CARE HOMES FOR OLDER PEOPLE
Bramley House Bromley Green Road Upper Ruckinge Ashford, Kent TN26 2EG Lead Inspector
Sally Gill Announced 01/08/05 at 9.30am 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 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. Bramley House H56-H05 S23350 Bramley House V231965 010805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Bramley House Address Bromley Green Road, Upper Ruckinge, Ashford, Kent. TN26 2EG Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01233 732629 Rooks (Care Homes) Limited Mrs Caroline Rooks Registered Care Home 18 Category(ies) of Older People aged 65 and over registration, with number of places Bramley House H56-H05 S23350 Bramley House V231965 010805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 15th November 2004 Brief Description of the Service: Bramley House is registered to provide residential care for up to 18 older people and admits people with low to medium dependancy needs. The premise is a detached property which has recently undergone major refurbishment work including an extension with an additional six ensuite bedrooms. There are 16 single bedrooms and one double situated on the ground and first floor. There is currently no lift/stair lift although a stair lift is planned. Six bedrooms have ensuite facilities and the others have a wash-hand basin. All rooms have a call bell and television point and a telephone is by arrangement. The residents have the use of three bathrooms. There is a spacious dining room which includes an additional seating area with patio doors overlooking the front entrance. The residents have the use of two lounges one which has a television and there is also seating in the front porch. There is a well maintained garden to the rear with a large patio/seating area and a water feature with fish pond. The rear garden also includes an aviary with birds, rabbit, and guinea pig. There is a patio/seating area and parking to the front situated in a quiet rural area approximately 5 miles from Ashford. A regular bus service runs into Ashford from just outside the Home. The company Rooks (Care Homes) Ltd owns the business. The Managing Director is also the Registered Manager. The Homes employs eight carers five of which are fulltime. Bramley House H56-H05 S23350 Bramley House V231965 010805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an announced inspection, which took place on Monday, 1st August 2005 between 9.30am and 5pm. Additional time was spent in preparation and report writing. During the inspection the Inspector spoke to eight residents, five in private and the remainder in company. Also, she spoke to the Registered Manager, the recently appointed chief of care and two carers. Surveys were received back from eleven residents (five were completed with the assistance of staff) and two relatives, the majority of which were totally positive. The care of two residents was case tracked. The Inspector examined various records including care plans, risk assessments, medication administration record charts, daily notes, staff files including training and supervision, the fire safety logbook and accident reports and menus. The serving of lunch and a group activity of cards was observed. A tour of the building was not undertaken but communal areas, the bathrooms and six resident bedrooms (by invitation) and two vacant bedrooms were seen. What the service does well:
The home provides residents with a very family orientated, pleasant, comfortable, clean and homely environment. The atmosphere is always relaxed and calm with staff emphasis on their commitment to providing a quality of life for residents and continuing to improve that quality wherever possible. The interaction between residents and staff is very good. Residents appreciate the manager’s availability to them, stating she listens and “when they say they will do something they will do it”. All residents spoke positively about the food, with comments ranging from “quite nice “ to “excellent”. The emphasis is on providing a menu with nutritious but wholesome home cooked meals. The home has worked hard to vary the menu and provide a wide choice for residents including vegetarian.
