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Inspection on 06/01/06 for Court House Residential Home

Also see our care home review for Court House Residential Home for more information

This inspection was carried out on 6th January 2006.

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

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

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

What the care home does well

The home assesses prospective residents and encourages them to visit the home. Health needs are recognised and health professionals involved appropriately. Improvements have been made in the management of medication. Residents feel that their dignity and privacy is respected. The home is developing the skills of staff in the care of people who are dying. Residents and visitors felt that visiting was flexible and residents also said that they were encouraged to maintain outside contacts and had choice about they managed their own routine in the home. Positive comments were made by the quality of the food and how their individual tastes were met. The home was clean and residents and visitors said this was always the case. The owner and acting manager react promptly to address poor practice and residents and visitors felt that staff were approachable if they had a problem or a worry. An experienced member of staff inducts new staff members and their practice is observed.

What has improved since the last inspection?

Medication practice has improved. Tools are now in place to help monitor residents` nutritional, fluid intake and tissue viability. A portable call bell system is now available to meet the needs of frailer residents. An acting manager is now working at the home and the outcome of satisfaction questionnaires have been made available to residents and relatives. Evidence has been seen to show that the electrical wiring has been tested within the appropriate timescale. Window restrictors that were spot-checked complied with Health and Safety Executive guidance.

What the care home could do better:

On this inspection, there were four requirements made, which includes improving the range of activities to meet the needs of all residents. This is a repeated requirement. The remaining requirements relate to staff recruitment practice, which has not improved and potentially puts residents at risk. This is also a repeated requirement. There is also the need for improved care plans to ensure staff have clear guidance and identified risks are well managed. Finally, the home has been required to submit an application to register a manager with CSCI. These are the five recommendations that have been made. To meet the changing needs of the residents, the home would benefit from buying an appropriate hoist. Staffing levels are still minimal and there is no formal supervision arrangement to develop staff members` skills. Finally, portable electrical equipment needs to be safety tested.

