Inspection on 27/07/06 for Bluebells

This inspection was carried out on 27th July 2006.

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

Bluebells 21/08/07

Bluebells 12/10/05

Bluebells 11/04/05

Bluebells 07/10/04

Bluebells 01/04/04

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 Bluebells 152 Moredon Road Swindon Wiltshire SN25 3EP Lead Inspector Bernard McDonald Key Unannounced Inspection 27th July 2006 08:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bluebells DS0000003169.V303698.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. Bluebells DS0000003169.V303698.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bluebells Address 152 Moredon Road Swindon Wiltshire SN25 3EP 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) 01793 611014 08708318894 Mr Abitalib Ebrahimjee Mrs Lesley Ann Hunt Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Bluebells DS0000003169.V303698.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th October 2005 Brief Description of the Service: Bluebells is a large bungalow in the Moredon area of Swindon offering accommodation and care to 16 older people. The home is close to local shops and services and on a bus route. The home offers a mixture of double and single rooms. There is an open plan area incorporating two lounges and a dining room. These rooms can be used for social and religious activities. The sitting rooms are smoke free. There is wheelchair access to the garden and there were two ramps. There is seating in the garden in the form of plastic benches and chairs. Lighting is domestic in style. The home offers long term care and occasional respite care. Bluebells DS0000003169.V303698.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was completed in thirteen and three quarter hours over two days. The first day of the inspection was unannounced and the second day was by appointment with the manager. The views of service users, their relatives, health practitioners and care managers were obtained. The Commission’s pharmacy inspector examined the medication records. The care plans of four service users were examined in detail. The inspector met with all service users and four visitors to the home to obtain their views of the service provided. No adverse comments were received. The range of fees for the service was not available at the time of writing the report. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. What the service does well: What has improved since the last inspection? Improvements have been made to the standard of recording in service users care plans. In addition service users involvement in their care review was clearly evidenced. Improvements have been made to the overall fabric of the building. Six bedrooms have been redecorated and new carpets purchased. The front door and hallway carpet has also been replaced which has greatly improved the overall appearance of the home. Bluebells DS0000003169.V303698.R01.S.doc Version 5.2 Page 6 Three service users who have recently moved to the home confirmed they had opportunity to visit prior to moving in. In addition copies of the homes statement of purpose and service user guide had been provided to each person. 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. Bluebells DS0000003169.V303698.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 Bluebells DS0000003169.V303698.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 5, 6. The home ensures service users needs are assessed prior to admission and contracts are in place to ensure they are aware of the terms and conditions of their stay. Opportunities are provided to enable service users to “try out” the home before moving. The Quality rating in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The records of two service users admitted to the home since the last inspection were examined in detail. The records demonstrated the home had received a community care assessment prior to the service users moving in. As a matter of good practice the manager had visited the service users in their own environment and completed the home’s assessment of need. The quality of the recording was limited and areas of the assessment were not completed. However the community care assessment provided a comprehensive assessment of the needs of the service users. Discussion with two service users confirmed they had opportunity to visit the home to meet service users and the staff before making a decision to move. One service users stated “ I liked the room” when asked about their trial visit. Bluebells DS0000003169.V303698.R01.S.doc Version 5.2 Page 9 In addition the relatives of a service user who had moved to the home two days before the inspection commenced confirmed they had visited the home on two occasions on behalf of their relative. The relatives stated, “it feels very homely and the staff are very nice”. Contracts were in place which specified the terms and conditions of their stay including, the room to be occupied and fees payable. The home does not provide intermediate care. Bluebells DS0000003169.V303698.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Service users care plans reflect the care they need but improvements are required to the tools used to assess risks. The home is making every effort to ensure service users health care needs are met. Medication is handled in an appropriate way for the resident’s safety, however records are not always clear and accurate which could lead to errors. The Quality rating in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The care plans of four service users were examined in detail. These included the care plans of two service users recently admitted. Each service user had a care plan. Records examined showed these were being reviewed each month. Discussion with service users confirmed they had attended their care review meeting and their attendance was recorded on the care plan. Comments received from the relatives of service users confirmed they were kept informed of important matters and that they were consulted about their relative’s care. Discussion with staff demonstrated an awareness of the contents of service users care plans and how they wish to be supported. Service users were very complimentary about the care provided. One service user said the staff are “lovely”. Another service user said they are “wonderful”. Comments received Bluebells