Inspection on 05/01/06 for Broomhills

This inspection was carried out on 5th January 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Broomhills 02/04/09

Broomhills 07/04/08

Broomhills 25/04/07

Broomhills 26/09/06

Broomhills 10/08/05

Broomhills 18/03/05

Broomhills 12/10/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Broomhills Stambridge Road Rochford Essex SS4 2AQ Lead Inspector Vicky Dutton, Ann Davey Unannounced Inspection 5th January 2006 08:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Broomhills DS0000018040.V275865.R01.S.doc Version 5.1 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. Broomhills DS0000018040.V275865.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Broomhills Address Stambridge Road Rochford Essex SS4 2AQ 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) 01702 542630 01702 542553 Runwood Homes Plc Mrs Sharon McGuire Care Home 47 Category(ies) of Dementia (23), Old age, not falling within any registration, with number other category (47) of places Broomhills DS0000018040.V275865.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Up to 47 persons of either sex to be accommodated who are over 65 years of age. Up to 23 persons of either sex to be accommodated who are over 65 years of age and who have dementia. No more than 47 persons to be accommodated at any one time. Date of last inspection 10th August 2005 Brief Description of the Service: Broomhills provides personal care and accommodation for 47 elderly people, included in this number the home can provide accommodation for up to 23 service users who have dementia. The original house is a 100-year-old building of character. There are 37 single and 5 double rooms, most with en suite facilities. There is a choice of lounges and a separate dining room. There is an entertainments room in part of the basement. Accommodation is provided on 3 floors and all areas can be accessed by the way of 2 passenger lifts. Broomhills is set in 3 acres of grounds. Local facilities are a mile and a half away in the town of Rochford. Broomhills DS0000018040.V275865.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a period of eight and a half hours. As there were two inspectors, this equated to seventeen hours input. The inspection focused mainly on the progress the home had made since the last inspection, although a number of other standards were also considered. The registered manager of Broomhills was available throughout the day. The inspectors were also assisted by care team managers (CTM’s) and other staff at the home. On the day of inspection 36 residents were being accommodated at the home. A partial tour of the premises took place. Staff, residents and visitors were spoken with. Care, staff, medication and other records were selected at random and inspected. A notice was displayed in the main entrance area advising all visitors to the home that an inspection was taking place with an open invitation to speak with an inspector. The inspectors gave a full and detailed ‘feedback’ to the registered manager with opportunity for clarification and/or further discussion. Copies of the ‘premises audit’ and a summary of good points and areas for development were also left with the registered manager. What the service does well: Staff at the home were helpful and the home had a welcoming atmosphere. The home has a strong and experienced local management team who try and make sure that the home is well organised and run in the best interests of residents. Individual staff members were attentive and kind in their dealings with residents. Visiting at the home is encouraged at any time. When permanent staff start working at the home they are given a good understanding of the home and of how to meet residents needs. Residents spoke positively of the homes manager and staff. They also said how much they had enjoyed the recent festive season. Broomhills DS0000018040.V275865.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Broomhills DS0000018040.V275865.R01.S.doc Version 5.1 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 Broomhills DS0000018040.V275865.R01.S.doc Version 5.1 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, 4. Prospective residents have their needs assessed before moving into the home. The homes own permanent staff are well trained. Development is needed to make sure that when agency staff are used, they have the skills and competencies needed to meet residents needs. EVIDENCE: Files of recently admitted residents were viewed as part of this inspection. These showed that a pre-admission process was in place. Information is sought from relevant sources and a member of staff from Broomhills visits the prospective resident to carry out an assessment. Assessments were well recorded and available on files. The registered manager went out to complete an assessment during the inspection, and liaised with families and other professionals about the admission. Staff at the home receive a good induction into meeting residents needs, and ongoing training in core areas and dementia care. Since the previous inspection a staff resource file has been developed. This contains information on other conditions relating to old age. Whilst the homes own permanent staff