Inspection on 22/11/05 for Bemerton Lodge

This inspection was carried out on 22nd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Bemerton Lodge 22/05/08

Bemerton Lodge 06/06/06

Bemerton Lodge 24/05/05

Bemerton Lodge 10/02/05

Bemerton Lodge 23/08/04

Bemerton Lodge 26/02/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Bemerton Lodge Christie Miller Road Salisbury Wiltshire SP2 7EN Lead Inspector Roy Gregory Unannounced Inspection 22nd November 2005 09:20 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 Bemerton Lodge DS0000028264.V265306.R01.S.doc Version 5.0 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. Bemerton Lodge DS0000028264.V265306.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Bemerton Lodge Address Christie Miller Road Salisbury Wiltshire SP2 7EN 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) 01722 324085 01722 324561 manager.bemertonlodge@osjctwilts.co.uk The Orders Of St John Care Trust Mrs Heather Mudie Care Home 56 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (36) of places Bemerton Lodge DS0000028264.V265306.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th May 2005 Brief Description of the Service: Bemerton Lodge is a purpose-built home for up to 56 Older People, 20 places being registered for people who have dementia. The home is one of a number in Wiltshire owned and managed by the Orders of St John Care Trust. The home was built in the 1970’s and has received refurbishments in a number of areas during the past three years, including redecoration of every bedroom. The accommodation is arranged as six wings, over two floors connected by passenger lift. A choice of communal accommodation is afforded by a variety of sitting and dining rooms, together with a craft room and gardens. Bemerton Lodge is located in attractive grounds in a residential area, north of Salisbury city centre. There is car parking on site, and it is near a bus route. Bemerton Lodge DS0000028264.V265306.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by Roy Gregory between 9:20 a.m. and 4:50 p.m. on Tuesday 22nd November, and 10:05 a.m. and 2:00 p.m. on Wednesday 23rd November 2005. The inspector spoke with a number of residents, including two service users who were staying at Bemerton Lodge for intermediate care. Lunch was taken on the first day with three residents. The manager, Heather Mudie, was available during all of the inspection, whilst there were conversations with other staff including the activities co-ordinator, the administrator and the care leader with lead responsibility for medications. The inspector sat in on a care staff shift handover. The inspector selected a number of care plans to compare observations of care, and residents’ perceptions, with written records. Other records consulted included those relevant to recruitment, residents’ monies, staffing and fire precautions. Most of the building was visited and a number of individual rooms were seen with the consent of their occupants. The inspector had the benefit of a “pre inspection questionnaire” provided by the manager; and 22 “comment cards” received from residents, plus one received from a resident’s relative. What the service does well: What has improved since the last inspection? New dining furniture has made a big difference to the ambience and comfort of residents at meal times. The dining and sitting experience of residents in Wing 6 will be greatly improved by work in progress at the time of this inspection, to install new ceilings in order to overcome heat and glare problems identified at previous inspections. Bemerton Lodge DS0000028264.V265306.R01.S.doc Version 5.0 Page 6 The activities co-ordinator role has become embedded in how the home operates, with increasing evidence of links being made between needs identified in care plans, and provision and encouragement of activities. 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. Bemerton Lodge DS0000028264.V265306.R01.S.doc Version 5.0 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 Bemerton Lodge DS0000028264.V265306.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 There is a clear admissions policy and procedure in place, including an effective standard of assessment in which prospective residents and their families are involved. Admissions are linked to the range of needs for which the home can provide. Residents admitted for intermediate care receive a tailored and coherent service that enables a return to independent living. EVIDENCE: Three separate documents were in use for the assessment of prospective residents. Together, these gave a picture of abilities and needs, on the basis of which a decision could be reached as to the home’s ability to meet needs, and thus whether a place would be offered. Some of the documentation used was not designed primarily as an assessment tool, and lacked a way of clearly showing who has taken responsibility for the decision reached. However, the inspector understands the provider Trust to be about to introduce a dedicated assessment tool, whilst the manager and care leaders felt comfortable that the systems in use were producing comprehensive information. A care leader had carried out an assessment the previous week, and declined to offer a place to the person referred because their needs were seen to be too great alongside Bemerton Lodge DS0000028264.V265306.R01.S.doc Version 5.0 Page 9 the high levels of dependency already being served among the existing resident group. Two residents staying for Intermediate Care were clear about the reasons for their stay, and the respective roles of home staff and the external health professionals directing re-enablement work. They were working towards respective dates for discharge home. Both saw the Intermediate Care facility as a valuable resource that enabled growth of confidence in a secure setting. Staff were aware of the changing needs of this group of residents. Bemerton Lodge DS0000028264.V265306.