Inspection on 04/05/05 for Appleton Lodge

This inspection was carried out on 4th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Appleton Lodge 18/07/07

Appleton Lodge 26/09/06

Appleton Lodge 21/10/05

Appleton Lodge 22/09/04

Appleton Lodge 14/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Appleton Lodge Lingard Lane Bredbury Stockport SK6 2QT Lead Inspector Sylvia Brown Announced 4 & 5 May 2005 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 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. Appleton Lodge F54 F04 appleton lodge A s8536 v219492 040505 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Appleton Lodge Address Lindgard Lane, Bredbury, Stockport, SK6 2QT Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0161-406-7261 0161-406-8962 Southern Cross Health Care Ltd Ms D Haughton-Tarmey Care Home 30 Category(ies) of Dementia - over 65 years of age (3) registration, with number Old age, not falling within any other category of places (30) Physical disability over 65 years of age (10) Appleton Lodge F54 F04 appleton lodge A s8536 v219492 040505 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: - Date of last inspection 22 September 2004 Brief Description of the Service: Appleton Lodge is owned by Southern Cross Healthcare Services Limited and is located in a semi industrial and residential area. Public transport is convenient and enables visitors and more able residents to travel to local shopping areas. Appleton lodge is purpose built and stands in its own grounds along with another home owned by the company. Appleton Lodge offers all residents single bedroom accommodation, all with en-suite facilities. Accommodation is provided on two floors. Residents have the opportunity of sitting in various communal seating areas, one of which is designated for residents who prefer to smoke. The home has wide corridors and is able to support residents who use manual and electric wheelchairs. Appleton Lodge F54 F04 appleton lodge A s8536 v219492 040505 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of Appleton Lodge was announced and conducted over two days, starting at 4pm on the first day and 10am on the second, with a total of 11 hours on the premises. The inspector spent time with a number of residents during the evening and had the opportunity of observing one mealtime and sharing another. Four residents were spoken to at length, two of whom had completed and returned a comment card to the inspector prior to the inspection. One resident’s care was fully evaluated, including the admission procedures and development of a care package to meet the required needs of the resident and personal requests. Time was spent talking with the resident about her care and support services. A total of six comment cards were returned from residents, whose remarks are included within the report. The inspector had the opportunity of meeting with and speaking to senior managers within the company during the inspection, in addition to spending time with staff and the registered manager. The home completed a pre-inspection questionnaire prior to the inspection, which assisted the inspector to evaluate the service. What the service does well: The home, in the main, plans well for the care of residents. Health care needs are met and support is provided, as far as possible, to maintain the residents’ good health. Care plans and pre-assessments are detailed and easily identify the residents’ needs and personal preferences. The home is spacious enabling residents to have ample communal sitting areas in addition to their own rooms. Residents stated they had nice rooms and enjoyed having their own private areas for quiet relaxation. Residents spoke well of the staff and of the support services, saying they were, in their opinion, “well cared for”. Though a number of residents stated they would have preferred to remain in their own home, there was an appreciation that Appleton Lodge was a “good alternative” if not able to live at home. Appleton Lodge F54 F04 appleton lodge A s8536 v219492 040505 stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: The home must develop ways in which to meet the spiritual needs of residents who state they wish to continue with their religious beliefs. Though care plans are written in detail, it was evident that action required by one resident was not followed leaving the resident without any support to maintain her spiritual beliefs. Health and safety systems were not appropriately monitored at the time of the inspection and request for repairs for one piece of vital equipment not followed through in a timely manner. The inspector identified that this placed some residents and staff at significant risk in relation to moving and handling. One fire safety exit door was also found to be faulty. Essential training for some staff required updating. The registered manager herself was identified as having significant gaps in her training. Staffing hours require reviewing as there appeared to be insufficient numbers