Inspection on 12/06/08 for Chiltern Court Care Home

This inspection was carried out on 12th June 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chiltern Court Care Home 22/06/07

Chiltern Court Care Home 16/01/07

Chiltern Court Care Home 06/04/06

Chiltern Court Care Home 08/11/05

Chiltern Court Care Home 17/08/05

Chiltern Court Care Home 13/12/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Chiltern Court Care Home Wendover Road Aylesbury Buckinghamshire HP22 6BD     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Christine Sidwell     Date: 1 2 0 6 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: Chiltern Court Care Home Wendover Road Aylesbury Buckinghamshire HP22 6BD 01296 625503 01296 624482 chilterncourt@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Type of registration: Number of places registered: Ashbourne (Eton) Limited vacant post care home 53 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Bedroom 26a is to be used as a respite room- able to offer flexible accommodation for example for husband- wife or siblings. Including 3 service users of Forty (40) years or over That as of the 24th of October the home is registered to provide Nursing Care for 53 (fifty-three) service users with Physical Frailties. The maximum number of service users to be accommodated shall not exceed fiftythree (53). 2 2 0 6 2 0 0 7 0 Over 65 53 Date of last inspection Brief description of the care home Chiltern Court is a care home that provides care for up to fifty-three older people. The home is located on the outskirts of Wendover, adjacent to a large garden centre with a coffee shop and a variety of shopping outlets. Public transport is not easily accessible. The home is a large detached property consisting of a Victorian house with a more recent extension to the rear and has two floors. There is a passenger lift to the first Care Homes for Older People Page 4 of 31 floor and a stair lift to a mezzanine area. Forty-three bedrooms are single and five are double. Twenty-four single bedrooms and four double bedrooms have en suite facilities, although these are not in all cases adapted to meet the needs of disabled people. The home has a pleasant garden, which is well maintained. Care Homes for Older People Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection was conducted over the course of five days and included an unannounced visit to the home. The key standards for older people’s services were covered. Information received about the home since the last inspection was taken into account in the planning of the visit. Prior to the visit, the manager completed an annual quality assurance self-assessment. Residents and families were spoken to on the days of the unannounced visit. Discussions took place with the manager, nursing, care and ancillary staff. Care practice was observed. A tour of the premises and examination of some of the required records was also undertaken. The homes approach to equality and diversity was considered throughout. An ‘expert by experience’ visited the service with the inspector. An ‘expert by Care Homes for Older People Page 6 of 31 experience’ is a person who, because of their shared experience of using services themselves or with families, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. What the care home does well: What has improved since the last inspection? What they could do better: The manager should continue to monitor the time taken to receive medication, which is prescribed outside of the monthly medication dispensing cycle, to ensure that it is received promptly. The activities coordinator should have training in the provision of therapeutic activities for the elderly and for those with cognitive decline. Care Homes for Older People Page 8 of 31 The home should continue to develop the activities, tailoring them to individual’s wishes and involving a wider range of staff to ensure that there are meaningful activities throughout the home on a regular basis. Residents should be involved in developing the menus and should be supported to make their own choices, nearer to the time that they are going to eat. Further advice is available in the Commission for Social Care Inspection for Social Care Inspection guidance ‘Highlight of the day’ available on www.csci.org.uk The organisation must provide sufficient bathing facilities, which are adapted to meet the needs of people with disabilities. This was a requirement of previous inspections, which has not yet been met in full. The organisation should use the department of Health’s ‘Essential steps’ to assess their infection control practices to ensure that residents are protected from the risk of acquired infection. Further information is available on www.dh.gov.uk. The manager should register with the Commission for Social Care Inspection. Regular residents and family surveys should be undertaken and the results published and made available for prospective residents, families and other stakeholders. The quality assurance programme should include regular review of requirements made at previous inspections to ensure that they are met in full. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line – 0870 240 7535. Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is information available to residents about the home and their care needs are assessed with them, prior to their move to the home to ensure that they can be met. Evidence: The home has information available to prospective residents in the form of a statement of purpose, service user’s guide and coloured brochure. The manager or her deputy visits prospective residents before they move to the home to meet them and to assess their needs. Prospective residents and their families may visit the home prior to moving to the home, although many move following a stay in hospital. All residents have contracts or statements of their terms and conditions if they are sponsored by the local authority. One family member was spoken to and said that they had visited the home on behalf of their father before he moved and that the Care Homes for Older People Page 11 of 31 manager had visited his father in hospital to assess his needs. The home offers respite care, which can be an introduction to the home. The home does not offer intermediate care for those in need of rehabilitation. Care Homes for Older People Page 12 of 31 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Resident’s personal, healthcare and medication needs are met, promoting their dignity and wellbeing. Evidence: The care of four residents was followed through. All had care plans, which had been updated regularly. Resident’s personal and healthcare needs were identified, risk assessments were undertaken and a plan to address these was documented. Residents had had a nutritional assessment, had been weighed regularly and those who had more that one weight recorded had maintained their weight since moving to the home. One resident has lost weight on moving to the home. This had been recognised and a dietician had assessed her and supplements had been provided. Her weight was increasing. Resident’s risk of developing pressure damage was assessed and documented. Where appropriate residents had the appropriate mattresses to help relieve pressure. There was evidence in the care plans that the general practitioner Care Homes for Older People Page 13 of 31 visits regularly and that staff take action promptly if a resident’s health deteriorates. Residents were well groomed and their clothing was in a good state of repair. The carers said that most residents had a shower once a week, as not all bathrooms were operational. They said that they would endeavour to offer residents more frequent showers if they wished. The bathing facilities are described more fully in the environment section of this report. Staff were observed to be courteous to them and to respond to their wishes promptly. The residents spoken to said that they did not have to wait long for a response to their call bell although they all said ‘they are very busy’. One said ‘I sometimes wait longer at night’. All the residents seen had a call bell within reach. Residents said that their care is given in their rooms and that they always see the doctor in their rooms. There are medication management policies and procedures in place and the staff spoken to were aware of these. Storage facilities are satisfactory. Records are kept of medication entering and leaving the home. The medication administration records were accurately completed. Controlled drugs were stored satisfactorily and all entries to the controlled drug register were signed. A contract is held for the disposal of unused medication. The registered nurses spoken to said that medication was not administered covertly. If a resident refused medication this would be recorded. If the medication was essential and the resident lacked the capacity to make the decision, the doctor and family would be informed and a way forward agreed. None of the residents in the home managed their own medication at present although there is a policy to facilitate this if a resident wishes. The home is aware that their medication supplier is not meeting the agreed targets for the delivery of medication, which is prescribed outside the monthly medication dispensing cycle. This may mean that residents have to wait for essential medication to be delivered. The manager should ensure that this is monitored carefully and appropriate action is taken. Care Homes for Older People Page 14 of 31 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There have been improvements in the provision of activities for residents, although this is an area, which could be developed further to engage more residents and to bring interest and diversion to their day. The food is of an adequate quality and served in pleasant surroundings, although more should be done to involve residents in the development of menus and to support them to make meaningful choices about what they eat. Evidence: The home has appointed one member of their staff as activities coordinator since the last inspection. She has not yet received any training for the role although said that she and the manager were considering a course at the present. Neither were aware whether the course led to a qualification in the provision of activities for older people. A new activities room has been set up and the manager said in the annual quality assurance assessment that she had invested in a stock of activities materials. On the afternoon of the unannounced visit a small group of residents were painting small Care Homes for Older People Page 15 of 31 china cups with china pens. One lady said ‘I like coming down here it gives me break’. One resident said ‘we had a good time the other day, sitting in the garden with a big jigsaw, each of us putting in a bit’. There is a weekly programme of activities including one two-hour session of one to one activities, with individuals, on each floor, once week. There was little evidence of residents being engaged in activities in the lounges or in their rooms, apart from watching their television. In one lounge there was no reaction to the television being turned off. In general those residents