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Inspection on 20/04/05 for Addison Court Nursing Home

Also see our care home review for Addison Court Nursing Home for more information

This inspection was carried out on 20th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

A senior member of staff carried out a detailed assessment of the care needs of prospective residents prior to admission. During the inspection members of staff were observed attending to residents in a friendly and professional manner. Residents comments included `good meals`, `nice staff` and `I like the home and the staff`. The daily routine was flexible in order to meet the needs and preferences of residents. A range of activities were organised for residents, these included trips out. Residents were consulted about meals and had decided that they would like to have the main meal at 4.30pm instead of lunchtime. The manager said that this would be tried for one month and only become a permanent arrangement if the residents agreed. All the residents spoken to with the exception of one said that the meals were good.

What has improved since the last inspection?

The lounge had also been rearranged so that residents were sitting in small groups. This created a homely environment. The general management and organisation of the home has continued to improve over the last year. Regular formal supervision for all care staff has been introduced. Mandatory training has been ongoing including regular up dates in fire safety, moving and handling and first aid. Some progress has been made with involving residents and their relatives in planning and reviewing care. The relatives of one resident said that they had been invited to a review of the care plan. Several members of staff have formed a health and safety committee. They were responsible for identifying any risks to the health and safety of residents and staff and suggesting ways to reduce these risks to the manager.

What the care home could do better:

The care plans must identify all the care needs of individual residents and explain how these needs are to be met. Detailed records about the treatment and condition of pressure sores must be kept. The times of positional changes for resident`s at risk of developing pressure sores must be recorded. The manager explained that progress to involve residents and their relatives in care planning would continue. Medication prescribed for one resident must not be used for others. Medication must not be left unattended on a resident`s table until he or she decides to take it. Detailed records of all medication received into the home must be available. The manager was also advised to ensure that all handwritten instructions on the medicines administration records should be signed and witnessed by a second member of staff. Alternatives to the menu should be available for any resident who does not like the planned meals. The manager should ensure that the `whistle blowing` policy is amended.

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Addison Court Nursing Home Addison Street Accrington Lancashire BB5 6AG Lead Inspector Susan Hargreaves Unannounced 20 April 2005 9:20 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 and Care Homes for Adults 18 – 65*. 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. Addison Court Nursing Home F57 F57 S22489 Addison Court V221025 April 20th 2005 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Addison Court Nursing Home Address Addsion Street Accrington Lancashire BB5 6AG 01254 233821 01254 393628 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) Speciality Care (Rest Homes) Limited Mrs Janet Elizabeth Hunstone Care Home with Nursing (N) 50 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia- over 65 years of age (MD(E) 25 of places Physical disability (PD) 25 Dementia (DE) 25 Old age, not falling within any other category (OP) 25 Addison Court Nursing Home F57 F57 S22489 Addison Court V221025 April 20th 2005 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1 A maximum of 25 service users requiring nursing care who fall into the category of either OP or PD 2 A maximum of 25 service users requiring personal care who fall into either the categoryof OP 3 A maximum of 25 service users requiring nursing care who fall into either the category of DE or MD(E) 4 A maximum of 10 service users requiring personal care who fall into the category of either DE or MD(E) 5 Staffing for service users requiring nursing care will be be in accordance with the Notice issued dated 16 August 200 6 Total numbe rof service users wuithin the categoies not to exceed 50 (fifty) Date of last inspection 07 September 2004 Brief Description of the Service: Addison Court is a purpose built home situated in a small cul-de-sac in a mainly residential area. It is close to a number of shops and a church. The centre of Accrington is approximately 10 minutes walk away. The home has a small garden, which is accessible to residents who wish to sit outside when the weather permits. There is adequate parking for staff and visitors.Addison Court offers 24 hour nursing and personal care for up to 50 residents. This includes the Baxenden unit, which offers care for up to 25 residents who suffer from mental health problems or dementia. Accommodation is provided in single en suite rooms. A passenger lift