Inspection on 15/05/07 for Afton Lodge Care Home

This inspection was carried out on 15th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Afton Lodge Care Home 25/11/08

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Afton Lodge Care Home 9-15 St Catherines Road Bootle Merseyside L20 7AC Lead Inspector Sylvia Brown Key Unannounced Inspection 15th May 2007 10:00 X10015.doc Version 1.40 Page 1 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 Afton Lodge Care Home DS0000069521.V335479.R01.S.doc Version 5.2 Page 2 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. Afton Lodge Care Home DS0000069521.V335479.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Afton Lodge Care Home Address 9-15 St Catherines Road Bootle Merseyside L20 7AC Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0151 922 6183 Muhammad Fayyaz Chauhdry Mr Asif Iqbal Alvi Care Home 27 Category(ies) of Learning disability (1), Old age, not falling registration, with number within any other category (27) of places Afton Lodge Care Home DS0000069521.V335479.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only. Care home only - code PC, to service users of the following gender:Either. Whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category - Code OP, (maximum number of places: 27) Learning Disability - Code LD, (maximum number of places : (1) Two named service users under pensionable age may be accommodated. The maximum number of service users who can be accommodated is: 27 Date of last inspection This is the first inspection under the new management. Brief Description of the Service: Afton Lodge is registered to provide accommodation and care without nursing for up to 27 older people. The home is a large double fronted house in a residential area of Bootle. The local shopping centre is near by as is the local train station . There is also good access to public transport close by. Internally the home offers two lounges, one of which is cuurently used by people who smoke, however due to change in legislation all lounges will be made non smoking in the near future. People who use the service have use of a communal dining room which is large enough to seat everyone in one sitting. People who use the service are able to have a private single bedroom or share facilities with another person if they wish. However most double rooms are currently used for sigle occupancy. To the rear of the home is a large garden area which is well maintained and safe for use, to the front there is limited parking within the walled forecourt. On-street parking is only allowed with a residents permit from the local council. Afton Lodge Care Home DS0000069521.V335479.R01.S.doc Version 5.2 Page 5 The home does not provide nursing care but has care staff 24 hours a day it also provides the services of a cook, handyman and domestic staff. The current charge for accommodation is £360.50 which includes care support, meals laundry and activities. Charges are made for personal purchases such as hardressing. Contubutions may be asked for towards external trips. Regency healthcare (UK)LLP became registered owners in March 2007. Afton Lodge Care Home DS0000069521.V335479.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The visit to Afton Lodge was undertaken on one day starting at 8.45am.The home was not told that the inspector would be visiting that day. Information was gathered from a number of sources such as the pre-inspection questionnaire and comment cards which were sent to people who use the service and where possible their relatives. Any information received by the commission since the last inspection is also taken into account. During the inspection the inspector sat and observed the day to day routines of people who use the service and staff who provided care support. Time was spent talking with people who use the service and sharing a lunchtime meal with them. The building was inspected as were records relating to the care needs of people who use the service and their health and safety. Staff and management were also involved in the visit, giving information to the inspector to help in getting a full picture of the home and how it operates. The care of two people who use the service was looked at in detail. This inspection is the first one under the new ownership. The manager made herself available throughout the inspection and was open and honest when asked about the running and development of the home. Overall it was clear that even in the short time from taking over Afton Lodge the company has made a commitment to improve many aspects of the home for people who use the service. What the service does well: What has improved since the last inspection? Afton Lodge Care Home DS0000069521.V335479.R01.S.doc Version 5.2 Page 7 This was the first inspection under the new ownership. It is evident that since the last inspection, which was completed in February 2006, standards were not maintained prior to the sale of the home. The manager stated that the care plans have been looked at and developed since she became manager in December 06 and are an improvement on what was originally at the home. The registered owners and manager have recognised that the home is showing signs of ageing and needs upgrading. So far ten new beds have been purchased and communal rooms have been measured for new carpets and redecoration is planned. The home has been requested to provide the CSCI with a full upgrading programme, which includes room-by-room details and the time scale for completion. Advice has been given to prioritise those areas that are used by people who use the service particularly private areas. One room had strong odours and required significant work to eliminate them. What they could do better: The homes statement of purpose has been developed to reflect the new owners view on the service, this now needs amending to show the actual way the service is provided. The service users guide also needs changing to give prospective users of the service a clear view of what is provided at Afton Lodge. The homes recording systems did not contained sufficient information. Some care plans did not sufficiently record the person’s individual preferences and care needs or how those should be met in an individual manner by care staff. Daily records failed to demonstrate what support was provided, records of food served were not kept and the homes menu was not followed, this meant that the home could not demonstrate that people who used the service received a varied diet. Medication administration records were not