Inspection on 12/12/05 for Alexandra Park Home

This inspection was carried out on 12th December 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 Park Home 10/06/08

Alexandra Park Home 21/05/07

Alexandra Park Home 11/04/06

Alexandra Park Home 16/05/05

Alexandra Park Home 13/09/04

Alexandra Park Home 04/05/04

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Townley Road, 2-3

Orchard House Nursing Home

St Josephs Rest Home

Foxley Lane (121a)

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

CARE HOMES FOR OLDER PEOPLE Alexandra Park Home 2 Methuen Park Muswell Hill London N10 2JS Lead Inspector Karen Malcolm Unannounced Inspection 14.40 12 December 2005 th 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 Park Home DS0000010757.V264790.R01.S.doc Version 5.0 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 Park Home DS0000010757.V264790.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Alexandra Park Home Address 2 Methuen Park Muswell Hill London N10 2JS 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) 020 8883 5212 020 8343 7459 Mr David Weston Mr David Weston Care Home 15 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (15), Old age, of places not falling within any other category (15), Physical disability over 65 years of age (8) Alexandra Park Home DS0000010757.V264790.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Limited to 15 people of either gender who fall into the category of old age (OP) and who may also have a mental disorder (MD(E)) and of whom no more than 8 people may be accommodated on the ground floor may also have a physical disability (PD(E)) Five specified service users who have dementia may remain accommodated in the home. The home must advise the regulating authority at such times as any of the five specified service users vacates the home. 16th May 2005 Date of last inspection Brief Description of the Service: Alexandra Park Home is a care home for 15 older people some of whom may have a mental health problem. There are 9 single rooms and 3 shared rooms. No rooms have en suite facilities, although there are a number of separate toilets plus two bathrooms. Alexandra Park Home is not purpose built and comprises of a large converted house with an extension. The home is situated in a quiet residential area of Muswell Hill and is not far from local shops and amenities.The home’s stated aims include that ‘residents right are at the top of our care philosophy. We will advance the rights in all aspects of the home and encourage our clients to take part fully in decision-making’. Alexandra Park Home DS0000010757.V264790.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over three hours and forty minutes. In the home at the time of the inspection were the registered manager/provider, two care staff and thirteen service users. Since the previous inspection the manager has appointed a deputy manager who works part time three days a week, the deputy was off duty on the day of the inspection however, she came back and was a part of the feedback session. The inspector would like to thank the staff and management for their time and patience during this time. As part of the inspection process the inspector was able to speak to approximately five service users and three members of staff, completed a tour of the building this included the inspector completing a fire risk assessment, examining a number of service users care plans and staff personal records. Service users interviewed expressed their satisfaction with the quality of care offered by the home and were happy living there. What the service does well: What has improved since the last inspection? At the previous inspection ten areas of improvement were made and two recommendations. It was evident at this inspection that six areas of improvement had been addressed. The areas of improvement addressed at the time of this inspection are: • Service users care plans were now reviewed and updated • The old-fashioned electric water boiler in one specific service user’s room has now been replaced. Alexandra Park Home DS0000010757.V264790.R01.S.doc Version 5.0 Page 6 • • Guidance notes were in place for the specific service user who is administered insulin injection. A list of all the carers who are trained by the district nurse to administer the insulin injection to the service users was in place. The service user medication review had taken place and evidence was recorded on file. What they could do better: This inspection has identified thirteen areas of improvement and one recommendation. While it’s evident that the staff are experienced and competent, the home has failed to ensure that service users needs are consistently being supported, recorded, reviewed, monitored and up-dated appropriately. It is therefore required that the registered person submits an action plan to the Commission for Social Care Inspection (CSCI), which describes how they will address these matters. The action plan must describe how the registered person: • Is to notify the CSCI regarding the home’s Condition’s of Registration, • Repair the door alarm • To ensure all fire doors are not wedged open and the registered person to consult with the London Fire Emergency Planning Authority (LFEPA) with regards to door closures • To ensure that the home’s environmental risk assessment include a section on fire • The registered person to complete at least a weekly water temperature test on all the sinks and bath in the home, record must be kept • The new service user whose MAR chart is completed incorrectly is change to reflect