facilitates access to all areas of the home. Addison Court Nursing Home F57 F57 S22489 Addison Court V221025 April 20th 2005 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 8.5 hours. One additional unannounced visit has been made since the last inspection. This visit was to investigate an anonymous complaint, which was not upheld. The report of this investigation is available from the CSCI office on request. A tour of the premises took place and staff and care records were inspected. Members of staff on duty, a student on work placement, 14 residents and 3 visitors were spoken to. Discussions also took place with the manager regarding issues raised during the inspection. What the service does well: What has improved since the last inspection? What they could do better: Addison Court Nursing Home F57 F57 S22489 Addison Court V221025 April 20th 2005 Stage 4.doc Version 1.20 Page 6 The care plans must identify all the care needs of individual residents and explain how these needs are to be met. Detailed records about the treatment and condition of pressure sores must be kept. The times of positional changes for resident’s at risk of developing pressure sores must be recorded. The manager explained that progress to involve residents and their relatives in care planning would continue. Medication prescribed for one resident must not be used for others. Medication must not be left unattended on a resident’s table until he or she decides to take it. Detailed records of all medication received into the home must be available. The manager was also advised to ensure that all handwritten instructions on the medicines administration records should be signed and witnessed by a second member of staff. Alternatives to the menu should be available for any resident who does not like the planned meals. The manager should ensure that the ‘whistle blowing’ policy is amended. 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. Addison Court Nursing Home F57 F57 S22489 Addison Court V221025 April 20th 2005 Stage 4.doc Version 1.20 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Standards Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6-10 and 18–21) (Standards 11–17) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37–43) Addison Court Nursing Home F57 F57 S22489 Addison Court V221025 April 20th 2005 Stage 4.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. 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. Prospective service users have an opportunity to “test drive” the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 (older people) and 2 (adults 18-65) Admission procedures were thorough. Appropriate pre-admission assessments were completed for each resident prior to admission in order to ensure that all members of staff were aware of their needs. EVIDENCE: Individual records of 7 resident’s were inspected. Each contained a detailed pre-admission assessment of need. The registered manager visited prospective residents in hospital or their own home prior to admission. One resident had been admitted in an emergency and on this occasion the assessment was completed following admission. The assessment of need provided valuable information for the care plan. The registered manager explained that all future residents would receive written confirmation that their assessed needs could be met at the home. Members of staff consulted were aware of the needs of individual residents. Addison Court Nursing Home F57 F57 S22489 Addison Court V221025 April 20th 2005 Stage 4.doc Version 1.20 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6-10 and 18 –21 (Adults 18-65) 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. Including their physical and emotional health needs. 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. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. Service users receive personal support in the way they prefer and require. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 7, 9, 18, 19 and 20 (Adults 18-65) are 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 (Older People) 6, 18,19 and 20 (Adults 18-65) Some progress has been made with involving residents and their relatives in care planning since the last inspection. Detailed information relating to all aspects of health care was not included in some care plans. This meant that there was the potential for health care needs not to be fully met. Medication practices needed to be improved to ensure that these were given in a way that met resident’s health care needs Addison Court Nursing Home F57 F57 S22489 Addison Court V221025 April 20th 2005 Stage 4.doc Version 1.20 Page 10 EVIDENCE: Individual care plans of 7 resident’s were inspected. These identified the personal care needs of each resident. However, they did not address all aspects of healthcare. It was evident that a ‘behavioural programme’ was being used for one resident with mental health needs. There were no details of this in the plan of care and no evidence that other professionals involved in his care had been consulted about this programme and were in agreement with it. Detailed information relating to the treatment, condition and progress of wounds including pressure sores had not been recorded. Records of the times of positional changes for a resident nursed in bed were not available. This potentially put the resident at risk of being