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Inspection on 01/11/05 for Crawshaw Hall Nursing Home

Also see our care home review for Crawshaw Hall Nursing Home for more information

This inspection was carried out on 1st November 2005.

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

During the inspection members of staff were observed attending to residents in a kind and caring manner. Discussions with members of staff confirmed that promoting privacy and dignity for residents was an important part of care. Resident`s comments included, "The staff are nice they don`t neglect you" and " the staff are champion, absolutely great". The meals were wholesome and a choice of menu was offered. One resident said, "The chef is good and feeds us well." Another resident said, "This is a nice place the food is really good." Visitors were welcomed into the home at anytime.

What has improved since the last inspection?

Risk assessments relating to pressure sores clearly identify the level of risk. This will help staff to give the care necessary to prevent the formation of pressure sores. After advice from the fire authority locks have been fitted to the doors at the top and bottom of the steep flight of stairs on the ground floor. These stairs would not be used to evacuate residents in the event of a fire. They were also dangerous if residents tried to climb them without assistance. To further promote the safety of residents a fire risk assessment has been carried out. A risk assessment has also been completed in order to prioritise the fitting of guards to radiators. Members of staff have recently been updated in the correct methods for moving and handling residents.

What the care home could do better:

To further improve the admission procedure prospective residents must be informed in writing if their needs can be met at the home. When a risk has been identified e.g. of developing pressure sores, information about the measures needed to reduce the risk must be written in the care plan. Care plans must be reviewed monthly and up dated when the needs ofCrawshaw Hall Nursing Home DS0000022508.V255361.R01.S.doc Version 5.0 Page 6the resident change. This will ensure that the care needs of all residents are fully met. To prevent errors in the administration of medication the dose of a drug written on the medicines administration record must be the same as the dose written on the packet. If prescribed medication is omitted the reason for this must be recorded on the medicines administration record. All hand written instructions on the medicines administrations records should be signed and witnessed. A written protocol should be in place explaining when medication prescribed `when required` should be given. The services of a licensed waste carrier must be obtained to ensure that unused medication is disposed of legally and safely. Thorough recruitment procedures help to protect residents from abuse. A CRB check must be obtained for all employees before they start working at the home. The system for monitoring and improving the quality of care and services provided at the home must be further developed. This includes obtaining the views of residents and their relatives and compiling an annual development plan. To promote the health and safety of residents all members of staff must receive training in fire prevention. Only approved, safe methods for the moving and handling of residents must be used.

