CARE HOMES FOR OLDER PEOPLE
Appleby Court Nursing Home 173 Roughwood Drive Kirkby Merseyside L33 8YR Lead Inspector
Miss Diane Sharrock Unannounced Inspection 23rd June 2006 10:00 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 Appleby Court Nursing Home DS0000042876.V295244.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. Appleby Court Nursing Home DS0000042876.V295244.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Appleby Court Nursing Home Address 173 Roughwood Drive Kirkby Merseyside L33 8YR 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) 0151 548 6267 0151 548 6697 Regal Care (Liverpool) Ltd Mrs Irene Ann McLaughlin Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (60), Terminally ill over 65 years of age (4) of places Appleby Court Nursing Home DS0000042876.V295244.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. Service Users to include up to 60 Old Persons and up to 4 in the category of Terminally Ill. Five registered places to be utilised for service users in the age range 55 years and over The service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. One female named service user under retirement age to be reviewed on 01/06/06 Date of last inspection Brief Description of the Service: Appleby Court is a Care Home that provides personal care and nursing care. The Home is registered for 60 residents over retirement age. The main centre of Kirkby is approximately 10 minutes away from the Home by foot. The Home is purpose built on 2 storeys and provides a passenger lift to the second floor. There are 56 single rooms, 2 double rooms and 21 rooms providing en-suite facilities. There are 2 lounges and 1 dining room on each floor. There are well kept gardens to the side of the Home, which are accessed by service users from the ground floor dining room. Parking is available to the front and rear of the Home, and there are main travel routes via bus that provide easy access to the area in which the Home is located. The registered Manager is Mrs Irene McLaughlin and the Responsible person is Mr Kang. The homes Manager have given details of the fees charged in the homes pre inspection questionnaire which range from £266 to £457.17 per week. Appleby Court Nursing Home DS0000042876.V295244.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This Key unannounced inspection took place over one day and was measuring all of the core standards.. A detailed tour of the premises took place and Resident care plans and various other records were inspected. Comment cards had been sent to a sample of Residents and a selection of comment cards were left with freepost envelopes so that they could be sent directly to CSCI offices. Interviews took place with both Staff and Residents. All areas of the inspection and findings were discussed with the Manager at the end of this inspection. What the service does well: What has improved since the last inspection?
The manager has developed a large visual training matrix located in her office which enables her to organise all necessary training including mandatory training especially when updates are due. Personnel files were found to be very organised with all appropriate records demonstrating safe recruitment and selection of staff.
Appleby Court Nursing Home DS0000042876.V295244.R01.S.doc Version 5.2 Page 6 The manager discussed plans in developing the reception and nurse station area and is in the process of obtaining quotes. She feels this area will be better utilised and offer further facilities including a general noticed board to ensure everyone at the home is aware of the developments at the home, there are also plans to develop the large window area in the main ground floor lounge area which will improve on the current privacy of Residents using that room. What they could do better:
Full feedback was given to the Manager during and on conclusion of this inspection. Some areas of improvement were noted including meeting most parts of the previous requirements made at the last inspection. Other areas were noted to need action taken and further evidence to be in place to meet all of the older persons and younger persons National Minimum Standards. 1) The Manager must access and make everyone aware and knowledgeable of the younger adults standards. Action must be taken by the company to evidence how they will eventually meet these standards. There was no type of Provider audit or any other type of evidence in place to demonstrate the company has measured themselves against the NMS and regulations. This should be considered to assist the manager and staff in achieving compliance of eventually meeting all parts of the national minimum standards. 2) The homes Statement of Purpose needs further development including the fees charged and the company’s commitment to the basic number of staff provided to the home each day. To ensure that staff, Residents and visitors are aware of the documents and their updates. 3) Care plans continue to be developed and need further work to meet all parts of the standards especially to meet the younger adult standards. Residents need access to be able to sign in agreement and consultation of their care plan. Care plans overall need a lot of development to evidence the care and support for social care and support of all Residents. All plans need to have consistent monthly-recorded reviews. 4) Any new Residents needs to have evidence of a planned approach including a detailed pre assessment so that Staff can identify whether the persons needs can be met at the home and detailed admission assessments must be carried out to assist with the admission to meet the persons needs. 5) Medications are much improved however some issues need further review to improve on current practices including the recording on medication records, “potting up” of tablets must stop”, and audit trail’s of medications should take place to ensure accurate storage and administration of medications.
