Inspection on 22/06/07 for Dent House Nursing Home

This inspection was carried out on 22nd June 2007.

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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Dent House Nursing Home 30 Chesterfield Road Matlock Derbyshire DE4 3DQ Lead Inspector Tony Barker Key Unannounced Inspection 22nd June 2007 09:25 Dent House Nursing Home DS0000068662.V339800.R01.S.doc Version 5.2 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 Dent House Nursing Home DS0000068662.V339800.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Dent House Nursing Home DS0000068662.V339800.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dent House Nursing Home Address 30 Chesterfield Road Matlock Derbyshire DE4 3DQ 01629 584172 01629 584172 denthouse@caritasservices.com 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) Caritas Services Limited Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Dent House Nursing Home DS0000068662.V339800.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Caritas Services Limited is registered to provide nursing, personal care and accommodation for service users whose primary care needs fall within the following categories: Learning disabilities (LD) The maximum number of persons to be accommodated at Dent House is 10. This is the first inspection since registration. Date of last inspection Brief Description of the Service: Dent House is a large detached property close to the town centre of Matlock with easy access to local facilities and on a main bus route. It provides personal and nursing care for up to ten people with learning disabilities and has single en-suite bedrooms on the ground, first and second floors. The first and second floor bedrooms are not accessible to wheelchair users or people with limited mobility. The fees for the Home are from £1337 to £3450 per week. The Statement of Purpose provides prospective service users with appropriate information about the Home. Dent House Nursing Home DS0000068662.V339800.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The time spent on this inspection was 8 hours and was a key unannounced inspection. It was the first inspection since registration of the service on 6 February 2007 and its opening on 15 May 2007. There was still no registered manager in post. There were only two service users resident in the Home and both had high levels of dependency. Therefore, they were unable to contribute directly to the inspection process, though they were observed working with and being cared for by staff. The Staff Nurse in Charge and two care support workers were spoken to and records were inspected. There was also a tour of the premises. The two service users were case tracked so as to determine the quality of service from their perspective. The inspection focussed on all the key standards. The pre-inspection, Annual Quality Assurance Assessment, questionnaire, was sent to the Home but this was not returned by the Registered Provider until after this inspection, due to misunderstanding. A telephone call was made to the social worker of one service user and her opinions of the Home are reflected in this report. What the service does well: What has improved since the last inspection? What they could do better: The dosage of tablets must be clearly recorded to ensure that people receive the correct levels of medication. All staff who handle food must be provided with Basic Food Hygiene training to ensure the health and safety of service users is not compromised. A number of improvements were needed in respect of the Home’s records, care planning and medicines system. Dent House Nursing Home DS0000068662.V339800.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Dent House Nursing Home DS0000068662.V339800.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Dent House Nursing Home DS0000068662.V339800.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate information about the Home was available to prospective service users, and people placing them, in order to make an informed decision about whether the service is right for them. EVIDENCE: The Home’s Statement of Purpose contained those details about the service that had been required to be added at the time of registration. These included the age range, gender and category of needs the Home intends to meet. There was evidence on one service user’s file of a pre-admission assessment of needs. This included a ‘Screening Assessment’ document and ‘Strengths and Interventions (Activities of Daily Living)’ document. Both had been completed by the Home. The former had not been signed or dated. The Inspector was informed that a more comprehensive pre-admission assessment had been completed but this was not available at the time of this inspection. There was no recorded pre-admission assessment, on the other service user’s file, to guide staff in meeting the person’s needs. However, in a telephone conversation with this service user’s social worker it was confirmed that a full assessment of need had been passed to the Home. She added that the Home was “very efficient at the assessment stage”. Dent House Nursing Home DS0000068662.V339800.R01.S.doc Version 5.2 Page 9 The two service users’ files both contained a blank contract with no signatures or note of actual fees to be paid or the room to be occupied. Dent House Nursing Home DS0000068662.V339800.