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Crawshaw Hall Nursing Home Burnley Road Crawshaw Booth Rossendale BB4 8LZ Lead Inspector Mrs Susan Hargreaves Unannounced Inspection 1st November 2005 10:15 X10029.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 Crawshaw Hall Nursing Home DS0000022508.V255361.R01.S.doc Version 5.0 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 and Care Homes for Adults 18 – 65*. 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. Crawshaw Hall Nursing Home DS0000022508.V255361.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Crawshaw Hall Nursing Home Address Burnley Road Crawshaw Booth Rossendale BB4 8LZ 01706 228694 01706 215670 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 Eileen Karoo Mr Jainarain Buluck Care Home 23 Category(ies) of Dementia (6), Dementia - over 65 years of age registration, with number (23), Mental disorder, excluding learning of places disability or dementia (6), Mental Disorder, excluding learning disability or dementia - over 65 years of age (23) Crawshaw Hall Nursing Home DS0000022508.V255361.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered provider shall, at all times, employ a suitably qualified and experienced person who is registered with the National Care Standards Commission as manager of Crawshaw Hall Nursing Home. Under Annex 2, a max of 6 service users aged 50 years and above requiring nursing care who fall into the category of MD or DE Staffing will be accordance with the Notice issued dated 7 August 2001 2. 3. Date of last inspection 31st May 2005 Brief Description of the Service: Crawshaw Hall Nursing Home provides 24 hour care for people who suffer from a mental disorder or dementia. Although the majority of people are over 65 years the home can admit up to 6 people who are under the age of 65 years old. The home is a large detached grade 2 listed building with extensive grounds. There is a secure garden area, which is easily accessible to residents when the weather permits. A parking area for use by visitors and staff is available at the front of the building. The home is situated on the outskirts of the village of Crawshawbooth and near to the local amenities provided in the village. Rawtenstall is approximately 2 miles away. Accommodation is provided in single and twin-bedded rooms. There are no ensuite rooms but bathroom and toilet facilities are easily accessible. Communal lounge and dining room are located on the ground floor. All the rooms are spacious and airy and there are many unique decorative features in keeping with the age of the building. Crawshaw Hall Nursing Home DS0000022508.V255361.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 6 hours. One additional visit was made on 1 July 2005 to monitor compliance with the requirements issued at the last unannounced inspection. At the time of this inspection 13 residents were living at the home. A tour of the premises took place and staff files and care records were inspected. Members of staff on duty and residents were spoken to. Discussions also took place with the manager regarding issues raised during the inspection. What the service does well: What has improved since the last inspection? What they could do better: To further improve the admission procedure prospective residents must be informed in writing if their needs can be met at the home. When a risk has been identified e.g. of developing pressure sores, information about the measures needed to reduce the risk must be written in the care plan. Care plans must be reviewed monthly and up dated when the needs of Crawshaw Hall Nursing Home DS0000022508.V255361.R01.S.doc Version 5.0 Page 6 the resident change. This will ensure that the care needs of all residents are fully met. To prevent errors in the administration of medication the dose of a drug written on the medicines administration record must be the same as the dose written on the packet. If prescribed medication is omitted the reason for this must be recorded on the medicines administration record. All hand written instructions on the medicines administrations records should be signed and witnessed. A written protocol should be in place explaining when medication prescribed ‘when required’ should be given. The services of a licensed waste carrier must be obtained to ensure that unused medication is disposed of legally and safely. Thorough recruitment procedures help to protect residents from abuse. A CRB check must be obtained for all employees before they start working at the home. The system for monitoring and improving the quality of care and services provided at the home must be further developed. This includes obtaining the views of residents and their relatives and compiling an annual development plan. To promote the health and safety of residents all members of staff must receive training in fire prevention. Only approved, safe methods for the moving and handling of residents must be used. 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. Crawshaw Hall Nursing Home DS0000022508.V255361.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Crawshaw Hall Nursing Home DS0000022508.V255361.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) 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 (Older People) 2 (Adults 18-65) Admission procedures were thorough. A pre-admission assessment was completed for each resident prior to admission. EVIDENCE: Individual records of two residents were inspected. Each contained a preadmission assessment of need. A senior member of staff visited prospective residents in hospital or their own home prior to admission. The manager was advised to confirm in writing to prospective residents that their care needs could be met at the home. The assessment of need provided useful information for the care plan. Crawshaw Hall Nursing Home DS0000022508.V255361.