CARE HOMES FOR OLDER PEOPLE
Abbeyfield Dene Holm Dene Holm House, Dene Holm Road Northfleet, Gravesend Kent DA11 8JY Lead Inspector
Jo Griffiths Unannounced 19 April 2005 12.30pm 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. Abbeyfield Dene Holm H56-H06 S23933 Abbeyfield Dene Holm V217670 190405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION
Name of service Abbeyfield Dene Holm Address Dene Holm House Dene Holm Road Gravesend Kent DA11 8JY 01474 567532 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) The Abbeyfield Medway Valley Society Vacant CRH Care Home 47 Category(ies) of DE(E) Dementia (21) registration, with number OP Old Age (25) of places DE Dementia (1) Abbeyfield Dene Holm H56-H06 S23933 Abbeyfield Dene Holm V217670 190405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION
Conditions of registration: Care of one younger adult with a diagnosis of dementia is restricted to one service user whose date of birth is 19.06.1941 Date of last inspection 29/11/04 Brief Description of the Service: Dene Holm is a large purpose built residential unit situated in Northfleet, on the outskirts of Gravesend. The home provides support to older people and people with Dementia. The large downstairs unit in the home is dedicated to supporting people with dementia. The building is accessible to wheelchair users with lift access to the first floor. Dene Holm has a team of staff covering a 24 hour rota. The Managers post is currently vacant and is being covered by a Manager of another Abbeyfield home until a permenant Manager is recruited. Abbeyfield Dene Holm H56-H06 S23933 Abbeyfield Dene Holm V217670 190405 Stage 4.doc Version 1.20 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced. A tour of the building was undertaken and a number of service users and staff were spoken with. Some care plans were viewed. There are 40 service users living at the home. There have been two complaints received by the home since the previous inspection. These have been dealt with in an appropriate and timely fashion. Further information can be obtained from the home. There have been no changes to the conditions or category of the registration of Dene Holm. There is currently no registered Manager of the home and this has been addressed within the report. What the service does well:
Service users live in a spacious environment at Dene Holm with plenty of communal areas giving them a choice of where to spend their time. They all have single bedrooms, unless they have chosen otherwise, and these have been furnished to personal taste and are personalised with their own belongings. Some bedrooms have en suite facilities and there are plenty of additional bathroom facilities around the home that are easily accessible to service users. Prospective service users are able to visit the home to look around and meet others before making a decision about moving in. They have a full assessment of their needs before a place at Dene Holm is agreed to make sure the home can meet those needs. Service users care plans are well written and tell the staff exactly what support they need on a daily basis. Their health needs are well met and there is a good working relationship with other health care professionals. Service users have lots of choice of meals and enjoy a balanced and varied diet. They can have tea, coffee and snacks as they are offered throughout the day and by request. Most service users said they enjoyed the food at Dene Holm. Service users spoke highly of the caring nature of staff and said that they are able to make choices about most aspects of their lives. Service users can choose to take part in the range of activities that are provided by the home and forthcoming events are displayed on the notice board. In the summer months the service users enjoy using the large well-maintained garden.
Abbeyfield Dene Holm H56-H06 S23933 Abbeyfield Dene Holm V217670 190405 Stage 4.doc Version 1.20 Page 6 Service users are supported to maintain relationships both within and outside the home and visitors are welcomed at any time. They can see visitors in private if they wish to. What has improved since the last inspection? What they could do better:
Staff still need to receive training in dementia care to ensure they fully understand and can respond to service users needs. The Support Manager to the Director of Care has arranged for this to take place within the next 3-4 weeks. Whilst service users have a wide range of choice of meals they said that they would like to know what the choices are earlier in the day. If service users do not eat all their meal this is not always recorded in their care plan, it is recommended that this happens and that their weight is monitored to make sure they are receiving enough nutrition. Not all service users in the downstairs unit eat in the dining room and the Manager must be able to evidence that this is through individual choice and not because the dining room is too small. Service users in the dementia unit do not have enough staff to support and supervise them during the day. This also affects the amount of time staff have to interact with service users outside of structured activities. The Support Manager has recognised this issue and said that it has been agreed for staffing numbers in the dementia unit to be increased. The communal areas of the home, in particular the hallways, would benefit from redecoration in consultation with the service users. It is also recommended that the bathrooms be decorated to give a more homely feel and maintain privacy. For example, window blinds and pictures. Service users with visual impairments and limited mobility need to have the long hallways well lit and the staff team need to be reminded of this.