who were unable to part in organised activities appeared to be sitting passively in the lounge or their bedrooms. Residents are encouraged to remain in touch with their families and relied greatly on their visits. One said ‘ a treat for me is to go to the garden centre next door and have a cup of coffee. Then I do not feel confined’. Another said ‘my family come twice a week, they are good company and make me laugh’. The activities programme shows that there is a church service once a week although one resident expressed a wish to go out to church sometimes. A group of residents were able to visit Waddesdon Manor recently and a strawberry tea is to be held in the grounds of the home shortly. The home should continue to develop the activities, tailoring them to individual’s wishes and involving a wider range of staff to ensure that there are meaningful activities throughout the home on a regular basis. There is a varied menu. There is a choice of main meal but not of sweet. Soup and sandwiches or a light cooked supper is available and staff said that hot drinks and biscuits or sandwiches were available in the evening. Salad is offered once a week. Residents are asked to order their lunch the day before but some appeared passive, ‘you get what they give you mostly, you hear what to eat from the carers’. One resident said ‘ I don’t worry much about food. I have it here in the lounge, I don’t know whether I could go downstairs, I suppose I could’. The manager has endeavoured to improve the mealtime experience for residents by improving the dining rooms. These are pleasant and look out over the gardens. The tables were laid well with tablecloths, cutlery and glasses. The carers were seen to support residents who could not eat unaided discretely. The organisation has a new computerised menu system ‘nutmeg’, which can be used to improve the menus and increase the amount of home cooked food available to residents, whilst measuring the nutritional content. This is not yet implemented in this home although a start has been made. The home should continue to improve mealtimes, involve residents in developing menus and support them to make their own choice from the menu, nearer to the time they are going to eat. Care Homes for Older People Page 16 of 31 Care Homes for Older People Page 17 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are complaints, whistle blowing and safeguarding policies and procedures in place to protect residents from harm. Evidence: There are complaints policies and procedures in place. The manager said that she would record both verbal and written complaints. The manager said that there have been no formal complaints since her appointment last November. Two families were spoken to on the day of the unannounced visit and both said that they knew who to speak to if they were unhappy. One family member said that the ‘managers and staff are very open and helpful’, another that’ the care staff are very responsive and try to care for my mother as I would wish’. The home has an up to date copy of the local multi agency strategy for safeguarding vulnerable adults. Most staff have had safeguarding training and those spoken to said that they would have no hesitation in reporting any concerns about resident’s welfare. There are whistle blowing policies and procedures in place. The home is secure and the manager said that restraint was not used. None was observed. The Commission for Social Care Inspection has not received any formal complaints since the last inspection and has not been notified of any safeguarding allegations Care Homes for Older People Page 18 of 31 made to the local authority, which is the lead agency in these matters. Care Homes for Older People Page 19 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Resident’s individual rooms are homely and they are encouraged to personalise them with their own furniture and mementos. There is a programme of redecoration and improvements to the outside pathways to provide better access for people with disabilities. The bathing facilities remain inadequate to meet the needs of people with disabilities. Evidence: The home is an older building, situated on the outskirts of Aylesbury and many period features have been retained. A programme of routine maintenance and redecoration has been undertaken throughout the last year, including redecoration of exterior paintwork and repairs to the drive to enable better access for those with disabilities. The communal areas leading to resident’s rooms were being redecorated on the day of the unannounced visit to the home. A programme of further decoration had been agreed for the following year. Residents are encouraged to bring small pieces of furniture and personal items to the home to personalise their rooms and many had chosen to do so. Rooms vary in size and there are some shared rooms. The grounds are attractive and some improvements have been made to enable access by people with disabilities. The last inspection by the Fire Safety Authority was in July 2007 when all matters were deemed satisfactory. Care Homes for Older People Page 20 of 31 The home’s annual quality assurance assessment (AQAA) showed that fifty residents have a physical disability, need help with washing and bathing and require two or more staff to help with their care. This indicates that residents have a high level of disability and are dependent on staff and suitable adapted equipment to meet their needs. A requirement was made at two previous inspections to improve the provision of bathing facilities for people with disabilities. A requirement was also made at