were observed to be caring and competent, the home need to ensure that Broomhills DS0000018040.V275865.R01.S.doc Version 5.1 Page 9 agency staff used have the same skill level, and are able to satisfactorily meet residents needs. Observations during the inspection raised concerns about this, and specific examples were fed back to the registered manager. Intermediate care is not provided at Broomhills. Broomhills DS0000018040.V275865.R01.S.doc Version 5.1 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. In general residents health and care needs were well identified and planed for. However, development work is needed to ensure that care plans always reflect all resident’s current needs, and adopt a holistic approach. Medication practices at the home are generally well managed and ensure that residents are kept safe. EVIDENCE: During the course of the inspection several care plans were viewed. In general they provided detailed information and guidance for staff providing care. The home maintains an audit system to monitor the quality of care planning information. Care plans were seen to be regularly reviewed and to involve residents and families where possible. The home must make sure that care plans cover all residents’ needs. During the inspection a number of residents at the home had chest infections and were taking antibiotics. This was not reflected in care planning information, to inform staff of residents additional care needs at this time. Other residents did not have care plans in place to reflect care needs relating to having district nurse input. Care is also needed to make sure that care plans have a holistic approach. For example, the care plans of a resident with a specific condition did not reflect that the condition needed management in relation to several aspects of daily care. Broomhills DS0000018040.V275865.R01.S.doc Version 5.1 Page 11 Records showed that resident’s health care needs are well catered for and their wellbeing monitored. Referrals are made to other professionals as appropriate to meet individual needs. Residents are assisted to access local and hospital based health services. To monitor resident’s wellbeing, records showed that their weight is regularly monitored. To complete this process and ensure that residents’ nutritional needs are being met, a full nutrition record must be maintained (including supper). Since the previous inspection an improved format has been put in place, but this was not being adequately maintained. Residents are kept safe and their medication well managed through the use of a monitored dosage system (blister packs.) When viewed the system was in good order and relevant policies and procedures were available to staff to inform their practice. Issues were noted in relation to one resident’s medication, and two aspects of practice. These were the management of creams and topical applications and new residents medication. These areas discussed with the registered manager. Throughout the day the homes own staff were noted to treat residents with courtesy and respect. One incident where a member of staff did not afford residents an appropriate level of care and respect was reported to the registered manager. Many residents have their own telephones installed in their rooms so that they can make calls in comfort and privacy. The homes pay phone can also be used in private. Broomhills DS0000018040.V275865.R01.S.doc Version 5.1 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. Development is needed to ensure that sufficient activity and occupation is provided for all residents living at the home, in accordance with their assessed needs. Visitors are always made welcome at the home. Residents said that the food at the home was good. Monitoring is needed to make sure that residents are always offered choice and served in a pleasant manner. EVIDENCE: Since the previous inspection the home has been successful in recruiting an activities co-ordinator who works for twenty hours each week. A programme of activities is in place and the home has a dedicated space where a variety of activities can take place. Current activities are biased towards the more able residents living at the home. Activity and occupation for residents with dementia needs to be developed. The registered manager reported that the activity co-ordinator is working with the organisations dementia specialist to gain experience and address this. Residents spoken with felt that they were offered choices in their daily lives. They also said that they had enjoyed all the recent activities associated with the Christmas and New Year festivities. A regular church service is held at the home, which residents can choose to attend. Visiting at the home is very open and there are no restrictions. During the day visitors came and went. They were always made welcome and had a good Broomhills DS0000018040.V275865.R01.S.doc Version 5.1 Page 13 rapport with staff at the home. A visitor’s room is available so that visits can take place in private. Residents are able to bring in personal possessions, and many rooms viewed were nicely personalised. Information on advocacy services was on display for the benefit of residents and visitors. Residents spoken