Inspection on 23/05/05 for East Riding

This inspection was carried out on 23rd May 2005.

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

East Riding 22/09/09

East Riding 05/12/08

East Riding 05/12/07

East Riding 30/10/06

East Riding 11/05/06

East Riding 24/11/05

East Riding 05/11/04

East Riding 06/05/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE East Riding Whoral Bank Ashington Road Morpeth, Northumberland NE61 3AA Lead Inspector Irene Bowater Unannounced 23 May 2005 09:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. East Riding B53-B03 S506 East Riding V223200 230505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service East Riding Address Whoral Bank Ashington Road Morpeth Northumberland NE61 3AA 01670 505444 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) east.riding@fshc.co.uk Four Seasons Health Care (England) Ltd Mr Jason Robert Woods CRH 67 Category(ies) of DE Dementia (34) registration, with number OP Old age (33) of places East Riding B53-B03 S506 East Riding V223200 230505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 named service user under pensionable age receiving EMI nursing care. 2 service users under pensionable age receiving general nursing care. Date of last inspection 5th November 2004 Brief Description of the Service: The home is a two storey purpose built facility situated on the outskirts of Morpeth.It is within walking distance of local shops and the town centre. The approach to the home is via a steep driveway,which leads to generous car parking from which there is level access to the home. The home comprises of two units. Millview Unit is situated on the ground floor and caters for thirty older persons with nursing care needs and there are three beds for residents who require social and personal care only. The Wandsbeck Unit is situated on the first floor and has thirty four beds for mentally ii service users requiring nursing care. Bedroom facilities are mainly single en-suite with a total of six double rooms throghout the home. Each unit has lounges and dining rooms and there are specialist bathrooms and shower rooms located on each floor. The kitchen and laundry is located on the ground floor and the first floor is accessed by stairs and a passenger lift. East Riding B53-B03 S506 East Riding V223200 230505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place over one day. The Registered Manager has transferred to another home after a period of sickness and a Manager from another home has been transferred into East Riding. The manager was available and assisted throughout the inspection of the home. The majority of the day was spent touring the premises, talking to staff residents and their representatives. A part of the day was spent in the office examining the records and discussing the previous requirements from the last report with the new manager. Thirteen resident’s, ten staff, two relatives and one professional visitor were spoken to throughout the day. What the service does well: The homes admission documentation is comprehensive which ensures that individual needs are met. The home has a core of staff that have been employed for a considerable time and they have formed good relationships with the residents families and other professionals. Residents said that they like the staff and they always work hard to improve things in the home. Relatives said that the communication is now good and they can approach staff with concerns and the issues are dealt with immediately. They also said that they are always kept informed about any changes or events in their relative’s condition and found this very comforting. Comments from another professional included that the staff are able to manage difficult behaviour and they give a good level of care. The activities person works hard to provide entertainment and leisure events in the home. East Riding B53-B03 S506 East Riding V223200 230505 Stage 4.doc Version 1.30 Page 6 The residents spoken with knew how to complain if they were unhappy about anything. What has improved since the last inspection? What they could do better: The terms and conditions of residency has not been given to residents who are self funding. No progress has been made to afford self-funding residents a trial period or a review of care after a six-week period. The care plans need to be comprehensive and detail all the care delivered. The changing needs of residents need to be recorded to ensure consistent care is given at all times. Risk assessments and other assessment tools also require regular review and up dating The advice from other professionals must be sought for those who have poor East Riding B53-B03 S506 East Riding V223200 230505 Stage 4.doc Version 1.30 Page 7 appetite or who have lost weight. The advice must be recorded and a care plan implemented. The meals must be reviewed and changed to meet the needs of the residents The residents must be provided with fresh fruit and fortified drinks. The redecoration and refurbishment of the home must be progressed without further delay to ensure the residents live in a safe pleasant environment. A training and development plan for the staff is needed to ensure all the needs of the resident’s are met by trained competent staff and to ensure all aspects of health, safety, protection and infection control measures for residents staff and visitors are in place. 