Inspection on 16/04/07 for Galtee More Nursing Home

This inspection was carried out on 16th April 2007.

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

Galtee More Nursing Home 22/09/08

Galtee More Nursing Home 10/04/08

Galtee More Nursing Home 07/12/05

Galtee More Nursing Home 21/06/05

Galtee More Nursing Home 21/04/05

Galtee More Nursing Home 13/01/05

Galtee More Nursing Home 18/08/04

Galtee More Nursing Home 24/03/04

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

CARE HOMES FOR OLDER PEOPLE Galtee More Nursing Home 164 Doncaster Road Barnsley South Yorkshire S70 1UD Lead Inspector Mrs Sue Stephens Key Unannounced Inspection 16th April 2007 09:00 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 DS0000006480.V331492.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. DS0000006480.V331492.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Galtee More Nursing Home Address 164 Doncaster Road Barnsley South Yorkshire S70 1UD 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) 01226 733977 None None Dr Gulzar Khan *** Post Vacant *** Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places DS0000006480.V331492.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons accommodated shall be aged 60 years and above. Date of last inspection 7th December 2005 Brief Description of the Service: Galtee More is a 28-bed home for older people; it provides both nursing and personal care. The home is in a residential area on the outskirts of Barnsley town centre, where there is good access to public services. There is a bus route, a variety of shops, health centre, post office, pubs, and church near by. The home has disabled access and a passenger lift to all levels. There are eighteen single and five double rooms, two lounges and a dining room. There is a garden and car parking is available at the side of the building. The information about the homes fees and charges was provided on 21.04.07. Nursing care Residential care Low band £373.50 £335.00 Medium band £420.50 High Band £472.50 There is also a NHS Nursing Care Component Additional charges Chiropody, hairdressing and personal newspapers. Prospective residents and their families can get information about Galtee More by contacting the manager. The home will also provide a copy of the statement of purpose and the latest inspection report. DS0000006480.V331492.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was unannounced; it took place between 09:00am and 16:20pm. The inspector sought the views of six people who live at the home, four relatives, a qualified nurse, and a care worker. Sue Dooler, the manager, assisted with the inspection. Dr Khan, the responsible individual was present for a short time during the visit. During the visit the inspector looked at the environment, and made observations on the staffs’ manner and attitude towards people. She checked samples of documents that related to peoples’ care and safety. These included three assessments and care plans, medication records, and two staff recruitment files. The inspector looked at other information before visiting the home. This included the pre-inspection questionnaire, which the Commission for Social Care Inspection (CSCI) had requested. And evidence from the last random inspection. Five people who live at the home returned surveys about what they thought of their care and the home. The random inspection visit took place on 16 November 2006; where the inspector found that the home had made good improvements towards meeting national minimum standards. This was a key inspection and the inspector checked all the key standards. The inspector would like to thank the people who live at the home, relatives, responsible individual, manager and staff for their welcome, help and contribution to this inspection. What the service does well: People said they felt staff looked after them well. They said staff understood their care needs and were friendly and helpful. People who live at the home made positive comments, which included, “They (staff) are very patient and caring, they see to your every need” “I never thought I would settle, but Galtee More is second to none; the people that run it and care for you are brilliant”. People had care plans and the staff reviewed these to make sure their care was up to date. DS0000006480.V331492.R01.S.doc Version 5.2 Page 6 People said they had good support with their health needs; they had good access to health care services. People got good attention from staff; the staff were polite, friendly and professional. Many people said they were satisfied with their daily routines. They said they enjoyed having visitors, and visitors said the home made them welcome. They joined in sing-along and dancing with people at the home and people said they enjoyed this a lot. People who lived at the home, or their families could continue looking after their own finance. Everyone said the meals were good. They said they were tasty, there was plenty and they could have plenty of drinks. Mealtimes were relaxed and sociable occasions. People said they found it easy to speak to staff and felt they could raise a concern and staff would listen and take action. People said they were happy with the homes environment. They said they felt the home was clean and the furniture was comfortable. The home made sure people had clean and good laundered clothes. Staff were very positive in their approach, people said staff were available to give them support when they needed it. Many care staff had a National Vocational Qualification in care; this meant they understood how to give people good care. What has improved since the last inspection? People had their needs reviewed and this included nurses assessing their risk of falls. The home now had a safe system to store, administer and record homely remedies. People could choose whether to sit in their wheelchair or transfer to a dining chair at mealtimes. The home had bought new cutlery and crockery and the cook said they could now replace this if they started to run short. People who used aprons had aprons that were clean and in good condition. Staff kept the fire exits clear and the garden was tidier. DS0000006480.V331492.