Inspection on 13/09/06 for Charlton Lodge

This inspection was carried out on 13th September 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Charlton Lodge 01/08/08

Charlton Lodge 31/08/07

Charlton Lodge 06/02/06

Charlton Lodge 08/09/05

Charlton Lodge 21/12/04

Charlton Lodge 21/07/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Charlton Lodge Orchard Way Tiverton Devon EX16 5HB Lead Inspector Stephen Spratling Key Unannounced Inspection 10:00 13 & 18 September 2006 th th 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 Charlton Lodge DS0000039224.V308279.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Charlton Lodge DS0000039224.V308279.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Charlton Lodge Address Orchard Way Tiverton Devon EX16 5HB 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) 01884 253319 01884 253319 http/www.devon.gov.uk Devon County Council Lorna Priest Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Charlton Lodge DS0000039224.V308279.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th February 2006 Brief Description of the Service: Charlton Lodge is a care home providing personal care and accommodation for 30 people over 65 years of age. Some residents at the home stay long term but the home does offer a short stay respite service and an intermediate care service. Up to ten people can be accommodated for intermediate care at any one time with the aim of helping them to regain their independence so that they can return to their own homes. The home is a detached purpose built property owned by the local authority, Devon County Council. It was refurbished in 2004 when many rooms were made bigger and facilities improved. The building is set over two floors, with access to the top floor by shaft lift, it has all single bedrooms with shared bathrooms and toilets. The home has three lounge areas and pleasant grounds. It is situated centrally in Tiverton, close to local shops and amenities. Fees currently set at £556.57 per week. Commission inspection reports are available from the home’s office. Charlton Lodge DS0000039224.V308279.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Before the inspection site visit the inspector sent out a total of 38 questionnaires, seeking people’s views about the service. Completed or partially completed questionnaires from six service users, five from health & social care professionals and four from staff were returned. The inspection site visit was made unannounced on the 13th September 2006, starting at 10 am and ending and 4 pm. A second site visit was made on the 18th September 2006 starting at 9 am and finishing at 1 pm During the course of the inspection site visit the inspector spoke with 10 residents, four members of care staff, the home cleaner and the acting home manager. He looked closely at (case tracked) the care of three residents and looked at other documents/records e.g. policies & procedures and recruitment records. What the service does well: This home provides a comfortable, clean and well maintained place for residents to live. The practice of collecting relevant information about people’s needs help to make sure they can be cared for at the home. Close links with health professionals helps to ensure residents’ health care needs are properly attended to. These close links support the intermediate care service, which successfully works to help people to regain their health and the skills they need to live more independently. Visitors are made to feel welcome at this home with activities and entertainments suitable to the needs of most residents available. Residents report that the food in the home is good and varied. The home is well managed on a day to day basis, with staff and residents reporting that they feel listened to. Residents can be confident that their complaints will be heard and that staff at this home would act to protect them from mistreatment. Charlton Lodge DS0000039224.V308279.R01.S.doc Version 5.2 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. Charlton Lodge DS0000039224.V308279.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Charlton Lodge DS0000039224.V308279.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessment practice of the home helps to ensure that residents’ needs can be met. The intermediate care service helps people regain their skills and confidence to move from the home and to live more independently. EVIDENCE: The three resident records seen contained clearly presented, basic information about their needs and included information provided by social workers and health care staff, which had been used to develop individual care plans. The home does take admissions at short notice and a deputy manager was heard gathering assessment information about the social, personal and health care needs of a person being admitted on the day of the inspection, so helping to ensure their individual needs and preferences can be met at the home. Charlton Lodge DS0000039224.V308279.R01.S.doc Version 5.2 Page 9 The home has a flat equipped with kitchen, large bed/sitting rooms and a bathroom where residents can develop their independent living skills. Many staff at the home are very experienced carers and showed an understanding of their role as promoters of independence. An Occupational Therapist is employed at the home part time and a Physiotherapist support the service. One resident spoken with said that they were staying at the home for the second time and had found the help received during both stays helped them to keep/regain their independence. Charlton Lodge DS0000039224.V308279.