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. East Riding B53-B03 S506 East Riding V223200 230505 Stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection East Riding B53-B03 S506 East Riding V223200 230505 Stage 4.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,3,5 The admission procedures are comprehensive and ensure that staff are aware of individual assessed needs . The home has not yet produced a Statement of Terms and Conditions for residents who are self-funding nor are they offered the same opportunities regarding living at the home on a permanent basis. Without this documentation the rights and obligations of the resident and provider is not clear. EVIDENCE: The home has not provided residents with a statement of terms and conditions (or contract) when purchasing their care privately. The care plans show that the staff carry out assessments prior to residents being admitted to the home. Evidence was available to confirm that appropriate assessments from Care Managers and other professionals are received to ensure the residents assessed needs can be met. From these documents the residents have a plan of care formulated. East Riding B53-B03 S506 East Riding V223200 230505 Stage 4.doc Version 1.30 Page 10 The home offers the opportunity for residents and their representatives to visit prior to admission. In practice it is usually the resident’s representatives and the care manager who makes the decisions regarding placements. Evidence from the care plans show that resident’s have a six week review before a decision is made about a permanent placement. Residents who are privately funded are not afforded the same opportunity at the six-week period. East Riding B53-B03 S506 East Riding V223200 230505 Stage 4.doc Version 1.30 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,10 The care planning system is not clear or consistent to provide staff with the information they need to meet resident’s needs. The staff have endeavour to promote the residents rights to privacy and dignity in regard to personal care delivery. EVIDENCE: Each resident has a care plan that is based on the admission assessment. The care plans use a recognised nursing model that covers all aspects of daily living. The standard of daily recording was satisfactory, however there was evidence from the care plans that the two units complete the plans differently. Both units use different assessment tools for pressure care and evaluate the plans at different times. The downstairs unit has residents information stored and documented in 3 different places, which makes the care information difficult to find and to follow. The care plans on the upstairs unit were more logical however focused on the mental health needs of residents and did not assess and document the necessary care for those who had superficial pressure damage. East Riding B53-B03 S506 East Riding V223200 230505 Stage 4.doc Version 1.30 Page 12 The home has comprehensive assessment tools for pressure care, fall prevention, dependency, nutrition, mental health status and the risk assessment documentation for the safe use of bed rails. Many of the risk assessments and other tools were not regularly reviewed. The care plans were not being reviewed nor up dated to reflect changes in personal, social and health care needs. Although residents weights are recorded, those who have lost weight have not had a care plan implemented nor have they been referred to other professionals. The daily progress records show that the staff ensure that the residents have full access to all NHS services and facilities. A visiting professional said that that each unit provides a good level of health care for the residents. Throughout the day it was observed that the staff respected the residents rights to privacy and dignity especially in regard to personal care giving. East Riding B53-B03 S506 East Riding V223200 230505 Stage 4.doc Version 1.30 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 standard(s) 12,14,15 The general social care needs of the residents are being met in the home. There is not sufficient variation or stimulation to meet residents’ needs on the mental health unit. The staff endeavours to support residents exercise choices and maintain control over their lives as far as the are able. The home currently does not provide a balanced, nutritious diet, which offers choices and variation. EVIDENCE: The home has a designated activities person who works 30 hours on a flexible basis. Activities are displayed in the home and pictorial evidence is available regarding previous events held both inside and outside the home. Resident’s and staff enjoyed playing some board games during the morning of the inspection. Many of the residents on the upstairs unit sat in the front lounge or wandered the corridors with no aim throughout the day. Visitors spoken with said that their relatives are able to exercise choice over their daily lives, including how and where to spend their day and when to get up or retire to bed. East Riding B53-B03 S506 East Riding V223200 230505 Stage 4.doc Version 1.30 Page 14 The home provides a four-week menu. The lunchtime meal was observed on both units. Only