Appleby Court Nursing Home DS0000042876.V295244.R01.S.doc Version 5.2 Page 7 6) A maintenance, refurbishment and decorating plan must be developed to show a planned approach in maintaining the home and could be used to involve Residents/Staff in the development of their home. Bathrooms and toilet areas need work and development to eventually achieve a more homely environment to these areas as currently they are quite “sparse” and basic in appearance. Window restrictors must be checked all over the home as one was found to be undone enabling the window to open widely. All radiator guards must be checked as one was found to be loose. The laundry area needs review to try and develop clean and dirty areas and procedures in such a small area and to review current provisions for ironing Residents clothes and bed linen. 7)Records should be developed further to show that Staff have individual training records including 3 paid days for training and an overall training development plan for the home, All staff must have all necessary training to assist them in their role and all mandatory training must be up to date for all Staff and evidence of in-house training should be formalised and included in staff records. The development plan should identify what actions will be taken to ensure the home’ has 50 of staff with nvq qualifications. 8)A complete review of how Residents finances are managed must take place and be fully accessible to the homes manager. Action must be taken to ensure that any procedures for managing finances are in line with the care home regulations 2001 and national minimum standards. To develop an audit for the safe. 9) To develop regular staff meetings and consider arranging monthly meetings supported by staff. 10) To completely develop activities at the home including appropriate provisions for younger adults. The home must have necessary resources to meet these standards including full time staff to support and organise activities at the home to meet all Residents needs. 11) To review the maintenance and contractor checks at the home including those for the homes heating system. 12) To review the current provision of appropriate beds including those beds that are currently “static” were Residents need the assistance of staff and hoists. Risk assessments must be applied for any of these occurrences and possibly the provision of “moveable up and down” beds if this would reduce and eliminate risks. 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. Appleby Court Nursing Home DS0000042876.V295244.R01.S.doc Version 5.2 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 Appleby Court Nursing Home DS0000042876.V295244.R01.S.doc Version 5.2 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): The required documents- Statement of Purpose is in need of being updated but this document and Service Users guide are accessible on both floors by the lift area. Pre assessments still need further developments to ensure the home can meet Residents needs. Quality in this outcome area is adequate. This judgment has been made using available evidence including a site visit to the service. EVIDENCE: The homes Manager explained that she plans to ensure all documents are accesiblie to everyone at the home including open access in the reception area which is soon to be developed once quotes are obtained.At present these documents are located on each floor. The homes Statement of Purpose needs further development including the fees charged and the company’s commitment to the basic number of staff provided to the home each day. Once updated steps should be taken to ensure that staff, Residents and visitors are aware of the documents and their updates.
