Inspection on 08/06/05 for Ashlea Park Residential Home

This inspection was carried out on 8th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Ashlea Park Residential Home 27/04/07

Ashlea Park Residential Home 19/04/06

Ashlea Park Residential Home 20/12/05

Ashlea Park Residential Home 17/01/05

Ashlea Park Residential Home 09/07/04

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

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

CARE HOMES FOR OLDER PEOPLE Ashlea Park Archer Road Farringdon Sunderland SR3 3DJ Lead Inspector Lee Bennett Unannounced Wednesday, 8 and Thursday 9 June 2005 at 07:45 am th th 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. Ashlea Park B52-B02 S34305 Ashlea Park V220755 290605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ashlea Park Address Archer Road, Farringdon, Sunderland SR3 3DJ 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) 0191 522 5977 0191 528 2044 Winnie Care Ltd Mrs Jean Robson PC Care home only 40 Category(ies) of 28 x OP; 22 x DE(E); 8 x PD(E); 5 x SI (E) registration, with number of places Ashlea Park B52-B02 S34305 Ashlea Park V220755 290605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The SI(E) service user category relates to current service users only. Date of last inspection 17th January 2005 Brief Description of the Service: Ashlea Park is care home, providing personal care for up to 40 older people, some of whom may have dementia related needs. Nursing care is not provided, but District Nursing services can be arranged where necessary. It is a purpose built care home with accommodation provided over two floors, with level access throughout. A lift provides access between the two floor of the home. There is a garden area in front of the home, which includes a paved seating area. The home is situated on the outskirts of Sunderland near to local public transport links. It is also situated near to a range of local facilities, including a doctors surgery, shops, pubs and places of worship. Ashlea Park B52-B02 S34305 Ashlea Park V220755 290605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This scheduled unannounced inspection was conducted by a team of two inspectors, over a 9½ hour period. Inspection visits undertaken by a CSCI Pharmacy Inspector and Regulation Inspectors following two complaints made to CSCI about the home, as well as evidence from a recent adult protection investigation have been included within this report. A tour of the building took place, and staffing and service users records were inspected. Service users, staff, the manager and visitors were spoken with, and both breakfast and lunch were taken by Inspectors, on both the first and second floor dining rooms. A member of staff was observed whilst undertaking their medication round, and the medication storage facilities and administration records inspected. The judgements made are based on the evidence available to the Inspector on the day of the inspection. What the service does well: What has improved since the last inspection? The manager has started to update care plans, and has worked to begin to address some of the issues raised in previous and complaint’s related inspections. Service user’s accidents and falls are now being monitored more closely, but the manager and her staff team must now change this information into a falls prevention strategy. Ashlea Park B52-B02 S34305 Ashlea Park V220755 290605 Stage 4.doc Version 1.30 Page 6 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. Ashlea Park B52-B02 S34305 Ashlea Park V220755 290605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Ashlea Park B52-B02 S34305 Ashlea Park V220755 290605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 6 Intermediate care is not provided at Ashlea Park. The admissions process ensures that service users’ needs are assessed prior to care being offered. This helps to ensure that service users are offered the right type of care at the home. EVIDENCE: Care managers assessments are now received before care is offered at the home. Following this care plans are developed, and a review takes place after six weeks with the service user’s social worker. Ashlea Park B52-B02 S34305 Ashlea Park V220755 290605 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 Service users’ care plans are in place, but do not fully reflect their observed needs. This can limit the guidance available regarding care practice and consistency. Service users’ health care needs have mostly been identified, but areas such as pressure care and falls prevention require further work, and individualised care planning if health related needs are to be fully met. Medication arrangements take a considerable proportion of the senior care workers time, but administration and recording arrangements are appropriately managed, which will ensure that service users receive their medication as prescribed by their GP. Arrangements are in place to help preserve service users’ privacy and dignity, however insufficient staffing