the correct dosage of prescribed medication to be administered • The registered person must monitor at least weekly checks on the MAR charts • The registered person must ensure that all service users have a medical review of their care needs with the GP. • Financial accounting for service users who monies held and managed by the home must be concise and clear • Criminal Record Bureau’s (CRB) enhance certificate for students on work place must be seen by the manager prior to the individual working in the home. • The manager to consult with the Occupational Therapist with regards a suitable and safe ramp to be positioned at the entrance to the building must. As the present wooden portable ramp is not suitable. The requirements made at the last inspection that have not yet been met and have been restated in this report, with a new timescale of compliance. Unmet requirements impact upon the welfare and safety of service users. Failure to comply by the revised timescale will lead to the Commission for Social Care Inspection considering enforcement action to secure compliance. Alexandra Park Home DS0000010757.V264790.R01.S.doc Version 5.0 Page 7 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 Park Home DS0000010757.V264790.R01.S.doc Version 5.0 Page 8 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 Park Home DS0000010757.V264790.R01.S.doc Version 5.0 Page 9 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 the following standard(s): 3 Service users prior to moving into the home are assured that their needs will be met, therefore receiving appropriate care to meet individual’s care needs. However, service users cannot be confident that this is consistently monitored appropriately in all cases. EVIDENCE: At present the home has thirteen service users and two vacancies. The home support service users of either gender who fall into the category of old age and who may have a mental disorder and of who no more than eight people may be accommodated on the ground floor may also have a physical disability. Five specified service users who have dementia might remain accommodated in the home until such time as they leave. One new service user had moved into the home since the previous inspection. Information sent from the social worker was very clear and comprehensive especially around the individual mental health needs. At the previous inspection it was required that the registered person notifies the CSCI of the specific service user who has dementia and has recently moved out of the home. It was evident at this inspection this has not been completed and it was also evident that one of the five specified service users Alexandra Park Home DS0000010757.V264790.R01.S.doc Version 5.0 Page 10 named on the home condition of registration remained in the home. It was advised that the registered person must notify the Commission of these changes in written. It was also advised that that the manager must cease to admit any service users into the home with a clinical diagnosis of dementia. Any new service users within the catergory of dementia must not be admitted to the home until such time as an application for variation has been submitted and granted/agreed by the Commission for Social Care Inspection (CSCI). Alexandra Park Home DS0000010757.V264790.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 7, 8 & 9 Service user’s health, personal and social care needs are monitored and reviewed according to the regulations, however, with regards to changes with individual’s medication this is not consistently monitored. Therefore service users can be placed at risk from harm if medication is not reviewed and monitored reguarly by the registered person. EVIDENCE: Monthly reviews are completed and each service users has a named key worker. At the previous inspection it was required that the registered person completes thorough risk assessments on each service user and consult with relevant professionals prior to a stair lift being installed. The assessment package is to include an environment risk assessment. A copy of the assessment is to be present on file and a copy on individual service user’s care plans. The manager stated that he is no longer going to install a lift in the home, as it is not needed. The manager stated that the seven service users whose bedrooms are on the first floor are able with one to one support to manage the stairs. It was advised that although the stair lift is not deemed necessary at present. The Occupational Therapist must be consulted to obtain professional advised to whether or not the service users who are getting older can access Alexandra Park Home DS0000010757.V264790.R01.S.doc Version 5.0 Page 12 the stair appropriately with one to one support. Each of the seven’s risk assess regarding accessing the stairs must be updated detailing what support is needed for each person. It was also required at the previous inspection for the registered person to update a specific service user’s (who went missing) care plan and risk assessment. The manager stated that this specific service user has now past away recently. However, the front door alarm to alert staff if someone has wandered out of the building remains broken at the time of this inspection. The manager stated that the door alarm was repaired since the previous inspection, but it is now not working. Therefore this requirement is restated in this report. At the previous inspection there were two areas of concern regarding medication. The first area of concern relate to one service user’s medication labelling to be amended by the GP. The