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Inspection on 06/10/05 for Carr Green Nursing Home

Also see our care home review for Carr Green Nursing Home for more information

This inspection was carried out on 6th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home was clean and tidy. Residents looked smart and well cared for.

What has improved since the last inspection?

Staff are being properly checked before they start work at the home to make sure they are suitable to work with older people. The dining room tables have been replaced. The emergency call bell cords in the bedrooms have been lengthened, so that residents can reach them. New bed linen and towels have been provided. New floor covering has been laid in one bedroom. Windows in the bedrooms now open. The carpet in the main entrance has be re fitted so that it is flat. A fire risk assessment has been completed. The sterilizer in the kitchen has been repaired and the broken tiles have been replaced.

What the care home could do better:

The assessment of prospective residents and care plans need to be more detailed, to make sure residents` needs are identified and met by staff. The medication system needs to be better managed to make sure residents get their medication at the right time. The activities programme in the home needs to develop so that residents receive appropriate, regular, individual or group activities. Staff need to have training to make sure that they treat people with respect. Details of residents` wishes during illness or following death need to be written down, so that staff know how to look after them when the time comes. Staff at the home need to make sure that residents feel able to raise any concerns or complaints and know that these will be sorted out.The home needs a lot of redecoration and refurbishment to bring it up to a good standard. The company that own Carr Green need to be pro-active in identifying problems with the building and making sure that repairs are made quickly. The owners need to make significant improvements at the home to make it a safe and comfortable place to live.

CARE HOMES FOR OLDER PEOPLE Carr Green Nursing Home Carr Green Lane Rastrick Brighouse West Yorkshire HD6 3LT Lead Inspector Paula McCloy Unannounced Inspection 6th October 2005 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 Carr Green Nursing Home DS0000001046.V256682.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Carr Green Nursing Home DS0000001046.V256682.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Carr Green Nursing Home Address Carr Green Lane Rastrick Brighouse West Yorkshire HD6 3LT 01484 710626 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) Flowertouch Limited Mrs Sandra June Speight Care Home 31 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (31), of places Terminally ill over 65 years of age (2) Carr Green Nursing Home DS0000001046.V256682.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Can provide accommodation and care for seven named services users - category DE(E) 7th April 2005 Date of last inspection Brief Description of the Service: Carr Green provides both personal and nursing care for 31 older people in what once was a school. The home is located in Rastrick close to local amenities. There is a small garden area and car parking is available in the grounds. All of the residents accommodation is on one level. There are single and double bedrooms available. None of the bedrooms have en-suite toilets. There is one large lounge and a dining room. There are four bathrooms and six separate toilets. The kitchen and laundry are in the basement. Carr Green Nursing Home DS0000001046.V256682.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Since the last unannounced inspection on 7 April 2005 there have been five additional visits to the home and a meeting with the fire officer and provider to agree timescales for the work that needs to be done to improve fire safety at Carr Green. At the unannounced inspection there were serious concerns about the procedures for recruiting staff as they were not thorough and were therefore leaving residents are at risk from being cared for by unsuitable people. Poor recruitment practices had been highlighted in two other inspection reports. A statutory requirement notice was served in May 2005 in order to make sure recruitment practices at the home were improved. The home have complied with the requirements of that notice and at a follow up visit that took place in July 2005 all the required checks were being completed. The remaining four visits to the home were looking at what progress was being made in meeting the requirements that were made about the environment in the April report. Progress has been slow and a number of those requirements are still outstanding. This inspection took place over 8 hours. Four residents, one visitor and seven members of staff were spoken to. Residents’ records, duty rotas and staff records were inspected. What the service does well: The home was clean and tidy. Residents looked smart and well cared for. Carr Green Nursing Home DS0000001046.V256682.