Inspection on 03/07/08 for Appleby Lodge

This inspection was carried out on 3rd July 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Appleby Lodge 12/07/07

Appleby Lodge 24/05/06

Appleby Lodge 27/10/05

Appleby Lodge 10/05/05

Appleby Lodge 27/10/04

Appleby Lodge 06/04/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Appleby Lodge 157 Launceston Road Kelly Bray Callington Cornwall PL17 8DU Lead Inspector Helen Tworkowski Unannounced Inspection 3rd July 2008 09:00 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 Lodge DS0000008945.V367495.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 Lodge DS0000008945.V367495.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Appleby Lodge Address 157 Launceston Road Kelly Bray Callington Cornwall PL17 8DU 01579 383979 01579 383108 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) Appleby Rest Homes Limited Mrs Janice Rider Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Appleby Lodge DS0000008945.V367495.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th July 08 Brief Description of the Service: Appleby Lodge offers accommodation and personal care for eighteen older people. The single storey, purpose built home is situated in Kelly Bray, one mile away from the town of Callington. It is reached via a driveway that leads off from the main road. Car parking is available at the end of the driveway. A public house, post office, shop and Methodist Chapel are all within easy reach. The accommodation comprises of 18 single bedrooms, 2 bathrooms, 5 separate WCs, an office, a well-equipped kitchen, an outside laundry area and a lounge/dining room with access to the patio and large well-kept garden via French doors. The garden is wheelchair accessible. The home has a no smoking policy. A variety of activities are offered to the service users and visitors are encouraged with no restrictions on visiting times. Appleby Lodge is fully wheelchair accessible. Copies of information about the home (the Statement of Purpose and Service User Guide) are available from the office. The fees for the home are £357.30 to £367.30; this fee does not include personal items such as toiletries, clothes, chiropody, or hairdressing. Appleby Lodge DS0000008945.V367495.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This inspection was unannounced and included visit to Appleby Lodge. This visit took place on 3rd July 08 between 9.20am and 4.30 pm. As part of this visit we looked around the home, talked with people who lived in the home, and looked at the care provided to three of the people. We looked at records of care and observed medication being administered. We also looked at staff records and other records relating to safety. We interviewed three of the care staff and spoke with the cook. The Manager, Jan Rider, was in the home during this inspection. In addition, we sent surveys to people who live at the home to find out about their views of the service, seven were sent in June 08, and six were returned, and 18 were sent in February 08 of which 15 were returned. We also sent surveys to seven of the staff, five were returned. Eight were sent to relatives of people at Appleby Lodge, five were returned. We also received a completed questionnaire from the Registered Provider about the quality of service offered at Appleby Lodge. What the service does well: The people who live at Appleby Lodge are very happy with the service they receive. Comments from people who live at the home included: “I feel safe, well cared for, and very happy”. “The home is just that, a home. The staff have mainly been here a long time, they are very kind”. “I feel confident they genuinely care for me” “This home is well run and a family atmosphere exists” We found that the staff working at Appleby Lodge had been employed there for a number of years, and were very happy in their work. This means that staff and residents have got to know each other very well. People trust the staff and Manager. Appleby Lodge is well laid out and the lack of steps means that people are able to move freely around any part of the home and out into the garden. The house is clean and there are no unpleasant smells. The meals are well cooked Appleby Lodge DS0000008945.V367495.R01.S.doc Version 5.2 Page 6 from fresh ingredients, cakes are baked every day, and the smell of good cooking pervades the home. People enjoy the food. Most people feel that they have enough to do; there are some planned activities. However the people at Appleby Lodge also enjoy the bar that is the corner of the lounge, and they are happy to stay up late with a drink watching special events such as football matches on the TV. People get up and go to bed when they please. The home is well managed and people feel confident in being able to raise concerns with the Manager or staff. There are sufficient staff who have received regular updates in their training. What has improved since the last inspection? What they could do better: Before people move to Appleby Lodge assessments of what the individual’s needs are, must be completed. This is important, as a decision must be made as to whether Appleby Lodge is able to meet these needs or not. The staff and Manager generally know the people at Appleby Lodge very well and so the fact that care plans are not detailed may not have a significant impact on the help people receive. However some of the people have more complex needs, and it is important that staff are clear exactly what to do if someone should become unwell. We found that the trolley for storing medication was unsafe as it could be easily opened without a key. There is no system for checking how much medication is in the home, and so it would not be possible to check if any were missing. We also discussed with the manager that where people administered their own medication that there should be a risk assessment, so that people can receive the help and support they may need. Where staff have to assist people with injections or test blood (invasive procedures) then this must be agreed with the individual and the medical person responsible for over seeing the treatment. We found that checks had been made to see if there was any significant risk of fire at the home. This fire risk assessment had identified that some works Appleby Lodge DS0000008945.V367495.R01.S.doc Version 5.2 Page 7 needed to be done. These works have not been completed even thought they were identified 18 months ago. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Appleby Lodge DS0000008945.V367495.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 Lodge DS0000008945.V367495.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (standard 6 is not applicable) Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The people who are considering moving to Appleby Lodge cannot be certain that their needs will be known before they move, and this could mean that the move to the home is not in their best interests. EVIDENCE: We looked at information about the care and support needed by someone who had recently moved to the home. Ms Jan Rider said that she had visited the individual, and had tried to find out about the individuals needs however this had proved difficult, and she had obtained little information. We were told that one of the professionals who support this individual was going to provide information in the next few days, but had not done so before the individual had moved. It is important that the home completes an assessment before someone moves to Appleby Lodge. This is important to ensure that Appleby Lodge and the individual concerned can be confident that it is the right move. Moving to a home that is not suitable is very disruptive for everyone concerned. We discussed with the Manager the importance of communicating Appleby Lodge DS0000008945.V367495.R01.S.doc Version 5.2 Page 10 to other professionals that a care home is only able to admit people who have been assessed, unless in an emergency. Appleby Lodge DS0000008945.V367495.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The quality of care at Appleby Lodge is based on the very good relationships that exist between residents and staff. However there is a lack of clear guidance to staff on how to manage more complex needs, and this could mean that people may not have these needs met. The way that medication is stored is not secure. There are no proper systems for the people at Appleby Lodge to receive the right support to be able to administer their own medication. EVIDENCE: Staff have all worked in the home for many years, and because of this have got to know the people who live at Appleby Lodge well. People living at Appleby Lodge told us that they were well care for. Comments in surveys included, “The home is just that, a home. They staff have mainly been here a long time, they are very kind”, “I feel confident they genuinely care for me” and “The staff know me so well and notice medical problems that occur at an early stage, thus ensuring I get medical attention at an early stage. This is Appleby Lodge DS0000008945.V367495.R01.S.doc Version 5.2 Page 12 particularly relevant to the chest infections I suffer from which come on quickly”. We looked at the information that is kept about each person living at Appleby Lodge that makes up a “Care Plan”. Such documents should give clear direction to staff as to how care needs are to be met. We found that these plans were very general, and lacked specific guidance on how to meet needs. This was not of consequence where residents were able to explain their needs, and because many of the staff and residents had known each other for many years. However it was of concern that it was noted that some of the people at Appleby had more complex needs such as diabetes. Care Plans should specifically identify how a person will be supported with this condition, including in relation to skin care, chiropody, and eye checks as well as who has responsibility for monitoring the condition on a day to day basis. We found that reference to this condition was little more that one line. We were told that some people are able to administer their own insulin. In such situations an assessment must be made of the person’s competence to do this, and to identify areas where the individual will need support. There was no such assessment. Where staff are supporting people, for example “supervising” the administration of insulin, or doing checks of blood sugar levels, then there must be a proper record of this. The individual must have given permission for staff to carry out such a procedure, and the medical person delegating their authority must have signed to say that the individual member of staff is competent. We also noted that some people had other complex health conditions that meant that they might urgently need qualified medical attention such as a paramedic or doctor. There was no record of the circumstances when staff are to seek this help, or what they are to do. The Manager said that staff had received some additional training as part of their first aid training. There was also no proper records of when this condition occurred, so that it could be readily monitored. We watched staff administering medication at lunchtime. The member of staff explained that she had been administering the medication for many years and was well practiced. The majority of medication is administered from a medication trolley. This trolley had little space inside it, and each person’s medication was crammed together. Ms Rider said that over the years people had needed more and more medication, and so there was less and less space in the trolley. It was of serious concern that we noted the original lock on the trolley had been replaced with a door lock. This lock was not key operated, but was operated with a square bar. The bar was kept on the shelf under the main storage area. This meant that the medication trolley could readily be opened. Appleby Lodge DS0000008945.V367495.R01.S.doc Version 5.2 Page 13 We looked at how staff recorded that medication was administered. We found that staff signed each time they administered medication. The record of what medication each person is on is written out by hand. We asked the Manager how this happened, and she explained that each month’s sheet was copied from the last month’s sheet. No one checked to see this was correct. This means that if an error is made in copying one month, it will be copied to all future months. We asked how anyone knew how much medication was in the home. We saw that there was a good record of “controlled drugs” that were held. However there was no record of amounts for any other medication. There was no record of the amount of medication received or returned for disposal. This means that it is not possible to check that there is the correct amount of medication in the home. Appleby Lodge DS0000008945.V367495.