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. DS0000006480.V331492.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 DS0000006480.V331492.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): 3. The home had no referrals for intermediate care. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People who live at the home have their needs assessed, and staff review this so that they can continue to meet peoples changing needs. EVIDENCE: People said they were satisfied that staff understood and could meet their needs. And one relative confirmed that the manager checked information about their family member’s needs before they came to live at the home. People had local authority assessments and the manager made sure she or qualified staff looked at these before meeting individuals and deciding if Galtee More could offer them care. Before agreeing that some one could come to Galtee More the manager said they carried out their own assessment. DS0000006480.V331492.R01.S.doc Version 5.2 Page 10 This was good practice, however, the homes assessment tool was basic. The home could improve this to help them get better information about peoples lives, their aspirations and their needs. The assessments considered peoples diverse needs. This helped the home understand and meet peoples’ different needs and aspirations, for example their disability, religion or culture. DS0000006480.V331492.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 and 10. People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People get health care and personal care based on their individual needs. However, the care plans, risk assessments and medication practices do not fully safeguard peoples safety and welfare. EVIDENCE: People said they were happy with their health care and that staff treated them with dignity and respect. They said, “Staff are excellent” “I’m alright here” People at the home and a relative confirmed the home made sure there was good access to health services. DS0000006480.V331492.R01.S.doc Version 5.2 Page 12 All the 5 surveys agreed people received the medical support they needed. The home has continued to improve peoples care plans. The care plans identified people’s needs and gave staff instruction about how to support them. Nurses and senior care staff reviewed the plans on a regular basis. Each person had a daily record about his or her care and this included information about visiting professionals, for example visiting palliative care nurses. This was good practice and helped the home monitor people’s conditions well. Some of the care plans were basic, for example someone who had a variety of complex conditions did not have a separate care plan for each condition. This could lead to inconsistent care and staff failing to identify changing symptoms. People had basic risk assessments that included falls and pressure care. However, when the home recognised potential risks to one person whilst monitoring and assessing them, they had not done immediate risk assessments to identify and minimise the risks to the person and other people who live at the home. The inspector checked a medication round. The nurse followed good practices, this included providing drinks with tablets, talking to and encouraging people to take their medicines; and asking about their health so that she could assess if giving medication was appropriate. (For example when she offered people their pain relief tablets). The inspector noted the following areas where the home did not maintain safe practices: • • • Nurses had not checked and countersigned hand written instructions on the medication chart. Nurses had not used consistent codes to identify why people had not taken their medication. Nurses had not recorded the reasons for giving pain relief medication on the medication record. This meant that they could not check if the pain relief was for the same, or different, reasons and therefore they could not accurately monitor people’s conditions. The medication trolley was dirty on the outside with grime and dirt engrained into seams, open cavities and the wheels. The inside of the cabinet had sticky shelves from spilt medicines. One medicine bottle had a spill running over the label. (It is good practice to always pour away from the label to prevent distorting the information on the label). The plastic file dividers on the tablet dispensers was dirty, this could lead to cross infection because the nurses handle the dividers with their hands. The home accepted a medication change from a G.P over the phone, but had not got written confirmation following this. DS0000006480.V331492.R01.S.doc Version 5.2 Page 13 • • • • • • • The home did not have a fax machine. This meant they could not receive G.P written instruction by fax (as advised in The Royal Pharmaceutical society guidelines). The nurse handled some ones tablets rather than using a spoon. This could also lead to cross infection. The inspector spent time observing