levels have impacted the ability of staff to promptly address service users care needs (see commentary in staffing section below). Ashlea Park B52-B02 S34305 Ashlea Park V220755 290605 Stage 4.doc Version 1.30 Page 10 EVIDENCE: Each service user has a plan of care in place, and the manager and senior cares are revising each service user’s care file to follow the same layout. A progression from an assessment, to a care plan, which is then monitored, evaluated and reviewed is to be developed for each service user. Monitoring of specific needs occurs by using monitoring charts (for pressure relief, continence and diabetes) and through daily progress notes. Highlighted risk areas, such as smoking, are also care planned/risk assessed, but are not always revised to reflect changing needs and care practices. Some care needs (such as pressure relief and falls prevention) are also not in place for specific service users where this is needed. One service user has a recliner chair, obtained following an Occupational Therapy assessment, and this includes restraining straps to ‘retain her posture’. Staff in the home have also used this as a form of restraint and this practice must cease. It is a requirement of this report that a clear protocol regarding the use of this chair be developed, including it’s purpose, guidance on how long the chair is to be used for, and the limitations to it’s use. Service users and their relatives made comments such as, “We’re well looked after,” “The girl’s are great,” and “nothings a bother.” But these were often tempered with remarks about staffing levels, that were felt by service users to limit staffs’ ability to meet their needs. One service user commented that she becomes angry when there aren’t enough staff to take her to the toilet, and it took 10 minutes for staff to respond to one service user’s request to go to the toilet, after her requests began to escalate into verbally challenging behaviour. Medication is, in the vast majority of cases, handled and administered by senior care staff. Medication rounds take place during the morning, at lunch time, at tea time and in the evening. A monitored dosage system (Nomad) is used, whereby the dispensing pharmacist supplies each service users’ medication within a tray. This contains a series of small boxes that correspond to the four medication rounds of the day, and the seven days of the week. Printed ‘medication administration records’ are also supplied by the pharmacist. The morning medication round is the longest, and it took the senior carer well over two hours to complete, in part because she needed to observe several service users properly take their medicines. This task was also undertaken by care staff, due to the length of time taken by service users to consume their medication, such as calcium supplements, taking staffs time away from other caring duties. Ashlea Park B52-B02 S34305 Ashlea Park V220755 290605 Stage 4.doc Version 1.30 Page 11 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 and 15 Arrangements to provide activities and occupation are underdeveloped within the home. The development of a planned, structured and well delivered activities programme can contribute to a more interesting and stimulating lifestyle for service users. Service users are offered and receive a varied, wholesome, nutritious and wellpresented menu. This can contribute to their general health and wellbeing. EVIDENCE: A member of staff was recently employed in the home to plan activities for service users for one day a week, but this person has now left. Activities are still carried out, however, these do not appear well planned, and staff have insufficient time, training and expertise to effectively develop this role. On the day of the inspection carpet bowls were being played in the upstairs lounge, but at times this had to be conducted around the medicine trolley, as it coincided with the morning medication round. One service user commented ‘I love it here’. They noted that they used to receive Holy Communion and Confession, but that this no longer happens. This was raised with the home’s manager to address. Ashlea Park B52-B02 S34305 Ashlea Park V220755 290605 Stage 4.doc Version 1.30 Page 12 Meals are provided within two large lounge areas, one on each floor. Some service users take meals within their own bedrooms. Service users were offered a range of choices for breakfast, including toast, a choice of breakfast cereals and a cooked breakfast. Staff, although rushed, were attentive to service users’ requests, and provided support and prompts to them. The lunch-time meal was attractively presented and service users were very complimentary about the food provided. Staff upstairs faced a number of challenges during this time, including a considerable delay between service users on the first floor sitting down for their meal and it arriving, difficult behaviours and a potential conflict situation, for which the Inspector offered advice on how to manage the situate more