Inspection on 09/06/05 for Alder House Cheshire Home

This inspection was carried out on 9th June 2005.

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

Other inspections for this house

Alder House Cheshire Home 07/10/08

Alder House Cheshire Home 31/10/06

Alder House Cheshire Home 03/03/06

Alder House Cheshire Home 13/01/05

Alder House Cheshire Home 27/05/04

Similar services:

Claremont House

Sun Court Nursing Home

Bramley Avenue (73)

15 Bramble Close

Dolphin Court

Fen Road

Wakes Hall

165 Putnoe Lane

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

CARE HOME ADULTS 18-65 Three Forests Cheshire Home Lambourne Road Chigwell Essex IG7 6HH Lead Inspector Gaynor Elvin Unannounced 09 June 2005 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Three Forests Cheshire Home I56-I05 S17981 Three Forests V231292 UI090605 - Stage 04.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Three Forests Cheshire Home Address Lambourne Road Chigwell Essex IG7 6HH 020 8500 8491 020 8500 4660 threeforests@lk.leonard-cheshire.org.uk Leonard Cheshire Foundation 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) Mr Dilip Mahadeo Care Home (CRH) 15 Category(ies) of Physical Disability (PD), 15 registration, with number of places Three Forests Cheshire Home I56-I05 S17981 Three Forests V231292 UI090605 - Stage 04.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, under the age of 65 years, who require care by reason of physical disability (not to exceed 15 persons). Date of last inspection 13/01/2005 Brief Description of the Service: Three Forests is a care home registered to provides care and accommodation to fifteen people with physical and sensory disabilities. The home is part of the Leonard Cheshire Foundation and Mr Dilep Mahadeo is the Registered Manager. Three Forests is a purpose built, single storey building set in beautiful gardens incorporating a large lake, located in a semi rural area of Chigwell, Essex on the border of London. A bus route provides access to the home, although the bus stop is approximately 10 minutes away by foot. There is a local train station and Woodford station is approximately 30 minutes away. Single accommodation is adapted for wheelchair users and has en suite toilet and bathroom facilities. Some rooms have additional space providing a sitting area and kitchen facilities. The home is set in attractive and mature grounds, which are well maintained and accessible to wheelchair users. Each room opens out onto its own well maintained individual garden and patio area with garden seating. Three Forests Cheshire Home I56-I05 S17981 Three Forests V231292 UI090605 - Stage 04.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place one day in June 2005. The process initially included a tour of the building; individual discussions with five residents, three staff members and the home’s administrator and examination of service users files, documentation and service records, which lasted approximately six and a half hours. The inspection process took more time over the following weeks for further discussions with the Registered Manager, who was not available on the day, and to receive requested documentation, also not available on the day, with regard to issues highlighted during the inspection. This report refers to the service users as residents, as this was the preferred term of address expressed by the residents, throughout Cheshire homes. What the service does well: What has improved since the last inspection? What they could do better: The home needs to review processes that will involve the residents to participate in the decision-making within their home and empower them to take a more active role within the service as a whole. Workable risk management strategies must accompany risk assessments with regard to health and safety in the workplace and measures taken ensure the health, safety and welfare of residents are protected and promoted and individual care needs are appropriately met within these strategies. Three Forests Cheshire Home I56-I05 S17981 Three Forests V231292 UI090605 - Stage 04.doc Version 1.30 Page 6 The practice of having one communal bathroom between fifteen residents does not meet the home’s stated purpose or National Minimum Standards, and is not acceptable and must be addressed immediately. The home must review staffing numbers according to the assessed needs of the residents regularly and ensure an adequate staff ratio to residents’ needs is provided. The manager needs to ensure the pre-admission process is revised in line with the required National Minimum Standard. Failure to carry out a thorough preadmission needs assessment and by not obtaining the Care Management assessment prior to admission results in serious repercussions for the health and welfare of the individual concerned and the home is unable to meet their needs appropriately. This, therefore, needs to be addressed. 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. Three Forests Cheshire Home I56-I05 S17981 Three Forests V231292 UI090605 - Stage 04.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Three Forests Cheshire Home I56-I05 S17981 Three Forests V231292 UI090605 - Stage 04.