care practices. The staff spoke to people in a dignified manner, the staff were positive and professional in their approach. When people asked to be left alone in their rooms and when using the bathroom staff respected their privacy. The inspector noted staff transferred people from one room to another without attempting to cover up people’s catheter bags. This was unnecessary and undignified for the individuals concerned. Where people shared bedrooms they had a screen to give them privacy for personal care. DS0000006480.V331492.R01.S.doc Version 5.2 Page 14 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 and 15. People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Some people are dissatisfied with the amount of activities at the home. People get good meals and nutrition. EVIDENCE: People had different views about the social activities in the home. Some people at the home said they were “fine” and satisfied with their daily routines. Other people said there was not enough activity. Two relatives confirmed the home did not put on much activity, however they said staff and visitors often joined in with singing and dancing and people at the home really enjoyed this. The visitors said they spoke to everybody, and that is what the people at the home liked. Three people replied in the survey that the home “usually” arranged activities, one said, “but (I) feel more activities could be included”. Another person replied the home arranged activities only “sometimes” and a fifth person replied “never”. DS0000006480.V331492.R01.S.doc Version 5.2 Page 15 A member of staff confirmed they found it difficult to put on activities inbetween care tasks, but said there was several staff at the home good at providing impromptu entertainment, for example singing, laughing and joking; and that the people loved this. Staff and relatives confirmed that people did not get much opportunity to go for short walks, for example to the local shop. People at the home and relatives all agreed that visiting times were suitable and that staff always made visitors welcome. The manager confirmed that all people (or their chosen relative or advocate) managed their own finance. People said they were satisfied with their meals. One person said, “The variety is good” and another said, “the meals are varied and tasty” A relative said, “my wife says the meals are brilliant”. The inspector observed a breakfast time and lunch. The atmosphere was relaxed and sociable. The staff supported people in a dignified way and made sure people had enough to eat and drink. Some people have to sit in the dining area for a long time before staff can serve their meals. The manager said she was aware of this and it was because most people depended on waiting for the lift to access the dining room. At teatime people ate in the lounge, this was a relaxed routine and people said they liked to do this. Some people had their meals in their own room because they preferred it. The home had purchased new aprons for people to use at mealtimes; these were of better quality than on the previous visit. There was sufficient crockery and the cutlery now matched. The home had improved this since the last key inspection. People could choose if they wanted to remain in their wheelchairs or transfer to a dining chair at mealtimes. DS0000006480.V331492.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People can express their concerns and the homes policies help protect people from abuse. EVIDENCE: People said they could raise concerns and complaints and that staff would listen, they said, “You can speak to any of the staff and they will sort things out whatever the problem is” “I have nothing to complain about” “There is always a member of staff to speak to” “If I have any problems, I can talk to any member of staff, and they are all very helpful”. The homes complaint procedure is available for people to see in the entrance hall. Staff confirmed they had adult protection training (protection of vulnerable adults); and they knew how to report poor practice. The manager had completed a course and was able to deliver adult protection training to the DS0000006480.V331492.R01.S.doc Version 5.2 Page 17 staff team; this included a question and answer task and the manager could check staffs’ understanding. The manager confirmed they had not had any adult protection referrals at the home. DS0000006480.V331492.R01.S.doc Version 5.2 Page 18 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, 23 and 26. People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People who live at the home are satisfied with their environment. Some décor and flooring does not promote good safety and cleanliness. EVIDENCE: People said they were happy with their environment. They said they had comfortable furniture and were happy with their bedrooms. They said they were satisfied with the cleanliness of the home. One relative confirmed they always found the home clean and their family members clothes well laundered. The inspector checked a sample of rooms. Most rooms were clean and homely, people had personalised bedrooms and most bathrooms were clean. DS0000006480.V331492.R01.S.doc Version 5.2 Page 19 Some rooms needed redecoration, for example corridors, bedrooms and bathrooms where skirting boards, wallpaper and paint was chipped, aged or stained. This did not promote the good hygiene standards. In one bedroom the floor covering was worn and had a hole in it, this put people at risk of tripping or slipping. The home had tidied the back garden, however some litter, debris and a bin used for burning