Inspection on 14/06/05 for Credenhill Court

This inspection was carried out on 14th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Credenhill Court 22/02/07

Credenhill Court 06/01/06

Credenhill Court 25/11/04

Credenhill Court 10/06/04

Credenhill Court 10/02/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Credenhill Court Credenhill, Hereford, HR4 7DL Lead Inspector Denise Reynolds Announced 14 & 15 June 2005 19.00 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 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. Credenhill Court E52 E02 S24702 Credenhill Ct V229283 140605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Credenhill Court Address Credenhill Hereford HR4 7DL Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01432 760349 01432 761460 Mr N Nauth and Mrs S Nauth Mrs S Davies Care Home 35 Category(ies) of Old Age:35 registration, with number Mental Disorder - over 65: 5 of places Dementia over 65: 35 Credenhill Court E52 E02 S24702 Credenhill Ct V229283 140605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Home can continue to accomodate the named current service users who are under 65 years of age as long as their social needs can continue to be met within a service primarily for older people. Date of last inspection 25th November 2004 Brief Description of the Service: Credenhill Court is registered primarily to provide accomodation and personal care for thirty five people over the age of 65 who need care due to their age or because they have care needs due to the effects of dementia related illnesses. There are also some people who have lived at the home for a while who are under 65 and have learning disabilities or mental health related needs. The home is no longer offering places to people under 65 or to people with learning disabilities. Credenhill Court is a large country house set in large grounds and has lovely rural views, especially from the rooms at the front of the house. Credenhill village church is reached from the same driveway and is just a few minutes walk from the Home. The village of Credenhill (with a post office and general stores) is about a mile away. Hereford city centre is 4 miles. The accomodation is on 3 floors with the majority of bedrooms being single. There are bathroom and toilet facilities on each floor and 2 sitting rooms and 2 dining rooms on the ground floor. Credenhill Court E52 E02 S24702 Credenhill Ct V229283 140605 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on two days – the first visit was in an evening from 7pm until 11.45 pm and the second visit was the next morning from 7.15am until 5.30pm. This gave a picture of the home throughout the day. Comment cards were sent to health and social care professionals by CSCI and provided for the Home to give to relatives, residents and staff. There was a good response with replies received from two residents, three social workers, a Community Nurse, five GP practices, fifteen relatives and ten staff. During the inspection 3 residents and five staff were spoken to individually as were the manager and deputy manager. A sample of records including care records and staff records were looked at. Time was spent looking around the building and sitting with residents in the sitting room and observing. The staff handovers between the evening and night staff and between the night and morning staff were observed. Because the majority of residents have dementia or mental health needs the extent to which their views could be sought directly was limited and some reliance had to be placed on observation to get an impression of what life at the home is like from their point of view. Part of the inspection was done jointly with an Environmental Health Officer from Herefordshire Council. This was because of a complaint received from a member of the public relating to the health and safety of staff employed at the Home. The information gathered showed that while some improvements could be made, the Home takes the health and safety of staff seriously and in general has good measures in place for this. What the service does well: There is a friendly, welcoming atmosphere at the Home. The staff group is hardworking and conscientious and have a caring, respectful approach to residents. People are treated very much as individuals. One person who had not lived at the Home long said that she felt she had made a very good decision and that she felt settled and well looked after. Another said the staff could not be more kind. Relatives’ comments provided a picture of a happy home, good care and consideration of their needs as well as those of the residents. The health of residents is given high priority and problems followed up promptly. This was confirmed by the positive responses on the comment cards Credenhill Court E52 E02 S24702 Credenhill Ct V229283 140605 stage 4.doc Version 1.30 Page 6 from GPs, for example one included the statement ‘The care in this home seems well organised, caring and efficient’. Improvements to the accommodation are carried out regularly and overall the house is clean and comfortable. What has improved since the last inspection? What they could do better: The management team have the challenge of building on the things they have already achieved. This includes further improvements to the content of the care plans and risk assessments to ensure that all the staff understand each resident’s needs and how they should be helping them with these. Similarly, staff training will need to continue to keep pace with the demands on staff skills especially in topics such as dementia care and moving and handling. This needs to be supported by better record systems to help with planning. Staffing levels need to be reviewed to make sure they are always good enough for staff to give residents enough time and attention over and above meeting their basic physical care needs. Staff also need time to become familiar with the care plans and important policies and procedures aimed at keeping Credenhill Court E52 E02 S24702 Credenhill Ct V229283 140605 stage 4.doc Version 1.30 Page 7 residents safe and to receive individual supervision to help them achieve their best. This will contribute to continued improvements in the care that residents have. Some aspects of the building need repairs or other remedial action and a better system is needed for assessing risk and for making sure faults are found, reported and put right. 