Bramley House H56-H05 S23350 Bramley House V231965 010805 Stage 4.doc Version 1.40 Page 6 Relatives confirmed that they are made to feel very welcome and are happy with the care provided. Comments included “x is improving in here because they like it”, “this place is paradise”, “staff keep me informed” and “cannot fault it”, “always clean and tidy”. What has improved since the last inspection? What they could do better:
Improvements to the medication system within the home are required to ensure residents safety. This has been carried forward from the previous inspection although some changes have been implemented. Care plans and risk assessments should contain sufficient up to date detail to ensure the resident needs can be met and actions are implement to reduce risks as far as possible. Discussions highlighted that residents could be more
Bramley House H56-H05 S23350 Bramley House V231965 010805 Stage 4.doc Version 1.40 Page 7 involved in their care plans. Thorough reviews should take place at least monthly and changes should be dated and signed. Care plans should contain details of resident’s medication. The rusty commode, which has been highlighted at previous inspections, should be repaired/replaced to avoid any cross infection to residents. Radiator guards or low temperature surfaces could be fitted to all radiators to ensure resident safety. The recruitment procedures must be strengthened to ensure the residents are not put at risk and staff files must contain all documents as per the regulations. Fire drills must be carried in line with the Fire Officers instructions to ensure residents and staff safety. A detailed record of food must be maintained in sufficient detail to evidence a satisfactory diet in relation to nutrition is available to residents. 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. Bramley House H56-H05 S23350 Bramley House V231965 010805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Bramley House H56-H05 S23350 Bramley House V231965 010805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3, 4 and 5 Prospective residents are given the information and opportunities they need to make an informed decision about living in the home. EVIDENCE: The home has a detailed statement of Purpose and Service User Guide. The Registered Manager stated that both these documents were reviewed and updated at the time of the increase in registered numbers and to reflect that respite care is now offered. A copy is held on file at the Commission. Prospective residents and/or families are encouraged to visit the home prior to making a decision to move in and all new residents and/or families spoken to confirm that they did take up this opportunity. In addition to this the Registered Manager visits the prospective resident within their own environment and carries out a full assessment of needs to ensure that the home is able to meet the needs of residents that move in. This also gives the prospective resident and/or families the opportunity to ask any further questions. A copy of the needs assessment is also sent to the prospective resident or family to try and ensure the home has a full picture of care needs.
Bramley House H56-H05 S23350 Bramley House V231965 010805 Stage 4.doc Version 1.40 Page 10 The Registered Manager is well aware of the pitfalls of taking residents where the home cannot meet their needs. The home does not provide intermediate care. Bramley House H56-H05 S23350 Bramley House V231965 010805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 The individual care plans and risk assessments are not sufficiently detailed and do not provide all the information that staff need to ensure residents needs are fully met and this could pose a potential risk to residents. Health and personal care needs are fully met. Residents are at risk from the shortfalls in the medication system. Residents are treated with respect and their right to privacy upheld. EVIDENCE: All residents confirmed that they could not fault the care they receive and that staff respect their privacy and dignity. A resident commented that they “were good at covering the likes and dislikes”. One resident was aware of their care plan and commented “it had been covered when I first came in” and the other spoken to was not aware and did not think they had seen it before which was agreed by their relative, neither were aware of monthly reviews. The level of detail in care plans was not sufficient to ensure that independence is always promoted and this was highlighted in discussions with residents about their care. The discussions also highlighted far more detail required to meet their care needs than the care plans contained. Since the residents had moved in further knowledge had been obtained however this had not all been followed through into the care plan. Some changes had been made to the care
Bramley House H56-H05 S23350 Bramley House V231965 010805 Stage 4.doc Version 1.40 Page 12 plans however these changes were not dated or signed. The Registered Manager stated that the newly appointed chief of care would be completing a thorough review of care plans however these should be working documents and updated as changes occur. Where there is input from health professionals this should be recorded in the care plan and cross-referenced to any other paperwork. Risk assessments were present but again the level of detail when needs are complex was not sufficient this is particularly the case with manual handling and mobility needs. These should be sufficiently detailed to ensure that any risks are minimised and state what input is required from staff. The care plan must contain a list of medication. Where possible care plans and risk assessments should be review with the residents, agreed and signed and should evidenced review at least monthly. The daily recording by staff has improved with far more comments made by staff rather than just ticking the boxes resulting in more informative information. The health care needs of residents are met with input from doctors, district nurse, continence adviser and diabetic nurse. The home has recently started to introduce a proactive approach to highlight those that are at risk of developing pressure sores. Residents will now be weighed monthly and a record maintained in their care plan. Since the last inspection the medication system has been changed and is now supplied in a Medi-dose system. A new lockable cupboard has been fitted however the position of this cupboard is against the advice of the Commission and as a result the Pharmacist Inspector will be asked to visit again. The storage cupboard must be monitored daily for temperature and the results recorded. Internal and external medication must not be stored together and this is carried forward from the previous inspection. The Inspector viewed the Medication Administration Record (MAR) charts. The home must ensure that when logging in medication that has arrived in the home all quantities are recorded not just the current week. Where medication is supplied PRN there should be clear written administration guidance for staff, this is outstanding from the previous inspection. All medication must be recorded on the MAR chart (again this is carried forward from the previous inspection) and creams must display in tact labels. No cream must be administered that is not prescribed for that resident, this instruction was also stated at the previous inspection. The home should ensure that residents and families are aware of the procedures for homely/over the counter remedies. Six staff have undertaken medication training although the Inspector was advised that this will be updated shortly. The chief of care to ensure competency has introduced medication audits however these should be recorded.