wood still remained. The home could improve this further to make it more pleasing for the people who live there. There is seating to the front of the home; people said they liked to sit there in fine weather because they could watch the traffic and people go by. DS0000006480.V331492.R01.S.doc Version 5.2 Page 20 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 and 30. People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People, who live at the home, and their relatives, are satisfied with the home’s staff. However the homes staffing availability, recruitment and training procedures do not protect and promote peoples welfare. EVIDENCE: People said about the staff, “There is always someone at hand to help with any problems” “The carers in the home are really caring, nothing is too much trouble for them” “They are very patient and understanding and see to your every need” A relative said, “Staff are brilliant, they don’t just leave (people at the home) they talk to them” “Nothing is too much trouble for them” DS0000006480.V331492.R01.S.doc Version 5.2 Page 21 People in the surveys said staff are “always” available; one person said staff are “usually” available. People said they were happy with the staffing levels. And the inspector noted that staff were very focussed on peoples care and support needs. People who lived at the home, relatives, staff and the manager all agreed that staff did not have much time to support people with leisure and social activities (see information in Daily Life and Social activities) this impacts on the quality of peoples lives and the home needs to look carefully at how it can release staff time to improve social opportunities. Over 50 of care staff had a National Vocational Qualification in care, and more staff were training towards the qualification. This is good practice because it provides people with good and consistent care practices. There was evidence to show that the home followed recruitment procedures when they employed staff. However their procedures had allowed staff to work before criminal record bureau checks and POVA 1st checks (protection of vulnerable adult list) were complete. Some records did not have full employment history; and details to check about criminal offences were missing. This did not protect peoples’ welfare. The Criminal Records Bureau requires that all staff have an enhanced criminal record bureau check before they commence unsupervised work. Staff can have a POVA 1st check, this allows staff to work supervised whilst waiting for the CRB check to complete. The inspector required the manager to take immediate action to make sure that staff do not work at the home unsupervised without POVA 1st checks. The home had not met the previous requirement that all staff employed after July 2004 must include a POVA 1st check. Staff had not received sufficient up to date training over the past year. Training is important because there are people at the home with complex health needs and it is important staff understand about their conditions, so that they can monitor and care for them safely. The homes induction package was not up to date with new Skills for Care Council guidelines. This means new staff may not have the recognised current good practice information. DS0000006480.V331492.R01.S.doc Version 5.2 Page 22 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, 33, 35 and 38. People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People live in a home that is fairly well run. However some of the homes safe working practice policies and quality assurance practices do not protect and promote people’s safety and welfare. EVIDENCE: The home has not met the previous requirement for the manager to apply for registration. This will enable the home and manager to demonstrate that she has suitable skills, integrity and qualifications to run the home. The registered provider has not carried out provider visit reports and submitted them to the Commission for Social Care Inspection since the last inspection. DS0000006480.V331492.R01.S.doc Version 5.2 Page 23 However the manager and provider confirmed that the provider calls at the home on a daily basis, checks the day to day running of the home and talks to people who live there. The manager and staff have worked hard to improve the quality of care at the home for example the manager has reviewed some of the policies and procedures and staff have improved how they record care plans. However the home still needs to improve some quality assurance areas, for example the manager should produce an annual development plan to identify and prioritise improvements such as training, décor and social activities. This will help the home maintain people’s safety, dignity and respect. The manager confirmed the home had a system for handling people’s money and valuables and encouraged people’s family to manage their relatives’ finances if the people were unable to do it themselves. Staff said they had safe working practice training, for example, health and safety, moving and handling, first aid, fire and food hygiene. Staff had not had recent guidance on infection control. However the manager did not have records to show this and said some training such as moving and handling was due for update. This did not protect the safety and welfare of the people at the home because the manager could not be sure staff understood and followed safe practices. In one bathroom the tap did not work properly, water came out too cold or too hot. And the home did not carry out water temperature checks to make sure water temperatures in other areas were at safe levels. This put people at risk, particularly people who might decide to run a bath for themselves. The inspector noted that on three occasions staff pushed people in their wheelchairs without footplates attached. This is dangerous practice because it can cause injury to the person if they catch their feet on the floor; they could tip out or injure their feet and legs. The home did have some risk assessments covering health and safety issues. However, these were out of date and did not reflect the changes in the home. This prevents the home from minimising possible risks to people, staff and visitors at the home. DS0000006480.V331492.