signed correctly and records that confirmed professional visitors attend the people who use the service were not properly completed. Records about people who use the service must be maintained to the highest standard in order to be accurately reflecting the care support they receive. Afton Lodge Care Home DS0000069521.V335479.R01.S.doc Version 5.2 Page 8 This enables people who use the service to be accurately assessed and ensure that their needs are known and met. The management have attempted to develop an activities room for people who use the service, however it is not situated where people can easily use it. Comments like, ‘ they (the home) could do more activities’,‘ I would like to go out shopping’ and ‘they could provide more entertainers’, were made by people using the service. Some of the practices at meal times did not show the promotion of independence for people using the service and should be reviewed. There was also no evidence that people were able to choose their meal from options, as the menu displayed was not followed by the cook. It was not possible to tell what training people had received and staff had not received regular supervision to ensure training needs and care practices were monitored. 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. The summary of this inspection report can be made available in other formats on request. Afton Lodge Care Home DS0000069521.V335479.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Afton Lodge Care Home DS0000069521.V335479.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 & 4 Standard 6 does not apply. This home does not provide this service. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who may wish to use the service receive information about the home, which enables them to make decisions about their future. EVIDENCE: Since taking over the home the new owners have produced a draft statement of purpose. The document still needs some development to ensure that it contains sufficient details in all areas. The home has yet to produce a service users guide. From information received it was unclear if all people who use the service had received up to date contracts. It was also unclear how they had been informed that new owners had taken over the home. Afton Lodge Care Home DS0000069521.V335479.R01.S.doc Version 5.2 Page 11 It was evident that the homes receives pre assessments from placing authorities and that a visit is made to the prospective person in their own home or placement prior to moving in and an assessment is completed. Once assessed people who are considering using the service receive written confirmation that the home can or cannot meet their needs. Afton Lodge Care Home DS0000069521.V335479.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who use the service have their health care needs met; however records are not kept in sufficient detail. EVIDENCE: At the time of the inspection new care plans had been put into place. Whilst they covered the basic elements of care, they need further development to ensure that all the individual care needs and personal preferences for care are recorded and how those needs should be met. Oral health care was not included, personal bathing routines and general care support was not sufficiently detailed. Furthermore records did not accurately reflect treatments and visits by health care professionals. Afton Lodge Care Home DS0000069521.V335479.R01.S.doc Version 5.2 Page 13 Whilst nutritional assessments were in place, records did not detail specific mealtime care plans or how the person who uses the service is supported to maintain a healthy well balanced diet. The monitoring of weights of people who use the service was not accurate or reliable. The home has several people who use the service who have significant mobility difficulties and cannot stand independently. The home does not have appropriate scales to weigh them. Notwithstanding the homes failings to maintain detailed records, people who used the service appeared well cared for. Staff supported them discreetly and with respect. It was evident that some received appropriate health care support such as optical checks and chiropody services. Comment cards stated that people who use the service felt they received the care and support they wanted and needed and that staff were there when they were needed. Medication administration records were looked at. They had been started two days prior to the inspection, however there were eighteen signature omissions. The manager stated that some of the medication was no longer required and accepted that records were not maintained, as they should have been. Medication where variable dosages could be given i.e. 1 or 2 did not detail how many were administered. One medication prescribed to be given in the evening was administered in the morning. There was no written information to confirm the doctor directed the changes. The home did not have any procedures in place to monitor staff’s competency regarding medication administration or for evaluating medication administration records. Afton Lodge Care Home DS0000069521.V335479.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. People who use the service do not socialise and join with others in the community. They are not consulted with and do not influence how the home is developed. EVIDENCE: The per-inspection questionnaire identified the homes activity programme. At inspection it was evident that the home had attempted to improve activities for people who use the service by creating an activities room on the uppermost floor of the home and a student Social Worker designated to provide activities. Unfortunately this provision was not well received by people living at the home, as a consequence activities have not been provided as planned. Comment cards indicated that at least two people who use the service would appreciate more activities, including visiting entertainers and by going out into the community. When asked how things could be improved one stated ‘ we Afton Lodge Care Home DS0000069521.V335479.R01.S.doc Version 5.2 Page 15 could have more to do’ and ‘ we would like more entertainment’ another stated ‘ would like more entertainment and to be taken out to do some shopping’. The pre-inspection questionnaire identified that three people who use the service have dementia type illnesses, three had mental health conditions, and furthermore one person has a learning disability. It was not evident if any staff had been trained in supporting people with such needs and or of their understanding