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 9 The care provided to residents is guided by care plans, which receive review regularly and in response to significant change; but in respect of attention to pressure areas, few preventive measures are identified, and there is incomplete evidence of weighing residents as a primary health monitor. Otherwise, residents can feel confident that health needs are identified and responded to, with good access to health services. Mainly safe medication practice is compromised by some specific shortfalls in documentation. EVIDENCE: Observations of strong relationships between residents and their key workers confirmed descriptions by residents. A carer was seen taking time out from direct care tasks, to bring a resident’s care plan up to date. There was evidence of active review of care plans, and all had recent inserts of pressure area care plans. Most of the latter, however, were limited to observation of change, which in turn was to be referred on for district nurse attention, rather than actively planning to identify the degree of risk and to minimise this by, for example, encouraging movement or ensuring adequate nutrition. In some cases there were two elements of a care plan about pressure area care, and these needed combining to ensure carers were aware of the whole picture. In one instance, daily records showed the district nurse had asked that a person’s Bemerton Lodge DS0000028264.V265306.R01.S.doc Version 5.0 Page 11 sacral area be creamed; records suggested this was happening, yet this had not been added to the pressure area care plan. Care plans were well linked to initial assessments, which in turn were often (but not always) reviewed. There was evidence of resident agreement to plans. One resident said he regarded the care plan as more a staff concern than his own, but went on to describe how he and staff had worked together to achieve a particular outcome that directly benefited his health. Records of liaison with health and mental health agencies were very good, including in some instances entries made by other professionals. For example, a community psychiatric nurse had recorded their intention to identify an alternative placement for someone, after sharing of concerns over a period of time. Another person’s care plan ensured six-monthly reviews with the diabetic nurse. Care plans routinely considered emotional and social needs. The home’s policy of recording observations of every resident on every shift was resulting in a good record of wellbeing and care offered. Notifications to the Commission have also indicated a high level of observation of and response to health indicators. Weight records were not always consistent with care plan guidance on frequency. One of the care leaders had primary responsibility for medications practice in the home. Evidence was seen of the in-house training of care staff for medication competency, which began with observation of practice and reading policies, followed by actual experience of short medication rounds under strict supervision, before being assessed as competent to undertake full rounds. The supplying pharmacy provided a quarterly audit visit. The stock cupboard, and records in respect of returns to the pharmacy and controlled drugs, were extremely well kept. Within the recording of administration of medicines, there were inconsistencies in how the administration (or non-administration) of paracetamol was being recorded. In many cases, there had been a change in usage over time, such that the terms of prescription, which remained unchanged, did not fit actual current use. For example, a direction for use four times a day might have been supplanted by use “as needed” or “as requested”, by agreement with the resident concerned. It would be difficult for a newcomer to the administration round to be sure of how to act. The care leader agreed that GPs should be asked to adjust prescriptions to fit changing circumstances, and that care plans must reflect any situations where there is an element of a resident asking, or being asked, about administration of a medicine on an “as needed” basis. A further recording matter, which had also been identified recently by the visiting pharmacist, concerned how to document administration by care staff of topical creams, and was under active consideration. For all Intermediate Care and respite residents, there was good checking with GPs for medication history to ensure residents did not miss important medicines. However, hand-written Medicines Administration Record sheets for Bemerton Lodge DS0000028264.V265306.R01.S.doc Version 5.0 Page 12 these and new permanent residents were not being routinely counter-signed for accuracy by a second member of staff. Bemerton Lodge DS0000028264.V265306.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14 & 15 Residents’ social needs and preferences are identified in order to make a choice of meaningful activities available. Support is given to the exercise of personal choice. Good quality meals are served. EVIDENCE: The home employs an activities co-ordinator for 20 hours per week, including some weekend and evening times, to supplement the degree to which key workers are able to address some social needs within their role. She is able in that time to ensure she sees each resident, and to arrange a number of activities. On the day of inspection, these were news reading and food tasting. The member of staff said she was getting support from other staff, both carers and housekeepers. That day, a carer had passed on a resident’s wish for bingo to be arranged. The activities co-ordinator had built up a profile of preferred activities for individuals, and care plans showed that activity provision was identified as an element in addressing several residents’ emotional needs. The activities co-ordinator thought it inevitable with the number of hours available, that actual provision of activities would continue to be based overwhelmingly on group rather than individual experiences. This suggests that the dedicated provision of hours (less than half an hour per person per week) could be reviewed by the provider Trust. Bemerton Lodge DS0000028264.V265306.R01.S.doc