Inspection on 10/07/08 for Bank House Residential Home

This inspection was carried out on 10th July 2008.

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

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

Bank House Residential Home 07/01/09

Bank House Residential Home 16/05/07

Bank House Residential Home 16/06/06

Bank House Residential Home 28/02/06

Bank House Residential Home 24/05/05

Similar services:

Hillside

Applegarth

122 Scorer Street

Byars Care Home

St Marys Nursing Home

Jubilee Villa Care Home

Bramble Lodge

Parkmanor Residential Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Bank House Residential Home Bank House Gosberton Bank Gosberton Lincs PE11 4PB Lead Inspector Alison Jessop Unannounced Inspection 10th July 2008 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bank House Residential Home DS0000061113.V368217.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. Bank House Residential Home DS0000061113.V368217.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bank House Residential Home Address Bank House Gosberton Bank Gosberton Lincs PE11 4PB 01775 840297 01775 840297 janemoore1@talk21.com 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) Miss Jane Louise Moore Miss Jane Louise Moore Care Home 30 Category(ies) of Dementia - over 65 years of age (1), Learning registration, with number disability over 65 years of age (3), Old age, not of places falling within any other category (26) Bank House Residential Home DS0000061113.V368217.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Home is registered to provide personal care for service users of both sexes whose primary needs fall within the following categories:Old age, not falling within any other category (OP) 26 Dementia - over 65 years of age (DE(E)) 1 Learning Disability - over 65 years of age (LD(E)) 3 The maximum number of service users to be accommodated is 30. 2. Date of last inspection 16th May 2007 Brief Description of the Service: Bank House is a two-storey, private, family-run care home located in a rural setting approximately a half of a mile from the village of Gosberton and 6 miles from the town of Spalding. The Georgian building has been extended to provide personal care for up to thirty older persons of both sexes, including one older person with dementia and three older persons having a learning disability. Accommodation consists of twenty-two single rooms, none of which is en-suite, and four shared rooms, on the ground and first floors. The first floor is accessible by stairs or a passenger lift. The home overlooks lawns and garden areas and has car parking spaces at the front of the home. The home’s philosophy, which is displayed around the building, is that residents are treated as individuals and that there is an ongoing development of best practice in clinical and social care. The fees for the home range from £348 to £431 with additional charges made for hairdressing, chiropody and newspapers. This and other information, such as the statement of purpose and a copy of the last inspection report is available from the office. Bank House Residential Home DS0000061113.V368217.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 0* star. This means the people who use this service experience poor quality outcomes. One Regulatory Inspector carried out the unannounced inspection over one day. This was an additional key inspection due to the outcome of the Annual Service Review carried out in May 2008. There were several areas of concern identified and therefore an additional key inspection was carried out. The Registered Manager and the deputy Manager were available throughout the day to answer any questions. We spoke to 8 residents, two relatives and three staff working at the home. We looked closely at the care of three residents. This involved talking to them and monitoring their well being, looking at their care plan and any other documentation in relation to their care, we also looked at their medication. This process is called case tracking. We have taken into account any concerns and complaints that have been raised about the service and any other information gained since the last key inspection. What the service does well: Bank House provides a comfortable, homely environment to the people who live there. People said that they are well looked after and were complimentary about the staff. They said ‘I like it here, I’m happy.’ Another resident said ‘I like the care staff.’ A relative said ‘we are happy with the care, the carers are very nice and caring.’ Staff spoken to were positive about their work and about the care people receive. One carer said ‘I am happy doing my job, if I have a problem I can speak to the Manager.’ Another said ‘we care for them well. We like to make their lives a bit better, I’m here to make sure peoples needs are met.’ All of the residents said they are treated in a dignified manner and staff were observed to be kind and caring towards the residents. Many of them said they try to give the best service they can and they all seemed committed to their job. Bank House Residential Home DS0000061113.V368217.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. Bank House Residential Home DS0000061113.V368217.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 Bank House Residential Home DS0000061113.V368217.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): 3, 4 & 6 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Applications for admission to the home are agreed without reference or consideration of the specialist care needs of the person or the conditions of the homes registration category. This may mean that people’s needs cannot be met. EVIDENCE: The Manager carries out an assessment prior to people moving in to the service. This process should ensure that prospective residents needs can be met and that the person’s needs are suitable for the conditions of registration of the home. The home is registered to accommodate one service user who has dementia. During the inspection there were two residents identified who have a dementia diagnosis. There were also a high number of residents who appeared to have dementia care needs. One member of staff spoken to also said ‘there quite a few people here with dementia but we haven’t had any training on this.’ (refer to standard 30 on staff training). Bank House Residential Home DS0000061113.V368217.R01.S.doc Version 5.2 Page 9 This service does not provide intermediate care. Bank House Residential Home DS0000061113.V368217.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 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The health needs of the residents are not responded to in a satisfactory way leading to very serious risks to the resident’s health and safety. EVIDENCE: Each resident has a care plan however these are not person centred. The care plan consists of a basic description of the persons needs and there is little evidence to suggest that these are thoroughly reviewed. There is a dependency profile for each resident. Many of the documents were not dated so it was difficult to establish the current care needs of the person. There were a lot of assessments where a scoring system is in place but where there are low scores there is nothing to explain what care is going to be given to ensure that the person’s needs can be met. Moving and handling risk assessments provide minimal instructions on how to safely move people. A review of a mental health assessment for one resident who has a dementia diagnosis has been carried out. The resident is known to display aggressive behaviour and can become agitated however there was nothing on the care Bank House Residential Home DS0000061113.V368217.R01.S.doc Version 5.2 Page 11 plan or risk assessment to say how to prevent or minimise this or what action to take when this occurs. On looking in two bedrooms, pillows had been put under one side of the mattress to prevent the resident from rolling out of bed. One resident had already fallen out of bed and the pillows had been put there to prevent this from happening again. There was no risk assessment on file to demonstrate how it had been concluded that this is a safe method to prevent falls out of bed, there was also no evidence that specialist equipment has been considered. One resident observed had a very large bruise across her eye and face with a large lump on her forehead. The resident said that she had fallen out of bed and had hit her face on the bedside table. The inspector asked the resident if the doctor had been and she said that he hadn’t. The daily notes confirmed that no medical intervention was sought even though the daily notes state ‘slight headache, forehead is swollen with bruise.’ Then ‘Paracetamol given at breakfast and dinner, gone to bed, looks terrible and feels it!’ And ‘complaining of feeling unwell this morning but seems ok.’ The Manager was asked why the resident received no medical intervention, when there were clearly symptoms for several days following the fall. The Manager stated that on the following day after the fall the optician had visited the home and had looked into the residents eye and said that he could not see any swelling inside the eye. Another resident was found with swollen lips after eating some soap. The GP was contacted and antihistamine medication was prescribed. The family of the resident said ‘we are happy with the care and the carers are very nice. My relative often goes into other people’s bedrooms. We found her one day with swollen lips, she had chewed a Steradent tablet.’ The inspector asked them if any medical intervention or advice was sought? They replied ‘no they just gave her some Piriton and that was ok.’ Its happened about three or four times now, although it hasn’t happened for about four months.’ On inspection of the residents daily notes there were three entries reporting swollen lips as a result of eating soap. On each occasion Piriton had been administered however no other medical intervention was sought. Procedures were also not followed on the Control of Substances Hazardous to Health (COSHH). Several concerns were identified on the inspection of medication administration procedures. One resident has refused her medication four times every day for over a month. Once again no medical intervention was sought to ensure that there would not be any adverse effects. Where a resident’s daily notes stated on two days that Paracetamol had been administered, this was not recorded on the medication administration record. In the medication trolley there were two strips of medication, there was no name on them and no record of whom these belonged to. There was also a medication pump spray and a bottle of Acidex not labelled. Bank House Residential Home DS0000061113.V368217.R01.S.doc Version 5.2 Page 12 Records for the administration of controlled drugs were satisfactorily completed however a box of Temazepam, which should be treated as a controlled drug was being stored in the medication cabinet and not the controlled drugs cabinet. There were supplies of controlled drugs and insulin in the cabinet that are no longer prescribed, these had not been returned to the pharmacy. All of the residents spoken to said that they are treated in a dignified manner. One resident said ‘ the carers are very nice to me.’ Bank House Residential Home DS0000061113.V368217.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 poor. This judgement has been made using available evidence including a visit to this service. Although there is a range of activities for the people who live at the home, there is inadequate social stimulation and comfort for the residents who have dementia. People’s rights to freedom are restricted due to a lack of knowledge on human rights, lack of knowledge on good dementia care practice and a lack of staffing resources. EVIDENCE: The home employed an activity co-ordinator in the home to provide a range of activities. On the day of the inspection there was a religious service being held in the lounge, which the majority of residents attended. Some of the residents said they enjoy the activities. One member of staff said ‘there’s no outings, and there’s not enough time to take people out to the village.’ A resident said ‘I don’t go out, I like the care staff but I want to go home.’ Although there was a variety of social stimulation for the residents, for those that were unable to participate in the planned activities, there was little social stimulation for people who have dementia. Several residents were observed walking around aimlessly and no items of comfort were provided. There is very little stimulation for people who cannot verbally communicate or people who Bank House Residential Home DS0000061113.V368217.R01.S.doc Version 5.2 Page 14 have dementia however there are a high number of people observed who have specialist needs. Care plans did not reflect the residents past history and personal interests. One resident was observed consistently trying to leave the home through the fire door in the lounge area. The door opened onto a well-maintained large lawn and open space. There was an alarm activated each time the door was opened and staff came and took the resident back into the home. One person said ‘she’s always trying to get out of there, last week they closed this lounge off and put chairs across the door so she couldn’t get to the fire door.’ Staff were asked by the inspector why the resident can’t go out into the garden. They said ‘it’s not safe as she can access the road which is a risk.’ When asked if staff ever take her out for a walk they said ‘not really, we don’t have the time.’ There was a keypad on the main door, which led to the entrance of the home, however there was nothing in the care plan to say why restrictions were placed on residents freedom. Residents are offered a choice of meals each day to suit their preferences. Feedback about the food was good. Snacks are also provided in between meals. One resident said ‘I like the food.’ Bank House Residential Home DS0000061113.V368217.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. There is a lack of awareness that poor practice could potentially be viewed as neglect or abuse. Staff are not fully aware of adult protection procedures, which increases the risks to residents as they may not report any concerns. EVIDENCE: The Commission is aware of one complaint that was made to the service in October 2007. The complainant did not receive a response from the Manager of the service. On inspection of the complaints log there were no complaints logged other than a record that the Adult Safeguarding Team are carrying out an investigation of the service. The Adult Safeguarding Team for Lincolnshire County Council are currently investigating allegations about the service. The referral was made to the team following the outcome of this key inspection where it was identified that there is poor practice, which is putting residents at risk. The investigation has not yet been concluded. There has been one other anonymous complaint about the service where it was alleged that physical abuse had taken place by a member of staff. This was investigated by the Safeguarding Adults team the allegation was eventually unsubstantiated. Bank House Residential Home DS0000061113.V368217.R01.S.doc Version 5.2 Page 16 Staff spoken to were not aware of Adult Protection procedures. Two staff spoken to said that they had heard about it but were not entirely sure what to do. Bank House Residential Home DS0000061113.V368217.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 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Vauxhall Court provides a comfortable and homely environment to the residents who live there. EVIDENCE: The home has several lounges where residents can relax. The rooms are decorated in a homely style and each resident’s bedroom has been personalised to individual taste. The home looked clean and tidy throughout, although some unpleasant odours were detected in some of the bedrooms and in the main lounge. The carpet in the main lounge also looked very stained and dirty in areas. Staff were observed practicing good infection control procedures. Bank House Residential Home DS0000061113.V368217.R01.S.doc Version 5.2 Page 18 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. Generally staff are well trained however there is a limited understanding of how to deliver good care to people who have dementia, this is due to a lack of training and therefore peoples needs are not being fully met. EVIDENCE: There are three carers on duty on each shift and a Manager. A lot of comments were received from the residents, staff and relatives about staffing levels. These included ‘the carers are nice and they do a good job most of the time but sometimes I have to wait for over half an hour to go to the toilet as they are too busy.’ A carer said ‘ there’s no time to take people out to the village.’ A relative said ‘there’s not enough staff on, sometimes for example when they have had an outbreak of diarrhoea and vomiting where residents need more care staff are really pushed.’ There was no other evidence to suggest that staffing levels are not sufficient however staffing levels may need to be adjusted according to the residents changing health and social care needs. Following an investigation by the Adult Safeguarding Team, it was discovered that there are people working in the home without satisfactory receipt of a current criminal record disclosure (CRB) and references. During the inspection the Manager was able to confirm that applications for these had been Bank House Residential Home DS0000061113.V368217.R01.S.doc Version 5.2 Page 19 submitted and that she is awaiting receipt. Staff spoken to also confirmed this. This will be followed up at the next inspection. Staff have received mandatory training such as moving and handling, first aid, food hygiene and health and safety. Other than the Manager and the deputy none of the staff have received dementia care training. This is reflected in their practice however the service is not registered to accommodate more than one person with dementia. Bank House Residential Home DS0000061113.V368217.R01.S.doc Version 5.2 Page 20 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, 37 & 38. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. People who use this service are not adequately protected or safe in this home. Incidents are not adequately reported or action taken to ensure this does not happen again. EVIDENCE: The registered provider who is also the registered Manager lives in a separate part of the home but is on site and was willing to stay in the home during the inspection even though she was not on duty. The registered Manager has completed her registered Managers award. A discussion was held about the lack of action taken to get medical intervention when incidents had occurred. She felt that the appropriate action had been taken at the time. There has not been any notifications of deaths, outbreaks of infectious diseases or serious events that may adversely affect the resident’s safety and well being. The Bank House Residential Home DS0000061113.V368217.R01.S.doc Version 5.2 Page 21 Manager stated that she thought that only deaths which were suspicious or unexpected had to be notified. An annual quality audit had been completed in April 2008. Questionnaires had been given out to residents and visitors. One visitor said ‘I have nothing but praise for the management and staff especially during my fathers recent illness, care and concern was outstanding.’ Several compliments had been recorded. Procedures relating to the storage of residents finances were not fully inspected however records were observed on resident’s files, which account for income and expenditure. There have been no previous or current concerns about this and therefore this standard will be fully inspected during the next key inspection. Record keeping generally was not satisfactory. Accident forms are now being completed but provided very brief information, daily notes made by staff were often stating ‘care as planned.’ Activity logs had not been completed for several months. During the inspection there was a bottle of bleach found on a shelf in the sluice room. This had been decanted into a bottle, which did not have a safety lid which may be more difficult to open. Bottles of shampoo, bubble bath and bars of soap were observed in the bathroom, which was accessible to the residents this is of particular concern about one resident in particular who has a history of eating soap and other chemicals. A fire safety inspection was carried out where three requirements were made. The Manager stated that the fire safety risk assessment had been updated and the safety signs had been changed however the smoke seals and intumescent strips on bedroom doors were due to be fitted in the following week. The fire safety inspector has not re-visited the home to check compliance. Regular safety checks are carried out on hot water, fire safety checks and other routine health and safety checks. Bank House Residential Home DS0000061113.V368217.R01.S.doc Version 5.2 Page 22 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 X X 1 1 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 1 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 1 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 3 X 3 X 2 1 Bank House Residential Home DS0000061113.V368217.R01.S.doc Version 5.2 Page 23 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 OP2 & OP4 Regulation 14(1) Requirement Admissions to the home must not be agreed unless a thorough admission assessment has been carried out which ensures that peoples needs and the conditions of the homes registration can be met. Care plans must reflect the resident’s individual needs and how they are going to be met. Individual, comprehensive risk assessments must be carried out with residents, which clearly explain how the risk is to be minimised or eliminated. Proper provision must be made for the care and, where appropriate the treatment of residents at all times. Advice/intervention must also be sought from health services. An immediate requirement was left at the inspection. Medication procedures must be adequately and safely maintained in order to protect the safety of the residents and staff. An immediate requirement was left at the DS0000061113.V368217.R01.S.doc Timescale for action 31/08/08 2. 3. OP7 OP7 15(1) 13(4)(c) 31/08/08 31/08/08 4. OP8 12 (1) (a) & (b) 10/07/08 5. OP9 13(4)(a) & (c) 10/07/08 Bank House Residential Home Version 5.2 Page 24 inspection. 6 OP12 12(1)(b) & 16 (2) (n) Awareness must be made to the specialist needs of people who have dementia. Items of comfort and stimulation must be left around the home and made available for people who are unable to participate in organised activities or for those with limited mobility and verbal communication. Residents must be given the opportunity to leave the home and visit areas of the local community. Residents must be given the opportunity to have safe access to the outdoors. Where restrictions are placed upon them for reasons of safety this must be recorded. All complaints received must be fully investigated and a response must be made within 28 days of receipt. All staff must be made aware of procedures, which will prevent residents from being placed at risk of harm or abuse. Attention must be given to the beige lounge carpet that is dirty. This requirement had a timescale of 10/08/07, which has not been met. Attention must be given to ensuring that the building is free from unpleasant odours. All staff must receive training on how to provide good dementia care. The registered person must notify the commission without delay about any deaths, outbreaks of infectious diseases or any other incident, which adversely affects the wellbeing and safety of service users. DS0000061113.V368217.R01.S.doc 31/08/08 7. OP13 16(2)(n) 31/08/08 8. OP14 13(7)&(8) 31/08/08 9. OP16 22 (3)(4) 31/08/08 10. OP18 13 (6) 30/09/08 11. OP26 232b 30/09/08 12. 13. 14. OP26 OP30 OP31 16(2)(j) 18 (1)(a) & (c) 37 (1) 31/08/08 31/10/08 31/08/08 Bank House Residential Home Version 5.2 Page 25 15. 16. OP37 OP38 17 (3)(a) 13 (3) & (4)(a) & (c) Comprehensive recording 31/08/08 systems must be put in place. Safe procedures must be 10/07/08 followed for the Control of Hazardous Substances. You must seek advice in accordance with health and safety legislation (Control of Hazardous Substances to health). An immediate requirement was left at the inspection. 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 OP27 Good Practice Recommendations It is recommended that staffing levels are reviewed in accordance with the residents changing health and social care needs. Bank House Residential Home DS0000061113.V368217.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Bank House Residential Home DS0000061113.V368217.R01.S.doc Version 5.2 Page 27 - 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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