CARE HOMES FOR OLDER PEOPLE
Appleton Manor Lingard Lane Bredbury Stockport Cheshire SK6 2QT Lead Inspector
Sylvia Brown Unannounced Inspection 6th September 2006 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 Appleton Manor DS0000017288.V308494.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. Appleton Manor DS0000017288.V308494.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Appleton Manor Address Lingard Lane Bredbury Stockport Cheshire SK6 2QT 0161 4067261 0161 4068962 appletonmanor@schealthcare.co.uk www.schealthcare.co.uk Southern Cross Healthcare Services Limited 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) Mrs Pamela Greenfield Care Home 59 Category(ies) of Dementia (41), Dementia - over 65 years of age registration, with number (33), Old age, not falling within any other of places category (59), Physical disability (41), Physical disability over 65 years of age (15) Appleton Manor DS0000017288.V308494.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. No more than 26 places can be used for nursing care. No service user may be received in the home who is less than 50 years old, male/female, described as Physical Disability 7th February 2006 Date of last inspection Brief Description of the Service: Appleton Manor Nursing Home is owned by Southern Cross Health Care Limited. The home shares its grounds with Appleton Lodge, which is owned by the same company. Appleton Manor is located on the borders of Brinnington and Bredbury and is close to local amenities, with convenient access to public transport and motorway networks. The home offers nursing care for up to 26 people. In addition, the home is registered to care for up to 33 people who have a physical disability and dementia. Accommodation is spread over two floors offering single en-suite bedrooms. One double room is provided for service users wishing to share. The first floor, called the Brinnington unit, accommodates service users who have dementia. The ground floor accommodates service users who require nursing and residential care and is called the Bredbury Unit. The fee structure ranges from £414 to £516 for those service users who have mental health or dementia type illnesses and £439 to £733 for those who have nursing needs. Appleton Manor DS0000017288.V308494.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The site visit to Appleton Manor was part of a key unannounced inspection, commencing at 9am. The inspector looked at all the required key standards to see how the home was meeting them. During the visit the inspector looked at a number of records, including Health and Safety, service user care files, staff files and various other records, which are either used to inform people of the services offered and/or used to ensure service users are appropriately cared for and supported. Most of the inspector’s time was spent on the Brinnington Unit which supports service users with mental health or dementia type illnesses. Time was spent talking with service users and sharing mealtimes. The inspector looked around the home and looked at action taken to maintain the required standards. Time was also spent speaking with staff, unit managers and the registered manager. Since the last inspection comment cards were provided to service users, relatives and professional visitors. A staffing survey was also completed. The comments received have helped the CSCI to gain information from people who use the service. Where appropriate and relevant, their comments have been included within the report. Most comments received were positive and demonstrate that service users are, in the main, happy and contented with the support they receive at Appleton Manor. What the service does well:
Appleton Manor provides a good level of personal and health care support to all service users. Doctors and district nurses visit the home, as do chiropodists and opticians. Feedback from service users was that they felt well cared for and observations made confirm that staff are attentive and recognise that service users need to be as independent as they wish and are able, and that they should be supported to develop their own daily routines within the home. Service users are able, as far as possible, to make choices and decisions for themselves for such things as getting up and going to bed, bath times and frequency, and where they may wish to spend the day. All the service users spoken with were satisfied with the care they received and the home. They spoke positively of the staff and from comments and observations made it appeared that service users and staff have formed positive relationships. Appleton Manor DS0000017288.V308494.R01.S.doc Version 5.2 Page 6 The meals served offer service users a variety of food choices at each mealtime and they may take their meals wherever they wish and at their preferred time. The home has again won the “Good Heartbeat “award for 2006. Many parts of the home are well maintained and all service users are able to have their own rooms which are en-suite. Service users are encouraged to bring in any items from home to personalise their rooms as they wish. Other than the understandable desire to return home, most service users stated that the home was a good place to live and that they were happy and contented. Staff are recruited appropriately and all statutory checks are completed before staff commence their first duty. At the start of their employment all staff complete a period of induction and have continuous opportunities for further training. Appleton Manor is well managed and appears to have a happy and relatively settled staff team. Comments received from the staffing survey identified that staff were generally happy working at the home and found it rewarding working with older people who needed their support. One staff stated “I have worked here for some time and have enjoyed my time here, everyone seems happy and there is a nice atmosphere”. Another staff said “I thoroughly enjoy my job and if I have any problems I know I can go to the management for help, everyone helps each other and the service users always have a smile for you”. What has improved since the last inspection?