Version 5.0 Page 14 Residents said the additional provision of the activities co-ordinator had made a difference to the home. Even if some were not inclined to join in many activities, something going on provided a point of interest, and many spoke of enjoying trips that had been organised, for example two into the New Forest to see the autumn colours, and concert trips. Many residents were content to rely mostly on their own entertainment, i.e. television and audio in their rooms, but records showed equally that many chose various offered events. A residents’ meeting had produced ideas for trips out in December, which related to Christmas and were being followed up. A resident said they were frequently asked for opinions and feedback in the home. Two Intermediate Care residents were pleased to have been informed about activities, and appreciated having been helped to access the home’s hairdresser. When seen by the inspector they were filling out a food monitoring form, which prompted complimentary comments about the food. Other monitoring forms, together with comments from residents, showed high rates of satisfaction with the catering at all times of day. Dining areas were pleasant venues in which to eat, and there was evidence of assistance to residents to choose to eat where they wished. A diabetic confirmed he had a diabetic version of one of the sweets on offer, and said he had no complaints about the degree of choice available routinely to him. Another person had recently had three members of their family join them for a meal. Two residents spoke of the routine of meals as a structure around which they were free to plan how they spent their time. For one this included going out of the home unaccompanied, in respect of which it was seen that they had signed agreement to a risk assessment. A resident was seen locking their door, and others confirmed this was a matter of choice for all. All residents spoken to considered themselves to have choice over how they spent their time, and there was evidence of choices being made available. They said staff consistently showed respect for their privacy, which was supported by observations of care practice. Bemerton Lodge DS0000028264.V265306.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 17 There are good formal and informal means for receipt of complaints, which receive appropriate investigation and lead to service improvement. Arrangements are made for residents to receive the support of advocates. EVIDENCE: Some care plans seen had been signed by family members acting as advocates and for one resident currently, an independent advocate had been brought in to assist the review process. Information about independent advocacy was readily available. There had been four complaints received since the previous inspection, two about noise, one about food and one about staff attitude. There were good records, following the provider Trust’s complaints guidance, which tracked the origin of and response to complaints, including a record of each complainant’s satisfaction with the outcome. Staff meeting and supervision records confirmed that lessons learned from complaints were fed into improving practice. A resident said he was aware of occasional complaints having been made by residents, and that he would feel comfortable initiating a complaint were there the need to do so. Bemerton Lodge DS0000028264.V265306.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 25 & 26 The environment is welcoming and safe, with identified shortcomings receiving attention. Communal rooms and grounds offer a choice of pleasant surroundings. Attention to some identified lighting and radiator protection is necessary to reduce environmental risk to residents. Provision for hygiene is good. EVIDENCE: All communal rooms, bathrooms and toilets were seen, along with a sample of individual rooms. All presented well in terms of décor and cleanliness. The administrator, who supervises housekeeping staff, confirmed that their rotas allowed for checking and cleaning of toilets through the afternoon as well as the morning, whilst night staff were also required to undertake these checks as part of their routine duties. Minutes of staff meetings for all staff groups showed a number of hygiene matters being revisited. Night staff had been reminded of the importance of cleaning attention to “touch points”, i.e. door handles, switches etc. One member of staff is employed specifically for laundry duties. Residents expressed no complaints about cleanliness or the operation Bemerton Lodge DS0000028264.V265306.R01.S.doc Version 5.0 Page 17 of the laundry, and there was generally expressed satisfaction about individual and communal rooms. There had been a visit by the Environmental Health Officer, leading to requirements to re-fit the food serveries upstairs and down, so that they will be easier to keep clean (mainly by replacing bare wood surfaces), and the work to do so had been arranged. There was inconsistency in the labelling and operability of bins in toilets, simply through wear and tear, and it is a requirement to conduct a check and upgrade as necessary, keeping in mind “user friendliness” for residents. New dining furniture had given a more homely and up to date feel to dining rooms. At the time of inspection, a new ceiling was being fitted in a part of the home identified at previous inspections as having significant temperature control problems, which affected the comfort of residents using the sitting and dining areas there. As at previous inspections, a number of small sitting rooms, although offering pleasant surroundings, appeared to be little used by residents. One said he never used one of these rooms close to his room because no-one else did! It may be worth considering how to encourage a greater sense of ownership of these rooms, perhaps through the resident meetings or use for certain activities. A visiting Trust manager had recently identified a bathroom with an unguarded radiator, as did the inspector, and Mrs Mudie said this was programmed to be corrected soon. The adjacent toilet had very dim lighting, unsuited to the needs of the resident group, and this also requires rectifying. Bemerton Lodge DS0000028264.V265306.