with made favourable comments about the food provided at the home. Lunch on the day of inspection looked appetising and was well presented. The home has a pleasant dining area. At lunchtime the tables were nicely laid with ironed cloths, but the effect was spoiled by the use of mismatched cutlery. All the residents were given plastic beakers to drink from. These two issues were raised at the previous inspection. New equipment was ordered through the registered provider immediately following that visit, but has not yet been provided. During lunchtime staff were kind, caring and supportive when assisting residents with their meal. The service of morning and afternoon drinks needs to be monitored to make sure standards of choice and proper service are maintained. During the morning on the ground floor residents were not routinely offered a choice of drink. Biscuits were given by hand with no choice offered. Broomhills DS0000018040.V275865.R01.S.doc Version 5.1 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 has an established complaints procedure in place, and residents are aware of how to raise concerns. Adult protection procedures are in place to ensure that residents are protected from abuse. EVIDENCE: The home has a complaints procedure in place. Records showed that when concerns are raised they are dealt with appropriately and promptly. Since the previous inspection no complaints have been received by the home or made through CSCI. Information regarding adult protection was on display for staff at the home. Most staff have received training in adult protection. Staff spoken with showed a good understanding of adult protection and of the actions they should take if they had any concerns. Broomhills DS0000018040.V275865.R01.S.doc Version 5.1 Page 15 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, 21, 22, 24, 25, 26. Broomhills generally provides a safe and pleasant environment for residents. Further work is needed to make sure that all residents have satisfactory private facilities available to them. EVIDENCE: Broomhills is situated in a rural area and is some distance from the nearest main road. This could present difficulties for visiting friends or relatives who do not have transport available. As part of this inspection a partial tour of the premises was undertaken and full feedback was given to the registered manager. Since the previous inspection works have been undertaken to improve the environment, and some areas have been re-decorated and refurbished to a good standard. An area of the home is being developed for staff accommodation. This has raised a number of issues relating to fire precautions, and the preservation of residents privacy. CSCI had given advice in relation to this project and asked to be kept informed. In spite of this works have continued without discussion. A path that could potentially be used by members of the public now runs from the car park, close by residents bedrooms, a lounge and through their garden. Broomhills DS0000018040.V275865.R01.S.doc Version 5.1 Page 16 These access arrangements are not satisfactory and compromise the residents privacy. The registered persons(s) must address this. Broomhills provides sufficient communal space and there are several lounges available. These areas need to be properly equipped. At this inspection it was observed that insufficient occasional tables were availables in lounges to provide for the safety and comfort of residents. A separate visitors room is available. The basement area of the home provides a hairdresser’s room and a recreational/activities area for residents, as well as providing staff facilities. The home provides sufficient bathroom and toilet facilities. Hoists and moving and handling equipment is available to assist residents. Wheelchairs are also available for use. Some of those seen were not being maintained in a clean and hygienic condition. One wheelchair was being used with only one footplate. This was pointed out to the registered manager. Since the previous inspection signage at the home has been improved for the benefit of residents and to assist those residents with dementia or orientation difficulties. A call bell system is provided throughout the home so that residents can call for assistance. All bedroom doors at the home are fitted with locks so that residents can choose to hold their own keys. Many residents have personalised their rooms and made them homely. Those spoken with expressed satisfaction with the accommodation provided. Although refurbishment work is ongoing some bedroom areas are still in a poor condition, and do not provide sufficient facilities. Most bedrooms at the home have en suite facilities, but most of these have no cupboards or shelves fitted. This means that resident’s toiletries are often stored on top of the toilet cistern or in a plastic box. It was noted that many beds were still not supplied with any form of mattress cover, and the bed made with the bottom sheet directly on to the plastic mattress. The registered manager said that these were items that had been on order since the previous inspection. A number of blankets bearing hospital or company logos were noted to be in use around the home. The registered manager