the last inspection that the advice of a specialist was taken as to the adaptations that should be made to the bathrooms and ensuite facilities to enable people with disabilities to use them. This was undertaken and the report was received on the 30th August 2007. The organisation submitted an improvement plan following the last inspection. There are currently 5 bathrooms in the home. Of these two have been converted into shower /wet rooms, although there are some minor outstanding repainting and decoration needed. Not all the recommendations of the occupational therapist were implemented, although staff said that they were a great improvement on the previous facilities. Minor adaptations to one bathroom have been made by cutting holes in the bath panel to enable a hoist to be used. The remaining bathrooms have yet to be upgraded, although quotes for their upgrade have been sought. Thirty-two of the rooms have ensuite bathrooms, most of which have not been adapted to meet the needs of people with disabilities. The manager said that six of the current residents could use their ensuite facilites with help. The organisation’s Facilities Manager was asked to report to the Operations Director (responsible person) in March 2008 on the available facilities. This was done and he recommended that the remaining bathrooms should be upgraded and that further advice should be taken on what aids and adaptations could be used to make the ensuite facilities usable. The timescale for completion and whether the upgrades will meet the recommendations of the occupational therapist are still unclear. Although some progress has been made, it is slow and the organisation has not yet met the requirement that the registered person must ensure that the bathing facilities meet the needs of people with disabilities. The timescale for meeting this is unclear. The organisation does not meet the recommendation that one assisted bathroom or shower room be provided for every eight residents. There are infection control policies and procedures in place, which have been updated in line with the Department of Health’s guidance issued in June 2006. Staff were observed to be wearing protective clothing and were observed to wash their hands and had had training in infection control. Alcohol hand rub was available to help prevent cross infection. The manager said that residents had their own sliding sheets Care Homes for Older People Page 21 of 31 where they needed them and that with the exception of the hoist slings used for bathing, they had their own hoist slings. There were no offensive odours. The manager has not yet used the Department of Health’s ‘Essence of care’ selfassessment of the infection control practices and it is recommended that this be done. This is available on the Department’s website www.dh.gov.uk. Care Homes for Older People Page 22 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing levels are good and there are sufficient well-trained staff to meet resident’s needs. The recruitment procedures are thorough and should protect residents from potentially unsuitable carers. Evidence: There is a consistent staff team who know the residents well. The manager said that she had a full staff complement at the moment. There were two registered nurses and nine carers on duty on the day of the unannounced visit to the home. The rota showed that the home does not use agency staff. The residents spoken to were very complimentary about the staff saying’ they can’t do enough for you’, ‘they are very kind’ and ‘they always come when I ring the bell’. The care staff are supported by a team of ancillary staff, all of whom were able to describe their role in supporting residents. The recruitment files of four recently recruited members of staff were reviewed. All had the required documentation to show that checks as to the potential staff member’s identity and suitability to work with vulnerable people had been undertaken. All had submitted an application form, which showed their work history. Criminal Records Bureau checks had been undertaken and references had been sought before the staff member commenced work. Interview records had been kept. Copies Care Homes for Older People Page 23 of 31 of the staff member’s passport and work permit were on file and their nursing registration up to date. There are training programmes for staff. The training matrix showed that all staff have had the mandatory training in safe working practices and that staff undertake an induction programme on appointment to the home. Most of the carers, who had been recruited from overseas, were qualified nurses in their own country, which is seen as the equivalent to the National Vocational Qualification in Care at level 3. The manager stated in the AQAA that twelve of the eighteen carers held the National Vocational Qualifications in Care at level 2. Care Homes for Older People Page 24 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The local and organisational management oversight of the home has lacked continuity over the last year. There is a quality assurance programme in place, which has resulted in ongoing improvements in care but has failed to ensure that requirements of previous inspections have been addressed, for the benefit of residents. Evidence: There have been two managers in post since the last inspection. The current manager has been in post since November 2007. She is a registered Nurse and holds the National Vocational Qualifications in Management at level 4. She has not yet registered with the Commission for Social Care Inspection. There is an experienced Care Homes for