Inspection on 19/01/06 for Foxearth Lodge Nursing Home

This inspection was carried out on 19th January 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

Foxearth Lodge Nursing Home 29/11/07

Foxearth Lodge Nursing Home 01/12/06

Foxearth Lodge Nursing Home 11/11/05

Foxearth Lodge Nursing Home 17/11/04

Foxearth Lodge Nursing Home 16/04/04

Similar services:

Claremont House

Oak Ridge

Coopers Mill Ltd

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Paradise Lodge

Bilney Hall

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

CARE HOMES FOR OLDER PEOPLE Foxearth Lodge Nursing Home Little Green Saxtead Woodbridge Suffolk IP13 9QY Lead Inspector Mary Jeffries Unannounced Inspection 19th January 2006 2:40pm 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 Foxearth Lodge Nursing Home DS0000024391.V279405.R01.S.doc Version 5.1 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. Foxearth Lodge Nursing Home DS0000024391.V279405.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Foxearth Lodge Nursing Home Address Little Green Saxtead Woodbridge Suffolk IP13 9QY 01728 685599 01728 685599 admin@foxearthlodge.co.uk 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) Mrs Eileen Patricia Cantrell Mr Brian Cantrell Mrs Eileen Patricia Cantrell Care Home 62 Category(ies) of Dementia (24), Old age, not falling within any registration, with number other category (38) of places Foxearth Lodge Nursing Home DS0000024391.V279405.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th November 2005 Brief Description of the Service: Foxearth Lodge Nursing Home provides nursing care to a maximum of 62 elderly service users, comprising of 38 older persons (OP) and 24 older persons with a diagnosis of dementia (DE). The home is in a rural location, a few miles from the market town of Framlingham and is set in large grounds, which are accessible to service users. Woodlands Unit (which caters for up to 24 older people with dementia) is on ground floor level and comprises 2 double and 20 single bedrooms, all with en suite toilet facilities. Foxearth main and Barn units are on two floors, linked by a shaft lift, and comprise 2 double and 34 single bedrooms, of which all except one have en suite toilet facilities. There are several lounges, dining rooms and small, quiet communal areas throughout the premises. Foxearth Lodge Nursing Home DS0000024391.V279405.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place one late afternoon/early evening in January 2006, and took five and a half hours. The inspection was facilitated by the nurse in charge and the trainee manager. The Deputy Matron, the administrator and the Housekeeper also participated, and were very helpful and accommodating. The inspection focused on service users with dementia, and the care plans, risk assessments and restraint records for these service users were inspected as part of the inspection; an application to vary the registration to accommodate service users with dementia over and above the number for which the home was registered was also considered on site on the same occasion. All service users were seen, and some time was spent talking with a service user with dementia on the mainstream unit, although they were very forgetful. Service users on Woodlands were observed at mealtime and medication administration was inspected on this unit. There were no vacancies in the home at the time of the inspection. What the service does well: What has improved since the last inspection? Some improvements to the environment on Woodland for the benefit of service users with dementia have been implemented and more are planned. The Protection of Vulnerable Adults Policy has been reviewed and is consistent with local guidelines, and training has been booked for two members of staff. Foxearth Lodge Nursing Home DS0000024391.V279405.R01.S.doc Version 5.1 Page 6 Doors to storage cupboards on fire exit routes marked Fire doors were seen to be appropriately locked. Documentation on staff files had been addressed. What they could do better: 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. Foxearth Lodge Nursing Home DS0000024391.V279405.R01.S.doc Version 5.1 Page 7 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 Foxearth Lodge Nursing Home DS0000024391.V279405.R01.S.doc Version 5.1 Page 8 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): 1,2,4,6 Service users can expect the home to be able to meet their needs. EVIDENCE: The Statement of Purpose was on display in the foyer of the home. A requirement was made at the last inspection that the complaints policy was included within the Service User Guide; the CSCI were notified that this had been done, but the staff on duty were unable to locate a copy on the day of the inspection, so this could not be verified. A recommendation had been made at the last inspection that the standard form of contract for the provision of services and facilities is updated to be explicit about what equipment is routinely provided at the home, what equipment must be provided by the service user and that no service user would be admitted to the home unless all requisite equipment was in place as identified by the pre-admission assessment. This had been done and a copy forwarded to the CSCI. The home had also provided a copy of a contract for respite care, but this did not include provision to insert the dates of the provision, or the charging implications if a planned stay was foreshortened. Foxearth Lodge Nursing Home DS0000024391.V279405.R01.S.doc Version 5.1 Page 9 The home is currently registered to provide care for 24 service users with dementia. At the last inspection it was identified that a greater number were being cared for and the home subsequently confirmed that there were 33 service users with dementia. The home subsequently submitted an application for a variation to the CSCI. These service users were tracked, care plans had been provided and each of the service users was observed by the Inspector and their care discussed with staff. Seven of these eight service users did not walk independently, so the lack of a secure garden for this part of the home did not pose any difficulty for their care. Two spent all of their time in bed. The