Inspection on 17/12/07 for Clarondene Residential Care Home

This inspection was carried out on 17th December 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Clarondene Residential Care Home 18/06/09

Clarondene Residential Care Home 17/04/09

Clarondene Residential Care Home 21/04/08

Clarondene Residential Care Home 04/07/07

Clarondene Residential Care Home 14/02/07

Clarondene Residential Care Home 04/07/06

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 Clarondene Residential Care Home View Road Lyme Regis Dorset DT7 3AA Lead Inspector John Hurley Key Unannounced Inspection 17th December 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Clarondene Residential Care Home DS0000065695.V358329.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. Clarondene Residential Care Home DS0000065695.V358329.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Clarondene Residential Care Home Address View Road Lyme Regis Dorset DT7 3AA 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) 01297 442876 01297 442025 alia@alcurtis.fsnet.co.uk Ms Mary Alison Curtis Care Home 12 Category(ies) of Old age, not falling within any other category registration, with number (12) of places Clarondene Residential Care Home DS0000065695.V358329.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th July 2007 Brief Description of the Service: Clarondene residential care home is registered to provide care and accommodation for a maximum of 12 residents. At the time of the inspection there were only seven individuals in residence. The home has been registered to Ms Alison Curtis, the proprietor, since January 2006 and she takes an active role in the management of the home. The home has not had a registered manager since April 2006 but employes a designated home manager. The home is situated in a quiet residential area of Lyme Regis. There is a steep walk to the town centre, which offers all the amenities of a small historic coastal town. A small parking area is available at the front of the home and a large town car park is situated nearby. The front door to the home is located at the side of the house and is accessed by a steep flight of steps. There is also a raised driveway to the home’s back entrance/kitchen door, which has an uneven surface but the proprietor said that improvements are planned for the near future. The proprietor’s private accommodation is located on the first floor close to private rooms used by their elderly mother. Neither the Proprietor nor their mother have a kitchen and so they share the home’s registered kitchen and basically eat what the people who use the service eat. The home has an assisted bathroom and a separate assisted shower room, which has recently been upgraded to a high standard. There is a small, enclosed and levelled front garden with flower borders and lawn at the side of the home near to the front entrance: this is easily accessed through patio doors from the lounge area. Garden furniture is available outside for residents to sit, relax and enjoy the warmer weather and potted plants provide an attractive display. Additionally, there is a back garden but residents rarely use this as it can only be accessed by a series of steep steps. The fees for the home range from £350 to £450 per week. Additional charges Clarondene Residential Care Home DS0000065695.V358329.R01.S.doc Version 5.2 Page 5 include hairdressing, chiropody and newspapers. See the following website for further guidance on fees and contracts. http:/www.csci.org.uk/about_csci/press_releases/better_advice_for_people_c hoos.aspx Clarondene Residential Care Home DS0000065695.V358329.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This was the fourth unannounced inspection of Clarondene care home for the inspection year 2007/8 and the second key inspection. The inspection process followed the Commission for Social Care Inspection Inspecting for Better Lives methodology. The inspector was joined on this inspection by an “expert by experience”. The expert by experience is a lay person who is employed through Help the Aged to give a further view into the residents home life. Their role at this inspection was to talk with residents and their families about their experiences of living in the home. Where appropriate their comments are included in this report. The inspector had a very brief tour of the building, spoke with the management and staff on duty. The expert by experience spoke privately with people who use the service on an individual basis. The inspector sampled some of the documentation relating to the individuals who reside at the home along with records of staff and other documents required by regulation. This report should be read in conjunction with the other key inspection report carried out on the 4 of July 2007 as not all of the standards were covered at this inspection. What the service does well: What has improved since the last inspection? Clarondene Residential Care Home DS0000065695.V358329.R01.S.doc Version 5.2 Page 7 The proprietor has met a number of the requirements made at the last inspection but not all. The proprietor has began to address the shortfalls in the care planning process used within the home but specific issues undermine the integrity of the plans and the reviewing process. Sufficient progress has been made regarding nutritional assessments and pressure ulcer issues to remove the previous requirement. The floor covering in the bathroom has been replaced. Some environmental risks have been reassessed but not all . It was noted that the office has been tided up and