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: The assessment of prospective residents and care plans need to be more detailed, to make sure residents’ needs are identified and met by staff. The medication system needs to be better managed to make sure residents get their medication at the right time. The activities programme in the home needs to develop so that residents receive appropriate, regular, individual or group activities. Staff need to have training to make sure that they treat people with respect. Details of residents’ wishes during illness or following death need to be written down, so that staff know how to look after them when the time comes. Staff at the home need to make sure that residents feel able to raise any concerns or complaints and know that these will be sorted out. Carr Green Nursing Home DS0000001046.V256682.R01.S.doc Version 5.0 Page 7 The home needs a lot of redecoration and refurbishment to bring it up to a good standard. The company that own Carr Green need to be pro-active in identifying problems with the building and making sure that repairs are made quickly. The owners need to make significant improvements at the home to make it a safe and comfortable place to live. 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. Carr Green Nursing Home DS0000001046.V256682.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Carr Green Nursing Home DS0000001046.V256682.R01.S.doc Version 5.0 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 the following standard(s): 3, 4 & 5 Prospective residents are not being properly assessed before they move into the home. Without this there is no assurance that their care and support needs can be met. EVIDENCE: The admissions procedure is not adequate to guide staff on the actions to be taken to ensure that new residents’ needs are properly assessed and planned for. Full assessment information was not available for two of the most recently admitted residents. Without this information it is impossible to formulate an individual plan of care and support for the resident concerned and to ensure that all of their needs are met. The homes assessment document needs to be revised and addition sections added to meet the requirements of Standard 3 (National Minimum Standards Carr Green Nursing Home DS0000001046.V256682.R01.S.doc Version 5.0 Page 10 Older People). Staff completing this document need to make sure that they put the date on that the assessment was completed. Following assessment, the manager of the home, in discussion with the service user and/or their representative must decide whether or not the home can meet that persons needs. The manager also needs to take into consideration the existing needs of residents already living at the home. If a place at Carr Green is to be offered the manager must make the offer in writing and confirm that the home is suitable to meet the prospective residents needs. Prospective residents or their relatives are encouraged to visit the home so they can assess the suitability of the facilities for themselves. Carr Green Nursing Home DS0000001046.V256682.R01.S.doc Version 5.0 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 the following standard(s): 7,8,9 & 10 Care plans need to develop further in order to ensure that individual residents personal care and social needs are fully met. Staff are involving all of the relevant professionals to make sure residents’ health care needs are met. The medication system is not well managed and residents are at risk of not receiving their medication at the prescribed times. There are practices in the home, which do not promote residents’ privacy or dignity. EVIDENCE: Each resident has a basic individual care plan, which gives brief details of their physical needs and how these are to be met. The plans do not contain any life histories or personal preference information. Information within the care plans is not consistent and is poorly organised. It is difficult to retrieve information quickly or locate a specific document. More attention needs to be given to completing individual residents risk assessments. For example one resident has been identified as being at high risk of falling, but no risk reduction measures have been documented. Another resident has bed rails in place but there is no risk assessment to indicate why these are necessary. Another resident has been identified as being at risk from developing pressure sores, Carr Green Nursing Home DS0000001046.V256682.R01.S.doc Version 5.0 Page 12 no information has been documented about how this risk will be reduced e.g. by use of a specialist mattress etc. Reviews of the care plans consist of a review of the risk assessment tools Waterlow (risk of developing pressure sores), falls etc. and are not based on a holistic review of the residents’ well being and whether or not their care plan is actually meeting their needs. Records showed that doctors, district nurses, opticians, chiropodists and dentists are being involved in residents care. The medication system is not well managed. Some medication administration records had not been signed and blank spaces have been left. Therefore it is not possible to know whether or not the residents received their medication. Also staff had consistently been signing that medication had been given to a resident in the morning, when this medication is given at tea time. Staff are not using a brought forward system for ‘as required’ medication making it very difficult to establish how much medication is in stock. No arrangements have made for the disposal of medication that is no longer required by those residents receiving nursing care. A lot of unwanted medication is being stored at the home. This is presenting an unnecessary risk. Residents all looked well cared for. There were some practices at the home that are not respectful of residents’ privacy and dignity. For example: Staff and residents do not close the toilet doors when they are in