Inspection on 12/01/06 for Danson House Residential Care Home

This inspection was carried out on 12th 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.

Other inspections for this house

Danson House Residential Care... 20/06/08

Danson House Residential Care... 10/09/07

Danson House Residential Care... 10/10/06

Danson House Residential Care... 21/07/05

Danson House Residential Care... 05/01/05

Danson House Residential Care... 07/07/04

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

CARE HOMES FOR OLDER PEOPLE Danson House Glynde Road Bexleyheath Kent DA7 4EU Lead Inspector Maria Kinson Unannounced Inspection 12th January 2006 10:25 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 Danson House DS0000006792.V276555.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. Danson House DS0000006792.V276555.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Danson House Address Glynde Road Bexleyheath Kent DA7 4EU 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) 020 8304 3762 020 8301 2646 Kent Community Housing Trust Mrs Nicole Sandra Shilling Care Home 46 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (43) of places Danson House DS0000006792.V276555.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Registration for 1 service user in category DE(E) (male) for named service user only. This service user is to be accommodated in a ground floor room. Registration for 1 service user in category DE(E) (female) for named service user only. Registration for 1 service user in category DE(E) (male) for named service user only. 21st July 2005 Date of last inspection Brief Description of the Service: Danson House is owned and managed by Kent Community Housing Trust which is a charitable not for profit trust. The home was purpose built and provides accommodation on two floors. It is located in a residential road within walking distance of shops, a mainline railway station and bus routes. The home is registered to provide personal care and accommodation for 46 older people. The building is divided into five separate units, Silver (10 beds), Katie (9 beds), Family (10 beds), Royal Blue (9 beds) and Rehab (8 beds). Each unit has a lounge/dining area, kitchenette, toilet/bathroom facilities and bedrooms. One of the units in the home provides short-term care for eight service users who require rehabilitation. Specialist advice, assessment and equipment are provided for the service users on this unit. There is parking to the side of the property with garden and patio areas at the rear. The home also provides day care for older people. This part of the service is not regulated. Danson House DS0000006792.V276555.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on 12th January between 10.25am and 3.40pm and on 31st January between 09.40am and 2.00pm. On day one of the inspection Mr T Heslington, home manager from Perrygrove Residential Home, assisted the inspector and on day two of the inspection the registered manager, Mrs N Shilling, provided assistance to access to information and records. A partial tour of the home was undertaken and the inspector spoke with four residents, one visitor and four members of staff. Care, recruitment and health and safety records were examined. Comment cards were distributed to relatives and health care professionals that were in regular contact with the home. Two comment cards were returned to the commission. What the service does well: This home provides a good standard of care for residents. Residents and relatives were positive about their experiences in the home and said that the permanent staff were attentive, helpful and caring. Staff addressed residents in a respectful manner and took action to ensure that resident’s privacy and dignity was maintained when undertaking personal care. Staff worked hard to ensure that residents received prompt medical attention despite facing some challenges in accessing this service. A stimulating programme of activities, social events, entertainment and outings took place in the home and local community. Resident’s rooms and communal areas were clean, tidy and odour free. Some of the bedrooms were personalised with the resident’s own possessions, which made the rooms feel homely and welcoming. The garden was well maintained and had a number of features to promote relaxation and interest. The home was well managed. Health and safety checks were undertaken regularly and complaints and concerns were dealt with according to the homes procedure. The home had good systems in place for assessing and reviewing the quality of care provided in the home. Danson House DS0000006792.V276555.R01.S.doc Version 5.1 Page 6 A structured training programme was in place for new staff and access to ongoing training was good. What has improved since the last inspection? What they could do better: The homes Statement of Purpose did not provide adequate information for residents. This document must be reviewed and updated. Care documentation was variable. Some care plans outlined the specific action that staff should take to meet resident’s needs. Other residents did not appear to have a plan of care. The management of medication in the home was poor. Failure to address this issue could compromise resident’s safety. A number of residents were taking four or more medicines. The home should work with the GP to ensure that all residents receive a formal review of their medication at regular intervals. Resident’s bedrooms and communal areas were homely and comfortable but other parts of the home looked neglected. In particular bathrooms, toilets, the hairdressing room and laundry room were looking very tired. The curtains in the shared bedroom did not fully extend around the bed and concerns were raised about the lack of space for meetings and storage. Danson House DS0000006792.V276555.R01.S.doc Version 5.1 Page 7 The number of older people attending the home for day care had increased. There were no designated staff to care for these people and staffing had not been increased to reflect this change. The registered person must ensure staffing levels are adjusted to meet residents assessed needs. Health and safety issues were good but records of fire drills and fire training could be improved. Staff must ensure that action is taken to store chilled food appropriately. 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. Danson House DS0000006792.V276555.