Inspection on 08/06/05 for Alexandra House

This inspection was carried out on 8th 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

Alexandra House 17/06/08

Alexandra House 19/06/07

Alexandra House 28/07/06

Alexandra House 15/11/05

Alexandra House 06/01/05

Alexandra House 09/08/04

Alexandra House 10/03/04

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Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Alexandra House Masons Court Hillborough Road Solihull B27 6PF Lead Inspector Amanda Lyndon Announced 8 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 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. Alexandra House E54 S4516 Alexandra House V223785 080605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Alexandra House Address Masons Court Hillborough Road Solihull B27 6PF 0121 245 1081 0121 707 090 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) Sir Josiah Masons Trust Mrs Hilary Lloyd Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number of places Alexandra House E54 S4516 Alexandra House V223785 080605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 6 January 2005 Brief Description of the Service: Alexandra House is a registered care home for older people. The home is located on the outskirts of Solihull, in a residential area, close to local amenities and a bus service which provides access to surrounding areas. The home is a single storey building, registered for thirty six beds, all rooms are for single occupancy. The home has two lounges, two areas for dining and a conservatory, there are four assisted bathrooms and one walk in shower room available plus toilets within close proximity to communal areas. There is level access for wheelchair users to the front entrance and throughout the home. An accessible well maintained garden area with a pond is provided. The home is approached through security gates where there is ample parking for visitors, alternatively there is ample off road parking. The organisations head office is on site, the complex also provides sheltered housing and domiciliary care from separate facilities. Alexandra House E54 S4516 Alexandra House V223785 080605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection was undertaken by two inspectors during a full day, and were assisted throughout by the Registered Manager and Deputy Manager. There were 35 residents living at the home on the day of the inspection. Information was gathered from speaking with the residents and staff, observing the care staff performing their duties and examining care and medication records. Prior to the inspection 20 comment cards were received by the CSCI about the service provided at Alexandra House, most of these were found to be positive in nature. What the service does well: What has improved since the last inspection? Some improvements have been made to ensure that medication is administered to residents in a safe manner. Comprehensive pre recruitment checks are carried out for all prospective staff prior to starting work at the home. Self closures had been fitted to all fire doors which are activated in the event of fire and residents can choose to keep their bedroom doors open or closed. Alexandra House E54 S4516 Alexandra House V223785 080605 Stage 4.doc Version 1.30 Page 6 What they could do better: 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. Alexandra House E54 S4516 Alexandra House V223785 080605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Alexandra House E54 S4516 Alexandra House V223785 080605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4 &5 Prospective residents are invited to spend a day at the home, enabling them to make a choice about whether or not they may wish to live in the home. Residents know before admission that the home can meet their care needs through the assessment process. Residents are issued with a contract to ensure that they are informed of the terms and conditions of their stay at the home. EVIDENCE: The home has produced a statement of purpose and a service user guide, however amendments need to be made to these to ensure that they are up to date and reflect current information. Each resident is issued with a statement of terms and conditions of residency and this included the room number to be occupied and trial periods. Pre admission assessments are completed using a comprehensive pre admission document. Residents are encouraged to visit the home and have a meal prior to making a decision about whether they would like to live there. Alexandra House E54 S4516 Alexandra House V223785 080605 Stage 4.doc Version 1.30 Page 9 Residents who have been admitted to hospital for a significant period of time are reassessed prior to coming back to the home, and on the day of the inspection, residents appeared to be well supported by the care staff to meet their personal needs. Alexandra House E54 S4516 Alexandra House V223785 080605 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 & 10 Residents’ health and personal care needs were generally well met by the care staff. Written care plans were not always comprehensive which may result in residents not receiving good continuity of care. Further development is required to ensure that medication is always administered to residents in a safe manner. Residents are supported in a respectful manner by the staff working at the home and this ensures that the dignity and self esteem of the residents are maintained. EVIDENCE: Each resident had a separate set of care plans, however they required further development to include details of actions to be taken by care staff to ensure that all aspects of health, personal and social care needs of individual residents are met, and that personal preferences are recorded. Care plans were reviewed on a monthly basis, there was some evidence that residents are involved in the care plan review, however the evaluations tended to be very repetitive and were all evaluated by the same person. Key workers wrote monthly reports. Pressure sore risk assessments and nutritional assessments are not completed. but residents are weighed each month. Alexandra House E54 S4516 Alexandra House V223785 080605 Stage 4.doc Version 1.30 Page 11 One care plan included a risk assessment for