three resident’s has a variation from the main meal. All the other residents had Hot Pot and peas followed by rhubarb and custard. A variation of the consistency of the meal was provided for those with swallowing difficulties. One had an omelette, one had sandwiches, and one resident has a Kiev. This resident confirmed that she provides her own food as the home cannot provide her with the choices she likes. The majority of the residents on the downstairs unit remained in their wheelchairs for lunch as the dining room chairs do not have arms or glide rails. The residents on the upstairs unit require assistance and supervision from staff to ensure that they receive suitable food throughout the day. This dining room was very busy with staff endeavouring to attend to all residents at the same time. Hot and cold drinks were offered throughout the day. The staff confirmed that fresh fruit is not available and supplementary fortified milkshakes are not available for residents who have poor appetite or have lost weight. East Riding B53-B03 S506 East Riding V223200 230505 Stage 4.doc Version 1.30 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 standard(s) 16,18 The complaints process within the home is currently satisfactory. The arrangements for protecting residents is not satisfactory, placing them at possible risk of harm. EVIDENCE: The home has comprehensive policies and procedures for dealing with complaints. Residents and relatives spoken with said they knew how to complain and said that their concerns were now acted on immediately. The home has procedures in place for the Protection of Vulnerable Adults, however the staff confirmed that they have not received any internal or external training. East Riding B53-B03 S506 East Riding V223200 230505 Stage 4.doc Version 1.30 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 standard(s) 19,20,21,24,25,26. Only limited improvements have been made to the decoration of the home. The overall quality of the furnishings and fittings is poor and does not create a pleasing, pleasant, safe and hygienic environment to live in. EVIDENCE: The home is purpose built and the location and layout is suitable for the current needs of the residents. A planned programme of maintenance, refurbishment and redecoration of the home has not been provided and many of the requirements from previous inspections have not been addressed. The new manager is aware of the maintenance and housekeeping issues and has completed a home audit. Limited redecoration, replacement of bedroom furniture and replacement of linen has taken place. East Riding B53-B03 S506 East Riding V223200 230505 Stage 4.doc Version 1.30 Page 17 Comments from visitors were that there is a good level of care but the home is let down by odours and general shabbiness. A tour of the building found that a number of areas require attention, in particular: The lounges and dining rooms were shabby with the furniture stained and worn. The wallpaper in the upstairs lounge is torn at various places. There is water stains on the walls of the upstairs dining room resulting in mould and the wallpaper missing. Many of the coffee tables are scratched and grubby, One lounge has the paint flaking of the walls, has few ornaments and only two armchairs. There are no carver chairs provided for residents to safely sit in at meal times. There is a breakdown of the double-glazing units in several of the rooms, which obscures the view. One specialist chair, which a resident was sitting in, was split and stained. The carpets were generally stained and grubby in the communal areas and the corridors. The lounge and dining room doors were chocked open The servery upstairs has cracked tiles, the fridge had food debris and the microwave had old food splashes on the insides. The toilets and bathrooms were found to be generally dusty, grimy and cluttered. Bathroom 42 had vases and a jug on the cistern and floor. The non-slip bath mat was mouldy underneath. Bathroom 36 the toilet seat was held together with white tape. The plastic covering on the shower drain was peeling off leaving a rusty drain, which would be difficult to clean. Bathroom 2 the flooring is water stained and the extractor fan is broken. Bathroom 7 the flooring is stained, the drain was broken and dirty water had pooled on to the floor up to the top of the drain. Bathroom 87 the drain was full of scum and dirty water. The extractor was broken and there is a lip to the threshold between the bathroom and corridor. Bathroom 61 is not in use. There is a stale odour from this room and the staff confirmed that the water is not regularly flushed. This is currently used as a storeroom. The bins in many of the bathrooms and toilets did not have lids, all of the call cords and light cords were grimy and difficult to clean. Many of the residents have brought some of their own possessions with them resulting in individualised rooms reflecting their previous lifestyles. Limited replacement of bedroom furniture has taken place. Several of the bedrooms had an odour problem and several of the bedroom carpets were stained, and one was torn. East Riding B53-B03 S506 East Riding V223200 230505 Stage 4.doc Version 1.30 Page 18 There have been ongoing problems with the under floor heating and it was confirmed