CARE HOMES FOR OLDER PEOPLE
Whincroft 18 Glen View Road Burnley Lancs BB11 2QN Lead Inspector
Jeff Pearson Unannounced 3 August 2005 9.30 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. Whincroft F57 F07 S61077 Whincroft V224157 090605 Stage4 doc.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Whincroft Address 18 Glen View Road Burnley Lancs BB11 2QN 01282 453158 01282 425983 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) Mrs Linda Jane Harris Care Home 24 OP 24 Category(ies) of Old Age registration, with number of places Whincroft F57 F07 S61077 Whincroft V224157 090605 Stage4 doc.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The staffing of the establishment shall, until further notice continue to be The registered provider/manager to work in the home on a full time basis 8.00 a.m. - 10.00 p.m. 3 x care assistants (one designated as in charge in the absence of the registered provider/manager) 10.00 p.m. - 8.00 a.m. 2 x waking watch care assistants (one designated in charge) Cook hours = 54 per week Cleaner hours = 35 per week 2. The following matters are required to be addressed within one month of registration: Bedrooms 2,3,4,5,6, and 14 require lockable storage space Units 1 and 4 (designated shared rooms) require screening to be available Units 1 and 2 require accessible call points in the showers Unit 1 shower room requires pipe work to be caovered, other areas of the home to be checked for such covering and fitted accordingly The call point in the ground floor back sitting room requires connection to the main call system An additional call point, connected to the main system is required to be fitted in the ground floor dining room An additional call point, connected to the main system is required to be fitted in the pink lounge Bedroom 5 requires a bedside table 3. The following matters are required to be addressed within six months of registration Bedroom 3 requires the carpet replacing; the washbasin was cracked and requires attention Bedrooms 7 and 8 en-suites, require upgrading/decorating The first floor bathroom/toilet requires upgrading A suitable hand wash basin is required in the first floor toilet Bedrooms 2,3,7,8,9,10,11,12,13,14,15,16 require additional double electric sockets Bedroom 1 requires additional overhead/bedside lighting Date of last inspection 10th March 2005 Whincroft F57 F07 S61077 Whincroft V224157 090605 Stage4 doc.doc Version 1.30 Page 5 Brief Description of the Service: Whincroft is a family run care home. The home is a semi-detached property located in a residential area on a fairly busy road on the outskirts of Burnley. There are attractive enclosed gardens accessible to residents. The home is registered to provide personal care and accommodation for 24 older people. The communal accommodation comprises of two lounges, two lounge/dining rooms and a separate dining room. Additional seating is also provided in the entrance hallway. Accommodation is provided on three levels there are 16 single rooms and 4 double rooms, 11 of these rooms have en-suite facilities. Some of the rooms (units) are fitted with kitchenettes. Whincroft is a no smoking establishment. Various aids and adaptations are provided; including hand rails and grab rails. Staff are available, to provide assistance with personal care and support, in response to individual needs/wishes. The home can provide for ‘in house’ recreational activities and outings. Whincroft F57 F07 S61077 Whincroft V224157 090605 Stage4 doc.doc Version 1.30 Page 6 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took 11 hours over 2 days. There were 22 residents accommodated. The files/records of 3 residents were examined as part of ‘case tracking’, this being a method of focusing upon a representative group of residents. During the inspection 10 residents, care assistants the cook and registered provider/manager were spoken with. Documents, including policies, procedures and records were looked at. A tour of the premises was carried out. Comment cards were left at the home for residents to complete, 3 were returned to the Commission. What the service does well:
Whincroft had a welcoming and friendly atmosphere. The home was ‘homely’ and pleasantly decorated; residents said they liked the accommodation provided, including their own rooms, shared rooms and the gardens, one resident said its “like living in a hotel” The home was clean and had no unpleasant odours. There was a good method of finding out about peoples’ needs and wishes before they moved into the home. There were some good care practices in place; staff had an awareness of the residents needs. The people living in Whincroft were treated with dignity and respect. The residents spoke positively about the staff describing them as “kind and helpful” People were getting support with medical and health care needs, such as seeing the Doctor or attending hospital appointments. Routines in the home were flexible, “we can do whatever we like” one resident said. Residents meetings were being held, which provided the opportunity for people to be consulted and involved with group decisions. Various activities were available, for individuals and groups. The residents spoken with were happy with the quality and variety of meals provided. Staff training and development was ongoing, staff meetings were being held. There had been minimal changes in the staff team since the last inspection, so continuity and familiarity was good. Whincroft F57 F07 S61077 Whincroft V224157 090605 Stage4 doc.doc Version 1.30 Page 7 What has improved since the last inspection? What they could do better: The guide to the home needed to be updated to make sure people were being given the correct information. To protect peoples’ rights, the contracts of residence should be further developed to specify more clearly terms and conditions and fees. The resident’s individual care plans needed to include clearer details of all their needs and how they are to be met, to ensure staff know exactly what to do for each person. Some care plans needed to be reviewed more frequently, to make sure the residents changing needs are addressed.