DS0000003169.V303698.R01.S.doc Version 5.2 Page 11 from the relatives of service users spoke highly of the staff team. One relative wrote “ we find the staff and managers very friendly and helpful and are always there to help. One service user is in a minority at the home being the only male. Discussion with service user confirmed they were more than happy with this arrangement and thinks its “fantastic”. The service user confirmed they could go to their room for quite time if needed. However the format used to develop service users plan of care can be somewhat confusing. Risks associated with falls and pressure sores are not clear and the tools used to assess risk need to be reviewed. Feedback from health care professionals confirmed they could visit their patient in private. Not all comments from health care professionals were positive about the care provided at the home. Since the last inspection a clear record is now kept on service users health care appointments. Records show service users have access to the dentist, optician and chiropodist in addition to the GP and district nursing service. The medication is stored securely and appropriate records kept. However not all the medicines received had been recorded. Some medication administration records had been hand written and were not clear, one did not have the resident’s name on it. New printed sheets were being delivered that afternoon which would ensure that there could be no further confusion. Controlled drugs and ‘as required’ medication is checked and recorded. Blood tests are carried out for diabetics under the supervision of the district nurse; evidence was seen of dietary changes being made due to the results. One eyedrop in use was not dated. No residents are currently self-medicating, records showed that reviews had been carried out and changes made when residents were no longer able to manage. The way in which service users are supported with their personal care is recorded in the care plans. Where there is a need for cross gender care the service users consent has been obtained before the care is given. Bluebells DS0000003169.V303698.R01.S.doc Version 5.2 Page 12 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, 13, 14, 15. The home is making every effort to enable service users to make choices about their lives but is failing to provide opportunities for service users to enjoy stimulating leisure and recreational activites. Mealtimes are relaxed and service users are supported to maintain contact with people who are important to them. The Quality rating in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: There is a relaxed and friendly atmosphere at the home and interactions between service users and staff was positive and respectful. Care plans outline service users cultural needs and a church service is normally held at the home once a month. Discussion with staff and observations made during the inspection showed service users are routinely offered choices in areas of personal living. For example a choice of meal is offered each day and service users confirmed they can get up and go to bed when they want. One service user commented they could go to their room whenever they wanted. Another service user has made a choice to have their meal in their room. Less evident was the opportunities for service users to enjoy stimulating leisure and recreational activities. Two service users commented there is “little to do” during the day. On the first day of the inspection music and singing was taking place in one of the communal lounges. This activity was not being directed or Bluebells DS0000003169.V303698.R01.S.doc Version 5.2 Page 13 supported by staff and service users were left to get on with it. Examination of the activites book showed only two recorded activities during May and June. Discussion with the relative of one service user and comments received from the relatives of two service users confirmed they could visit the home whenever they wanted and were always made to feel welcome. One service user has made a decision to have a private telephone line put in their room to enable them to contact their relatives whenever they wanted. There is also a cordless telephone available for service users to make private calls. The manager stated they are not responsible for service users finances as service users families or legal advisers have this responsibility where service users cannot manage their finances. Examination of the menu showed a choice is offered at each meal. A record is kept of all meals served including any alternatives offered if service users did not want the choices on offer. Service users were generally complimentary about the quality of meals serviced though one service user did comment the meals were “usually good but sometimes are a bit ropey”. The lunchtime meal was observed. The mealtime was relaxed and unhurried with the majority of service users choosing to eat their meal in the dining room. Discussion with the manager confirmed service users do not require any cultural or religious dietary needs. The dietician is not involved in the home at present and a nutritional assessment is completed as part of the care plan. Bluebells DS0000003169.V303698.R01.S.doc Version 5.2 Page 14 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, 18. The home is making every effort to ensure service users views are listened to but more attention needs to be given to ensure that any bruising to service users is recorded and investigated. The Quality rating in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Discussion with the manager confirmed no complaints have been received since the last inspection. However concerns have been raised with the Commission over the manual handling practices at the home. The manager stated a referral had been made to the occupational health service due to the deteriorating needs of two service users. The occupational therapist found the equipment being used was not suitable and raised these concerns with the Commission and the home. New equipment has now been obtained that are more suited to the needs of service users. An abridged version of the complaints procedures is on display at the entrance to the home. Comments received from relatives confirmed they were aware of the homes complaints procedure. Discussion with service users confirmed they would tell the manager if they were unhappy. Two service users said they speak to their relatives Discussion with staff confirmed they had received training in abuse awareness. Certificates demonstrating successful completion of the training were available for inspection. Staff demonstrated an awareness of what to do if they had any concerns about the welfare of service users. The inspector was concerned to find one service user with unexplained bruising to their arms. The service user could not recall how the bruising had occurred Bluebells DS0000003169.V303698.R01.S.doc Version 5.2 Page 15 and there was no record of the bruising in the service users daily notes. The manager was reminded of the need to ensure any bruising is recorded in service users daily notes and if necessary reported, using the local vulnerable adults procedures. Bluebells DS0000003169.V303698.