undertook to address this. On the day of inspection the home was generally warm and well ventilated. During the morning of the inspection residents in one ground floor lounge were complaining about being cold and asking for blankets. Staff in attendance failed to deal appropriately with this situation, or report it to the registered manager. On the day of inspection the home was generally clean and odour free. Areas where cleanliness needs to be improved, for example the hairdresser’s room, were pointed out to the registered manager. The homes laundry area is situated in the basement area of the home. Only domestic washing machines are provided. These do not have a sluicing cycle. A Health Protection Agency Broomhills DS0000018040.V275865.R01.S.doc Version 5.1 Page 17 officer raised this issue as an area of concern some time ago, as the current arrangement does not provide for adequate infection control. The registered provider has not taken any action to resolve this issue or provide adequate facilities. Broomhills DS0000018040.V275865.R01.S.doc Version 5.1 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. Established staffing levels have not been maintained at the home on all occasions. The home is quite reliant on the use of agency staff to provide care for residents. Staff are recruited safely and receive training to carry out their roles. EVIDENCE: Broomhills previously maintained staffing levels of six care staff plus one senior during the day and three care staff and one senior at night. As the home is currently operating with a number of vacant beds a senior manager in the organisation advised that the daytime staffing levels be reduced to five care staff and one in charge. This was not done in consultation with CSCI. The registered manager said that there was mostly still six staff on duty. This was borne out by the homes rotas. The home has a high level of staff vacancies and finds it difficult to recruit staff. Although some staff such as cook, handyman and activity co-ordinator have been recruited, significant care vacancies remain. This means that the home use many agency staff. As observed during this inspection this does not always provide a consistent service for residents. No house keeping staff are on duty in the main building after 12.00 each day. Previous inspections have asked for a review of staffing levels and staff deployment to take place at the home with information sent to CSCI. This has not yet happened. The records of two recently recruited staff were viewed. These showed that residents are protected by staff being properly recruited, with all checks and procedures being carried out before staff commences their duties. Broomhills DS0000018040.V275865.R01.S.doc Version 5.1 Page 19 The registered manager said that currently out of 18 care staff three have completed NVQ at level 2, and a further seven staff are currently undertaking this qualification. Staff spoken with and records viewed showed that staff recruited by the home receive a good induction programme to nationally agreed standards. The home have developed their own format for ensuring that new staff are fully supported by a ‘mentor,’ and have a good understanding of their role and responsibilities. Broomhills DS0000018040.V275865.R01.S.doc Version 5.1 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, 32, 33, 35, 36, 38. Resident’s benefit from a home which is well locally managed. Communication systems in the home are good. Action is needed to address health and safety issues identified in this report. EVIDENCE: Not all aspects of these standards were assessed. Broomhills has an established and experienced registered manager in post. She is currently completing her Registered Managers Award. Broomhills provides opportunities for residents to influence and express their views on the service they receive. Regular residents meetings are held. Periodic family forums are held. The registered manager said that much feedback and comment is gained on a one to one basis in discussion between staff residents and visitors. Regular staff meetings are held. Broomhills DS0000018040.V275865.R01.S.doc Version 5.1 Page 21 The registered provider has strategies in place to monitor the quality of the service provided. An annual audit of the service is conducted. For Broomhills this exercise was last completed in March 2005. The process is very detailed and includes the use of questionnaires to gauge levels of satisfaction. The format needs development to make the information it contains readily available for residents and other interested parties. The registered provider also nominates an operations manager to conduct a monthly visit to the home to seek the views of people using the service, and make sure that the home is being managed correctly. Resident’s finances were sampled. These were satisfactory. However, currently residents can only access their monies, or other items that the home might hold for safekeeping, during office hours Monday to Friday. This is not satisfactory or stipulated in the Homes Service User Guide. Residents should be able to access their money or property at any time. Staff felt that they were appropriately supervised and said that an appraisal system is now