Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Garden Lodge Care Centre Middlemass Hey Liverpool Merseyside L27 7AR The quality rating for this care home is:
two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Michael Perry
Date: 2 1 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home
Name of care home: Address: Garden Lodge Care Centre Middlemass Hey Liverpool Merseyside L27 7AR 01514984776 Telephone number: Fax number: Email address: Provider web address: gardenlodge@schealthcare.co.uk Name of registered provider(s): Type of registration: Number of places registered: Ashbourne Homes Ltd care home 48 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: To accommodate one named service user under 65 years old in the residential unit of the home. Date of last inspection Brief description of the care home Garden Lodge is a residential care home providing 24 hour personal care and accommodation for 24 older people and 24 older people with mental health problems (Dementia) Garden Lodge is owned and managed by Southern Cross Health Care. Southern Cross healthcare provide healthcare services across the U.K. The home is located on the edge of a housing estate in the Netherley area of Liverpool. Although the home is some distance away from local shops and amenities, they are easily accessible via a local bus service. The home is a purpose built single storey building that was opened in 1992. There are two separate units, catering for the two different categories of service users. The bedrooms do not have en-suite facilities, however there are sufficient bathrooms and toilets situated throughout the home to meet the needs of service users. Communal space within the home consists of two lounge areas on one unit and two lounges plus a separate dining room on the other unit. Central to Care Homes for Older People Page 4 of 30 24 0 Over 65 0 24 Brief description of the care home both units is a garden area, which is well maintained. Garden furniture is provided and service users use it in the summer. The current fees for the service range between 322 and 475 pounds per week. Care Homes for Older People Page 5 of 30 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Before we visited the home the manager filled out a form (Annual Quality Self Assessment, or AQAA) we sent and returned this. It had a lot of information about the home and how the people are supported to live their lives. We visited the home without telling the staff we were coming so that we could see how things work normally. We spoke with many of the people who live there and watched how they spend their day and how the staff support them. We also spoke with visitors. We looked at the records kept on people who live in the home and other records to do with how the home is run. Care Homes for Older People
Page 6 of 30 We looked around the home to see if it was clean and a nice place to live and some of the people living in the home showed us their bedrooms. What the care home does well: We looked at the information supplied by the home at the point of people moving in. Those residents spoken with said that the information supplied had helped them to settle into the home. We also looked at the assessments carried out prior to and during the admission phase. These were comprehensive and included all aspects of the persons care. This sort of assessment helps the staff in the home to meet the persons needs. We spoke to one relative who said that nothing was to much trouble and that staff had been very informative during the admission stage. We spoke to residents and looked at care records and found that health care is assessed and supported in the home. Care records evidenced that people are supported to attend GP appointments and also to attend for other health checks such as dentist and opticians. All of the residents have a plan of care. Reviews of the plan are carried out with the resident or relative so that they are kept up to date with their care and can also feel more involved. We found that the home help to cater for residents with diverse care needs. For example one person has care needs around intimacy with another resident in the home. This was complicated by issues around mental capacity and risk but the home had followed good practice guidance and included family and professionals to both protect and also to enable the residents concerned. This demonstrates that the home are considering a wide range and diversity of care need. Also the home meets with current legislation by providing disability access at all areas as well as the grounds. We spoke with one resident who uses a wheel chair who said that staff were available to support him to move around the home. Residents spoken with said that staff where helpful and respected their privacy. Relatives also reported that they are always kept informed of the care. One resident said: The carers are very good. I get looked after. The carers are quick to respond to the call bell. They help me to wash and dress. I can have a bath everyday if i want. We spoke to residents and relatives who were pleased with the social life in the home and particularly the relaxed and friendly atmosphere. Some comments were; I like it here now. The staff are very good. Theres a lot going on in the day. Time flys. You can relax here. Food is excellent. The chef will get what you want. Today its either gammon or steak pie. Its a very good home. They [staff] are all nice. I went out recently. The activities person always asks. Went to church last week. Care Homes for Older People Page 8 of 30 On the dementia care unit we observed that the managers and staff are developing the environment on this unit in line with many good practice principals such as orientation aids and placement of furnishings to assist with interaction and socialization. We found the home to be relaxed and welcoming and residents spoken to and observed were clearly at home and enjoyed the positive atmosphere. Bedrooms are personalized and generally well maintained so that individual lifestyles were reflected. Staff