Bramley House H56-H05 S23350 Bramley House V231965 010805 Stage 4.doc Version 1.40 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 standard(s) 12, 13, 14 and 15. Routines within the home are flexible and residents are able to exercise choice in their individual and group activities. A variety of appropriate activities are offered to provide stimulation. Residents are able to maintain contact with family and friends. Meals are varied and residents are offered a wide choice of appetising and wholesome food. EVIDENCE: The atmosphere in the home is one of calm and relaxation. Some residents said they preferred to spend time in their bedrooms and staff respect this choice. Staff provide organised activities such as bingo, cards, and cake making. Individual activities include crosswords, reading, daily newspapers, television (including digital), scrabble, jigsaws and other games. Residents also spend time in their rooms chatting to their ‘neighbours’ and in nice weather the seating areas in the garden are taken advantage of. A local vicar visits once a fortnight. Residents talked about their families and the nice welcome they receive when visiting the home, which was confirmed by relatives visiting during the inspection together with the prompt arrival of mugs of tea. All relative’s
Bramley House H56-H05 S23350 Bramley House V231965 010805 Stage 4.doc Version 1.40 Page 14 comments were positive about the home included “this is paradise”, staff keep me informed” “cannot fault it” and “its clean and tidy”. Two families commented that the good care was reflected in the resident’s improved well being. Since the last inspection significant improvements have been made to the catering arrangements. Some residents have breakfast served in their bedrooms and others have a selection of cereals, toast, juice and fruit laid out in the dining room to which they help themselves. A fried breakfast is offered on occasion. The main meal is at lunchtime with a choice of two meat and one vegetarian dish; there is also a choice of potatoes. A selection of usually three vegetables is put in dishes on the table so residents can help themselves. Sweet is a choice of two and residents can choose at the time. Jugs of drink are available for residents to help themselves as well as cup of tea. Teatime is a choice of a light snacks or sandwiches and supper is available such as cheese and biscuits, sandwiches or biscuits. All comments about the food were positive and ranged from “quite good” to “excellent”. Residents are encouraged to the dining room for their main meals and the majority choose to. The recently refurbished dining room is very pleasant over looking the front drive. Table are laid with linen clothes and napkins and a small vase of flowers. On the day of the inspection residents enjoyed a wholesome and appetising meal in relaxed and pleasing surroundings. Special diets are catered for. The only shortfall in this standard is the recording of the record of food, which showed several gaps. If this minor shortfall can be addressed by the home and the other improvements maintained the standard will be exceeded. Bramley House H56-H05 S23350 Bramley House V231965 010805 Stage 4.doc Version 1.40 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 standard(s) 16 and 18. Residents consider that their views are listened to and as necessary are acted upon. There are shortfalls in the protection of residents from the prevention of unsuitable personnel working at the home. EVIDENCE: Several residents confirmed whom they would speak to should they need to make a complaint although no one could find anything to complain about although one resident told the Inspector “they would soon let her (the Inspector) know if and when there was something to complain about”. The complaints procedure is not currently displayed within the home however the Registered Manager stated that this was due to the re-decoration and would be resolved shortly. No complaints have been received since 2001. Care staff had a good understanding of abuse and how to report incidents of abuse both in the home and outside. Four staff have attended adult protection training. Restrictions on resident’s choices were discussed and the importance of agreement from all involved in the care to be recorded in the care plan. A shortfall relating to protection and also standard 29, involves the recruitment process currently employed within the home. Written references and POVA (protection of vulnerable adults) checks are not always being sought in advance of a new staff member commencing employment; greater details can be found under standard 29.
