Inspection on 13/03/08 for Flowerdown House

This inspection was carried out on 13th March 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Flowerdown House 20/02/07

Flowerdown House 27/03/06

Flowerdown House 04/08/05

Flowerdown House 05/04/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Flowerdown House 55 Beach Road Weston Super Mare North Somerset BS23 1BH Lead Inspector Patricia Hellier Key Unannounced Inspection 13th March 2008 11:00 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 Flowerdown House DS0000033678.V360252.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. Flowerdown House DS0000033678.V360252.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Flowerdown House Address 55 Beach Road Weston Super Mare North Somerset BS23 1BH 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) 01934 621664 01934 420111 The Royal Air Forces Association Mary Hart Care Home 8 Category(ies) of Old age, not falling within any other category registration, with number (8), Physical disability (8) of places Flowerdown House DS0000033678.V360252.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Younger adults falling in to other categories may be accommodated subject to the prior agreement of the Inspector. Only rooms with level access to be used for residential care. Rooms 17 and 3 only to be used by wheelchair users. Rooms 1,2,3 14,18,19 and 20 can be used as single or double rooms for family members or people who actively request to share together. May accommodate people, aged 40 years and over, with a physical disability. 20th February 2007 3. Date of last inspection Brief Description of the Service: Flowerdown House is owned and managed by the Royal Air Forces Association. RAFA and the Royal Air Force Benevolent Fund work closely together to offer holiday and respite breaks to RAF personnel and their relatives. Only a small proportion of these guests receive personal care. The majority of the guests, who require personal care, are older people. younger adults, falling into other categories may be accommodated subject to the prior agreement of the CSCI. Guests with care needs are referred to as residents in this report. Mrs Tricia Freer, Welfare Director for RAFA is responsible individual for the organisation. Flowerdown House is situated on the sea front at Weston super Mare. The property dates from the turn of the century, and has been converted to provide spacious hotel style accommodation. Guests who require personal care are accommodated in designated rooms. These have level access, good adaptations and a call bell system. The fees range between £370 and £420 a week with additional charges being made for hairdressing, chiropody, newspapers, and toiletries. This information was provided in March 2008. Flowerdown House DS0000033678.V360252.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This key inspection took place over 7 hours on two day. Manager, Ms Hart, was present for the second day The Registered Before the inspection the information about the home was received from the file held in the office, surveys received from one person who uses the service and four relatives. The last inspection report was reviewed together with the completed Annual Quality Assurance Assessment (AQAA) form, from the provider. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. We (The Commission) also reviewed all correspondence and regulatory activity since the last Key inspection. The accumulated evidence for this report comes from the above and also fieldwork that included discussions with six residents, two relatives, and four staff. Practices were observed and documents relating to care, recruitment and health and safety were reviewed. Of the 10 resident surveys sent one was returned. The reply indicated that responsive staff meets their care needs, and they are provided with what they need. Comments from residents were “I can’t fault the home” “excellent service and stay.” “The staff are marvellous”. No areas of concern were raised. Of the eight relatives surveys sent four were returned and all felt that their relatives were well cared for by competent staff. Comments from relatives were “friendly staff and atmosphere”. “Excellent care”. “Staff have the appropriate skills and experience”. All relatives felt they were kept up to date with information regarding their relatives’ health and well being. There were no comments of concern. All residents and relatives spoken with told us that the home was good and the staff very kind. Comments received were “another wonderful stay with you. All of you do such wonderful work”. Flowerdown House DS0000033678.V360252.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Prospective residents would benefit from a Statement of Purpose that includes all the information as listed in the Care Home Regulations (2001), to ensure they have comprehensive information on which to base their choice of the home. Residents would benefit from more comprehensive care plans to ensure that consistency of care delivery is given. They would also benefit from clear documentation of care needs and actions to meet the needs. If abbreviations are to be used then a key to their meaning would assist staff in understanding actions described. Flowerdown House DS0000033678.V360252.R01.S.doc Version 5.2 Page 7 Residents would be better protected from the potential mishandling of medicines if systems for the handling of medicines ensured a clear audit trail, of medicines entering and leaving the home. The implementation of a robust recruitment system would enable residents, and their relatives, to know that they are well protected from potentially harmful people being employed. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Flowerdown House DS0000033678.V360252.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 Flowerdown House DS0000033678.V360252.