service user who was ambulant had been diagnosed with dementia since moving to the home, and staff advised that whilst the service user used to walk freely into the village, since becoming forgetful they had never wandered. This service user had French windows opening onto to the garden. Some of these service users had been admitted and subsequently diagnosed as having dementia, some had been on Woodlands but their physical frailty and lack of mobility meant that they could be cared for in the area without a secure garden. Almost all staff work across all units, and the home has a dementia unit, so all have some knowledge and experience of working with dementia. The Registered manager had confirmed in writing that staff have all undertaken an Alzheimer’s examination. The Inspector was advised that the home does not provide intermediate care. Foxearth Lodge Nursing Home DS0000024391.V279405.R01.S.doc Version 5.1 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): 7,9,10,11 Service users can reasonably expect to reside at the home until the end of their days, and to be well cared for at the end of their life. The home’s system of administration of medicine involves some unnecessary risks for service users. EVIDENCE: The service users who were not placed on Woodlands but who had a diagnosis of dementia were observed and / or spoken with where restraint was in place, i.e., bedsides (3) or lap belts (2). Risk assessments were in place. The risk assessments for lap belt use had been revised, and signed by the GP. The Risk assessments had been sent to relatives for consent. Lap belts were also in use with two other service users who were placed on Woodlands. Their risk assessments had also been revised and signed by the GP and had been sent to relatives for consent but had not been returned at the time of the inspection. Risk assessments included the need to review on a monthly basis. Restraint records were seen to have been fully completed and to reflect the risk assessments, however, when records were analysed following the inspection, recording for three service users was seen to show periods of Foxearth Lodge Nursing Home DS0000024391.V279405.R01.S.doc Version 5.1 Page 11 approximately 4 hours during the morning of the inspection. During the day, periods spent talking with staff when the belts were not in use were detailed. The nurse manager advised the use of lap belts had been discussed at a staff meeting, and a copy of information taken to the nurse meeting on 11th January 2005 was provided. This detailed the necessity of removing a lap belt during meals or sensory activities or when under direct supervision, stating that they must never remain in place for more than 2 consecutive hours, and that restraint form must be completed including the reason for its use each time it is fastened or unfastened. Staff advised that service users who were also being encouraged to come into the main area more often, as the use of lap belts was mainly when service users were in their own rooms, and could not be constantly supervised, but noted that they had to have choice about this. A service user with dementia, whose room had direct access to non-secure gardens, was considered not to be at risk of wandering by staff, as they had never done so. This service user was spoken with, and presented well but could not remember the times when they had first been at the home and used to walk into the village. They were seated in their own room and very content. None of the service users seen presented as distressed in any way. Some of those who were in bed had music playing which staff said reflected their taste in music. Written confirmation had been provided that arrangements had been made so that lunchtime medication was not given during the main meal, but as this was an afternoon inspection this could not be verified on this occasion. The administration of medicines on the special needs unit was observed, and records examined. The inspector was advised that medication is supplied by a dispensing GP practice. The Deputy Matron was in charge stock taking, and they spoke with the Inspector about this and also the system of administration. Whilst individual Medical Administration Records Sheets (MARs) had space to enter any unused or returned medication, the Inspector was advised that this was not collated in a returns book, and that this had not been required by the pharmacy. Medication was seen to be in individual named pots with lids on, and taken round on a tray to service users. The Inspector was advised that it was put into pots either by the person giving the medicine, or by another to whom they had devolved responsibility. The records were not signed after each service user was given their medication; the inspector was advised they were signed for after the medication had been given out to all of the service users on the unit. The staff member observed giving out medication displayed a pleasant and respectful manner with the service users. Foxearth Lodge Nursing Home DS0000024391.V279405.R01.S.doc Version 5.1 Page 12 Two omissions were found in the MAR record Woodlands, for lactulose for two separate service users on one occasion each. Where the prescribed medication was for one or two tablets, this was marked. Records contained photographs of each service user. The Inspector was advised that there were no controlled drugs currently in use on Woodlands; the controlled drugs cupboard was locked. Eye drops were kept in a fridge and were in date. All interactions observed between staff and service users were appropriate, professional and friendly. Staff were heard speaking courteously to service users and were aware of how they liked to be addressed. The GP was visiting the home at the time of the inspection, and their routine twice-weekly visits to the home were briefly discussed. Two members of staff advised the Inspector about the Liverpool Care Pathway, which had been recently introduced, to be used when service users are thought to have only a little time left by the GP. This had been was currently being used for one service user, and was a very comprehensive document which covered all aspects of care, including the service users comfort and liaison with