Inspection on 08/07/08 for Alexandra House [Poole]

This inspection was carried out on 8th July 2008.

CSCI found this care home to be providing an Adequate service.

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

Alexandra House [Poole] 04/12/06

Alexandra House [Poole] 08/11/05

Alexandra House [Poole] 07/06/05

Alexandra House [Poole] 04/01/05

Alexandra House [Poole] 14/07/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Alexandra House Alexandra Road Parkstone Poole Dorset BH14 9EW Lead Inspector Gloria Ashwell Unannounced Inspection 8th July 2008 10:10 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 Alexandra House DS0000004036.V368125.R02.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. Alexandra House DS0000004036.V368125.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alexandra House Address Alexandra Road Parkstone Poole Dorset BH14 9EW 01202 746640 01202 743627 alexandra@care-south.co.uk www.care-south.co.uk Care South 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) Mrs Christine Trinder Care Home 39 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (39) of places Alexandra House DS0000004036.V368125.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 39 in the category OP (Old Age) including up to 20 in the category DE(E). One person under the age of 65 may be accommodated, from time to time, to receive care. 4th December 2006 Date of last inspection Brief Description of the Service: Alexandra House is a purpose built home; erected in 1965 it transferred from the control of Dorset County Council to the current provider organisation in the early 1990s. The Borough of Poole currently own and lease the property. The home is situated close to a busy shopping area with a range of facilities including banks, a post office, supermarket, public houses, local public transport, etc. Resident’s accommodation is on the ground and first floors; each floor has lounge/dining areas and a small kitchen, used for preparing drinks, breakfasts and light snacks. On the ground floor is the main lounge and dining room with a central kitchen for preparation of all meals. Bedrooms do not have en suite hygiene facilities but there are numerous toilet and bathroom facilities throughout the home. The fee range quoted in the service user guide at the time of inspection was £475 to £665 per person per week. Up to date fee information may be obtained from the service. Information regarding the subjects Value for Money and Fair Terms in Contracts can be obtained from the web link: www.oft.gov.uk A report entitled Care Homes in the UK - A Market Study is available on web link http:/www.oft.gov.uk/NR/rdonlyres/5362CA9D-764D-4636-A4B1A65A7AFD347B/0/oft780.pdf Alexandra House DS0000004036.V368125.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was a statutory inspection required in accordance with the Care Standards Act 2000. The first visit of this inspection was unannounced; two inspectors arrived at 10.10am on 8 July 2008, toured the premises and spoke to residents, staff and the manager and examined a sample of documents relevant to care practise and administration of the home. By arrangement with the manager the inspectors revisited the home the following day at 10.00am and again spoke to and observed the interactions of residents and staff, and the carrying out of routine tasks and spoke to the manager, giving feedback on the inspection findings. The duration of the inspection (both visits, care service inspectors combined) was 16 hours. During the inspection, particular residents were ‘case tracked’; for example, for evidence regarding Standards 3, 7 and 8, records relating to the same residents were examined and the residents spoken with. The care records of nine people who live at the home were examined in detail. Additional information used to inform the inspection process included the Annual Quality Assurance Assessment completed in advance of the inspection by the manager and ‘Have Your Say’ questionnaires completed and sent to the Commission by 21 people living at the home, 2 of their representatives (e.g. relatives, friends), a care manager, 2 health professionals and a staff member of the home. During this inspection compliance with all key standards of the National Minimum Standards was assessed. What the service does well: Alexandra House provides a service for older people including those with dementia. Visitors are very welcome at the home and there is a wide range of activities to suit all residents. Alexandra House DS0000004036.V368125.R02.S.doc Version 5.2 Page 6 ‘Have Your Say’ questionnaires received in advance of the inspection stated: “I could not be happier anywhere else” and “You can find staff at any time to talk to and they are always very helpful.”. Residents were happy with the quality and choice of meals available. Alexandra House is a comfortable home in which residents are respected, encouraged and supported to make their own decisions and retain as much independence as possible. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Alexandra House DS0000004036.V368125.R02.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Alexandra House DS0000004036.V368125.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (The home does not provide intermediate care so St 6 does not apply) Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prior to admission, the needs and circumstances of each proposed resident are assessed; however, for persons who are to enter the home on a short term basis, this process is often hurried and does not reliably provide the home with enough information to base the decision regarding the ability to properly meet the needs of the person. EVIDENCE: Alexandra House DS0000004036.V368125.R02.S.doc Version 5.2 Page 9 The files for six residents were inspected. All contained evidence of preadmission assessments although those for two people recently admitted for short-term care not contain sufficient or accurate details about the needs of each resident so that a plan could be made giving the staff information about how to meet their needs. The manager stated that it is the policy to admit residents for short term care within 24 hours of pre-admission assessment. An associated recommendation is contained in this report. A resident confirmed that prior to admission Mrs Trinder had visited and the person thereby had felt confident about moving to Alexandra House. In advance of making the decision to enter the home the relative of the other resident had visited the care home to view the premises and meet residents and staff. Following pre-admission assessment of the prospective residents needs and circumstances the home writes to them confirming agreement and ability to accommodate and care for them. Alexandra House DS0000004036.V368125.R02.S.doc Version 5.2 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. 