that the problems are still being addressed. The home was very warm and ventilated. The lighting levels in the upstairs reception area and corridors were dim. The lighting in bedrooms and communal areas was satisfactory. The laundry is separate from resident areas and the manager confirmed that issues identified at the last inspection have not been addressed. There are odour problems, which are prevalent especially on the upstairs unit, and the standard of cleanliness was generally unsatisfactory. The sluices were cluttered, the floor was dirty, commodes had the plastic backing missing and the metal frames on the clinical waste bins were rusty. There was a lack of liquid soap and paper towels in resident’s rooms to enable the staff to wash their hands effectively. East Riding B53-B03 S506 East Riding V223200 230505 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 The home is adequately staffed with qualified nurses and care staff given the current needs of residents. The number of staff deployed should be constantly reviewed following assessment of dependency levels. The procedures for the recruitment of staff are comprehensive and offers protection to residents living in the home. A detailed training and development programme is needed to ensure the staff are able to meet the residents assessed needs. EVIDENCE: The previous manager has been transferred to another home within the company and a new manager has been appointed. The home was without a manger for some considerable time and this has impacted on the record keeping and training of the staff in the home. The new manager is endeavouring to audit all the staff files and source training for the staff team Several of the staff have been employed at the home for some considerable time and have formed good relationships with residents, relatives and the multidisciplinary teams. Comments from visitors and other professionals were complimentary about the staff and how they provide a good level of care. East Riding B53-B03 S506 East Riding V223200 230505 Stage 4.doc Version 1.30 Page 20 The current staffing levels are: On the ground floor unit: 1 General Registered Nurse throughout 24 hours. 5 care staff in the morning 3 care staff in the afternoon 4 care staff in the evening 2 care staff overnight. On the first floor unit: 1 Registered Mental Health Nurse throughout 24 hours 4 care staff in the morning 3 care staff in the afternoon and evening 2 care staff overnight. The home has domestic, laundry, and kitchen. administration, activities and maintenance staff. A sample of staff files showed that the company policies and procedures for recruitment were being followed. References, Criminal Record Bureau checks proof of identity and staff contracts were available. The new manager is sourcing training for the staff. Not all statutory training is up to date. The home has a moving and handling coordinator who said she has completed the required update to allow her to train the staff. Only some of the staff have completed fire and first aid training. The staff have not received any specialist training including Infection Control, Abuse, Challenging Behaviour or Dealing with Aggression. East Riding B53-B03 S506 East Riding V223200 230505 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,38 , EVIDENCE: The company have transferred a new manager into the home. He is a qualified nurse with many years experience. This should result in a greater stability within the home. He has competed a range of audits in the home and has a good understanding of his responsibilities. Progress is being made for him to become Registered Manager of this home. The residents, relatives and other professionals were complimentary regarding the management. They said they were aware of the changes being made, were pleased that any concern raised was being addressed and were very satisfied that the manager was always available in the home. Since coming into post staff, resident and health and safety meetings have been held. Minutes of all meetings are available and the manager is endeavouring to action all issues raised. East Riding B53-B03 S506 East Riding V223200 230505 Stage 4.doc Version 1.30 Page 22 There are many outstanding environmental and health and safety issues, which have been documented within the report, which need to be addressed to eliminate hazards for safety . The staff have not received continuous statutory training in regard to moving and handling, infection control and fire training. Several of the bedroom doors and communal doors were held open by wooden chocks and bespoke metal chocks. Risk assessments for fire, the environment, use of plug in air freshners, the up stairs windows and the safe use of bed rails were not available. Accident recording and reporting was satisfactory. East Riding B53-B03 S506 East Riding V223200 230505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 1 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 3 15 2 COMPLAINTS AND PROTECTION 2 2 1 x x 2 2 1 STAFFING Standard No Score 27 3 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 1 2 3 x x x x x 1 East Riding B53-B03 S506 East Riding V223200 230505 Stage 4.doc Version 1.30 Page 24 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP 2 Regulation 5 Requirement The home must