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are 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 and 9 (Older People) 6, 19 and 20 (Adults 18-65) Some care plans did not address all aspects of healthcare. This meant that there was the potential for some care needs not to be fully met. A safe system for disposing of unused medication was not in place. EVIDENCE: The individual care plans of two residents were inspected. These plans identified the personal care needs of each resident and explained how these needs were met. Appropriate risk assessments had been carried out. However, where a risk, e.g. of developing pressure sores had been identified, a care plan giving information about the action being taken to address the risk Crawshaw Hall Nursing Home DS0000022508.V255361.R01.S.doc Version 5.0 Page 10 was not in place. Although care plans were reviewed this was not done monthly. One of the care plans had not been up dated when the needs of the resident had changed. A care plan had not been written for an acute care need. A written report about the care given to individual residents was completed during each shift. Residents were registered with a GP and had access to other healthcare professionals. Members of staff were observed attending to residents in a friendly and professional manner. At the time of the inspection none of the residents were self-medicating. Registered nurses were responsible for administering all medication. Records relating to the management of medication did not provide a reason why medication prescribed for one resident had been omitted on several occasions. The dose a drug written on the medicines administration differed from the dose written on the packet. Hand written instructions on the medicines administration records were not signed and witnessed. Written instructions should be available for individual residents stating when medication prescribed ‘when required’ should be given. Although medication was stored correctly the manager was advised to check and record the temperature of the storage area daily to ensure medication did not deteriorate if the temperature exceeded 25 degrees Celsius. A small quantity of unwanted medication was being stored in the home. The manager was informed that a licensed waste carrier must be contracted to dispose of all unused medication safely. Crawshaw Hall Nursing Home DS0000022508.V255361.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 and 15 (Older People) 15 and 17 (Adults 18-65) Visitors were welcomed into the home at anytime. The meals were varied and offered choice. EVIDENCE: Friends and relatives were welcomed into the home at anytime. The residents could choose whether to see them in the lounge or in their bedroom. The meal served at lunchtime looked wholesome and appetising. The menus were varied and offered choice. Lunchtime was unhurried allowing residents time enjoy their meal. Members of staff were observed assisting residents in a sensitive and patient manner. All the residents asked said they had enjoyed their lunch. Crawshaw Hall Nursing Home DS0000022508.V255361.R01.S.doc Version 5.0 Page 12 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) 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 and 18 (Older People) 23 and 24 (Adults 18-65) Complaints would be taken seriously and investigated. Appropriate procedures were in place to ensure the protection of residents at the home. EVIDENCE: A complaints procedure was available. No complaints had been made to the home or the commission since the last inspection. Policies and procedures relating to the protection of vulnerable adults were in place. This issue was discussed with three members of staff. They were aware of the procedure and said they would report any concerns immediately. Crawshaw Hall Nursing Home DS0000022508.V255361.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) 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 and 25 (Older People) 24 (Adults 18-65) The home was clean, comfortable and well maintained. This meant the residents had a homely place to live. EVIDENCE: At the time of the inspection the home was clean, free from offensive odour and well maintained. This provided a safe and comfortable environment for the residents. However, the front door bell was broken causing inconvenience for visitors. Crawshaw Hall Nursing Home DS0000022508.V255361.R01.S.doc Version 5.0 Page 14 To ensure the safety of residents several radiators had been fitted with covers. A risk assessment was in place to prioritise the fitting of covers to all other radiators. Crawshaw Hall Nursing Home DS0000022508.V255361.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 and 29 (Older People) 32, 33 and 35 (Adults 18-65) Staffing levels were appropriate to meet the assessed needs of the residents. Recruitment procedures were not robust potentially putting residents at risk. EVIDENCE: Examination of the duty rota confirmed that a sufficient number of staff were on duty for all shifts to meet the assessed needs of the residents. Four members of staff were overseas nurses doing adaptation training. This caused quite a high turnover of staff because adaptation training usually only lasted for six months. Almost half of the care assistants had achieved NVQ level 2 in care. The files of two recently appointed members of staff were inspected. One of these files contained all the required pre-employment checks to ensure protection of the residents. However, the registered person had not applied for a CRB check for the other member of staff. Crawshaw Hall Nursing Home DS0000022508.V255361.R01.S.doc Version 5.0 Page 16 Crawshaw Hall Nursing Home DS0000022508.V255361.