Inspection on 28/08/07 for Ashmead Care Centre

This inspection was carried out on 28th August 2007.

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

Ashmead Care Centre 15/02/07

Ashmead Care Centre 09/10/06

Ashmead Care Centre 31/05/06

Ashmead Care Centre 07/03/06

Ashmead Care Centre 02/06/05

Ashmead Care Centre 13/12/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Ashmead Care Centre 201 Cortis Road Putney London SW15 3AX Lead Inspector Davina McLaverty & Sharon Newman Unannounced Inspection 28th August 2007 08:30 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 Ashmead Care Centre DS0000060799.V348470.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. Ashmead Care Centre DS0000060799.V348470.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashmead Care Centre Address 201 Cortis Road Putney London SW15 3AX 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) 020 8246 6430 020 8445 3624 ManagerAshmead@lifestylecare.co.uk www.schaelthcare.co.uk Southern Cross (LSC) Ltd Vacant Care Home 110 Category(ies) of Dementia (60), Old age, not falling within any registration, with number other category (50) of places Ashmead Care Centre DS0000060799.V348470.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Nursing Unit Ground Floor - Staffing A minimum of two qualified 1st level nurses and six carers must be available on the ground floor nursing unit on each of the morning and afternoon at all times. A minimum of one qualified 1st level nurse and three carers must be available at all times during the night shift. Nursing Unit First Floor - Staffing A minimum of two qualified 1st level nurses and six carers must be available on the first floor nursing unit on each of the morning and afternoon at all times. A minimum of one qualified 1st level nurse and three carers must be available at all times during the night shift. Nursing Unit Second Floor - Staffing A minimum of two qualified 1st level nurses and four carers must be available on the second floor nursing unit on each of the morning and afternoon at all times. A minimum of one qualified 1st level nurse and two carers must be available at all times during the night shift. Each unit of the home must be co-ordinated as a separate unit and staffing levels must not fall below those stated above for each unit at any time. The qualified nurses must not have any management responsibilities for the home other than within the unit in which they are working. 15th February 2007 2. 3. 4. Date of last inspection Brief Description of the Service: Ashmead Care Centre is a purpose built care home with nursing that provides care for persons who may have dementia. The home is able to accommodate up to one hundred and ten residents. The home is organised into six units, each containing communal areas, comprising of a lounge and dining room. Residents have single room with ensuite toilet and washbasin facilities. Bathroom, shower and other toilet facilities are situated at intervals in the units. In addition to communal lounges the home has quiet lounges. The accommodation is situated on the ground, first floor and second floor, with the kitchen, staff rooms and some offices on the second floor. Ashmead Care Centre is situated in Putney, close to the main A3 road and has access to local bus routes within walking distance. There is provision for car parking on site. The weekly fee range from £550 - £1100 per week. Ashmead Care Centre DS0000060799.V348470.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of this service included an unannounced visit to the home on 28th August 2007 by two regulation inspectors. A CSCI pharmacy inspector visited the home unannounced on the 25th September 07 and assessed the management of medication in the home. The manager was present and was available throughout the day for discussions about the service. Two relatives and a number of residents were also spoken to. Documentation looked at included medication records, staff recruitment information, residents care plans and health and safety documentation. A tour was also taken of the premises. The manager has also completed and returned an Annual Quality Assurance Assessment (AQAA), which is a self-assessment survey of the home. This survey has been used to support some of the judgements made concerning the service. Surveys were sent out to residents, staff, relatives and health professionals to complete. Returned surveys were very poor at the time of writing this report. From 15 health professional’s- five surveys were received back. None were returned from residents and 20 surveys were sent to relatives/carers and advocates of which 5 were returned. Twenty staff was sent questionnaires of which none were returned. Comments received were varied but due to the small percentage returned it is difficult to draw conclusions. However, some of the comments received have been stated in this report. What the service does well: The home is clean, well decorated and has a homely atmosphere. Some staff were observed to have a good rapport with residents and to treat them with respect. The feedback from relatives spoken to during the visit was good. Relatives and friends are welcome at the home. Residents spoken to were complimentary about the home and staff and reported that they enjoyed living here. Comments in questionnaires included “communication is very good”, “my patient recognises different members of staff as being helpful” “ they generally follow –up any recommendations that we make” and “ it is a clean, safe and well run home. Ashmead Care Centre DS0000060799.V348470.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Ashmead Care Centre DS0000060799.V348470.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Ashmead Care Centre DS0000060799.V348470.