no longer poses a fire risk. The COSHH register has now been brought up to date and substances hazardous to health are appropriately stored. What they could do better: The responsible individual (proprietor) must ensure that; • All manual handling assessments are reviewed and any action that is required to ensure the safety of the people who use the service and staff are recorded and acted upon. There is a recorded rationale and practice guidelines for the administration of medication via the per required needs route. They can evidence that all staff that administer medication have been adequately trained. Comprehensive risk assessments are carried out for those residents that self medicate. Suitable lockable storage is made available to those who self medicate. All people who use the service have a detailed care plan which is reviewed on a monthly basis. Approaches in dealing with challenging behavior are age appropriate and recognize the depth and scope of the reasons for the behaviour, setting out a clear and consistent approach to this issues • • • • • • Clarondene Residential Care Home DS0000065695.V358329.R01.S.doc Version 5.2 Page 8 • All environmental risks are assessed and the identified action to minimize the risk is recorded and acted upon to minimize the risk of harm to people who use the service and staff All new staff receive the statutory training The services vulnerable adults policy is updated to reflect the local authorities policies. All staff must receive formal supervision on a regular basis. They must ensure that the office is kept in such a way that is does not undermine any fire risk assessments. • • • • The proprietor has been informed that they must ensure that a manager is appointed and an application made for the manager to be approved by the Commission for Social Care Inspection by no later than 31st March 2008. Any further non-compliance may result in enforcement action. 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. Clarondene Residential Care Home DS0000065695.V358329.R01.S.doc Version 5.2 Page 9 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 Clarondene Residential Care Home DS0000065695.V358329.R01.S.doc Version 5.2 Page 10 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): 3,6 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The service gives sufficient information with regards to what it can offer to prospective residents enabling them to make an informed choice. The pre admission assessments are not robust and may put people at risk. Intermediate care is not offered at Clarondene EVIDENCE: The statement of purpose has been updated to reflect the current managerial arrangements at the home. The individuals documentation that was sampled contained an assessment that had been undertaken before the home confirmed by letter that they were able to meet the individual needs. This assessment included the individual’s personal details and basic information relating to their care needs. A basic Clarondene Residential Care Home DS0000065695.V358329.R01.S.doc Version 5.2 Page 11 contract was also seen. Copies of these details were seen on the individual’s documentation. The information contained in the pre-assessment documentation lacked detail and did not contain evidence that the prospective resident had been involved. For one prospective resident there were clear concerns over the individuals mental health needs. These were not explored prior to offering a short term place. Through discussion with the designated homes manager and staff the inspector established that intermediate care is not a feature of this service. Clarondene Residential Care Home DS0000065695.V358329.R01.S.doc Version 5.2 Page 12 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): 7,9,10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Not all care records provide sufficient detail to ensure that the resident’s health and personal needs are being fully and safely met. The home has systems in place for managing residents’ medicines but aspects continue to require improving to protect residents. Staff treat residents with respect and dignity, promoting residents’ feelings of worth. EVIDENCE: The expert by experience established that the resident’s consider that the staff are kind and caring. Staff spoken with were able to inform the inspector of peoples needs. The care plans did not evidence these needs. The feedback from people important to the service users confirmed that they felt that in general terms needs were being met. Clarondene Residential Care Home DS0000065695.V358329.R01.S.doc Version 5.2 Page 13 The inspector sampled the individuals documentation and found that care plans are still not maintained in a useful way. Whilst some care plans now contain a large amount of detail with regards to individuals’ needs, daily routines, preferences and health care needs they still fails to inform staff what should be done to meet the needs. For a recent admission no care plan existed. The inspector noted that those residents who require nutritional and pressure ulcer assessments have been made. A visiting district nurse informed the inspector that they considered that the staff at the home deal well with these issues. Through sampling the resident’s documentation the inspector noted that not all care plans are reviewed. The inspector observed one member of staff carry out the task of reviewing a care plan under the direction of the designated home manager. At no point did they consider consulting the resident until the inspector suggested that this should be the first