The home generally maintains a good and consistent standard of service. As a consequence, there are no major developments to be made. Since the last inspection the home has improved its infection control practices. Staff were more aware of their own practice and the transferring of soiled items within the home. Air-conditioning has been provided on the upper levels which improves ventilation and reduces the build-up of heat. Carpets have been replaced in some bedrooms and the main reception area. The dining room on the Bredbury Unit has received new hardwood flooring and some new chairs and side tables have been ordered for around the home. Appleton Manor DS0000017288.V308494.R01.S.doc Version 5.2 Page 7 What they could do better: 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 Manor DS0000017288.V308494.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 Appleton Manor DS0000017288.V308494.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): 1, 2, 3 & 5 Quality in this outcome area is good. Prospective residents have information about the home provided to them, they have their needs assessed and are provided with a contract which tells them about the service they will receive. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The home has an up to date service user guide and statement of purpose, which are provided to prospective service users upon enquiry. The registered manager visits the prospective service user in their current placement to assesses their needs. All care files evaluated had the pre-assessment documents in place which were also supported by assessments completed by placing authorities. Each file contained contracts which detail service users’ agreement to services and funding arrangements.
Appleton Manor DS0000017288.V308494.R01.S.doc Version 5.2 Page 10 Comments received from some service users and relatives identified that they were able to visit the home and observe day to day routines and practices before making decisions about a future placement. Relatives’ comment cards stated that they were, in the main, provided with sufficient information and made to feel welcome. Appleton Manor DS0000017288.V308494.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 Quality in this outcome area is adequate. Service users receive support to maintain their health and welfare and were, in the main, treated with dignity and respect. Medication administration records were not appropriately maintained. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: All service users had written up to date care plans in place. There was some evidence that service users and/or their relatives had been consulted about the identified needs and personal preference as to how those needs should be met. Risk assessments were in place and kept under review. Observation of care practices identified that service users were treated as individuals and had their needs met as they desired. Of the 14 comment cards returned from relatives, all were satisfied with the care service provided at the home. Appleton Manor DS0000017288.V308494.R01.S.doc Version 5.2 Page 12 Service users have their health care needs met as identified. Records demonstrated that district nurse and doctors visit as required and chiropody and optical tests are routinely completed. One service user’s comment card stated they felt ‘well looked after’; another stated she was ‘never ill, only her eyes’ but when asked, she said she was ‘supported nicely.’ Staffing records confirmed service users receive their medication from appropriately trained staff, however medication administration records identified signature omissions and indefinable codes. To ensure the safety of service users and that they get their medication as prescribed, records must be accurately maintained. Service users’ preferred names are recorded and used. Staff spoken with on the Brinnington Unit had a clear understanding of mental health and the ageing process. Service users were happy with the way most staff delivered their care and respected their dignity. However, the inspector observed one instance when personal care routines carried out by staff minimised the dignity of service users and which indicated some institutionalised practice. Appleton Manor DS0000017288.V308494.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 Quality in this outcome area is adequate. Service users keep in contact with family and friends and have the opportunity to socialise. They receive a healthy, varied diet. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The home has a structured activities programme in place, however it appears that the Brinnington Unit should have its activities programme reviewed, as activities such as ‘going round with the bonus ball’ is, in the main, meaningless as an activity for those with mental ill-health or advancing dementia. There was no indication that the activities programme for those with mental illhealth and/or dementia related conditions differed from other activities carried out within the home. This issue has been raised on a number of occasions and the company should ensure that the staff receive support and training in occupying and providing a stimulating environment for those with mental health frailties. Appleton Manor DS0000017288.V308494.R01.S.doc Version 5.2 Page 14 One service user stated she had visited the adjacent home and met with others which she enjoyed and that she had also been taken out on a trip with other service users from other homes within the company. Records are not able to demonstrate service users’ individual participation in activities, however staff stated that the activities co-ordinator records all activities; these records are not held within the service users’ individual files. Service users were observed to be supported and encouraged to have daily routines which were meaningful to them, though this aspect of care support could be developed further. One service user was observed to have dementia, however after talking with the unit manager it was evident that the service user has sufficient capacity and ability to undertake small tasks around the home and would benefit from stimulating daily routines which were meaningful and promoted self worth. Feedback from relatives was positive and confirmed that they were made to feel welcome when visiting. The home maintains a visitors records which was up to date and demonstrated that service users are able to receive visitors. The