of staff to meet the needs and demands of the home at peak times. The company has failed to provided enough laundry staff. On the days of the inspection it was identified that routines and management systems within the laundry area were unsatisfactory. The manner in which social activities are organised does not lead to residents having regular social stimulation. Morning breakfasting routines were also identified as needing improving, including the preparation, delivery and serving of hot food items. Appleton Lodge F54 F04 appleton lodge A s8536 v219492 040505 stage 4.doc Version 1.30 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Appleton Lodge F54 F04 appleton lodge A s8536 v219492 040505 stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Appleton Lodge F54 F04 appleton lodge A s8536 v219492 040505 stage 4.doc Version 1.30 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 standard(s) 2, 3, 4 & 5. Standard 6 is not applicable to Appleton Lodge Residents are provided with sufficient information to enable them to make informed decisions about their accommodation prior to and during their stay. EVIDENCE: Inspection of a resident’s file, who had recently moved into the home, identified that she was given enough information about the home and told about the services offered to enable her to make an informed decision about her future accommodation prior to moving in. Social services contacts were in place for funded residents, and terms and conditions of residency contracts produced by the company were in place for private residents. The registered manager and administrator confirmed Funded residents did not receive a copy of the company’s terms and conditions of residency as expected. Appleton Lodge F54 F04 appleton lodge A s8536 v219492 040505 stage 4.doc Version 1.30 Page 10 The registered manager visits residents prior to moving, and they also have the opportunity of visiting Appleton Lodge to look at routines and accommodation. Residents confirmed this. Assessments of residents’ needs are completed prior to them being accommodated, and after moving in. Records identified that they were reviewed regularly to make sure that any improvements or deterioration in residents’ condition were recorded. The home does accommodate residents for short stays, however it does not provided an intermediate care service. Appleton Lodge F54 F04 appleton lodge A s8536 v219492 040505 stage 4.doc Version 1.30 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 standard(s) 7, 8, 9 & 10 Residents receive support to maintain, as far as possible, good health. Personal care routines are promoted with dignity and respect. EVIDENCE: Four of the five comment cards completed by residents showed that they felt well cared for. At inspection residents stated they were looked after and that staff made sure medical appointments were made when required. Care plans contained the residents’ medical histories and identified the health care support now required. Medication records were, in the main, correct, however one newly admitted resident’s record was unclear, in that, it appeared that one medication was not administered whilst appearing on two records signed for as though administered twice. The home must improve how it records and administers medicines for newly accommodated residents. Residents are supported to continue with administering their own medication as they require and are able. Appleton Lodge F54 F04 appleton lodge A s8536 v219492 040505 stage 4.doc Version 1.30 Page 12 During the course of the inspection an incident occurred within the home, which created some significant noise while residents were in their rooms preparing and prepared for bed. The next day residents appeared confused and alarmed about the noise. They told the inspector that when they had asked about the matter they had not been told what had happened. One resident stated that “sometimes we are treated like small children, they tell us nothing”. This conduct does not promote the residents’ self-worth or demonstrate they are treated with the respect. Appleton Lodge F54 F04 appleton lodge A s8536 v219492 040505 stage 4.doc Version 1.30 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 standard(s) 12, 14 & 15 Some residents are not supported to take control over their own daily routines. The home’s activities programme fails to meet the social needs of residents, and the delivery and serving of hot breakfast items is poor. EVIDENCE: During the inspection residents gave their opinions on social activities provided by the home. Some residents stated they were satisfied with what they were offered, whilst others stated that there was not enough to do. One comment card received from a resident on short stay stated that life within the home was “ boring”. The home employs an activities co-ordinator and although she is dedicated and committed to providing a variety of activities and personal one to one interaction with residents, she cannot solely provide enough social activities and opportunities