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33 and 38 (Older People) 37, 39, and 38 (Adults 18-65) Appropriate procedures were in place to safeguard the health, safety and welfare of residents. Not all members of staff had received training in fire safety. An effective quality monitoring system was not in place. EVIDENCE: Crawshaw Hall Nursing Home DS0000022508.V255361.R01.S.doc Version 5.0 Page 18 The registered manager was an experienced nurse with NVQ level 4 in management. He maintained an up to date knowledge of current practice by attending relevant training courses and reading articles in the nursing press. The home had achieved the nationally accredited Investors in People award. However, a formal system of obtaining the views of residents and their relatives about the care and services provided at the home was not in place. Policies and procedures were not reviewed and an annual development plan to help monitor the quality of the service and improve outcomes for residents was not available. Fire alarms and emergency lighting were tested regularly. Fire drills were held every six months. A fire risk assessment was in place. However, members of staff had not received up to date training in fire safety. A member of staff qualified to administer first aid was on duty for all shifts. During the inspection members of staff explained how they used an unsafe moving and handling technique because a resident was nervous when the hoist was used. The manager was advised that this was unacceptable and an alternative safe method must be found. Records of the routine servicing of equipment were seen. Records maintained by the cook included fridge freezer and food temperatures. Crawshaw Hall Nursing Home DS0000022508.V255361.R01.S.doc Version 5.0 Page 19 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 X 2 X 3 2 4 X 5 X 6 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 ENVIRONMENT Standard No Score 19 2 20 X 21 X 22 X 23 X 24 X 25 2 26 X STAFFING Standard No Score 27 3 28 3 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 X 33 2 34 X 35 X 36 X 37 X 38 2 Crawshaw Hall Nursing Home DS0000022508.V255361.R01.S.doc Version 5.0 Page 20 YES Are there any outstanding requirements from the last inspection? 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 OP3 Regulation 14(1)(d) Requirement The registered person shall not provide accommodation to a service user at the care home unless, so far as it shall have been practicable to do so – (d) the registered person has confirmed in writing to the service user having regard to the assessment the care home is suitable for the purpose of meeting the service user’s needs in respect of his health and welfare. Timescale of 29 July 2005 not met. The registered person shall – (b) keep the service user’s plan under review. (c) where appropriate and, unless it is impracticable to carry out such consultation, after consultation with the service user or a representative of his, revise the service user’s plan. Care plans must be reviewed monthly and up dated when necessary. Timescale for action 01/11/05 2 OP7 15(2)(b) 09/12/05 Crawshaw Hall Nursing Home DS0000022508.V255361.R01.S.doc Version 5.0 Page 21 3 OP8 4 OP9 5 OP29 6 OP33 The registered person shall ensure that – unnecessary risks to the health and safety of service users are so far as possible eliminated. A care plan must be developed explaining the strategies in place to minimise all identified risks. Timescale of 29 July 2005 not met. 13(2) The registered person shall make suitable arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. The reason why any medication is omitted must be recorded. The dose of a drug stated on the medicines administration record must be the same as that stated on the packet. A licensed waste carrier must be contracted to dispose of all unused medication. 19(1)(b) The registered person shall not Schedule 2 employ a person to work at the care home unless (b) he has obtained in respect of that person the information and documents specified in (i) paragraphs 1 to 7 of schedule 2 A satisfactory POVA/CRB check must be obtained before a person starts work 24(1)(2)(3) (1) The registered person shall establish and maintain a system for (a) reviewing at appropriate intervals, and (b) improving at the care home, including the quality of nursing where nursing is provided at the care home. (2) The registered person shall supply to the Commission a report in respect of any review conducted by him for the DS0000022508.V255361.R01.S.doc 13(4) 09/12/05 30/12/05 01/11/05 31/03/06 Crawshaw Hall Nursing Home Version 5.0 Page 22 7 OP33 10(1) 8 OP38 23(4)(d) 9 OP38 13(5) purpose of paragraph (1), and make a copy of the report available to service users. (3) the system referred to in paragraph (1) shall provide consultation with service users and their representatives. (Timescale of 28 May, 26 Nov 2004, 25 March and 2 Sept 2005 not met.) The registered provider and the 31/03/06 registered manager shall, having regard to the size of the care home, the statement of purpose, and the number and needs of service users, carry on or manage the care home (as the case may be) with sufficient care and competence and skill. All policies and procedures must be reviewed and up dated regularly. (Timescale of 25 March and 2 Sept 2005 not met.) The registered person shall after 30/12/05 consultation with the fire authority (d) make arrangements for persons working at the care home to receive suitable training in fire prevention. Timescale (25 March and 2 Sept 2005 not met.) The registerd person shall make 09/12/05 arrangements to provide a safe system for moving and handling service users. 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 Standard Good Practice Recommendations Crawshaw Hall Nursing Home DS0000022508.V255361.R01.S.doc Version 5.0 Page 23 1 2 3 4 5 OP9 OP9 OP9 OP19 OP25 All handwritten instructions on the medicines administration records should be signed and witnessed. Written instructions should be in place for individual residents stating when medication prescribed when required should be given. The temperature of the area where medication is stored should be checked and recorded daily. The front door bell should be repaired. All radiators should be fitted with covers. Crawshaw Hall Nursing Home DS0000022508.V255361.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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. Crawshaw Hall Nursing Home DS0000022508.V255361.R01.S.doc Version 5.0 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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