Inspection on 23/06/06 for Allison House

This inspection was carried out on 23rd June 2006.

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

Allison House 09/05/07

Allison House 11/10/05

Allison House 09/06/05

Allison House 08/11/04

Allison House 01/06/04

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

CARE HOMES FOR OLDER PEOPLE Allison House Fudan Way, Teesdale Thornaby Stockton-on-Tees TS17 6EN Lead Inspector Julia Connor Key Unannounced Inspection 23rd June 2006 10:05 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 Allison House DS0000000140.V299236.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Allison House DS0000000140.V299236.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Allison House Address Fudan Way, Teesdale Thornaby Stockton-on-Tees TS17 6EN 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) 01642-675983 01642 675985 Cleveland Alzheimer’s Residential Centre Mrs Angela Jane Blythe Care Home 38 Category(ies) of Dementia - over 65 years of age (38) registration, with number of places Allison House DS0000000140.V299236.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of 8 places can be used for people with dementia aged 50 . 11th October 2005 Date of last inspection Brief Description of the Service: Allison House is a care home providing nursing care for older people with mental health needs. It is a single storey purpose built home all bedrooms are for single occupancy; bedrooms are not en-suite. The bedrooms are a minimum of 10 sq.m. There are two dining rooms and several lounges. The home is on a bus route and close to the local town centre. Car parking facilities are provided. Allison House DS0000000140.V299236.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out by an Inspector and a Regulation Manager, over three days’, the fist visit was on the 23rd June 2006 and commenced at 10.05 a.m. and concluded at 3.40 p.m. The second visit on the 24th June 2006 was to observe the quality and quantity of food served to the Residents’ for their evening meal and the third visit was on the 3rd July 2006. Due to the nature of their mental health problems the Residents were unable to voice their opinions of the home, however, two visitors’ and three members’ of staff were spoken to during the inspection. Two Relative/Visitor comment cards were returned to CSCI; both of the respondents were satisfied with the care their relative received. There are requirements outstanding from 2004 and 2005 inspections reports. During the inspection the Inspectors’ were informed of an adult protection issue by other visiting professionals’. The incident that was over heard was that of a member of staff goading a Resident. When the Manager was informed of the allegation she suspended the staff member until the allegation could be investigated. On the second visit to home the Inspectors’ gained entry to the home without a member of staff meeting them at the front door to check their identities. This was discussed with the Manager who stated that she would speak to staff about security within the home. The current fees structure is £400.00 a week. What the service does well: One family member informed the Inspector that she was happy with the care her husband received. She stated that the staff were pleasant and helpful and they always told her if her husband was not well and they had recently sorted his medication regime to ensure that he was not too sleepy. Another family member stated that she was mostly happy with the care and when she had any issues she spoke to the nurse who ‘sorted it out for her’. She stated that the staff always let her know if her relative was unwell. One family member who had returned one of the comment cards to the Commission for Social Care Inspection had recorded that s/he was satisfied with the overall care provided. Allison House DS0000000140.V299236.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: The Registered Manager should ensure that the information in the Residents’ care documentation is more detailed and agreed by the Resident’s representative. The Registered Manager should ensure that Residents’ are served a suitable and nutritious diet. The Manager should follow the recommendations made by the Pharmacist from Stockton Primary Care Trust. The Responsible Individual should ensure redecoration programme is continued. that the refurbishment and The Manager should ensure that sufficient staff are on duty to meet the needs of the Residents. The Registered Manager should ensure that the home is kept clean, hygienic and free of offensive odours. The Registered Manager should ensure that staff receive training appropriate to the work they carry out, and that 50 of the care staff should be qualified to NVQ Level 2. Activities should be provided on a regular basis. 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. Allison House DS0000000140.V299236.R01.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 Allison House DS0000000140.V299236.R01.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is POOR. This judgement has been made using available evidence including a visit to this service. The Residents’ have their needs assessed prior to their admission to the home, but there was no evidence that they or their family member had been involved in the assessment process. EVIDENCE: Three of the Residents care files were audited and all contained assessments carried out by Nurses from the discharging ward or Social Workers. Preadmission assessments had been carried out by the home staff prior to admission. There was no documentation in place to show that the Resident or their family member had been involved in the assessment that took place. Allison House DS0000000140.V299236.R01.S.doc Version 5.2 Page 9 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 and 10 Quality in this outcome area is POOR. This judgement has been made using available evidence including a visit to this service. Residents’ care documentation does not reflect their current needs; nor does the care documentation contain sufficient/detailed information. Residents’ health care needs are met. The Manager and staff should be guided by the recommendations