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 3 & 4 The home promoted the opportunity for prospective residents to visit the home prior to admission, enabling the prospective resident and their relative/representative to feel confident and comfortable about their move. The home did not operate a thorough pre-admission assessment process, giving care and attention to ensuring the home was admitting individuals whose entire assessed needs could be fully met. EVIDENCE: The most recently admitted resident visited Three Forests prior to admission, together with family; this enabled an informed choice to be made with regard to the appearance of the home, environment, food, staff and residents. The home did not obtain a Care Management Assessment prior to the individual’s admission to the home nor did the home carry out a thorough pre-admission needs assessment to ensure the service and facilities provided by the home could fully meet the prospective residents identified personal and health care needs, specifically with regard to adequate, suitable bathing facilities. It was recognised following admission that the facilities provided were not adequately suitable to meet their needs. Three Forests Cheshire Home I56-I05 S17981 Three Forests V231292 UI090605 - Stage 04.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. 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 The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 & 8 The home does not have an adequate system for regularly reviewing plans of care with the resident and re-assessing needs. External management of Leonard Cheshire did not fully consider the psychological, emotional or social effects the current building renovations would have on the residents with regard to the loss of an important part of their private accommodation. Appropriate consultation, active listening and promotion of choice, wishes and the maintenance of optimal independence, on this occasion, were not considered or the residents’ rights respected. EVIDENCE: Three care files were examined; two of these contained clear care plans, covering all key needs and providing detail of the action required of staff to meet those needs. There was no evidence of the care plans being regularly reviewed or evaluated or the service users being continually involved with the care planning process. Residents indicated that their care was reviewed annually but felt they should be reviewed more often than this as their needs were changing. Staff spoken with demonstrated their knowledge and understanding of the residents’ needs and familiarity with their care plans. Three Forests Cheshire Home I56-I05 S17981 Three Forests V231292 UI090605 - Stage 04.doc Version 1.30 Page 10 The file for a resident admitted to the home some three weeks prior to the inspection did not contain an assessment of needs or a care plan, although care staff indicated they clearly knew the care needs even though they were not documented. Care plans commenced with the resident’s expectations of the service and were jointly signed by the resident and the key worker, however there was no evidence of a review to actually look at whether their expectations had been met. Residents’ meetings took place but it was felt that they were used as a means for the home to provide information with regard to planned developments within the home, or within Leonard Cheshire, as opposed to a two-way consultation. Residents said they had an opportunity to give their views or raise concerns regarding day to day living within the home but felt they no longer had a voice enabling them to influence key decisions with the external management of Leonard Cheshire with regard to services. With regard to the current upgrade of the home, residents felt they had been actively involved in the preliminary planning of the home’s refurbishment, to be financed by a substantial donation to Three Forests. They were later informed that the final plans were very different. Four residents found that their flatlets were to be reduced to a bedroom with en suite shower facilities and they were losing their kitchenette and lounge/sitting area. One resident had resided at Three Forests for approximately sixteen years and was very distraught at this loss. She said that she used the kitchenette facilities to make drinks and snacks during the evenings and this was all she had left to maintain optimal independent living and the sitting area was used for private, quiet times and receiving visitors. The opportunity of moving into supported living accommodation was offered to this individual, which she did not take up due to the potential deterioration of her disease process and the potential isolation and loneliness after living amongst friends. Three Forests was also central to family enabling family links to be maintained with ease. The service user and her family attended a meeting to express her concerns with the reviewing officer. They were advised that as long as the alterations met NMS her placement contract would not be affected, and the current accommodation was for independent living and not required within a residential setting such as Three Forests. They were also advised of the complaints procedure. The residential contract did not include the possibility of reducing long-term private facilities. Discussions with other service users affected by the same situation indicated they also were distressed but did not feel they had a right to speak up. One was worried she would be evicted. Three Forests Cheshire Home I56-I05 S17981 Three Forests V231292 UI090605 - Stage 04.doc Version 1.30 Page 11 Subsequent to the inspection a senior manager of the providing organisation has contacted the CSCI to state that the final plans were as agreed with the residents and had not been subsequently amended. Three Forests Cheshire Home I56-I05 S17981 Three Forests V231292 UI090605 - Stage 04.