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. Residents generally receive the care they need but staff do not always respond appropriately to changing needs and care records do not provide sufficient guidance and information to staff to enable them to properly care for the residents. Residents receive the medicines they have been prescribed and are protected from the harm and ill health that incorrect administration might cause. EVIDENCE: Comments received by the Commission in advance of the inspection indicated satisfaction e.g. “Everyone is very helpful; there is always someone to help. Staff have contacted the doctor or nurse when required” and comments made by residents during the inspection were also good. Alexandra House DS0000004036.V368125.R02.S.doc Version 5.2 Page 11 Care records of 9 residents were examined and found to be of generally poor standard, frequently without relevant risk assessments forming the basis for care plans, and with many care plan components out of date, thereby rendering the plans inaccurate and not reflective of separately recorded descriptions of condition of each person. The failure to provide reliable and thorough plans of care for these residents placed them at risk of poor and inappropriate care because their needs and circumstances had not been fully assessed and thereby were not recorded in the care plans, and may not be known to staff. There was evidence that on occasion staff appeared slow to respond to the changing care needs of some residents. For example, a resident was recorded to have had several urinary tract infections but records indicated that until a social worker undertaking a review of care needs intervened the resident was not reassessed. Thereafter appropriate action was taken to minimise the risk of further infection. There was insufficient evidence that all accidents to residents are thoroughly investigated with findings reflected in the care plan, to ensure that future risks are minimised. It is required that for each resident the home record an accurate and comprehensive care plan ensuring provision of sufficient information to staff enabling them to properly care for and safeguard every resident. The medications policies and procedures were reviewed. The home has a medicines policy and procedure including reference to self-administration and associated risk assessment and arrangements for ordering, administration and disposal. It includes information about the use of homely remedies. It was recommended that the home discusses the use of homely remedies with the GP and seek approval of their use. Medicines were stored securely. Medications needing to be kept cool were stored in a designated fridge and daily temperature recordings were taken. It was recommended that a maximum/minimum thermometer be used in future. Examination of records indicated that medicines are properly administered in accordance with the prescriber’s instructions. However, the pre-admission assessment of a resident recently admitted for short term care failed to establish if the person was bringing sufficient medicines into the home and in consequence supplies ran out before re-ordering took place. The home had been unsure of the medicines prescribed to the person and on the second day of admission it was necessary to check the amounts with the GP. A recommendation linked to pre-admission assessment is made. Alexandra House DS0000004036.V368125.R02.S.doc Version 5.2 Page 12 In the presence of staff residents appeared relaxed, confident and at ease; staff interactions with residents were of a friendly and considerate manner and the atmosphere throughout the home was calm and unhurried. Comments received during the inspection from residents included “The staff are lovely. Nothing is too much trouble”, “They do respect my privacy” and “The home is excellent.” Alexandra House DS0000004036.V368125.R02.S.doc Version 5.2 Page 13 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 good. This judgement has been made using available evidence including a visit to this service. Residents have opportunities to engage in social and recreational activities and are encouraged and supported to pass the time according to individual preference. A choice of menu is provided and meals are nutritional and appetising. EVIDENCE: Most residents were spoken with during this inspection; all expressed satisfaction with the home, including the range of activities, meal provision, staff and premises. The home employs an activities organiser for 30 hours per week. At the time of inspection this member of staff was on leave and no provision had been made to cover her absence; care staff were attempting to organise some activities amongst their other duties but it is recommended that proper provision is made for planned absence of all staff members, including the activities organiser. Alexandra House DS0000004036.V368125.R02.S.doc Version 5.2 Page 14 Displayed in each unit is a programme of activities including games such as Bingo, and one to one activities such as manicures. Recent activities had included: • Bingo • Musical entertainment • Trips out to local places of interest • Indoor hockey. Residents spoken with said they enjoyed the activities; “The hockey is great fun.” All residents spoken with confirmed they enjoyed the food provided. Records showed that residents’ likes and dislikes with regard to food were known and residents were aware that alternatives to the main menu were always available. There was a plentiful supply of