effectively. Hot and cold drinks are provided at regular intervals throughout the day to allow service users to receive an adequate fluid intake. Ashlea Park B52-B02 S34305 Ashlea Park V220755 290605 Stage 4.doc Version 1.30 Page 13 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 and 18 A clear complaints procedure is available, but is not fully implemented. This can affect service users’, and their relatives, confidence in the process, and the ability of the management team to improve the service provided. Local adult protection procedures have been implemented and instigated to help contribute to the protection of service users from abuse. EVIDENCE: Two complaints have, within the four months prior to the inspection, been referred directly to CSCI to investigate. These raised concerns over the extent to which expressions of dissatisfaction are documented, and responded to. These two complaints investigations generated several requirements and recommendations, that have to date been only partially addressed by the home’s manager. They included requirements relating to medication management (following an administration error), cleanliness and the way in which complaints are documented. Staff must record all complaints made to them. A series of adult protection referrals have emerged from the home over the past twelve months. These again have raised a variety of issues, some of which have now been addressed by the home’s manager. At a recent adult protection meeting an ‘alert’ was made, for which a referral is still to be made to the local adult protection procedures. This must be followed up and is a requirement of this report. Issues raised through the adult protection process have included the need to seek and obtain comprehensive care assessments from the care manager (social worker), which are now being sought; the need to develop individualised care plans and risk assessments in relation to falls Ashlea Park B52-B02 S34305 Ashlea Park V220755 290605 Stage 4.doc Version 1.30 Page 14 and pressure care, which require further work; and the need to utilise the companies probationary and supervision arrangements where staffs performance is less than satisfactory. The staff member concerned has now been dismissed. Ashlea Park B52-B02 S34305 Ashlea Park V220755 290605 Stage 4.doc Version 1.30 Page 15 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, 20, 24, 25 and 26. The home is clean, well decorated and maintained. This can help promote a positive image for service users, and ensure they remain safe. Some dining chairs need to be repaired or replaced, as they could break and injure a service user. Some lounge chairs are worn and need to be repaired or replaced, as they do not promote good hygiene. Service users’ bedrooms, communal areas and bathing/WC facilities are accessible to meet service users’ mobility needs. EVIDENCE: The service users rooms were clean and many contained furniture and possessions personal to the person. New carpets have been fitted in many areas of the home, and several bedrooms have been redecorated, although service users who were asked stated that they have not been given a choice of décor scheme in their own bedrooms, limiting the opportunity for people to continue making decisions about their lifestyle. Ashlea Park B52-B02 S34305 Ashlea Park V220755 290605 Stage 4.doc Version 1.30 Page 16 Some dining chairs were loose and wobbly, and could potentially collapse. Some dining room chairs have worn covers and must be repaired or replaced. There is only one clinical waste bin on each floor, and this must be increased, as staff have to carry soiled pads considerable distances within the home, affecting general hygiene in the home, and the dignity of service users. These items are requirements of this report. There is only one hot lock provided for the transport of food throughout the home. This resulted in a considerable delay in the serving of food to the first floor dining room which is upsetting for service users, spoiling their enjoyment of the meal time experience. Corridors and WC / bathing facilities have been provided with grab rails, and other adaptations to enable access for service users who are disabled or who are physically frail. Ashlea Park B52-B02 S34305 Ashlea Park V220755 290605 Stage 4.doc Version 1.30 Page 17 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 Staffing levels are insufficient to effectively meet the needs of service users living in the home. Staff require further training in relation to the care needs of service users, to ensure they have a good understanding of these needs and how they can be met. EVIDENCE: Throughout the period of the inspection staff appeared to be unable to fully meet service users needs, and additional staffing cover has not been provided to meet the health and safety requirements relating to pregnant workers. This has placed additional pressures on the team in respect of manual handling tasks. For example, where requests for assistance cannot be promptly