made by the Pharmacist in her report. There is a small number of staff that require training to ensure the Residents’ are treated with respect and dignity. EVIDENCE: Three Residents care plans were audited. The Manager informed the Inspectors’ that new care documentation was currently being implemented. Allison House DS0000000140.V299236.R01.S.doc Version 5.2 Page 10 A new Resident to the home had an incomplete admission assessment. One care plan/risk assessment had not been reviewed weekly as the nurse had recorded it would be. Another care plan/risk assessment had nothing recorded since it was written on the 14th June 2006. The information that was contained in the care file was not sufficient to meet the care, social or psychological needs of this Resident. There was no evidence that the Resident’s next of kin had been involved in the planning of their relative’s care. Care documentation is not always reviewed as stipulated but when it is the evaluation recording is of a poor standard for example ‘incidents of agitation and aggression still occurring, continue plan’ is not sufficient. The nurse should be recording how many incidents there had been and what, if anything, had they been the result of and what action the staff had taken to calm the Resident. There was no evidence that the Resident’s next of kin had been involved in the planning of their relative’s care. One family member who had returned the comment card had recorded ‘the home is looking after my Mum very well but I feel that communication between me and the home could be improved a great deal’. Doctors, District Nurses, Chiropodists etc are requested to visit the Resident as and when necessary. On the first visit to the home the Inspectors’ were informed that the Pharmacist and her Assistant, from Stockton Primary Care Trust was also in the home carrying out an audit as well as offering support and advice to the care staff. The following are some of the suggestions made by the Pharmacist:• • • • The application of creams/ointments should be recorded on MAR sheet. When a medication is not given the code for the medication being omitted should be used. The medication cupboard should be kept clean and tidy at all times and the medication trolley fixed to the wall when not in use. It is vitally important that medication needing cool storage is stored appropriately. The date of opening eye drops etc should be written on the box/bottle along with the date to be discarded. Allison House DS0000000140.V299236.R01.S.doc Version 5.2 Page 11 On touring the building the Inspector observed that the Residents’ were able to wander around freely and were appropriately dressed. The two family members’ who returned the comment card had recorded that they were satisfied with the overall care the home provided. The wife of a Resident who spoke to the Inspector stated that she was satisfied with the care her husband received and the daughter of a Resident stated that she was mostly happy with the care her Mother received. However, it was recorded in the quality audit report that a Relative had made the following statement ‘sometimes it feels like a real chore for the staff to carry out a task that we ask them to do for our relative, such as changing them if they are wet’. Allison House DS0000000140.V299236.R01.S.doc Version 5.2 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 the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is POOR. This judgement has been made using available evidence including a visit to this service. Social activities do not take place on a regular basis within the home therefore Residents’ are not stimulated or their needs met. Residents’ maintain contact with family and friends and are encouraged to exercise choice and control over their lives as far as they are able to. The food served is unacceptable and Residents’ do not eat in pleasant surroundings. EVIDENCE: The Manager stated that there was no designated activity person in the home; the staff carried out some form of activity for the Residents’ if they had the time. There were no activities taking place on the full day of the inspection. It was recorded in the quality audit report that a Relative had made the following statement regarding activities ‘there doesn’t appear to be any, our relative is visited up to five times a week and we have never been aware of activities going on’. Another Relative had made the statement ‘activities for Residents’ and activities for Residents and families to do together i.e. trips out’ Allison House DS0000000140.V299236.R01.S.doc Version 5.2 Page 13 There were visitors’ in the home on all three-inspection visits. Both visitors’ who spoke to the Inspector stated that they was always made welcome and the staff were pleasant and helpful. The two family members’ who returned comment cards recorded that they could visit their relative and do so in private should they wish. Due to the nature of their mental health problems the Residents’ were unable to voice their opinion of the home and the care they received. The Residents’ which the Inspectors’ came into contact with on the days of the inspection were clean, tidy and appropriately dressed. One Resident who was being nursed in bed looked comfortable. The first day of the inspection was a Friday but instead of fish and chips the Residents’ had a large fish finger, chips and mushy peas. However, the peas looked dry and Residents’ were pushing their plates away and refusing to eat. The dessert for the day was a portion of something white with a whole digestive biscuit pushed into it. The staff and Inspectors’ were unable to identify the dessert, as it had no smell, just looked unappetising. This dessert was eventually identified as apple snow, which were pieces of apple mixed with whipped cream. The Inspectors’ visited the home on the Saturday evening to observe the tea being served. The Inspectors’ were concerned to see sandwiches placed directly on the dining table (which had streak marks as if it had not been cleaned properly) instead of being served on a plate. There appeared insufficient sandwiches for the number of Residents’ waiting for their meal, however, the Inspectors’ were