Bramley House H56-H05 S23350 Bramley House V231965 010805 Stage 4.doc Version 1.40 Page 16 Bramley House H56-H05 S23350 Bramley House V231965 010805 Stage 4.doc Version 1.40 Page 17 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25 and 26 After the major refurbishment residents are able to enjoy a standard of environment, which is very good with a planned maintenance and fabric renewal programme in place. There is one shortfall in fire safety, which poses a risk to residents. Residents have a selection of pleasant communal space indoor and a very nice garden. There is sufficient lavatory and washing facilities refurbished to a high standard. All resident’s rooms are individual and meet their needs. The home is clean and hygienic except for one commode, which is a risk to resident’s health. Improvements have been made to equipment to maximise resident’s independence. EVIDENCE: The home has recently completed a major refurbishment project, which included an extension of six ensuite bedrooms. As part of this project the kitchen was refurbished and a new laundry and office developed. All communal areas have also been redecorated, re-carpeted and have new curtains. The refurbishment has been completed to a high standard and the
Bramley House H56-H05 S23350 Bramley House V231965 010805 Stage 4.doc Version 1.40 Page 18 results are that the residents have a very pleasant and comfortable although homely environment. Planned maintenance and renewal is also on going and the Registered Manager agreed to dispose of the rusty commode, which is unhygienic due to the risk of cross infection and was highlighted at previous inspections. The six residents rooms (both the new extension and existing) seen were highly personalised, comfortable, clean and homely. All residents say they are totally happy with their rooms and were able to bring in their own possessions, which was evident during the inspection. Very decorative radiator covers have been fitted to radiators in the communal areas and the new bedrooms also have low temperature covers to ensure the safety of residents only the existing bedrooms are now not fitted with low temperature surfaces. The fire safety logbook was viewed and all tests except fire drills have been carried to the required frequencies to ensure resident and staff safety. The refurbishment to the ground floor bathrooms has been completed to a high standard and also includes new equipment to aid independence. The home plans to install a stair lift in the future to further aid independence. The home was clean, tidy and hygienic throughout apart from the rusty commode highlight above. Residents and relatives commented, “ It is always clean and tidy”. Bramley House H56-H05 S23350 Bramley House V231965 010805 Stage 4.doc Version 1.40 Page 19 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30. There is an adequate number of staff on duty to meet the current needs of residents. Residents are at risk from the homes recruitment practice. Staff morale is high resulting in an enthusiastic workforce that works positively with resident to improve their whole quality of life. Following training, staff competency should be evidenced to ensure the health and welfare of residents. EVIDENCE: In addition to the Registered Manager there were three carers on duty 8am – 1pm and two carers 2pm – 9pm plus the cook 9am – 2pm on the day of the inspection. The staff team is male and female. Creating the position of chief of care has recently strengthened the team. All staff spoken to were very positive and showed a commitment to improving the quality of life for residents. Care staff were quick in attendance when called. The Inspector observed care staff when they were assisting residents. She noted this help to be delivered in an appropriate manner often with use of good humour and the care staff were kind and caring in their approach. Two staff files for recently appointed staff were sampled. One file showed a lack of written references and POVA or CRB enhanced disclosure. The file also lacked a job description and any terms and conditions. The other file lacked an application form. This is totally unacceptable practice and leaves vulnerable residents at risk. Bramley House H56-H05 S23350 Bramley House V231965 010805 Stage 4.doc Version 1.40 Page 20 Staff have been recruited with an NVQ qualification and therefore the home is currently meeting the 50 target of qualified staff. One new member of staff is currently undertaking the Skills Sector Council induction training and