Abbeyfield Dene Holm H56-H06 S23933 Abbeyfield Dene Holm V217670 190405 Stage 4.doc Version 1.20 Page 7 Staff do not have easy access to gloves and aprons when providing personal care to service users so it is recommended that these are made available in each bathroom. Service users are put at risk by cleaning products being stored in an unlocked electrical cupboard downstairs. These products need to be moved to a locked cupboard. Staff need to follow the correct procedures for disposing of clinical waste so that service users dignity is maintained and the spread of infection is prevented. Not all service users bedrooms have self-closing fire doors. The fire officer should be contacted for advice regarding the provision of these. The fire doors in the home must not be propped open with objects. Whilst there is a competent Manager in an acting post at the home the service users would benefit from the security of a permanent registered Manager. The requirement for this to be achieved by 29/02/05 has not been met. This must be addressed by 1st August 2005. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Abbeyfield Dene Holm H56-H06 S23933 Abbeyfield Dene Holm V217670 190405 Stage 4.doc Version 1.20 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 Abbeyfield Dene Holm H56-H06 S23933 Abbeyfield Dene Holm V217670 190405 Stage 4.doc Version 1.20 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) 3,4,5 Service users have a full assessment of their needs to ensure they can be met before moving into the home. Prospective service users have the information they need to make an informed decision about moving into the home. EVIDENCE: The Statement of Purpose and Service User Guide were not inspected on this occasion, but were seen on the previous inspection to provide service users with all the information they need about the home. A full assessment of need is carried out prior to the service user moving into the home, these were seen within the care plans that were sampled. Service users said that before they made their decision to move to the home they had been able to visit and have a look around with their relatives. Abbeyfield Dene Holm H56-H06 S23933 Abbeyfield Dene Holm V217670 190405 Stage 4.doc Version 1.20 Page 10 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) 7,8,10, Service users care plans are clear and directive and meet their health and personal care needs fully, however there is some compromise to the protection of their dignity. EVIDENCE: Care plans were viewed for 3 service users. These clearly detail the support required in all aspects of the individual’s life. Detailed pen portraits have been included in some of the care plans and these give plenty of information about service users backgrounds. The care plans have been regularly reviewed. Two service users were seen to be supported in maintaining their friendship as detailed in their care plans. Good records have been maintained on a daily basis within the care plan. It is recommended that the service user is involved in the development of their care plan and that they or their relative sign to agree the care plan where possible. The care plans show regular contact with various health care professionals including the GP, district nurse, chiropodist, dentist and optician. During the inspection the chiropodist visited service users at the home. Service users said that their health needs were always met. Waterlow pressure area assessments have been completed for all service users and staff said there are no service users currently with pressure sores.