other area of concern relates to the care staff daily were administering insulin injections to one specific service user. At the previous inspection the senior carer stated that the district nurse had trained the staff, however, there was no evidence of this on file. It was required that the registered person ensures that the specific service user, who is administered insulin injections, has in place on their care plan, clear instruction by the district nurse as to how the medication is administered daily. Consent given by the service user or their representative on their behalf with regards to care staff administering their medication must be in place. Only care staff that are trained by the district nurse can administer the medication. A listed of all trained care staff is to be placed on the front of the specific service user’s Medication Administration Records chart (MAR), with the dates of training undertaken. At this inspection a detailed account of the training undertook and a list of the carer who were trained was on file along with name of the district nurse. This document was impressive. Other MAR charts were examined. It was evident that on two specific service user’s MAR chart R for refusal was recorded on the front of the chart. Yet, no recorded evidence was on the back of the chart. It was advised that both service users medication must be reviewed by the GP if there is continuous refusal to take their medication. Evidence of refusal must be recorded on the back of the MAR chart. A new service user had recently moved into the home had a number of medication in bottles and packages prescribed. A list of the medication prescribed was recorded on the individual’s MAR chart. However, one of the medication record stated that Frusemide 60mgs two tablets, when it should have been recorded as Frusemide 20 mgs two tablet to be taken daily and Frusemide 40 mgs two tablet to be taken daily. This was discussed with the registered manager and the deputy at great length. A number of service users have PRN medication it was advised that guidance of when the medication is administrated must be on file. To ensure that PRN medication is given appropriately and when needed. Alexandra Park Home DS0000010757.V264790.R01.S.doc Version 5.0 Page 13 The home had completed a thorough risk assessment of a number of service users who are in need of continence care. The analysis format shown had individual’s name, their diagnosis, current medication prescribed, continence issues and current pads begin used by the individual. The analysis was requested by the GP. The concerns raised with the manager and the deputy, relate to individuals diagnoses that have been recorded. On the format seen it stated that a number of service users had dementia. The continence test revealed that a number of service users had some abnormalities found in their urine. The manager and the deputy explained that the reasons for the continence analysis were at the request of the District Nurse and the GP. It was advised that from the outcome of the analysis completed there were a number of medical issues found. This must be investigated further with the District Nurse and the GP. Therefore registered person must ensure that all service users have a medical review of their care needs with the GP. Any service users, whose needs have changed, must be reviewed accordingly. If it is found that any of the service users have a diagnosis of dementia this must be discussed with the lead inspection as this could affect the home’s condition of registration. Alexandra Park Home DS0000010757.V264790.R01.S.doc Version 5.0 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 & 17 Service users maintain family contact and participate in various planned in house activities. The meals are good offering both choice, variety, and catering for special needs. EVIDENCE: The home has an activity folder of all the activities participated by the service users in the home. There were no activities planned on the day of the inspection, individuals were either watching TV or wandering around the home’s enclosed garden area. The lounge/dining area is the only area where activities can take place and where the users sit and watch TV or listen to music. The visitor’s book was in place and all visitors sign in and out. Individual’s contact details were on their care plan files. A number of the users are unable to go out unsupported. The manager stated that the home maintains community links through planned activities and visitors. One service user interviewed stated that they often go out for short walks. Alexandra Park Home DS0000010757.V264790.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not inspected EVIDENCE: These standard were not inspected at this inspection. These were addressed at the previous inspection and found to be satisfactory. Alexandra Park Home DS0000010757.V264790.R01.S.doc Version 5.0 Page 16 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 the following standard(s): 19, 24 & 26 The home is satisfactorily decorated, therefore providing service users with a pleasant environment in which to live. However, there are a number of maintenance issues which need addressing in the home. EVIDENCE: The home has a large lounge/ dining area. There is also a small smokers lounge. There is a kitchen and laundry room. The main office is on the first floor. The home meets with the current requirements in terms of communal space. The home also has nine single bedrooms and three double bedrooms. All the double bedrooms have a screen in place to ensure privacy when