told that more sandwiches could be made if necessary. The hot meal (served after one triangle of sandwich) was mince and dumplings with mixed vegetables, which looked unappetising, followed by treacle sponge and custard. Staff was available to give assistance to those Residents’ who required help. The staff expressed their concerns regarding the food served at the home especially on an evening. They felt that the quantity of sandwiches was insufficient, one triangle of a sandwich for each Resident. The staff stated that the menu did not reflect the food served which the Inspectors’ evidenced for themselves. Staff also felt that the soup was not acceptable and many described it ‘like dishwater’. The daughter of a Resident stated that the food was poor and often too dry and she took desserts in for her Mother that she knew she liked. The wife of a Resident stated that usually the food was OK but agreed that the lunch was of poor quality that day. Allison House DS0000000140.V299236.R01.S.doc Version 5.2 Page 14 It was recorded in the quality audit report that a Relative had made the following statement regarding the food ‘the meals tend to be bland and over cooked. I understand the salt has to be kept to a minimum but this can be substituted with herbs’ another Relative had made the comment ‘more fresh fruit/fibre – e.g. wholemeal bread’. Allison House DS0000000140.V299236.R01.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is POOR. This judgement has been made using available evidence including a visit to this service. The Manager needs to ensure that there is a record kept of all complaints’ and the resulting investigations. The Manager and qualified staff require training in the use of the Teeswide No Secrets Protection of Vulnerable Adults Guidance. EVIDENCE: There was conflicting information regarding complaints. There was one complaint recorded in the complaints folder, however, the Manager had recorded on the pre-inspection questionnaire that she had received three complaints and one comment card returned by a Relatives had ticked that they had made a complaint. The complaint that the Manager had received should have been referred into Adult Protection. When this was discussed with the Manager she replied that she had not thought that such action was required, but she had investigated the complaint. The person who made the complaint had also referred to it in the quality audit questionnaire. The Manager should ensure that there is a clear and concise complaint procedure for the staff to follow. Policies and procedures are in place in relation to adult protection and prevention of abuse. The home has a copy of the Teeswide No Secrets Protection of Vulnerable Adults Guidance; the Manager and qualified staff require training in the use of this guidance. Staff who spoke to the Inspector were aware of the action to take should they witness any form of abuse. Allison House DS0000000140.V299236.R01.S.doc Version 5.2 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, 25 and 26 Quality in this outcome area is POOR. This judgement has been made using available evidence including a visit to this service. The Residents’ do not live in a well-maintained environment. There are lounge chairs and commodes that are well worn. Although the Residents’ bedrooms have been personalised many are in need of decorating. There are areas within the home that have offensive odours. EVIDENCE: There are areas within the home that have offensive odours, which were discussed with the Manager during the tour of the home. Although six new commodes have been purchased (one by a family member) there are still twenty-four commodes that require replacing. Allison House DS0000000140.V299236.R01.S.doc Version 5.2 Page 17 The bathroom floor, in Apen unit, requires a deep clean. The carpet and chairs in Aspin lounge one require a deep clean. Fourteen bedrooms required decorating – these bedrooms where discussed with the Manager during the tour of the home. One bedroom was being decorated on the first day of the inspection. The carpet on Willow Unit corridor looks worn and faded; and the dining room carpet is stained. The Inspector was informed that new lounge chairs were to be purchased as funding was now available. It was good to see four bathrooms’, three bedrooms’, the visitors’ lounge, and Willow dining room and Aspen lounge two had been decorated. The majority of the Residents’ bedrooms had been personalised by the Residents and/or their family member. Allison House DS0000000140.V299236.R01.S.doc Version 5.2 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, 28, 29 and 30 Quality in this outcome area is ADEQUATE. This judgement has been made using available evidence including a visit to this service. The duty rota indicated the appropriate number of staff where present in the home on the day of the inspection. However, the Manager should assess Residents’ needs, which would ensure that sufficient staff are on duty. There are staff are being trained to NVQ level 2 that should ensure that they can meet the Residents’ care needs; the remaining staff require training to ensure they are competent to do their jobs. The Residents are protected by the home’s recruitment policy and procedures. EVIDENCE: On the day of the inspection two trained staff and seven care assistants’ were on duty during the day. The duty rota recorded that one trained nurse and seven care assistants would be on the evening shift and one trained nurse and four care assistants on the night shift. An audit of four weeks of the duty rota showed that the above staffing was the norm. The staff who spoke to the Inspector gave conflicting information. One member of staff stated that the staffing was Ok, another member of staff stated that it had improved and the third member of staff stated that there was not enough staff on Aspen Unit as the Residents’ dependency levels were high. Allison House DS0000000140.V299236.R01.S.doc Version 5.2 Page 19 One Relative who had returned the comment card had recorded that in their opinion there was not always sufficient staff on duty. The Manager had recorded in the pre-inspection questionnaire that 39.2 of the staff had