falls and pressure sores but there was no evidence of a care plan to follow this up. The falls risk assessment did not include details of action to be taken should a resident fall, or details of any equipment to be used. Daily reports were written five times a day and information was often repetitive. It was recommended that this be reduced to three a day (am,pm and night) with a more individual in depth report. No reference was made to any participation in activities during the day. Residents were registered with the same General Practitioner who visits the home on a weekly basis as well as on request, however residents can retain their own GP on admission to the home (if the GP is in agreement) Residents have access to health and Social Care Professionals such as District Nurses, Social Workers and Dentist. It is recommended that a separate record is kept of Social and Healthcare Professionals visiting each resident, for ease of monitoring the care provided. The management of medication, including Controlled Drugs was generally good and most of the requirements from the previous inspection had been addressed. Robust procedures were in place for homely remedies, and prescriptions were checked by staff prior to medication being dispensed and a record of these was kept with the MAR chart. The amount of medication administered was not always recorded on the MAR chart for variable dosage medication, and prescription ointments were not signed for at the time of administration and improvements must be made in respect of these. Residents are offered a key for their bedroom door and the locks can be overridden by staff in the event of an emergency, however a written record of the reasons why it would not be appropriate for individual residents to have a key to their bedroom door was not kept. Alexandra House E54 S4516 Alexandra House V223785 080605 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 & 15 Residents are able to exercise their choice over their daily lives and the activities that they choose to participate in, which promote their individuality and independence. Residents receive a wholesome and varied diet which meets any specific dietary needs, but have no control over portion sizes of food served to them. EVIDENCE: There was a range of activities on offer for residents to participate in should they wish to, including coffee mornings, music and movement, bingo, whist drive, scrabble, sing a longs, manicures and a mini bar. Holy communion and the hairdresser are available each week. Singing entertainment was booked in advance. A morning and evening newspaper is delivered to the home, and residents can request their own paper if they choose. Some residents were participating in music and movement activity, on the morning of the inspection. Activity care plans were not written and no log of activities participated in was recorded. There was a visible notice board in the main lounge where details of all activities were displayed. Residents are able to go outside of the home with family and friends as they wish. Alexandra House E54 S4516 Alexandra House V223785 080605 Stage 4.doc Version 1.30 Page 13 One member of staff said “relatives can come at anytime”, whilst a resident said “there are not really any rules about the time to get up or go to bed” Menus are on a four week cycle and cooked breakfasts are available as well as cereals, fruit, toast and orange juice. Two choices of hot meal are available at lunchtime or a choice of salad if preferred, with the exception of Friday, when two choices of fish are offered. The evening meal consists of soup of the day, followed by choice of sandwich or warm snack, and a dessert. A daily record of food eaten was kept although information is needed to evidence that supper is offered and eaten. Hot drinks and biscuits are offered mid morning, evening and at supper. Meals were brought to each resident on a plate so there is no choice about size of portion, gravy was also brought around by care staff. One resident was being assisted with her meal by a care assistant in a respectful manner. The dining room was very quiet during the lunchtime meal, and although dining area arrangements promoted social interactions, none of these were apparent. Alexandra House E54 S4516 Alexandra House V223785 080605 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 The complaints procedure is comprehensive and is accessible to the residents and their visitors should they need to make a complaint. The home has an adult protection policy, which needs some amendments, to ensure that such incidents are recognised and dealt with appropriately by staff working at the home. EVIDENCE: The home had a comprehensive complaints procedure and this included the contact details of CSCI, this was on display in the lounge. There was no complaints file available on the day of the inspection and CSCI have not received any complaints referring to Alexandra House. An enhanced criminal records bureau check had been obtained prior to new staff members commencing employment. The adult protection policy requires some amendments to ensure that all the relevant information is included, including social services as the lead agency regarding adult protection and the contact details of the CSCI. Alexandra House E54 S4516 Alexandra House V223785 080605 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24 ,25 & 26 Alexandra House provides a homely, comfortable and safe environment in which service users are relaxed and secure. The home needs to address infection control procedures which could pose a potential health risk to service users and staff. EVIDENCE: Although the internal environment was fit for purpose, some areas had an offensive odour. There were some items of furniture and fittings that were found to be soiled, and required cleaning or replacing. There was adequate seating for all residents living at the home, but the seating arrangements did not promote social interaction. Residents were sitting in the conservatory and later in the afternoon, some were out in the garden with their relatives. Adequate assisted bathing facilities were available, however lack of storage space meant that wheelchairs and hoists were being stored in some of the Alexandra