for all the residents accommodated. Inspection of the one service user’s records, who was being case tracked, failed to identify that she had been offered or taken part in any activity since her arrival. Appleton Lodge F54 F04 appleton lodge A s8536 v219492 040505 stage 4.doc Version 1.30 Page 14 The inspection of one newly admitted resident’s file, identified that she strongly wished to continue with her religious practices and required support to do so. The home could not demonstrate how or if the resident had been supported to attend church or receive routine visits from a minister of her preferred denomination. The resident spoke of her distress that a calendar that contained religious verses had been removed from her room and that she had not been able to identify the date or day or read her scripture. Another resident was observed to be sat at breakfast table at 7am asleep. Later, when spoken to, she informed the inspector that she had been very tired. She stated staff had woken her that morning and supported her to dress, she stated that she would have preferred to have had a “lie in” that morning. The more independent residents were observed rising and retiring as they wished. Observations were that the morning hot food items were delivered from the central kitchen which is not within Appleton Lodge. Beans were delivered warm and in a covered bowl, one boiled egg was delivered hot. The beans were observed being served over a period of 45 minutes, some being served barely warm. The boiled egg was not served for some 50 minutes and was cool if not cold. One resident stated she had received porridge, which was not cooked and cold. Staff stated that kitchen staff were not amenable to change and that it was they who dictated how food was prepared and delivered. Two residents stated that although they did not always have teapots made available to them, as on the day of the inspection, they did like the opportunity of pouring their own or others’ drinks, however they commented that the teapots currently provided were too heavy and restricted their ability to pour drinks. Notwithstanding the above information, residents did generally speak favourably of the meals served and that they were offered a variety of food to choose from at each mealtime. Four comment cards from residents stated they were satisfied with the food served, one stated sometimes they were satisfied, whilst another stated they were not satisfied. Appleton Lodge F54 F04 appleton lodge A s8536 v219492 040505 stage 4.doc Version 1.30 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 standard(s) 16 & 18 The home does not ensure staff are appropriately trained in adult protection procedures which safeguard residents from abuse and harm. Complaints were taken seriously and appropriately actioned. EVIDENCE: The home has protection procedures in place, however there were records about allegations of abuse made by one resident about a member of staff and that unexplained bruising/marks were evident. The resident’s care plan identified that the resident was prone to making allegations, however, formal adult protection procedures should commence with independent advice being sought each time an allegation is made to ensure a multi-disciplinary approach. Failure to follow procedure could lead to the abuse of a resident being undetected or ignored. Staff stated they had not received any specific training in adult protection. When asked, they were not familiar with the action required when an allegation or suspicion of abuse occurs. It was also identified that the registered manager had not completed up to date training in adult protection or whistle blowing procedures. Comment cards received from residents stated that they felt safe and that they had someone they could talk to if they felt unsafe or concerned. Appleton Lodge F54 F04 appleton lodge A s8536 v219492 040505 stage 4.doc Version 1.30 Page 16 The home had received 22 complaints within the previous 12 months, one of which was referred to the CSCI. Records detailed the nature of the complaint and action taken to find a positive outcome. Appleton Lodge F54 F04 appleton lodge A s8536 v219492 040505 stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 22, 25 & 26 Appleton Lodge was clean and, in the main, well maintained. Residents’ safety was compromised through faulty moving and handling equipment and a faulty fire exit door. EVIDENCE: Observations were that the home was bright, clean and generally well maintained. The inspector observed that at least one bathroom door failed to have a correct locking device and one fire door failed to open effectively to enable use in a fire emergency. Immediate action was taken to rectify the fire door and a senior facilities manager confirmed that the door had been tested the day before and found to be working. Appleton Lodge F54 F04 appleton lodge A s8536 v219492 040505 stage 4.doc Version 1.30 Page 18 The inspection of records identified that one hoist continued to require repair. Inspection