Older People Page 25 of 31 Head of Care who is also a registered Nurse. Two relatives expressed concerns about the frequent change in manager but said that the home had ‘settled down’ since the last change. The lines of accountability within the organisation are clear, although there have also been a number of changes of operational manager, who oversee the home. The Operations Director who is registered with the Commission for Social Care Inspection as the responsible person has remained the same. The organisation has a quality assurance system in place. Regular resident, family and staff meetings are held. The organisation does not have a systematic approach to seeking residents or their families view at an organisational level. The manager and her deputy regularly audit processes in the home. The audits show an improvement in care planning and medication management. Routine monitoring of adverse outcomes, e.g. falls, pressure damage, weight loss, is also undertaken. The organisation also monitors the quality of care by means of regular visits. These visits are recorded on a structured from, which includes an ‘inspection of the premises’ section. This covers all areas with the exception of the bathrooms, which perhaps should be considered. A dedicated section relating to the recommendations and requirements of previous inspections may also help to focus on whether these have been achieved. The documentation used to record these visits would benefit from review. Two requirements were made following the last inspection. As these requirements had been made previously and had only been partially met an improvement plan was requested from the organisation. This was submitted. One of these requirements has now been met and some progress has been made towards meeting the second, the provision of sufficient bathing facilities, which are adapted for the use of people with disabilities. However this has not yet been met in full. The organisation has not notified us as to why the improvements could not be achieved, within the timescales agreed. The home does not manage residents’ financial affairs. A small amount of personal allowance may be kept at the home. This is banked separately and individual receipts are given and records are kept. There are health and safety policies and procedures in place. The manager said that regular health and safety meetings are not held but that this was to be commenced soon. Health and safety matters may be discussed at staff meetings. The information sent prior to the visit showed that service and maintenance records are up to date. Most staff have had moving and handling training, health and safety, food hygiene, infection control and fire safety training. Fire safety records are kept and were up to date. The staff spoken to were aware of the fire evacuation procedures. Risk assessments for safe working practices have also been undertaken. Records are kept Care Homes for Older People Page 26 of 31 of safety checks of hot water temperatures, particularly baths and showers. Accidents are recorded. Care Homes for Older People Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action 1 22 23(2)j The registered person must 31/10/2007 ensure that bathing facilities meet the needs of people with disabilities. Professional advice must be sought to ensure that the facilities and equipment purchased is suitable. This is an unmet requirement of the previous inspection, which has only been partially complied with. A new timescale has been set. Care Homes for Older People Page 28 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 22 23 The organisation must provide sufficient baths and showers, which are adapted to meet the needs of people with disabilities. In order that people with disabilities may have a choice of bath or shower and thta they may bathe in safety and comfort. 31/10/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 9 9 The manager should continue to monitor the time taken to receive medication, which is prescribed outside of the monthly medication dispensing cycle, to ensure that it is received promptly The activities coordinator should have training in the provision of therapeutic activities for the elderly and for those with cognitive decline. The home should continue to develop the activities, tailoring them to individual’s wishes and involving a wider range of staff to ensure that there are meaningful activities throughout the home on a regular basis 10 12 11 12 Care Homes for Older People Page 29 of 31 12 15 Residents should be involved in developing the menus and should be supported to make their own choices, nearer to the time that they are going to eat. Further advice is available in the Commission for Social Care Inspection for Social Care Inspection guidance ‘Highlight of the day’ available on www.csci.org.uk. The organisation should use the department of Health’s ‘Essential steps’ to assess their infection control practices to ensure that residents are protected from the risk of acquired infection. Further information is available on www.dh.gov.uk. The manager should register with the Commission for Social Care Inspection. The quality assurance programme should include regular review of requirements made at previous inspections to ensure that they are met in full. Regular residents and family surveys should be undertaken and the results published and made available for prospective residents, families and other stakeholders. 13 26 14 15 31 33 16 33 Care Homes for Older People Page 30 of 31 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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