Inspection on 21/05/08 for Chestnut Lodge

This inspection was carried out on 21st May 2008.

CSCI found this care home to be providing an Poor service.

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

Chestnut Lodge 19/03/10

Chestnut Lodge 11/01/10

Chestnut Lodge 20/11/08

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 28/10/2008.

CARE HOMES FOR OLDER PEOPLE Chestnut Lodge 43 Glenwood Road West Moors Ferndown Dorset BH22 0EN Lead Inspector Jo Pasker Unannounced Inspection 21,22 & 29 May 2008 09:30 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 Chestnut Lodge DS0000070886.V362433.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. Chestnut Lodge DS0000070886.V362433.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chestnut Lodge Address 43 Glenwood Road West Moors Ferndown Dorset BH22 0EN 01202 723846 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) Mrs Jane Travers Mrs Jane Travers Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10) of places Chestnut Lodge DS0000070886.V362433.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Old age, not falling within any other category (Code OP) The maximum number of service users who can be accommodated is 10. New service. Date of last inspection Brief Description of the Service: Chestnut Lodge is situated in a residential area of West Moors, local shops, churches, pubs and a library are available close by following a level walk. It is a detached property with a pleasant front garden and summerhouse. It is registered to provide residential care only for up to 10 male and female residents over the age of 65yrs. There are 5 bedrooms on the ground floor rooms all of which are single occupancy and most with en suites. On the first floor there are a further 5 bedrooms, 2 of which are double size and communal bathroom facilities. It is privately owned by Mrs Jane Travers, who is also the Registered Manager and manages the home on a day-to-day basis, together with her son, who is deputy manager. The service aims to provide individualised care to people in a friendly, family atmosphere and tries to encourage residents to continue with the lifestyle and interests they had prior to moving into the home. At the time of this inspection, fees ranged from £450-£600. Additional charges are made for hairdressing, chiropody, newspapers and personal shopping. See the following website for further guidance on fees and contracts www.oft.gov.uk (Value for Money and Fair Terms in Contracts). Chestnut Lodge DS0000070886.V362433.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 0 star. This means the people who use this service experience poor quality outcomes. This unannounced key inspection was carried out over approximately 8 hours on the 21 and 22 May 2008. A follow up visit to the home then took place on 29 May to check actions taken regarding an immediate requirement that had been made the previous week. This was a statutory inspection and was carried out to ensure that the residents who are living at Chestnut Lodge are safe and properly cared for. The Registered Manager, Mrs Jane Travers, was on hand throughout to aid the inspection process. Information gathered for this report came from several sources including: • Reports made to the Commission for Social Care Inspection by the home. • The annual quality assurance assessment (AQAA) completed by the home. • 4 questionnaires completed by residents, 1 by relatives and visitors and 3 by staff. • Tour of the premises. • Review of a variety of documentation including care records, staff records, maintenance records, policies and procedures. • Discussion with residents and staff. During the course of the inspection 8 residents, 2 visitors and 4 members of staff were spoken with and asked their views on the service provided at the home. Comments received through the questionnaires and discussion included: • ‘It’s lovely here-a home from home’ • ‘The food is lovely, if you don’t like what’s on offer you can have something else’ • ‘My daughter visits nearly everyday’ • ‘I’m very satisfied with the service’ • ‘Provides a home from home for my mum’. Chestnut Lodge DS0000070886.V362433.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? This is the first key inspection of this home since it’s change of registration and Mrs Travers becoming the registered provider and manager. Chestnut Lodge DS0000070886.V362433.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Chestnut Lodge DS0000070886.V362433.R01.S.doc Version 5.2 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 Chestnut Lodge DS0000070886.V362433.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (Standard 6 does not apply to this home). Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admissions procedure enables prospective residents (and/or those acting on their behalf), to make informed decisions about admission to the home and ensures that only residents whose needs can be met by the home are offered places there. EVIDENCE: The pre admission documentation for 1 resident was inspected. This showed that the home has a good procedure in place and ensures that a full assessment of needs was undertaken with the prospective resident, family and hospital staff prior to them moving into the home. Sufficient information was obtained so that a comprehensive care plan could be drawn up for staff to follow and ensure that individual needs are met. Chestnut Lodge DS0000070886.V362433.R01.S.doc Version 5.2 Page 10 All 4 residents who responded to the surveys sent out replied that they had received a contract and enough information about the home, before they moved in, to help them decide if it was the right place for them. Chestnut Lodge DS0000070886.V362433.