Inspection on 16/01/08 for Avon Court

This inspection was carried out on 16th January 2008.

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

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

Other inspections for this house

Avon Court 09/06/09

Avon Court 29/06/06

Avon Court 16/03/06

Avon Court 08/09/05

Avon Court 08/02/05

Avon Court 03/08/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Avon Court All Saints Road Warwick Warwickshire CV34 5NP Lead Inspector Jo Johnson Key Unannounced Inspection 16th January 2008 10:00 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 Avon Court DS0000004490.V339227.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. Avon Court DS0000004490.V339227.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Avon Court Address All Saints Road Warwick Warwickshire CV34 5NP 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) 01926 401324 01926 401324 info@prime-life.co.ukwww.prime-life.co.uk Prime Life Ltd Sylvia May Wright Care Home 34 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (34) of places Avon Court DS0000004490.V339227.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th June 2006 Brief Description of the Service: Avon Court is a care home providing personal care and accommodation for up to 34 service users over the age of 65 years. Accommodation consists of all single bedrooms, over two floors. Two types of service are provided at the home, dementia care and transitional care. There are 5 permanent dementia care places, 5 short stay dementia care places ands 24 transitional care places. Avon Court does not take any privately funded service users. Referrals for the transitional places are through the hospital social work team. Copies of the last inspection report are available at the home. Avon Court DS0000004490.V339227.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people who use the service and their views of the service provided. This process considers the agency’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. The manager supplied the commission with an AQAA (Annual Quality Assurance Assessment). Information from this has been used to make judgements about the service, and have been included in this report. Surveys were sent to ten of the people staying at the home, ten care staff and ten relatives and visitors. Nine people, eight relatives and eight staff returned surveys. All of the surveys show that people and their relatives are satisfied with the service. Information from surveys has been included in the report. The inspection was unannounced, which means that they did not know we were coming and took place on 16th January 2008 at 9.00am until 4.30pm. The inspection involved: • • • Observations of and talking with the people who live at the home and the staff and manager. Observation of working practices and of the interaction between individuals and staff. Three people were identified for close examination by reading their, care plan, risk assessments, daily records and other relevant information. This is part of a process known as ‘case tracking’, where evidence is matched to outcomes for people. A tour of the environment was undertaken, and home records were sampled, including staff training and recruitment, health and safety, and staff rotas. • The inspector would like to thank the people who were staying or living at the home, manager and staff for their hospitality and cooperation during the inspection visit. Avon Court DS0000004490.V339227.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? The statement of purpose has been updated and submitted for the change in registration category. Peoples’ needs are assessed before they are admitted to the home and care plans are developed. Care plans are in enough detail to make sure that staff can meet their needs. Avon Court DS0000004490.V339227.R01.S.doc Version 5.2 Page 7 The food provided to people is hot. A record of complaints and allegations of abuse are now kept at the home. The policy is clear as to what action staff need to take following any allegations of abuse. The kitchen has received a Gold award from Environmental Health. There is a planned programme of maintenance and redecoration. Any areas of the home that need attention have been identified in the plan. 75 of the staff group now have NVQ level 2 or above. The commission has now registered the manager. CRB (Criminal Records Bureau) reference numbers are now kept on staff files. Staff now have regular support meetings with the manager. 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. Avon Court DS0000004490.V339227.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 Avon Court DS0000004490.V339227.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 Quality in this outcome area is good. People’s needs are assessed and they are provided with some information so that they are clear about their rights and entitlements at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection, the home has been registered to care for 10 people with dementia. There are five short stay and five permanent places available. The statement of purpose and service user guide was submitted with the application to vary the registration. The remainder of the places are used as ‘transitional beds’ for people who are discharged from hospital so they can either return home or move into a care home. Avon Court DS0000004490.V339227.R01.S.doc Version 5.2 Page 10 Information about the home is given to people by the hospital social work team or wards when they are referred to the service. Further information is given to people when the manager completes their assessment at the hospital. The manager has identified that the service user guide needs updating particularly in relation to the permanent dementia care service and plans to do this. People spoken with and surveys show that they received enough information about the home before deciding if it was the right place to come. Relatives’ surveys also show that they had enough information to help them make decisions about the service. Since the last inspection, the manager has ensured that