Appleby Court Nursing Home DS0000042876.V295244.R01.S.doc Version 5.2 Page 10 Residents who chatted to the inspectors stated were very happy at the home. One care plan viewed for someone recently admitted contained a preadmission assessment but this was rather brief and covered basic personal care needs only. There was no evidence of consultation regarding preferences of care or social needs. Any new Resident needs to have evidence of a planned approach including a detailed pre assessment so that Staff can identify whether the persons needs can be met at the home and detailed admission assessments must be carried out to assist with the admission to meet the persons needs. Appleby Court Nursing Home DS0000042876.V295244.R01.S.doc Version 5.2 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): 7/8/9/10 Care plan documentation and procedures were found to be in need of further development including the provision of consultation with residents. Residents are not generally involved in the process. Discrepancies in medication were noted on some units. Residents were happy their needs were being met. Quality in this outcome area is adequate. This judgment has been made using available evidence including a site visit to the service. EVIDENCE: The care plans case tracked were detailed and have records in place to eventually meet the standards however during case tracking of 4 care Residents care records various areas were in need of review and improvement. Residents need access to be able to sign in agreement and consultation of their care plan. Care plans overall need a lot of development to evidence the care and support for social care and support of all Residents. All plans need to have consistent monthly-recorded reviews. Most records did have consistent monthly reviews just one did not. Medications are stored within a separate locked room and minimal stock was kept and all cupboards viewed appeared tidy and organised. Medication
Appleby Court Nursing Home DS0000042876.V295244.R01.S.doc Version 5.2 Page 12 administration records were viewed which contained photographs of each resident. Medications are much improved however some issues need further review to improve on current practices including the recording on medication records, “potting up” of tablets must stop”, and audit trail’s of medications should take place to ensure accurate storage and administration of medications. Internal auditing of medications must be developed further so that actions can be taken to improve on the present standards. The staff observed during the inspection were attentive and polite to the residents at all times. Residents spoken with said that “staff are lovely here”, Appleby Court Nursing Home DS0000042876.V295244.R01.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12/13/14/15 Residents have contact with family, friends and the community and this is appropriately supported by the staff, Unfortunately there is no written record of resident’s choices or preferences. Fulfilling activities including outings are not always available. There were many compliments about the food. Quality in this outcome area is adequate. This judgment has been made using available evidence including a site visit to the service. EVIDENCE: A care plan was viewed which contained no information about the resident’s social needs or how staff were to meet these. A full review of activities needs to address the Residents needs and request to meet their social needs and aspirations and the care documentation needs to reflect the national minimum standards. Staff confirmed that activities such as bingo and sing-along take place, However there was no display of any organised events, this should be developed and Residents should have their opinions and requests taken into account so that this programme is reflective of their needs. The home unit do not meet the younger adults standards were a weeks holiday should be provided each year for those Residents who would like to participate.
Appleby Court Nursing Home DS0000042876.V295244.R01.S.doc Version 5.2 Page 14 The care plans for the home specifically for younger adults should be adapted to cover the younger adults national minimum standards. Some staff were unaware of these standards and indicated a training need. The home currently do not have a copy of the younger adult standards this must be in place and accessible to everyone. Residents stated that they were happy with the food provided and commented that it was, “very nice” A copy of the homes menus were viewed which showed that a choice was available, the dining room was attractively maintained and well presented with matching linen and table clothes which added to a high standard of presentation. Appleby Court Nursing Home DS0000042876.V295244.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): 16/18 All complaints are dealt with in an appropriate manner, they are taken seriously with and acted on promptly. The Home has a procedure in place to ensure a proper response to any suspicion of allegation of abuse. Quality in this outcome area is good. This judgment has been made using available evidence including a site visit to the service. EVIDENCE: The manager keeps clear records of any complaints and how they have been dealt with. Staff spoken with were aware of how to deal with any complaints including allegations of abuse and how they would be dealt with, this was evidenced during this inspection and met in full in the staffs commitment to protect vulnerable adults. Most staff have received training in Abuse awareness and the manager has an organised training matrix to help her identify when refresher courses are needed. Appleby Court Nursing Home DS0000042876.V295244.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): 19/26 Appleby Court is well presented, clean and hygienic. Quality in this outcome area is good. This judgment has been made using available evidence including a site visit to the service. EVIDENCE: Residents bedrooms viewed were well presented and the residents had been supported to personalise their bedrooms with pictures, ornaments and furniture. Residents were appreciative of these. Most liked their bedrooms and were positive about the way that they were kept clean. Some areas now need further development to maintain an overall standard throughout the home. A maintenance, refurbishment and decorating plan must be developed to show a planned approach in maintaining the home and could be used to involve Residents/Staff in the development of their home.