about appropriate activities that may support their wellbeing. Arrangements were in place to support one person who used the service to have an annual holiday away from the home. The person was being offered a holiday in another home owned by the owners near the seaside. Advocacy services are provided for those people who use the service who require independent advice and guidance. Visitors were observed during the inspection, most of who chose to sit in the communal parts of the home, mainly the lounge. The manager stated that people who use the service are able to make as far as possible their own decision and choices regarding their daily routine. Rising and retiring times are flexible as are bathing routines. The home did not at the time of the inspection hold group meeting that enabled people who used the service to influence how the home was run and develop. Prior to the inspection the home provided the CSCI with a copy of the homes menu. It identified a variety of food that offered choice and appeared to be nutritionally balanced. On the day of the inspection the menu was displayed within the home, but this was not followed. The presentation of the meal was poor and indicated little thought as to what food items were being served together. There was no evidence that records of food served were properly maintained and although it was stated that a dietician had been involved for one person there was no written record of recommendations or actions required to improve diet for that individual. The manner in which the lunchtime meal was provided did not promote independence and there was evidence of institutional practice in the delivery of drinks to people. Crockery was a miss matched and chipped and there had not been provision of adapted cutlery and crockery where this was necessary. Afton Lodge Care Home DS0000069521.V335479.R01.S.doc Version 5.2 Page 16 The manager indicated that changes to the crockery and dining room furniture was under consideration and that they had recruited a cook who would be commencing work once all statutory checks had been completed. The manager was hopeful that this would improve the service. Comments received from those who used the service reflected that they accepted the situation and found the food to be tasty. One stated ‘more choice was needed’. Afton Lodge Care Home DS0000069521.V335479.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who use the service know about and felt able to use the homes complaints procedure. EVIDENCE: The home has written complaints procedures in place. There have been no complaints received at the home since the new ownership. No complaints have been report to the CSCI. Information received from comment cards indicated that people who use the service were aware of and felt confident in the homes complaints procedure. All indicated they knew who to go to if the were not happy with the service. Adult protection procedures were in place, however the manager was a little vague when asked about local authority procedures and was not sure if staff had received training in those procedures. The manager stated that staff that have achieved NVQ training have received some training in adult protection. It was clear when speaking with the manager that should she become aware of and or have suspicion of any form of abuse she would take action to protect people who use the service. Afton Lodge Care Home DS0000069521.V335479.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who use the service live in a home that requires upgrading. EVIDENCE: The new owners took ownership approximately seven weeks prior to the inspection. It was evident that the home was showing signs of wear and tear prior to the change in ownership. The new owners have purchased, ten new beds and new carpeting has been planned for all communal parts of the home. In the manager is looking for dining chairs that will be suitable to meet the needs of all people who use the service. Urgent repairs and or replacement are planned for some windows. Afton Lodge Care Home DS0000069521.V335479.R01.S.doc Version 5.2 Page 19 Many parts of the home require upgrading, and the registered owners have been asked to produce a full detailed upgrading programme which includes fixtures and fittings, bedding, crockery and all other items which will increase the comfort of people who use the service and provide a more inviting living environment. The home was almost completely free of odours. One room had odours, however plans were in place to replace the carpet once the under flooring had been disinfected and treated. Most bedrooms were of a good size, they were personalised and some decorated to an adequate standard. Discussions were held with the manager regarding enabling people who use the service to choose their own colour schemes and bedding etc. Most people had personalised their rooms as they wished. Most double bedrooms are used for single occupancy; this enables people who use the service to have privacy and suitably sized rooms for their private use. Comment cards identified that people who use the service were contented with the home and that the home was kept fresh and clean. Afton Lodge Care Home DS0000069521.V335479.R01.S.doc Version 5.2 Page 20 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29& 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who use the service are protected by the homes recruitment and selection procedures. They have sufficient numbers of staff on duty to assist them EVIDENCE: The home maintains an appropriate staffing level to meet the needs of people accommodated. All staff files seen indicated that staff were recruited correctly. Appropriate documentation was completed and statutory checks were in place. Some improvement in recording of interview processes would enhance the quality of these records. The home does not provide laundry staff. The placement of the laundry is external to the main part of the home; therefore staff are not able to attend people who use the service whilst they complete laundry. Each new employee commences an induction programme, however it was not evident that the induction met the standards set by Skills for Care and thus did not confirm competence of carers in all aspects of their duties. Afton Lodge Care Home DS0000069521.V335479.R01.S.doc Version 5.2 Page 21 Five of the eighteen care staff have achieved NVQ training at level 2 or above. In addition four staff were completing NVQ training. The manager is aware that 50 should be NVQ trained and is working towards meeting that standard. The