contracts are in place between the home and social services. Three people’s care records and assessments were seen. One person lives at the home permanently, another person was placed as an emergency short stay and the other person has been at the home in a transitional place for almost a year. There were health and social care assessment in place completed by professionals. There were comprehensive assessments in place completed by the home. For people who have dementia a ‘getting to know you’ assessment is completed so that staff have a better understanding of the person as an individual and so are better able to meet their needs. The relatives’ surveys show that the care home ‘always’ or ‘usually’ meets their relative or friends needs. The manager closely monitors ‘transitional’ and co-ordinates referrals from the hospital wards and social work team to make sure that they are appropriate and the home is able to meet their needs. The manager spoke of positive working relationships between the home and hospital discharge co-ordinators and the hospital social work team. This was confirmed by a social worker from the hospital team who was visiting the home. Avon Court DS0000004490.V339227.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. There is a clear, consistent care planning system in place that provides staff with the information they need to meet individuals’ needs. Risk management strategies are in place to meet the assessed needs of the people living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three people’s care plans and records were seen. The care plans were of a high quality and were clear and easy for staff to able to meet peoples identified needs. All of the people had tissue viability, nutritional and moving and handling risk assessments and management plans in place. Depending on Avon Court DS0000004490.V339227.R01.S.doc Version 5.2 Page 12 the level of risk the assessments are reviewed either on a weekly or monthly basis. One person, who was admitted as an emergency, had a nutritional risk assessment completed and they were weighed weekly. They subsequently lost weight as anticipated following being prescribed diuretics and antibiotics by the GP for a chest infection. There was good practice in terms of the person being seen by the GP and the subsequent follow up on their health needs. However, the reason for the individual’s weight loss should have been reflected in an updated nutritional risk assessment. There are good systems of staff handovers and a short descriptions of each person’s needs is available to staff. From discussions with staff and the manager, the handover sheets assist staff in keeping up to date with who is staying at the home and what and how they can meet their needs. Peoples’ preference of gender of staff is identified on their assessment and as there is a mixed staff group, they are able to meet people’s preferences. People are registered temporarily with a local GP practice and their medical history is faxed to the temporary GP from their own surgery. A GP visits the home on a daily basis. There is also access to other health professionals such as dentist, optician, chiropodist, speech and language therapists and district nurses as required. People spoken with and surveys show that people receive the medical support that they need. No people currently at the home have any pressure sores. Only senior staff that have been trained administer the medication. The medication systems and administration at the home are well managed. Particularly, as there is a high turnover of people coming in and out the home. The medication administration sheets seen were correct and corresponded the medicines kept in the drug trolley. There are PRN ‘as needed’ protocols in place for each person and medication. Some PRN records had gaps where the medication was not needed and a few had a code written in when it was not given. It is recommended that just one system for the recording of PRN medication is used so it is clear how often people have actually had ‘as needed’ medication. Staff observed and spoken with had a good understanding of person centred care and people’s diverse needs. Avon Court DS0000004490.V339227.R01.S.doc Version 5.2 Page 13 Surveys from people show that staff listen and act on what they say. Interactions between staff and people at the home were relaxed, respectful and dignified. People with dementia freely approached staff and staff gave them reassurance when needed. Avon Court DS0000004490.V339227.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. People living in the home are supported to maintain their independence, contact with important others and lifestyle, which enhances their quality of life. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Due to the unique nature of the service, the manager explained that it is difficult to provide a structured activity programme that suits everybody’s needs, along side supporting people in the community to attend appointments and prepare them for their move home or onto other care homes. It is acknowledged that a majority of people who use the service are only at the home for a short period. From discussions with two people who have been at the home for a number of months, whilst waiting for appropriate care packages or care homes, that there are times when they would like more to do during the day. Avon Court DS0000004490.V339227.R01.S.doc Version 5.2 Page 15 Eight of the nine peoples’ surveys returned show that there are activities that they can take part in. There are three days a month where transport and day trips are provided and fortnightly ‘creative mobility’ sessions. Staff record when they have spent time with people doing specific activities. The records were seen and included one to one activities such as, manicures, going out for lunch and shopping. People spoken with said that their visitors were made to feel welcome whenever they visited. One person said, “My visitors can come whenever they want, they are made to feel welcome and staff always give them cups of tea”. During the inspection there were many