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. Credenhill Court E52 E02 S24702 Credenhill Ct V229283 140605 stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Credenhill Court E52 E02 S24702 Credenhill Ct V229283 140605 stage 4.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 (Standard 9 does not apply to this Home) Before they offer a place to someone the Home obtains the required information to be able to decide if they can meet the person’s care needs. EVIDENCE: When a prospective resident is referred to the Home by a social services department, the manager insists on receiving a copy of their assessment before considering the placement. The manager or deputy manager do their own assessment of a person’s needs whether they are funded by a placing authority or in a position to fund their care themselves. A letter is sent to the person and/or their representative and to the social worker if there is one confirming a place is being offered and that the person’s care needs can be met by the Home. Credenhill Court E52 E02 S24702 Credenhill Ct V229283 140605 stage 4.doc Version 1.30 Page 10 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 standard(s) 7, 8 and 10 The Home places emphasis on people being individuals and having their rights respected. Staff deal with the care needs of the residents conscientiously. People living at the home are treated with respect and staff are caring towards relatives as well as residents. Communication about each person’s care is generally well organised. Ongoing developments to the content of the care plans will enhance the hard work that has already been done. Further work is needed in respect of safe moving and handling for service users with dementia who are unable to comprehend the need for assistance by staff and/or equipment. EVIDENCE: There is a care plan for each person. The format provides space for describing all the expected aspects of a person’s care. The content needs to be more specific so that it describes more clearly the action needed to meet residents’ needs. The sections about goals and evaluation also need more specific information. This is particularly important where the use of handling equipment such as hoists is made difficult due to people with dementia related needs being frightened and reluctant to use it. This creates risk of injury to staff and Credenhill Court E52 E02 S24702 Credenhill Ct V229283 140605 stage 4.doc Version 1.30 Page 11 residents. Clear information must be set out in the care plan for the people this applies to and it would be advisable to seek specialist guidance about the possible solutions. More comprehensive formats for bedrail risk assessments, nutritional assessments and self-medication risk assessments would be beneficial. The care plans have been kept in the office with staff given access as needed. The manager recognised that at times this may be difficult and has decided to move them to the staff duty room. The management team also need to address the task of enabling all staff to familiarise themselves with all the care plans. The staff handovers were used to talk about how residents had been during the previous shift and what needed to be done for them during the next shift. Particular attention was given to talking about anyone staff were concerned about, for example if it was considered that someone needed to be seen by their Doctor. Examples were seen in the individual daily reports of healthcare issues being identified, recorded, reported and followed up. The responses in the comment cards from GP surgeries provided a picture of good communication and consultation. One included the comment ‘ The care in this home seems well organised, caring and efficient’ A positive view of the care was also reflected in replies from relatives; one commented that the Home had managed the health problems of their relation ‘brilliantly’. Examples were observed of staff speaking politely and warmly when helping residents. The importance of privacy and dignity was emphasised in each of the care records looked at. Staff interviewed understood the importance of this. For example, one person asked for confirmation that it was alright to speak to the inspector about a resident before doing so. The residents spoken to said staff are kind and respectful. Replies from relatives included comments such as ‘the kindness and compassion to my mother are wonderful’ and ‘it is always a difficult time when a loved one needs to have full time care, but the situation has been made so much easier with everyone’s help’ Two staff were seen dealing with an argument between two residents. They remained calm and dealt with both people fairly, finding a solution that satisfied both people. They worked well as a team with other staff reassuring other residents. There was an opportunity to observe how the disorientation and distress of one resident was dealt with when he came to the office during feedback at the end of the inspection. He was given the manager and deputy’s full attention and all the time he needed to calm and reassure him. Credenhill Court E52 E02 S24702 Credenhill Ct V229283 140605 stage 4.doc Version 1.30 