Inspection on 30/04/07 for Gold Hill Residential Home

This inspection was carried out on 30th 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

Gold Hill Residential Home 27/02/09

Gold Hill Residential Home 24/09/08

Gold Hill Residential Home 15/12/06

Gold Hill Residential Home 21/04/06

Gold Hill Residential Home 29/11/05

Gold Hill Residential Home 29/07/05

Gold Hill Residential Home 14/03/05

Gold Hill Residential Home 18/08/04

Gold Hill Residential Home 26/03/04

Gold Hill Residential Home 15/12/03

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

CARE HOMES FOR OLDER PEOPLE Gold Hill Residential Home 5 Avenue Road Malvern Worcestershire WR14 3AL Lead Inspector Nic Andrews Unannounced Inspection 30 April & 1 and 2 May 2007 09:30 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 Gold Hill Residential Home DS0000018654.V335042.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. Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gold Hill Residential Home Address 5 Avenue Road Malvern Worcestershire WR14 3AL 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) 01684 574000 Manor Care Limited Position Vacant Care Home 40 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (40), of places Physical disability over 65 years of age (40) Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The Home may also accommodate a maximum of two people, under the age of 65, with both a mental disorder and physical disorder. The Home may also accommodate one named person with mental health needs who is below the age of 65 years. The admission criteria for people with dementia care needs are those specified in the Statement of Purpose dated March 2006. 15th December 2006 Date of last inspection Brief Description of the Service: Gold Hill is a large building occupying a corner position within close proximity to the centre of Malvern which has all of the amenities usually associated with a small town. There are car-parking facilities at the front of the premises and a garden is located at the side of the building. The home is registered to provide personal care for a maximum of 40 older people. The service users are accommodated in 24 single bedrooms and 8 double bedrooms on four levels i.e. lower ground, ground, first and second floor. Sixteen of the single bedrooms and 7 of the double bedrooms have an en suite facility. Several of the bedrooms enjoy attractive views of the Malvern Hills and the surrounding area. The home has a small, two-person passenger lift. The home also has two lounges on the ground floor and a dining room on the lower ground floor. The dining room has an adjoining conservatory that is used as a designated smoking area. The homes stated aim is to offer the best of care whilst preserving the right of each resident to be regarded as an individual and to assist each resident to achieve maximum independence. At the time of the inspection there were thirty-six service users in residence and four vacancies. The fees ranged from £1412.00 to £1700.00 per month. Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection that took place over the course of three days and included an inspection of the medication practices and procedures by the Pharmacist Inspector. The home was inspected against the key National Minimum Standards and time was spent with the acting manager, deputy manager and area manager assessing the home’s response to the requirements and recommendations that were made as a result of the previous inspection. Various records and a number of policies and procedures that the home is required to maintain were inspected. A tour of part of the premises was also made. Individual discussions were held with four service users, the relative of one service user, two members of staff and the project manager. As part of the inspection Comment Cards were also issued to the relatives/visitors of service users and to visiting professionals. None of the Comment Cards were completed or returned. What the service does well: What has improved since the last inspection? Since the last key inspection the atmosphere in the home has improved. A new acting manager has been appointed. The staff recruitment procedure and the system for recording, storage, handling and administration of medication have improved. Progress has been made in the work to upgrade the physical environment by, for example, improvements to the car parking area and the home’s heating system. Training for staff has continued. Meetings have been held with other professionals to help develop closer liaison and working relationships. All the staff have been issued with a contract and the service users have been given a statement of their terms and conditions of residence. Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 Page 6 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. Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 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 Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 5. The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users are given the opportunity to visit the home prior to admission and are provided with information to enable them to make a choice about the home. Their needs are assessed and they are given a contract that tells them about the service they will receive. EVIDENCE: Two requirements and one recommendation were made in regard to Standard 1 as a result of the previous inspection. The first requirement was that the statement of purpose must be amended so that it includes all the information detailed in Regulation 4 and Schedule 1 as outlined in this (i.e. the previous) report. A copy of the statement of purpose dated April 2007 was made available for inspection. The contents of the statement of purpose had improved. However, the statement of purpose still needed to be amended in order to include the following information, • a statement that the home is not registered to provide nursing care, • the arrangements for the care and accommodation of service users in the event of a temporary closure of the home as a result of fire, Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 Page 9 • the number and size of