CARE HOMES FOR OLDER PEOPLE
Belgarth Nursing Home Wheatley Lane Road Barrowford Nelson Lancashire BB9 6QP Lead Inspector
Mrs Marie Matthews Key Unannounced Inspection 26th June 2007 09:30 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 Belgarth Nursing Home DS0000022470.V333262.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. Belgarth Nursing Home DS0000022470.V333262.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Belgarth Nursing Home Address Wheatley Lane Road Barrowford Nelson Lancashire BB9 6QP 01282 699077 01282 619030 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) Belgarth Care Home Limited Mrs Lynne Margaret Markham Care Home 47 Category(ies) of Dementia (25), Mental disorder, excluding registration, with number learning disability or dementia (24), Old age, of places not falling within any other category (47) Belgarth Nursing Home DS0000022470.V333262.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The registered person may provide the following categories of service only. Care home with nursing – code PC, to people of the following gender:- either. Whose primary care needs on admission to the home are within the following categories:-Old age not falling within any other category – code OP, (maximum number of places: 47). Dementia – code DE (maximum number of places: 25). Mental disorder, excluding learning disability or dementia – code MD (maximum number of places: 24). The maximum number of people who can be accommodated is: 47. 15th May 2006 Date of last inspection Brief Description of the Service: Belgarth is a detached older building situated on the outskirts of Barrowford, near Nelson. The building has been extended over the years and is registered to provide both nursing care and personal care for older people. There are separate units for people who are elderly and have dementia or a mental disorder. There is a passenger lift to access the first floor. The home has garden and patio areas for service users to sit out in and provides a parking area for visitors and staff Information about the services offered by the home is provided in the form of a service user guide and is available, with a summary of the most recent inspection report, to existing and prospective residents and their relatives. On the day of the inspection the weekly fees ranged from £342.50 to £511.00. Items not included in the fee include newspapers, hairdressing, chiropody and escorted hospital visits. Belgarth Nursing Home DS0000022470.V333262.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The key unannounced inspection, including a visit to the home, took place on 26th June 2007. The inspection process included looking at records, a tour of the home, discussions with three staff, two visitors and four residents who lived in the home. Information was also included from survey forms filled in by ten visitors and one resident. The inspection also looked at things that should have been done since the last visit and a number of areas that affect people’s lives. There were forty-four residents living in the home on the day of the inspection. The registered manager was on leave at the time of this visit. What the service does well:
Information about the home was clear and detailed the services that were being offered. This was given to residents and their families to help them to make a decision about whether staff at Belgarth would be able to meet their needs. Residents were admitted only when detailed assessments had been completed and when staff were clear the person could be looked after. Care plans were developed from the assessments and contained information about how staff would meet resident’s needs. Residents and their relatives had been involved in decisions about changes to care and were kept up to date. Care plans had been reviewed and updated to reflect resident’s current needs. The medication policies and procedures had been reviewed and gave clear guidance for staff to ensure the safety of residents. Records were accurate and showed that resident’s medicines were managed safely. Records showed that a varied and nutritious diet was provided and that alternatives to the original menu were available. Comments about the meals were varied and included positive comments such as ‘I always like the meals’ ‘sometimes I like the meals’ and ‘we always have a choice of food and its always very nice’. Belgarth Nursing Home DS0000022470.V333262.R01.S.doc Version 5.2 Page 6 Staff were provided with appropriate training had a range of skills and qualifications to help them to meet the resident’s needs. Training in relation to privacy and dignity had been provided and staff were seen responding to residents and visitors in a friendly but respectful manner. Residents and their relatives were confident that if they raised a concern or made a complaint they would be listened to and action taken to resolve the problem. One resident said ‘they would sort out any problems for me’. The adult protection procedures were clear and provided safe guidance for staff to ensure they were able to protect residents from abuse. Staff records showed they had received regular training in this area to ensure their skills and knowledge were up to date and that they would be able to respond appropriately. Residents were provided with a safe, homely and comfortable place to live. The patio and garden areas provided a safe, attractive and accessible area for residents to sit out in the warmer weather. Bedrooms were clean and bright; residents were happy with their rooms and in many cases had brought in treasured possessions to enhance the homely feel. There was a programme of planned maintenance and renewal to support future improvements that needed to be made to improve the home. The way the home recruited new staff made sure that new staff were suitable to work in the home and that residents were looked after properly. The home continued to seek the views of people who used the service to determine whether the home was meeting people’s needs. One resident said ‘the staff are very helpful’ another said ‘staff very good and look after me’. One visitor said staff are very friendly and ‘take good care of my mother’. Comment card information from relatives indicated that they were satisfied with the care provided. Systems were in place to make sure that people who visited or lived in the home were safe and protected. What has improved since the last inspection? What they could do better:
Belgarth Nursing Home DS0000022470.V333262.R01.S.doc Version 5.2 Page 7 A number of residents were observed receiving foot care treatment in the main lounge area of the home and this had compromised their privacy and dignity. Records did not support that a range of activities had been provided to meet people’s diverse social needs. One visitor said there were ‘never appropriate activities’, another said fortnightly musical sessions were organised. One resident said she preferred to stay in her room and watch her TV and this was respected; another said ‘there is very little going on so I just stay in my room’. The menus were not up to date although the records of food served generally supported that a varied and nutritious diet was provided and that alternatives to the original menu were available. Comments about the meals were varied and included some negative comments such as ‘the meals are unsuitable’ and ‘there isn’t enough seasoning and there is often only one salt and pepper pot for all the tables’. The provision of furniture varied from room to room and number of rooms did not have lockable storage keys or keys to rooms which impacted on the privacy of residents; the reasons for this had not been included in their care plan. Nine out of ten visitors said there was ‘not always sufficient staff’ on duty particularly at the weekend. One visitor said ‘staff appear stretched sometimes but they are always very caring’ and another said ‘there are usually sufficient staff but sometimes an imbalance with the skills and ages of staff’. Management was asked to keep this under review to ensure there was sufficient staff available at all times. In light of recent discrepancies with financial records the registered provider needs to develop a procedure to support staff with management of finances to ensure all parties are protected. 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. Belgarth Nursing Home DS0000022470.V333262.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 Belgarth Nursing Home DS0000022470.V333262.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 and 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents and their representatives were provided with information that helped them to make an informed choice about admission to the home. Resident’s needs had been assessed and staff had the skills and experience to meet their needs. EVIDENCE: People were given clear information about services offered by the home to be able to decide whether the home was suitable for them and whether their needs would be met. Detailed information was collected about residents before they were admitted to the home to determine they could be looked after properly. Belgarth Nursing Home DS0000022470.V333262.R01.S.doc Version 5.2 Page 10 Records showed that staff had a range of skills and experience and had received appropriate training to help them to meet the needs of individual residents. Belgarth Nursing Home DS0000022470.V333262.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 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Care plans included details about how residents’ health and personal care needs would be met; records showed that residents and their relatives had been involved in decisions about care. Some care practices did not always support that resident’s privacy and dignity were respected. EVIDENCE: Three care plans were looked at in detail. The care plans had been improved following concerns raised at previous inspection visits and receipt of a recent complaint regarding lack of detail. The care plans were clearer, developed from information obtained prior to admission and included details about action to be taken by staff to meet residents’ health and personal care needs. Records showed that residents and their relatives had been involved in decisions about their care. Relatives said they were kept up to date and consulted about changes to care although one relative said they were ‘usually’ kept informed and were not always informed when a GP had been booked to visit. Residents said they received the care and support they needed and
Belgarth Nursing Home DS0000022470.V333262.R01.S.doc Version 5.2 Page 12 were provided with a range of specialised aids and equipment to maintain their comfort and safety and to help them to maintain their independence wherever possible. Residents had access to a key worker who would work with them on a one-to-one basis. The medication policies and procedures had been reviewed and gave clear guidance for staff to ensure the safety of residents. However the policies and procedures still needed minor additions to reflect that prescriptions needed to be seen by staff prior to dispensing and this practice needed to be followed to ensure residents were prescribed the correct medication. A procedure and protocols should be developed for ‘PRN’ or ‘as needed’ medicines to ensure staff were supported with administration of these medicines. Records were generally clear and accurate and showed that medicines were managed safely. Handwritten directions had been witnessed by a second person to ensure the information was correct. Medicines were stored securely and storage areas had been monitored to ensure medicines were stored at recommended temperatures. Oxygen signage was in place although the cylinders were free standing and could present a risk to staff. Staff had received training to help them to maintain residents’ privacy and dignity and were seen to respond to residents and visitors in a positive and friendly way. Care plans referred to methods of maintaining resident’s privacy and dignity. One resident said he was always visited by his GP in the privacy of his room although a number of residents were observed receiving foot care treatment in the main lounge area of the home and this had compromised their privacy and dignity. Belgarth Nursing Home DS0000022470.V333262.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 and 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Social activities did not meet resident’s diverse needs and expectations. Residents generally received a healthy, varied diet that was suited to their individual preferences and requirements. EVIDENCE: Residents said they were given choices in a number of aspects such as diet, times of rising and retiring, where to sit and who to talk to. Records did not support that a range of activities had been provided to meet people’s diverse social needs. Care plans contained information about likes and dislikes but not enough detail regarding social preferences and past history; it was again recommended that staff should involve residents and relatives in providing ‘life history’ information to assist with the planning of appropriate and suitable activities. One visitor said there were ‘never appropriate activities’, another said fortnightly musical sessions were organised. One resident said she preferred to stay in her room and watch her TV and this was respected; another said ‘there is very little going on so I just stay in my room’.