left in the same position for several hours. Another resident, who was immobile, said at lunchtime that he had been sitting in his chair since 7.00am without any assistance to change position. Appropriate risk assessments were in place and strategies to minimise the risks were recorded these included the use of pressure relieving equipment. However, in one care plan these was a discrepancy in the risk of developing pressure sores identified in the risk assessment and the level of risk documented in the care plan. It was unclear from one of the risk assessments relating to pressure sores how the overall risk had been determined. One of the care plans inspected had not been reviewed since February. Some progress had been made since the last inspection with involving resident’s and relatives in care planning. This was evident in one of the care plans inspected. Two visitors confirmed that they had recently been involved in the review of the care plan for their relative. Apart from one tube of cream, which was in a resident’s room and not the fridge, medication was stored correctly in cupboards, trolleys and a fridge inside a locked utility room. The temperature of these areas was checked and recorded daily. One resident was responsible for self-medicating using an inhaler. An appropriate risk assessment was in place. Qualified nurses administered all other medication. Medication prescribed for one resident was being used communally. This practice is illegal and must cease. A dressing was being applied to a resident’s wound on a regular basis but this had not been signed for on the Medicine Administration Recording chart. A record of all medication received into the home was not available. Medication was observed to have been left on a table for a resident to take. This practice increases the risk of the medication not being taken and of another resident taking the medication by mistake. It was also noted that transcribing on the medicines administration records in some instances was not signed or witnessed. Members of staff consulted were aware that promoting privacy and dignity for all residents was an important aspect of their care. Addison Court Nursing Home F57 F57 S22489 Addison Court V221025 April 20th 2005 Stage 4.doc Version 1.20 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 11 – 17 (Adults 18-65) are: 12. 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. Including opportunities for personal development. Service users engage in appropriate leisure activities. Service users maintain contact with family/ friends/ representatives and the local community as they wish. And have appropriate personal, family and sexual relationships. 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. 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15, 16 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,14 and 15 (Older People) 14,16, and 17 (Adults 18-65) A variety of social activities were available. Residents were encouraged to make decisions relating to lifestyle and daily routines. Menus were varied and nutritious. EVIDENCE: The residents consulted said that the daily routine was flexible and they were able to get up and go to bed at a time of their choosing. A range of activities were planned and implemented by the activities co-ordinator. These included dominoes, cards, board games, skittles, crafts, knitting and trips out. In addition to this the activities co-ordinator had completed a diversional therapy care plan in respect of each resident, which contained information about his or her hobbies and interests. In one lounge the TV was switched on but the sound muted and ‘pop’ music was being played through a music centre. This meant that resident’s were getting mixed communication signals and had the potential to increase their level of confusion. During the inspection the Addison Court Nursing Home F57 F57 S22489 Addison Court V221025 April 20th 2005 Stage 4.doc Version 1.20 Page 12 activities co-ordinator was observed playing dominoes with a group of residents. The meal served at lunchtime on the day of the inspection looked appetising and wholesome. Members of staff were observed assisting residents in a patient and professional manner. Although the majority of residents commented that the meals were good one resident was unhappy with the choice of food available and consequently ate very little at lunchtime. The manager explained that following consultation with the residents she had decided to change the main meal to 4.30pm and serve a lighter meal at lunchtime. The new menus were available for inspection. These offered reasonable choice and would be rotated 4 weekly. The manager intended to monitor this change and after 4 weeks canvas the views of residents using a questionnaire. Addison Court Nursing Home F57 F57 S22489 Addison Court V221025 April 20th 2005 Stage 4.doc Version 1.20 Page 13 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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. Including neglect and selfharm. The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) 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 (Opder People) 22 and 23 (Adults 18-65) Complaints were taken seriously and investigated. Appropriate procedures and training were in place to ensure the protection of residents at the home. EVIDENCE: A comprehensive complaints procedure