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 6 N/A Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Statement of Purpose and Brochure is not comprehensive to provide prospective residents with information on which to make an informed choice. The home’s assessment process is satisfactory and ensures that it is able to meet residents’ needs. EVIDENCE: Perspective residents are provided with a brochure and a copy of the mission statement of the home. They are not provided with the Statement of Purpose; however it is on display in the entrance of the home. The Statement of Purpose seen at inspection was more than two years out of date and does not contain all the elements as required under the Care Home Regulations 2001. This must be updated to ensure prospective residents are provided with comprehensive information on which to make their choice. Flowerdown House DS0000033678.V360252.R01.S.doc Version 5.2 Page 10 One resident spoken with told us “I had no idea of the extent of care that would be provided. I was not made aware of the aids available to help me”. Another person said, “I came to something I was not fully sure about”. In the AQAA returned we are told “we need to concentrate on ensuring that prospective residents give us a truthful account of their individual needs and are not frightened to be honest in case we refuse”. We are also told “ we seek to obtain information about care needs prior to admission, and if applicable a care plan from the Local Authority. If the person is not known to the Local Authority we seek to obtain information from our welfare officer’s network.” All residents were aware they had a contract of residency and were happy with the provision that they receive. The contracts reviewed as part of the case tracking exercise were signed and contained information about fees and the obligations of the provider and resident. The contract terms and conditions were clear and understandable. Three care records of current residents were inspected. Self assessment forms for these residents were seen and contained clear information as provided by the residents themselves. We were told that the welfare officer then visits the prospective resident, to clarify the assessment and ensure that the home can meet their needs. Discussion is also had with the prospective resident’s spouse or carer to ascertain needs. No direct evidence of the welfare officer’s involvement was seen to show how the home had ensured they could meet the needs of the prospective residents. A letter confirming their stay was seen providing confirmation of their stay, to the prospective resident. Flowerdown House DS0000033678.V360252.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents personal and social care needs are met with attention to detail but consistency of care provision is not supported by clear care plans. Personal and environmental risks are well managed. Medication administration and practices are satisfactory. Respect and dignity are well maintained by kind and caring staff. EVIDENCE: Individual records are kept for each of the residents. Inspection of the records for three residents had care plans that contained some details about the health and social care needs of the resident and actions to meet these needs. There were some gaps in the completion of the records, where key information about the resident should have been recorded. One person did not have a plan of care identifying their needs and how they were to be met. A self-assessment form was present; however this did not Flowerdown House DS0000033678.V360252.R01.S.doc Version 5.2 Page 12 contain key information about how their needs were to be met. A plan of care should be provided for all residents. In the other two care plans inspected there were gaps in information e.g. one did not have allergies recorded; and another had not recorded the person’s religion. In the third care plan inspected a need had been identified at bedtime but no actions to meet that need were recorded, thus the resident could receive inconsistent care. In all three care plans inspected a large number of abbreviations were used, but no key of explanation as to what these abbreviations mean. Abbreviations should only be used when it is clear what they mean to ensure that all staff can understand the plan of care, and provide consistent care provision for the benefit and safety of the residents. Residents spoken to confirm the staff were well aware of their needs and did everything to meet them. For example one resident said ‘they notice when you are unwell and come and help you’. Another resident said ‘they are absolutely lovely and I would always come back here.’ All care plans contained well-formulated risk assessments for Manual Handling and falls. Other personal and environmental risk assessments were present to ensure the safety of the resident while promoting independence as able. One resident said, “It is just nice to have the reassurance of someone there to help”. Daily records were up to date and written in a respectful manner. Care practices observed showed caring interactions and good communication skills from staff. Choices and preferences were observed being discussed and offered. Detailed conversations with eight of the residents confirmed a satisfactory standard of personal care. Two residents said, “it’s homely” another resident said, “people are very kind, we are well looked after” and a third said “they are very respectful and helpful”. Another resident told us “I would recommend the home to anyone”. Facilities for the storage of medicines were seen to be secure. Many residents self medicate, keeping the medication in a locked cabinet in their room, which is also locked. A full audit trail of medicines entering and leaving the home is still not always correct giving rise to concern that medication is not always managed in the best interests of, or for the safety of residents. The systems for the receipt and disposal of medication were satisfactory. Flowerdown House DS0000033678.V360252.