needed. At the previous inspection a number of areas of maintenance needed addressing. The old-fashioned electric water boiler in one of the service user’s bedroom has now been removed. The water supply now comes from the main supply. The service user was asked if happy with the current water supply. The service user stated that she was although the water is cold at times. Alexandra Park Home DS0000010757.V264790.R01.S.doc Version 5.0 Page 17 The laundry door was not close effectively. This is a potential fire hazard. It was advised that an appropriately door must be in place. The other areas of maintenance required at the previous inspection have no been addressed. Dorguard is now in place on the lounge door. It was also evident that the wooden portable ramp placed at the outside at the entrance to the home is not suitable. The ramp is moveable and the angle of degree from the step to the path was very steep. It was advised that the registered person consult an Occupational Therapist to obtain advice on the correct ramp that could be used. Part of the inspection process included the inspector completing a fire risk assessment whilst touring the building. The purpose of the fire risk assessment was discussed with the manager. It was identified through the fire risk assessment that there were a number of good practices and some areas of concern. All the fire extinguishers are in place and the means of escape is clear all fire door and fire checks and drills have been completed as stated in the NMS. However, the main lounge/dining room is in constant use and at times this is wedged open. The laundry door was unable to close properly. This must be repaired as it is a fire hazard. It is advised that the manager must completes a environmental and fire risk assessment which is reviewed and monitored annually or when changes occur to the envronment. Appropriate action must be taken in respect of fire doors that continue to be propped open, therefore a self-closing device must be in place. It was also advised that consultation with the London Fire Emergency Planning Authority (LFEPA) is to be sought. Alexandra Park Home DS0000010757.V264790.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 & 29 The home has ensured that the skills mix of staff meets service users needs. However, the home’s students and volunteers procedures have failed to ensure that service users are protected by staff that volunteers or is on placement in the home. EVIDENCE: In the home at the time of the inspection were the manager, one senior carer and two carers. The staffing structure in the home has changed since the previous inspection. The structure now includes a deputy manager who is employed part time and works three days a week. One of the senior carers also now works part time, their role is a job shared between each other. It was evident at this inspection that the carers were more knowledgeable about individuals service users and their care needs. Information with regarding to care plan was explained by the care staff on duty. This was a great improvement from the previous inspection. This was impressive and commend by the inspector. The manager in agreement with a nursing agency accepts student carers on placement. It was required at the previous inspection that the manager ensures that all volunteers or students on placement must have in place an enhanced Criminal Records Bureau check (CRB) certificate prior to working in the home. It was evident on file that the information submitted by the agency to the home was a letter from the CRB confirming a CRB had been received and in the process of being completed. The letter did not indicate a name of Alexandra Park Home DS0000010757.V264790.R01.S.doc Version 5.0 Page 19 the person applying for a CRB. This was discussed at great length with the registered manager/provider and the senior carer that this was not acceptable and a copy of a satisfactory CRB certificate must be seen or a note of the particular student’s CRB number must be recorded and kept on file prior to working in the home. Alexandra Park Home DS0000010757.V264790.R01.S.doc Version 5.0 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 The registered person has failed to ensure service users’ financial interests’ are managed, and accounted for appropriately. Therefore ensuring that service users’ ‘financial interests’ are safeguarded. EVIDENCE: Service users’ financial interest was examined. The manager manages two service users personal allowance weekly. The manager stated that their individual monies get paid into his bank account. The account shown to the inspector did not give a clear account of how individual’s personal allowance was received by the manager and when given to the individual. It was required that the registered person must have a clear account system for each service users who personal allowance is managed by the evidence of this must be available upon inspection. It was also evident that a number of service users accounts seem to have a large sum of minus of payment. The manager stated that a number of service user’s families are their account holders and when necessary a bill for payment is submitted to family account holder to Alexandra Park Home DS0000010757.V264790.R01.S.doc Version 5.0 Page 21 update the individuals account. It was not clear from the accounts examined if bills were paid or whether the individual was in credit. It was recommended that the manager improve the accounting system, which in place by obtaining individual’s person allowance from their families in advance when the expenditure is low. Submit and expenditure accounts of what funds have been spent, clearly showing how much the individual is in credit. At the same time requesting more funds for the individual. Alexandra Park Home DS0000010757.V264790.R01.S.doc Version 5.0 Page 22 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 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 15 2 X X X X 2 X 2 STAFFING Standard No Score 27 X 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X 2 X X X Alexandra Park Home DS0000010757.V264790.