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The needs of residents are assessed prior to admission to make sure that the home can meet these. The written guide for residents needs updating to provide good information to residents. EVIDENCE: A Statement of Purpose and Service User Guide is in place, however it was discussed with the manager that both of these need to be updated as they still make reference to the previous manager and Provider. The manager acknowledged this and stated that this would be addressed. Many individuals are assessed by a social services representative prior to admission and these assessments were seen in some of the resident’s files. Ashmead Care Centre DS0000060799.V348470.R01.S.doc Version 5.2 Page 9 The manager reported that he also completes a pre-admission assessment to help ensure that the home can meet their needs. The resident’s needs are then fully assessed again when they are admitted to the home. Assessments of need were seen in the documentation looked at. However some parts such as the life history and social sections within this documentation was not always seen to be fully completed. Residents spoken to at the time of inspection reported that they were happy living at the home. Ashmead Care Centre DS0000060799.V348470.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Care plans are in place but must be fully completed in order to ensure that residents needs can be fully met. There is evidence of multi disciplinary working with health care professionals. Appropriate systems are in place for the administration of medication. EVIDENCE: The care plans looked at were varied in content. As found at the previous inspection there were some examples of good recording, but this was not consistent across the home. One of them contained an assessment that highlighted needs relating to continence, communication, personal hygiene and the risk of skin problems developing. However, no care plans had been drawn Ashmead Care Centre DS0000060799.V348470.R01.S.doc Version 5.2 Page 11 up for these issues so it was difficult to see how these needs could be addressed by the staff caring for this resident. In some cases care plans did not follow on from the risk assessments. For example in one care plan risks were highlighted in the areas of nutrition and risk of falling however there were no care plans in place for these issues. One continence risk assessment was not signed or dated and it was not fully completed. The staff member completing the risk assessment had indicated that a residents skin was affected by their continence but had not specified how, where or what treatment was being administered. Also a nutritional risk assessment indicated a high risk and the need for dietetic advice however this was not documented to demonstrate that this advice had been sought. Although life history information had been completed in the resident’s files, those seen did not have sufficient information to help to meet the social needs of the residents. Also, in some instances where interests were recorded in the life history sections there was no evidence in the care plans or daily recording logs of how these interests were being followed up. Risk assessments for bed rails were seen to be in place in the residents files looked at. Also evidence was available to show that relatives were involved in this decision. Although some information was available about individuals wishes regarding death and dying this information had not been completed in all the care plans looked at. Staff need to find ways of tactfully approaching this subject so that residents wishes in this important area are clearly documented. Medication Administration Record charts inspected for the current month and the previous month were completed accurately, there were no missing signatures, or prescribed items out of stock. The use of all prescribed medication is recorded, including food supplements and external products. Allergy information is recorded and photographs of residents are available in the MAR chart folder to enable residents to be identified before medicines are administered. Records of receipts and returns are kept and are accurate, daily stock balances are recorded and this ensures a good audit trail for all medication. Records and stocks of controlled drugs were checked and were accurate. Medication storage areas are secure, clean and in good order. A number of Homely Remedies (over the counter non-prescribed items for minor ailments) are kept and used at the home; stock records are kept and are accurate. Only trained nurses administer medication and there is an up to date list of these staff. Care staff are also going to received medication training. The supplying Pharmacy conducted an audit of medication in May and made a number of recommendations, which have all been met except for a training Ashmead Care Centre DS0000060799.V348470.R01.S.doc Version 5.2 Page 12 recommendation, which is in progress. Monthly audits of medication are carried out by the home staff, and evidence from these shows that the home is taking action to address any issues picked up. Very few residents are able to self-administer their medication. The home should continue to assess each resident on admission to ensure that those who wish to manage their own medicines are supported to do so. A small number of issues were noted which need to be addressed however requirements have not been made as the incidence was small and the risk to residents low. These are: -Two items received mid month did not have the quantity received recorded on the MAR chart. -Staff have added some instructions by hand to the MAR chart to make it clear when and where to apply creams. All amendments/additions/corrections to MAR charts must be signed and dated by staff. -One prescribed item was labelled as dispersible, however the pharmacy had supplied non-dispersible. Staff must check with the Pharmacy and Prescriber if there are any discrepancies with prescribed medication. Ashmead Care Centre DS0000060799.V348470.