Abbeyfield Dene Holm H56-H06 S23933 Abbeyfield Dene Holm V217670 190405 Stage 4.doc Version 1.20 Page 11 Most service users said that the staff are caring and treat them with respect, although some service users said that the staff are often too busy to spend time helping them. Staff were respectful in their approach to the service users during the inspection. It was of concern that one service user’s dignity was compromised due to a used continence pad being found on the floor of their bedroom. The team leader on duty took action to rectify this immediately. Staff spoken with during the inspection demonstrated knowledge of how to respect service users privacy. Abbeyfield Dene Holm H56-H06 S23933 Abbeyfield Dene Holm V217670 190405 Stage 4.doc Version 1.20 Page 12 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) 12,13,15 Although Service users can take part in a range of structured activities that are offered, they would benefit from more as they spend significant periods of the day without stimulation. Service users are supported to maintain contacts with family and friends and can receive visitors at any time. Although Service users enjoy the wide and varied menu choices of foods are not offered appropriately to service users. EVIDENCE: Service users spoke of a number of activities provided by the home including quizzes and bingo, they said they enjoy these but would like more activities during the day. The activity notice board displays information of forthcoming events. During the inspection most service users spent the afternoon in the lounge with the television on, one service user had gone out for the afternoon. There was little interaction between staff and service users aside from direct care tasks and it was evident that this is due to a shortage of staff (see standards 27-30). Abbeyfield Dene Holm H56-H06 S23933 Abbeyfield Dene Holm V217670 190405 Stage 4.doc Version 1.20 Page 13 Service users said that they can have visitors at any time and see them in private. The visitor’s book showed that relatives visit the home frequently. Staff were seen to make effort to enable service users to build and maintain friendships in the home. Service users said that they can choose when to get up and go to bed. Service users have access to a payphone, although this is located in a public area. Staff said that a cordless phone is available for service users to use in private if they wish. Service users said that a hairdresser visits weekly and there is a hairdressing salon allocated for this. The kitchen assistant described how the 5-week menu is planned. This was last reviewed some time ago and would benefit from review to ensure the preferences and needs of the current service user group are catered for. At least 2 choices of a hot meal are offered at lunchtime with a dessert. There is a choice at breakfast, tea and supper. Examples were seen of catering for specific dietary requirements and a vegetarian option is included each day. Service users said that although they are given a choice they do not know what the choice is until the meal trolley is brought up from the kitchen. They said they would like to be able to choose earlier in the day. Service users have been assessed for their nutritional requirements. Care plan records do not clearly show what foods service users have actually consumed, making it difficult to monitor nutritional intake. None of the plans seen had up to date monitoring of weight. Each service user has a nutritional assessment in their care plan. Abbeyfield Dene Holm H56-H06 S23933 Abbeyfield Dene Holm V217670 190405 Stage 4.doc Version 1.20 Page 14 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 Service users know how to complain and complaints are taken seriously and acted upon. EVIDENCE: Most service users were aware of how to make a complaint and felt that their concerns would be listened to and taken seriously. Service users and their relatives can access the complaints procedure in the home or Service User Guide. The Support Manager described how the response to complaints has improved and outcomes are now being recorded and followed up. Abbeyfield Dene Holm H56-H06 S23933 Abbeyfield Dene Holm V217670 190405 Stage 4.doc Version 1.20 Page 15 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) 19,20,21,22,23,24,25,26 Service users live in a comfortable and well-furnished environment, although they would further benefit from redecoration of some communal areas. EVIDENCE: Dene holm is purpose built and spacious. Whilst service users live in a clean and warm home they would further benefit from the communal areas of the home being redecorated, in particular the hallways. The small works department were contacted during the inspection and confirmed that decoration to the outside of the building will commence in August 2005, with internal decoration not scheduled until the next financial year. Some service users have had their bedrooms redecorated to reflect their own taste. Service users are accommodated within 3 units and each one has a lounge and dining room. The downstairs dining room is not large enough to accommodate all service users should they wish to eat at the table; some service users eat in the lounge. The lounge areas are spacious and fully furnished, including music