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 standard(s) 12,13 and14 The elements of these standards that were looked at provided indicators that staff work hard to treat people as individuals and to create a friendly, happy and welcoming place for people to live and to visit. EVIDENCE: One resident spoken to spends the majority of time in her room. She said the food is ‘plain but well cooked’ but was not aware of a choice being routinely available (food provision will be inspected at the next inspection). She prefers to stay in her room and has all she needs around her including her TV, a small fridge and a kettle so she or her visitors can make drinks. One man said he likes the fact that staff don’t tell him what to do. Walking around the Home radios and TVs could be heard in some bedrooms during the day and staff accept that some people prefer not to spend time with others. The visitors book shows that there are numerous visitors to the Home and replies from relatives confirmed that they are always made welcome when they visit, for example ‘ the staff are very welcoming and always do their utmost to help’ and ‘ management and staff are always friendly and helpful’ A number of telephone conversations with relatives were heard during which staff were helpful and unhurried and gave the caller their full attention. Credenhill Court E52 E02 S24702 Credenhill Ct V229283 140605 stage 4.doc Version 1.30 Page 13 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 standard(s) 16 and 18 Staff are aware of the importance of providing good quality care and know that poor care or mistreatment must be reported. They are aware of the complaints procedure. Management and staff are viewed as friendly and approachable which should reassure anyone who may need to bring a concern to their attention. These topics need to be covered regularly with staff to make sure that they all know the right action to take. EVIDENCE: A number of staff questionnaires confirmed they had received training about prevention of abuse and adult protection. Some staff were not familiar with the Home’s written policy on Adult Protection and not all of them knew that there is a Herefordshire Multi Agency Adult Protection Procedure. However, all staff interviewed were clear that neither they nor other staff would accept residents being mistreated and that if they suspected this was happening they would report it to the manager. Information about reporting abuse is displayed on the notice board outside the office and is contained within the staff handbook. To make sure that all staff are familiar with what is expected of them it is recommended that additional training be arranged and that the topic is covered at staff meetings and in individual staff supervision. None of the relatives or professional who returned comment cards had made or received complaints about the Home but two of the relatives did not know about the complaints procedure. Staff spoken to knew that if they are approached about a complaint they could not deal themselves they should take details and pass the information on to the manager. Credenhill Court E52 E02 S24702 Credenhill Ct V229283 140605 stage 4.doc Version 1.30 Page 14 A complaint received jointly by CSCI and the Environmental Health Department of Herefordshire Council regarding the health and safety of staff was jointly investigated by both organisations as part of this inspection; the Provider also carried out an internal investigation. The complaint was not upheld although this report includes some recommendations arising from the situation that gave rise to the complaint. Credenhill Court E52 E02 S24702 Credenhill Ct V229283 140605 stage 4.doc Version 1.30 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 standard(s) 19, 20, 21 and 26 The house is generally well maintained and comfortable and there is a rolling programme of redecoration and refurbishment. The rural setting and lovely views provide a peaceful and attractive setting, especially in good weather. Completion of the remaining refurbishment and attention to identified remedial work is needed. EVIDENCE: The house has been continually refurbished over a number of years and further work is planned. Completed work has been done to a good standard for example a bathroom on the first floor has been refurbished and is now spacious, pleasantly decorated and well equipped as is the new shower room on the ground floor. The ground and second floor bathrooms have not been updated for several years and need to be improved to the standard of the one on the first floor. Although it is a large house with high ceilings most areas are furnished and decorated in a way that makes them look homely and comfortable. Credenhill Court E52 E02 S24702 Credenhill Ct V229283 140605 stage 4.doc Version 1.30 Page 16 All of the rooms seen were clean and tidy. Staff were following good infection control practice and had protective clothing, liquid soap, paper towels and alcohol hand gel readily available throughout the building. The only concern about hygiene was that the underside of the downstairs bath hoist was not clean. The following remedial work was identified; window restrictor to a second floor window, uneven floorboards in some corridor areas and a small flight of wooden steps to the cleaning store that need to be replaced and also need a handrail and a warning sign on the outside of the door. The Environmental Health Officer has taken the lead in following these matters up with the Home although CSCI will also monitor compliance. Further development of in-house quality assurance and general risk measures should ensure that things like this are identified and dealt with promptly in future. A fire door leading to the ground floor toilets was held open with a wooden wedge; it is recognised