House E54 S4516 Alexandra House V223785 080605 Stage 4.doc Version 1.30 Page 16 bathrooms. Hoists and bath aids had recently been serviced. There was an emergency call system available in each bathroom. Handrails and raised toilet seats were available as required, as were hygienic hand washing facilities. Hot water temperature checks were recorded weekly and were all within safe limits. All bedroom doors have had magnetic door closures fitted, to enable doors to be kept open if the resident prefers. All bedrooms had a call system fitted to enable residents to summon help from care staff if required. Bedrooms had some personal items that reflected individual residents tastes to ensure their surroundings were as comfortable as possible. The home does not have mechanical commode pot disinfectors/washers therefore staff are manually cleaning commode pots, posing a health and safety risk. A action plan must be submitted CSCI to ensure that this procedure ceases and an appropriate and hygienic procedure for the cleaning of commode pots must be implemented. A recent environmental health inspection had recently taken place and requirements made from the inspection had been addressed. Alexandra House E54 S4516 Alexandra House V223785 080605 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 & 30 The home has maintained adequate staffing levels, and staff undertake training to improve their level of knowledge of caring for older people. There is a robust system for staff recruitment in place. EVIDENCE: In addition to care staff, the home employs ancillary staff, including kitchen, domestic, laundry and three maintenance persons. Management staff provide on call support to the person in charge of the shift, however the detail of this was not recorded on the staffing rotas. Staffing levels are maintained and there are currently no vacancies in the home. Core agency staff are used to cover periods of annual leave. One resident said “the staff come promptly if we use our buzzer” Each member of staff had a staff file. One was looked at in depth and contained all the information required by Regulations. Criminal record checks had been made prior to commencing employment. Two other staff files were reviewed, there was evidence of some formal staff supervision taking place and annual appraisals had been completed. Staff had received training specific to their role including abuse, Parkinsons Disease, diabetes, and food hygiene. Alexandra House E54 S4516 Alexandra House V223785 080605 Stage 4.doc Version 1.30 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,35,36 & 38 The Registered Manager ensures that a good standard of service is provided at the home. A robust system for the management of residents personal allowances is in place. Remedial action is required in relation to health and safety and infection control issues identified as these may pose a risk to residents and staff. EVIDENCE: The Registered Manager has had much experience in caring for older people and has the appropriate qualification to perform well within her management role. One resident said “I would talk to the manageress if I was unhappy” Visits to Alexandra House are made by the Director and a report of this is sent to CSCI as per Regulation 26, in order to ensure a high standard of service is provided at the home. Alexandra House E54 S4516 Alexandra House V223785 080605 Stage 4.doc Version 1.30 Page 19 Currently no residents meetings take place and this must be addressed to ensure that residents and their families are given the opportunity to discuss and share any ideas or concerns about the home in an open and inclusive atmosphere. Quality-of-service questionnaires are distributed to residents living at the home, however no report is produced on the findings. A formal quality assurance and auditing system has been purchased and will be implemented in the home. There was a robust system in place for the management of personal allowances within the home, including an individual transaction record for each resident and receipts for transactions made. Two residents allowances were checked by the Inspectors and were found to be correct. There was some evidence that auditing takes place. Staff appraisals were up to date and the majority of staff had received some supervision. Staff had received training in health and safety issues including first aid, food hygiene and moving and handling. Fire drills had been undertaken but staff require fire safety training. The adult protection policy requires some amendments to ensure that all the relevant information is included, including social services as the lead agency regarding adult protection and the contact details of the CSCI. Health and safety maintenance checks had been undertaken on all equipment used at the home including the portable electrical appliances, emergency lighting, gas appliances, fire fighting equipment and hoisting equipment. Fire escape routes and signs must be checked and a written record of this must be kept. Accident records were found to be fully detailed and all reports are reviewed by the retaining GP. Not all of the reports were signed by the Registered Manager as evidence of the auditing of accidents involving residents living at the home. Risk assessments in respect of fire, premises and COSHH products used at the home need to be undertaken and reviewed. Alexandra House E54 S4516 Alexandra House V223785 080605 Stage 4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 2 3 2 3 3 3 3 2 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 3 2 2 x 3 3 x 2 Alexandra House E54 S4516 Alexandra House V223785 080605 Stage 4.doc Version 1.30 Page 21 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 4(1)(c ) Schedule 1 5(1) 12(1)(2)( 3) 13(4)(b)( c) Requirement Timescale for action 08 October 2005 2. 7 Further work is required to ensure that the statement of purpose and service user guides are fully up to date and reflect current requirements. (time scale of 06/06/05 not met) 31 August Personal risk assessments of residents must contain sufficient 2005 detail of the actions to remove or reduce the risks identified. (time scale of 31/10/04 and 06/04/05 not met) Care plans must include information derived from risk assessments in respect of nutritional needs and the risk of falls. Risk assessments and incidences of pressure sores must be recorded in a care plan, and these must detail the type of equipment required, treatment and outcomes. The care planning system must be further developed including: Care plans must detail the action to be taken by care staff to ensure that all aspects of the 3. 