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people at Appleby lodge are treated with respect, feel valued and enjoy the company of staff and other people at the home. Meals are well cooked, from fresh ingredients. Relatives and visitors are welcome, and kept well informed of things they need to know about. EVIDENCE: We sent surveys to people living at Appleby Lodge in February 08 and again in June 08. We found that people felt that they were listened to and staff acted upon what was said. Comments from people at Appleby Lodge included, “they listen to my requests and help me lead as independent a lifestyle as possible, taking into account my disabilities”, “I like all members of staff and I feel that they like me, I am happy here” and “staff assist me whenever I need them. Always a smile and a joke they never make me feel a nuisance to them.” One relative commented “the staff … telephone me when there is cause for concern and speak to me weekly at the home”. Many of the people at Appleby Lodge maintain a degree of independence and it was apparent that many of the residents of were friends and able to share activities and interests. People visited each other, and initiated activities. The Appleby Lodge DS0000008945.V367495.R01.S.doc Version 5.2 Page 15 Manager said that some residents had stayed up late and watched a concert, whilst others had watched a football tournament on the TV. There is bar in the corner of the lounge and we were told that people enjoy a drink and snack whilst they watch TV together. Residents told us that there were no rules, and it was clear from the banter that took place between people that this was a home where people enjoyed each other’s company. On the day of the inspection someone visited the home to do an exercise session, and we were told that other activity sessions were planned, as well as a trip out. Some of the people who replied to the survey said that they thought that there should be more activities, one person commented “Personally I would like to have more entertainment at the home, but I appreciative that there are some residents not interested and as this is a small home it could be embarrassing if the entertainer had a small audience”. We met with the cook and saw that all food in the home is cooked fresh each day. At lunchtime the plates that went back to the kitchen were all empty. Staff also said that they ate and enjoyed the same food as the residents. There is information about what each person does and does not like, and the cook said he tried to make sure that people do not ever get given something they don’t like. It was noticeable that when you entered this home there was a very pleasant smell of good food cooking. Appleby Lodge DS0000008945.V367495.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live at Appleby Lodge feel confident in being able to raise any concerns, and are protected from abuse by trained and knowledgeable staff. EVIDENCE: Fourteen out of the fifteen people responding to the survey in February 08 said that they knew how to make a complaint. One person commented, “The manager is very approachable and well versed in coping with any problems which occur, and always finds a solution”. There is a copy of the complaints procedure in the hallways and this information is also contained in the “Service User Guide” a document given to people when they move to the home. We found that the complaints procedure had been up dated that to a change of address by the Commission, however since then the postal address has since changed and a further amendment is needed. The Manager said that she had not received any concerns in the last year. We talked with staff about recognising abuse, and they knew what to do if they had concerns. The manager confirmed that all staff, apart from the cooks, had received training in relation to recognising and reporting suspected abuse. Appleby Lodge DS0000008945.V367495.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people at Appleby Lodge live in a pleasant, well-maintained home that is comfortable and clean. EVIDENCE: As part of this inspection we looked around Appleby Lodge. The house was clean and there were no unpleasant odours. Many of the people had chosen to bring items of their own furniture into their bedrooms. The communal areas are spacious, and the lounge area looks out on to a patio area. Many of the bedrooms look out on to the large garden; others look out on to the entrance drive and car park. The Manager said that some people like to look out at the entrance as they can see who is coming and going. There is level access throughout the home and the design of the home is such that the lounge and dining area are at the centre of the house. Appleby Lodge DS0000008945.V367495.R01.S.doc Version 5.2 Page 18 We looked at the laundry area, which is in a separate building a short distance from the front door of the home. In addition to being used for laundry this area is also used to store equipment. There is a wash hand basin, though no soap or paper towels. We also noticed that the walls and floor could not be readily cleaned. When we looked around the bathrooms we noticed that mops were being stored wet. We discussed with the manager systems for ensuring that any infections that happen in the home are not spread. Advice can be provided by Environmental Health or the Health Protection Agency, to ensure that the laundry is properly designed and that there are safe systems of working, to reduce as far as is possible any spread of infection. We discussed with the manager the need to report any outbreak (i.e. 2 or more people) of diarrhoea or vomiting to the Health Protection Agency. Appleby Lodge DS0000008945.V367495.