that the door presents a significant barrier to residents but a different solution to this must be found. In a Home this size it would be reasonable to expect there to be a commercial size dishwasher in the kitchen; this would be more efficient and provide better safeguards against infection. Two wooden gazebos have been built at either side of the front lawn providing a pleasant shaded place to sit and look at the views. This positive addition to the garden could be of greater benefit if paths with handrails were created to help residents walk across to them. The drop from the edge of the front lawn to the field beyond is unguarded and in view of the needs of the residents now being accommodated, a risk assessment needs to be done and consideration given to a barrier of some description to prevent someone falling. Credenhill Court E52 E02 S24702 Credenhill Ct V229283 140605 stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30 The staff group are an able and hard working team. Training opportunities are provided to increase their knowledge and skill. Increasing demands on staff as a result of the move towards providing care for more people with dementia related needs must be supported by making specialist training in this type of care a central feature of the staff training programme. EVIDENCE: Staff seen during the inspection were tidy and smart and acted in a professional way. Their manner towards residents was caring and respectful. The increase in the number of people at the home with dementia related care needs has had an impact due to the time needed to provide good person centred care. Responses from relatives and staff gave a mixed picture about the adequacy of staffing levels; the majority felt that there are enough staff but some said that there are not. Staff felt that they have time to look after the residents’ physical care but some did not think that they are able to spend enough time to talk to residents and to cater for their social needs. Having enough time to keep up to date with each person’s care plan and to do regular reviews of these was also proving to be difficult. A range of staff training has been provided and is ongoing. Recently a one day course on dealing with aggressive behaviour had been arranged. The trainer, an experienced mental health nurse, had written to the manager to compliment the interest shown by staff and the positive attitude they have towards residents. The course is being repeated for staff unable to attend the Credenhill Court E52 E02 S24702 Credenhill Ct V229283 140605 stage 4.doc Version 1.30 Page 18 first one. The staff questionnaires received showed that most staff have done all the relevant health and safety related core training and details of forthcoming training is displayed on the notice board for staff. Credenhill Court E52 E02 S24702 Credenhill Ct V229283 140605 stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 36 and 38 This is a well managed home with a management team that are open to constructive criticism and eager to continually improve their practice. They provide positive role models for staff in the attitudes they show towards residents and their relatives. The challenge they now have is to consolidate the progress made in recent years and to strengthen the arrangements for making sure that the homes policies and procedures are firmly established. EVIDENCE: The comments received through the consultation process provided a picture of an approachable and supportive management team. In response to the question ‘ Do you receive enough support and advice from your manager?’ all the staff ticked the ‘yes’ box. One comment written was ‘ Home’s management team couldn’t be better. (They) always strive to tend to individual staff and residents needs to the best of their ability’ The staff interviewed confirmed this – one said that the management team was ‘one of Credenhill Court E52 E02 S24702 Credenhill Ct V229283 140605 stage 4.doc Version 1.30 Page 20 the two best things about the home’ (the other thing being the standard of care). A social worker wrote ‘Managers at Credenhill are excellent. They provide a positive lead to staff and work hard to meet the needs of individuals in the home.’ The manager has been managing the home for 12 years and is currently working towards gaining her Registered Managers Award. The Manager is aware of the importance of individual staff supervision and in line with the Home’s stated policy is trying to get this underway but, with such a large staff team, finding it hard to fit this in with all the other demands on staff and management time. This was discussed and a steady, planned approach to this agreed as the most realistic way forward. This needs to involve senior staff and provision of training for them to be able to supervise staff rather than the manager and deputy trying to see everyone themselves. Structured supervision arrangements aren’t yet established but staff said that the manager and deputy willingly make themselves available to talk to staff who need to discuss work issues and any personal difficulties. Health and safety of staff is covered in the Home’s written procedures including the Health and Safety policy and the grievance procedures. Information about an employment helpline is prominently displayed if staff want to get advice about employment matters. Health and safety related training is provided by external trainers and the cook has done a health and safety course. She has additional hours during which she does basic health and safety induction for new staff and annual refresher training for all staff. Responsibility for health and safety is shortly to be taken on by an additional staff member who has a HSE recognised Health and Safety qualification. Equipment is serviced as required