Inspection on 25/05/06 for Docking House

This inspection was carried out on 25th May 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

Docking House 12/01/09

Docking House 19/12/07

Docking House 27/04/07

Docking House 21/12/06

Docking House 25/01/06

Docking House 30/10/05

Docking House 18/05/05

Docking House 17/02/05

Docking House 06/01/05

Docking House 01/03/04

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Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Docking House Station Road Docking Kings Lynn Norfolk PE31 8LS Lead Inspector Kim Patience Unannounced Inspection 25th May 2006 10:00 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 Docking House DS0000042254.V297678.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 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. Docking House DS0000042254.V297678.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Docking House Address Station Road Docking Kings Lynn Norfolk PE31 8LS 01485 518243 01485 518436 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) ARMS Associates Ltd Mrs L Brooks Care Home 28 Category(ies) of Dementia - over 65 years of age (18), Old age, registration, with number not falling within any other category (10) of places Docking House DS0000042254.V297678.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th January 2006 Brief Description of the Service: Docking House is a residential home for 28 older people in the village of Docking situated between the towns of Hunstanton and Fakenham. There is a post office and shop close by. The home is supported by two G.P. practices. It cares for 18 older residents who are mentally frail and 10 older residents who need care in a residential setting. The accommodation is all on the ground level, which is divided into two units to offer the support to the two types of older people requiring care. The home has shared and single bedrooms with hand wash basins. Docking House DS0000042254.V297678.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted unannounced by two regulatory inspectors and completed in nine hours. The manager and the proprietor were available for consultation throughout the inspection and were helpful in facilitating the process. During the inspection, a tour of the premises was completed and records relating to staff and residents were inspected. Staff, residents and visitors were interviewed and observations of interaction between staff and residents were made. Twenty-five comment cards were returned by residents, relatives and health professionals. Comments made have been incorporated in this report and used as supporting evidence. What the service does well: What has improved since the last inspection? • Improvements to the fabric of the building have continued. Some carpets have been replaced, new furniture has been added to bedrooms and the work on the new shower room is almost complete. New care plans have been introduced and if completed correctly will provide good information from which staff can deliver effective care. • What they could do better: This inspection has shown a number of ongoing concerns and it is very disappointing to note the lack of progress towards meeting all of the requirements made at previous inspections. It is of particular concern that the home has not addressed those issues that place people at risk of harm. 19 requirements are made as a result of this inspection and of these 8 are repeated from previous inspections. The Commission expects the management to meet the requirements within the timescales or may consider taking enforcement action to seek compliance. Docking House DS0000042254.V297678.R01.S.doc Version 5.2 Page 6 • • • • • • • • • • • • • • • • • Care plans still need to be improved in order to meet people’s holistic needs. Risk assessments need to be completed to identify and eliminate risks to people’s health and welfare. Nutritional needs assessments need to be completed and peoples needs met in this respect. The medication arrangements still do not protect people’s health, safety and welfare. The home does not fully promote privacy and dignity. The home still does not fully meet people’s social, emotional and psychological needs. There is little meaningful activity and needs are not fully assessed and met in this respect. The home does not maintain records of dietary intake and it is not possible to see whether people are having a nutritious diet. Mealtime was chaotic, noisy and residents were not given adequate supervision and support with meals. Food was not always presented in a manner that is appealing and appetising. The complaints procedure is not well advertised. The environment still needs some maintenance and renewal. The home still needs to address the problems with odours. Specialist equipment is needed to meet the needs of people with dementia. Staffing levels need to be reviewed and additional staff appointed where necessary. Recruitment practice is still a concern and must be improved in order to protect people from potential abuse. Staff still need to be provided with adequate training in order to fulfil their role. Docking House DS0000042254.V297678.R01.S.doc Version 5.2 Page 7 • • The manager must undertake training to update her knowledge and skills and enable her to provide good leadership. The home does not have a system for monitoring quality and this must be developed. 