relatives. The documentation required recording of any aspect of care that had not been carried out according to the plan, and the reason for this. The plan for the service user seen noted that it had not been discussed with the service user, as they were capable of participating in this. The assistant manager advised staff had had training on the use of the care pathway, but that this was only the second time it had been used and was at this time the responsibility of the deputy nurse manager who worked with the doctor on this. The members of staff advised that the home tries to look after service users who are dying when ever possible, and that after a death the service users belongings remain in the room until the relatives decides, and that the relative is not hurried. Staff advised that service users final wishes are elicited at admission. The service user on the Liverpool care pathway was seen; they were in bed in a very pleasant room with classical music playing softly. The home provided a copy of their policy on death and dying. Foxearth Lodge Nursing Home DS0000024391.V279405.R01.S.doc Version 5.1 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): 12,14,15 Service users can expect to enjoy an appetising and well balanced diet, and to have attention paid to their preferences regarding where they wish to eat, how they like their drinks made and what they like to drink from. EVIDENCE: Fumble baskets had been made available for service users with dementia. A notice of activities available was displayed in each service users room, and a record of activities service users had participated in was seen on Woodlands. Service users on Woodlands were seen to be having their teatime meals in a variety of places; some were sat at the table, some had individual chairs and tables, some were assisted in their rooms. Staff advised that service users are asked each day what they would like to eat the following day. The Inspector was advised that in care plans, it specifies whether the service user needs a normal diet or a high protein diet, and that one service user who is a diabetic has a sugar free diet as far as is possible. No service users were known to require a special diet for cultural reasons, but the housekeeper advised that two vegetarians are catered for. The main meal at teatime was cauliflower cheese, followed by artic roll. Some service users had soup, some had sandwiches. The main lunchtime meal was chicken casserole, according to the menu. An 8-week plan of menus was seen and the meals detailed were well balanced and wholesome. The housekeeper advised that the home tries to use Foxearth Lodge Nursing Home DS0000024391.V279405.R01.S.doc Version 5.1 Page 14 fresh vegetables wherever possible. Service users can have a cooked breakfast; the housekeeper advised one chooses to do so three times a week. The housekeeper showed a list that record all service users preferences and needs in terms of the size of meal (plate) they wanted, the type of cup they liked to drink out of, the strength of drink they preferred. This included any that needed a liquidised diet. The kitchen staff were involved with serving the teatime meal, and there was an upbeat and positive mood in Woodlands during the mealtime, with service users joining in friendly banter and moving around freely after their meal. Foxearth Lodge Nursing Home DS0000024391.V279405.R01.S.doc Version 5.1 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): 16,18 Service users cannot yet be confident that staff will feel they are able to whistle blow if necessary. EVIDENCE: The revised Service User Guide, containing a copy of the complaints policy was not available for inspection and will be inspected next time. The homes policy on prevention of abuse had been reviewed and was consistent with local interagency policy. The home had provide a revised whistle blowing policy following the last inspection, but it required further work. Whilst it clarified the responsibility of staff to act if they are aware of possible abuse, it did not include clear advice that if the referrer fears they may be victimised, dismissed or perceived as a trouble maker, the provisions of the Public Interest Act 1998 may protect the alerter in raising concerns outside of the workplace, given certain stated provisions. The revised policy also stated all allegations of abuse must and will be referred to the NCSC in the first instance. (Although it later correctly names the organisation CSCI). The lead agency – as noted in the amended complaints policy is Social Care Services. The Inspector was advised that this was still being worked on. Foxearth Lodge Nursing Home DS0000024391.V279405.R01.S.doc Version 5.1 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): 19,26 Service users can expect to live in a very comfortable and clean home. EVIDENCE: The home was in a good state of repair and decoration. The inspector walked through out the entire home, and no requirements were identified. Temperature records were seen to be maintained for all hot water outlets. Individual rooms of service users with dementia had been identified by a relevant picture, relating to service users identity or interests, in addition to their title/name of choice. Staff advised that they are planning to put up mobiles on Woodlands for more sensory stimulation. The home was clean throughout the inspection. No unpleasant odours were detected in any part of the care home. The laundry had was in good condition and had a washing machine with a sluice cycle. The procedure for laundry was explained by the housekeeper, who advised that laundry is transported in the home in tied bags. Alcohol wipes are not used in the home, so there was no need for the policy to deal with the use of these. Foxearth Lodge Nursing Home DS0000024391.V279405.R01.S.doc Version 5.1 Page 17 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): 29,30 Service users can expect staff to all have received an appropriate induction course. EVIDENCE: The deputy Matron had also advised the CSCI in writing that action had been taken to obtain a second reference for two of the conversion course nurses where this had been missing, and for a third nurse where the reference had not been