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X 3 X X 2 STAFFING Standard No Score 27 2 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 2 X 3 X X 2 DS0000006480.V331492.R01.S.doc Version 5.2 Page 25 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 OP7 Regulation 15.1 Requirement Care plans must reflect peoples health and personal needs so that people get safe and consistent care. The care plans must include risk assessments based on their individual and changing needs, so that risks to themselves and others are identified and minimised. Medication storage, administration and record practices must be safe. And include the following • • • Checked and countersigned handwritten instructions Consistent use of codes to identify missed medication Recorded reasons for giving ‘as required’ medication Timescale for action 31/05/07 2 OP9 13.2 30/04/07 The home must not accept verbal prescription changes without follow up written confirmation. DS0000006480.V331492.R01.S.doc Version 5.2 Page 26 3 OP10 12.4(a) The home must make sure they respect people’s dignity by covering (where possible) people’s catheter bags when staff are assisting them to move. The home must replace the worn bedroom floor to avoid people slipping or tripping on it. The home must redecorate rooms where the décor is worn, chipped or stained. So that the homes hygiene standards are maintained. Staff must have infection control guidance or training to make sure people are safe from cross infection risks. 30/04/07 4 OP19 16.2(c) 31/05/07 5 OP26 13.3 30/09/07 6 OP29 19.1 (b)(i) Schedule 2 Criminal bureau record checks must include POVA checks for all staff employed at the home after July 2004. (Protection of vulnerable adult checks). (Previous timescale of 30/06/06 and 30/11/06) 30/04/07 7 OP29 19.1 (b)(i) Schedule 2 Immediate requirement The home must safeguard people by making sure they do not allow staff to work without a completed criminal record bureau check (CRB) or a POVA 1st check (protection of vulnerable adults). Staff with a POVA 1st check must be supervised until their CRB is complete. 16/04/07 8 OP29 19.1 (b)(i) Schedule 2 The home must include the following in their recruitment procedures: • Full employment history DS0000006480.V331492.R01.S.doc 30/04/07 Version 5.2 Page 27 • 9 OP38 13.4 (a)(c) Declaration of physical and mental wellbeing. The bathroom tap must be 30/04/07 repaired to make sure people are not at risk of scalds. The home must check water temperatures regularly to make sure people are not at risk of scalds. 10 OP38 13.4(a)(c) People must be transported wheelchairs with footplates on unless they have expressed they do not want them, and there is a suitable care plan and risk assessment to support it. 30/04/07 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 OP9 Good Practice Recommendations The home should have a fax machine so that it can receive written instructions from the G.P. about prescription changes. They should renew or totally clean the medication trolley and plastic dividers. Staff should pour medicine in the correct way to prevent spoiling the label. Staff should not handle tablets. 2 3 OP12 OP13 The home must review their social activities and make arrangements to enable people to participate in activities. The home should review their staffing arrangements to enable people to take short visits into the community DS0000006480.V331492.R01.S.doc Version 5.2 Page 28 4 5 OP19 OP27 The home should tidy the back garden better so that it is nicer and more dignified for the people who live there. The home should review the staffing compliment to make sure there is sufficient staff to help support people to participate in social activities. The home should review staff training and make sure staff have training based on the needs of the people who live at the home. New staff need to have an induction based Sector Skill Council induction standards to make sure they get current good practice training. 6 OP30 7 8 OP31 OP33 The manager needs to demonstrate fitness to manage the home by completing the CSCI registration process. The provider should carry out provider visit reports so that he can show evidence that the home is making progress in the best interests of the people who live there. The home should have a development plan to prioritise the improvements they need to make. For example training, décor and social activities. 9 OP38 The homes health and safety risk assessments should be reviewed to make sure risks to people at the home are identified and minimised. The manager should make sure all staff safe working practice training is up to date and recorded. This will help make sure people live in a safe home. 10 OP38 DS0000006480.V331492.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Text phone: 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 DS0000006480.V331492.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!