home has open visiting arrangements and feedback from comment cards confirmed that residents know they can meet with their family and friends in private. The dependency of most people within Appleton Manor is such that they either require constant monitoring due to mental frailty or have medical/nursing needs. Therefore, most routines are devised around their individual care support or management programmes. The home continues to support service users to rise and retire when they wish and have meals at their chosen time and place. Nutritional assessments were in place and service users’ weights were recorded. On the Bredbury Unit, some service users are specifically monitored regarding their food and fluid intake. The records were in detail and indicated the amounts of food and liquid taken. On the Brinnington Unit however, those records failed to identify what the home’s expectations were regarding minimal intake and the action to be taken if the minimum intake was not met. Furthermore, there was no evidence of calculating intake or of any monitoring processes being undertaken. It is unclear why the records were in place. Soft diets were observed being served and were fine. Staff training records identified that staff are trained to help those residents who need help when eating. Feedback from service users identified that, in the main, they enjoyed the food served and had a variety of options to chose from. Appleton Manor DS0000017288.V308494.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 Quality in this outcome area is good. Service users have access to an effective complaints procedure, and are protected from abuse. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: Of the 14 comment cards received from relatives, seven stated they were aware of the home’s complaint procedure. Information about the complaints procedure is displayed around the home and further information is included in the service user guide. The CSCI has received one complaint regarding the home. The home was asked to investigate the matter and deal directly with the complainant. Records demonstrated they had taken the appropriate action to investigate and, as far as possible, have an agreeable resolution. The home’s complaints record detailed all complaints received and the action taken by the home to investigate. At the time of the inspection no service users had any complaints to make and appeared satisfied with the services provided. Appleton Manor DS0000017288.V308494.R01.S.doc Version 5.2 Page 16 Adult protection procedures were in place. Staff receive information at induction about professional conduct and adult protection. This training is then followed up by formal adult protection training. Training records demonstrated that staff had received or were planned to receive updated training in adult protection. Appleton Manor DS0000017288.V308494.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26 Quality in this outcome area is adequate. Parts of the home are well maintained, other parts are not. The laundry is insufficiently staffed and procedures require improvement. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The main reception area to the home has received some upgrading. On entering this area the home appears clean, pleasantly decorated, well maintained and homely, however not all parts of the home reflect this standard. On the Brinnington unit the reception area was dimly lit and service users were observed to be using dining type chairs to sit on all day. The air in this section of the home was stale and the general feel was depressing and not suitable for the promotion of good mental health.
Appleton Manor DS0000017288.V308494.R01.S.doc Version 5.2 Page 18 One lounge looked drab and generally worn out, in that, decoration was worn and some chairs were shabby. There are appropriate numbers of toilets and bathing areas within the home, however on the Brinnington Unit one bathing and a toileting area was not in use. When asked, staff stated that door locks were not appropriate for the safety of service users and one bathroom was not used as it requires an assisted bath rather than an everyday bath which service users cannot use. Another showering and toileting facility was also below standard. The flooring was peeling and broken, not all the bulbs within the strip lighting were working and the radiator cover appeared faulty and hanging at an angle. Generally service users’ own rooms were appropriately personalised with their belongings. Specialist equipment, such as pressure mattresses and hoisting equipment was in place as required. Service users’ safety was promoted. The home has a number of hoists which had up to date servicing records evident. Wheelchairs were clean and presentable and had lap straps. Notwithstanding the above issues, a number of rooms were found to be below the required standard, in that, repairs to furniture was required. Odours were evident, ranging in some rooms from stale to completely overpowering and unacceptable. Staff’s comment cards reflected that the ancillary staff felt they required additional staffing levels to cope with the demands of the home and maintain the standards that are expected and required. One staff wrote ‘More staff are needed to ensure that the cleaning gets done and everything is correct.’ Another wrote ‘More staff are needed for cleaning on the units and more cleaning equipment is needed so the jobs can be done correctly’. One relative’s comment card stated that though care was excellent, cleaning standards were not. “Cleanliness does not exists, the room needs a new carpet and paintwork needs painting, and redecoration is required to improve the room. This would help my relative feel happier, its not a nice place to sit in, its filthy and untidy and is never cleaned properly” Another stated “The home looks run down and needs some TLC.” Both units’ kitchens require some attention to ensure they are maintained the required standard. Appleton Manor DS0000017288.V308494.R01.S.doc Version 5.2 Page 19 The Brinnington dining room looks bare and institutionalised; there are no added features to enhance its homeliness. Carpet replacement is required in a number of areas, as are redecoration and upgrading. Stains and odours were evident; paintwork was badly marked and wallpaper is in need of repair or replacing in a number of areas. Some en-suites had faulty equipment and some bulbs were not working in some bedrooms. The