reported that the home is settled in terms of consistency with little turnover of staff numbers and staff records confirmed this so that there is a good continuity of care for residents. We observed the staff to be warm and supportive in their interactions with the residents and this was confirmed as consistent by speaking to residents. We found the general management of the home to be good. All senior staff and the manager were open and work well as team. There are appropriate management systems in place so that the care in the home is constantly reviewed and managers are keen to get feedback from people in the home so that they can improve things further. What has improved since the last inspection? What they could do better: Some of the people who are funded by social services did not have any reference to a social work assessment before coming into the home. This is important because there is a need for the home to get all information to get a clear picture of the persons care needs. The information given to residents and relatives on admission is generally good. We spoke to one resident however who has poor eyesight and could not read the small print. We would recommend that the home produce more diverse versions of the information such as large print for example. We looked at medication administration records [MAR] and also the homes policies around self administration. Overall we found satisfactory safe practice but there are areas that need to be tightened up and also further developed. For example there are no residents self medicating to any degree. The homes policy is very specific about the need to encourage as much independence in this area as possible and gives appropriate good practice guidance. There is also reference to a risk assessment tool [although this could not be produced]. The homes managers should review the culture of the home in this area of care which currently does not facilitate any level of independence and aim to introduce appropriate practice. There are other recommendations and one requirement around the importance of Care Homes for Older People Page 9 of 30 maintaining clear medications records as this will ensure safe monitoring at all times. The medications are subject to auditing by the manager and we would require that these audits are conducted more stringently so that recording errors are reduced. The staff reported that more could be done to develop social interaction for people in the home and with 20 hours allocated weekly for the whole home there are still long periods when some residents are not engaged. Staff spoken with have received training in how to recognize and report abuse and were knowledgeable about identifying abuse and said were confident about this to the manager. Staff were not really aware of the wider picture in terms of understanding how investigations are conducted and the role of statutory agencies such as social services. It would be recommended that future training includes these elements so that staff are more aware of the broader picture in terms of safeguarding of vulnerable adults. We looked at some staff files and found that staff are recruited thoroughly. We did find that one staff had not had a reference from their last employer and this is required as this was from a care home. These recruitment checks ensure that staff who work in the home are fit to do so. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 10 of 30 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 30 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed prior to addmisssion so that their care needs are known and are given information so that they are assisted to settle into the home. Evidence: We spoke with some of the people in the home who had recently been admitted and also spoke with relatives and friends. All had been pleased with the way they had received information about the home and felt that managers and staff had been helpful and reassuring so that they had been helped to settle into the home. One commented: Nothing was to much trouble. We saw copies of the service user guide in bedrooms and this contained useful information about the home. One person had eyesight difficulties and could not read the print. We discussed this with the manager and feel there is a need to develop information in different formats such as large print for example so that people with
Care Homes for Older People Page 12 of 30 Evidence: more diverse communication needs can be enabled. We looked at three admission assessments carried out by the managers. Mostly people are seen prior to coming into the home and an assessment is carried out. This assists in making sure that the home can meet the needs of people being admitted. The assessments had good detail. There was not always copies of social work assessments for those people who are funded by social services. We discussed the importance of ensuring copies of these assessments so that all useful information is available. Care Homes for Older People Page 13 of 30 Health and personal care
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health and personal care is managed so that peoples privacy and dignity is respected. Evidence: We looked at care records for people living in the home. All residents have a care plan and these are completed well and are easy to follow. The people spoken with said that they are kept up to date with any changes to the plan and these are reviewed. We saw that residents and/or relatives had signed records to say they had been discussed. This is good practice and ensures that people are included in their care. One care plan covered care needs around intimacy with another resident in the home. This was complicated by issues around mental capacity and risk but the home had followed good practice guidance and included family and professionals to both protect and also to enable the residents concerned. This demonstrates that the home are considering a wide range and diversity of care need. Records contained numerous references to medical referrals and GP and hospital visits.