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. Docking House DS0000042254.V297678.R01.S.doc Version 5.2 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 Docking House DS0000042254.V297678.R01.S.doc Version 5.2 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): Standards not assessed on this occasion. EVIDENCE: Standards not assessed on this occasion. Docking House DS0000042254.V297678.R01.S.doc Version 5.2 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): 7,8,9,10 The quality outcome in this area is poor as the home still needs to improve the care plans before it can be said that they are meeting peoples assessed holistic needs. Improvements still need to be made to ensure that the home has a safe system for the administration of medicines. The home needs to consider how they can work harder at promoting peoples rights to privacy. EVIDENCE: Two care plans were inspected and there has been little improvement since the last inspection. New care plans have been introduced and the home are transferring information to the new care plan format. The care plans seen did not contain adequate person-centred information, for instance there is little information about peoples social and emotional needs. Some information on care plans was inaccurate and was not consistent with observations and daily record notes. Care plans need to provide clear, detailed Docking House DS0000042254.V297678.R01.S.doc Version 5.2 Page 11 information from which care assistants can deliver effective care to meet peoples holistic needs. A requirement is made for the second time. In addition care plans had not been reviewed in accordance with the standards and therefore do not reflect the changing needs of residents. See requirements. Risk assessments had been completed for some risks such as falls and pressure sores, however there was no care plan for the management of pressure sores even though the score was high. Not all risks had been considered and some risk assessments did not provide clear information. For instance, Moving and handling assessments contained lots of irrelevant information making it difficult to identify key points and there were no risk assessments for toiletries and other products stored in peoples rooms. See requirements. People’s nutritional needs had not been assessed and records gave little indication of peoples preferences in respect of food. See requirements. Medication arrangements were inspected and still need to be improved to make the arrangements safe. For instance, the home does not have a trolley to transport medicines safely around the home and medicines were seen unattended in the kitchen at times when the care assistant was taking medicines to each individual. The resident’s medication administration records (MAR) were disorganised and did not contain a photo for each person. The home still does not have a controlled drugs register, however, they were not administering any controlled drugs at the time of this inspection. At the start of the inspection it was observed that one resident had been left at the dining table with a tablet in a pot. All prescribed medicines should be given and the resident should be observed to take the tablet before signing the chart to say it has been administered. An audit of the medicines showed that there were some discrepancies in the charts and the number of tablets remaining in the boxes. The home did not have an internal audit system to identify and rectify errors. Prescribed external applications were seen in resident’s rooms and this may be unsafe for some residents. No risk assessments had been complete in this respect. The home was still not able to produce guidance on PRN medicines. A requirement in respect of medicines is made for the second time. Docking House DS0000042254.V297678.R01.S.doc Version 5.2 Page 12 The home has a blanket policy on locking doors to prevent people walking into each other’s rooms. This is a restriction on people’s rights and restricts their choice of privacy. It was also said by a relative that she never goes to her husbands room and would have to ask for a key if she wanted to, this does not promote peoples rights to privacy. In the dementia unit, each chair had an incontinence sheet placed on the seat without a cover over the top. This does not promote peoples dignity and highlights the fact that some people may have incontinence problems. See requirements. Docking House DS0000042254.V297678.R01.S.doc Version 5.2 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, 13, 14, 15. The quality outcome in this area is poor, as it still cannot be said that the home is meeting people’s holistic needs and planning activities in a personcentred manner. The home does promote contact with relatives and people from the local community. It cannot be said that the home enables people to make their own choices and have control over their lives. The home cannot fully demonstrate that people are provided with a balanced diet due to the lack of records in this respect. EVIDENCE: Care plans did not show sufficient detail of peoples social emotional needs and interests and hobbies. Therefore, the home cannot offer activities and occupation that is meaningful to the individual. At the last inspection the home had purchased some games and were making great efforts to provide activity in the home. This work needs to be progressed and the idea of activity being incorporated into daily life should be adopted. Docking House DS0000042254.V297678.R01.S.doc Version 5.2 Page 14 People may like to be involved in assisting with setting the table for lunch or helping to clear tables. Staff were observed to spend time with residents talking and one was providing hand-massages. It