CARE HOMES FOR OLDER PEOPLE Court House Residential Home Court House Station Road Cullompton Devon EX15 1BE Lead Inspector Louise Delacroix Unannounced Inspection 11:50 6 & 10th January 2006 th X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Court House Residential Home DS0000055579.V271091.R01.S.doc Version 5.1 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. Court House Residential Home DS0000055579.V271091.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Court House Residential Home Address Court House Station Road Cullompton Devon EX15 1BE 01884 32510 01884 32510 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 Manjula Odedra Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23), Physical disability over 65 years of age of places (23) Court House Residential Home DS0000055579.V271091.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th July 2005 Brief Description of the Service: Court House is a large detached and extended property with attractive gardens. It was bought by the owner in January 2004.The home has twenty bedrooms, fifteen of which are en-suite and provides personal care for twenty three older people. There is a through lift to the first floor, although the layout of this floor may make it unsuitable for people using a wheelchair or for those who have difficulty with steps. The owner has undertaken to re-decorate, recarpet and refurbish the communal areas of the home, with the involvement of the residents in choosing colours and fabrics. Court House is a short walking distance from the town of Cullompton and has parking space for visitors. Court House Residential Home DS0000055579.V271091.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over two days totalling approximately eight hours. On the first day of the inspection, there were twenty people living at the home but on the second day there were nineteen people living at the home as one person had been taken to hospital as part of a planned admission. The home is registered for twenty-three people. Due to the layout of the building, some areas of the home are unsuitable for people using a wheelchair or who have difficulty using the stairs. During the inspection, three visitors, three members of staff, the acting manager and ten residents contributed to the inspection with their views on the service. As part of the inspection the following records were looked at; fire records, care plans and risk assessments, medication records, staff files, entertainment records, communication book, complaints book and staff rota. A tour of the building took place with five bedrooms spot-checked. Case tracking took place, which means that as part of the inspection four residents were met, their care plans looked at, and their rooms visited. This report should be read in conjunction with the inspection report for 20th July 2005. An additional inspection also took place on 20th October due to the requirements made in July 2005. At this time the home had no registered manager in place and this has been the case since April 2005. An acting manager is currently working at the home. A requirement has been made for an application to be submitted to CSCI to register a manager. What the service does well: The home assesses prospective residents and encourages them to visit the home. Health needs are recognised and health professionals involved appropriately. Improvements have been made in the management of medication. Residents feel that their dignity and privacy is respected. The home is developing the skills of staff in the care of people who are dying. Residents and visitors felt that visiting was flexible and residents also said that they were encouraged to maintain outside contacts and had choice about they managed their own routine in the home. Positive comments were made by the quality of the food and how their individual tastes were met. The home was clean and residents and visitors said this was always the case. The owner and acting manager react promptly to address poor practice and residents and visitors felt that staff were approachable if they had a problem or a worry. An experienced member of staff inducts new staff members and their practice is observed. Court House Residential Home DS0000055579.V271091.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Court House Residential Home DS0000055579.V271091.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Court House Residential Home DS0000055579.V271091.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,5,6 Prospective residents are encouraged to visit and an assessment of support they require ensures that the home can meet their care needs, EVIDENCE: Three pre-admission assessments were looked at on three residents’ files, as part of case tracking, and these covered a broad range of care needs, including skin care, social needs and continence issues. Residents confirmed that either they had visited prior to moving to the home or a relative on their behalf. The home does not provide intermediate care. Court House Residential Home DS0000055579.V271091.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 The information in residents’ care plans does not always promote continuity in the care provided for residents. Residents’ health needs are recognised and health professionals involved appropriately, with residents’ benefiting from improved management of medication. Residents are treated respectfully by caring staff through all stages of care. EVIDENCE: The acting manager is introducing a new care plan format. Care plans were looked at as part of case tracking. Some care plans have been formatted into a new style as the acting manager aims for the information/guidance to be clearer for care staff, but this work is still on going. Two of the four care plans did not contain risk assessments or guidance for patterns of behaviour that were acknowledged by staff and other residents as being regular i.e. using the stairs when unsteady, misuse of alcohol, regular bouts of crying, leaving the building and management of incontinence. Out of the five care plans looked at; four were unsigned. Social interests needs are recorded but not how these will be met. Court House Residential Home DS0000055579.V271091.R01.S.doc Version 5.1 Page 10 There are currently two types of monthly reviews because of the two different care planning systems. Some were task orientated i.e. focussing on skin care rather than providing a holistic overview of how the residents’ overall needs were being met. In the daily notes there was evidence of a multi-disciplinary approach to try and resolve issues for residents by involving health and social care staff. Daily notes show regular contact with local surgeries and the acting manager described the support provided by the local Gps and district nurses, including diabetes services. Written reports provided by the home to CSCI also evidence good links with health professionals. During the first day of inspection, the senior was able to describe what systems they would put in place to monitor the well-being of a frail resident, including food and fluid charts, and pressure area checks. Another member of staff described how a ‘turning’ regime had been implemented to ensure that a resident being cared for in bed had not been at risk of pressure sores. Monthly reviews with clear guidance highlight the focus on skin care and preventative measures. The acting manager explained how she had reviewed the storage of medication and instigated a clearer system. A spot check was carried out and the medicine seen was in date and stored in a clear manner with appropriate signage for the storage of oxygen. Medication administration sheets were appropriately completed, with no gaps, handwritten additions signed by two members of staff and a list of staff initials. The communication book was seen to remind staff of good practice and a member of staff spoke about recent medication training provided by an external chemist. A senior carer explained that they had begun observing staff to