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15, 16 & 17 The home offered opportunities to promote and maintain social inclusion and a purposeful lifestyle in and outside the home. Contacts with family and friends were strongly encouraged and well developed. Not all staff respected the rights of residents or showed respect when entering bedrooms. The home supplied a good quantity and quality of food and provided a wellbalanced and nutritious diet that met individuals’ needs. EVIDENCE: The home employs an activity co-ordinator for 30 hours a week, and together with the volunteer co-ordinator, seven volunteers and care staff, residents are supported in pursuing activities of their choice individually or in groups and opportunities are pursued to participate in bigger events. The home had successfully applied for the disabled ballot for Wimbledon and received four tickets for No 1 Court on finals day. All the residents wanted to go so a draw was organised to fairly distribute the tickets. Three Forests Cheshire Home I56-I05 S17981 Three Forests V231292 UI090605 - Stage 04.doc Version 1.30 Page 13 Residents were satisfied with the type and level of activity available. From discussion with residents, individual choices were accommodated with regard to day-to-day activities. A new plasma TV had been purchased from donations and ideally placed in the lounge for all to see. One resident, who never left her room and watched her own TV, now comes out every day to watch the large screen. Visiting arrangements were open and relaxed and the home promoted contact with the local community. Residents spoken with felt some staff did not always respect privacy and dignity, especially during the night, to the point that one resident had to put a ‘please knock and wait’ sign on the door. The residents had raised this issue with the manager and staff were reminded to observe privacy and dignity in their approach to care. However, some residents felt there had been little improvement. Residents spoken with were positive about the meals provided and confirmed that a choice of food was always available. The main meal of the day of the inspection was sampled and was commendable in view of it being freshly prepared, nutritional value, presentation and taste. Staff assisted residents with eating appropriately. The dining room was pleasant. The home had two vehicles for the residents, one to take residents to outpatient/GP appointments and the other for leisure activities. Family members are encouraged to book a vehicle to enable family outings to take place. Driving licenses are checked, named daily insurance cover is taken out under the home’s policy and test drives are given and risks assessed. Holidays were promoted in alternative Leonard Cheshire homes around the country. Three Forests Cheshire Home I56-I05 S17981 Three Forests V231292 UI090605 - Stage 04.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 & 19 Personal care needs with regard to maintaining hygiene, promoting self esteem and body image were not appropriately met. EVIDENCE: Feedback from residents with regard to delivery of personal care and meeting health needs was overall positive, and felt staff supported them well. Records generally showed good monitoring of health needs and appropriate referrals to healthcare professionals were made. The home’s weighing equipment had recently ceased to function resulting in residents not being weighed and monitored. A newly admitted resident had not been weighed prior or on admission to the home which placed her at risk with regard to appropriate use of bathing and lifting equipment. During the inspection process it became clear that individual needs with regard to bathing and personal care were not being met appropriately. Residents were restricted to one or two baths a week as only one bath was being used in the home. One resident was very distressed at not being able to have daily baths and hair wash. Some residents indicated they would like to be able to access a bath more regularly but understood the staff were very busy. Three Forests Cheshire Home I56-I05 S17981 Three Forests V231292 UI090605 - Stage 04.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 Arrangements satisfactory. EVIDENCE: A clear and effective complaints procedure was in place. Leaflets were accessible around the home entitled ‘Have Your Say’. Residents said they felt comfortable in raising any concerns with Mr Mahadeo, the Registered Manager, and would not necessarily go through a formal complaints procedure. One resident had recently spoken to him about a staffing problem and felt confident the situation would be managed and resolved appropriately. for responding and acting upon any complaints were Three Forests Cheshire Home I56-I05 S17981 Three Forests V231292 UI090605 - Stage 04.