the rooms. The second requirement was that the service users’ guide must be amended in accordance with the guidance given in this (i.e. the previous) report and copies given to all prospective service users. A copy of the service users’ guide dated April 2007 was made available for inspection. The service users’ guide contained relevant information. However, the service users’ guide should also include the following information, • information about how to contact the local social services and health care authorities, • details of the physical environment referred to in Standard 1.1 of the National Minimum Standards. These requirements had not been fully implemented and are referred to again in this report as recommendations. The previous recommendation was that a written record should be maintained on each of the service users’ files as evidence to show that they and/or their representatives have been issued with a copy of the service users’ guide and a copy of the contract. It was pleasing to note that the recommendation had been implemented. A requirement was made in regard to Standard 2 as a result of the previous inspection. The requirement was that a copy of the home’s statement of terms and conditions of residence (contract) that includes all of the information detailed in Standard 2.2 must be issued to all current, and any prospective service users and a copy retained on the service users’ individual files. The requirement had been implemented. It was noted that although the contracts did not specify the rooms to be occupied, they did state that service users would not be asked to change their rooms without being consulted. It was also confirmed that prospective service users were informed of their room allocation in a letter. One requirement was made in regard to Standard 3 as a result of the previous inspection. The requirement was that the home’s assessment form must be amended to include all of the issues referred to in Standard 3.3 in accordance with the guidance given in this (i.e. the previous) report. A copy of the home’s assessment form was made available for inspection. The assessment form did not include very much space for recording details of the prospective service users’ needs. The amount of space provided may need to be increased in order to ensure that a full assessment of need is carried out. However, the requirement had been implemented. It was confirmed that the acting manager and deputy manager would be responsible for carrying out the assessments of prospective service users in the future. Assessments are normally undertaken in the service users’ own homes or in hospital. Standard 4 was not fully assessed on this occasion. However, one requirement was made in regard to Standard 4 as a result of previous inspections. The requirement was that the home must be able to demonstrate that the care provided for service users with a dementia illness is based on current good practice and reflects specialist guidance. There as no evidence in the care Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 Page 10 plans or in the activities provided to show that this requirement had been implemented. There were no unreasonable restrictions on visiting. One recommendation was made in regard to Standard 5 as a result of the previous inspection. The recommendation was that prospective service users who are not able to make a pre-admission visit should only be admitted in exceptional circumstances. It was confirmed that only one of the four service users most recently admitted to the home had made a visit to the home prior to admission. However, the deputy manager confirmed that they were given the opportunity to visit prior to admission. It was also stated that their relatives did make a visit to the home on their behalf. One of the service users stated that she had visited the home prior to admission and two service users said that their relatives had visited. The recommendation was regarded as having been implemented. The area manager stated that if prospective service users did not have any relatives the social workers did not often arrange a pre-admission visit. The home operated a four-week trial period following admission. Gold Hill Residential Home DS0000018654.V335042.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. The quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. The service users’ health and personal care is based on their individual needs. The home’s medication policy and procedures have continued to improve and the service users received their medication safely and reliably. However, more attention needed to be given to care planning and risk assessments in order to ensure that all of the service users’ needs are met. EVIDENCE: Three requirements were made in regard to Standard 7 as a result of the previous inspection. The first requirement was that the care plans must include all of the aspects of care referred to in Standard 3.3 and be reviewed every month and any changes recorded, signed and dated. The date of the reviews must be recorded in full. The care plans must set out in detail the action to be taken by the staff to ensure that all aspects of the service users’ needs are met. It was noted that, since the previous key inspection, new care plans had been introduced. The care plans had been completed by the area manager. The care plans were quite lengthy and both the acting manager and deputy manager felt that they needed more time to become more familiar with them. However, it was pleasing to note that the care plans included all of the Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 Page 12 aspects of care referred to in Standard 3.3. The contents of the care plans had also improved. However, the reviews of two of the care plans that were inspected were overdue. It was also noted that a risk assessment had not been carried out and recorded in respect of one service user who was subject to seizures and had fallen on two occasions earlier in the year. More recently, the same service user had smacked another service user across the face. There was no record of this incident in the service user’s care plan and no instructions to guide