met, service users may attempt to mobilise independently and therefore place themselves at an increased risk of falls. During the inspection domestic staff were involved in undertaking caring and manual handling duties, and youth experience staff are used to supplement the work of the staff team. The youth experience workers are not able to undertake personal care tasks, due to their age and levels of experience. Ashlea Park B52-B02 S34305 Ashlea Park V220755 290605 Stage 4.doc Version 1.30 Page 18 Service users have varied needs, including many with confusion, some who present challenging behaviours, several who require manual handling, and several with health related needs, such as diabetes, continence and pressure care needs. There is also a high incidence of falls in the home. Those staff present during the inspection were observed to be pleasant and courteous with service users. Ashlea Park B52-B02 S34305 Ashlea Park V220755 290605 Stage 4.doc Version 1.30 Page 19 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) 35 and 38 Centralised arrangements for the handling of service users’ personal savings does not serve their interests well and may put them at risk of being financially disadvantaged. The health and safety of service users, visitors and staff and not always promoted and protected, which can result in unnecessary accidents and injuries. EVIDENCE: Some service users living in the home have their ‘personal allowance’ (sometimes referred to pocket money) managed centrally by Winnie Care. The income from this is held within one of two pooled bank accounts, one of which accrues interest, the other not. There is no mechanism to allocate and pay this interest to service users, either current or past. There is no clear means of reconciling the various means by which the money is held (bank accounts, petty cash system and individual cash floats). On occasions service users may Ashlea Park B52-B02 S34305 Ashlea Park V220755 290605 Stage 4.doc Version 1.30 Page 20 be indebted to this account, consequently borrowing from other service users without their permission. Unsafe working practices, the use of unsafe manual handling techniques, insufficient clinical waste facilities, low staffing levels, and the unlocked storage of paints were all observed during the inspection. Manual handling equipment is available, and in the majority of cases used, but several instances of ‘banned’ manual handling techniques (such as drag and underarm lifts) were apparent. The manager has started the process of monitoring the frequency of falls experienced by service users, but this is yet to be converted into risk management and falls prevention strategy. Ashlea Park B52-B02 S34305 Ashlea Park V220755 290605 Stage 4.doc Version 1.30 Page 21 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 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 2 2 x x x 3 2 2 STAFFING Standard No Score 27 1 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 x x x x 1 x x 1 Ashlea Park B52-B02 S34305 Ashlea Park V220755 290605 Stage 4.doc Version 1.30 Page 22 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement Timescale for action 17/9/05 2. OP12 16 The registered manager must review care planning arrangements to ensure that care plans are: * Derived from the comprehensive assessment. * Based on an individuals needs. * Involve service users or their representatives. * Available to care staff to guide their practice and to act as a point of reference. * Monitored and reviewed regularly, and linked to daily recording. * Delegated to competent senior and care staff for completing. This requirement was first identified at the inspection of 9/7/04 and the previous action plan date was 1/7/05. The registered manager must 17/9/05 ensure that a programme of group and one to one activities, based on service users needs and preferences, is developed and implemented within the home. This requirement was first identified at the inspection of 9/7/04 and the previous action B52-B02 S34305 Ashlea Park V220755 290605 Stage 4.doc Version 1.30 Ashlea Park Page 23 plan date was 1/7/05. 3. OP15 12 The registered manager must review meal time arangements to enable the needs of service users with dementia to be adequately supported. This requirement was first identified at the inspection of 9/7/04 and the previous action plan date was 1/7/05. The registered manager must ensure that staff receive specialist training for service users with sensory impairment and physical disabilties. This requirement was first identified at the inspection of 9/7/04 and the previous action plan date was 1/7/05. The registered manager must ensure that risk assessments are reviewed to accurately reflect service users current needs in regards to health, social, personal and psychological care. This requirement was first identified at the inspection of 9/7/04 and the previous action plan date was 1/7/05. The registered person must review service users financial arrangements. This requirement was first identified at the inspection of 9/7/04 and the previous action plan date was 1/7/05. The registered manager must ensure that policies and procedures, covering all aspects of medicines management (including correct ordering procedures, covert administration and dealing with drug errors) are reviewed in line with current Royal Pharmaceutical Society of Great Britain guidelines entitled The 17/9/05 4. OP4 12 17/9/05 5. OP8 14 17/9/05 6. OP35 20 17/9/05 7. OP9 13(2) 17/9/05 Ashlea Park B52-B02 S34305 Ashlea Park V220755 290605 Stage 4.doc Version 1.30 Page 24 8. OP9 13(2), 17(1)(a) Sch 3(3(i)) 9. OP9 13(2), 17(1)(a) Sch 3(3(i)) 13(6) and (7) 10. OP8 11. OP8, OP17, OP18 OP11, OP35 13(6) and (7) 18(1)(a) 12. 