Care Homes for Older People Page 14 of 30 Evidence: Those spoken with reported that staff were quick to refer and liaise as nesarsary with health professionals. One person has been assessed as high risk of pressure sores and the appropriate action had been planned including an assessment by district nurses and the provision of a support mattress for the persons bed and cushion for the chair. People spoken with said that they receive their medication on time. Staff were observed administering medicines from the medication trolley. We looked at medication administration records [MAR] and also the homes policies around self administration. Overall we found satisfactory safe practice but there are areas that need to be tightened up and also further developed: * There are no residents self medicating to any degree. This was discussed with reference especially to people on the general residential unit. Staff reported that nobody really asks for this. The homes policy is very specific about the need to encourage as much Independence in this area as possible and gives appropriate good practice guidance. There is also reference to a risk assessment tool [although this could not be produced]. The homes managers should review the culture of the home in this area of care which currently does not facilitate any level of Independence and aim to introduce appropriate practice. * We looked at two residents who are having medication as required [PRN]. There were no obvious records either on the medication record or in the care plan as to when these medicines should be given other that give when required. The importance of maintaining a consistent approach with PRN medication was identified and it would be recommended that such medicines are managed through the care plan so all all staff are aware of the reasons for giving the medication and it can also be regularly reviewed through the routine evaluation of the plan. *Records were not always clear so that in one instance it was difficult to audit medicine which was a controlled medication and by law has to be monitored very tightly. In this instance a tablet had been destroyed as it had been refused by the resident but this had not been recorded so that the stock of medicine was not accurate. The medications are subject to auditing by the manager and we would require that these audits are conducted more stringently so that recording errors are reduced. * One resident has a cream applied by staff. Records should indicate the staff who has applied the cream and when so that this can be monitored. We discussed ways that this can be practically recorded including a chart in the persons room so that staff can record once they have applied the cream.
Care Homes for Older People Page 15 of 30 Evidence: All staff administering medicines are receiving appropriate training and further updates have been booked. This shows that staff have a good level of competence in managing medicines and the manager was open to the improvements discussed. We spoke to people who said that staff assisted them with their personal care and that they felt supported and that their privacy and dignity were respected. One said: The carers are very good. I get looked after. The carers are quick to respond to the call bell. They help me to wash and dress. I can have a bath everyday if i want. Care Homes for Older People Page 16 of 30 Daily life and social activities
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The social life of people living in the home continues to be developed so that they feel relaxed and engaged in the daily life. Evidence: We spoke to the activities organizer who is employed for 20 hours a week to plan activities for residents. She explained that activities are planned for residents and these include bingo, sing alongs, keep fit, regular trips out to the local church, day trips and party nights. Also special birthdays are celebrated. Currently there is some organization under way to organize a raffle to raise more funds for activities in the home. We spoke to residents and relatives who were pleased with the social life in the home and particularly the relaxed and friendly atmosphere. Some comments were; I like it here now. The staff are very good. Theres alot going on in the day. Time flys. You can relax here. Food is excellent. The chef will get what you want. Today its either gammon or steak pie.