Whincroft F57 F07 S61077 Whincroft V224157 090605 Stage4 doc.doc Version 1.30 Page 8 Further attention must be given to residents taking risks, particularly those who look after their own medication, or who are unsteady, to ensure risks are kept to a minimum and there is a balance between personal safety and independence. To make sure peoples’ medication is managed as safely as possible, medication guidelines needed updating and clear instructions should be written on ‘when necessary’ medication. For new residents, their medication should be checked out with their GP, medication reviews should be arranged. The Controlled Drugs cabinet should meet all requirements. Guidelines for protecting people from abuse needed updating, to make sure staff do the right things and training in this subject should be provided for all staff. Staff practices should be further developed to improve the service at mealtimes. People living at Whincroft, their relatives and others must be formally asked if things are OK, to make sure the home is being run in their best interests. The suitability of one ground floor bathroom should be included in the homes development plan, to show improvements will be made for the benefit of the residents. To make sure the environment is as safe as possible, the home must be carefully considered to reduce the risk of harm to people living there, staff and visitors. Window restrictors must be suitable for use and in good working order. All radiators should be covered. The laundry floor covering should be replaced. Any recommendations made by Environmental health should be carried out. Guidelines for dealing with peoples’ pensions should be updated, to make sure they are in line with changes at the Post Office. 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. Whincroft F57 F07 S61077 Whincroft V224157 090605 Stage4 doc.doc Version 1.30 Page 9 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 Whincroft F57 F07 S61077 Whincroft V224157 090605 Stage4 doc.doc Version 1.30 Page 10 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 The homes written material for potential and current residents provided good information about the services provided, but was in need of updating to ensure all details were correct. New contracts/statement of terms and conditions had not been agreed with all residents. Contracts were lacking in specifying some safeguards for residents. The admission process aimed to ensure residents’ were assessed, their needs and wishes known and planned for, prior to moving into the home. EVIDENCE: Whincroft ’s guide for residents was available in the home along with a copy of the Statement of purpose and the last inspection report. Residents spoken with had been provided with a copy of the guide. The guide included appropriate information, but due to changes in the staff structure needed some updating. Residents’ records seen included copies of contracts/statement of terms and conditions. A revised contract had been used for the most recent admission. The contract did not include a breakdown of the fees payable and by whom, or the circumstances under which a resident may be asked to leave.