action to take. For one resident the home is working with other professionals to address a complex problem. Whilst the manager can discuss what is happening to address the issue there is little evidence in the care plan to acknowledge this issue and to demonstrate what needs to happen in the future. The requirement made at preceding inspections continues to be unmet. The hand over sheets used by staff continue to evidence that doctors, district nurses and other health care professionals visit the home to address any health care needs. Pressure-relieving equipment was seen to be available for one individual but the reasons why were not apparent in their documentation. Medication is supplied by a local pharmacy and dispensed using a NOMAD system. A list of staff who administer medication is available and a sample of their signatures was seen at the beginning of the medication recording sheets. The previous requirement to ensure all staff are suitably trained to carry out medication administration has yet to be fulfilled. It was noted that a recent resident was self-medicating. There was no associated risk assessment relating to this and the home had failed to provide self-storage for the medication. At previous inspections the inspector has discussed at length the need to ensure there is a recorded rationale for the administration of medication via the PRN route. Whilst it is acknowledged that efforts have been made to address this issue whilst sampling one resident’s medication records it was noted that they required Lorazapan on a PRN basis. There was no recorded evidence of the rationale for administering the medication. Clarondene Residential Care Home DS0000065695.V358329.R01.S.doc Version 5.2 Page 14 People who use the service informed the expert by experience that they are able to meet privately with visitors in their bedroom. Interaction between staff and people who use the service was friendly and respectful. Through discussion with the residents the inspector established that the care staff respected their privacy and dignity and that they were not made to do anything they did not wish to, such as attending activities or having meals in the dining room. They further confirmed that all personal care was provided in the privacy of their bedrooms or bathrooms. Again it would be helpful if all care plans and associated documents supported these representations. Clarondene Residential Care Home DS0000065695.V358329.R01.S.doc Version 5.2 Page 15 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): 12,13,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides activities based on individuals wishes. The flexibility of the home enables people to maintain contact with their family and friends. It would be helpful if people who use the service are made aware of what is planned for meals in advance. EVIDENCE: People who use the service continue to receive visitors whenever they wish. A record is maintained of all visitors to the home. The home encourages friends and relatives to keep in contact. Visitors spoken with confirmed that they were always made welcome by the staff and that the manager kept them informed of the resident well-being if appropriate. They confirmed that they could spend their time as they want to and that they are given choices. Clarondene Residential Care Home DS0000065695.V358329.R01.S.doc Version 5.2 Page 16 There are planned activities, which provide some stimulation to the resident group. These range from singing and bingo, gentle exercise, ball type games and outings. Several people told the expert by experience that they knew what activities were taking place, some they liked others they did not. There is now some recorded evidence to demonstrate that the activities are based on the persons past or emerging interests or social needs. One resident spoken with informed the expert by experience that although they do not often leave their room (by choice) staff come to them and play cards or dominos. Those people who require support during meal times were assisted in a dignified manner. Through discussion with the residents it was further established that the food is good, home cooked and plentiful. The dining room table was laid with a tablecloth. No menu is displayed, food being cooked fresh each day. Although there is a record of what people have had for their lunch in the kitchen diary, people who use the service were not aware of what it would be in advance. Clarondene Residential Care Home DS0000065695.V358329.R01.S.doc Version 5.2 Page 17 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): 18 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. More needs to be done to ensure that staff are knowledgeable with regards to vulnerable adult procedures in order to ensure the safety of those who reside at the home. EVIDENCE: The registered manager informed the inspector that all staff have completed a distance learning course on the Protection of Vulnerable Adults. The registered manager acknowledged that the completed knowledge papers had yet to be sent to the course provider for verification. It therefore remains that the existing requirement to have all staff trained with regards to vulnerable adult procedures has yet to be met. Clarondene Residential Care Home DS0000065695.V358329.