Care Homes for Older People Page 17 of 30 Evidence: Its a very good home. They [staff] are all nice. I went out recently. The activities person always asks. Went to church last week. The menus were discussed and are well balanced being based on a specially formulated diet plan [nutmeg plan]with includes nutritional balance and healthy eating. This is in all Southern Cross homes. Residents reported that the chef seeks their views and continually updates the menu accordingly. People were observed to be settled and relaxed. The hairdresser was in on the day of the visit and some people were looking forward to having their hair done. There is plenty of day space and people were observed to be socializing. Staff reported that although they are busy they have time to socialize with the residents. There are some activities organized for those people on the dementia care unit and these residents regularly join in activities on the general care unit. We observed that the managers and staff are developing the environment on this unit in line with many good practice principals such as orientation aids and placement of furnishings to assist with interaction and socialization. The staff reported that more could be done to develop social interaction for people in the home and with 20 hours allocated weekly for the whole home there are still long periods when some residents are not engaged. In terms of quality of life for people in the home the pursuit of further activities should be continued. Care Homes for Older People Page 18 of 30 Complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are policies and procedures and staff are trained so that peoples concerns are listened to and reported and they are protected Evidence: There is a complaints procedure available for people in the home. Those spoken with were very relaxed around staff and said that they were listened to so that any concerns could be addressed. The complaints procedure is displayed in the entrance foyer as well as being available in the information supplied in each bedroom so this is easily accessible. We looked at the complaints recorded. There were two complaints recorded. One had been well managed and the complainant had been appropriately responded to so that redress was evident. The other complaint is current and is being investigated by one of the service managers. The issues around the complaint are management of pressure sores, managers interaction with staff, provision of meals and management of incontinence. These concerns were looked at as part of this inspection and there was no evidence to substantiate them. We were shown policies and procedures around the recognition and management of
Care Homes for Older People Page 19 of 30 Evidence: allegations of abuse. Copies of the locally agreed procedures were not readily available although the manager did eventually produce them before the end of the inspection. Staff spoken with have received training in how to recognize and report abuse and were knowledgeable about identifying abuse and said were confident about this to the manager. Staff were not really aware of the wider picture in terms of understanding how investigations are conducted and the role of statutory agencies such as social services. They were also unclear about where to look for the locally agreed procedures and policies [as further evidenced by the above lack of availability]. It would be recommended that future training includes these elements so that staff are more aware of the broader picture in terms of safeguarding of vulnerable adults. Managers did display an understanding of what to report through the safeguarding process and have completed appropriate referrals previously and liaised with social services so that people in the home are protected. Care Homes for Older People Page 20 of 30 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is generally well maintained and clean so that people living there enjoy comfortable surroundings. Evidence: We toured the home and visited some residents in their bedrooms and spoke to other people living in the home. We found the home to be relaxed and welcoming and residents spoken to and observed were clearly at home and enjoyed the positive atmosphere. Areas seen were clean and well maintained. We were invited to look at some of the residents bedrooms and found these to be very personalized and generally well maintained so that individual lifestyles were reflected. Those people spoken with said that privacy was respected. The external grounds are accessible. We spoke with one resident who has difficulty with mobilizing and the home have made it possible for this person to move freely around the home by providing ramped access for example. This shows that the management have considered people with physical disability and have taken time to ensure they can access facilities in the home and also externally. Care Homes for Older People Page 21 of 30 Evidence: We saw good provision of bathing facilities and these variable so that some choice is provided. The manager reported that a further shower room has been planned. Likewise there are adequate numbers of toilets. The dementia care unit is being designed and developed along good practice guidelines and we observed good use of orientation aids such as signs and boards and the manager of the unit is keen to develop themes further. There is a reminiscence room and themed areas around the unit so that residents can walk around and feel comfortable and stimulated. There are plans to develop other areas along similar lines. We spoke to one relative who said that the appearance of the unit was very reassuring and this had been a factor in choosing the home. Care Homes for Older People Page 22 of 30 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are recruited and trained appropriately so that the care needs of residents can be met. Evidence: At the time of the inspection visit the dementia unit had 23 residents. Staffing consisted of 1 senior and 3 carers. [1:6 ratio]. The general unit also had 23 residents and had 1 senior and 2 carers. [1:8 ratio]. The manager is supernumerary to these figures. Staff reported that the home is settled in terms of consistency with little turnover of staff numbers and staff records confirmed this so that there is a good continuity of care for residents. The care staff are supported by domestic staff on a daily basis. Staff spoken with felt that they were supported by the management and that there was enough staff to carry out the care needs of the residents. Staff spoken with clearly understood the care needs of the people in the home and could explain their role in providing support. They identified the residents as having fairly low dependency in terms of care needs and this was supported by the manager. We observed the staff to be warm and supportive in their interactions with the residents and this was confirmed as consistent by speaking to residents.