satisfactory. The nurse facilitating the inspection advised that a second reference was still awaited for one conversion nurse, only. This and the proof of identity of one worker whose documentation had been on their induction file at time of the last inspection was verified. The staff facilitating the inspection did not know if any new carers had been started since the previous inspection. Staff spoken to advised that they were aware that the assistant nurse manager had commenced work on a training analysis but this was not available at the time of the inspection. The assistant manager had also confirmed in writing that action had been taken in respect of the recommendation made at the previous inspection that further training in the care of dementia and the impact of person centred care and the environment on behaviour should be provided for workers on Woodlands. The assistant manager was not on duty at the time of the inspection and information was not available to verify this action; it will be sought at the next inspection. A member of staff advised that they and another had been booked onto a Protection of Vulnerable Adults course scheduled for March 2006. The trainee assistant manger advised that manual Foxearth Lodge Nursing Home DS0000024391.V279405.R01.S.doc Version 5.1 Page 18 handling training was carried out annually for everyone. Topss induction certificates were evidenced in staff files selected at random. Foxearth Lodge Nursing Home DS0000024391.V279405.R01.S.doc Version 5.1 Page 19 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): 32,33,35,38 Despite one requirement, service users can generally expect to live in an environment where their health and safety are well protected. EVIDENCE: Staff name badges were being worn so that their names were clearly visible. The home had provide copies of an annual quality assurance report in April 2004 and April 2005, and the Inspector was advised that this occurs annually but was not yet due. The home’s certificate of Public Liability Insurance was displayed. The Inspector was advised that a start had been made on a business plan, but that it had been decided that at this point the home wished not to seek to convert existing mainstream places to places for service users with dementia, but to seek vary the current registration to accommodate eight named persons with dementia, as currently resident outside of Woodlands Unit. The inspector was advised that the intention was for these to revert to Foxearth Lodge Nursing Home DS0000024391.V279405.R01.S.doc Version 5.1 Page 20 mainstream places as and when each of these service users were no longer accommodated on the mainstream unit. Service users had a lockable drawer in their own rooms. Small amounts of money are looked after for some service users. Three were inspected and the amounts kept were found to tally exactly with monies held. Receipts were kept. The only signatures evidencing monies deposited, withdrawn or spent on receipted purchases were of the staff member who administered this system. Cupboard doors marked as fire doors were checked and were found to be locked. Two large bottles of detergent marked with a X were stored outside of the back kitchen door in an area that was accessible to service users. Product data sheet for substances used in the laundry were posted on the wall. A Hazzard Analysis Critical Control point (HACPP) risk analysis was seen to be in place for processes involved with the homes food. A record of food temperatures was seen to be kept. Foxearth Lodge Nursing Home DS0000024391.V279405.R01.S.doc Version 5.1 Page 21 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 2 3 X 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 2 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 2 X X 2 Foxearth Lodge Nursing Home DS0000024391.V279405.R01.S.doc Version 5.1 Page 22 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 OP1OP16 Regulation 5 Requirement The Service User’s Guide should include a summary of the complaints policy, including who to complain to and how to complain. This is a repeat requirement from the previous inspection. A risk assessment for the possibility of wandering that is kept under regular review is required for an ambulant service user with dementia who has direct access to a non-secure garden. The use of lap belts as a restraint must be in accordance with the home’s policy. The system of medication administration must be reviewed to reduce the possibility of error enhance the security of medication inherent in the system. Medication records must be complete. A record of all returned medication must be kept and signed. The homes policy on whistle DS0000024391.V279405.R01.S.doc Timescale for action 14/02/06 2. OP7 13(4)(b) (c) 14/02/06 3 4. OP7 OP9 13(7) 13(2) 05/02/06 14/03/06 5. 6. 7. OP9 OP9 OP18 13(3) 13(3) 13(6) 19/01/06 28/02/06 14/02/06 Page 23 Foxearth Lodge Nursing Home Version 5.1 8. OP34 16(1) 9. OP38 13(4) (a)(c) blowing must be reviewed and revised, and include advise on protections if whistle blowing outside of the home, in accordance with local interagency policy. This is a repeat requirement from the previous inspection. Monies deposited, withdrawn or spent on behalf of service users Must be signed for by the service user or their representative and a second member of staff. All products that are hazardous to health must be stored in a locked cupboard. 14/02/06 19/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2. 3. Refer to Standard OP2 OP30 OP30 Good Practice Recommendations The contract for respite care should include the dates of the stay and the fees due if a planned stay is foreshortened. A training analysis should be conducted. More extensive training in the care of dementia and the impact of person centred care and the environment on behaviour should be provided for workers on Woodlands. The home should have a business plan for the establishment, reviewed annually. 4. OP33 Foxearth Lodge Nursing Home DS0000024391.V279405.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Foxearth Lodge Nursing Home DS0000024391.V279405.R01.S.doc Version 5.1 Page 25 - 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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