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The standard of care was good although care plans for individual residents do not accurately reflect the practice that is carried out, in meeting people’s needs and preferences. The health needs of the residents are well met with evidence of good support from community health professionals and residents are treated with dignity ensuring that that their rights and privacy are upheld. Documentation relating to medication administration was not sufficiently robust to protect residents. Chestnut Lodge DS0000070886.V362433.R01.S.doc Version 5.2 Page 12 EVIDENCE: The care files for 4 residents were viewed. The care plans present were found to cover all necessary areas of care, including hygiene, mobility, safety, mood and eating and drinking. They were also very personalised, with a good level of detail about individual routines, needs, abilities and likes and dislikes. Relevant assessments were present for nutrition; pressure area care and falls with any risks and action needed being fully documented. Care plans seen were regularly reviewed although there was no evidence that they had been discussed with and signed by the resident or relative. Specific needs for one person, whose first language was not English, were also not referred to in the communication care plan. However, the manager was seen to communicate well with the resident during the course of the inspection and identify any care required. There was clear evidence of GPs’ and other healthcare professionals’ involvement in residents’ care, documented in the care records and also confirmed in discussion with staff and residents. From the 4 residents surveys returned, 2 stated that they ‘always’ received the medical support they needed, 1 ‘usually’ and 1 ‘sometimes’. The medications policies and procedures were reviewed. Medicines seen were stored securely, although there was no separate fridge box for medication, which was stored in the home’s main refrigerator. There were no controlled drugs kept however, the controlled drug cabinet was being used to store residents valuables instead. There were also shortfalls in recording seen, which included: • Where instructions for medications were handwritten on the medication administration records they were not signed, countersigned or dated. • Not all residents had allergies or ‘none known’ listed. • Where medicines had been prescribed ‘as required’, it was not documented why and when they should be administered. • No homely remedies list was available. • Where a medication had been prescribed as ‘take 1 or 2 tablets’, it was not recorded how many had been given when they were administered each time. • No clear audit trail was available, as the date medicines had been received by the home, was not documented on the medicine administration charts. No residents were self-medicating and a list of staff signatures was seen. All staff responsible for the administration of medication had received appropriate training, however it is recommended that more training be taken, given the shortfalls noted above. Chestnut Lodge DS0000070886.V362433.R01.S.doc Version 5.2 Page 13 The residents spoken with said they were very well cared for and observation of staff working in the home showed they were caring and respectful. When asked ‘Do you receive the care and support you need?’ in the survey, 2 residents responded ‘always’ and 2 ‘usually’. Visitors spoken with also confirmed this and said that they were ‘Very happy with the care, can’t fault it’. Chestnut Lodge DS0000070886.V362433.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a wide range of activities and events for residents and they are encouraged to maintain contact with the local community. Friends and relatives are also warmly welcomed by the home. Both relatives and staff members assist residents to make choices about their daily lives and the meals offered provide choice and variety ensuring that people receive a wholesome diet. EVIDENCE: Chestnut Lodge offers a wide choice of activities and actively provides games and events that the residents choose. A newsletter is available which informs everyone of what activities are taking place and these include: • Physical motivation classes • Bingo • Piano entertainment The home has also recently bought a season ticket for Stapehill for the benefit of the residents and has planned: • Drives in the countryside and afternoon tea Chestnut Lodge DS0000070886.V362433.R01.S.doc Version 5.2 Page 15 • • • A visit to Compton acres A night of classical music Individual choice of activity, such as a picnic or lunch at the pub. Residents are free to choose whether or not they join in activities and when asked in the survey ‘Are there activities arranged by the home you can choose to take part in?’ all 4 responded ‘always’ and relatives confirmed that people were supported to live the life they choose. Comments received from residents, included ‘We enjoy bingo and motivation classes, also Jane does word games that keep us active’. Residents are able to attend church services if they wish and visiting clergy are made welcome. Residents and visitors spoken with confirmed that visitors are made welcome at any time and that they are able to spend time privately in residents’ rooms if wished. One visitor said they were very happy with the home and that Chestnut Lodge ‘Provides a home from home’. All rooms seen contained personal pictures, photographs, ornaments and items of furniture. A varied menu is offered and people are free to choose whether to eat in the dining room or in their rooms. Lunch was beef casserole with mashed potato and strawberry gateau on the first day of inspection and residents stated that they were looking forward to it. The kitchen appeared clean and tidy, with plenty of storage areas and sufficient amounts of food stored. When asked on the survey ‘Do you like the meals at the home?’ all 4 people responded ‘always’ and comments included, ‘Lots of home cooking; great choice of food’. Chestnut Lodge DS0000070886.V362433.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 17. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns openly although a more thorough, effective complaints procedure and policy is needed. Although staff awareness has been raised in relation to safeguarding, shortfalls in the adequacy of recruitment procedures and training do not fully promote the protection of residents from abuse. EVIDENCE: The home has a complaints policy in place but did not have a complaints book to fully record any received. Any complaints/concerns received had been documented by the manager though individually and appropriate action taken. All residents and relatives that responded to the survey question ‘Do you know how to make a complaint?’ responded ‘Yes’. The home has written policies and procedures for the protection of residents from abuse or neglect however not all staff have received training. The registered manager demonstrated a good understanding of abuse and staff’s role in protecting residents from abuse in its many forms, including neglect. Yet, other staff spoken with during the inspection did not demonstrate a clear understanding of the home’s procedures. Chestnut Lodge DS0000070886.V362433.R01.S.doc Version 5.2 Page 17 Other significant weaknesses documented in this report in the ‘Staffing’ section, also reflect a general lack of understanding regarding the procedures required in ensuring residents are well protected from harm. Chestnut Lodge DS0000070886.V362433.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment at Chestnut Lodge is good providing residents with an attractive, homely and safe place to live. EVIDENCE: The home appeared clean and free from any unpleasant odours and has a programme of routine maintenance and on going refurbishment. Records seen showed that the equipment and facilities within the home are regularly serviced. All bedrooms seen contained built in wardrobes and sinks and several had en suite facilities also. The communal areas inside and outside of the home were easily accessible to residents, including an attractive front garden area with seating for residents and visitors to sit outside. Chestnut Lodge DS0000070886.V362433.R01.S.doc Version 5.2 Page 19 The annual quality assurance assessment (AQAA) submitted by the home prior to inspection, stated that new carpets and radiator covers were also planned to be fitted. The laundry appeared well managed, with all residents’ clothing labelled and numbered individual baskets used for washing. All staff had received some training in infection control however the homes policy on managing this did not make reference to the Department of Health’s guide ‘Essential Steps’. Chestnut Lodge DS0000070886.V362433.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Sufficient care staff are employed at Chestnut Lodge however serious shortfalls in recruitment practice and training undertaken mean that residents may be at risk of harm from unsuitable or poorly trained staff working at the home. EVIDENCE: Staff rotas demonstrated that there were sufficient staff on duty to meet the needs of the residents and this was observed in practice, during the inspection. At the time, 8 care staff were employed, including the registered manager, all of whom shared the responsibilities for caring, cooking, cleaning and activities. Surveys given to residents asked the question ‘Are the staff available when you need them?’ 2 replied ‘always’, 1 ‘usually’ and 1 ‘sometimes’. Staff surveys asked ‘Are there enough staff to meet the individual needs of all the people who use the service?’ and 3 said ‘always’. Comments included ‘Sometimes they are seeing to others but they always tell me’ and ‘Yes, always well staffed for each shift’. The AQAA submitted prior to inspection showed that 5 care staff have completed their NVQ level 2 or above and 2 staff members will soon be undertaking it. Chestnut Lodge DS0000070886.V362433.R01.S.doc Version 5.2 Page 21 Five staff files were reviewed however necessary documentation, including references; copies of identification and photographs were not present. Other information had also not been appropriately discussed, risk assessed and documented, such as enhanced CRB disclosures and gaps in application forms. An appropriate recruitment policy and procedure was also no in place. This potentially placed residents at risk of harm from unsuitable staff therefore an immediate requirement was issued. A return visit was carried out a week later to check the home’s actions and found that the registered manager and deputy manager had made significant progress with collating the necessary documentation. A new set of home policies and procedures had also been sent for from an appropriate company. Copies of recent staff training certificates were displayed on the walls in the communal hallway, including infection control and first aid and this was confirmed with staff spoken with during the inspection. Other training completed included care planning, dementia training and induction. However not all mandatory training was up to date, including safeguarding and fire training. (See Management and Administration section.) Further information on available training can be accessed through the following websites: www.picbdp.co.uk www.skillsforcare.org.uk Chestnut Lodge DS0000070886.V362433.