is good practice to see staff spending one to one time engaging with people. Staff would benefit from some training in working with people with dementia and the provision of meaningful person-centred care. Relative comment cards indicate that there is a lack of activity and stimulation in the home. Requirements are made for the second time. Mealtime was observed in the dining areas in the residential unit and in the dementia unit. In the dementia unit, mealtime appeared disorganised and at times chaotic. The dining tables are situated in the two lounge areas making it difficult for staff to properly supervise people in both areas. Staff were assisting in the kitchen and serving the meals. Whilst they were doing this people were left seated at the tables and in some cases were arguing. The meal looked appetising and people appeared to enjoy the food, however no choice was offered to people. Drinks were provided but again no choice was given. One resident was clearly having some difficulty using cutlery and was using her fingers to eat, the care assistant told her to stop but did not have time to give her assistance. In this case finger foods would be more appropriate and easier for the resident to manage independently. As mentioned in standards 7-11 people’s nutritional needs had not been assessed and therefore staff are not able to meet peoples individual needs in this respect. See requirements. The cook was spoken with, she said she was made aware of any special dietary needs such as diabetics and those that needed pureed food. This information was written on a board in the kitchen. The cook was unable to produce any records relating to peoples dietary intake. For instance the home should maintain a record of the meal provided, what meal each individual chose and any alternatives offered. See requirements. It was observed that people requiring soft food were presented with a bowl of food all pureed together. Food should always be pureed in individual portions, retaining the individual tastes and colour to make it more appetising and appealing. In addition, one member of staff assisting a resident with feeding was interrupted several times by the need to attend to other residents who were arguing and moving from the tables. See requirements. During mealtime the door between the kitchen and lounge/diner was open, creating lots of noise. For instance the food mixer was being used and the Docking House DS0000042254.V297678.R01.S.doc Version 5.2 Page 15 crashing of kitchenware could be heard. All these loud noises could add to people’s confusion and cause anxiety. It is recommended that the kitchen door is kept closed to reduce the noise levels. See recommendations. During the inspection, several visitors were seen entering the home. Some visitors were spoken with and said they were always welcome at the home. They found the manager and staff very friendly and approachable. Docking House DS0000042254.V297678.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The quality outcome in this area is poor as the home still need to improve the complaints procedure by ensuring it is well publicised. They also cannot fully demonstrate that people are protected due to poor recruitment practice. EVIDENCE: The home has a policy and procedure for handling complaints. A copy of the procedure was seen on display in one of the lounges, however, it was not displayed clearly and the print was very small and difficult to read. Residents who completed and returned comment cards said that they knew who to speak to if they had a concern. However, a number of comment cards returned by relatives stated that they were not aware of the procedure for making a complaint. Therefore it is recommended that the home reproduces the complaints procedure and displays it in a prominent position. The home also needs to ensure that each relative is given a copy of the complaints procedure. See requirements. Some staff have still not been trained in adult protection, however, the training was scheduled for 21 June. Staff interviewed stated they knew how to raise concerns about adult protection matters. Staff files were inspected and recruitment practice was found to be poor with a number of concerns about staff being employed before the proper preemployment checks have been completed. This practice does not promote the protection of vulnerable people. See requirements. Docking House DS0000042254.V297678.R01.S.doc Version 5.2 Page 17 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, 26 The quality outcome in this area is poor even though some improvements have been made to the fabric of the building since the last inspection. However, further work is needed before it can be said that the home is meeting the standards. There were still concerns about cleanliness and hygiene in the home. EVIDENCE: Some improvements had been made to the environment such as the new shower room, which is almost complete, the redecoration of some areas and the replacement of some carpets. The home has responded to recommendations made by the falls advisor from the Primary Care Trust (PCT). Further improvements need to be made and the home has a plan to address these areas. Some signage has been placed around the dementia unit to aid orientation and this is good. However, the home should consider signage that is clear and in bold print. Bedroom doors were named but were not easily readable or recognisable to people with dementia and perhaps should give some Docking House DS0000042254.V297678.R01.S.doc Version 5.2 Page 18 consideration