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. These standards need to be viewed within the home’s context as a respite/holiday provision. Residents’ benefit from flexible routines and menus, with staff who are committed to ensuring that guests and residents enjoy their stay. A variety of activities is offered, and residents right to choice and control over their lives is well respected, and encouraged. Friendly staff always welcome relatives and visitors. EVIDENCE: Residents confirmed that they came to Flowerdown because they were amongst ‘kindred spirits’. Many guests and residents return repeatedly as they so enjoy their stay. An excellent range of varied activities is provided; this includes trips out to places of interest in the hotel/homes’ mini bus, and organised in house games such as bingo and quizzes. In the home there is a bar where a number of residents meet for quizzes and other recreational activities. Flowerdown House DS0000033678.V360252.R01.S.doc Version 5.2 Page 14 Residents spoken with said, “we have plenty of choice and variety, there are quizzes and things to help keep your mind active, also outings.” “The staff are always willing to accommodate what we want”. “The bar is a real asset and we enjoy good conversation there.” All the residents said that the ‘food is good’ and were very positive about the variety and quality of the food. For example one resident said ’if you don’t like something they’ll change it’. Another resident spoken to confirmed that she was supported to maintain dietary restrictions required by her religion. Menus showed a varied, balanced and nutritious diet. Plate guards and adapted cutlery were seen, available and in use, for residents who need these aids to enable them to eat their meals independently. The dining room is homely and tables well presented. The kitchen is clean, tidy and well organised. Flowerdown House DS0000033678.V360252.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are confident that they are listened to and their requests acted upon. Residents are protected from abuse by knowledgeable and competent staff EVIDENCE: The home has a detailed complaints procedure that is displayed in the hall together with a suggestions box. All residents are given a copy of the’ Complaints, Concerns and Suggestions’ leaflet. Residents stated that if they were not happy about anything they would speak to the manager. Staff and residents spoken to say ‘the manager is very approachable and understanding’. One resident said ‘I’ve nothing to complain about it’s the best.’ ‘I come here every year’. There have been no complaints in the last year. In the AQAA we are told “we encourage individuals to raise their concerns so we can address them during their stay”. We are also told that the plans to provide more training for staff to ensure they understand the positive nature of complaints and concerns raised. The registered manager promotes the resident’s individual rights in the home. The home has a copy of the North Somerset ‘No Secrets’ guide and a Whislteblowing policy. A procedure for responding to allegations of abuse is Flowerdown House DS0000033678.V360252.R01.S.doc Version 5.2 Page 16 available and staff were fully aware of it. Staff said they had never seen any signs of abuse in the home and demonstrated a good understanding of what forms abuse can take. Since the last inspection ther have been three episodes of theft, which have been appropriately handled. The manager tells us she is working with the police to enure sytems that provide greater safeguards in the home. All residents said ‘the staff are very kind and take time, you can’t fault them’. Flowerdown House DS0000033678.V360252.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with safe, homely and comfortable surroundings. The home has suitable equipment to maximise resident independence. Robust Infection control practices are followed EVIDENCE: The property is well maintained, with homely and comfortable communal spaces. The living accommodation is well decorated and homely. In the AQAA we are told “ we are currently in the process of improving the fabric of the building repainting the outside of the home and replacing windows with uPVC double glazing” A maintenance plan was seen which evidenced the ongoing routine maintenance and renewal of the fabric for the benefit of residents Residents’ rooms are personalised, well decorated and have electric profile beds and other aids as required by the resident during their stay to suit their Flowerdown House DS0000033678.V360252.R01.S.doc Version 5.2 Page 18 needs. All rooms have en suite facilities for residents’ comfort. There are plenty of toilets within easy access of all communal rooms, for the comfort of residents. The home has sufficient bathroom facilities with aids for the benefit of residents. Equipment was clean and well maintained to ensure protection for residents from cross infection. Hot water outlets are thermostatically controlled and temperatures measured were within the guidelines of 43ºC for the safety of residents. Thermometers were present for staff to check the water temperature before baths for the safety and protection of residents. The home has grab rails situated at relevant points and a shaft lift to all floors that is easily used to assist resident mobility, and aid independence within the home. The home has a large number of aids and adaptations for use by residents during their stay. The home was clean and free from offensive odours throughout. Staff interviewed and observed demonstrated good understanding of Infection control procedures and practices and maintained a clean and hygienic environment. Flowerdown House DS0000033678.V360252.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from sufficient numbers and skill mix of competent staff to meet their needs. Residents are not protected by robust recruitment practices. Training is provided in a variety of topics to ensure competent staff. EVIDENCE: The personal care needs of the guests vary enormously from week to week. Sufficient care staff are provided to meet the needs of up to 8 guests who require personal care. Residents spoken to said, “the staff are kind and caring and always there to help.” During the visit staff were observed spending time with residents when not providing personal care, thus meeting their social care needs as well. There are also domestic and kitchen staff who are part of the close teamwork, to ensure the residents’ needs are met in their chosen way. Residents are not protected by the home’s recruitment practices, as not all the necessary safeguards are in place prior to staff commencing employment at the home. Two staff recruitment records were inspected. In one it was seen that the person commenced work in the home without a satisfactory Criminal Record Bureau (CRB) check or a Protection of Vulnerable Adult (PoVA) first check. In the second file it was not possible to ascertain the date of commencement of employment thus the same could apply in this case. There Flowerdown House DS0000033678.V360252.R01.S.doc Version 5.2 Page 20 were no medical details, no interview records and gaps in employment had not been explored. Also in both files two written references had not been obtained prior to employment. These missing checks potentially put residents at