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users had an individual plan of care which indicated that they were treated as individuals and their personal goals were being considered. EVIDENCE: Care plans were in place for both service users who had only lived at the Home for between three and five weeks. On one file there was evidence of a ‘person centred approach’ being taken in respect of the service user. For example, documents had been completed on topics such as ‘What a good day is like’ and ‘Hopes and dreams for the future’. There was also a ‘Networking Chart’ on this service user’s file. The Person in Charge said that these person centred documents would also be completed for the second service user within the forthcoming weeks. Recorded assessments of need were holistic, covering social, emotional and physical needs. However, action plans for staff to follow were limited to health needs – though there was evidence that wider needs were being addressed in practice (see standard 12). The Person in Charge spoke of plans to hold three monthly in-house care plan review meetings and the first was due on 3 July 2007. Dent House Nursing Home DS0000068662.V339800.R01.S.doc Version 5.2 Page 11 Care plans illustrated how staff assist service users to make everyday choices. The two care support workers spoken to gave examples of service users making their own decisions and choices, with staff assistance. Overall, there was a good system of recorded risk assessments covering a variety of topics. The risk assessment covering outings was particularly comprehensive. However, there was evidence of some risk assessments being completed inappropriately or without making the degree of risk clear. The person in charge provided evidence of the Home having a positive approach to risk-taking as part of service users’ personal development. However, this philosophy was not fully reflected in discussion with care support staff, one of whom said, “I try to avoid any risk in any activity”. Dent House Nursing Home DS0000068662.V339800.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home provided activities and services that were age-appropriate and valued by service users and promoted their independence. EVIDENCE: There was evidence of service users being enabled to take part in activities that were valued by them and fulfilling. One service user had identified horse riding as one item in a list of personal ‘Hopes and dreams’. This ‘dream’ came to fruition during a horse riding session on the week prior to this inspection. The Person in Charge said that the service user thoroughly enjoyed this new experience. The care support workers described other examples of service users being involved in age-appropriate and personally valued activities. The Person in Charge said that structured day services for the service users, in external settings, were being considered. The care support staff said that the service users go out with staff most days, depending on the weather. These trips into the local community included food Dent House Nursing Home DS0000068662.V339800.R01.S.doc Version 5.2 Page 13 shopping and walks in the park. The Home was awaiting delivery of a ‘people carrier’ that would expand these activities. One staff member commented that enquiries were being made about membership of a local gym, swimming pool and sauna. The mother of one service user was telephoning the Home daily to speak with her relative and staff. She had also made a visit to the Home. It was stated that there was a close relationship between both service users and their mothers and this was clearly being encouraged. There was evidence of daily routines promoting service users’ independence. One staff member said he helps one service user to shave, with an electric razor, and to get dressed as independently as possible. The other staff commented that, “I encourage the service users to do as much for themselves as possible”. The Home’s weekly menus indicated that meals were balanced and nutritious. The Person in Charge spoke of creating pictorial weekly and daily menus that were more understandable to service users. Photographs of meals had already been taken, she explained. Lunch was observed during this inspection. It looked tasty and service users appeared to be enjoying it. Staff were eating alongside service users. Foodstocks were at a satisfactory level and included fresh fruit and vegetables. The food preferences of one service user were on file. Staff said that both service users were involved in food shopping but both chose to have only limited involvement in food preparation. One service user helped to clear up after meals. Dent House Nursing Home DS0000068662.V339800.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Inconsistently completed medication records mean that service users may being given the wrong dose of medicine. This puts service users at risk of harm. EVIDENCE: The staff provided evidence of daily routines being flexible. These included times of rising and going to bed, based on expressed choice, meal times and activity programmes. The Person in Charge explained that there was structure to each day but this was flexible. She said that staff ensure that service users have a bath or shower, according to their choice, every day. One care support worker confirmed that service users’ privacy needs were met by, for example, staff ensuring they wear a dressing gown or towels between the bathroom and bedroom. Equipment was in place to maximise service users’ independence including use of a wheelchair and of wall rails in one service user’s en-suite bathroom. Both service users had significant health needs. The Home’s records included a useful ‘Health and Social Care Record’ that followed a ‘person centred approach’. This had been partially completed in respect of one service user Dent House Nursing Home DS0000068662.V339800.R01.S.doc Version 5.2 Page 15 but not the other, as yet. Health assessments covered a number of areas and appointments with health professionals were included. The Person in Charge spoke about the involvement of a ‘continence nurse’ with one service user who was being, successfully, encouraged to use a toilet again following a prolonged period of permanent use of continence pads. There was a generally good medication recording system and of recording ‘prn’ (as and when required) medicines. However, one example of inconsistent recording of the maximum dose of Clobazam tablets ‘prn’ was found – both 20 mgs and 30 mgs were recorded. This was concerning. All medication administration record (MAR) sheets were handwritten as the Home was awaiting new printed MAR sheets from a local pharmacy. Several of these MAR sheets had only one staff signature recorded. Sample staff signatures were recorded. One service user was being administered a controlled drug but this was being recorded on a MAR sheet rather than in a Controlled Drugs Register. Medication, including controlled drugs, was being securely stored. Dent House Nursing Home DS0000068662.V339800.