use, they just pull the curtain (that is outside the door) across. When people want to check if the toilet is in use they ‘peek’ around the curtain. Some residents mail has been left unopened on the table in the entrance hall. Possibly awaiting collection by relatives. A resident was transferred from a chair to a wheelchair, without staff explaining what they were doing. A member of staff taking two residents to the toilet at the same time. (one resident being pushed in a wheelchair with one hand and the other resident holding her other hand being pulled along behind her) Staff member standing up whilst feeding a resident who was sitting at the dining room table. A resident that was waiting for a member of staff to assist them with her lunch, had a plate of food put in front of her. She was not given any assistance until a member of staff had finished feeding someone else, by which time her meal would not have been hot. There is no information recorded about residents’ wishes about the care and support they want during illness and following death. Carr Green Nursing Home DS0000001046.V256682.R01.S.doc Version 5.0 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Social activities at the home are not being provided consistently to keep residents stimulated. Residents’ right to choice is sometimes being compromised by the homes routines and other factors. Residents’ opinions about the meals were mixed. EVIDENCE: There is very little recorded in the care plans about residents’ interests, their likes and dislikes or their preferred routines. The activities programme that was on display was dated week commencing 22 August 2005. From talking to staff some individual activities are offered, but not in any planned way. There is nothing recorded in residents care plans about individuals preferred routines e.g. what time they like to get up, go to bed etc. One resident stated that staff sometimes put her to bed too early. Residents’ choice in relation to when they want a bath is also limited as there are periods during the day when there is not enough hot water available e.g. early afternoon. Residents are able to have visitors at any time. One visitor confirmed that they are made to feel welcome, but said that they weren’t offered a drink. The visitors book showed that there are frequent visitors to the home. Carr Green Nursing Home DS0000001046.V256682.R01.S.doc Version 5.0 Page 14 Residents are able to bring personal possessions with them upon admission. Details of how to contact advocacy services are on display in the hallway. Residents views’ about the meals served at the home were mixed, some thought that they were very good whilst others felt they could be better. There is a two week menu in operation. Residents received breakfast, lunch, tea and supper. Drinks are also served mid morning and mid afternoon. The main meal is served at tea time. There is only one main meal on the menu if residents don’t want this and alternative is offered. Residents are not given a drink when they get up in the mornings. One resident had got up at 7.45am on the day of inspection and did not get a drink until around 9.30 when she had breakfast. At lunchtime residents had a choice of sandwiches or omelette and chips. The residents that required a soft diet received mashed potatoes and minced beef. No vegetables were served which made the soft diet look particularly unappetising. The records of meals served only give details of the main meal that is provided. These records need to be improved. Carr Green Nursing Home DS0000001046.V256682.R01.S.doc Version 5.0 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 & 18 Residents are aware of the home’s complaints procedure, but are not using it to resolve any concerns. Staff are aware of adult protection issues, which should ensure residents are protected from abuse. EVIDENCE: The homes complaints procedure is on display. There have been no complaints recorded this year. Staff need to think about what constitutes a complaint and make sure that details of the complaint are recorded together with the action taken and the outcome. For example, staff reported that there have been problems with residents’ laundry. These problems have not been recorded as complaints. Residents stated that if they had a complaint that they would speak to the manager, however, one resident said that she would only do this if it was something really serious because she didn’t want to cause any problems. Staff need to make sure that residents can raise concerns, however minor, know that they will be dealt with and be reassured that there will be no reprisals. One resident confirmed that she receives a postal vote at election time. Staff at the home have received training about protecting vulnerable adults and the local procedures are available. To date these procedures have not been used. Staff are being checked properly before they start work at the home to make sure they are suitable to work with older people. Carr Green Nursing Home DS0000001046.V256682.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The home is not well maintained and is not providing residents with safe, comfortable surroundings. EVIDENCE: The environment at the home was looked at in detail during the last inspection and during the follow up visits. The remaining areas still require action. 1. At the meeting with the fire officer in April it was agreed that the updated fire alarm system would be completed by 1 November 2005. 2. There are still some bathrooms and toilets that do not have locks on the doors. 