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Residents benefit from well trained staff, in whom they place confidence. Staffing is sufficient to meet the residents’ care and domestic needs. The process of staff recruitment ensures that all the checks and references necessary to protect service users are in place. EVIDENCE: Rotas confirmed the home was consistently operating with six care staff on duty on morning shifts, occasionally extending to seven, and five on later shifts. On the day of inspection there were six care staff, plus a care leader and the activities co-ordinator. Care staff said they found the minimum number of five staff to be essential. As things were, finding time simply to spend with residents or to offer additional baths was said to be difficult. However, the Trust has been pro-active in trying to free up care staff time to maximise time available for care tasks, both by appointment of activities coordinators, and also by designating some housekeeper time (three hours per day on six days per week) as “care support”. This encompasses tasks such as bed making and laying tables. A further development in hand was the appointment of a “head of care”, who may be expected to release some care leader time for more direct work with residents. Use of agency workers fluctuated, but Mrs Mudie said that agency staff used were usually from a core group who knew the home well. One use of agency workers had been to provide cover to enable home staff to attend dementia training. It was now seen as essential within the Trust that all care staff receive training in working with dementia. The Trust has developed a certificated course with Bemerton Lodge DS0000028264.V265306.R01.S.doc Version 5.0 Page 19 the Alzheimer’s Society, and Mrs Mudie has taken a lead in this, in order to be able to cascade training to others. There was also a clear record of other training undertaken by staff in all roles, including promotion of NVQ. A psychiatrist had come into the home to give insight into working with mental health needs. Recruitment records for recently recruited staff were very good, including all required checks, and a clear record of each interview. Bemerton Lodge DS0000028264.V265306.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 & 38 Reliable and transparent systems are in place to assist residents with management of finances where this is agreed. Provision for health and safety of residents and staff is of a high order. EVIDENCE: The administrator said that arrangements were made with newly admitted residents and their families about how they wished personal finances to be handled. A number of residents choose to use the home’s safe-keeping arrangements, for which the Trust has clear procedural guidelines. Residents spoken to who used this facility were fully aware of how to access their monies. The administrator informs families if she observes that available funds are low. There were clear records of signing monies in and out, and assistance was given to residents when requested in respect of paying their monies into banks and building societies. Some residents said they were completely in charge of their day-to-day cash needs, and had no concerns about this, or about how to make other arrangements if they wished. Bemerton Lodge DS0000028264.V265306.R01.S.doc Version 5.0 Page 21 Provision for health and safety of residents and staff was good. The works in progress in part of the home had been explained in advance to the residents affected, and alternative arrangements made for their sitting and dining needs. Access to personal rooms was maintained, and all contractors’ materials and tools were made safe at the end of the day. There were excellent fire precautions records. There had been swift attention to identified defects. As an ex-fireman, the handyman acted as an observer in fire drills. Work had been ordered for the fitting of fire shutters to the kitchen servery downstairs. Bemerton Lodge DS0000028264.V265306.R01.S.doc Version 5.0 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 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 X 3 3 X X X X 2 2 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 X X X X 3 X X 3 Bemerton Lodge DS0000028264.V265306.R01.S.doc Version 5.0 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 OP7OP8 Regulation 12 (1)(a) Requirement There must be a single pressure area care plan for each resident, based on a risk assessment and directing care to actively minimise any identified risks. Weight records must be maintained in a consistent way in accord with individual care plans. Ensure that prescriptions for paracetamol accord with actual usage by individual residents. Ensure care plans include guidance on the use of any “p.r.n.” medicines. Ensure any hand-written entries to Medicines Administration Records are counter-signed as a check on accuracy. Improve the lighting in the identified toilet in Wing 6. The radiator in the identified bathroom in Wing 6 must be made safe from presenting risk of burn injury. Check the labelling and operation of all waste bins in toilets and bathrooms, and make good or replace as necessary. DS0000028264.V265306.R01.S.doc Timescale for action 31/01/06 2 OP8 12 (1)(a) 31/12/05 3 4 5 OP9 OP9 OP9 13 (2) 13 (2) 13 (2) 31/01/06 31/01/06 18/11/05 6 7 OP25 OP25 23 (2)(p) 13 (4)(a,c) 13 (3) 31/01/06 31/01/06 8 OP26 31/01/06 Bemerton Lodge Version 5.0 Page 24 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 2 Refer to Standard OP12 OP20 Good Practice Recommendations Review the number of Activities Co-ordinator hours available to residents. Consider ways to increase residents’ awareness, and use, of all communal sitting rooms. Bemerton Lodge DS0000028264.V265306.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Bemerton Lodge DS0000028264.V265306.R01.S.doc Version 5.0 Page 26 - 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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