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): 19,25,26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has been decorated and furnished to a good standard. There are sufficient communal areas and bathroom facilities to meet service users needs. Service users rooms are personalised to reflect their individual tastes. There continues to be areas within the home where the safety of residents cannot be assured and require robust risk assessments. EVIDENCE: The home is adequately decorated and furnished to provide a homely, comfortable environment. People spoken with agreed that it was a very homely, friendly place to live. Clarondene Residential Care Home DS0000065695.V358329.R01.S.doc Version 5.2 Page 19 The home has nine single bedrooms and one double bedroom situated on the ground floor. It was evident that residents continue to be encouraged to personalise their rooms with items of furniture, pictures and possessions from their former homes. Two bedrooms have en-suite WC’s and the remaining rooms are fitted with vanity units and washbasins. The inspector noted that in the hot water is regulated by the means of individual thermostatic regulators. The ground floor dining room/ lounge is accessed from the bedrooms by negotiating two steps. The inspector noted that the staff were using the internal ramps to aid residents mobility around the home. This is an improvement on man-handling residents up the internal steps. However, it was noted that one resident who required a walking aid rather than a wheelchair was still expected to negotiate the steps with the support of the staff. It would be better practice if the ramp was used as the person concerned did not have a valid risk assessment relating to the steps. When the inspector first entered the home it was noted that there were two soiled incontinence aids in the corridor. Although these were in a bag they should have been disposed of without delay so as to ensure robust infection control policies and maintain the dignity of those who reside at the service. Clarondene Residential Care Home DS0000065695.V358329.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): 27,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Short falls in staff training means that people who use the service cannot be assured that they are in safe hands at all times. EVIDENCE: Discussion with the proprietor, designated manager, staff and residents reassured the inspector that there are sufficient staff on duty to meet the needs and dependency levels of those who reside at the home. There are however care staff vacancies which need to be filled. During the night time period there is one wakeful and one sleeping member of staff on duty. This will need to be reviewed if the dependency levels change. A housekeeper has been employed to undertake the laundry, general cleaning and the provision of the morning coffee/tea. Training is provided to staff using a distance-learning programme. The staff work through the learning material, complete a questionnaire and then send the papers away to be marked. Whilst the staff are using distance learning materials to further their knowledge of the caring sector, at the time of the inspection the knowledge papers that have been completed by the staff had yet to be sent to the provider of the package, Red Crier, for verification. Clarondene Residential Care Home DS0000065695.V358329.R01.S.doc Version 5.2 Page 21 It is however noted that from the observations of both the inspector, expert by experience and representation made by residents and people important to them it is clear that the staff work hard to ensure the needs are met in an empathetic manner. Further training would help develop the skills of the staff team to further enhance this empathy. The inspector looked at the staff records and noted that the gaps in the employment process had been addressed albeit retrospectively. Clarondene Residential Care Home DS0000065695.V358329.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): 31,32,36,38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The lack of a registered manager has impacted on the progress that is required to ensure the National Minimum Standards are established and maintained. Not all of the previous requirements have been met within the time scales agreed thus putting service users at risk of harm. EVIDENCE: The registered provider produced an action plan which detailed the actions that would be taken to address the shortfalls acknowledged following inspection visits. The timescales for the completion of these requirements were agreed in partnership with the Commission for Social Care Inspection. The Clarondene Residential Care Home DS0000065695.V358329.R01.S.doc Version 5.2 Page 23 aforementioned plan has not been adhered to and very little has been achieved. The proprietor had hoped to take over the management of their home once they had completed the National Vocational Qualification level four in care management. Whilst they have enrolled on the course little progress has been made in completing any of the modules. The staff group have had some supervision but this remains ad hoc and no clear plan has been implemented to demonstrate that the staff will have formal recorded supervision in the future. As mentioned earlier in the environment section, during the inspection a number of residents were observed requiring assistance with their mobility. Whilst there have been improvements in the manual handling assessment some risk assessments still relate to moving an object and not a person. The office is situated on the first floor and is also used for staff that occasionally provides ‘sleep in’ cover. The office has now been tidied up and no longer poses a risk in relation to fire. The Dorset Fire and Rescue Service have provided the home with a written report of a recent visit that stated they were pleased with the standard of fire safety making some recommendations to improve further. The communal bathrooms no longer have unlocked cupboards and the Control of Substances Hazardous to Health (COSHH) has improved. The COSHH register was briefly sampled and found to reflect the observable substances on the premises. Clarondene Residential Care Home DS0000065695.V358329.