Whincroft F57 F07 S61077 Whincroft V224157 090605 Stage4 doc.doc Version 1.30 Page 11 The records of the most recently admitted residents were looked at; the registered provider had carried out a comprehensive pre admission assessment. Social Services assessment information was also available, but it was not clear if this had been obtained prior to admission. A copy letter was seen advising the new resident the home was able to meet their needs. Whincroft F57 F07 S61077 Whincroft V224157 090605 Stage4 doc.doc Version 1.30 Page 12 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 Progress had been made in improving residents care plans, but not all needs had been identified. Staff were not being adequately instructed to effectively respond to the residents individual needs and abilities. Assessing responsible risk taking needed further attention, to ensure a reasonable balance is achieved between personal safety, independence, choice and rights. Improvements had been made with medication management, but policies and practices needed further attention for the protection of the residents. Support with personal care was provided sensitively in a way which promoted service users privacy and dignity. EVIDENCE: A new care plan format had been introduced, this provided for many relevant details to be noted, however, some aspects of care such as foot care and oral hygiene and food intake had not been included. Of the care plans seen, few
Whincroft F57 F07 S61077 Whincroft V224157 090605 Stage4 doc.doc Version 1.30 Page 13 had been fully completed in respect of all needs and abilities. One care plan included risk assessments, which had been agreed with the resident concerned. There were no risk assessments on the use of bed rails. Some of the care plans had been reviewed on a monthly basis others had not. Residents spoken with had an awareness of their care plans, some had signed in agreement with them. Staff had an awareness of individual residents needs and abilities and said they had been involved with the care planning process. Health related policies were available. Records indicated residents were receiving attention from health care professionals and that general health was being monitored. Risk assessments were not in place for self-administering insulin and the management of this procedure was in need of review. Medication management policies had been revised, but still needed further matters including. Medication storage was satisfactory, temperatures were being recorded. All staff responsible for administering medication had attended accredited training. A controlled drugs register was in use. Several residents said they were treated with dignity and respect, this approach and maintaining privacy, was observed within care practices. Whincroft F57 F07 S61077 Whincroft V224157 090605 Stage4 doc.doc Version 1.30 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) 12,13,14,15 Flexible lifestyles and activities were being encouraged in response to individual and group needs, abilities and wishes. Visiting times were flexible so residents could continue relationships with relatives and friends. Some community contact was being maintained to enable the residents to retain links with others. Residents were being given the opportunity to make choices and decisions, to enable them to have as much control over their lives as possible. The meals provided were good, offering choice and variety. Specific diets were being catered for. The manner in which some staff served food, did not create a pleasant mealtime for the residents. EVIDENCE: Residents meetings were being held approximately every three months, residents spoken with felt their views and suggestions were listened to and
Whincroft F57 F07 S61077 Whincroft V224157 090605 Stage4 doc.doc Version 1.30 Page 15 acted upon. Residents and staff described the various activities available, including various games, sing-a-longs, visiting entertainers and celebrations. Records included details of resident’s interests, previous lifestyles/history and hobbies. Routines in the home appeared flexible. Residents said they were able to go to bed and get up, whenever they wished, and were observed to spend time in their rooms. Some residents said how they often go out with families, also that visiting times were flexible. The visiting arrangements were specified in the homes guide. Residents had been encouraged to bring their own personal possessions and furniture with them, they were seen to be supported and enabled, to make their own choices and decisions. Financial arrangements were outlined in the homes guide, residents where possible managed their own monies. The residents spoken with said they were happy with the quality, variety and choice of meals provided. Choice menus were available, the menu being discussed with residents each day. Fresh produce was being obtained from local sources. Fresh fruit was seen to be readily available. Diets were being catered for. New table decorations, cutlery and mats had been provided and the dinning room was due to be decorated. The record of meals served did not include breakfast and suppers. The mealtime service was observed, staff were generally considerate but some approaches were less sensitive and lacked attentiveness. Whincroft F57 F07 S61077 Whincroft V224157 090605 Stage4 doc.doc Version 1.30 Page 16 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) 18 There had been limited progress in amending the protection of vulnerable adults policies and procedures to ensure a proper response to any suspicion or allegation of abuse, this