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live at Appleby Lodge are supported by competent and welltrained staff, who enjoy working at the home. EVIDENCE: No new staff have been recruited to work at Appleby Lodge since the last inspection. The manager told us that she was aware of the need to ensure that checks are made on any new staff recruited to the home in the future. Staff spoken to had worked at the home for many years, and were clearly very happy in their work. This level of continuity in staff teams is now unusual in care homes. We looked at training plans for staff and found that all staff had received training in relations to areas such as first aid, moving and handling and fire. Many of the staff had also received training in relation to dementia and the Mental Capacity Act. All of the five staff who returned a survey to the Commission said that they had received training to do their work and to keep them up to date with new ways of working. One staff said on the survey “Our manager is always aware of new courses and keeps us up to date on all our courses which are renewed every three years”. We were told that there are two care staff on at all times, in addition is an additional member of staff on duty between 9am and 11 am on week days. In Appleby Lodge DS0000008945.V367495.R01.S.doc Version 5.2 Page 20 addition there is a cook on each day, and a cleaner during the week. Staff said that there was usually enough staff on duty, one commented, “…if a crisis happens we may need an extra pair of hands but the manger is always on hand or at the other end of a phone”. At night there are two staff on duty, one awake and the other sleeping and available if additional support is needed. One of the most impressive things that came across from staff spoken with during this inspection was how well they worked together. Comments from staff included “We all come and support each other, clients and staff”, and “We are a happy home. All the staff get on well”. There was a record of monthly supervision that the Manager provides to all of the staff. Staff said that the manager is always available, and the Manager confirmed that she is available at all times when she is not in the home. When she takes a holiday one of the staff provide this support. Appleby Lodge DS0000008945.V367495.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Appleby Lodge is well managed by Jan Rider. The people who live at Appleby Lodge and the staff are being placed at unnecessary risk by the failure to carry out works identified in a Fire Risk Assessment. These works would reduce the likelihood and seriousness of a fire should one break out. EVIDENCE: Ms Jan Rider, Registered Manager, told us that she has now completed her Registered Manager’s Award. Ms Rider has worked at the home for a number of years. It is a reflection of Ms Rider’s competence as a Manager that the staff team at the home are not only competent and provide a high quality service, Appleby Lodge DS0000008945.V367495.R01.S.doc Version 5.2 Page 22 but clearly enjoy their work and have chosen to stay at the home for a number of years. The Manager said that she felt it was important to show staff she was prepared to be involved in providing care, and was not just in the office. We asked the Manager about the quality assurance system, and was told that surveys had been sent to people, however the Manager has not yet seen the results of the surveys. The Manager said that forms were to be collated by the Registered Provider. The Manager confirmed that the Registered Provider visited the home every month to check that it was being run properly. We asked to see copies of the reports of these visits, but was told that they had not been sent to the home. Copies of the reports of these visits should be available to be inspected. There were records to show that checks of the fire system had been made by staff. Jan Rider, the Manager, said that a Fire Risk Assessment had been completed. We were shown a copy of this assessment, dated December 2006. This assessment completed by an external company identified a number of areas of work in the home to make it a safe place. Works identified included changing the heat detectors in bedrooms to smoke detectors, and ensuring that an internal window on an escape route was of a standard that would not compromise the exit. The Manager confirmed that she had completed some of the smaller works that were identified on the risk assessment but the major works were waiting the agreement of the owner. We found this assessment of concern, given that it was over 18 months old and they’re many major issues outstanding, and that there were no timescales for this work to be completed. Appleby Lodge DS0000008945.V367495.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 1 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 1 Appleby Lodge DS0000008945.V367495.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP3 Regulation 14 (1) Requirement New people may only be admitted to Appleby House only on the basis of a full assessment, and to which the prospective service user, his/her representatives (if any) and relevant professionals have been party. Each person at Appleby Lodge must have a Care Plan (Service User Plan) that details how their needs are to be met. This must include health care needs such as diabetes and epilepsy. Staff must only assist the people living at Appleby Lodge with such procedures as administering insulin or testing blood sugars, once they have received delegated authority from the relevant medical professional, and have the consent of the individual concerned. Medication must be kept in a secure cabinet, as per the guidance of the Royal Pharmaceutical Society. There must be a record of DS0000008945.V367495.R01.S.doc Timescale for action 01/09/08 2. OP7 , OP8 15 01/09/08 3 OP8 12 (1) b 01/09/08 4. OP9 13(2) 01/08/08 5 OP9 13(2) 01/08/08 Page 25 Appleby Lodge Version 5.2 6 OP9 13(2) 7 OP9 13(2) 8 OP38 23 (4) a medication received into, held in the home and disposed of. It must be possible to know at any point in time how much medication is held in the home. The method of recording what 01/08/08 medication are to be administered must be reviewed, so that risks of transcriptions errors are reduced. The Manager must ensure that 01/09/08 people who wish to manage or administer their own medication are provided with the support or assistance they need, based on a risk assessment. The advice of the local fire 01/09/08 service must be sought to establish timescales for the completion of works identified in the Fire Risk Assessment. 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 OP26 Good Practice Recommendations Control of infection procedures should be reviewed with advice from Health Protection Agency. This should include the laundry. This is to ensure that if there is an outbreak of an infectious illness any spread is minimized. Appleby Lodge DS0000008945.V367495.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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