Inspection on 13/06/06 for Earls Lodge Care Home

This inspection was carried out on 13th June 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

Earls Lodge Care Home 13/03/07

Earls Lodge Care Home 03/10/06

Earls Lodge Care Home 28/11/05

Earls Lodge Care Home 21/08/05

Earls Lodge Care Home 14/07/05

Earls Lodge Care Home 24/03/05

Earls Lodge Care Home 15/10/04

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

CARE HOMES FOR OLDER PEOPLE Earls Lodge Care Home Queen Elizabeth Road Wakefield Yorkshire WF1 4AA Lead Inspector Gillian Walsh Key Unannounced Inspection 13th June 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 Earls Lodge Care Home DS0000044498.V291639.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. Earls Lodge Care Home DS0000044498.V291639.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Earls Lodge Care Home Address Queen Elizabeth Road Wakefield Yorkshire WF1 4AA 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) 01924 372005 01924 372011 www.fshc.co.uk Tamaris Healthcare (England) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Ms Amanda L Bennett Care Home with nursing 50 Category(ies) of Old age, not falling within any other category registration, with number (50) of places Earls Lodge Care Home DS0000044498.V291639.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Staffing arrangements for a maximum of 25 nursing and 25 personal care places Daytime 1 RN and 4 care assistants (upstairs) 4 care assistants (downstairs), one of whom is a senior care assistant Night-time 1 RN and 2 care assistants (upstairs) 2 care assistants (downstairs), 1 of whom is competent to administer medication Maximum of 25 nursing at any one time Can accommodate one named service user who is under 65 years of age 28th November 2005 2. 3. Date of last inspection Brief Description of the Service: Earls Lodge Care Home was purpose built to provide personal and nursing care for 50 older people. The home is situated in close proximity to Pinderfields Hospital on Queen Elizabeth Road, Wakefield, close to main bus routes from Wakefield town centre. The home is surrounded by gardens that provide a pleasant environment for service users to sit in. It is a two storey building with nursing care provided on the first floor of the home. There are pleasant lounges and dining areas on both floors. All rooms are single and most have en suite facilities. A team of qualified nurses, care assistants and ancillary staff work at the home and the local Doctors and their Primary Health Teams support them. The proprietor is Tamaris Healthcare (England) Limited (wholly owned subsidiary of Four Seasons Health Care Limited). The manager informed the Commission for Social Care Inspection on 13/06/06 that fees range from £370 to £420 per week. Additional charges include hairdressing, private chiropody and newspapers. A small charge is made for some activities such as Bingo and trips out. Information about the home is available to potential residents via the Statement of Purpose, Service User Guide and the last inspection report, all of which are available in the home’s reception. Earls Lodge Care Home DS0000044498.V291639.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. As part of this full inspection two inspectors from the Commission for Social Care inspection (CSCI) undertook a visit to the home. The visit started at 10am and finished at 5pm. Alongside this, the service provider was asked to complete a pre-inspection questionnaire, which was returned prior to the site visit. Questionnaires were sent to residents, their relatives, visiting professionals and GPs. 34 service user questionnaires were received back but these had all been completed by staff either with, or on behalf of, the service users. Of the 55 relatives questionnaires sent out, 9 were returned. Of the 5 General practitioner questionnaires sent, 1 was returned, 1 of the 2 district nurse surveys was returned and 1 of the 5 social worker questionnaires was returned. Relevant comments made within these questionnaires have been included within the body of the report. In writing this report, information and evidence was not only obtained by way of visiting the home, but also from notifications and information obtained by CSCI and from the last CSCI inspection report. In gathering evidence, CSCI undertook case tracking, reviewed documentation, sought feedback from service users and their families, staff, the home’s manager and other relevant stakeholders, and undertook relevant observations and discussions appropriate to needs of the service users taking into account their needs and communication needs. Inspectors would like to thank residents and staff for their time and assistance during this inspection. What the service does well: Earls Lodge Care Home DS0000044498.V291639.R01.S.doc Version 5.2 Page 6 Residents and visitors spoken with, or who returned questionnaires, made positive comments about the care provided at the home. A visitor said that they were well informed about the condition of their relative. One relative questionnaire said that staff “go out of their way” to support their relative. Staff were observed to be treating residents with respect and kindness. Complaints or concerns are dealt with thoroughly and the majority of residents indicated that they knew who to speak to if they had any problems. What has improved since the last inspection? What they could do better: Developments in care planning should continue to make sure that care plans accurately reflect an individual’s needs and are based on results of assessments. Daily records should reflect that residents have more in their daily lives than just clinical interventions. Improvements must be made to ensure that systems for the administration of medication are safe. Residents’ comments about needing more activities should be acted upon. Review of menus should continue to ensure that residents are provided with better choices in food. The fire officer’s recommendations must be complied with to ensure fire safety. Please contact the provider for advice of actions taken in response to this Earls Lodge Care Home DS0000044498.V291639.R01.S.doc Version 5.2 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Earls Lodge Care Home DS0000044498.V291639.