an NVQ Level 2 or 3 in care. The Manager stated that the reduction of staff with an NVQ was due to her having recruited more staff who required NVQ training. An audit of five personnel files showed that the home complied with the requirements stipulated in Schedule 2 of the Care Home Regulations 2001. Mandatory training has taken place e.g. fire and manual handling. The staff informed the Inspector that they had also had a Dementia Workshop, which was delivered by a member of staff from their sister home. The staff confirmed that they had not received training in the protection of vulnerable adults. Allison House DS0000000140.V299236.R01.S.doc Version 5.2 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): 31, 33, 34, 35, 36, 37 and 38 Quality in this outcome area is ADEQUATE. This judgement has been made using available evidence including a visit to this service. The Manager is a registered psychiatric nurse with many years experience of working in the care home setting. There was evidence that quality assurance and quality monitoring takes place. However no action appears to be taken when an area of concern is highlighted. Evidence of current financial viability has been received by the Commission for Social Care Inspection. Staff at the home do not manage Residents’ financial affairs. Care staff does not receive regular formal supervision. The health, safety and welfare of the Residents’ are promoted and protected. Allison House DS0000000140.V299236.R01.S.doc Version 5.2 Page 21 EVIDENCE: The registered manager has the required nursing qualification to ensure that the needs of the Residents’ are met. The Manager has commenced her NVQ Level 4 in management. The staff spoke well of the Manager. The Inspectors’ where shown the latest quality audit report dated February 2006. One family member made the following comment under the heading ‘further comments’ – ‘To sum up – the general day to day care i.e. food, comfort etc is catered for. Most staff OK. Mental and emotional support for patients not very evident – often when I visit and ask about my loved one I am told “I’m not sure, I’m working on the other side today”. I have also on many occasions had to highlight various things that require attention medically. I am always aware that there are other things needing to be done and that there is not time available to discuss things – unless I make arrangements to speak to someone, which is usually after whatever has upset me. However, despite the above, I am happy with the environment provided. The full quality audit report can be accessed from the Manager of the home. Evidence of financial viability has been provided by the Clevearc Accountant. The staff at the home does not handle any of the Residents personal finances. Five personnel files were audited; only two had evidence of supervision having taken place. However the staff who spoke to the Inspector confirmed that supervision was taking place on a regular basis. There are policies and procedures for the health and safety of Residents and staff. The Manager had recorded in the pre-inspection questionnaire that the required maintenance had taken place for example the emergency lighting had been serviced on the 17th March 2006 and the fire equipment had been checked on the 24th March 2006. Allison House DS0000000140.V299236.R01.S.doc Version 5.2 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 X X X X 2 2 2 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 3 N/A 2 3 3 Allison House DS0000000140.V299236.R01.S.doc Version 5.2 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 OP3OP3 Regulation 15 Requirement Timescale for action 30/08/06 2. OP7OP7 15 3. OP15OP15 16 4. OP19OP19 23 The registered person must ensure that the Service User plan be drawn up with the involvement of the Resident and/or their representative. THIS IS OUT STANDING FROM THE OCTOBER 2004 INSPECTION. 30/08/06 In order to demonstrate the home’s capacity to meet the assessed needs of the Resident, the registered person must ensure that there is sufficient information about Resident in the nursing documentation. Care plans must be evaluated as stipulated. THIS IS OUT STANDING FROM THE OCTOBER 2005 INSPECTION The registered person must 23/06/06 provide, in adequate quantities, suitable, wholesome and nutritious food, which is varied and properly served. THIS IS OUT STANDING FROM THE OCTOBER 2005 INSPECTION The registered person must 23/06/06 ensure that all parts of the home are kept reasonably decorated. DS0000000140.V299236.R01.S.doc Version 5.2 Allison House Page 24 5. OP20OP20 OP24OP24 16 6. OP26OP26 16 7. OP30OP30 18 THIS IS OUT STANDING FROM THE OCTOBER 2004 INSPECTION. The registered person must 30/09/06 provide adequate furniture, bedding and other furnishings suitable to the needs of the Residents. THIS IS OUT STANDING FROM THE OCTOBER 2004 INSPECTION. The registered person must 23/06/06 make suitable arrangements for maintaining satisfactory standards of hygiene in the care home. THIS IS OUT STANDING FROM THE OCTOBER 2005 INSPECTION The registered person must 30/08/06 ensure that all staff receive training appropriate to the work they perform including which should include the protection of vulnerable adults. 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. Refer to Standard OP9OP9 OP12OP12 OP16OP16 OP27OP27 OP28OP28 Good Practice Recommendations The registered manager should be guided by the recommendations made by the Pharmacist from Stockton Primary Care Trust. Activities should be provided on a regular basis to provide stimulation. The Manager needs to ensure that a record is kept of all complaints’ and the resulting investigations. The Manager should ensure that sufficient staff are on duty to meet the needs of the Residents’. The registered person should make arrangements for a minimum of 50 of care staff to be qualified to NVQ Level 2. DS0000000140.V299236.R01.S.doc Version 5.2 Page 25 Allison House Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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 Allison House DS0000000140.V299236.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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