might place service users at risk. EVIDENCE: The homes protection/abuse policies had been revised and updated and included relevant information based upon the ‘No secrets ’ guidance. Clear procedures were not available advising managers and staff of the action to follow, should there be any allegations or incidents of abuse. Staff were not fully aware of the procedure to be followed. A restraint policy was seen to be available, and policies had been defined on the ‘none acceptance of gifts’ from residents. Some staff had covered protection and abuse matters as part of NVQ (National Vocational Qualifications) training. Mrs Harris said additional abuse/protection training was being considered. Whincroft F57 F07 S61077 Whincroft V224157 090605 Stage4 doc.doc Version 1.30 Page 17 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) 19,21,25,26 The standard of the accommodation was good; providing the residents with an attractive and homely place to live, some matters needed attention to ensure the residents have safe surroundings and facilities, which adequately meet their needs. EVIDENCE: Records were seen of ongoing maintenance and refurbishment. The areas of the home seen were appropriately maintained and provided a comfortable environment for the residents. The gardens were accessible to the residents, attractive and well kept. The residents spoken with said they were happy with the accommodation provided and expressed and appreciation of the homes grounds. Various aids and adaptations had been provided; including hand rails and grab rails. Rails were fitted on some corridors. Whincroft F57 F07 S61077 Whincroft V224157 090605 Stage4 doc.doc Version 1.30 Page 18 A wash hand basin had been fitted in the first floor toilet. Eleven of the bedrooms had en-suite toilets four had en-suit showers. The first floor bathroom was satisfactory; one ground floor bathroom provided suitable facilities for the residents. The bathroom to the front of the home was not in a good location, and was not very suitable for the residents this facility was not in use. Emergency lighting and central heating was provided throughout the home. Thermostats were fitted to most radiators in bedrooms others had regulators, enabling temperatures to be controlled individually. To prevent risks from scalding pre-set valves had been fitted to all bathing facilities. Radiator covers had been fitted to some radiators this work was ongoing. Some residents said they had been consulted about the fitting of radiator covers in their rooms. Risk assessments had been completed on radiators without covers. The home was clean and free from offensive odours. Appropriate laundry equipment was in place. Infection control policies and procedures were available. The floor covering in the laundry was in need of attention; Mrs Harris said this matter was to be addressed. Whincroft F57 F07 S61077 Whincroft V224157 090605 Stage4 doc.doc Version 1.30 Page 19 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) 27,29,30 Staffing levels had been increased in the evening to ensure the resident’s needs are effectively and safely met. An improvement in staff recruitment practices, showed appropriate attention was being given to protecting the service users. Arrangements were in place to enable new employees to become familiar with role, duties and responsibilities. EVIDENCE: The required numbers of staff were on duty. Staff rotas and records of hours worked, indicated that the staffing levels were in accordance with the conditions of registration. Due to staff holidays Mrs Harris was working as part of the staff rota, Mrs Harris explained this was a temporary arrangement. Staff spoken with considered the staffing levels to be satisfactory. Two staff were employed to cook and two to clean the home. Mr Harris was responsible for carrying out maintenance duties. Residents spoken with were complimentary about the staff team; several had worked at the home for a number of years. The records of the two most recently employed staff were examined and found to include satisfactory information. Mrs Harris explained existing staff records were still in the process of being brought up-to date. A TOPPS induction training programme was available, however, Mrs Harris explained staff were being to supported to commence NVQ level 2, following
Whincroft F57 F07 S61077 Whincroft V224157 090605 Stage4 doc.doc Version 1.30 Page 20 their initial induction training. Records were seen indicating new staff had completed the homes induction training. Whincroft F57 F07 S61077 Whincroft V224157 090605 Stage4 doc.doc Version 1.30 Page 21 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) 33,35,38 The residents and others were not yet being formally consulted about the quality of the service, so had limited opportunity to influence change. Good systems had been introduced which showed residents’ monies were being appropriately and accountably managed. The policies and practices in respect of handling residents pensions needed to be changed to safeguard residents finances. Arrangements had been made to maintain health and safety; further safeguards were needed to promote the well being of residents and staff. EVIDENCE: Whincroft F57 F07 S61077 Whincroft V224157 090605 Stage4 doc.doc Version 1.30 Page 22 The home had attained Investors In People Accreditation. There were no formal quality assurance/consultation systems being carried out. A quality assurance survey was seen to have been devised for residents; this was yet to be used. The records of resident’s individual payments and charges had been