic auditing of accidents to establish if there is a pattern to incidents. Staff training sessions on topics which relate to health and safety, including first aid, food hygiene and manual handling are underway; a few staff members are in need of updated training. Batchfoot Country House D55 S26763 Batchfoot Country House V248218 Stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 x
COMPLAINTS AND PROTECTION 3 3 3 2 3 2 3 3 STAFFING Standard No Score 27 3 28 2 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x 3 x x x 3 x 2 Batchfoot Country House D55 S26763 Batchfoot Country House V248218 Stage 4.doc Version 1.40 Page 23 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 7 Regulation 15(2) Requirement When significant changes to service users care arrangements take place care plans must be updated to reflect the current circumstances of service users as soon as practicable. Evidence of consultation with service users regarding the content of the care plan must be held on record, e.g. by asking service users or their representaive to sign the document. Where it is not possible to do so a note to that effect should be kept on record. An accurate record of the administration of controlled medication must be kept at all times. Safety precautions must be undertaken in all instances where identified by risk assessment with regard to service users vulnerability to the hot surface temperature of radiators. Timescale set in the most recent report (30/9/05) had not expired at the time of the inspection. Timescale extended. All staff must receive training in Timescale for action 31/10/05 2. 7 15(1) 30/11/05 3. 9 13(2) 30/9/05 4. 25 13(4) 30/11/05 5. 38 18(1) 30/11/05
Page 24 Batchfoot Country House D55 S26763 Batchfoot Country House V248218 Stage 4.doc Version 1.40 first aid. This requirement has been partially met. Timescale set in the most recent report (30/9/05) had not expired at the time of the inspection. Timescale extended. 6. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 9 Good Practice Recommendations When staff handwrite details of prescribed medicines on to the MAR chart a second competent person should check and countersign to confirm that all the details are correct. This recommendation is made for the second time. A note recording nil known should be included on the MAR chart for service users receiving medication who do not have a known allergy. The risk assessment for the service user who currently self-medicates should be updated to take account of the situation regarding storage arrangements. The manager should carry out a session with the staff member who has not undergone POVA training, familiarising her with the homes policies/procedures and No Secrets guidance and make a record in the persons file of this session. A programme of fitting approved door locks to service users bedrooms should be commenced. This recommendation was a requirement in previous reports. Commode pots should be dried and not left to dry on shelves in the laundry room. Further advice may be obtained from the Health Protection Unit. There should be a periodic audit of all accidents to demonstrate the preventaive measures that the home is taking to minimise the risk of reoccurrences. The home should ensure that all care staff receive up-todate manual handling training. 2. 3. 4. 9 9 18 5. 6. 7. 8. 24 26 38 38 Batchfoot Country House D55 S26763 Batchfoot Country House V248218 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Unit 4, New Fields Business Park Stinsford Road Poole Dorset, BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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