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 29 & 30. The home is comfortable, clean and homely and residents live within a safe environment. Residents are able to express their individuality in personalising their own rooms with possessions and decoration of their choice. An appropriate amount of bathing facilities or the choice of a shower were not available for the current residents accommodated at Three Forests to meet their individual needs. EVIDENCE: Single accommodation was provided in the form of four flatlets and eleven bed sits, all above minimum required floor space with en suite facilities. All rooms were lockable but one resident indicated they did not have lockable facilities within their rooms. Taps, light switches, plug sockets and call bell panels were at accessible heights for wheelchair users. Each room had a large push open fire door accessible for large wheelchairs and beds, which opened out onto the resident’s own garden and patio area. Overhead hoist facilities were available in each bedroom and bathroom. Three Forests Cheshire Home I56-I05 S17981 Three Forests V231292 UI090605 - Stage 04.doc Version 1.30 Page 17 No further action had been taken to address the extensive damage to doorframes, which do not have an accessible minimum width of 800mm for wheelchairs, highlighted in previous inspection reports. Previous discussions had taken place with regard to the improvements to wheelchairs and their power pack capacity resulting in them being replaced by larger models. It was not evident this issue had been taken into consideration or addressed within the current renovations. All residents’ bedrooms have an en suite facility with a bath and overhead hoist. Discussion took place in previous inspections with regard to some en suite facilities requiring upgrade to enable the safe manoeuvre of some residents and assurance was given that these issues were being addressed within the refurbishment plans. Prior to the inspection an enquiry had been received by the Commission with regard to the bathing facilities for all residents at Three Forests. This and associated issues highlighted during the inspection required a further line of inquiry with the Registered Manager who was not available on the day of the inspection. Through further discussion with the Manager it became apparent the home had not been using any of the en suite facilities or the communal shower for approximately two years, as they did not meet health and safety guidelines according to the Leonard Cheshire moving and handling policy and procedure and workplace risk assessment. One communal bathroom was being used for fifteen service users. It is of great concern to the CSCI that Leonard Cheshire allowed this situation to go on and short term contingency plans and arrangements were not put in place to meet service users’ needs and National Minimum Standards of the Care Standards Act 2000. Care placement authorities were also not informed of the lack of suitable bathing facilities for the residents placed at Three Forests. Three Forests Cheshire Home I56-I05 S17981 Three Forests V231292 UI090605 - Stage 04.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 The deployment and number of staff available during the busy times in the morning and at lunchtime were not sufficient to meet the needs of the residents. EVIDENCE: Residents spoken to commented positively with regard to the care and support received from the care staff but felt there should be more staff available during the busier times. Staff spoken with indicated there are usually four members of staff on a shift unless there is sickness or unexpected absences. However, they indicated that due to the residents’ changing needs and decreasing mobility, staffing numbers should be increased to cover the busier times when all the residents require assistance with their personal needs. The majority of residents require two members of staff for moving and handling. Relatives and social workers had raised concerns with regard to the amount of staff available to support residents in having a bath daily. The manager had not undertaken a staff/service user ratio calculation based upon guidance recommended by the Department of Health, as required in previous inspection reports. Staff allocation was based on agreement with previous inspection regulator before The Care Standards Act 2000. Three Forests Cheshire Home I56-I05 S17981 Three Forests V231292 UI090605 - Stage 04.doc Version 1.30 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 Assessments with regard to moving and handling had been carried out for a newly admitted resident, however risks identified were not managed appropriately to protect the health, safety and welfare of the individual with regard to following safety precautions and warnings for the use of bathing equipment. EVIDENCE: There is immediate concern raised from a discussion with the registered manager with regard to a Leonard Cheshire