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good procedures for handling complaints and abuse were in place ensuring service users were fully protected. EVIDENCE: The Home’s Complaints Policy, in the Policies and Procedures file, was comprehensive. There was, however, no summary of this Policy displayed for visitors to the Home. A well-worded, ‘easy read’ version of the Complaints Policy was available for service users. The Home’s blank Complaints Book indicated that there had been no complaints received about the service. The Person in Charge said that all staff had been provided with training in Safeguarding Adults (keeping vulnerable adults safe from abuse). This training had been provided by the Home’s Deputy Manager who had achieved a trainers’ certificate in the subject from Derbyshire County Council. The Home’s written policy on safeguarding adults and on whistle blowing were examined and were well-worded. One member of staff spoken to showed good awareness and sensitivity regarding these policies. The Person in Charge could find no Derbyshire Safeguarding Adults referral forms available in the Home. In the telephone conversation with one service user’s social worker it was stated that her client was being provided with a safe environment to live. Dent House Nursing Home DS0000068662.V339800.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,26 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users were living in a safe and well-maintained environment, which was furnished and decorated to a good standard. EVIDENCE: The Home was attractively decorated and homely in appearance. It had good quality furnishings and floor coverings. All the work required at the time of registration had been completed, to a high standard, except for the provision of lockable storage space in bedrooms. The Home was clean with no unpleasant odours. One of the service users was using continence aids and the Person in Charge stated there had been no soiling of clothing or bedding. However, there was no sluicing programme on the Home’s washing machine should the need arise. There was no actual explicit Infection Control policy, just reference to such a policy within a broad Health Care policy. Dent House Nursing Home DS0000068662.V339800.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Home’s recruitment practices and staff training fell short of fully safeguarding the welfare of service users. EVIDENCE: The staffing rota, seen on the day of the inspection, indicated that there were two qualified nurses currently employed by the Home who were undertaking regular shifts. The Person in Charge confirmed that these were herself and the Deputy Manager - both of whom had nursing qualifications in the field of learning disabilities. Agency nurses provided additional qualified staffing. She also stated that there were currently seven care support workers employed at the Home. Two of these staff had achieved a National Vocational Qualification (NVQ) to level 3 in Care and two to level 2. This met the National Minimum Standard to maintain a staff group with at least 50 qualified care staff. The Person in Charge stated that both service users had funding for a two to one staffing ratio. This was confirmed in the telephone conversation with one service user’s social worker who was satisfied that her client’s needs were being adequately met. The staffing rota indicated that sufficient staff were in place to meet the needs of the two service users – with one qualified nurse Dent House Nursing Home DS0000068662.V339800.R01.S.doc Version 5.2 Page 19 and two care support workers on duty during the day and one qualified nurse and one care support worker on waking duty during the night. The Person in Charge stated that nursing staff had been recruited through local newspaper adverts and applicant’s CVs prior to interview. Care support workers had been recruited through the Job Centre. The file of a recently appointed member of care staff was examined. There was a Job Centre application form in place but none from the Home. The Person in Charge stated that she was not aware of a job application form developed by the Home. (The Inspector was later informed by the Company Director that there was a job application form in place). Matters relating to the recruitment of this member of care staff were satisfactory, except that there was no recorded evidence that the applicant had been requested to provide ‘details of any criminal offences of which the person has been convicted...including any which are spent...and in respect of which (s)he has been cautioned by a constable and which, at the time the caution was given, (s)he admitted’, as required by Schedule 2 of the Regulations. The Person in Charge stated that she was asked this question at her interview. She added that Criminal Records Bureau (CRB) disclosures were still awaited for four members of nursing staff, including the proposed manager. The Person in Charge stated that all staff had been provided with mandatory training on the topics of Fire Safety, First Aid and Moving & Handling. It was noted from the Fire Trainer’s certificate that the next fire training was due in 12 months. The Person in Charge was informed about the need to provide sixmonthly fire safety training, every six months, for staff undertaking night duties. Only half of the staff group had had recent Basic Food Hygiene training and three staff had had Health & Safety training. There was no ’at a glance’ training matrix available for quick confirmation of training undertaken. One care staff member confirmed training received and this had included the topic of ‘Epilepsy Crisis’. The other care support worker confirmed he was just about to commence the Skills for Care Common Induction Standards training and produced the Workbook as confirmation. Dent House Nursing Home DS0000068662.V339800.