provide a statement of terms and conditions(or contract)if self funding. Ensure that self funding residents have trial visits followed by a review before deciding to live in the home. All care plans must be evaluated at least monthly and updated to reflect the changing needs of the residents. Risk assessments must be evaluated and up dated . Qualified nurses must ensure that they adhere to the requirements of the Nursing and Midwifery Council for Record Keeping. The home must ensure that a record of of nutrition with weight gain or loss is recorded,a care plan implemented and professional advice sought and actioned. The home must provide suitable stimulation for residents with dementia and other cognative impairments in formats suited to their capabilities. The menu must provide a Timescale for action 31st July 2005 1st September 2005 31st July 2005. 2. OP 5 14 3. OP 7 13,15 4. OP 8 14,17 31st July 2005 5. OP 12 12,16 1st September 2005 23rd May Page 25 6. OP 15 12,13,15 East Riding B53-B03 S506 East Riding V223200 230505 Stage 4.doc Version 1.30 7. OP 15 12,14 8. OP 18 12,13 9. 10. OP 19 OP 20 23 16,23 11. OP 21 23 varied,appealing nutritious diet which includes the provision of fresh fruit and fortified foods. The choices of meals must be in written or other formats to suit the capacities of all residents. The dietary needs of individual residents must be recorded and agreed in the care plan. The home must provide all staff with Protection of Vulnerable Adults training which links into the Local Authority Procedural Framework. Provide a planned and refurbishment programme for the home with records kept. Replace worn lounge and occassional furniture. Redecorate the communal areas. Provide suitable dining room chairs for residents. Deep clean or replace the corridor and communal area carpets. Repair faults in the double glazing. Provide suitable specialist lounge chairs for individual residents. Deep clean all bathroom and toilet flooring.Where stains and ingrained debris cannot be removed the flooring must be replaced. The flooring in bathroom7 and 42 requires replacing. The shower drains require cleaning and the scum removed.The plastic on one drain is peeling off and needs replacing. All of the bathrooms,toilets and shower rooms which are not used require the water to be drawn at regular intervals. The odour from the drain in bathroom 61 requires investigation. 2005 31st July 2005 1st September 2005 1st September 2005 1st December 2005 ST December 2005 East Riding B53-B03 S506 East Riding V223200 230505 Stage 4.doc Version 1.30 Page 26 12. 13. 14. OP21 OP 21 OP 24 23 23 16,23 15. OP 25 23 16. OP 26 12,13,16, 23 17. OP 30 12,18 18. 19. OP 38 OP 38 12,13,23. 12,13,23 Where there is pooling of water in bathrooms the flooring must be repaired . All emergency call cords and light cords must be accessible and easily cleaned. Provide bins with suitable lids in bathrooms and toilets. Replace identified torn,stained carpets in bedrooms and adress the odour problems in identified bedrooms.. Ensure the ambient temperatures are maintained throughout the home. Ensure the lighting levels on the upstairs corridor and reception area meets lux 150. Implement a programme of cleaning to control odours especially on the upstairs unit. Replace the rusty clinical waste stands. Deep clean the laundry. Ensure that the sluices are cleaned regularly Ensure that the policies and procedures for control of infection are followed. Replace the commodes which have split plastic backings and seats. Provide staff with training in principles of care,safe working practices and specialist training to meet the assessed needs of the residents. Ensure that all staff have a training and deveolpment assessment and profile. The home must provide all staff with up to date training in all safe working practices. Fire risk and environmental risk assessments must be available. Risk assessments are required for the use of plug in air freshners. 31st July 2005 31st July 2005 1st December 2005 1st September 2005 31st July 2005 31st September 2005 1ST September 2005 31st July 2005 East Riding B53-B03 S506 East Riding V223200 230505 Stage 4.doc Version 1.30 Page 27 Update the risk assessments for the window restrictors on the first floor. Risk assessments for the safe use of bedrails must be available and follow MDA guidance. 20. 21. OP 38 13 Ensure that the water in the unused bathrooms,shower rooms and toilets is flushed on a regular basis. 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 OP 26 OP 27 Good Practice Recommendations It is highly recommended that liquid soap and hand towels are provided in all resident rooms to enable effective handwashing. It is recommended that the staffing levels are monitored in accordance with the geography of the home,the dependency levels of the residents and the skill and experience of the staff. East Riding B53-B03 S506 East Riding V223200 230505 Stage 4.doc Version 1.30 Page 28 Commission for Social Care Inspection Northumbria House Manor Walks, Cramlington Northumberland NE23 6UR 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 East Riding B53-B03 S506 East Riding V223200 230505 Stage 4.doc Version 1.30 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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