Health and Safety risk assessment, carried out approximately two years ago, identifying all en suite bathing facilities as unsuitable for use and that only one bath is currently in use for fifteen residents, a situation that was not addressed immediately and cannot continue. Comprehensive risk assessments with regard to the health and safety in the workplace were in place for most areas. However, a risk assessment with regard to the acceptable safe weight load for the Parker Bath had not been carried out. Staff were unaware of the weight limit for the bath and associated Three Forests Cheshire Home I56-I05 S17981 Three Forests V231292 UI090605 - Stage 04.doc Version 1.30 Page 20 risks of not adhering to the weight limitation. Staff indicated that an additional member of staff was required to support the bath from tipping backwards when it was in use for one resident. It was indicated that the bath had received its annual service one week previous but there was no evidence of this. An immediate requirement was put in place to terminate the use of the bath until the bath had received a maintenance service and all residents had been weighed accordingly. The bath was found to be unsuitable to meet the health, safety and welfare needs of one resident. A short term plan of care agreed in consultation with the resident, relatives, care co-ordinator and Three Forests to meet personal needs has been put in place until the provision of an en suite shower room and appropriate equipment is provided. This will continue to be monitored throughout the inspection process. Three Forests Cheshire Home I56-I05 S17981 Three Forests V231292 UI090605 - Stage 04.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 2 2 3 x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 2 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 1 x 2 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 2 4 Standard No 31 32 33 34 35 36 Score x x 2 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Three Forests Cheshire Home Score 2 2 x x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x I56-I05 S17981 Three Forests V231292 UI090605 - Stage 04.doc Version 1.30 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 2 Regulation 14 Requirement The Registered Person must ensure service users are not admitted until a summary of the single Care Management assessment has been received, and service users are admitted only on the basis a full assessment of needs has been carried out to ensure the home is able to meet those needs. The Registered Person must ensure that the care home is conducted so as to promote and make proper provision for the health and welfare of service users. The Registered Person must ensure an individual plan of care is generated from a needs assessment and covers all aspects of personal and social support and healthcare needs, and reviewed with the service user regularly to reflect appropriate planning and/or changing needs. The Registered Person, must for the purpose of providing care to service users, making proper provision for health and welfare take into account their wishes Timescale for action 1st September 2005 2. 3 12 1st September 2005. 3. 6 14, 15. 1st September 2005 4. 7 12 1st September 2005 Three Forests Cheshire Home I56-I05 S17981 Three Forests V231292 UI090605 - Stage 04.doc Version 1.30 Page 23 and feelings. 5. 8 24 The Registered Person must ensure service users have opportunities to participate in activities which enable them to influence key decisions in the home and receive feedback about the outcomes of their involvement and participation. The Registered Person must ensure that the care home is conducted in a manner which respects the privacy and dignity of service users. Pre existing care homes, which provided at least enough bathrooms so that they were shared by no more than 3 people as at 16 August 2002, must continue to do so. The Registered Person must ensure facilities are provided to meet the individuals personal hygiene needs. The Registered person should determine the ratios of care staff to service users according to the assessed needs of the service users by using the Residential Forum tool, in accordance with guidance recommended by the Department of Health. The Registered Person must ensure staff are aware of safe practice and working of the Parker bath and adhere to manufacturers instruction ensuring the safety of service users. 1st September 2005 6. 16 12 1st September 2005 1st December 2005 7. 18, 19, 27. 29. 23, 12 8. 33 18 1st September 2005 9. 42 12 1st September 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations I56-I05 S17981 Three Forests V231292 UI090605 - Stage 04.doc Version 1.30 Page 24 Three Forests Cheshire Home Standard 1. Three Forests Cheshire Home I56-I05 S17981 Three Forests V231292 UI090605 - Stage 04.doc Version 1.30 Page 25 Commission for Social Care Inspection 1st Floor, Fairfax House Causton Road Colchester Essex, CO1 1RJ 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 Three Forests Cheshire Home I56-I05 S17981 Three Forests V231292 UI090605 - Stage 04.doc Version 1.30 Page 26 - 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. 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