being put into place. Fire records and records relating to the servicing of systems and equipment were satisfactory. Consideration and consultation with the fire service needs to take place with regard to the means of fire escape in the basement area of the home. The main escape route for residents in this area has now been designated as staff accommodation, and a safe exit may therefore be compromised. Training at the home is ongoing. Training records were not examined in detail, but it was seen from a training chart that staff training in core areas is generally up to date. Development is needed to ensure that safe working practices and COSHH information is on display in relevant areas such as the laundry area and sluice rooms. To ensure residents safety work to secure the staircase to the basement area needs to be completed. An accident record is maintained but the forms in use had not been fully completed or ‘signed off’ since November 2005. Broomhills DS0000018040.V275865.R01.S.doc Version 5.1 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 2 X X 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 3 2 2 3 3 X 2 3 2 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 2 3 X 2 Broomhills DS0000018040.V275865.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP4OP10O P15 Regulation 18 (1)(b) Requirement Timescale for action 01/03/06 2. OP7 15 The registered person must ensure that that the employment of staff on a temporary basis will not prevent residents from receiving continuity of care to meet their needs. This refers to the use of agency staff at the home and the need to ensure that they are competent and well trained. Residents care plans must reflect 01/03/06 their current needs and show how these are to be met. Previous requirement of 01/09/05 not met. The registered person must maintain a record of all foods eaten by service users to demonstrate that they are in adequate quantities, it is suitable, wholesome and nutritious and is also varied and properly prepared. Previous requirements of 30/04/05 and 14/09/05 not yet met. The registered person must DS0000018040.V275865.R01.S.doc 3. OP8 16 01/03/06 4. OP9 13 01/03/06 Page 24 Broomhills Version 5.1 5. OP12 16 make arrangements for the safe management of medicines in the care home. This refers to the issues raised in the body of the report. Arrangements must be made to consult with residents and provide social occupation and activities suitable to their individually assessed needs. 01/04/06 6. OP19 23 Previous requirement of 01/11/05 not met. The registered person must 01/03/06 maintain the premises in a way that is suitable for achieving the aims and objectives of the home. This refers issues identified in the body of report in relation to staff/visitor access arrangements. Previous requirement of 01/10/05 not met. Suitable private accommodation must be provided for residents. This refers to the issues and shortfalls raised in the body of the report. The registered person must take appropriate action to promote effective infection control measures. This refers to the need for action to be taken to provide washing facilities that are effective in supporting infection control. Previous requirement of 01/01/06 not met. The registered person must demonstrate that a full review of staffing levels has taken place. This must also included a review of the seniors role at weekends and the consistent use of agency staff to maintain minimum staffing levels and their DS0000018040.V275865.R01.S.doc 7. OP24 23 01/03/06 8. OP26 12 01/04/06 9. OP27 17 01/03/06 Broomhills Version 5.1 Page 25 10 OP38 23 11. OP38 12 deployment. The home must able to demonstrate that sufficient levels of staff are on duty at all times to meet the needs of service users. It is not sufficient for the home to state that a review has taken place; it must demonstrate how outcomes are achieved. Previous requirement dates of 30/04/05 and 01/11/05 not met. The registered person must evidence to CSCI that it has consulted with the fire authority regarding the arrangements for means of fire escape in the basement area of the home. The health and safety issues raised in the body of the report to be addressed. 14/02/06 01/03/06 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. 5. 6. 7. 8. 9. Refer to Standard OP15 OP20 OP22 OP25 OP22 OP28 OP35 Good Practice Recommendations Issues in relation to equipment used in the dining room should be addressed. Staff should be instructed in appropriate serving practices. Sufficient occasional tables should be provided in lounges to provide for the safety and comfort of residents. Wheelchairs should be kept in a clean and hygienic condition and used properly to keep residents safe. Heating at the home should be maintained to ensure residents comfort at all times. Consideration should be given to the provision of mattress covers for the comfort of residents. 50 of care staff should be trained to NVQ level two or above by 2005. Current practice relating to residents access to their monies should be reviewed. Broomhills DS0000018040.V275865.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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. 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