was in place. One complaint had been made to the home since the last inspection. This complaint was upheld and appropriate action had been taken. Written records of the complaint, investigation and action taken were available. One complaint had been made to the Commission but this was not upheld. All members of staff had received a copy of the policies and procedures for the protection of vulnerable adults and the General Social Care Council’s code of practice. Training in the protection of vulnerable adults was included in the induction programme and NVQ training. Members of staff consulted said that they would report any concerns immediately and were aware of the procedure. The manager explained that she was waiting for the ‘whistle blowing’ policy to be amended at the company’s head office. Addison Court Nursing Home F57 F57 S22489 Addison Court V221025 April 20th 2005 Stage 4.doc Version 1.20 Page 14 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) 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. Shared spaces complement and supplement service users’ individual rooms. Service users have sufficient and suitable lavatories and washing facilities. Provide sufficient privacy and meet their individual needs. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. And lifestyles. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 24 (Older People) and 24 and 26 (Adults 18-65) There was a well-maintained environment within the home. This meant that service users had a comfortable and homely place to live. EVIDENCE: A number of areas on general unit had been redecorated since the previous inspection. These looked clean and attractive. The lounge areas on this Unit had also been arranged so that there were small cosy groups of seating, which gave a homely impression. Residents spoken to said that they were happy with their rooms. The decoration on Baxenden Unit looked ‘tired’ in comparison with this. Also a number of wardrobes were without drawer fronts and knobs on drawers. This meant that they had reduced space for their clothes and belongings and may have difficulty in accessing these. The manager explained Addison Court Nursing Home F57 F57 S22489 Addison Court V221025 April 20th 2005 Stage 4.doc Version 1.20 Page 15 that there were plans to continue the decoration to include Baxenden Unit. Carpets and wardrobes would also be replaced as part of this programme. Locks had been fitted to the dining rooms on Baxenden Unit that had been fitted out as kitchenettes. Resident’s who had a late breakfast were seen to be unsupervised in these areas. This meant that they had the potential to access a hot kettle and microwave, as would any resident who wandered into the room. If these rooms are not to be kept locked or supervised by staff at all times then a risk assessment must be done on the use of these by residents. The shower room on Baxenden Unit was not in use and the bathroom on the second floor was being repaired. This meant that there were only two bathing facilities for 25 residents. Addison Court Nursing Home F57 F57 S22489 Addison Court V221025 April 20th 2005 Stage 4.doc Version 1.20 Page 16 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 36 (Adults 18-65) are: 27. 28. 29. 30. • • • Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. 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. Service users benefit from clarity of staff roles and responsibilities. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers standards 27, 29 and 30 (Older People) and Standards 34 and 35 (Adults 18-65) the key standards to be inspected at leat once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 29 (Older People) and 34 (Adults 18-65) Staffing levels and the skill mix of staff were appropriate to meet the assessed needs of the residents. Recruitment procedures were robust in order to protect the residents. EVIDENCE: Examination of the duty rota confirmed that a sufficient number of staff were on duty at all times to enable the needs of the residents to be met. The manager said that staff turnover and absence levels had continued to improve. Robust procedures for recruiting staff were in place. The files of 5 members of staff appointed since the last inspection were examined. Each file contained all the required information including 2 written references and a CRB check. On appointment members of staff were issued with a contract of terms and conditions of employment. Addison Court Nursing Home F57 F57 S22489 Addison Court V221025 April 20th 2005 Stage 4.doc Version 1.20 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 37 – 43 (Adults 18-65) are: 31. 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 a well run home and from competent and accountable management of the service. 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. Service users are confident their views underpin all self-monitoring, review and development by the home. 32. 33. 34. 35. 36. 37. 