home provided a training matrix which detailed staffs completed training. It was evident that the registered manager and some care staff required mandatory training and or were due for updated training in medication administration, moving and handling, health and safety, and infection control. It would also be expected that all care staff receive some training in dementia and associated conditions and behaviours, learning disability, providing stimulating and enjoyable activities which improve general well being. Afton Lodge Care Home DS0000069521.V335479.R01.S.doc Version 5.2 Page 22 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who use the service live in a home that is managed by an experienced manager. EVIDENCE: The manager Mrs Teresa Roston has been at Afton Lodge for approximately seven months. She was recruited and selected by the previous owners and continued in her positions of manager under the new ownership. She has experience in managing care homes and has some training in management procedures. The manager has not been registered with the CSCI nor has it been confirmed that her management training is equivalent to NVQ level 4. The manager has not achieved the registered managers award. Afton Lodge Care Home DS0000069521.V335479.R01.S.doc Version 5.2 Page 23 The manager’s style appears to be direct, during conversations she was aware of all the needs of people who use the service and appeared to have a good relationship with them and the staff team. Currently the home does not provide people who use the service with routine or regular meetings within which they are consulted about their individual and or group opinions on how the home is manage, developed or if they are satisfied with the quality of the services provided. Health and safety records looked at identified that the home did have systems in place for monitoring of safety matters, however the system for monitoring safety in the kitchen was not fully implemented. Work place risk assessments that comply with Management of Health and Safety at Work Regulations 1999 were not in place. It was unclear if the manager and those who had been delegated with the responsibility for health and safety had received appropriate training and guidance. Fire safety checks appeared to be completed at the appropriate frequency and there was evidence that some fire safety training and lectures were provided to some staff. However records could no demonstrate that all staff had received up to date practical fire drill training. Gas and electrical appliances had been serviced. Environmental health officers inspected the premises in 2006 and were generally satisfied with the standards maintained. The home has commenced providing staff with formal supervision. The manager has delegated some aspects to the deputy manager. It was not evident if the home had an up to date supervision policy or procedure that all staff were familiar with and if training had been provided for those undertaking supervision. Afton Lodge Care Home DS0000069521.V335479.R01.S.doc Version 5.2 Page 24 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 2 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 2 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 3 3 3 2 2 2 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 2 X 3 2 X 2 Afton Lodge Care Home DS0000069521.V335479.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No 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 OP9 Regulation 13.2 Requirement Staff must stick to policies; procedures and guidance for the safe recording of and administering medicines to ensure medicines are given at the right time to the right person in the right dosage. The manager and all staff must receive training in and be familiar with Local authority adult protection procedures. To ensure that all staff are able to identify and respond to abuse appropriately. A detailed plan for upgrading of the home including timescales must be provided to ensure that the environment is improved for the benefit of people using the service. The manager must make application to register with the commission. Timescale for action 15/05/07 2 OP18 13.6 18.1 (c ) (i) 01/07/07 4 OP19 19 15/06/07 5 OP31 8,9 &10 01/07/07 Afton Lodge Care Home DS0000069521.V335479.R01.S.doc Version 5.2 Page 26 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 8 9 10 11 12 Refer to Standard OP1 OP2 OP7 OP7 OP8 OP8 OP9 OP12 OP12 OP14 OP15 OP29 Good Practice Recommendations The statement of purpose and service users guide should be up to date and provided to current and prospective service users. People who use the service should have amended contracts that reflect the new company’s terms and conditions. Care plans should be individual and detail all the care needs and support for people who use the service and how those needs are to be met. Daily records should be completed to evidence care support provided to the people who use the service. People who use the service should have their health care treatments and support services recorded. Weighing scales provided should enable the accurate monitoring of weights for all people who use the service. Management systems should be introduced and followed to monitor staff competency in medication administration procedures and for monitoring associated records. An activities programme should be developed which meets the needs of individuals and groups of people accommodated. Staff receive should be trained and developed to meet the needs of people accommodated at the home. People who use the service should be consulted about services offered when making decisions about developments in the home. Menus should offer variety and choice to people using the service. Current photos, interview procedures, letters of employment and job descriptions should be held in staff files to evidence recruitment and selection procedures are fully followed. DS0000069521.V335479.R01.S.doc Version 5.2 Page 27 Afton Lodge Care Home 13 14 15 16 OP30 OP36 OP38 OP38 Induction procedures should meet the standard set by Skills for Care. A supervision policy and procedure should be developed that is shared with staff and those conducting supervision should have appropriate training. Environmental risk assessments should be in place and known to staff, these must include food safety procedures for the kitchen All staff should receive practical fire drill training. Afton Lodge Care Home DS0000069521.V335479.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. 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