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 OP3 Regulation 4(3)(b) Requirement The registered person must notify the CSCI of the specific service user who has dementia and has recently moved out of the home. So that the Certificate of Registration may be amended accordingly. (Previous timescale of 16/07/05 was not met.) The registered person must ensure that the new alarm system for the front door is working at all times. (Previous timescale of 16/07/05 was not met.) The registered person must complete and record weekly hot water temperature checks on all of the sinks and bath taps in the home to ensure that they do not exceed over 43°c or below. The registered person must update each of the seven service users whose bedrooms are on the first floor, with regards to accessing the stair. Copies of the updated risk assessment must be kept on file and update accordingly when any changes DS0000010757.V264790.R01.S.doc Timescale for action 30/01/06 2. OP19 13(4) 23(2)(c) 30/01/06 3. OP19 13(4) 30/01/06 4. OP7 14(2)(a) (b) 20/03/06 Alexandra Park Home Version 5.0 Page 24 occur. The registered person must consult with relevant professionals and update individual’s mobility risk assessments regarding the specific seven service users whose bedrooms are on the first floor. Copies of the assessments are to be present on each individual’s care plan. 5. OP19 13(4) The registered person must complete an environmental risk assessment that includes a fire risk assessment. This is to be reivewed annually. The registered person must ensure all staff employed, volunteers or student on placement have in place before commencing work in the home an enhanced CRB check that has been completed by the home or if completed by an agency a verification record stating the individual’s CRB number, the date applied for, the individual’s date of birth and any conviction/s that appears on the CRB form. A record of this is to be kept on file. (Previous timescale 30/06/05 not met.) The registered person must ensure that if prescribed medication is not administered a record and evidence must be kept on the back of the form and review accordingly with the service user’s GP. The registered person must have in place clear guidance notes with regards to all service users who are prescribed PRN medication. Copies of the PRN guidance notes must be kept on Alexandra Park Home DS0000010757.V264790.R01.S.doc Version 5.0 Page 25 28/02/06 6. OP29 19 Schedule 2.7 30/01/06 7. OP9 13(2) 30/01/06 8. OP9 13(2) the front of each service users MAR chart file. The registered person must ensure that the new service user who MAR chart is completed incorrectly is change to reflect the correct dosage of prescribed medication to be administered. The registered person must monitor at least weekly checks on the MAR charts to ensure that any gaps or discrepancies can be immediately addressed. Evidence that checks have been completed are to be kept. The registered person must ensure that all service users have a medical review of their care needs with the GP. Records of the reviews are to be kept on file. Any service users, whose needs have changed, must be reviewed accordingly. If it is found that any of the service users are diagnosed with dementia this must be discussed with the lead inspector. The registered person must consult with the a Occupational Therapist regarding installing a suitable and safe ramp to be positioned at the entrance to the home for service users in wheelchair/s to access the home safely. The current portable wooden ramp in place must be removed as this is deemed a hazard. The registered person must keep an accurate record of individual’s personal monies that is kept by the registered person. A detail account of income and expenditure are to be kept and must be available for inspection. The registered person must ensure that Medication DS0000010757.V264790.R01.S.doc 30/01/06 9. OP8 13(1) & 14(2) 20/03/06 10. OP19 13(4) & 14(2)(a) (b) 28/02/06 11. OP35 17(2) Sch 4.9 28/02/06 12. OP9 13(2) & 17 30/01/06 Page 26 Alexandra Park Home Version 5.0 13. OP26 13(4) Administration Records (MAR) all policies and procedures in place are monitored and reviewed regularly to ensure any discrepancies are addressed straightaway. The registered person must ensure the laundry door is a fire door and is able to close effectively. 28/02/06 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 OP35 Good Practice Recommendations It was recommended that the manager improve the accounting system, which in place by obtaining individual’s person allowance from their families in advance. When the expenditure is low. Submit and expenditure accounts of what funds have been spent, clearly showing how much the individual is in credit. At the same time requesting more funds for the individual. Alexandra Park Home DS0000010757.V264790.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Park Home DS0000010757.V264790.R01.S.doc Version 5.0 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. 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