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 Earls Lodge Care Home DS0000044498.V291639.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): 1 and 3. Standard 6 is not applicable. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The current Service User Guide and Statement of Purpose give prospective residents and their families accurate information about the home. The systems operated by the home ensure that people only move into the home after having had their needs assessed and are assured that these will be met. EVIDENCE: The Statement of Purpose and the Service User Guide have both been developed to provide accurate information about the home. All of the residents’ files seen included a comprehensive pre-admission assessment based on activities of daily living, which included past medical history as well as current needs. Earls Lodge Care Home DS0000044498.V291639.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 and 10. Quality in this outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service and is particularly affected by outcome for standard 9 (Medications). Not all of the individuals’ health, personal and social care needs are set out in the plans of care. People are not protected by the home’s policies and procedures for dealing with medicines. The work of the staff ensure that people feel that they are treated with respect and that their right to privacy is upheld. EVIDENCE: Care plans for two residents from each floor were looked at in detail. The files included pre-admission assessments, care plans, activity records, record of professional visits and a range of assessments. Positively, the home is moving away from use of generic care plans although some of those still being used were seen and had not been fully personalised to give details of the individuals’ needs and how these needs should be met. Earls Lodge Care Home DS0000044498.V291639.R01.S.doc Version 5.2 Page 11 The newly formulated care plans in general give better detail although some specific details are not included. An example of this is where the care plan states that, for managing continence, staff should “obtain products” but no detail was given of which products should be used. Similarly, care plans and manual handling assessments did not give detail of which size sling should be used when the resident needed to use the hoist. Some care plans contradicted each other, for example one person’s care plan for safety said to ensure access to the call bell but the plan for sleeping said the person was unable to use the call bell. Another care plan for eating and drinking for a resident who took some nutrition orally and some via a peg feed said “Be aware of risk of aspiration” but gave no detail of what actions need be taken should this occur. Care plans are being reviewed but new plans are not always being developed where the review indicates that a person’s needs have changed. Some discussion took place with the manager about how care plans could reflect residents’ abilities as well as needs. An example of this is communication where new or agency staff may not be aware of residents’ abilities regarding communication or comprehension and need the care plan to gain this information. Assessments are being completed and reviewed regularly. In one of the files seen, the waterlow assessment for skin integrity said that the resident was at high risk of developing pressure sores and positively a very detailed plan had been produced in response to this. Other assessments where residents had been identified as being at risk had not been followed up with an appropriate care plan. Daily records were very clinical and gave little indication of the residents’ day other than what care interventions they had received. Evidence is available in care plans that residents’ health care needs are being met appropriately. Each file contains a professional visits form which indicates when GPs, district nurses, speech therapists etc have been to see the resident. One of the resident’s relatives spoken with said that they had had the opportunity to see the dietician whilst they were visiting their relative and had been given information about the treatment they were receiving. None of the questionnaires received back from professionals indicated any problems with the service delivered by the home. Systems for the receipt, storage and administration of medication were checked. No problems were found on the ground floor residential unit but a number of anomalies were found within the four residents’ medications checked on the first floor nursing unit. These included gaps on medication administration record sheets, adequate explanation of why medications had Earls Lodge Care Home DS0000044498.V291639.R01.S.doc Version 5.2 Page 12 not been given and amounts of medication not tallying with the amounts received and the amounts administered. Care plans seen referred to maintaining residents’ needs with regard to privacy and dignity. From observations of staff interventions with residents, there was no evidence that these needs are not considered and maintained. None of the residents spoken with felt that their privacy and dignity needs were not met. Earls Lodge Care Home DS0000044498.V291639.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 and 15. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Due to the size of the home and the current staffing arrangements, residents’ social and recreational needs are not fully met. Residents maintain contact with family and friends as they wish and are helped to exercise choice and control over their lives. Residents receive a wholesome appealing balanced diet in pleasant surroundings. EVIDENCE: One part time activities organiser is employed at the home to organise and deliver activities for all of the residents. An activities programme is available on the notice board in the entrance to the home, which indicates what the activities are for that morning and afternoon and where they are to take place. Minutes from residents’ meetings suggest that some residents are unhappy with the amount of activities available to them and this was also mentioned in a questionnaire returned to CSCI by a visiting professional. Staff and residents indicated that the activities organiser works very hard and gives a lot of her own time to organising events such as barbeques and trips out but is unable, on a daily basis, to meet the needs of fifty residents within the time allowed. Earls Lodge Care Home DS0000044498.V291639.R01.S.doc Version 5.2 Page 14 Some records were seen within care plans about individuals’ interests and preferences regarding their social and recreational needs. One of the care plans seen was for a resident who had had a very active role within their religion. The manager said that this person’s relatives deal with this aspect of their life but it was disappointing that this was not reflected within the care plan other than in the pre-admission assessment. Positively, one relative commented within a questionnaire “All staff treat residents as individuals, quickly learning their likes/dislikes/foibles”. Resident participation in activities is not well reflected within the activities records. One record had “all activities” written in the activity list with the box “unable” ticked on several occasions. This was to indicate that the resident was unable to join in any of the activities on offer but did not indicate what the person may have done with their time instead of joining the activity. Relatives spoken with said that they were happy with the arrangements for visiting and all of the relative/visitor questionnaires received also indicated satisfaction in this area. Both units have pleasant dining areas which residents are encouraged to use to take their meals. One of the professional visitor’s questionnaires received said that residents were not always happy with the choice of food available to them. On the day of the visit, the lunchtime meal was a choice of chicken casserole or tagliatelle. None of the residents had chosen the tagliatelle as they said they didn’t like it. One of the residents said that they didn’t like their meal as it was “sloppy” but others appeared to be enjoying it. Two residents had said in their questionnaires that they “never” enjoyed the food at the home and 9 said that they “sometimes” enjoyed the food. Meals were nicely presented including liquidised or softened meals and were nutritious in content. The manager said that she was trying out some new meals in response to residents’ requests but would continue to review menus to provide residents with better choice. Earls Lodge Care Home DS0000044498.V291639.R01.S.doc Version 5.2 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. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The systems operated by the home ensure that people can raise concerns and complaints, and feedback shows that they are confident that their complaints will be listened to, taken seriously and acted upon. There are appropriate systems in place to protect people from abuse. Staff know what to do if alerted to suspected or alleged abuse EVIDENCE: Since the last inspection two complaints have been received by the home. The complaints log evidenced that both of these complaints had been properly investigated and dealt with in line with the home’s complaints procedure. A copy of the complaints procedure is displayed in the reception area and is included in the Service User Guide. One relative said in a questionnaire that a concern they had was “properly investigated” and that the manager dealt with the situation “very well”. Staff training is ongoing in protection of vulnerable adults and a recent allegation was dealt with appropriately through Wakefield’s adult protection procedures. Earls Lodge Care Home DS0000044498.V291639.R01.S.doc Version 5.2 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 and 26 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Maintenance routines at the home are sufficient to protect residents’ safety. More attention to detail is needed to ensure high standards of hygiene within the home. EVIDENCE: A tour of the premises confirmed that generally the home is well maintained. Standards of decoration were good both in communal and personal areas. Water temperatures in two baths were found to exceed the recommended 43ºC but the handyman dealt this with immediately. It was also noticed that bath thermometers were not available in all bathrooms. Some minor redecoration is needed in two bathrooms where water damage has caused staining to the ceiling. Earls Lodge Care Home DS0000044498.V291639.R01.S.doc Version 5.2 Page 17 Generally the home was clean and tidy although dirty bath mats were seen and the safety side bumpers and pressure-relieving cushion in one resident’s bedroom were in need of cleaning. One visitor commented that there was a smell of urine in the corridor and a relative’s questionnaire had also indicated that this could be a problem on some occasions. Earls Lodge Care Home DS0000044498.V291639.R01.S.doc Version 5.2 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. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service and is particularly affected by the availability of staff to meet residents’ recreational needs. The number of staff working at the home enables the healthcare needs of people to be met appropriately, although activities staff are not available in sufficient number to meet residents’ recreational and social needs. Systems in place for recruitment and training ensure that residents are safely supported by a competent staff team. EVIDENCE: Staff duty rotas indicated that care staff are available in sufficient numbers to meet the needs of the current residents. Staff said that, although they felt that they struggled when the home is at full occupancy, the current reduced occupancy levels meant that staff were comfortable that they were able to spend sufficient time with residents making sure that their needs are met. One relative questionnaire said that they thought there are sometimes insufficient staff on duty although this did not appear to be the case at the time of the site visit. Earls Lodge Care Home DS0000044498.V291639.R01.S.doc Version 5.2 Page 19 One relative questionnaire was very complimentary of the staff team saying that they “go out of their way” to support their relative and in keeping them informed of their relative’s condition. The availability of only one part-time activities organiser is not sufficient to meet with the social and recreational needs of the residents. Staff training is ongoing; the training matrix indicated that all mandatory training is up to date. NVQ training in health and social care for care staff is now being organised through the company and 6 staff are about to start the training. 17 of care staff currently hold the award. Documentation contained within staff personnel files indicated that recruitment policies and procedures to protect residents are being followed. Earls Lodge Care Home DS0000044498.V291639.R01.S.doc Version 5.2 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, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home’s manager demonstrates competence in her role. A quality assurance programme is in place, although this is not robust enough to ensure that the home is run in the best interests of the residents. Residents’ financial interests are protected by systems operated in the home. Residents’ and staff’s health and safety interests are not fully protected in respect of fire safety. EVIDENCE: The home’s manager is a Registered Nurse who has just completed the registered managers award. Earls Lodge Care Home DS0000044498.V291639.R01.S.doc Version 5.2 Page 21 Quality monitoring is done on an ongoing basis. Weekly audits are conducted by the manager in areas such as pressure sore management, weight loss, accidents, infection control and POVA (Protection of vulnerable adults) issues. Monthly audits are then completed by the manager in medications, health and safety and staff training. On an annual basis, questionnaires are sent to approximately half of the residents for their comments on the service they receive at the home. The manager does not see the full results of this survey, only a very brief report from head office which does not include any comments and only states what percentage of people are satisfied with each of the identified areas. It does not state the reasons for the dissatisfaction of the remainder of the residents completing the questionnaires and an action plan is not developed in respect of this. Residents’ meetings are held every 3 months and the minutes of these meetings are displayed on the notice boards. Small amounts of money are kept in the home on behalf of some residents. An accurate accounting system for a selection of these monies was seen. Discussion took place with the manager about the availability of residents’ money out of office hours. Currently there is no system in place for residents to access their money when the manager or the administrator are not available. The manager said that, up to now, this has not been a problem but consideration would be given as to how this may be organised. The home’s health and safety file was seen to contain all relevant and up to date certification for maintenance of systems relating to health and safety of residents and staff. A recent fire report detailed some outstanding recommendations, which the manager said have not yet been met. Earls Lodge Care Home DS0000044498.V291639.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 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 3 X 3 X X N/A 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 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 1 Earls Lodge Care Home DS0000044498.V291639.R01.S.doc Version 5.2 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 OP9 Regulation 13(2) Requirement A safe system of recording, handling and administration of medication must be followed by staff at the home. The registered person must ensure that the recommendations made by the fire service are completed. Previous timecale of 31 March 2006 not met. Timescale for action 13/06/06 2. OP38 23(4)(a) 31/07/06 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. Refer to Standard OP7 Good Practice Recommendations Care plans should: • Give specific detail of resident’s current needs. • Detail actions necessary to maintain residents safety. • Be newly developed when a review indicates a change of needs or an assessment highlights specific DS0000044498.V291639.R01.S.doc Version 5.2 Page 24 Earls Lodge Care Home • And needs. Include details of resident’s abilities. 2 3 4 5 6. OP12 OP27 OP15 OP38 OP19 OP26 OP28 Daily records should give detail other than just clinical interventions made. Consideration should be given to increasing the availability of staff to provide social and recreational activities to residents. Reviews of menus should continue in response to resident’s comments. Bath thermometers should be available in all resident’s bathrooms and staff should check and record temperatures before assisting residents to bathe. Cleaning schedules should ensure that good standards of hygiene are maintained in all areas, including residents own equipment. The registered person should continue to make NVQ level 2 training available for staff in order to achieve 50 of the number of qualified staff by December 2005. Quality monitoring should be developed to include the views of staff and other professionals involved in the care of resident’s at the home. The report based on these findings should detail any dissatisfaction and an action plan should be developed in response to this. 7. OP33 Earls Lodge Care Home DS0000044498.V291639.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 Earls Lodge Care Home DS0000044498.V291639.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. 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!