13. 14. 15. OP12 OP16 OP18 12(4)(b) 22(1 to 3) 13(6) 16. OP22 23(2)(c) Control and Administration of Medicines in Care Homes and Childrens Services. The previous action plan date for this requirement was 30/6/05. The registered manager must ensure that records are kept of all medication entering the home, including the contents of the NOMAD system. The previous action plan was 30/4/05. The registered manager must ensure that the disposal of Controlled Drugs is recorded in the Controlled Drugs register. The previous action plan date for this requirement was 30/4/05. The registered manager must, in cooperation with other relevant professionals, develop guidance on the use of the reclining chair used on the first floor. The registered manager must ensure that the reclining chair used on the first floor is not used as a means of restraint. The registered manager must ensure that, with regard to the needs of service users, at all times there are suitably qualified, competent and experienced persons working in such numbers as are appropriate for the health and welfare of service users. The registered manager must make arrangements to meet the religious needs of service users. The registered manager must ensure that staff document all complaints made to them. The manager must make an adult protection referral following the alert made at the strategy meeting of 5/5/05 The registered manager must arrange for the repair or 17/8/05 17/8/05 17/8/05 8/6/05 9/6/05 17/8/05 9/6/05 17/8/05 8/7/05 Page 25 Ashlea Park B52-B02 S34305 Ashlea Park V220755 290605 Stage 4.doc Version 1.30 17. OP22 23(2)(c) 18. OP10, OP26, OP38 OP35 12(4)(a), 13(3), 16(2)(j) 13(6), 20(1)(a and b) 19. 20. OP35 13(6), 20(1)(a and b) 21. OP38 13(4)(c) and 13(5) replacement of the dining chairs that are loose. The registered manager must arrange for the repair or replacement of lounge chairs that have worn covers. The registered manager must arrange for additional clinical waste facilities to be available throughout the home. The registered person must arrange for individual savings accounts to be established for those service users whoes savings are held within the pooled service users savings account. The registered person must equitably allocate to service users (or should they have died their estate) the interest earned on their savings, but not paid out to them. The registered manager must ensure that staff use safe manaual handling techniques. 8/7/05 17/8/05 17/10/05 17/10/05 8/6/05 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 OP12 Good Practice Recommendations The registered person should employ a worker responsible for the co-ordination and implementation of an activities programme, including group and one to one activities for service users. The registered person should actively seek the views of stakeholders about the services provided at the care home and should have an annual development plan. The registered manager should complete and review regularly risk assessments for all service users wishing to self-medicate. The registered manager should develop criteria for the administration of when required and variable dose B52-B02 S34305 Ashlea Park V220755 290605 Stage 4.doc Version 1.30 Page 26 2. 3. 4. OP33 OP9 OP9 Ashlea Park 5. 6. 7. OP9 OP9 OP9 8. 9. OP8, OP38 OP15 medication for all service users prescribed such items. The registered manager should ensure that a second member of staff should witness all hand written annotations on Medication Administration Record charts. The registered manager must ensure that the temperatures of the medication storage areas are recorded on a regular basis (fridge temperatures recorded daily) The registered manager should introduce a formal system for the prompting of medication reviews in line with the recommendations in the National Service Framework for Older People. The registered manager should introduce a falls prevention staregy within the home. The registered person should provide an additional hot lock for the transportation of food within the home. Ashlea Park B52-B02 S34305 Ashlea Park V220755 290605 Stage 4.doc Version 1.30 Page 27 Commission for Social Care Inspection Baltic House Port of Tyne South Shields NE34 9PT 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. 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