3. Bedroom doors are still being wedged open. 4. Staff reported that there are still two bedrooms without hot water. 5. Acquisition of a Landlords Gas Safety Certificate. 6. Replacement of the cooker hood. 7. No lockable space in residents bedrooms. 8. No locks on bedroom doors. Carr Green Nursing Home DS0000001046.V256682.R01.S.doc Version 5.0 Page 17 9. Residents are unable to control the temperature of their rooms, as the radiator controls cannot be accessed through the radiator covers. The radiator covers still need painting. Areas of concern during this inspection: 1. The roof is leaking. Staff reported that each time it rains heavily leaks are noted in various places. Recently water has leaked onto a resident whilst they were in bed. Also staff have needed to puncture a ceiling tile to let the water out that was collecting on top of it. This is providing a very serious hazard to residents and staff. 2. The kitchen door was being wedged open. 3. The doors to the dumb waiter were being left open. 4. The walls in the kitchen were dirty 5. The laundry assistant is brining in her own iron, as the one in the home is not adequate. 6. The rotary iron that staff need has not been supplied. 7. Confirmation is required that the works identified following the electrical installation inspection (2003) have been completed. 8. The registered manager is making requests for equipment and for redecoration at the home. However, the company are slow to respond to these requests and there is no redecoration or refurbishment plan in place for the home. Carr Green Nursing Home DS0000001046.V256682.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 The homes recruitment practices have improved. Staff are checked thoroughly before they start working in the home to make sure they are suitable to work with older people. EVIDENCE: Following concerns about recruitment practices in the home that had been raised in 3 successive inspection reports a statutory requirement notice was served in May 2005 to make sure the home complied with the legislation. A follow up visit in July 2005 confirmed that the requirements of that notice had been met. The one staff file examined on this inspection had all the necessary checks in place. Carr Green Nursing Home DS0000001046.V256682.R01.S.doc Version 5.0 Page 19 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): 33, 35 & 38 Residents have very little say in how the home is run. Money that is held for residents is kept safe. The health and safety of residents and staff is not being promoted or protected, leaving people at risk. EVIDENCE: The registered manager has developed some quality assurance documents, but no survey in relation to residents’ satisfaction with the service has been completed. Residents meetings are not held. Residents’ views are only sought in a very informal way. Records of residents’ monies that are being held in the home are kept and receipts for any purchases made on the residents’ behalf are available. One member of staff takes responsibility for this and has developed a clear system. Carr Green Nursing Home DS0000001046.V256682.R01.S.doc Version 5.0 Page 20 There were a number of health and safety issues identified that must be addressed: 1. Wheelchairs were being used without the footplates being attached so that residents’ feet were being dragged along the floor. 2. Two members of staff were dragging a very full laundry bag along the corridor. The bag was then thrown down the cellar steps to the laundry. This practice is unsafe. 3. A member of staff bringing in their own iron to use in the home. 4. The laundry baskets are broken and need replacing. 5. The tumble drier hose is split and needs replacing. 6. The employer’s liability insurance certificate, that is on display, is out of date. Carr Green Nursing Home DS0000001046.V256682.R01.S.doc Version 5.0 Page 21 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 1 1 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 1 10 1 11 1 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 1 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 3 18 3 1 X 1 X X 1 1 1 STAFFING Standard No Score 27 X 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 1 X 3 X X 1 Carr Green Nursing Home DS0000001046.V256682.R01.S.doc Version 5.0 Page 22 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 OP3 Regulation 14 Requirement All prospective service users must be assessed, prior to admission. In the case of an emergency admission This assessment must be completed within the first five days of admission. The homes assessment document must be updated so that all of the areas identified in standard 3 of the national minimum standards for older people are covered. Following assessment the manager must write to the prospective resident and/or their representative to confirm that the home can meet their health and welfare needs. Risk assessments must detail all of the identified risks for each individual resident, together with details of how the risk is to be minimised. The monthly reviews must identify whether or not the care plan that is in place is meeting the needs of the resident. The registered manager must DS0000001046.V256682.R01.S.doc Timescale for action 20/10/05 2 OP3 14 20/10/05 3 OP4 14 20/10/05 4 OP7 13 31/10/05 5 OP7 15 30/11/05 6 OP9 13 31/10/05 Page 23 Carr Green Nursing Home Version 5.0 make arrangements to safely dispose of medication through a licensed waste disposal company and retains records of the transactions. They must also check that the contracted waste disposal company has authorisation to transfer and dispose of controlled drugs. 