of the hoist confirmed that it was not safe to use. Staff stated that there was only one hoist and that they continued to use the unsafe hoist. When informed, the registered manager stated she was unaware that the equipment remained faulty. Both she and the operational manager took immediate action and confirmed that a replacement would be provided immediately. Through talking to staff and observing practice, it is concluded that an additional hoist may be required. Residents on the upper floor were observed waiting for transfer by hoist due to it being used on the ground floor. Inspection of the laundry area on the first day of the inspection identified that routines to maintain safety were not satisfactory. Excessive amounts of clothes were stored in boxes. Pillows, chair cushions and quilts were stored within the laundry area which is not permissible under fire safety regulations. Residents’ personal items were stored waiting for ether labelling or repairs. On the second day of the inspection, routines deteriorated further as the home’s overnight and morning laundry increased the amount of items within the area. Appleton Lodge F54 F04 appleton lodge A s8536 v219492 040505 stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 & 30 The home has robust recruitment and selection procedures in place for the protection of residents. Staff were not provided in sufficient numbers during peak times to meet the needs of service users. EVIDENCE: The staff team at Appleton Lodge are of mixed age and experience. Residents spoke highly of staff, one stating they were “caring”, another stated, “I would be lost without them”. Comment cards stated that all staff treated them well. One resident’s care plan stated that, for her protection and the protection of staff, two members of staff should provide the support required. Staff stated that due to morning and evening routines they attended the resident alone as numbers did not allow two staff to assist. Staffing levels within the laundry were far below that required. One member of staff was designated to attend to the laundry needs of both Appleton Lodge and Appleton Manor. Appleton Lodge F54 F04 appleton lodge A s8536 v219492 040505 stage 4.doc Version 1.30 Page 20 Through inspection of the rota and talking to staff, it became evident that staff shortages also occur at break times. Contracts on file and staff confirmed that they are not paid for break times. Staff also stated that they felt the 12-hour shifts were excessive when breaks could not be effectively taken and that shift patterns led to continuous numbers of days being consecutively worked without a day off. They stated that they felt tired and found it hard to keep the standards required at such times. Inspection of staff files identified that robust recruitment and selection programmes were in place and followed. Induction programmes were also completed. One resident was observed to have been left at the dining table with her foot trapped between the footrests on her wheelchair. It was also evident that the resident could not comfortably sit in her wheelchair at the table, indentations were evident on the resident’s legs where they were pinned underneath the table. Appleton Lodge F54 F04 appleton lodge A s8536 v219492 040505 stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 35, 36, 37 & 38 Appleton Lodge is managed satisfactorily. Written policies and procedures are in place for the protection, safety and well being of residents. Residents were satisfied with the service and stated they felt well cared for and safe. EVIDENCE: The registered manager’s hours are divided between completing care support on rota and administration duties off rota. Whilst this has previously been agreed with the CSCI, it has become evident that since her return from extended leave and with the merger of the two companies, re-establishing her management role has been difficult. The operations manager stated that the registered manager’s return to work programme has not been undertaken as she would have desired. Appleton Lodge F54 F04 appleton lodge A s8536 v219492 040505 stage 4.doc Version 1.30 Page 22 Records relating to health and safety were found to be in order and indicated monitoring systems were in place. Notwithstanding the outcomes of some of the standards, residents continue to state they feel happy and contented living at the home and feel it is a good pace to live. Appleton Lodge F54 F04 appleton lodge A s8536 v219492 040505 stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 2 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 x 14 2 15 2 COMPLAINTS AND PROTECTION 2 x x 2 x x 1 1 STAFFING Standard No Score 27 1 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 1 2 3 x x x 3 3 3 Appleton Lodge F54 F04 appleton lodge A s8536 v219492 040505 stage 4.doc Version 1.30 Page 24 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 2 Regulation 5 (1)(b) Requirement The registered person must supply all residents with a copy of the homes terms and conditions