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Activity provision is limited and only some activities meet the needs of the people who live here. Residents are able to maintain contact with family and friends. EVIDENCE: No arranged activities were seen to take place during the visit. Many residents were seen to be sleeping in their chairs whilst either the television was on or music was playing. On one unit residents were not given a choice of what television programme to watch and no resident were seen to be watching it although it remained switched on for most of the morning. At one point a staff member switched the television off and put a music CD on but did not consult the residents. After a short while this CD was then switched off again there was no consultation with the residents. Little positive interaction was seen between staff and residents. On one unit a staff member sat in the lounge area and said very little to the residents unless they asked for attention. Ashmead Care Centre DS0000060799.V348470.R01.S.doc Version 5.2 Page 14 On another unit staff were celebrating a residents birthday and were playing a selection of music. Interaction in this unit appeared a little better. Residents on one unit were not given a choice about where they would like to eat their lunch. Two residents were woken up to be told that they were being taken to the dining room. Once there they then had to wait approximately twenty minutes before being given any lunch. As stated in the previous inspection report residents are able to take meals in pleasant surroundings. Tables are attractively laid and cloth napkins available for residents to use. Residents were offered a choice of meal - staff plated up the two main course options and showed them to residents so they could choose which they preferred. Residents commented favourably on the food and said that the food was good. Staff were observed to sit down to support residents to eat their lunch. Residents were observed to be appropriately dressed and groomed. Residents appeared content. Several when spoken to, said that they liked the home, the food was good and that the staff were kind. One new resident on the ground floor had nothing but praise for the staff and support given to him. A visiting relative and a resident’s friend were also positive about the home. Both said that they were always made to feel welcomed and could visit more or less when they wanted. One reported that they liked the friendliness of the staff. One was aware of the relative group stating that they not always able to make the day but thought it was a very good idea getting relatives together. Ashmead Care Centre DS0000060799.V348470.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Not all staff are up-to-date with the new Wandsworth Safeguarding Adults Procedures and this may present a risk to residents. Not all staff are aware of correct moving and handling procedures and this may place residents at risk. EVIDENCE: The home follows the London Borough of Wandsworths’ Adult Protection Procedures (SOVA) and a copy of these procedures is available at the home. A recent SOVA allegation was observed to be referred to the London Borough of Wandsworth. However an entry in one residents care plan was not seen to have been referred appropriately and this was discussed with the manager who reported that he was unaware of this issue and would ensure that this was investigated. There was insufficient evidence to show that all staff have attended up-to-date training in abuse awareness. All staff must attend to ensure that residents are not placed at risk and staff are aware of the correct procedures to follow. The manager stated that a complaints log is kept at the home to monitor any issues raised and the action taken and outcome. Ashmead Care Centre DS0000060799.V348470.R01.S.doc Version 5.2 Page 16 Poor moving and handling practice was observed at the home and this was discussed with the manager at the time of inspection. Ashmead Care Centre DS0000060799.V348470.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,23,24 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment at the home is attractive and homely. It is well decorated and presents as a pleasant place for people to live. Residents can personalise their bedrooms to their own taste. The home is clean and hygienic. There is an effective maintenance and decorating programme. EVIDENCE: The home is well furnished throughout with attractive sturdy furniture and the pictures, photographs and paintings add to the homely feel. Doorways to specific places, such as bathrooms and toilets have yellow frames, to aid identification. Ashmead Care Centre DS0000060799.V348470.R01.S.doc Version 5.2 Page 18 All bedrooms are ensuite and those seen were observed to be well personalised to individual taste with photographs, personal belongings, pictures and ornaments. There is a small and well-maintained garden area and one resident said that they liked to sit out there in good weather. Adapted bath and shower rooms were seen throughout the home and there are many storage areas for equipment to help ensure that the environment remains clutter-free. The home was clean and free from any offensive odours on the day of the inspection. Ashmead Care Centre DS0000060799.V348470.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff training needs to improve to ensure that staff are up-to-date in mandatory areas such as moving and handling, first aid, protection of Vulnerable adults and also in dementia care. EVIDENCE: Feedback from residents spoken to was positive. One said ‘the staff are very good – they help me as much as they can.’ Another said ‘I like it here and the staff are nice.’ Although it is acknowledged that there is a training programme in place there was little evidence to demonstrate that sufficient care staff have attended training in dementia care. Staff must attend training in this area to ensure that they can meet the needs of the residents. Inspectors also saw poor moving and handling of two residents. The manager reported that adequate staff are employed in the home and that staffing levels are kept under review depending on the needs of the residents. The organisation employs bank staff to aid consistency to residents. Ashmead Care Centre DS0000060799.V348470.R01.S.doc Version 5.2 Page 20 In the AQAA the manager states that the organisation intends to increase the number of care staff who have or are completing NVQ 2 and 3 in care. The home has its own trainer who appropriately trained to deliver training to staff; this will include dementia, promotion of continence, tissue viability and psychological welfare. A system is in place for inducting new staff. Staff recruitment information was looked at for six staff, which included three new staff members. These contained evidence of all required recruitment checks including Criminal Record Bureau checks and two references. This helps to ensure that residents are not placed at risk. Ashmead Care Centre DS0000060799.V348470.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has the experience to run the home. The quality assurance system must include the views of stakeholders and other involved health care professionals. Health and safety systems are in place to ensure the safety of residents and staff. EVIDENCE: The manager is suitably experienced to manage the home. He has a good understanding of the key principles and focus of the service and feels supported by the management structure within the home as well as by the Ashmead Care Centre DS0000060799.V348470.R01.S.doc Version 5.2 Page 22 staff team. An application for registration as the homes manager must be made to the Commission for Social Care. Regular residents and relatives meetings are taking place to try to ensure that residents and relatives views are heard and responded to. Since the previous inspection there has been no changes to the management of residents finances. Monthly audits are carried out which ultimately feed into the organisational quality assurance system. The home must ensure that as part of their Quality assurance system that they consult with other stakeholders such as care managers and health professionals as to the operation of the home. Copies of Regulation 26 visit reports must be forwarded to the Commission for Social Care and a copy of the report following a visit must also be available in the home. No issues relating to health and safety were identified during the site visits. The hoists were being serviced on the day of the inspection. Ashmead Care Centre DS0000060799.V348470.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 X 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X 3 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Ashmead Care Centre DS0000060799.V348470.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 OP1 Regulation 5 (1) Timescale for action The information in the Statement 12/11/07 of Purpose and the Residents Guide must be accurate and up to date. This is to ensure that residents have an informed choice when they are deciding whether to come to this home Resident assessments must be 12/11/07 completed fully and include details of life history, interests and significant events. Previous timescale of 30/07/07 not met. Care plans must lead from the 12/11/07 assessments of residents and specific details of care given must be included in the daily records. Previous timescale of 30/07/07 not met. Instructions on how to meet 12/11/07 needs must be detailed in care plans. Previous timescale of 30/07/07 not met. Special food and fluid 12/11/07 requirements must be detailed in care plans and this is evidence as being given. DS0000060799.V348470.R01.S.doc Version 5.2 Page 25 Requirement 2 OP3 14 3 OP7 15 4 OP7 12 (1) 5 OP7 17 (1) (a) & Sch 3 (m) Ashmead Care Centre 6 OP10 18 (1)(c) 7 OP11 12 (3) 8 OP12 16 (2) (m) & (n) 9 OP12 16 (2) (m) & (n) 10 OP14 12 (4) (b) 11 OP15 12 (5) (b) 12 13 OP18 OP18 13 (6) 18 (1) 14 OP30 18 (1) (c) Previous timescale of 30/07/07 not met. Staff must be competent in dealing with challenging behaviour and have a good understanding of specific needs of persons with dementia. Previous timescale of 30/07/07 not met. Residents’ wishes on death and dying must be recorded sensitively. Previous timescale of 30/07/07 not met. Activities must be developed to ensure that all residents benefit and have individual time. Previous timescale of 30/07/07 not met. Residents who tend to stay in their rooms must be provided with choices about how to spend their day and be supported in this. Previous timescale of 30/07/07 not met. Staff must be supported to discuss intimate issues with residents, such as death and dying and sexuality, in order that residents retain autonomy. These wishes must be acted upon where necessary. Previous timescale of 30/07/07 not met. All staff must interact positively with residents. Previous timescale of 30/07/07 not met. All staff must attend up-to-date training in the safeguarding of vulnerable adults (SOVA). Staff must ensure that they put into practice training they have received in moving and handling. All staff must attend up-to-date training gin this area. All staff must receive training on DS0000060799.V348470.R01.S.doc 12/11/07 12/11/07 12/11/07 12/11/07 12/11/07 12/11/07 12/11/07 12/11/07 12/11/07 Page 26 Ashmead Care Centre Version 5.2 15 OP30 18 (1) (c) fire awareness at least twice a year. Previous timescale of 30/07/07 not met. Training in dementia care must be given to staff and put into practice. Previous timescale of 30/07/07 not met. The manager must submit an application to the Commission to be registered as the service manager. The quality assurance system must include the views of stakeholders. A copy of the report written following the monthly Regulation 26 visit must be sent to the Commission as well as being available in the home. 12/11/07 16 OP31 The Care standards Act & 24(3) 26 12/11/07 17 18 OP33 OP33 01/09/08 01/11/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ashmead Care Centre DS0000060799.V348470.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ashmead Care Centre DS0000060799.V348470.R01.S.doc Version 5.2 Page 28 - 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. 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