Belgarth Nursing Home DS0000022470.V333262.R01.S.doc Version 5.2 Page 14 Nine visitors said they were welcomed into the home and four residents confirmed they were able to maintain contact with their families and friends. The home had open visiting arrangements and residents could entertain their visitors in their own room or in the communal areas. Residents were able to access their records if they wished and could bring personal possessions with them to help them to feel more settled and at home. The menus were not up to date although the records of food served generally supported that a varied and nutritious diet was provided and that alternatives to the original menu were available. Residents confirmed that drinks and snacks were available throughout the day although one visitor said ‘standards have slipped as afternoon tea was served in nice cups and biscuits on a plate, now it’s a mug and biscuits out of a packet’. Comments about the meals were varied and included ‘I always like the meals’, ‘ the meals are unsuitable’, ‘there isn’t enough seasoning and there is often only one salt and pepper pot for all the tables’, ‘sometimes I like the meals’ and ‘we always have a choice of food and its always very nice’. One resident was on a special diet and although there had been initial difficulties her relatives were having discussions with the cook to plan a suitable and nutritious menu. It was noted that although pureed meals were initially served in separate portions they were presented to residents all mixed together and were not appealing in texture, flavour or appearance. The dining areas were clean and tidy although most tables were not provided with condiments and some tables were covered with paper tablecloths from the previous sitting, which impacted on the dining experience. Staff were seen giving support to residents who required assistance. One visitor was unhappy with the standards of hygiene in the kitchen although at the time of the visit the kitchen was clean and a cleaning schedule was being followed. The waste disposal machine had been removed and other methods of removing food waste were being used; it was recommended that repair or replacement of the food waste disposal equipment should be considered. Belgarth Nursing Home DS0000022470.V333262.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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. People had access to a clear and effective complaints procedure and were protected from abuse by staff awareness and policies and procedures. EVIDENCE: There was a clear record maintained of complaints or concerns that had been raised. Two relatives spoken to were aware of the procedure. Survey information indicated that nine visitors knew how to complain and one was unaware of the procedure. Three residents said they would speak to the person in charge and one said ‘they would sort out any problems for me’. The adult protection procedures were clear and provided safe guidance for staff to ensure the protection of residents from abuse. Staff records showed they had received regular training in this area to ensure their skills and knowledge were up to date and that they would be able to respond appropriately. There were procedures to support staff with dealing with aggression and verbal abuse but none to support staff with dealing with resident’s finances (see standard 35). Belgarth Nursing Home DS0000022470.V333262.R01.S.doc Version 5.2 Page 16 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, 22, 24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home was safe, clean, comfortable and well maintained with evidence to support that further improvements were planned to develop the home and provide a pleasant place for residents to live. EVIDENCE: During a tour of the home it was clear that the home was well maintained, safe, accessible and comfortable and was equipped with specialist equipment and adaptations to meet resident’s individual needs and maintain their comfort. Bedrooms were clean and bright; the provision of furnishings varied from room to room although residents were happy with their rooms and in many cases had brought in treasured possessions to enhance the homely feel. All rooms had accessible call facilities to enable residents to summon assistance from staff. Lockable storage keys and keys to rooms were not provided for all residents which impacted on the privacy of residents; the reasons for this had not been included in their care plan.
Belgarth Nursing Home DS0000022470.V333262.R01.S.doc Version 5.2 Page 17 A development plan to support ongoing and future improvements to the home was available and had been discussed with staff. The garden and patio areas were safe and accessible to residents and their visitors. Residents and relatives said the home was always clean, bright and odour free. Belgarth Nursing Home DS0000022470.V333262.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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Staff were provided in sufficient numbers and were competent and skilled to meet the diverse needs of residents in their care. The home had followed safe recruitment procedures to protect residents from being cared for by unsuitable people. EVIDENCE: Staffing rotas were clear and showed that the home was well staffed to meet the needs of the residents. One resident said ‘there are enough staff around I only have to ring the buzzer for some help’; another said ‘there are enough staff and the staff are very helpful’. However nine out of ten visitors said there was ‘not always sufficient staff’ on duty particularly at the weekend. One visitor said ‘staff appear stretched sometimes but they are always very caring’ and another said ‘there are usually sufficient staff but sometimes an imbalance with the skills and ages of staff’. Staff records showed this situation had been recognised and appropriate action had been taken to ensure levels were sufficient at all times. It was recommended that the situation continued to be monitored to ensure there were adequate staff at all times to meet residents needs. Records showed that staff had received appropriate training to help them to understand the needs of residents in their care. One member of staff said ‘everyone gets on well, we have a good team’.