Abbeyfield Dene Holm H56-H06 S23933 Abbeyfield Dene Holm V217670 190405 Stage 4.doc Version 1.20 Page 16 and televisions. There is lots of space to wander which is particularly important for those service users with dementia. Service users are able to use the large and well-maintained garden, which have a decking area and wooden furniture. There are plans to add a conservatory to the rear of the building. Some service users have ensuite facilities and there are plenty of communal toilets and bathrooms located near bedrooms and the lounge. The communal bathrooms are clean and well maintained but lack any colour or pictures that give rooms a homely feel. There are no blinds at any of the bathroom windows and one upstairs toilet has a stained toilet seat. One bathroom and toilet are kept locked and out of use to service users, currently staff whom “sleep in” use these facilities, although there are plans to remove the “sleep in” duty. This toilet and bathroom are in need of refurbishment if they are to be used by service users. Service users can access the 2nd floor via a shaft lift and there are a number of portable hoists within the home to aid mobility. Rails are in place along hallways to help service users get around independently and a call system is in place in all the bedrooms, bathrooms and lounges should they require staff assistance. Service users bedrooms are suitably sized to meet the needs of the current occupants and are personalised with service users own belongings. Furniture is provided by the home and service users can bring in their own items if they wish, providing they meet fire safety requirements. Service users have a choice to occupy a single room allowing them personal and private space. The lighting in the home is appropriate for the needs of the service users although staff should be made aware of the need to keep hallway lighting on to avoid long dark corridors that pose a threat for service users with visual or mobility problems. Service users have plenty of hot water in their rooms supplied at an appropriate temperature. Not all radiators are safety covered but these are maintained at a suitable temperature. The risk assessment for this was not viewed on this occasion but will be requested at the next inspection. Service users live in an environment that is generally kept clean and aside from a continence pad being found on the bedroom floor (see standards 7-11) staff are able to describe good practice in the handling of clinical waste and soiled laundry. Service users clothes are laundered and returned quickly. Gloves and aprons are available for staff but these are located in a hallway cupboard and the dining room. Staff said it would be easier if there were a supply of these available in each bathroom and toilet area to avoid them having to leave service users to go and get protective equipment.
Abbeyfield Dene Holm H56-H06 S23933 Abbeyfield Dene Holm V217670 190405 Stage 4.doc Version 1.20 Page 17 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, 30 Staffing levels and training in the home are inadequate and the needs of the service users, particularly in the dementia unit are not being fully met. EVIDENCE: During the inspection service users were left unsupervised in the lounge areas for significant periods of time, this was of particular concern in the dementia unit where there were only 2 staff on duty. Staff spoken with said that despite there being 3 staff allocated per shift in the dementia unit this rarely occurred due to staff shortages and sickness. Service users said that staff are busy and are not always around in the communal areas and that they often have to wait to be taken to the bathroom. The staff on duty were clearly very busy and were unable to supervise service users in the lounge whilst also supporting others with personal care tasks. The Support Manager visited the home during the inspection and stated that plans are in place to increase the numbers to 4 staff per duty in this unit and is confident this will meet the needs of the service users. Rotas showed that sufficient kitchen and domestic staff are employed and service users said their meals are always served on time. The Support Manager said that regular meetings have been occurring for the senior team and that the Acting Manager has been providing training for staff in general care practice. Staff training was not inspected in depth but through discussion with staff it was evident that the required dementia training for care staff has not yet been provided. It is essential that this occur to ensure the
Abbeyfield Dene Holm H56-H06 S23933 Abbeyfield Dene Holm V217670 190405 Stage 4.doc Version 1.20 Page 18 care needs of service users with dementia are fully met. The Support Manager said this training is planned to take place within the next 4 weeks. Abbeyfield Dene Holm H56-H06 S23933 Abbeyfield Dene Holm V217670 190405 Stage 4.doc Version 1.20 Page 19 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) 31, 38 Service users do not have a registered and permanent Manager who runs their home, however there is an acting Manager who is qualified to manage on a temporary basis. The health, safety and welfare of service users are protected, however fire safety and infection control risks need assessing. EVIDENCE: The Registered Manager post is currently vacant. The acting Manager is suitably qualified and has achieved some improvement to the home, however a permanent Manager must be recruited and registered with CSCI. Service users safety needs have been assessed within the care plan and action taken to reduce risks. Window restrictors are in place throughout and some radiators are safety covered. The kitchen and laundry areas are kept locked when unattended, however some cleaning products are stored in an unlocked electric cupboard in the downstairs hallway, these products need to be moved