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home’s close links with local health services help to promote residents good health and residents can be generally confident that staff will treat them with respect. Lack of detail in some care plans means that residents cannot be fully assured that their personal and health care needs will always be met consistently. Systems for managing medications are in place but they are not robust and do not ensure that medications are always properly stored and administered safely. EVIDENCE: All three care plans seen contained information that variably reflected residents’ needs. One read contained an adequate description of how all this persons identified needs should be met. For example providing good description of how staff should respond when the resident behaved in a way that they could find challenging, reflecting advice provided by a Community Charlton Lodge DS0000039224.V308279.R01.S.doc Version 5.2 Page 11 Psychiatric Nurse. The second seen provided some useful description of how the resident’s care needs should be met though it was not clear that one element about monitoring of this person’s diet was being followed. The third care plan seen, for a resident who was becoming increasingly frail and who was at risk of pressure damage to their skin contained only very general/limited guidance on how this person should best be cared for. Care plans did show evidence of regular review, though it was not evident that this was done with resident involvement. Residents indicated that staff generally know what their individual care needs are. Professionally recognised tools for monitoring the health and wellbeing of residents were seen in use. These help staff to identify when a resident’s condition is deteriorating; for example an assessment for a resident regarding the risk of them developing pressure sores had been used to prompt staff to request pressure relieving equipment and a more appropriate bed. The two GPs who returned Commission questionnaires indicated that they believe that home staff demonstrate a “clear understanding of the care needs of service users”, that their advice is acted upon and that they are “satisfied with the overall care provided at the home”. Care managers responding to questionnaires also confirmed that they believe staff understand residents’ needs and an overall satisfaction with the service provided. Of six residents completing Commission questionnaires three indicated that staff “always” “treat them well” with three responding “usually” to this question. During the site visit the inspector met with two of the three people who had said “usually”, one declined to talk; the other said that staff always treat them well excepting for one occasion which is being addressed by the home’s management. Other residents spoken with indicated that staff are always polite and respectful. The home’s medication policy provides limited guidance on how medications should be managed and administered, but it is neither comprehensive nor sufficient. For example it does not guide staff about how controlled medications should be managed, nor does it provide guidance about how medications should be safely disposed of. The inspector looked at the storage of medications, which is suitably secure. A monitored dosage system is used for the administration of many medications and though most medication administration was properly recorded, recording errors were found on three of the six charts looked at. One of the recording errors related to a controlled drug; staff had signed to confirm it had been given when it had not. In the medication fridge, eye drops stored had been appropriately dated when opened. The fridge temperatures were being monitored daily, however the record indicated that temperatures regularly exceed the recommended maximum of 8°C, on one occasion reaching 25°C, but there was nothing to Charlton Lodge DS0000039224.V308279.R01.S.doc Version 5.2 Page 12 indicate what was done when this happened. The home’s medication policy did not provide any guidance as to what should happen in such event. Temperatures in the medication room were also being routinely recorded and showed that during the summer temperatures had risen above 25°C, the maximum recommended temperature for the storage of many medications, yet no action was apparent. Charlton Lodge DS0000039224.V308279.R01.S.doc Version 5.2 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Activities available meet the needs of most residents, though more needs to be done to ensure that all residents receive the occupation and stimulation they want and need. Residents can be confident that their choices will be respected, that their visitors will be made welcome and that they will receive good food in sufficient quantities. EVIDENCE: The majority of residents spoken with said that they were happy with the activities available with some of them saying they enjoy the visiting entertainers and the regular church services. Two of the residents spoken with said they get bored at the home and would like more to do. The care plan of one them mentioned that more stimulation and outings should be provided; the previous month’s activity record for this person showed that during this time they had not been out of the home and that they had been involved in five activities, which included three Sunday services and one period of listening to the radio. Another resident’s care plans seen contained some very limited information about offering them activities, Charlton Lodge DS0000039224.V308279.R01.S.doc Version 5.2 Page 14 the third contained no information about how the resident should be helped to access activities/stimulation of interest to them. Residents confirmed they have access to newspapers and TV as they wish and that visitors are welcomed to the home at any time and can be received in private if preferred. One of the care staff spoken with confirmed that they are allocated eight hours per week to arrange activities for residents and spoke about taking individual residents out for walks to the park or shops and arranging activities such as bingo. Throughout the day staff were seen providing support to residents sensitively, giving residents time to do things for themselves and providing assistance as requested. Residents spoken with confirmed that they spend time where they choose and get up and go to bed when they choose. One resident spoken with said that they prefer to stay in their room for most of the day and that staff respect this choice. Of six residents asked by the inspector what they thought of the food; four said that it is “good” or “very good” and a fifth said that it is “alright”. Five confirmed that quantities of food are fine and that drinks are available when wanted. One person said they wished