check their medication practice. There has been a recent incident where a controlled drug went ‘missing’ and was then returned. The acting manager and owner are currently investigating this and the Police and CSCI were informed promptly. The Police are not taking any action on this occasion. Residents spoke positively about staff, who were described as ‘very good’, ‘cheerful’ and ‘lovely’. Discussion took place with residents about how they were supported with washing and bathing and people said they felt they were treated with respect and their dignity respected. Records showed that a senior observed a new member of staff providing personal care with the focus being on maintaining dignity and respect. A letter from a relative contained the comment, ‘Nothing seems to much trouble’. Where possible the home, with the support of the local district nurses and GPs, tries to offer a home for life for residents. The acting manager explained how staff members are supported with this area of care to build their skills. For example, by being mentored and through writing a reflective diary, which will be used towards a professional qualification. A written report from the home shows how staff respect the wishes of the bereaved family. Staff from the Court House Residential Home DS0000055579.V271091.R01.S.doc Version 5.1 Page 11 home attend residents’ funerals where possible and a letter was seen on file, which praised the care of their dying relative. Court House Residential Home DS0000055579.V271091.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13, 14,15 Limited progress has been made to the home’s activity programme as activities can be intermittent and do not meet the needs of all residents. Visiting is flexible, and the home provides food of a good quality and promotes choice. EVIDENCE: The entertainment/activities offered within the home are beginning to improve, which was confirmed by some of the residents and by records kept by the acting manager of the people who have attended. There are plans for a sensory garden. An activity programme on display stated that activities take place five days a week. However, this does not happen. Since the last additional inspection in October 2005, there has been seven gentle exercise groups, one craft session, three quizzes, three living history discussions and one word game, which have all been run by staff. Over Christmas, there was a cabaret, a well-attended Christmas meal, which family and friends were invited to and a carol concert. There is a regular Holy Communion held at the home for those that wish to attend. However, activities are not provided on a daily basis and some residents commented that time dragged with little to do, apart from thinking about their memories or snoozing. Court House Residential Home DS0000055579.V271091.R01.S.doc Version 5.1 Page 13 The perception of some of the residents of the entertainment offered is that there is ‘not a lot’ to do and other people spoke of being isolated, particularly those with a hearing difficulty, who find group activities difficult to participate in. One person said, ‘You have made my day by sitting and talking to me’. However, those activities they did remember or attended, they spoke positively about, such as a singer who has visited the home three times since the last inspection. Residents said that sometimes activities are cancelled, which staff confirmed, due to the increased care needs of residents who are unwell. To address this problem, a local advert has been placed for an activities co-ordinator for ten hours a week. The visitors’ book, daily records, staff communication book and a number of residents spoken to confirmed that many family and friends visit the home, and that they could see them privately. During the inspection, three people visited relatives and said they chose what time they visited and this was also confirmed from the results of the quality assurance survey, which showed that residents felt encouraged to maintain outside contacts. Residents’ room evidence that they are able to bring in personal possessions when they move to the home and during conversations with residents they gave examples of making choices over their lives, which were confirmed by care records. For example, where they ate their meals, whether they have a portable call bell or whether they chose to attend the activities arranged. These views were echoed in the home’s quality assurance survey. Comments by the residents about the quality of the food during this inspection were positive, such as ‘excellent’ and ‘good’. One resident confirmed that their specialist dietary needs were met and the acting manager gave an example about how a gentle approach had been used to encourage a resident with improving their diet. Court House Residential Home DS0000055579.V271091.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Complaints are responded to promptly with satisfactory outcomes. Residents are protected by staff who know their duty to report poor practice. EVIDENCE: Information about making a complaint has been updated, and residents spoke positively about how they felt they could approach care staff with any problems or concerns. A visitor confirmed that problems had been addressed and with a good outcome. The complaints book was looked at and a complaint made by a resident had been addressed promptly by the acting manager and owner, which resulted in a new member of staff being dismissed. The resident said that they were satisfied with the outcome. The CSCI were informed of the event at the time. Two members of staff were able to give examples of poor practice and whom they would report this to. One person needed some prompting regarding reporting concerns to external agencies and the acting manager said they would discuss this further with them. On previous occasions, care staff at the home have alerted management to poor practice by newly recruited staff and appropriate action has been taken. Action has been taken by the owner and management to address poor practice, which has meant several staff dismissals in the last year. Court House Residential Home DS0000055579.V271091.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22,23,26 Major investment has been made to the home with resulting improvements to the social areas providing a comfortable and safe environment for the residents. Portable call bells have improved the safety of frailer residents, although the purchase of a hoist would further maximise the independence of residents. EVIDENCE: On previous inspections, the owner has said that longer-term plans include upgrading the decoration in the communal bathrooms, re-fitting the kitchen, and replacing some windows at the front of the building. One communal bathroom has recently been re-painted. Improvements to the home have included better access to the lift, new lighting, armchairs, dining room chairs, a new call bell system, lockable storage cupboards, paper towel dispensers and investment in the garden. Residents’ needs can generally be met in their environment. There are grab rails and raised toilet seats as appropriate. There is a fixed Arjo chair in the Court House Residential Home DS0000055579.V271091.R01.S.doc Version 5.1 Page 16 downstairs bathroom and two portable electric seats. Due to the different floor levels, parts of the first floor would not be suitable for residents who use a wheelchair or have difficulty in managing stairs. One resident’s health needs have recently deteriorated and was assessed as needing a hoist to help with transfers. The home does not currently have a hoist but the owner and acting manager responded quickly and have begun making enquiries to buy one. Since the last inspection, the owner has installed a portable call bell system to meet the needs of frailer or sensory impaired residents. A resident was positive about this as it made them feel safer. This inspection was unannounced, and as on previous visits the home was clean and odour free. Residents and a visitor confirmed this to always be the case, and this view was repeated in the home’s quality assurance survey. The provider has invested in a washing machine with a sluicing facility. Hand washing facilities are available in the laundry area. Liquid soap, gloves and paper towels were seen in residents’ rooms to help prevent cross infection. Court House Residential Home DS0000055579.V271091.