Abbeyfield Dene Holm H56-H06 S23933 Abbeyfield Dene Holm V217670 190405 Stage 4.doc Version 1.20 Page 20 to a locked area. Service users are protected by good security systems with an intercom entry box in place at the entrance of the home. Some of the bedroom doors are not linked to the fire system and will not close in the event of a fire and some automatic closing fire doors were propped open. This must be addressed following discussion with the fire officer. Infection control procedures are not being followed consistently by staff with a soiled continence pad being left on a bedroom floor. Gloves and aprons are not easily accessible to staff. Staff spoken with said they would prefer them to be available on the wall in all bathroom areas. The manager must make sure that protective equipment for staff is available and is recommended that the request of the staff is implemented. Staff said they have received some training in areas of health and safety such as Food Hygiene, Manual Handling, 1st aid and COSHH. Abbeyfield Dene Holm H56-H06 S23933 Abbeyfield Dene Holm V217670 190405 Stage 4.doc Version 1.20 Page 21 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3
COMPLAINTS AND PROTECTION 2 3 3 3 3 3 3 2 STAFFING Standard No Score 27 1 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 2 x x x x x x 2 Abbeyfield Dene Holm H56-H06 S23933 Abbeyfield Dene Holm V217670 190405 Stage 4.doc Version 1.20 Page 22 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 OP4 Regulation 18(1)(a) Requirement Competency based training in dementia care must be provided to all staff working within the dementia unit of the home. This requirement is outstanding from the previous inspection. The registered person must ensure that effective infection control procedures are followed in the home. Timescale for action 31/07/05 2. 0P10 OP26 12(4)(a) 13(3) 3. OP12 OP27 12(1)(b) 18(1)(a) 4. OP38 13(4)(a) The registered person shall, having regard to the size of the home, the statement of purpose and the needs of the service users, ensure that suitably qualified, competent and experienced persons are working at the home in such numbers as are appropriate for the health and welfare of service users. This is in particular relation to the dementia unit in the home. Cleaning products must be stored appropriately and safely Action plsn to be submitted to CSCI detailing action to be taken and timescales. Action plsn to be submitted to CSCI detailing action to be taken and timescales. Action plsn to be submitted
Page 23 Abbeyfield Dene Holm H56-H06 S23933 Abbeyfield Dene Holm V217670 190405 Stage 4.doc Version 1.20 5. OP31 6. OP38 8(1)(a,b,i) The registered person shall appoint a permanent Manager to apply to be registered with the commission. This requirement is carried forward from the previous inspection. The required timescale of 29/02/05 was not met. 23(4)(c,i) The registered person shall consult with the fire authority to ensure the home is fitted with appropriate fire doors. Fire doors must not be propped open. to CSCI detailing action to be taken and timescales. Managers application to be received by CSCI by 1st August 2005 Action plsn to be submitted to CSCI detailing action to be taken and timescales. 7. 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. 2. Refer to Standard OP7 OP15 Good Practice Recommendations It is recommended that service users or their representatives sign the care plan where possible. It is recommended that service users are made aware, by means appropriate to each individual, of the choice of meals for the day at least on the morning concerned. It is also recommeded that the planned menu is reviewed and changed regularly It is recommended that a record is kept of nutritional intake for each service user and a record of their weight maintained on a monthly basis. It is recommended that a review of the size and layout of the dining room take place to ensure all those service
H56-H06 S23933 Abbeyfield Dene Holm V217670 190405 Stage 4.doc Version 1.20 Page 24 3. 4. OP8 OP20 Abbeyfield Dene Holm 5. 6. 7. 8. 9. 10. OP19 OP25 OP26 OP26 OP10 OP19 users who wish to eat in there are able to. It is recommended that the communal bathroom areas are decorated and furnished in a way that provides a homely and warm feel for service users. It is recommended that all staff are made aware of the needs of service users with visual impairments in relation to the lighting of rooms and hallways. It is recommended that a supply of protective gloves and aprons are provided in each bathroom area. It is recommended that the stained toilet seat in the upstairs toilet is replaced. It is recommended that blinds are fitted to bathroom windows. It is strongly recommended that the communal areas of the home be redecorated in consultation with service users. Abbeyfield Dene Holm H56-H06 S23933 Abbeyfield Dene Holm V217670 190405 Stage 4.doc Version 1.20 Page 25 Commission for Social Care Inspection The Oast, Hermitage Court Hermitage Lane Maidstone, Kent ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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