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 22, 24, 26. The home is making every effort to improve the overall standard of accommodation at the home to ensure service users live in a clean and comfortable environment. The Quality rating in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Improvements to the overall environmental standards have continued since the last inspection. A total of six bedrooms have been decorated and a new carpet has been fitted in the entrance hall. In additional a new door has been fitted to the entrance of the home, which has greatly improved the overall appearance. Discussion with the manager and the representative of the registered provider confirmed there is a plan to further improve the overall fabric of the building and purchase new furniture for all bedrooms. Following an assessment by the occupational therapist three service users now require a hoist to assist with manual handling. All staff have been trained in the operation of the hoist. To accommodate the new hoists the service users have been accommodated in double bedrooms. While this practice reduces the Bluebells DS0000003169.V303698.R01.S.doc Version 5.2 Page 17 number of service users that can be accommodated at the home it does enable the three service users to live in a comfortable environment that is suited to their needs. Service users were complimentary about the standard of accommodation. One service user said, “ I like my room”. Another said, “ I have everything I need”. The inspector viewed all communal living areas and all service users bedrooms. One service user commented that they had brought some of their bedroom furniture from home. However some furnishing in service users rooms were showing signs of wear. In particular one set of bedroom drawers were broken and need to be replaced or repaired. There was slight odour in one bedroom and following the inspection confirmation has been received that the carpet has now been replaced. A risk assessment has been completed on the walk-in shower and service users are now using this facility. One service user has been injuring themselves on the toilet roll holder resulting in bruising to their arm and hand. When this was brought to the attention of the manager adjustments were made to reduce the risk of any further injury. It was a very hot day on the inspection and the patio doors were open for ventilation. However there was a significant step down to the ground. The manager was informed to risk assess the drop to ensure the safety of service users. The laundry room is situated outside. This ensures no soiled laundry is brought through the home. To further reduce the risk of infection it is recommended that red alginate bags be purchased for soiled or infected laundry. Bluebells DS0000003169.V303698.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. The home is ensuring safe recruitment practices are followed and that staff receive formal induction training. The number of staff with NVQ training is commended but the failure to ensure sufficient staff are on duty at all times impacts on the quality of care provided to service users. The Quality rating in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The rota shows there is normally three staff on duty on each shift. However on the day of the inspection only two members of staff were covering care duties. This clearly had an impact on service users as observations made during the inspection showed staff were very busy and task orientated. This did not allow staff time to interact with service users as the homes routine dictated what staff were required to do. On the second day of the inspection staffing numbers had increased and staff were observed spending time speaking to service users and not just focussed on the homes routine. It is evident that when the staffing numbers fall below three it directly impacts on the quality of care provided to service users and the management team must ensure staffing levels are maintained at all times. Out of a total of nine care staff six have completed the National Vocational Qualification (NVQ) in care at level 2. One person has completed NVQ 3. Certificates to demonstrate successful completion of the award were available for inspection. Three staff recruitment records were examined. All records contained a satisfactory Criminal Records Bureau (CRB) check at enhanced level. In Bluebells DS0000003169.V303698.R01.S.doc Version 5.2 Page 19 additional records contained proof of identity 2 written references and a satisfactory C.V. to demonstrate safe recruitment practices were being followed. All staff complete in house induction, which incorporates the “skills for care” standards. This training is normally completed within the first six weeks. In addition staff that are new to the care industry complete induction standard training through the local college. Certificates to demonstrate successful completion of the award were available for inspection. Discussion with staff confirmed they were satisfied with the level of training they are provided with. Training records that were examined demonstrated staff are receiving in excess of the minimum three days training per year. Discussion with the manager and examination of records confirmed the majority of staff have completed training in meeting the needs of older people. The manager stated they are still trying to access a dementia care course for staff as this has been identified as a training need. Bluebells DS0000003169.V303698.