Appleby Court Nursing Home DS0000042876.V295244.R01.S.doc Version 5.2 Page 17 Bathrooms and toilet areas need work and development to eventually achieve a more homely environment to these areas as currently they are quite “sparse” and basic in appearance. Window restrictors must be checked all over the home as one was found to be undone enabling the window to open widely. All radiator guards must be checked as one was found to be loose. The laundry area needs review to try and develop clean and dirty areas and procedures in such a small area and to review current provisions for ironing Residents clothes and bed linen. The manager discussed plans in developing the reception and nurse station area and is in the process of obtaining quotes. She feels this area will be better utilised and offer further facilities including a general noticed board to ensure everyone at the home is aware of the developments at the home, there are also plans to develop the large window area in the main ground floor lounge area which will improve on the current privacy of Residents using that room Appleby Court Nursing Home DS0000042876.V295244.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): 27/28/29/30 There is a variety of training available for staff in the Home that is assists the staff in caring for the residents appropriately All staff are appropriately checked before they start work. Residents and Relatives say they are very happy with the home and the care provided by Staff. Quality in this outcome area is good. This judgment has been made using available evidence including a site visit to the service. . EVIDENCE: Staff have a caring attitude and are confident that they take care of the residents properly. The staff said that there is sufficient staff at the home, The homes Statement of Purpose needs further development including the company’s commitment to the basic number of staff provided to the home each day, this will ensure that staff, Residents and visitors are aware of the companies commitment to the basic numbers of staff daily supplied to the home, inclusive of activities support. The manager has developed a large visual training matrix located in her office which enables her to organise all necessary training including mandatory training especially when updates are due. Personnel files were found to be very organised with all appropriate records demonstrating safe recruitment and selection of staff. Records should be developed further to show that Staff have individual training records including 3 paid days for training and an overall training development plan for the home, All staff must have all necessary training to assist them in their role and all mandatory training must be up to date for all Staff and evidence of in-house training should be formalised and included in
Appleby Court Nursing Home DS0000042876.V295244.R01.S.doc Version 5.2 Page 19 staff records. The development plan should identify what actions will be taken to ensure the home’ has 50 of staff with nvq qualifications. Appleby Court Nursing Home DS0000042876.V295244.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): 31/33/35/38 The manager has suitable skills and experience to undertake her job role. Health and safety within the home is in need of further development and appropriate action to be taken by the company. Quality assurance audits are taking place and identify areas in need of improvement. The management of Residents finances must be revised to ensure weekly access to personal allowances into their own accounts. Quality in this outcome area is good. This judgment has been made using available evidence including a site visit to the service. EVIDENCE: The manager has been in post for several years and is registered with CSCI. Residents and Staff were complimentary about the matron and comments
Appleby Court Nursing Home DS0000042876.V295244.R01.S.doc Version 5.2 Page 21 included “the matron is lovely and always listens.” The rapport and relationship was obvious and observed as being very friendly and warm with genuine caring attitudes promoted throughout the home, Staff themselves commented that due their good relationships they felt this gave a friendly atmosphere to the home. Staff felt they would benefit from regular staff meetings and this should be considered to arrange monthly meetings to support further procedures in encouraging staff to air their views and comments. Finances are well managed and very organised however a complete review of how Residents finances are managed must take place and be fully accessible to the homes manager. Action must be taken to ensure that any procedures for managing finances are in line with the care home regulations 2001 and national minimum standards. This should include a review of accessing residents personal allowances once they are paid by the authority and transfer of their money should be arranged as soon as possible to their own account. Its recommended that the manager should develop an audit for the safe to assist with any type of financial audit regarding the safe storage of Residents belongings and items. Health and safety arrangements are well managed just some issues were noted to need further attention. Various maintenance certificates were produced showing some evidence of appropriate checks to facilities at the home. A review of the maintenance and contractor checks at the home including those for the homes heating system was noted to be in need of review and the manager agreed to take appropriate action. To review the current provision of appropriate beds including those beds that are currently “static” were Residents need the assistance of staff and hoists. Risk assessments must be applied for any of these occurrences and possibly the provision of “moveable up and down” beds if this would reduce and eliminate risks. To check all window restrictors and radiator covers as one was found to be faulty. Appleby Court Nursing Home DS0000042876.V295244.