to placing the persons photo on the door or a picture that they are familiar with. In addition, some directional signage would be useful to orientate people as they walk around the home. All bedroom doors in the dementia unit were locked and following a discussion with the manager, the reason seemed to be to stop people walking into other rooms. Signage would help people to find their way around. People should not be restricted from going to their rooms unless this is deemed necessary to protect the individual from harm, as determined by a risk assessment. The home should consider ways of making the environment more enabling, for instance investing in assistive technology such as door sensors and pressure mats. See requirements One door was seen to have a sensor fitted to it. Several rooms in the dementia unit were entered, some smelt very offensive. Carpets were stained and some are still in need of redecoration. See requirements. Call bells were not easily accessible in all rooms and there was no assistive technology to trigger the need for assistance. Where people are not able to use a call bell, the home must find an alternative to ensure that staff can monitor residents and assist where needed. See requirements. As mentioned in standards 7-11, there were several items in people’s rooms that would present a risk to health if ingested. For instance, denture cleaning tablets and other toiletries. There were no risk assessments in place and these must be written to determine whether these products need to be stored in a safe place. In addition, communal toiletries are still being used and were seen in bathrooms. See requirements. The home looked generally clean and tidy, however, some areas needed a thorough clean such as some of the communal toilets/bathrooms. As mentioned earlier, there are issues with stained carpets and strong odours in some rooms. Following the last two inspections the home has had requirements to increase the domestic hours and it does not appear that the requirement has been met. Therefore, the requirement is made for the third consecutive time. See requirements. Docking House DS0000042254.V297678.R01.S.doc Version 5.2 Page 19 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): 27,28,29,30 The quality outcome in this area is poor, as the home cannot demonstrate that people’s needs are being met by adequate numbers of trained and competent staff. There are also still some concerns about the recruitment practice in the home. Whilst staff have received some further training, improvements are still needed here. EVIDENCE: The home employs four care staff in the mornings and three in the afternoon/evening. There are 10 residents in the residential unit and 18 residents in the dementia unit. Whilst these people are contained in one area, staff may be able to provide adequate support and supervision. However, the home should progress towards enabling people to have more freedom to walk around the home and into their rooms, in addition to increasing the amount of activity and supervision at mealtimes. Therefore, the home needs to review the staffing levels and increase them to meet people’s individual assessed needs. At the last inspection a requirement was made to take on an extra member of staff to act as kitchen assistant at teatime. This has not been met and the inspector was told that the manager and the proprietor’s mother still covered some teatimes preparing food. The requirement is made for the third time. Docking House DS0000042254.V297678.R01.S.doc Version 5.2 Page 20 Nine staff files were inspected. It was found that files are still not being kept in accordance with schedule 2. Some files did not contain application forms, two references or a CRB check. The recruitment practice has been of concern at the last two inspections and is still a concern. The home must improve the recruitment practice in order to ensure that vulnerable people are protected from potential abuse. A requirement is made for the third time. The staff files also showed that some new employees have not completed an induction-training programme. See requirements. In general, the provision of training still needs to be improved. Some training programmes have been booked and cover subjects such as, protection of vulnerable adults, medication and challenging behaviour. The home must continue to source and provide appropriate training to ensure staff are competent and trained to fulfil their role. See requirements Docking House DS0000042254.V297678.R01.S.doc Version 5.2 Page 21 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): 31,33,35,38 The quality outcome in this area is poor, as the manager has failed to ensure that the home is managed to the National Minimum Standards and the Care Homes Regulations. She needs to enhance her skills and knowledge and provide some clear leadership in this home. There is no adequate system in place to monitor the quality of the service. The home does not handle resident’s money, which is good practice. The home cannot fully demonstrate that it promotes the health safety and welfare of service users and staff due issues raised within the report. EVIDENCE: The registered manager has worked in the home for 20 years and has a very visible, approachable style. Visitors and residents know the manager and appear to have a good relationship. Docking House DS0000042254.V297678.R01.S.doc Version 5.2 Page 22 Likewise, the proprietor and his mother work in the home for three days a week and also appeared to be well known by all, with a friendly