although filing of the relevant records needs to better organised. Copies of servicing and maintenance records kept in the adjacent administration building should made so that they are available in the Home. This is important because of the statutory responsibility the registered manager has in respect of the running of the Home. The Environmental Health Officer is following up a query regarding the level of inspection of equipment carried out by an external company. There was no written information about the action on the findings of a report by a Moving and Handling specialist from the PCT. The manager confirmed that things had been dealt with but was advised that doing an action plan for things like this is a helpful way to prioritise and plan work. Credenhill Court E52 E02 S24702 Credenhill Ct V229283 140605 stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 x COMPLAINTS AND PROTECTION 2 x 2 x x x x 3 STAFFING Standard No Score 27 2 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x 4 x x x 2 x 2 Credenhill Court E52 E02 S24702 Credenhill Ct V229283 140605 stage 4.doc Version 1.30 Page 22 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 7 Regulation 13 Requirement Arrangements for the safe moving and handling of service users with dementia for whom the use equipment such as hoists is problematic must be reviewed; in particular the moving and handling assessments must descibe the particular difficulty and give guidance to staff about how to manage this. The manager, deputy or a senior member of staff must do moving and handling training at a level that develops their knowledge and skills for carrying out moving and handling assessments and for monitoring moving and handling practice at the home. A risk assessment must be done in respect of the drop in level at the end of the lawn at the front of the house and consideration given to a barrier to prevent someone falling. An assisted bathroom must be provided on the second floor and the ground floor bathroom must be refurbished and assisted bathing facilities provided. (Previous timescale of 31st E52 E02 S24702 Credenhill Ct V229283 140605 stage 4.doc Timescale for action 31st July 2005 2. 7 13 30th September 2005 3. 19 13 31st July 2005 4. 21 23 30th September 2005 Credenhill Court Version 1.30 Page 23 March 2005 not fully met) 5. 19 13 Timescales for work cited in the report by the Environmental Health Officer must be met and written confirmation sent to CSCI when the work has been completed. 31st July 2005 for matters given a 1 month timescale and 31st August for those with a 2 month timescale. 31st July 2005 6. 19 13 and 23 7. 19 13 and 23 8. 27 18 9. 30 18 Professional fire safety guidance must be sought regarding an acceptable method of holding back the fire door by the ground floor toilets. Temporary measures for holding the above door open must be subject to risk assessment and clear instructions given to staff regarding closing it at night. A review of staffing levels in relation to the care needs of residents must be carried out (it is suggested that the Residential Forum guidance would provide a useful framework for this work). The results of the review must be forwarded to CSCI. Training in Dementia Care must be established as a core element of management and staff training drawing on expert sources such as the Alzheimers Society, Bradford Dementia Group, Stirling University and Dementia Care Matters in addition to local trainers. Immediate. 30th September 2005 31st December 2005 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 E52 E02 S24702 Credenhill Ct V229283 140605 stage 4.doc Version 1.30 Page 24 Credenhill Court 1. Standard 7 2. 18 3. 19 4. 5. 19 19 6. 7. 19 36 8. 38 9. 38 The content of care plans should continue to be developed so that they provide more specific details about how peoples care needs are to be met. It is recommended that this starts with a prioritised rolling programme of all the care plans and that all staff take part in this as discussed during the inspection. More comprehensive risk assessment formats would be beneficial. It is strongly recommended that discussion about adult protection is regularly included on the agendas of staff meetings and individual supervision as well as in staff training to make sure that all staff are fully aware of the correct action to take if an adult protection issue arises. Review car parking arrangements to ensure emergency vehicles have good access to the premises. NOT REVIEWED DURING THIS INSPECTION CARRIED FORWARD. Access to the two new pagodas in the garden would be improved by laying paths with handrails. The radiator covers should be altered to allow residents and satff access to the temperature controls.NOT REVIEWED DURING THIS INSPECTION CARRIED FORWARD. It is recommended that a dishwasher be provided in the kitchen. It is recommended that a small group of suitably experienced staff are identified to provide staff supervision to the wider team and that these staff are given the necessary training to equip them for this role. It is recommended that more robust recording of staff attendance at training and tracking of gaps in staff training is set up to assist in the prioritising and planning of staff training. It is recommended that more robust risk assessment, and reporting systems are established in respect of general health and safety in the Home. Credenhill Court E52 E02 S24702 Credenhill Ct V229283 140605 stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Hereford Area Office 178 Widemarsh Street Hereford HR4 9HN 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 Credenhill Court E52 E02 S24702 Credenhill Ct V229283 140605 stage 4.doc Version 1.30 Page 26 - 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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