the staff in their response to the service user’s behaviour. Therefore, these aspects of the requirement had not been fully implemented and still stand. The second requirement was that recordings made on a daily basis must contain adequate information about all aspects of the service users, including emotional care and social interaction. The requirement had been implemented. There were two parts to the third requirement. The first part concerned the provision of a photograph on each of the service users’ files. This part of the requirement had been implemented. The second part concerned the maintenance of untoward incident reports, dependency profiles and behaviour monitoring forms. The deputy manager stated that the home no longer maintained these forms. Therefore, this part of the requirement has been deleted. It was confirmed that all of the service users were registered with local GPs. The service users received support from the district nurses when necessary. For example, the district nurses were visiting two diabetic service users that required insulin injections. The district nurses also provided special equipment when necessary such as mattresses. A recent meeting had been held with the district nurse to see whether the home could receive any additional support and advice. The service users received annual checks on their eyesight. Dental checks were carried out when necessary via a local dental access centre. The service users also received help from the community psychiatric nurse, psychologist and community physiotherapist. One service user had also received help and support from a behaviour therapist. It was confirmed that bed rails were being used in respect of three service users. However, a risk assessment regarding their use had been carried out in respect of only one service user. The pharmacist inspector assessed the control and handling of medication in the home. Medication procedures, storage and records were inspected. The home had a good relationship with the supplying pharmacy. Medication was secure and locked within cupboards in a dedicated lockable room. Medication requiring refrigeration was kept inside a lockable refrigerator. The medication keys were held by the person in charge to ensure safety. Medication was administered to the service users by trained care staff. Some of the service users looked after their own medication. Lockable storage was available in the service users’ bedrooms for the safe storage of their medication. A comprehensive and detailed medication policy was available in the office, which staff could easily access. It was last updated in February 2007. It contained specific details about the medication management in the home Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 Page 13 including procedures for obtaining medication, receipt, administration, records, storage, controlled drugs, disposal of medication and medication errors. The written medicine procedure helped to ensure that service users were safeguarded. Up to date records for the receipt and disposal of medication were available. All of the medicine record charts which recorded the administration of medication to service users were seen. Several medication audits were undertaken at the inspection and all were correct. This provided evidence of good practice. Some medicine charts were handwritten. However, there was no signature or a double check system to ensure the accuracy of the records. Two service users’ care plans were inspected. Both of the care plans were up to date regarding the service users’ medication requirements. The service users’ consent for staff to administer medication was available and risk assessments had been carried out and recorded for service users who wished to look after their own medication. This was good practice. The member of staff with whom a discussion was held understood the importance of maintaining the service users’ privacy and dignity. The responses given to the questions asked reflected good practice. It was stated that service users were able to receive their relatives in their bedrooms and that they were examined and treated by visiting professionals in private. It was also confirmed that curtains had been provided in double bedrooms. A mobile handset was available for service users to make and receive telephone calls in private. One requirement and two recommendations were made in regard to Standard 10 as a result of the previous inspection. The requirement was that action must be taken to ensure that all the staff address the service users appropriately and in a manner which respects their dignity at all times. It was stated that, ‘dignity and respect were general issues that were discussed in staff meetings’. However, the issue referred to in the requirement had not been mentioned or discussed specifically with any of the staff. The requirement had not been implemented and still stands. The first recommendation was that all items of clothing belonging to the service users should be appropriately marked or labelled with the name of the individual service user. The deputy manager confirmed that approximately 70 of the service users’ clothes had been labelled. The recommendation had not yet been fully implemented and still stands. The second recommendation was that appropriate action should be taken to ensure that all the service users wear their own clothes at all times. It was stated that all of the service users had their own supply of personal clothing. It was also stated that the home did not have a stock of clothing and that any items that were needed by the service users were provided by their relatives or the local authority. The recommendation was regarded as having been implemented. The service users with whom discussions were held confirmed that they were treated with respect and that their privacy was maintained. One service user said, ‘There is no intrusion of privacy. Staff never walk into my room without knocking and don’t ask personal questions. The staff who are here are friendly but not intrusive. We are not treated like children, we are treated like equals’. Gold Hill Residential Home DS0000018654.V335042.