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents live in a home, which is managed by a person who is committed to the service; possessing a good knowledge of residents’ needs and is well respected by members of the team. Quality assurance systems are being developed and although the safety and welfare of residents is upheld in most areas of working practice, key failures compromise the competent management of the home and safety of residents. (See Health and Personal Care and Staffing.) EVIDENCE: The Registered Manager and owner of the home is Mrs Jane Travers, who is assisted in running Chestnut Lodge by her son, who is also the deputy manager. They are both currently undertaking the Registered Managers Award Chestnut Lodge DS0000070886.V362433.R01.S.doc Version 5.2 Page 23 (RMA). Mrs Travers is a registered nurse and has more than 30 years experience in working in the care sector. She has an active role in the daily running of the home and was on site during all visits. She ensures that she speaks to all residents each morning and spoke to everyone during a tour of the premises and clearly had a good rapport with all people, including residents, visitors and staff. Chestnut Lodge is clearly a family business and as such offers a small, individual service which several people spoken with referred to as ‘a home from home’. Unfortunately key shortfalls in medication recording, recruitment practice and mandatory training (see the Health and Personal Care and Staffing sections of this report) do not reflect the home’s aim of ensuring that it is run in the best interests of the residents. These areas of concern mean that people are placed at risk of not being adequately protected or cared for whilst in the home. However, Mrs Travers has expressed a commitment to getting this right and spoke of her recognition of her responsibilities and accountability as a trained nurse and as manager of the home to do this. This was further demonstrated by the significant actions taken by the home, following the immediate requirement issued regarding recruitment. The home has submitted an annual quality assurance assessment (AQAA) to the Commission, detailing how they currently meet Care Standards and how they plan to improve. Annual questionnaires for residents and their families are sent out and meetings are held to gain their opinions on the running of the home. It is recommended that stakeholders’ opinions are also sought. Some audits were in place, however the home needs to further develop these and an annual development plan. Residents either deal with their own finances or have a representative to do so. The home will hold a small amount of money for people but had none at the time of inspection. The home has well kept records for the maintenance of equipment and facilities in the home. Routine checks were seen for the monitoring of electrical wiring and fire equipment. The home maintains a fire log detailing routine checks of fire equipment, drill practice and training, however not all staff members are satisfactorily updated in fire safety. Accident records are kept with a summary of incidents including details such as time, the nature of the accident and the person affected. It is recommended that the results of the audit be collated to also identify trends, action required and outcomes. Chestnut Lodge DS0000070886.V362433.R01.S.doc Version 5.2 Page 24 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 1 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 2 X 3 X X 2 Chestnut Lodge DS0000070886.V362433.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? N/A STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15(1) Requirement The registered person must, after consultation with the service user, or a representative of his, prepare a written plan as to how the service user’s needs in respect of his health and welfare are to be met. • This must include all communication needs. • Evidence of consultation with the service user must be documented appropriately. Timescale for action 30/09/08 2 OP9 13 30/09/08 The registered person must make arrangements for the recording, safe handling, safekeeping, safe administration and disposal of medicines received including: • Medicines must be appropriately stored. • Handwritten instructions on the MAR charts must be signed, dated and counter signed. • All residents’ allergies must be listed. • Medication prescribed ‘as required’ must have the DS0000070886.V362433.R01.S.doc Version 5.2 Page 26 Chestnut Lodge • • • 3 OP18 13(6) reason and frequency of dose documented. A homely remedies list must be held. The quantity of medication actually administered must always be documented. A clear audit trail for all medicines must be kept. 30/09/08 The registered person must make arrangements, by training staff, or by other measures, to prevent residents being harmed, or being placed at risk of harm, or abuse. 4 OP29 19 Schedule 2 The registered provider must 21/05/08 ensure that, prior to a member of staff commencing employment all the information outlined in Schedule 2 of the Care Homes Regulations 2001 is obtained. • • Copies of which must be kept in each staff members file. A copy of documented discussion regarding any staff convictions disclosed must also be held and a risk assessment regarding the suitability of that person to work in the home. Any omissions or concerns from recruitment documentation received must be verbally followed up and documented, with appropriate action if needed. 21/07/08 • 5 OP38 23(4)(d) The Registered Person must make proper provision for the health and welfare of the residents. This must include the provision of adequate fire DS0000070886.V362433.R01.S.doc Chestnut Lodge Version 5.2 Page 27 training for staff. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 Refer to Standard OP9 OP16 OP26 OP31 OP33 Good Practice Recommendations It is recommended that all staff undergo further medicine handling and administration training to further improve practice. It is recommended that all complaints and concerns received by the home are recorded together along with any actions necessary and outcome. It is recommended that the home’s policy and procedure on infection control is updated in accordance with the Department of Health’s guidelines. The Registered Manager should complete a managers qualification, equivalent to the Registered Managers Award It is recommended that the home’s quality assurance system is further developed to include an annual development plan, more substantial audits and to gather the opinions of stakeholders on the running of the home. Chestnut Lodge DS0000070886.V362433.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Chestnut Lodge DS0000070886.V362433.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!