38. • The Commission considers standards 33, 35 and 38 (Older People) and Standards 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36 and 38 (Older People) and 36 and 42 (Adults 18-65) All care staff received regular supervision and training. Appropriate procedures were in place to safeguard the health, safety and welfare of residents. EVIDENCE: Members of staff said that they had an annual appraisal and regular supervision. Records to support this were available. The manager explained that a health and safety committee had recently been convened. This consisted of the maintenance man, chef, administrator, nurse, one care assistant from the day shift and one from night duty. The remit of Addison Court Nursing Home F57 F57 S22489 Addison Court V221025 April 20th 2005 Stage 4.doc Version 1.20 Page 18 this committee was to meet monthly to discuss health and safety issues and suggest solutions to any problems. Minutes of the meetings were available. Members of staff had received training in fire safety, moving and handling and first aid. Records confirming this were seen. Safety procedures were displayed in the home. Addison Court Nursing Home F57 F57 S22489 Addison Court V221025 April 20th 2005 Stage 4.doc Version 1.20 Page 19 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 Standard No Score 1 x 2 x 3 2 4 x 5 x 6 N/A HEALTH AND PERSONAL CARE ENVIRONMENT Standard No 19 20 21 22 23 24 25 26 STAFFING Score 2 x x x x x x x Score Standard No 7 8 9 10 11 Score 2 2 2 x x Standard No 27 28 29 30 3 x 3 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No 16 17 18 Score 3 x 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 x 32 x 33 x 34 x 35 x 36 3 37 x 38 3 Addison Court Nursing Home F57 F57 S22489 Addison Court V221025 April 20th 2005 Stage 4.doc Version 1.20 Page 20 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 3 Regulation 14(1)(d) Requirement Timescale for action 1 July 2005 2. 7 15(2)(b) (c) 3. 8 13(1)(b) Thr registered person shall not provide accomodation to a service user at the care home unless, so far as it shall have been practicable to do so - (d) the registered person has confirmed in writing to the service user that having regard to the assessment the care home is suitable for the purpose of meeting the servide users needs in respect of his health and welfare. The registered person shall (b) 1 July 2005 keep the service users plan under review; (c) where appropriate and, unless it is impracticable to carry out such consultation, after consultation with the service user or a representative of his, revise the service users plan. The registered persons shall 27 May ensure that service users receive 2005 where necessary treatment, advice and other services from any health care professional. All relevant health care professionals should be consulted about, and be in agreement with, any behavioural Version 1.20 Page 21 Addison Court Nursing Home F57 F57 S22489 Addison Court V221025 April 20th 2005 Stage 4.doc plan to be used. 4. 8 12(1)(a) (b) The registered person shall ensuoure that the care home is conducted so as (a) to promote and make proper provision for the health and welfare of service users; (b) to make proper provision for the care and, where appropriate, treatment, education and supervision of service users. Records must be kept of all positional changes for residents at risk of developing pressure sores. A record of incidence of pressure sores and of treatment provided to the service user. The registered person shall make arrangements for the recording, handling, safe keeping, safe administration and disposal of medicines received into the care home. Prescribed medication must not be used communally. A record of all medication received into the home must be kept. Medication must not be left unattended on a table. The registered persons shall ensure that all parts of the home to which residents have access are so far as reasonably practicable free from hazards to their safety, and that unnecessary risks are identified and so far as possible eliminated. A risk assessment should be done on the use of the dining rooms with kitchenettes, especially access to these by residents when the rooms are unlocked or unsupervised by staff. (Timescale of 26 Nov 2004 not met) 27 May 2005 5. 6. 8 9 17(1)(a) Schedule 3 (p) 13(2) 27 May 2005 27 May 2005 7. 19 13(4)(a) (c) 27 May 2005 Addison Court Nursing Home F57 F57 S22489 Addison Court V221025 April 20th 2005 Stage 4.doc Version 1.20 Page 22 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. 3. 4. 5. 6. 7. Refer to Standard 9 9 12 15 18 19 19 Good Practice Recommendations All prescribed dressings should be signed for on the medication administrtaion record when administrered Transcribing on medicines administration records should be signed and witnessed. The use of the TV and music should not take place at the same time. Residents be consulted about which they prefer. An alternative to the planned menu should be available for any resident who does not like the meal offered. The whistle blowing policy needs amending to include details of the protection available for the Whistle Blower. Details of the programme of refurbishment and decoration on to be done on Baxenden unit should be sent to the Commission That the number of bathing facilities on Baxenden Unit is increased to the number previously provided. Addison Court Nursing Home F57 F57 S22489 Addison Court V221025 April 20th 2005 Stage 4.doc Version 1.20 Page 23 Commission for Social Care Inspection 1st Floor, Unit 4 Petre Road Clayton-Le-Moors, Accrington Lancashire BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Addison Court Nursing Home F57 F57 S22489 Addison Court V221025 April 20th 2005 Stage 4.doc Version 1.20 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!