of residency, regardless of their funding arrangements. The registered person must ensure the safe recording, handling and administration of medicines within the home at all times. The registered person must, whenever and wherever possible, ensure that information is provided to residents upon their request. The registered person must ensure that routine systems are in place for the provision of social activities and all residents have the opportunity to join in social activities as they require and desire. The registered person must ensure that they support those residents who wish to continue with their religious beliefs and practices. The registered person must ensure that routines are developed to meet the needs of Timescale for action 30/6/05 2. 9 13 (2) 5/5/05 3. 10 12 (2) 5/5/05 4. 12 16 (2)(m)(n) 15/6/06 5. 12 12 (4)(b) 31/5/05 6. 14 12 (2) & 13 (3) 31/5/05 Appleton Lodge F54 F04 appleton lodge A s8536 v219492 040505 stage 4.doc Version 1.30 Page 25 7. 15 16 (2)(a) 8. 18 13 (4)( c) & (6) 9. 18 13(6) 10. 19 23 (2) (b) 11. 22 16(2)(c) 12. 25 13 (2)( c) 13 (5) 13. 26 16(2)(j) 14. 26 13(2)(j) residents and not staff. Cease waking residents in the morning unless it is identified to do so as part of their care programme. The registered person must ensure that food served is freshly prepared and served at the appropriate temperature. The registered person must ensure adult protection procedures are followed each time an accusation is made and/or suspicions of abuse arise. The registered person must ensure that all levels of staff including the registered manager receive up to date training in adult protection and whistle blowing procedures. The registered person must ensure that systems are in place for the checking of fire safety doors and that they continually operate affectively. The registered person must ensure that all bathrooms and toilets rooms have appropriate safe locking devices which can be used by residents and enable staff entry in times of emergency. The registered person must ensure that moving and handling equipment is maintained in good, safe working order at all times. The registered person must ensure that the laundry area conforms to fire safety standards at all times. Remove all items of storage, including clothing, pillows, seat cushions, quilts and bedding which do not require laundering. The registered person must ensure routines within the laundry area reduce the risk of cross infection. 15/5/05 5/5/05 15/7/05 5/5/05 30/6/05 5/5/05 15/5/05 31/5/05 Appleton Lodge F54 F04 appleton lodge A s8536 v219492 040505 stage 4.doc Version 1.30 Page 26 15. 27 18 (1) 16. 28 13 (4)(c) 17. 31 10 (3) 18. 25 12 19. 25 13(4)(a) 20. 28 13(4)(a), 13(5) The registered person must ensure that the home is appropriately staffed at all times to meet the individual and group needs of residents. The registered person must ensure that staff are trainined in moving and handling procedures and that they ensure the safety and comfort of residents at all times. The registered person must ensure that the registered manager has an up to date training analyasis and programme in place, which ensure she continues with her learning and is qualified to undertake her roles and resonsibilities. A copy of the registered managers training programme must be submitted to the CSCI for monitoring purposes. The registered person must have effective systems in place to ensure the safe reporting, repairing and monitoring of faulty equipment. The registered person must ensure that a full assessment is undertaken of all residents needs in respect of transferring with a hoist and ensure that sufficent hoists are available to provide timely transferrance for residents. A copy of the assessment should be made available to the CSCI. The registered person must ensure that suitable arrangments are made to ensure residents safe, comfortable seating at meal times. 31/5/05 31/5/05 15/7/05 31/5/05 31/5/05 31/5/05 Appleton Lodge F54 F04 appleton lodge A s8536 v219492 040505 stage 4.doc Version 1.30 Page 27 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 15 Good Practice Recommendations The registered person must ensure that residents independance is promoted by the provision of teapots which are of an appropriate size and weight, enabling them, where preferred, to pour their own drinks. The registered person should consult with staff regarding their rota of work, and agreement sought where staff are working consecutive days without time off. The registered person should, as far as possible, attempt to reduce the amount of hours worked by the manager on the care rota. 2. 3. 4. 5. 6. 7. 8. 27 31 Appleton Lodge F54 F04 appleton lodge A s8536 v219492 040505 stage 4.doc Version 1.30 Page 28 Commission for Social Care Inspection 2nd Floor Heritage Wharf Portland Place Ashton under Lyne, OL7 0QD 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 Appleton Lodge F54 F04 appleton lodge A s8536 v219492 040505 stage 4.doc Version 1.30 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!