Belgarth Nursing Home DS0000022470.V333262.R01.S.doc Version 5.2 Page 19 The recruitment procedure was clear and had been followed to ensure that residents were protected from harm. One resident said ‘the staff are very helpful’ another said ‘staff very good and look after me’. One visitor said staff are very friendly and ‘take good care of my mother’. Comment card information from relatives indicated that they were satisfied with the care provided. Belgarth Nursing Home DS0000022470.V333262.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 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home was safe and well managed by a qualified and competent manager and there were systems that monitored whether the home was meeting people’s needs and expectations. Systems to safeguard residents’ finances were being improved. EVIDENCE: Mrs Lynne Markham is the registered manager of Belgarth. She is a registered nurse with many years experience in care and management and has completed the registered managers award. Mrs Markham is also the NVQ assessor, moving and handling trainer, fire marshal and person with responsibilities for health and safety. Belgarth Nursing Home DS0000022470.V333262.R01.S.doc Version 5.2 Page 21 Residents and their relatives had taken part in an annual survey to determine whether their needs and expectations had been met although there were no records to support that meetings had been held to allow residents and their relatives to regularly air their views. Staff said regular staff meetings, for staff to air their views, had taken place. Memos were also used to keep staff informed of any changes prior to meetings taking place. The home had achieved Investors In People award; this is a quality assurance award accredited by an outside body and demonstrates a commitment to staff training and development. Records of financial transactions and resident’s accounts were clear and could be tracked to show that resident’s finances were safeguarded. In light of recent discrepancies with financial records the registered provider needs to develop a procedure to support staff with management of finances to ensure all parties are protected. All financial records were being audited as part of an investigation into reported financial discrepancies. Policies and procedures had been reviewed and updated in response to complaints and concerns and changes to legislation although there were no systems in place to monitor whether staff were complying with them; staff said audit systems were to be introduced this year. Visits to the home were regularly undertaken to monitor the day to day running of the home and a record had been maintained. Information provided by the registered manager indicated that certificates to evidence servicing of systems were up to date and that people’s health, safety and welfare was maintained. Belgarth Nursing Home DS0000022470.V333262.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 3 X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X 2 X 3 STAFFING Standard No Score 27 2 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 2 X X 3 Belgarth Nursing Home DS0000022470.V333262.R01.S.doc Version 5.2 Page 23 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. 1. Standard OP15 Regulation 17 Requirement There must be an up to date menu and accurate records of meals served to show that residents have received a varied and nutritious diet. Timescale for action 19/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations The criteria for ‘PRN’ or ‘as needed’ medication should be clearly defined and recorded. A procedure should be developed to support and guide staff. Prescriptions should be seen by the home prior to dispensing and the policies and procedures should reflect this safe practice. Oxygen cylinders should be secured and stored safely. 2. 3. OP10 OP12 The practice of residents receiving foot care in communal areas should be re considered to protect people’s privacy. Residents and their relatives should be involved in
DS0000022470.V333262.R01.S.doc Version 5.2 Page 24 Belgarth Nursing Home providing a range of information to assist with the planning of appropriate and suitable activities to meet resident’s diverse needs. Records of residents’ involvement in activities and entertainments should be maintained. Pureed meals should be served to residents in separate portions. Condiments and suitable tablecloths should be available in the dining rooms. Consideration should be given to replacing or repairing the food waste disposal machine. The registered person should ensure that each room is audited for contents against standard 24 and this is discussed with the resident and their representative, to ascertain their wishes. These wishes regarding furnishing should then be recorded as part of their care plan. The registered person should ensure that residents are provided with keys to their lockable space and to their rooms unless a risk assessment determines otherwise. The ‘weekend’ staffing situation should be monitored closely and if necessary action should be taken to ensure there were adequate staff at all times. Residents and relatives meetings should be arranged to give people the opportunity to air their views. There should be a procedure to support staff with management of residents’ finances. 4. OP15 5. OP24 6. 7. 8. OP27 OP33 OP35 Belgarth Nursing Home DS0000022470.V333262.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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
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