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 2 X 2 X X X 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 1 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 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 2 X X 2 Appleby Court Nursing Home DS0000042876.V295244.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation 4 5 6 Requirement Timescale for action 24/08/06 2. OP3 14 15 The Responsible Person must provide an updated and accurate Service User guide and Statement of Purpose to Residents and all other parties, to submit the updated document to CSCI once complete. 24/08/06 The Responsible Persons must ensure that Residents care plans, pre assessments and admission records detail the needs of the residents and how the staff are to meet these needs. They must be updated on a monthly basis and include residents, their relatives and care staff as appropriate to the resident. The Responsible Persons must 24/08/06 ensure that the home has a maintenance programme inclusive of all bathrooms toilets and the planned development of the reception area, The maintenance programme must detail for residents the planned dates of individual room decoration and general refurbishment. Environmental risk assessments must be carried
DS0000042876.V295244.R01.S.doc Version 5.2 3. OP19 23 2 (b) 13 Appleby Court Nursing Home Page 24 4. OP35 20 1) 5. OP9 13(2) out to all identified risks including faulty window restrictors, broken radiator guards, and fixed beds were Residents need the support of Staff and a hoist. Also the laundry area needs review to reduce any potential risks of cross infection. The maintenance certificates for appropriate checks for the heating must be up-to-date and in place. The Responsible Person is 24/08/06 required to provide evidence that all Service Users finances managed by the company will be reviewed and that weekly access to personnel allowances are arranged into Residents own accounts. An audit must be developed for the safe. 24/08/06 The Responsible Person is required to provide evidence to the Commission that the arrangements for the safe handling, recording, safe keeping and administration of medicines are provided in the home at all times, Please submit a detailed action plan stating how this regulation will be met. The Responsible Person is required to ensure that the staffing of the home meets the ongoing needs of the Service Users, and submit evidence to the CSCI describing the actions taken to meet this regulation including appropriate staff to support people with their social needs. The Responsible Person must consult Residents about the programme of activities to enable the developments in the activities programme to meet this regulation especially in providing support for Younger
DS0000042876.V295244.R01.S.doc 6. OP27 18 16 2 n 24/08/06 Appleby Court Nursing Home Version 5.2 Page 25 Adult provision 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 OP7 Good Practice Recommendations Care staff should be supported to read care plans and to keep detailed records of the care provided to residents on a daily basis. To continue developing and updating training records and provide evidence of 3 days paid training for all Staff each year. ( 5 days for staff on supporting younger adult’s) To develop an overall training and development plan for the home based on both the identified staff training needs and Service Users needs including the trained staffs clinical needs.. The registered manager should continue with development of NVQ training so as to meet the target of 50 by 2005 A review as to how residents access their own money should be undertaken and appropriate arrangements put into place. The staffing levels should be kept under review in order to make sure that staffing levels are appropriate to the needs of the residents .To publish the homes staffing commitment for each day in the statement of purpose. To review and develop the display of accurate advertising of organised activities events in the home. To develop and implement quality assurance audits to the home including the use of questionnaires to all parties. To develop monthly staff meetings to ensure staff have appropriate processes to openly discuss any issues. To review the current procedures in the laundry area and
DS0000042876.V295244.R01.S.doc Version 5.2 Page 26 2. OP30 3. OP35 4. OP27 5. 6 OP12 OP33 7 OP19 Appleby Court Nursing Home 7 OP27 ensure all linen and Residents clothing are appropriately pressed. If the manager considers developments to provide a younger adult unit then the younger adult standards must be applied, a copy of the standards must be at the home with training and updates given to staff for this category. Discussions must take place with younger adult residents to encourage development of future goals and to promote empowerment and control over their own lives. A complete review of the model of support for young people must take place to promote an environment and module that will meet the national minimum standards and meet the needs of young adults admitted to Appleby Court. The company should consider a no uniform policy for this category. Appleby Court Nursing Home DS0000042876.V295244.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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