risk from unknown staff. All staff interviewed stated they had contracts of employment and job descriptions. Newly appointed staff confirmed they had completed an induction programme which they told us “was very helpful”. There were no records to evidence the induction or to show what topics had been covered, to ensure that staff have been provided with the necessary skills and knowledge to meet residents’ needs in a safe manner. Mandatory training in Health and Safety, Fire and Moving and Handling is provided annually to ensure current best practice guidelines are followed. Staff are encouraged to undertake their National Vocational Qualification (NVQ) training. This ensures staff are competent to meet residents needs. It is recommended that staff access specialist training in the more common conditions that residents may have when coming to the home e.g. Parkinson’s Disease, Diabetes. Training is encouraged and staff told us they are keen to undertake training to ensure they have the skills and knowledge to meet residents’ need and provide a high standard of care. Flowerdown House DS0000033678.V360252.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run, and residents interests are at the heart of decisionmaking. Quality assurance processes in the home are formal demonstrating that the home consults with residents, families and visiting professionals. Resident’s monies in the home are well managed for their safety and protection. Health and safety issues are monitored in the home to ensure that issues are identified and addressed where they arise for the safety of residents. EVIDENCE: The manager gives clear leadership, guidance and direction to staff. Residents feel she is approachable, available and seeks to ensure all their needs are met. Flowerdown House DS0000033678.V360252.R01.S.doc Version 5.2 Page 22 Staff interviewed stated they felt “well supported by an approachable manager”. A formal quality assurance tool was available for inspection in order to demonstrate that the home consults with residents and relatives. A summary report of the most recent survey was available demonstrating the responses and action taken to address identified areas of weakness. Residents’ monies held by the home were inspected and found to be accurate and to have clear records. Supervision for staff is provided both formally, and informally at hand over times and other times, when the staff discuss resident’s care needs and how best to meet them. Records seen were sporadic and did not evidence the practices spoken of by staff and the manager. Records seen showed evidence that care practices for residents and training needs were discussed. Supervision records need to show that supervision is provided regularly to ensure the staff have the skills and knowledge to meet resident needs using best practice guidance. Policies and practice guidance are provided in the home but they have not been reviewed and updated in the last three years. Thus current good practice is not contained within them to provide clear guidance on best practice provision for the benefit of residents. Information received indicated regular safety and fire checks are carried out. Information regarding certificates of safety checks, servicing of equipment and other required safety inspections was supplied. Staff spoken to confirmed that regular fire instruction and drills had taken place. Flowerdown House DS0000033678.V360252.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 1 2 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 2 X 3 Flowerdown House DS0000033678.V360252.R01.S.doc Version 5.2 Page 24 NO 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 OP1 Regulation 4.1 (c) Requirement The registered person must compile a written Statement that includes all the information as requested in Schedule 1 of the regulations to ensure prospective residents are provided with comprehensive information prior to their stay. The registered person must ensure that a clear audit trail of medicines through the home is available for the safety and protection of residents. The registered person must ensure that all required information and checks are undertaken prior to a person commencing employment at the home for the protection of residents Timescale for action 16/08/08 2. OP9 13.2 31/07/08 3. OP29 19.1 Schedule 2 31/07/08 Flowerdown House DS0000033678.V360252.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP3 Good Practice Recommendations Although feedback is now sought from other professionals involved in resident’s care, as part of the assessment process, there were no records available in care plans to evidence this. This should be addressed. Permission given by individuals to contact their GP for information about their health should be extended to include other health care professionals. To promote best practice, it is recommended that care plans are developed to include greater details of care needs. The registered person should ensure attention to detail when completing care plans to so that all key information about the resident is recorded to inform care provision. The registered should ensure that if abbreviations are used in care records there is a clear key as to the meaning of the abbreviations so that every one knows what is being said, for the safety and well being of the residents. There is a payphone for use by residents and guests situated in a hall way in the home. This arrangement offers little privacy when making calls, and seems outdated in this age of cordless and mobile phones. Consideration should be given to improving this facility to ensure privacy or removing it. The registered provider to supply hand washing facilities in the laundry to reduce the potential spread of infection. The registered person keeps policies under regular review (at least every three years) to ensure current best practice guidelines are incorporated and available for staff to ensure best practice care provision to residents. The registered person to ensure that regular supervision, as appropriate, is provided to all staff to ensure they have the skills and knowledge to meet residents’ needs. 2. OP7 3. OP14 4. 5. OP26 OP33 6. OP36 Flowerdown House DS0000033678.V360252.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Flowerdown House DS0000033678.V360252.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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