Care Homes for Older People Page 23 of 30 Evidence: Most staff are involved with some training. The preinspection information states that 50 percent of staff have achieved a National vocational Qualification [ NVQ], and most other staff are on these courses. Staff files seen and staff spoken with evidenced ongoing support around training which is monitored through regular supervision sessions with the manager. Some of the senior staff on the dementia care unit have attended training courses around providing care for people with dementia. This shows that the staff have the basic skills to care for people in the home. We looked at some staff files and found that the checks required for each staff prior to employment had been made and that staff were recruited thoroughly. We did find that one staff had not had a reference from their last employer and this is required as this was from a care home. Overall recruitment checks were good and this ensures that staff who work in the home are fit to do so. Care Homes for Older People Page 24 of 30 Management and administration
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are management systems in place to ensure standards are monitored and the home is run in the best interests of the residents. Evidence: The manager is Paula Mooney. We spoke at length and she was able to give a clear outline of the current needs of the service in supporting residents with elderly care needs and also outline how future developments would fit in with best practice with particular reference to dementia care. We asked how the service promotes peoples views and suggestions and was told about the regular community meetings so that residents can air any views or concerns. The service also canvases opinions of residents through surveys so that people can provide feedback about the service and feel more involved in the running of the home. The manager discussed the various internal audits that are carried out including
Care Homes for Older People Page 25 of 30 Evidence: regular environmental checks and also visits by the service managers for the company who also complete a regular inspection and report [Regulation 26 report] which provides further feedback for the manager. We found that the management of health and safety in the home was good. The pre inspection information completed states that all safety certificates are up to date and some of these were spot checked on the inspection. This ensures that the environment for people is safe and maintained. The Health and Safety policy is available. Staff receive basic raining in Health and Safety and this was confirmed by the available training records as well as staff interviews. Care Homes for Older People Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 30 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 9 17 Full and clear records must be kept of all medicines received, administered and leaving the home including those disposed of. This ensures no mishandling of medicines and that all medicines can be easily audited. 01/01/2009 Recommendations
These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 1 3 We would recommend that the service user information supplied is made available in more diverse formats. Any social work or health assessments should be made available at the tine of admission so that full information concerning residents admission is considered. It is strongly recommended that the homes written policy around residents self medication is positively applied so that Independence is encouraged and promoted. There is a need to clearly identify the risk assessment tool used for any person self medicating. 3 9 Care Homes for Older People Page 28 of 30 any person being administered medication that is give when necessary [PRN] should have this monitored through the care plan so that all staff have a consistent approach and it is regularly evaluated. Any person being administered cream should have a record maintained of the staff who administered the cream and the time of administration. 4 12 We would recommend that the provision of activities in the home continues to be developed so that the quality of life for residents can be further enhanced. We would recommended that future training in safeguarding of vulnerable adults includes an understanding of the locally agreed procedures and the role of statutory agencies such as social services so that staff are more aware of the broader picture in terms of safeguarding of vulnerable adults. References from a persons last employer should be gained [particular a care work reference] as part of the staff recruitment process. 5 18 6 29 Care Homes for Older People Page 29 of 30 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 30 of 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!