7 8 OP9 OP9 13 13 All medication records must be accurately maintained and signed contemporaneously A brought forward system must be implemented for all ‘as required’ medication so that a balance of medication held can be established easily at any time. All staff must receive training regadrding maintaining residents privacy and treating them with respect. The residents wishes concerning terminal care and arrangements after death must be discussed and documented in individual care plans Residents must be consulted about what activites they would like to participate in. Following this consultation group and individual activities must be arranged. Residents must be consulted about their preferred routines e.g. times for going to bed, gettting up. These must be documented and staff must follow residents wishes. Hot and/or cold drinks must be offered to residents when they get up. The records of the food provided for residents must include all meals that are served. It must DS0000001046.V256682.R01.S.doc 12/10/05 12/10/05 9 OP10 12 30/11/05 10 OP11 12 31/12/05 11 OP12 16 31/12/05 12 OP12 16 31/10/05 13 14 OP15 OP15 16 17 15/10/05 15/10/05 Carr Green Nursing Home Version 5.0 Page 24 15 OP16 17 16 17 OP19 OP21 23 21 18 OP24 13 19 OP24 16 20 OP24 12 21 OP25 23 22 OP25 13 be of sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory. Details of any complaints must be documented in the complaints log together with details of the action taken and outcome of the complaint. All works as identified on the fire schedule dated 25 October 2005 to be completed. Bathrooms and toilets must have suitable locks fitted to ensure residents privacy. (previous requirement from inspction that took place on 7 April 2005) When residents wish to have their bedroom doors open suitable automatic self closing devices should be installed, following discussions with the fire officer. (previous requirement from inspction that took place on 7 April 2005) Lockable space must be provided for residents in their bedrooms. (previous requirement from inspction that took place on 7 April 2005) Suitable doorlocks must be fitted on bedroom doors. These must meet the requirements of the fire service. (previous requirement from inspction that took place on 7 April 2005) The radiator controls must be accessble so that the temperature of individual rooms can be varied to suit the resident. (previous requirement from inspction that took place on 7 April 2005) All of the bedrooms must have a DS0000001046.V256682.R01.S.doc 15/10/05 01/11/05 31/05/05 31/05/05 31/08/05 30/08/05 31/08/05 07/05/05 Page 25 Carr Green Nursing Home Version 5.0 23 OP38 23 24 OP38 13 25 OP19 23 26 OP19 23 27 28 OP26 OP26 23 16 29 OP38 13 30 OP38 13 hot water supply. (previous requirement from inspction that took place on 7 April 2005) The cooker hood must be replaced. (previous requirement from inspction that took place on 15 July The Landlords Gas Safety Ceryificate Must be obtained. (previous requirement from inspction that took place on 7 April 2005) The responsible individual must make sure that the roof is in a safe state and that it is inspected for any loose tiles, broken felt etc. He must also ensure that any necessary repairs are carried out. Confirmation that the inspection of the roof and of repairs must be forwarded to the Commission for Social Care Inspection. The registered manager must ensure that the fire precautions in the home are maintained. The kitchen door must be kept closed. The doors to the dumb waiter must be kept closed, when not in use. The walls in the kitchen must be cleaned The responsible individual must ensure that staff have suitable ironing equipment so that sheets and clothing can be ironed properly. The responsible individual must confirm that the works identified on the electrical installation inspection report have been carried out. Risk assessments must be in place in relation to safe working practices for staff. DS0000001046.V256682.R01.S.doc 31/07/05 14/05/05 15/11/05 06/10/05 31/10/05 20/10/05 20/10/05 30/10/05 Carr Green Nursing Home Version 5.0 Page 26 31 OP38 13 32 33 34 35 OP38 OP38 OP38 OP38 13 13 13 13 Footplates must not be removed from wheelchairs. In exceptional circumstances if footpates are causing a particular problem, they must only be removed after a risk assessment has been completed. An up to date employers liability insurance report must be on display Ther tumble drier hoses must be replaced New laundry baskets are needed. The responsible individual must ensure that the current hot water system at the home is adequate to provide hot water consistently throughout the day and night. Details of their findings must be forwarded to the Commission for Social Care Inspection. 20/10/05 20/10/05 20/10/05 20/10/05 31/10/05 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 Refer to Standard OP7 OP7 OP25 Good Practice Recommendations Care plans should contain a life history and details of the residents person preferences. Care plans need to be constructed in a way that makes information easily accessible to care staff. The radiator guards should be painted. (previous requirement from inspction that took place on 7 April 2005) Carr Green Nursing Home DS0000001046.V256682.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 Carr Green Nursing Home DS0000001046.V256682.R01.S.doc Version 5.0 Page 28 - 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. 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