Brinnington Unit does not appear to have had equal investment as other parts of the home. This unit has high demands placed on it by the service users and, as a consequence, increased investment should be in place to ensure all service users within the home share the same standard. Inspection of the laundry identified improved infection control procedures were in place and routines had been developed and maintained to minimise the spread of infection. However, the laundry service is seriously understaffed which has affected the quality. On relative stated “there are always items of clothing missing, even though it is clearly marked”. Another stated “Improvements could be made within the laundry”; whilst another stated “The laundry facility is too severe for some items like jumpers, everything is tumble dried”. Laundry personnel were interviewed and found to be committed to providing a quality service, however due to poor staffing levels, no further improvements can be effectively made. Appleton Manor DS0000017288.V308494.R01.S.doc Version 5.2 Page 20 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 Quality in this outcome area is good. Care staff in the home are trained, skilled and are in sufficient numbers to meet the changing needs of service users. Laundry staffing levels are insufficient to meet the demands of the home. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: Currently, the home has 78 of its staff trained to NVQ level 2 or above. Training records identified the home’s routine programme for training. Staff commented that “Ongoing training is very good and staff are given enough notice to attend”. The staffing survey identified that staff received varying decrees of training at induction and that they received enough support to complete their duties appropriately. Three staff files were evaluated and found to contain the required information. Recruitment procedures were followed and statutory checks were completed before staff commenced their first duty. Appleton Manor DS0000017288.V308494.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33 & 38 Quality in this outcome area is good. Appleton Manor is a well managed home which safeguards service users for the most part through commitment of staff and managers. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The registered manager has been at the home for some considerable time and is experienced and competent at running and managing a care home. She has a strong leadership style and clearly sets the standard required within the home. Appleton Manor DS0000017288.V308494.R01.S.doc Version 5.2 Page 22 Currently, the home does not undertake quality assurance procedures or consult with relatives and service users as a group. Notices displayed within the home inform visitors that they are able to speak with the manager at any time. The registered manager stated that it is her intention to commence consultation procedures with service users and families. The home could not confirm that Regulation 26 visits are completed, as required, on a monthly basis. The visitor’s book confirmed that the operations director routinely visits the home; however there was no evidence that standards were being monitored. The home maintains a good standard of safety for the benefit of service users. Records checked identified that servicing contracts and reports for all equipment, electrical appliances and gas supplies were in place and up to date. Environmental health and fire safety officers have inspected the premises and found them satisfactory. Accidents are recorded and action taken where injuries occur. The home keeps the CSCI appropriately informed of any significant incidents and occurrences. Appleton Manor DS0000017288.V308494.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 2 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 2 3 3 3 2 2 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X X X X 3 Appleton Manor DS0000017288.V308494.R01.S.doc Version 5.2 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 OP19 Regulation 23(2)(b) (d) Requirement Timescale for action 01/11/06 2 OP9 13 3 OP27 18 The registered person must undertake a full assessment of the Brinnington unit and produce an action plan that must be supplied to the CSCI detailing all individual rooms and action to be taken to ensure that the environment is maintained to adequate standards. Timescales should be included and, where required, negotiated with the CSCI. (Previous timescale of 30/07/05 not met). The registered person must 01/10/06 ensure that medication administration records are signed appropriately and that codes used relate to practice undertaken. The registered person must 01/11/06 ensure that dedicated laundry staff are employed to meet the demands of the homes provided with a service from the laundry. (Previous timescale of 01/04/06 not met). Appleton Manor DS0000017288.V308494.R01.S.doc Version 5.2 Page 25 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. 4 Standard OP27 Regulation 13 & 16 Requirement The registered person must take appropriate action to disinfect and clean floor under carpets and replace carpets in rooms where odours of incontinence are evident. Timescale for action 01/11/06 Appleton Manor DS0000017288.V308494.R01.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP7 OP7 OP12 Good Practice Recommendations The registered person should ensure that all required health care charts are completed appropriately and evaluated to ensure residents’ health. The registered person should ensure that all personal care routines are carried out in a respectful and dignified manner at all times. The registered person should develop an activities programme which meets the needs of those with mental health and dementia type illnesses. Staff should receive appropriate training in those conditions and devise ways to provide meaningful daytime occupation. The registered person should ensure Regulation 26 visits are completed and records retained of the outcome. The registered person must undertake full quality assurance procedures which comply with Regulations 12 and 24 and standard 33. (Previous timescale of 1/12/04 not met). The registered person should commence routine consultation with service users regarding the quality of the service within the home. 4 5 OP33 OP33 6 OP33 Appleton Manor DS0000017288.V308494.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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