the Inspector was advised this will include competency checks. Where care staff are carryout tasks under the instruction of a health professional i.e. the testing of blood sugar there should be evidence of training and competency by the professional. Bramley House H56-H05 S23350 Bramley House V231965 010805 Stage 4.doc Version 1.40 Page 21 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 35, 36, 37 and 38. The Registered Manager communicates a clear sense of leadership, is open and positive. She has four years experience in care but has no formal qualification. Effective quality assurance ensures the home is run in the interests of residents. No resident’s finances are dealt with by the home. Staff are appropriately supervised. There should be improvement in some practices and records to ensure residents are safeguarded and protected. EVIDENCE: The Registered Manager has four years experience managing Bramley House although she does not have an NVQ at level 4 in care. She creates a clear sense of leadership and residents comment that she is easy to talk to and listens to them. Effective quality assurance systems are in place including six monthly questionnaires for residents, relatives and others. The Commission has the
Bramley House H56-H05 S23350 Bramley House V231965 010805 Stage 4.doc Version 1.40 Page 22 results of the last survey on file. A formal committee meeting is also held twice a year where those involved in the home can discuss any issues or concerns. The home does not have any dealings with residents finances. Records showed that supervision had been completed within the recommended timescales. Staff said they felt well supported. Some records require improvement to safeguard residents. These are detailed previously in this report. Resident’s comments indicate that they could be more involved in some of the records for instance care plans and risk assessments. Staff are trained in core subjects. Since the last inspection further training has been delivered in first aid. Information supplied confirmed that all equipment remains in good working order, which was confirmed by both residents and staff. There is a shortfall in fire safety regarding drills as detailed in standard 19. Bramley House H56-H05 S23350 Bramley House V231965 010805 Stage 4.doc Version 1.40 Page 23 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2
COMPLAINTS AND PROTECTION 2 3 3 3 3 3 2 2 STAFFING Standard No Score 27 3 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 2 3 3 x 3 3 2 2 Bramley House H56-H05 S23350 Bramley House V231965 010805 Stage 4.doc Version 1.40 Page 24 yes Are there any outstanding requirements from the last inspection? 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 9 Regulation 13(2) Requirement There must be written guidelines for administration of all PRN medication Medication prescribed for a resident must not be administered to any other Medication must be logged into the home in the correct quanities Medication audits must be recorded The tempreture of medication storage space must be monitored and recorded daily All medication must have a label which is intact Maintain a record of food in sufficient detail The home must follow a robust recruitment practice and obtain appropriate checks prior to employment Take adequate risk against fire including carry out fire drills at least 6 monthly Staff files to contain all appropriate information Timescale for action 30August 2005 5 August 2005 5 August 2005 5 August 2005 5 August 2005 5 August 2005 5 August 2005 30 August 2005 30 August 2005 2. 3. 15 & 37 18 & 29 17 19(5) 4. 5. 19 29 & 37 23(4) 17 & Sch 4 Bramley House H56-H05 S23350 Bramley House V231965 010805 Stage 4.doc Version 1.40 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. Refer to Standard 7 7 7 25 26 Good Practice Recommendations Care plans and risk assessments to contain sufficient detail to level of needs Care plans and risk assessments to be thoroughly reviewed at least monthly to ensure information is up to date and any changes should be dated and signed Care plans to contain details of medication Radiators are guarded or have guarenteed low tempreture surfaces Repair/replace rusty commode to avoid cross infection Bramley House H56-H05 S23350 Bramley House V231965 010805 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent. TN23 1HU 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 Bramley House H56-H05 S23350 Bramley House V231965 010805 Stage 4.doc Version 1.40 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