welcoming approach. The manager is very hands-on and likes to be involved in delivering care. Whilst this is positive, it takes her away from some of the management tasks that need to be completed. In addition, the manager needs to source and undertake management training and some advanced training in dementia. It is vital that the manager is trained to a standard at which she can provide a good model of best practice and clear leadership. See requirements. The home employs an independent person to carry out the regulation 26 visits. There does not appear to be any other formal monitoring of quality in the home and this needs to be developed. See requirements. Health and safety records were inspected and found to be in good order with servicing and safety checks being completed as necessary. The home was not able to produce a risk assessment for the premises or risk assessments for the products stored in people’s rooms. In addition, some of the risk assessments relating to residents and staff had not been completed. Therefore, it cannot be said that the home fully promotes health and safety. See requirements. Docking House DS0000042254.V297678.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 1 2 X X X X X X 2 STAFFING Standard No Score 27 1 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 1 X 3 X X 2 Docking House DS0000042254.V297678.R01.S.doc Version 5.2 Page 24 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 OP29 Regulation 19 Requirement It is required that the Proprietor obtains the information listed in Schedule Two of the Care Homes Regulations for all members of staff prior to them starting work. This is made for the third time It is required that the care plans include detailed guidance for staff about how to meet individuals’ needs. This is made for the third time It is required that the nutritional needs of each individual are assessed and met. It is required that risk assessments are written and that unnecessary risks to peoples welfare are identified and minimised or eliminated. It is required that written guidance is available for the use of PRN medication This is made for the third time It is required that peoples dignity DS0000042254.V297678.R01.S.doc Timescale for action 28/07/06 2. OP7 15 31/07/06 3. 4. OP8 OP8 17(1a)sc3 4(c) 31/07/06 31/07/06 5. OP9 13 (2) 28/07/06 6. OP10 4(a) 01/07/06 Page 25 Docking House Version 5.2 7. OP12 16(m)(n) 8. OP15 16(i) 9. 10. OP15 OP16 17(2)sc4( 13) 22(5)(6) 11. OP19 16(c) 12. OP38 4(c) 13. OP26 18 (1a) 14. OP19 16 (2k) and privacy is promoted. It is required that the home assess peoples social and emotional needs and that these are met. This refers to the need to provide person-centred activity in the dementia unit. It is required that the home provides nutritious food that is appealing and appetising. This refers to pureed food. It is required that the home maintains a record of people’s dietary intake. It is required that the complaints procedure is produced in easily readable text and is well publicised. It is required that the home provides specialist equipment to meet people’s individual needs. This refers to the need for an alternative to call bells, assistive technology, signage and cues. It is required that risk assessments are completed for all risks posed by the environment. This refers to toiletries in people’s rooms, communal areas and a premises risk assessment. It is required that the domestic hours are increased This is made for the third time It is required that the Home is free from offensive odours This is made for the third time 31/07/06 31/07/06 31/07/06 31/07/06 31/08/06 31/07/06 28/07/06 28/07/06 15. OP14 12 (4a) It is required that the residents 28/07/06 have their own toiletries and that communal toiletries are not used. This is made for the second time It is required that the staff DS0000042254.V297678.R01.S.doc 16. OP30 18 31/08/06 Version 5.2 Page 26 Docking House receive training with regard to providing care for older people with dementia with a particular emphasis on communication. This is made for the second time. 17. OP27 18 It is required that an additional member of staff is on duty during the afternoon to prepare, serve and clear up at tea time This is made for the third time. It is required that the home has a quality assurance system, which includes consultation with all stakeholders. It is required that the manager undertakes regular training to update her skills and knowledge. This refers to the need for some formal management training and advanced training in dementia care. 31/07/06 18. OP33 24 30/09/06 19. OP31 9 30/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP9 OP9 Good Practice Recommendations It is recommended that the Proprietor purchase a proper medication trolley It is recommended that the controlled drugs are kept in a locked container within the locked medication cupboard and that a register is kept for this medication which includes the signatures of two staff It is recommended that the kitchen door be closed during meal preparation to reduce noise and confusion. It is recommended that there is a training and DS0000042254.V297678.R01.S.doc Version 5.2 Page 27 3. 4. OP15 OP30 Docking House development plan for each member of staff 5. OP36 It is recommended that regular staff meetings take place Docking House DS0000042254.V297678.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Docking House DS0000042254.V297678.R01.S.doc Version 5.2 Page 29 - 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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