snacks were available in the evenings, though staff and other residents indicated that they are. Four weeks of menus seen by the inspector showed a good variety on offer to residents for the main meal of the day, at lunch times, consisting of mostly traditional British foods. Residents were seen taking lunch in different areas of the home, some choosing to sit up around dining tables and other choosing to eat in their armchairs, the atmosphere at lunchtime was leisurely and pleasant. Charlton Lodge DS0000039224.V308279.R01.S.doc Version 5.2 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 & 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents at this home can be confident that their concerns and complaints will be listened to and acted upon and that staff would act to protect them if they were being mistreated. However they cannot be fully assured that concerns about abuse will be dealt with in the best way. EVIDENCE: The home’s complaints procedure is posted on the home’s notice board. The homes records indicate they have received one formal complaint in the past 12 months, with records seen showing it was satisfactorily resolved. All but one resident asked said that they feel complaints/concerns would be/are listened to and acted upon. Since the last inspection the Commission has been notified of one allegation of abuse at this home, which is being formally investigated. At the time of the alleged incident staff acted promptly to ensure the safety of residents though it was four days before the allegation was reported to outside (statutory) agencies i.e. Social Services, the Commission and the Police, potentially compromising the investigation. Of four care staff spoken with all were clear about their responsibilities to recognise and report abuse to managers. Two said they had recent training about recognising and reporting abuse, one said they had training some years Charlton Lodge DS0000039224.V308279.R01.S.doc Version 5.2 Page 16 ago and one did not recall receiving this training. The inspector saw copy of the Devon Multi-agency Protection of adults at risk alerter’s guide available for reference and guidance in the home’s office and the deputy manager was aware of it. Charlton Lodge DS0000039224.V308279.R01.S.doc Version 5.2 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 the following standard(s): 19, 25 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. This home provides a clean and comfortable place for residents to live; though they are not adequately protected from risks presented by hot surfaces. EVIDENCE: All six residents who returned Commission questionnaires indicated that they think the home is always kept “fresh and clean”. The inspector walked around all the shared areas of the home and looked in ten private bedrooms. All areas seen were clean and free from unpleasant odours. Bedrooms were comfortably furnished and personalised. As seen at previous inspections most radiators and hot pipes are guarded to prevent residents getting burnt, though the tops of radiators are still not covered as the home’s own risk assessments indicate they should be. Charlton Lodge DS0000039224.V308279.R01.S.doc Version 5.2 Page 18 Though most of the beds in the home are at a fixed height, the inspector saw that adjustable beds are ordered when needed, with one being delivered for an increasingly frail resident on the day of the inspection. The inspector looked in the Laundry which was clean, well organised and suitably equipped. Charlton Lodge DS0000039224.V308279.R01.S.doc Version 5.2 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 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents can be confident that staff are suitably skilled and on duty in sufficient numbers to care for them properly. Residents cannot be assured that they are protected properly by the home’s recruitment procedures. EVIDENCE: Seven of the nine residents asked said they think all the staff are good at their jobs, with one person describing them as “very obliging” and another saying that care staff are “very good nurses”. All residents spoken with confirmed that staff are available to help when needed and that they are not made to wait unreasonable periods for help. Care staff confirmed that staffing levels are generally adequate to allow them to provide care in an unrushed manner. Some staff indicated that staff sickness can leave them feeling pressured but acknowledged that managers do try to call in additional agency staff when this happens. Three of the four members of staff spoken with have done NVQ training and all four described receiving a variety of training, paid for and done in work time, over the past year. Charlton Lodge DS0000039224.V308279.R01.S.doc Version 5.2 Page 20 The home’s records indicate that 25 of the 40 care staff have NVQ qualifications. Records seen for one new staff member contained evidence of them going through a structured induction. Four care staff completing Commission questionnaires indicated that they received induction training when they first started working at the home and that the home provides funding and time for them to receive relevant training. The home uses relief staff from three care staff agencies; the inspector saw evidence that two of them provide, to the home, evidence that proper recruitment and training has been provided to each of the individual staff they supply. The third provides an more general assurance. On the first day (13th September) of the inspection the inspector requested recruitment files for three staff members. One seen for a staff member in post for six months contained all the required checks e.g. Criminal Records Check and references etc. The other two, for people recruited more recently, did not contain evidence that all the required pre-employment checks had been done. The acting manager reported that this information is held else where for new employees, but that she sees references and POVA First checks before staff start work. The inspector requested that complete files for these staff members be made available for the second day of the inspection (18th September) but they were not. Charlton Lodge DS0000039224.V308279.