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Danson House DS0000006792.V276555.R01.S.doc Version 5.1 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 the following standard(s): 1. The home did not provide adequate written information about the rehabilitation service for prospective residents. EVIDENCE: The manager said that there were plans in place to update the homes Statement of Purpose to include information about the rehabilitation unit. The manager was asked to forward a copy of the updated Statement of Purpose to the commission by 01/03/06. See requirement 1. Danson House DS0000006792.V276555.R01.S.doc Version 5.1 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 the following standard(s): 7, 8, 9 and 10. Staff did not have access to adequate written information about residents care needs. If other systems such as handover failed, residents might not receive adequate care. Daily care records indicated that resident’s health needs were met. The management of medication in the home was poor. This could compromise resident’s safety and wellbeing. EVIDENCE: Two care files were examined, one for a resident that was staying on the rehabilitation unit and one for a resident that was living on one of the long stay units. Documentation was satisfactory for the resident on the rehabilitation unit. Information about the residents needs had been sent to the home by the referring agency and staff had carried out their own assessment and formulated a short- term care plan to meet the resident’s needs. Multidisciplinary staff also developed a separate plan. New documentation had recently been introduced. The assessment form included an assessment of resident’s needs and any observations made by staff. The assessment form followed a tick box format with limited space for individual information about residents. The form indicated that staff should include information from the Danson House DS0000006792.V276555.R01.S.doc Version 5.1 Page 11 assessment in the service user plan but there was no form for this purpose. A care plan for the resident living on the long stay unit could not be located. The assessment indicated that the resident was aggressive, had continence problems and weight loss. Although the daily care records provided evidence that staff were taking appropriate action to manage these issues the resident did not have a care plan. Staff that were not familiar with the resident would not know what action they should take to meet the individuals needs. All of the files included a variety of risk assessments for issues that had been identified as potentially hazardous such as moving and handling and smoking. Staff ticked the important dates sheet when they reviewed the care plan. It was not possible to identify the staff member that had carried out this task, as the record was not initialled. See requirement 2. Arrangements were in place to ensure that residents were referred to the GP and other local services when necessary. The GP does not undertake any regular visits to the home. This was causing some difficulties for residents and staff. The manager of the home had met with the GP to discuss the matter. One of the residents tracked had lost a significant amount of weight. Staff had referred the resident to the Dietician and were monitoring the residents weight. Staff had attended training about following a set pathway for managing residents with an acute urinary tract infection. This initiative will ensure that residents receive prompt treatment and may help to avoid hospital admissions. The management of medication was poor. Two medication charts were examined on each floor. The arrangements for residents to manage their own medication were well organised and flexible. Risk assessments were carried out prior to residents self- medicating and staff took prompt action to review the arrangements when residents were unwell. Good records were maintained about medication received in the home and storage facilities were satisfactory. On the rehabilitation unit staff copied the information from the label onto the medication chart. Some of the charts on this unit were not checked and countersigned by a second person. This may have contributed to some of the errors that were identified on the charts that were assessed. Some of the charts had gaps where it was not clear whether medication had been administered, some items were out of stock, the information about the frequency of medication on one of the records did not correspond with the instructions on the label and several discrepancies between the amount of medication that had been given and the amount of medication that should be remaining was noted. Some residents were taking a significant amount of medication. There was no evidence that a formal review of medication had been carried out as outlined in the National Service Framework for Older People. For residents taking three or more medicines this should take place every six months. The record of medications sent back to the pharmacy did not always include adequate information such as the name of the resident disposal records did not always include adequate details such as the name of the resident. The manager said that it had been identified that there were Danson House DS0000006792.V276555.R01.S.doc Version 5.1 Page 12 issues around some staff members competency in administering medication and this issue was being monitored and dealt with. See requirement 3 and recommendation 1. Staff knocked on resident’s bedroom doors before entering and showed respect for resident’s personal property and possessions. Staff addressed residents in a respectful manner and demonstrated concern for residents well being. Residents were able to meet relatives or health care professionals in their bedroom or the communal areas. Danson House DS0000006792.V276555.R01.S.doc Version 5.1 Page 13 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. The programme of activities and entertainment taking place in the home provided daily variation and interest for residents. EVIDENCE: The home has a part time Activities Coordinator who was responsible for organising and facilitating activities, social events, entertainment and outings. A weekly activity programme had been developed. The programme included a variety of activities such as gentle exercises, quizzes, board games, arts and crafts, bingo, a gardening competition, reminiscence and cooking. Morning and afternoon sessions were arranged and took place on all of the units to give everyone an opportunity to attend. The home also hosted a number of social events such as coffee mornings and a tea dance for residents from other homes. Once a month a