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 38. The manager is failing to ensure staff are supervised in their work but is making every effort to ensure service users live in a safe environment. Quality assurance is progressing but it has failed to capture the views of staff and stakeholders. The Quality rating in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The registered manager has been working at the home since 1988 and was appointed manager in 1992. The manager has successfully completed the registered managers award. Since the last inspection quality assurance surveys have been sent out to service users and their relatives to obtain their views on the service provided. Copies of the survey are held at the London office. However the results of the last survey have been collated into a graph, which has influenced the refurbishment work at the home. The letters and report from the last survey Bluebells DS0000003169.V303698.R01.S.doc Version 5.2 Page 21 were stored electronically and were made available for inspection. Records examined demonstrated the participants of the survey were informed of the outcome of the review. The home must now extend the quality review to include the views of stakeholders and staff. Discussion with the staff team confided they had received training in safe working practices such as manual handling, first aid and infection control. However formal supervision is not happening. One member of staff stated they could not remember when they had their last supervision meeting. Another member of staff thought they had supervision about six months ago. In addition the frequency of staff meetings has significantly dropped and one member of staff could not recall when the last staff meeting was held. The home was holding money on behalf of one service user. The records were examined and demonstrated accurate accounts were being kept. Examination of fire safety records demonstrated a fire risk assessment has been completed and reviewed in the past year. In addition fire safety drills are taking place a minimum of four times a year. Discussion with staff demonstrated an awareness of what action to take in the event of a fire at the home. Records showed staff receive fire safety training every three months. Environmental risk assessments have been completed but there was no evidence to demonstrate staff were aware of the risk assessments. Gas and electrical safety checks have been completed. Radiators are guarded and hot water is regulated close to 43c to ensure the safety of service users. Bluebells DS0000003169.V303698.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 3 2 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 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 2 2 X 3 3 X 2 X 2 STAFFING Standard No Score 27 2 28 4 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 2 X 3 Bluebells DS0000003169.V303698.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 OP7 Regulation 13(4)(c) Requirement The registered person must review the risk assessment tool for service users at risk of falling. The registered person must review the risk assessments tool for service users at risk of developing pressure sores. The registered person must ensure all medication received is recorded including each weekly receipt of the dossette box. The registered person must ensure written medication administration records and additions to the printed record are clear and accurate, they should be signed, dated and checked by two members of staff to ensure this. The registered person must ensure all eye drops are dated on opening and discarded by the appropriate date. The registered person must consult service users about their social and leisure interests. Following the consultation the registered person must take DS0000003169.V303698.R01.S.doc Timescale for action 01/10/06 2. OP8 13(4)(c) 01/10/06 3. OP9 13(2) 01/09/06 4. OP9 13(2) 01/09/06 5. OP9 13(2) 01/09/06 6. OP12 16(2)(m) 01/11/06 Bluebells Version 5.2 Page 24 7. OP18 13(6) 8. OP19 13(4)(a) 9. OP24 16(2)(c) 10. 11. 12 OP27 OP30 OP33 18(1)(a) 18(1)(c) (i) 24(2)(b) 13. OP36 18(2) action to ensure service users interests are met. The registered person must ensure any unexplained bruising is reported using the local vulnerable adult procedures. The registered person must complete a risk assessment on the practice of leaving the patio door open in the second communal lounge. The risk assessment should pay particular attention to the drop down to the garden. Where a risk is identified then action must be taken to reduce any risk to service users. The registered person must repair or replace the chest of drawers in the service user bedroom identified at the time of the inspection. The registered person must ensure there is adequate staff on duty at all times. The registered person must ensure staff receive training in dementia care. The registered person must ensure the quality review takes into account the views of service users representatives and staff working at the home. The registered person must ensure staff receive formal supervision from a competent person for a minimum of six times a year. 01/09/06 15/09/06 01/09/06 01/09/06 01/03/07 01/03/07 01/10/06 Bluebells DS0000003169.V303698.R01.S.doc Version 5.2 Page 25 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. 3. 4. 5. 6. 7. Refer to Standard OP3 OP12 OP15 OP18 OP26 OP27 Good Practice Recommendations The registered person should improve the quality of recording in the “in house assessment of need”. The registered person should consider employing an activities coordinator. The registered person should monitor the quality of meals served to service users. The registered person should ensure any bruising found on service users is clearly recorded. The registered person should consider purchasing red alginate bags for soiled or infected linen. The registered person should consider the use of agency staff to cover any shortfalls in maintaining the minimum numbers of staff on duty. The registered person should ensure staff meetings are held a minimum of four times a year. OP36 Bluebells DS0000003169.V303698.R01.S.doc Version 5.2 Page 26 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 Bluebells DS0000003169.V303698.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. 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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