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,29,30 Staffing levels operate at a minimal level, which do not increase when residents’ needs increase resulting in not all residents’ social care needs being met. Staff recruitment practices continue to be poor with the required checks not taking place at the appropriate times, which has the potential to place residents at risk of harm or abuse. However, the induction system at the home does promote good practice. EVIDENCE: On the first day of the inspection, there was a senior and two care staff on duty at lunchtime and in the afternoon. There was also the cook and one of a team of two domestics. The rota showed that from 6pm there were two staff members on duty, with waking night staff from 10pm with sleep in cover. The senior confirmed that the sleep in cover was woken if necessary. This was particularly relevant, as one of the residents had increased care needs. The residential forum recommends that for up to twenty residents with the category of older people that there should be four care staff in the morning, three in the afternoon and three in the evening. The duty rota did not show that extra staff had been rostered, despite one resident having a higher dependency on care staff and needing an escort to hospital. On the second day of inspection, the acting manager and two care staff were on duty in the afternoon. Residents’ perception was that their care had not been directly affected, although some felt the staff were always busy Court House Residential Home DS0000055579.V271091.R01.S.doc Version 5.1 Page 18 and therefore had less time to stop and chat with them, and pressure of work resulting in activities being cancelled. During the two day inspection, staff expressed concern that increased staffing was needed in the mornings to assist residents with washing and dressing. Two staff files were checked as on the last additional evening inspection staff files were not available to check. On the previous inspection, in July 2005 a requirement was made, as staff files did not contain the required information. On this occasion, one staff member had started work prior to POVA clearance and before a Criminal Records Bureau (CRB) check had been received. There was only one reference instead of the required two. Issues of possible concern had not been followed up and no record had been made of discussion regarding these issues. Two forms of ID and a photo were on file. The second person also started work prior to POVA clearance and before a Criminal Records Bureau (CRB) check had been received. Two written references, two forms of ID and a photo were on file. Induction records were not available for two members of staff on the day of inspection but have been provided since. Staff files showed monitoring of care practices as part of new staff members induction, which are signed off by an experienced member of staff. This is good practice. The acting manager is in the process of gathering of staff training needs as she is aware that up dates are due for first aid, food hygiene, and moving and handling. Court House Residential Home DS0000055579.V271091.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,36,38 The residents have not benefited from having a registered manager in post to over see the development of the service. However, quality assurance surveys within the home enable residents to make their views known about the running of the home. Generally, safety checks are up to date, and there has been improvement in fire training. EVIDENCE: The home has been operating without a manager registered with the CSCI since April 2005. Part of the registration process includes a Fit Person Interview, and a self-assessment form to enable judgements to be made on the applicant’s knowledge and experience. The acting manager has been in post since October 2005. Court House Residential Home DS0000055579.V271091.R01.S.doc Version 5.1 Page 20 Quality assurance questionnaires have now been collated and the responses fed back in a friendly letter to residents and relatives. Staff do not currently have formal supervision sessions. They explained that if they have concerns they would normally go to senior staff. The home is appropriately insured. The electrical wiring has been checked and is due for re-checking in 2007. Portable electrical appliances have not been checked recently, lists date back to 2004. A window restrictor was checked and was the appropriate width. All the staff on duty during the inspection received external fire training within the last six months, apart from one member of staff who been advised of the fire procedure during their induction. The staff member and induction records confirmed this. Fire records were up to date. The acting manager provide prompt, informative regulation 37 reports to advise the CSCI of any deaths or incidents at the home. Court House Residential Home DS0000055579.V271091.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x 2 x x x 3 STAFFING Standard No Score 27 2 28 x 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 x 3 x x 2 x 2 Court House Residential Home DS0000055579.V271091.R01.S.doc Version 5.1 Page 22 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 OP7 Regulation 15 (1) Requirement Timescale for action 30/03/06 2. OP12 16 (2) The registered person shall prepare a written plan as to how the service user’s needs in respect of his health and welfare are to be met. (Care plans must contain clear guidance about recognised needs of residents to provide continuity in care. Care plans must contain risk assessments that provide guidance to staff to address recognised risks i.e. frail residents leaving the building.) The registered person shall 30/03/06 consult service users about the programme of activities arranged by or on behalf of the care home. (Provide a regular programme of activities to meet the needs of all residents, including those people with a sensory impairment). The registered person shall not employ a person to work at the care home unless he/she has obtained in respect of that person the information and documents specified in paragraphs 1-9 of Schedule 2. DS0000055579.V271091.R01.S.doc 3. OP29 19 Schedule 2 28/02/06 Court House Residential Home Version 5.1 Page 23 (Staff files must contain all the required checks and information i.e. two written references. Staff must not commence work until a clear POVA has been received by the home). 4. OP31 8 (1) (b) (i) An application to register a manager must be submitted to the CSCI. 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations Care plans should be signed by the resident or if necessary their representative. Monthly reviews should also cover mental health needs and social needs of residents. The owner should buy an appropriate hoist to meet the needs of physically frail residents and provide suitable training to staff to ensure safe moving and handling techniques for staff and residents. It is acknowledged that the home had responded quickly and is already gathering information for this purchase. It is strongly recommended that care staff numbers are reviewed and increased, particularly when residents are ill. Staff should receive formal supervision at least six times a year. All portable electrical appliances should be tested to confirm they are safe to use. 2. OP22 3. 4. 5. OP27 OP36 OP38 Court House Residential Home DS0000055579.V271091.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Court House Residential Home DS0000055579.V271091.R01.S.doc Version 5.1 Page 25 - 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. 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