themed day was arranged to celebrate significant events or festivals. A special menu was organised to compliment theses events. Some of the residents had visited a local exhibition, restaurants, coastal resorts and shopping centres. Once a month entertainment was provided in the home. The ‘pat a dog’ service visits the home regularly and a mobile shop enables residents to purchase small items such as toiletries, birthday cards and sweets. Danson House DS0000006792.V276555.R01.S.doc Version 5.1 Page 14 Danson House DS0000006792.V276555.R01.S.doc Version 5.1 Page 15 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 and 18. The home had a comprehensive complaints and adult protection procedure in place for responding to complaints or allegations of abuse. EVIDENCE: The homes complaints procedure was prominently displayed. The procedure includes a timescale for responding to concerns and contact details for the commission. The home had not received any complaints since the last inspection. A number of letters and cards thanking staff for their care and support had been received in the home. The home had a copy of the local authority adult protection guidance and a local adult protection procedure. The procedure includes reporting allegations to the Commission and Social Services. Abuse awareness was discussed with staff during induction and forms part of vocational training. Staff were aware of the need to report allegations of misconduct or abuse to senior staff. One incident was being investigated under the local authority adult protection procedure at the time of this inspection. This incident did not relate to staff. Danson House DS0000006792.V276555.R01.S.doc Version 5.1 Page 16 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 and 26. The home was warm and comfortable but some areas were looked worn and tired. This made the home less welcoming for residents and their visitors. The building does not have adequate space for storage, meetings and rehabilitation therapies. EVIDENCE: Since the last inspection some of the corridors and satellite kitchens had been redecorated and new carpets were fitted in some of the bedrooms. A section of the carpet, in the corridor on family unit, had been replaced. The new carpet was a different colour and pattern to the rest of the carpet. This made the area look ‘patched up’ and untidy. New equipment including dining lounge chairs, commodes, a washing machine and freezer had been purchased and the call system was replaced. The paving stones at the front of the home had been re-laid. Temporary action had been taken to address the concerns identified during the previous inspection. This included the torn corridor carpet on silver unit and the broken bath panel, both of which were secured with tape. The drier and carpet cleaner were now in working order. See Danson House DS0000006792.V276555.R01.S.doc Version 5.1 Page 17 requirement 5. Material had been obtained to make dividing curtains for the shared bedroom. See requirement 4. The inspector received comments from two health care professionals raising concerns about the size of the rooms in the home and the lack of space for meetings and private discussions with resident’s families. Some parts of the home particularly the laundry room, bathrooms, hairdressing room and toilets look very tired and unwelcoming. The ceiling in toilet 106, the vinyl flooring in the laundry room and the carpet in room 35 were stained. The smoking room was located next to a resident’s bedroom. There was little ventilation except a ceiling fan. See requirement 6. The manager advised the inspector that a surveyor had assessed the room. The registered company is currently considering the future of the building. A meeting had taken place to discuss possible options with residents, relatives and staff. The commission should be notified about the outcome of these discussions. All parts of the home excluding the hairdressing room were clean and tidy. Several boxes were stored in this room making the area congested and unwelcoming. This area should be tidied and cleaned to a satisfactory standard. See requirement 6. Staff had checked and recorded refrigerator temperatures regularly. The records indicated that the refrigerators on two of the units were running at 10 and 12 degrees centigrade. See recommendation 2. The rehabilitation unit does not include dedicated space for therapies and treatment. Danson House DS0000006792.V276555.R01.S.doc Version 5.1 Page 18 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, 28, 29 and 30. The increase in the provision of day care places had led to additional demands on staff time. Staffing levels must be reviewed. The number of permanent staff working in the home had increased. This should provide greater continuity of care for residents. Records about the recruitment of new staff showed that care was taken to select and appoint staff that would not pose a risk to residents. EVIDENCE: In recent months the number of residents attending the home for day care had increased. Whilst day care is not regulated there are significant implications for residents and staff. The residents now have additional people coming and going from their home and no additional staff had been provided. Staff indicated that on a Friday there were sometimes up to eight day care and nine permanent residents to assist with meals, toileting and activities. There was one carer based on this unit. The manager had reviewed staffing levels and submitted a report to request additional staff. See requirement 7. The duty roster indicated that there were six carers and a team leader on duty of a morning and five carers and a team leader of an evening. During the night there were three waking care staff. On day one of the inspection there were six care staff and a Team Leader on duty. Four of the staff were agency staff. Staff indicated that this was due to staff annual leave and sickness and Danson House DS0000006792.V276555.R01.S.doc Version 5.1 Page 19 was unusual. A number of staff said that the number of temporary staff used in the home had decreased during the past year. Some of the residents commented that agency staff “don’t know what they are doing” and said they “they do not teach them enough”. Records and discussions with the manager indicated that the home had now recruited an almost full establishment of staff. There were three part time vacant care staff posts remaining. Two health care professionals that visit the home provided written feedback about the service. Both respondents