7 15(1)(2) 31 August 2005 Alexandra House E54 S4516 Alexandra House V223785 080605 Stage 4.doc Version 1.30 Page 22 personal, health and social care needs of residents are met. Residents personal preferences must be identified within their care plans. Care plan evaluations must be recorded in detail and reflect the monitoring of the particular care need. Daily reports must be recorded in more detail and include information about the activitites that the residents had engaged in during that day. Improvements are required in respect of the management of medication including: Prescription ointments must be signed for following administration. Regular medication audits must be undertaken, and written evidence of this maintained. The actual amount of medication administered for variable dosage medications must be recorded on the medication charts. Temazepam must be stored and administered as a controlled drug.(The Registered Manager received this as an immediate requirement dated 10/06/05) Activity care plans must be written and a log of social activities must be recorded. A record of complaints received about the service provided at the home must be kept. The adult protection policy must be further developed to include the new identity and contact 4. 9 13(2) 31 July 2005 5. 6. 7. 12 16 18 15(1) 16(2)(m)( n) 22 13(6) 31 August 2005 31 July 2005 01 September 2005 Page 23 Alexandra House E54 S4516 Alexandra House V223785 080605 Stage 4.doc Version 1.30 details of CSCI and to identify that social services is the lead agency regarding adult protection. 8. 26 13(3) 16(2)(j) 13(3) 23(2)(j) (time scale of 06/05/05 not met) Cleaning procedures must be reviewed to ensure that all areas of the home are clean and fresh smelling. The portable raised toilet seat/frame is not fit for purpose in bathroom 4 and must be replaced. Toilets must be kept clean and ready for the next persons use. The Registered Manager received this as an immediate requirement. Mechanical commode pot 08 August washers/disinfectors must be 2005 available for staff use and staff must not manually clean soiled and used commode pots. An action plan is to be submitted to CSCI by. The Registered Manager received this in the form of an immediate requirement. All staff must undertake fire 22 June safety training. 2005 The Registered Manager received this in the form of an immediate requirement A formal quality assurance 08 system must be implemented at November the home and quality surveys 2005 must demonstrate how the quality of care has been reviewed and improved as a result of the survey being carried out. A report based on the findings of these surveys must be produced and accessible to all E54 S4516 Alexandra House V223785 080605 Stage 4.doc Version 1.30 Page 24 31 July 2005 15 June 2005 9. 21 10. 26 23(2)(k) 11. 38 23(4)(d) 12. 33 24 Alexandra House interested parties. (Time scale of 06/06/05 not met, however a quality assurrance system has been purchased and is being implemented) 23(4)(b)(c Fire escape routes and safety 15 June ) signs must be observed and 2005 checked weekly and a written record of this must be kept. The registered manager received this as an immediate requirement. COSHH safety data sheets and risk assessments must include issue and review dates. Fire risk assessments must be undertaken. A premises risk assessment must be undertaken. Temazepam must be stored and administered as a controlled drug. (The Registered Manager received this as an immediate requirement) The home must document the reasons why some residents are not able to hold the key for their bedroom door. The Registered Manager must undertake a review of the main meal options each Friday to ensure that an alternative to fish is available. The daily record of food provided must be further developed to evidence that supper is offered and eaten. Furniture and fittings must be of a good standard in the home. Residents meetings must take place to ensure that residents and their families are given the opportunity to discuss and share E54 S4516 Alexandra House V223785 080605 Stage 4.doc 13. 38 14. 15. 16. 17. 38 38 38 9 13(4) 23(4) 13(4) 13(2) 08 September 2005 01 August 2005 30 September 2005 10 June 2005 18. 10 12(4)(a) 31 August 2005 31 July 2005 19. 15 16(2)(i) 20. 15 16(2)(i) 31 July 2005 01 October 2005 and ongoing 01 September 2005 Page 25 21. 22. 19 32 23(2)(b)( d) 24 Alexandra House Version 1.30 23. 38 13(4) any ideas or concerns about the home in an open and inclusive atmosphere. The Registered Manager must audit all accidents involving residents living at the home. 31 July 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. 1. 2. 3. 4. 5. 6. Refer to Standard 7 7 14 20 21 27 Good Practice Recommendations Is it recommended that a comprehensive daily report is written three times a day instead of five times a day. It is recommended that a separate record is kept of Social and Healthcare Professionals visiting each resident, for ease of monitoring the care provided. Residents should be given a choice about the size of food portions served. The seating in communal areas should be arranged to promote social interactions between residents. Wheelchairs and hoists should not be stored in bathrooms and an alternative storage facility for these should be sought. Detail of the arrangements for on call support for the person in charge of the shift should be recorded on the staffing rotas. Alexandra House E54 S4516 Alexandra House V223785 080605 Stage 4.doc Version 1.30 Page 26 Commission for Social Care Inspection Birmingham & Solihull Local Office 1st Floor, Ladywood House 45-46 Stephenson Street Birmingham, B2 4UZ 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 Alexandra House E54 S4516 Alexandra House V223785 080605 Stage 4.doc Version 1.30 Page 27 - 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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