fresh fruit and vegetables. Residents said “The food is lovely” and “They always give me something nice.” Residents spoken with confirmed that when they had visitors they could visit in private and were always made welcome. Alexandra House DS0000004036.V368125.R02.S.doc Version 5.2 Page 15 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 good. This judgement has been made using available evidence including a visit to this service. The complaints procedure provides information on the procedure to follow to persons wishing to make a complaint; all complaints are recorded and investigated and the home has implemented an adult protection procedure. EVIDENCE: To ensure residents and their representatives have access to the complaints procedure it is included in the service user guide to the home displayed at the entrance with a copy provided to each residents’ relative/representative. Residents know how to complain and feel confident that if they had concerns or complaints they will be listened to and taken seriously. The home keeps records of all complaints received and investigated. Three complaints had been received since the last inspection and had been investigated appropriately. The home has developed and implemented written policies and procedures for the protection of residents from abuse or neglect and provides all staff with training in the understanding of abuse and their role in protecting residents from abuse in its many forms, including neglect. The policy and procedure document provides incorrect instruction on the reporting and investigation of Alexandra House DS0000004036.V368125.R02.S.doc Version 5.2 Page 16 alleged or suspected abuse, and in consequence staff have incorrect guidance and may thereby fail to properly protect residents from risks of harm and abuse. An associated recommendation is contained in this report. Training has been provided to all care service managers employed by the provider organisation on the recently introduced Mental Capacity Act to ensure accurate understanding of the relevant provisions. Care staff spoken with during the inspection said they think the standard of training available to them is very good and they are encouraged to undertake training in subjects that interest them. Alexandra House DS0000004036.V368125.R02.S.doc Version 5.2 Page 17 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 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is well equipped and comfortable and meets the expectations of the people who live there, but staff do not always adhere to good control of infection procedures. EVIDENCE: Alexandra House is a purpose built care home; bedrooms do not have en suite hygiene facilities but toilet facilities for general use are close to all resident accommodation. There are bathrooms equipped for the use of persons requiring assistance and a range of hoists to assist residents with impaired mobility. Alexandra House DS0000004036.V368125.R02.S.doc Version 5.2 Page 18 On the days of inspection all areas appeared tidy but there were some unpleasant smells of stale urine. The décor looked old and dated in some areas. Associated recommendations are contained in this report. There was an attractive, secure garden accessible from the dementia care unit on the ground floor. There was ample seating for residents wishing to sit outside. The balcony on the first floor was a pleasant place for people to sit and was well used. It was decorated with a seaside theme, which had been chosen by the residents. Radiators are not fitted with covers and are not of low surface temperature so risk assessment is recorded for each resident with regard to scalds/burns; where a risk from hot pipes has been identified lagging has been fitted to cover the pipes. During the inspection some examples of poor infection control were observed; in particular staff were seen to place household linen and clothing on floors while bed making and after bathing a resident. These matters were brought to the attention of the manager and an associated recommendation is contained in this report. Alexandra House DS0000004036.V368125.R02.S.doc Version 5.2 Page 19 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 good. This judgement has been made using available evidence including a visit to this service. The home employs enough staff to meet the needs of residents and to ensure their safety and comfort and maintenance of the good condition of the premises. The home promotes the achievement of nationally recognised care qualifications. EVIDENCE: The home is at all times in the charge of an experienced team leader and staffing levels are provided in accordance with the assessed needs of residents to ensure that at all times sufficient staff are available to properly meet their needs. All staff spoken with during the inspection were enthusiastic about their work and felt that they provided a good standard of care to residents and are properly supported by the management and training provision. The records of four recently employed staff members and one established volunteer were examined and found to contain all essential information including written references, interview assessment, health details and Alexandra House DS0000004036.V368125.R02.S.doc Version 5.2 Page 20 evidence of identity. Protection of Vulnerable Adult disclosures are obtained for all staff in advance of employment and until the Criminal Records Bureau (CRB) disclosures are obtained staff work under close supervision. The home has developed and implemented a comprehensive induction process for all new staff, designed to ensure their familiarity with all aspects of the home and a clear understanding of their responsibilities. There is an enthusiastic approach to staff training; clear records of staff training, supervision and appraisal are kept, indicating that all staff receive training appropriate to their needs. Staff are required to undertake (and as necessary update) training in core subjects including fire safety, moving and handling, food hygiene, adult protection and emergency aid. Alexandra House DS0000004036.V368125.R02.S.doc Version 5.2 Page 21 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, 33, 35 