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a home which is generally safe and well managed on a day-to-day basis. They can be confident that their views will be listened to and acted upon. However the lack of clear policies and the absence of a systematic approach monitoring the effectiveness of the service means that they cannot be assured that safety and quality of the service are as good as they could be. Satisfactory accounting systems help to ensure their money is properly managed. EVIDENCE: The current registered manager of this service is on long term leave. Devon County Council, the provider of this service, have appointed an acting manager Charlton Lodge DS0000039224.V308279.R01.S.doc Version 5.2 Page 22 who is an experienced deputy manager; she is supported by a team of deputies. Every shift in the home is led by the manager or a deputy manager. Care staff spoken with report that they find management at the home approachable and supportive, confirming that regular staff meetings are held where information and ideas are shared openly. The inspector saw minutes compiled following bi-monthly residents’ meetings. Where residents make requests for changes to the service efforts are made to act on them; an example given was that following resident requests a cooked breakfast is now available once a week. The manager showed the inspector how different monitoring tasks are shared among the staff group, for example one staff member is responsible for monitoring the cleanliness, general condition and safety of the furnishings on a monthly basis and another for checking that all nurse call buzzers are working. Record of these checks were seen. The inspector looked at the home’s policies and procedures file; the documents within it were mostly dated as having been developed in 1997; none seen related specifically to this care home and many were irrelevant to the service being provided e.g. referring to children’s services. The home looks after small amounts of money for some service users. The inspector saw that this money is kept securely and proper record of deposits and withdrawals are kept. With the exception of the tops of radiators which are not covered (see standard 25) all areas of the home seen were safe and properly maintained. Upper floor windows seen had appropriately restricted opening and fire doors were seen to be kept closed as appropriate. Records seen confirmed that the homes “handy man” conducts regular checks to the home’s hot water systems, the window restrictors and fire equipment. Receipts confirming that the fire detection and alarm systems were serviced in January 2006 were seen, together with certificates confirming that Portable electrical appliances were tested, also, in January 2006. Evidence that other equipment in the home has been professionally maintained was also seen Staff spoken with confirm that they receive regular and comprehensive safe moving and handling training, together with other training that helps them to work safely. Risk assessments for two residents who have bed rails fitted to their beds to prevent them falling were requested but were not available and therefore the quality of these assessments, which had been a concern at the last inspection could not be assessed. Charlton Lodge DS0000039224.V308279.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X 2 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 x X 2 Charlton Lodge DS0000039224.V308279.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13 (2) Requirement The registered person must make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. The registered person must maintain in the care home all the records specified in Schedule 4 (6).. and they must be available for inspection in the care home by a person authorised by the Commission to enter and inspect the care home. Previous timescale of two previous inspections of 08/11/05 and 06/04/06 Not met Timescale for action 18/11/06 2. OP29 17(2&3) 04/12/06 Charlton Lodge DS0000039224.V308279.R01.S.doc Version 5.2 Page 25 3. OP25 13 (4) The registered person must ensure that all parts of the care home to which service users have access are so far as reasonably practicable free from hazards to their safety. (Where risk assessments indicate that hot surfaces should be guarded this work should be completed i.e. tops of radiators currently unguarded should be guarded) Previous timescale of 06/05/06 not met 06/12/06 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 Refer to Standard OP7 Good Practice Recommendations Service users plans (care plans) should set out in detail the action which needs to be taken by care staff to ensure that all aspects of the health, personal and social care needs of service users are met. The registered person should ensure that there is a full and clear policy regarding all aspects of medication management. Medications should be stored at the correct/recommended temperatures. Records of administration of medication should be kept accurately. 3 OP12 More needs to be done to ensure that all residents receive the opportunities for stimulation through leisure and recreational activities in and outside the home which suit their needs, preferences and capacities. 2 OP9 Charlton Lodge DS0000039224.V308279.R01.S.doc Version 5.2 Page 26 4 OP18 Allegations of abuse must be reported to the responsible/relevant (Social Services/police/CSCI)agencies without delay. The home should have an annual development plan based upon a systematic cycle of planning –action-review, reflecting on the outcomes for service users. Policies, procedures and practices should be regularly reviewed in the light of changing legislation and of good practice advice. Policies and procedures should be relevant and specific to the service being provided. 5 OP33 6 OP38 Where bed rails are used risk assessments should be completed and take into account all potential risks (e.g. height of mattress) and suitable control measures put in place (e.g. a more suitable bed provided). Charlton Lodge DS0000039224.V308279.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Charlton Lodge DS0000039224.V308279.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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