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 & 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There was no registered manager in post and this could potentially compromise service users’ safety. EVIDENCE: The proposed manager had not yet been approved as the Home’s registered manager, by the Commission for Social Care Inspection (CSCI), at the time of this inspection. She had not presented herself for a ‘fit person’ interview and more than four months had passed since registration of the service. The Person in Charge stated that the proposed manager had enrolled on an NVQ level 4 training course in Management, although not yet commenced. The Company Director had previously informed the CSCI that until the manager’s registration was approved the day-to-day running of the Home would be overseen by the Responsible Individual, on behalf of the Registered Provider. Dent House Nursing Home DS0000068662.V339800.R01.S.doc Version 5.2 Page 21 Records of the monthly, unannounced audit visits to the Home, undertaken on behalf of the Registered Provider, had just commenced following the opening of the Home on 15 May 2007. The June 2007 report was examined and found to be satisfactory. Completed weekly management checklists were also seen. The Person in Charge confirmed that the Home’s quality assurance measures did not include an annual development plan for the Home or surveys of the opinions of service users, relatives, staff or external professionals. The Inspector accepted that it was rather early for surveys to have been put in place. However, in the telephone conversation with one service user’s social worker it was stated that the person’s family were “very satisfied with the care being provided by the Home”. There was evidence of good food hygiene practices in the kitchen. Cleaning materials were being securely stored in the staff locker room, along with Product Data sheets, as required by the Control Of Substances Hazardous to Health (COSHH) Regulations. There were plans to move these materials to a locked cupboard in the laundry room. Weekly fire alarm tests were being recorded as part of a full Fire Safety Maintenance weekly check. Fire drills had not commenced. The gas safety certificate was dated February 2007. Recorded environmental risk assessments had been developed in April 2007. Accident records were in place. Dent House Nursing Home DS0000068662.V339800.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Dent House Nursing Home DS0000068662.V339800.R01.S.doc Version 5.2 Page 23 N/A 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 YA20 Regulation 13(2) Requirement The maximum dose of tablets administered ‘prn’ must be consistently recorded to ensure that people receive the correct levels of medication. All staff who handle food must be provided with Basic Food Hygiene training to ensure the health and safety of service users is not compromised. Timescale for action 01/08/07 2. YA35 13(3) 01/10/07 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. 2. 3. 4. 5. Refer to Standard YA2 YA2 YA5 YA6 YA9 Good Practice Recommendations All records used by the Home should be signed and dated. Recorded assessments of service users’ needs should always be maintained on file within the Home. Fully completed contracts should be in place regarding the agreement to provide care for service users. Action plans should reflect all aspects of service users’ health, social care and personal needs. The quality of recorded risk assessments should be reviewed. DS0000068662.V339800.R01.S.doc Version 5.2 Page 24 Dent House Nursing Home 6. 7. 8. 9. 10. 11. 12. 13. 14. YA9 YA20 YA20 YA22 YA23 YA26 YA30 YA30 YA34 15. 16. 17. 18. 19. YA35 YA35 YA35 YA37 YA39 Staff should be supporting service users to take responsible risks as part of their personal development. All hand-written entries, on medicine records, should be signed, countersigned and dated, in order to maintain a clear audit trail. The Home should keep records of receipt, administration and disposal of controlled drugs in a Controlled Drugs Register. A summary of the Home’s Complaints Policy should be displayed for visitors to the Home. Derbyshire Safeguarding Adults referral forms should be kept in the Home. Lockable storage space should be made available in service users’ bedrooms. A sluicing facility should be provided in the laundry room. A clear, explicit Infection Control policy should be in place. The Home should maintain a record of job applicants’ response to ‘details of any criminal offences of which the person has been convicted...including any which are spent...and in respect of which (s)he has been cautioned by a constable and which, at the time the caution was given, (s)he admitted’. The Home should ensure that Fire Safety training is provided every six months, for staff undertaking night duties. Staff should be provided with Health & Safety training. An ’at a glance’ staff training matrix should be developed. The Provider should ensure that the proposed manager presents herself to the CSCI for a ‘fit person’ interview. An annual development plan for the Home should be created. Dent House Nursing Home DS0000068662.V339800.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Dent House Nursing Home DS0000068662.V339800.R01.S.doc Version 5.2 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. 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