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home generally operates in the best interests of service users but more must be done to ensure their protection from risks of harm. Care planning processes are weak and not based on reliable comprehensive assessment of each persons needs and circumstances, and management of accidents should be improved to ensure future risks are minimised. EVIDENCE: Mrs Trinder has managed Alexandra House for a number of years and has completed the Registered Managers award and undertakes periodic training to ensure she maintains and further develops her knowledge base and skills. Alexandra House DS0000004036.V368125.R02.S.doc Version 5.2 Page 22 Senior staff of the provider organisation conduct monthly visits to monitor standards in the home. Quality Assurance surveys for Alexandra House are periodically gathered from residents, relatives, staff and other healthcare professionals; the results are reflected in the annual development plan. The home does not manage the finances for any of the residents who either deal with their own finances or have a representative to do so. Staff spoken with said that the manager was very approachable and supportive. Communication within the home (between staff, between staff and residents) was good. There are regular staff meetings and people said they would feel confident if they had to voice concerns. Processes for staff recruitment, employment and training are good, but more should be done to ensure staff observe good control of infection standards. Records are kept of all accidents and untoward incidents but there was insufficient evidence that all accidents to residents are thoroughly investigated with findings reflected in the care plan, to ensure that future risks are minimised. A policy/procedure relating to the management of accidents (beyond provision of immediate health care) has not been developed or implemented. This report contains a related requirement and recommendation. During the inspection a sample of records regarding equipment servicing and maintenance were examined and found to be in good order. Documents confirming the safe condition of the electrical installation were not available during the inspection; the manager said they are kept at the head office of the provider organisation. It is recommended that a copy of all premises maintenance records be kept in the care home to ensure the manager is aware of the safety status of each aspect. Records were maintained for the servicing and testing of hoists and lifting equipment used in the home. Staff carried out audits of water temperatures to ensure that the thermostatic mixing devices on the baths were operating correctly. Contractors also carry out annual inspections of water quality. Alexandra House DS0000004036.V368125.R02.S.doc Version 5.2 Page 23 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 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Alexandra House DS0000004036.V368125.R02.S.doc Version 5.2 Page 24 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 OP7 Regulation 15 Timescale for action The registered person shall, after 01/09/08 consultation with the service user, or a representative of the service user, prepare a written plan (‘the service users care plan’) as to how the service users needs in respect of health and welfare are to be met, and shall keep the plan under review: Care plans and other care records must be improved to ensure provision of accurate information to staff to enable them to properly care for residents. 2. OP8 13(5) The registered person shall ensure that unnecessary risks to the health or safety of service users are identified and so far as possible eliminated: All accidents to residents should be thoroughly investigated with findings reflected in the care plan, to ensure that future risks are minimised. Alexandra House DS0000004036.V368125.R02.S.doc Version 5.2 Page 25 Requirement 01/09/08 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. Refer to Standard OP3 Good Practice Recommendations The record of pre-admission assessment should contain sufficient detail about the needs of the prospective resident to enable the development of a plan giving staff information about how to meet the person’s needs. Scales used to weigh residents should be regularly calibrated to ensure accuracy. The home should discuss the use of homely remedies with the GP and seek approval of their use. A maximum/minimum thermometer should be used to record the temperature of areas in which medicines are stored. Prior to admission of each resident the home should establish what medicines and doses the person is prescribed, and to ensure that re-ordering takes place soon enough to avoid running out of the medicine. Proper provision should be made for planned absence of all staff members, including the activities organiser. The policy and procedure for the management of alleged or suspected abuse of vulnerable adults should be amended to ensure that every such concern is promptly reported to the Commission and to the local Social Services office, in accordance with established protocols for safeguarding vulnerable people. A programme of updating and ongoing refurbishment would be of benefit to ensure the home continues to provide suitable accommodation. Regular premises audit should be carried out and recorded, and then used to inform the housekeeping programme to ensure that thorough cleaning takes place promptly and unpleasant odours are eliminated. Established control of infection procedures should be practised at all times. A copy of all premises maintenance records should be kept in the care home to ensure the manager is aware of the safety status of each aspect. 2. 3. 4. 5. OP8 OP9 OP9 OP9 6. 7. OP12 OP18 8. 9. OP19 OP26 10. 11. OP26 OP38 Alexandra House DS0000004036.V368125.R02.S.doc Version 5.2 Page 26 Alexandra House DS0000004036.V368125.R02.S.doc Version 5.2 Page 27 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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. Extracts may not be used or reproduced without the express permission of CSCI Alexandra House DS0000004036.V368125.R02.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!