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 3 x 1 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 x 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 x 17 x 18 1 3 x x x x x 2 3 STAFFING Standard No Score 27 3 28 x 29 x 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 1 x x x 2 x 2 Clarondene Residential Care Home DS0000065695.V358329.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13 (2) Timescale for action The Registered Person shall make 25/02/08 arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received in the care home including: 1. Must ensure that staff that administers medication have been suitable trained and hold the appropriate certificates relating to there competence Previous timescale of 30/06/07 & 12/11/07 not met. The Registered Person shall make 31/01/08 arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received in the care home including: 2. Must ensure that staff that administers medication have been suitable trained and hold the appropriate certificates relating to there competence Previous timescale of 30/06/07 & Clarondene Residential Care Home DS0000065695.V358329.R01.S.doc Version 5.2 Page 26 Requirement 2. OP9 13 (2) 12/11/07 not met. 3. Recording the rationale for administering Per required needs’ administration of medication. Previous timescale of 30/06/07 & 12/11/07 not fully and consistently met. 4. Comprehensive risk assessments are carried out for those residents that self medicate. 5. Suitable lockable storage is made available to those who self medicate. This requirement was not met the time scale for action was the 12/10/07 & the 12/11/07 3. OP7 15(1)(2) The registered person must 31/01/08 ensure that the residents care records include an action plan with sufficient detail to provide clear guidance to staff on the actions to be taken to meet all their identified needs. The resident or their representative must be consulted when preparing the care plan and sign the plan to evidence they agree with actions taken on their behalf. Previous timescale of 12/10/07 & 12/11/07 has not been met. 4. OP18 13(6) The registered person must be able to evidence that all staff are trained in the Protection of Vulnerable Adults. 25/02/08 Clarondene Residential Care Home DS0000065695.V358329.R01.S.doc Version 5.2 Page 27 Previous timescale of 1/7/06 and 30/06/07 has not been met. This requirement was still not met the timescale for action was 10/08/07 & the 12/11/07 5. OP19 13(4)(a) (b)(c) The registered person must ensure that the steps that need to be negotiated to access the communal areas from the bedrooms are risk assessed . (As action has been taken to address this issue the requirement has been reworded in recognition of the improvements made to the care practices observed ie the use of the ramps). The registered person must ensure that the persons working at the home receive training appropriate to the work they are to perform including structured induction training and the specialist needs of the residents. Previous timescale of 30/06/07 and 12/11/07 has not been met. The registered person must establish and maintain a system for evaluating the quality of the services provided at the care home. Whilst there have been some improvements the previous timescale of 30/06/07 and 12/11/07 have not been fully met. 8. OP36 18(2) The registered person must ensure that staff receive regular formal supervision. Whilst there have been some improvements the previous Clarondene Residential Care Home DS0000065695.V358329.R01.S.doc Version 5.2 Page 28 31/01/08 6. OP30 18(c)(1) 25/02/08 7. OP33 24 31/01/08 31/01/08 timescale of 30/06/07 and 12/11/07 have not been fully met. 9. OP38 13(4)(5) The registered person must: make suitable arrangements for the training of staff in first aid; ensure - a person trained in first aid is working in the home at all times. - make suitable arrangements to provide a safe system for moving and handling residents including assessment, the development of an action plan and staff training that is certified by an assessor who themselves are certified to carryout the training Whilst there have been some improvements the previous timescale of 30/06/07 and 12/11/07 have not been fully met. 10. OP7 14 (2)(a)(b) The responsible individual must 31/01/08 ensure that all care plans are kept under review to ensure that people who use the service needs are recorded and being met. The previous time scale of 12/11/07 has not been met. 25/02/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000065695.V358329.R01.S.doc Version 5.2 Page 29 Clarondene Residential Care Home 1. Standard OP9 The home should follow guidance from the Royal Pharmaceutical Society including: a) When medicines are handwritten on the MAR chart a second competent person should check the details are accurate and countersign. 3. OP30 The registered person must be able to evidence the training that has been supplied to staff influences their practice. Clarondene Residential Care Home DS0000065695.V358329.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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. 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