visitors to the home and those spoken with confirmed that they are welcomed and that staff are approachable. The inspector joined people for lunch the meal was well presented hot and tasty. People spoken with said they enjoy the meals and stated that they are always offered choices. One person said, “The food is always tasty”. During the inspection the cook was observed to go, to ask each person what they wanted for lunch and again for their supper. This is excellent practice and the cook had a very good understating of each person’s dietary needs. She was able to identify who was on specialist diets including a person who had been admitted that morning. Staff were observed to sit with people and assist them to eat where needed. The support given was relaxed, sensitive and discreet. Staff spoke to people through out the meal about what they were eating and offering choices. All the surveys returned show that they like the meals at the home. The kitchen was well stocked with a variety of fresh and long-life foodstuffs. The kitchen had an Environmental Health inspection in May 2006 and was awarded a ‘Gold’ Award. Fresh fruit and snacks were available throughout communal areas in the home. Avon Court DS0000004490.V339227.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. Complaints procedures make sure that peoples, relatives and representatives concerns and complaints are listened to and acted upon. A staff team who have a good knowledge of how to respond to any suspicion of abuse and to keep people safe from harm support the people living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints policy is displayed in the entrance hall of the home and is in the service users guide. From discussion with the manager and information provided in the AQAA, there has been one complaint that has been investigated and resolved in the last 12 months. There is another complaint that is currently being investigated by Social Services and the Chief Executive of the organisation. The manager went through the background and the information relating to the complaint. One concern was raised with the commission in the last twelve months about the cleanliness of the home, poor provision of food, poor nutritional monitoring Avon Court DS0000004490.V339227.R01.S.doc Version 5.2 Page 17 and lack of activities. All of these areas were looked at during the inspection and the findings are reflected throughout the report. People spoken with and surveys show that people know who they can talk to if they are unhappy and know how to make a complaint. Relatives’ surveys show that they also know how to make a complaint if needed. The manager has reported one allegation of physical abuse to social services, the police and the commission. The manager and staff followed the correct procedures, co-operated with all professionals involved and kept the commission informed. Procedures and systems for the home to respond to potential abuse are robust. All staff have had adult protection refresher training following the allegation of abuse. Staff spoken with had a good understanding of how to recognise and report any allegations of abuse. This means that people are supported and cared for by staff who know how to keep them safe from harm. People spoken with said that the felt safe at the home. People with dementia appeared to be very relaxed with staff and were happy to approach them. This may indicate that they feel safe. Avon Court DS0000004490.V339227.R01.S.doc Version 5.2 Page 18 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, 26 Quality in this outcome area is good. The home is maintained and furnished so that people live or stay in a homely, clean, comfortable environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was clean and free from offensive odours throughout the inspection. The manager went through and provided a copy of the organisation’s recent audit of the home and the redecoration and replacement programme. Avon Court DS0000004490.V339227.R01.S.doc Version 5.2 Page 19 Only two of the rooms have ensuite toilets and some of the bedrooms are small. The building is leased from Warwickshire County Council and the organisation is responsible for all elements of maintenance and redecoration. The organisation has plans to undertake major building works and refurbish the building to meet current standards. However, until a decision about the future plans for the service, is made by the buildings owners this cannot be progressed. Peoples’ families and friends do most of the personal laundry whilst people stay at the home. Bedding and towels are laundered through an external laundry company. All staff are trained in infection control. From discussion with staff and observation good infection control practices are in place. The home is to be commended that they have managed any incidents of hospital acquired infections. Particularly, as commodes are used in a majority of the bedrooms due to the lack of ensuite facilities. Avon Court DS0000004490.V339227.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good The people living in the home are protected by robust recruitment practices and supported by a skilled, competent and well managed staff team. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff rotas were seen, there are a minimum of five care staff on duty during the day and the evening. An extra person works a twilight shift that is determined by the manager dependent on the needs of people at the home and there are two waking night staff. The manager is supernumerary to the rota. People, staff spoken with, and surveys show that there are enough staff to meet people’s needs and that staff are available when people want them. People spoke highly of the staff and said, “they give me good care, they help me with everything I couldn’t manage at home” and “the carers are wonderful. The home has a low turnover of staff with only a few staff leaving since the last inspection. Staff sickness levels are also reasonably low and this means Avon Court DS0000004490.V339227.R01.S.doc Version 5.2 Page 21 that a consistent staff team that people know well supports the people staying at the home. One person spoken with said “get on very well with all the staff, we know them all, we don’t have many new faces all the time”. Three staff files were seen including the most recently recruited staff. The files were well organised. All files included evidence of CRB (Criminal Records Bureau) checks and PoVA (Protection of Vulnerable Adults) checks. One staff file did not include a full a full adult life or working history. This information should be obtained to make sure that staff are suitable and safe to work with vulnerable people. One person resigned following a safeguarding investigation for an allegation of physical abuse. As this person resigned from their post, the organisation did not complete their disciplinary process. It is strongly recommended that when staff resign following an allegation of abuse that the planned disciplinary action and hearing continues. This is so that accurate references can be given in terms of disciplinary history and any referrals to the POVA (Protection of Vulnerable Adults) register can be made. This may prevent staff working with other vulnerable people in the care sector. New staff spoken went through their induction programme. Staff surveys show that their induction covered everything they needed to do the job when they started and that they are given training that is relevant to their role. There is an active NVQ programme and over 75 of staff have achieved level 2 or above. From the AQAA (Annual Quality Assurance Assessment) completed by the manager, the training programme and discussions with staff there is a comprehensive training programme in place that focuses on mandatory training and the specific needs of the people living at the home. Ten staff have completed the certificate in dementia care. The manager is looking at different types of training that suits individual staff’s different ways of learning. This is good practice. Avon Court DS0000004490.V339227.R01.S.doc Version 5.2 Page 22 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 People benefit from staying and living in a well run home. They are able to express their views of the service provision and know that their views will be listened to and acted upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has now been in post for over 18 months and is registered with the commission. She is a Registered General Nurse, an Enrolled Nurse in Avon Court DS0000004490.V339227.R01.S.doc Version 5.2 Page 23 Mental Health, has a City and Guild certificate in teaching, the Registered Managers Award and has been trained in dementia with Stirling University. The requirements made at the last inspection have been met. The manager has focused on improving the home and the management systems in place. This has meant that she has managed all referrals into the service and all assessments. The management structure currently consists of the manager and senior care staff. From discussion with the manager, she proposes that due to the uniqueness of the service, that the management structure includes a deputy manager and senior care staff. This is to ensure that the robust systems she has implemented are continued and the deputy manager can undertake the hospital assessments and she can focus on monitoring and developing the quality of the service. It is recommended that this structure be adopted to make sure that the quality of the service is maintained. During the visit staff appeared confident in their roles, the home was relaxed and people appeared at ease and comfortable. Staff spoken with commented positively about the style of management and leadership from the manager, their job role and the people living at the home. There is a quality assurance system in place from the organisation. The manager also monitors and audits regulation 37 notifications, accidents, falls and activities on a monthly basis. This is good practice as it supplementary to the organisation’s own quality audits. Staff spoken with and records seen show that staff are supervised and have had an annual appraisal. Information provided before the inspection, by the manager in the AQAA (Annual Quality Assurance Assessment) shows that relevant Health and Safety checks and maintenance are being carried out at the home. A number of Health and Safety records were checked, including the fire safety log. These records showed that health and safety matters are well managed. Avon Court DS0000004490.V339227.R01.S.doc Version 5.2 Page 24 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 3 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 3 x 3 Avon Court DS0000004490.V339227.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 OP7 Good Practice Recommendations Nutritional risk assessments should be updated following any weight loss and cross referenced throughout the care plan. This is to show that appropriate action has been taken and documented. It is recommended that just one system for the recording of PRN medication is used so it is clear how often people have actually had ‘as needed’ medication. It is strongly recommended that if staff resign following any allegation of abuse, that the planned disciplinary action and hearing continues. This is so that accurate references can be given in terms of disciplinary history and any referrals to the POVA (Protection of Vulnerable Adults) register can be made. This may prevent staff working with other vulnerable people in the care sector. Staff applications should include a full a full adult life or DS0000004490.V339227.R01.S.doc Version 5.2 Page 26 2 OP9 3 OP29 4 OP29 Avon Court working history. This information should be obtained to make sure that staff are suitable and safe to work with vulnerable people. 5 OP31 It is recommended that the proposed management structure be adopted to make sure that the quality of the service continues to be maintained. Avon Court DS0000004490.V339227.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Avon Court DS0000004490.V339227.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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