further developed to include full and accurate details. Individual accountable records were seen of residents monies kept at the home for safekeeping, monies were being safely stored in locked facilities. Due to changes in pensions and benefits payments, it was apparent the homes policies and practices in respect of residents’ allowances and savings were in need of review/attention. Extensive health and safety systems had been introduced, including risk assessments; these needed ongoing monitoring and up dating. Advice had been sought from the Fire Authority about the locking system on the front door. There were no specific fire risk assessments in place. Some of the window restrictors in the home were not working properly or were insufficient. The environmental health officer’s report indicated a cover was needed over the kitchen light and that fridge temperatures needed to be checked/recorded twice per day. Staff spoken with confirmed they had undertaken training in Health and Safety, moving and handling, first aid and infection control. Some certificates were available in support of this training. Documents were available showing the servicing of equipment and installations. It was noted the electrical inspection was due in August 2005. Whincroft F57 F07 S61077 Whincroft V224157 090605 Stage4 doc.doc Version 1.30 Page 23 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 2 2 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2
COMPLAINTS AND PROTECTION 3 x 2 x x x 2 2 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 x x 2 x 2 x x 2 Whincroft F57 F07 S61077 Whincroft V224157 090605 Stage4 doc.doc Version 1.30 Page 24 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 1 Regulation 4,5,6 Requirement The registered person must ensure that the homes Statement of Purpose and Service User Guide, are updated to include correct details. Service user plans must be in sufficient detail to provide clear guidance to staff, of the actions to be taken to meet their health and welfare needs.Service user plans must be kept under review. Risk assessments/management strategies must be completed, on service users engaging in activities which may affect their health or well being, with particular attention to the prevention of falls, restraint and self managing medication. Medication management policies and procedures must be in accordance with current recgnised guidelines and legislation (Timescale of 31/5/05 not fully met) The protection of vulnerable adults procedures must include clear details of the action to be taken, on suspicion or allegations of abuse. Staff must Timescale for action 31/10/05 2. 7,8 15 31/10/05 3. 7,8,9 13 9/9/05 4. 9 13,17 31/10/05 5. 18 13 9/9/10 Whincroft F57 F07 S61077 Whincroft V224157 090605 Stage4 doc.doc Version 1.30 Page 25 6. 33 7. 38 be made aware of this procedure. 4,5,33,14, A formal system for reviewing 15,17,21, and improving, the quality of 22 care provided at the home must be implemented. (timescale of 10/6/05 not met) 6,13,14,1 Where fitted, window restrictors 5,17,23 must be in good working order and fit for purpose. Risk assessments must be completed on windows without restrictors. 6,13,1 4,15,17,2 3 Specific Fire safety risk assessments must be carried out. 31/10/05 9/9/05 8. 38 23/9/05 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 2 Good Practice Recommendations The residents contract should include a break down of the fees payable and by whom. The contract should include details of the circumstances a resident may be asked to leave. The management of insulin should be reviewed with the resident and the District Nursing Services. Criteria for the administration of when required and variable dose medication should be clearly defined and recorded for all service users prescribed such items. Controlled Drugs should be stored in a Controlled Drug cabinet compliant with the Misuse of Drugs (Safe Custody) Regulations 1973. There should be a formal system of verifying a service users medication on admission. There should be a formal system for the prompting of medication reviews in line with the recommendations in the National Service Framework for Older People. Mealtime service should be improved, to ensure this is a more pleasurable occasion for the residents. Training in abuse and protection should provide for all staff. Suitable systems should be set up to appropriately
F57 F07 S61077 Whincroft V224157 090605 Stage4 doc.doc Version 1.30 Page 26 2. 3. 8 9 4. 5. 15 18 Whincroft 6. 7. 8. 9. 10. 11. 21 25 26 29 35 38 respond to and record allegations and incidents of abuse. The process of referral to the Protection of Vulnerable Adults register should be reflected within the staff disciplinary procedures. The suitability and location of the ground floor bathroom to the front of the home should be included within the registered providers long-term development plans. All radiators should be fitted with appropriate covers. The floor covering in the laundry should be replaced as soon as possible. Existing staff records, need to be brought up to date as soon as possible. Policies and procedures relating to the management of residents pensions and benefits, should be updated in response to the changes in payment systems. Any recommendations made by the borough Environmental Health Officer should be attended to. Whincroft F57 F07 S61077 Whincroft V224157 090605 Stage4 doc.doc Version 1.30 Page 27 Commission for Social Care Inspection Unit 4 Petre Road Clayton-le-Moors Accrington BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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