were satisfied with overall standard of care provided in the home but some concerns were expressed about the poor attitude and skills of some members of staff. Similar concerns have been raised in the past. See standard 33. Five care staff had a vocational qualification in care and seventeen staff were currently undertaking this training. The home had not met the target set by the Department of Health for 50 of care staff to have this qualification by December 2005 but was actively working towards complying with this standard. Two staff recruitment files were examined. The previous requirement to ensure that adequate documentation was obtained for new staff had been addressed. The manager wrote to the applicant’s previous employer to request information about why the applicant was no longer in their employment. The home had a structured induction and foundation-training programme in place for new staff. Staff had been advised to attend a moving and handling and fire safety training updates. Several sessions had taken place in the home throughout the year and letters had been sent out to staff that had not attended a session. Danson House DS0000006792.V276555.R01.S.doc Version 5.1 Page 20 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, 32, 33 and 38. This home was well managed. Health and safety checks were carried out at regular intervals and the quality of care provided in the home was monitored closely. EVIDENCE: The management arrangements in the home were stable. The manager’s application for registration was assessed and agreed by the commission in August 2004. Staff were happy with the level of support that they received and indicated that all of the management team were approachable and helpful. The home had a good system in place for monitoring the quality of care provided in the home. The manager completes reports to head office about significant issues such as accidents and complaints. Senior management or managers from other homes undertook regular audits. An external auditor had assessed the home to ensure that it met the requirements for ISO Danson House DS0000006792.V276555.R01.S.doc Version 5.1 Page 21 accreditation. Regular unannounced visits were undertaken to comply with regulations and satisfaction surveys were sent to resident’s relatives at regular intervals. A random selection of health and safety records were examined. All of the records seen complied with health and safety requirements. Records were well organised and up to date. Comprehensive schedules were in place to ensure that daily, weekly and monthly checks were undertaken. The maintenance employee was advised to ensure that fire drill records included information about the time that the drill had taken place and staff response. Records of fire training updates were not always clear but there was evidence that numerous sessions had taken place. See recommendation 3. The records indicated that the water tank was rusty. The inspector was shown written confirmation that this work was planned. Danson House DS0000006792.V276555.R01.S.doc Version 5.1 Page 22 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 2 X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X 3 X X X 2 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X X X 3 Danson House DS0000006792.V276555.R01.S.doc Version 5.1 Page 23 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 OP1 Regulation 4 Requirement Timescale for action 01/03/06 2. OP7 15 3. OP9 13 The Registered Person must update the Statement of Purpose to include additional information about the criteria for admission to the rehabilitation unit, the range of needs that the staff on rehabilitation unit can meet, details of any therapies used on this unit and the maximum period that residents can spend on the unit. The Registered Person must ensure that the Statement of Purpose includes accurate information about the range of needs the care home is intended to meet. This requirement was set following the previous inspection. The timescale had not expired at the time of this visit. The Registered Person must 01/05/06 ensure that the care plan sets out in detail the action which needs to be taken by care staff to ensure that all aspects of the health, personal and social care needs of the resident are met. The Registered Person must 01/04/06 ensure that adequate systems DS0000006792.V276555.R01.S.doc Version 5.1 Danson House Page 24 4. OP19 12 5. OP19 23 6. OP19 23 7. OP27 18 are in place to facilitate the safe ordering, recording, administration and disposal of medication in the home. The Registered Person must replace the curtains in the double room so that they fully extend around each bed. (Previous timescales of 01.11.04 and 21.02.05 were not met) This requirement was set following the previous inspection. The timescale had not expired at the time of this visit. The Registered Person must ensure that the carpet on Silver unit and the bath panel in room 229 are replaced. This requirement was set following the previous inspection. The timescale had not expired at the time of this visit. The Registered Person must forward a copy of the homes maintenance programme for 2006 to the commission by 01/05/06. The programme must make reference to the issues listed in this report under standard 19 and 26. The Registered Person must increase the number of staff provided in the home to ensure that there are an adequate number of staff to meet residents needs. The arrangements for meeting this requirement must be confirmed in writing to the commission by 31/03/06. 01/02/06 01/04/06 01/05/06 31/03/06 Danson House DS0000006792.V276555.R01.S.doc Version 5.1 Page 25 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 OP9 Good Practice Recommendations The Registered Person should work with the GP to ensure there is a system in place to prompt the review of residents medication. This should occur once a year for all residents on 1-3 medicines and six monthly for all residents on 4 or more medicines. The Registered Person should ensure that staff take appropriate action when the temperature in the refrigerator is outside the recommended range. The Registered Person should ensure that fire drill records include the time that the drill took place and how staff responded. Adequate records about fire safety training updates should be maintained. 2. 3. OP26 OP38 Danson House DS0000006792.V276555.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Danson House DS0000006792.V276555.R01.S.doc Version 5.1 Page 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!