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. The quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. The service users are able to maintain contact with their relatives and friends and visitors are made welcome. Steps are being taken to improve the range and quality of social and leisure activities in order to meet the service users’ preferences and needs. However, further consideration needed to be given to the provision of a more varied diet. EVIDENCE: The home provided various social and leisure activities including television, music, board games, cards, Bingo, softball exercises and manicures. It was stated that a new television had been ordered for one of the lounges and that some service users had had new televisions for their bedrooms. A hairdresser visited the home every two weeks and an organist also visited regularly. A show was being held for the service users at the time of the inspection. The service users appeared to enjoy it. The local library provided a regular supply of large print books. The community bus was used earlier in the year on two occasions to take a small number of service users on outings. The deputy manager stated that it was intended to take some of the service users on an outing to Upton on Severn in the near future. No activities were held specifically for service users with dementia. It was stated that the service users with a dementia illness tended ‘to join in with sing-a-longs’. Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 Page 15 Representatives from the Priory Church visited every month to hold a service. A Communion service was held every six weeks. One service user attended three different day centres for a total of five days per week. A requirement was made in regard to Standard 12 as a result of the previous inspection. The requirement was that a comprehensive range of social and leisure activities must be provided in accordance with the service users’ individual and collective needs, preferences and capacities and a record of all such activities maintained. It was noted that activity sheets were now being completed in respect of all the service users recording the activities in which they were involved. It was also confirmed that the home was in the process of appointing a part time activities coordinator for 24 hours per week. It was stated that this appointment would help to ensure that a consistent approach was taken towards the provision of a range of appropriate social and leisure activities including individualised activities for service users with a dementia illness. The requirement was regarded as having been implemented. One of the service users with whom discussions were held said, ‘Christmas was very nice’. Another service user said, ‘I enjoyed the show on Monday’. However, another service user said, ‘Social activities and going out more could be improved’. There were no unnecessary or unreasonable restrictions on visiting. The service users with whom discussions were held confirmed that they were able to receive their relatives and other visitors in private. They also confirmed that their visitors were made welcome and offered a drink. A recommendation was made in regard to Standard 14 as a result of the previous inspection. The recommendation was that the service users’ guide should include details of the local advocacy service, a reference to the service users’ entitlement to bring personal possessions with them when they are admitted to the home and their right of access to the records held about them by the home. A copy of the service users’ guide dated April 2007 was made available for inspection. The recommendation had not been implemented and still stands. It was stated that approximately 40 of the current service users had no relatives or friends that visited them. Therefore, a representative from the local advocacy service had been asked to visit the home to talk to the service users. The purpose of the proposed visit was to decide whether any of the service users that did not have a visitor would welcome and benefit from the involvement of an advocate. It was recognised that any proposed involvement would also depend on whether there was an appropriate role for an advocate to play. The service users with whom discussions were held confirmed that they were able to get up and go to bed when they wished and that they could eat their meals in their bedrooms if they chose to do so. A requirement was made as a result of the previous inspection regarding Standard 15 that the record of food provided for the service users must be fully and accurately maintained in sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory. The Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 Page 16 requirement had been implemented. It was pleasing to note that a full record of the food provided was being maintained. The food that was observed being served during the inspection was wholesome and sufficient in quantity. The service users’ comments about the food were generally positive. One service user said, ‘The food is properly cooked and a lot better than you get in hospital’. The other service users described the food as ‘excellent’, ‘very good’ and ‘acceptable’. However, one service user said, ‘The food is not exciting but homely. I don’t like the teas much. There is less choice at teatime and there is no grill. Teatime could be improved’. Two of the service users confirmed that an alternative meal would be provided if they did not like the meal that was offered. One service user said, ‘Occasionally the food’s not as warm as it could be’. One service user said that she did not understand why the staff did not know that she did not like a particular meal. It was confirmed that service users were able to eat their meals in their own rooms if they so wished. It was also confirmed that the service users were offered a choice of two main meals each day. The exception to this was on Wednesdays when there was roast for lunch. It was stated that the majority of service users enjoyed a roast meal. The acting manager said that he would look closely at the way in which greater variety could be introduced into the provision of meals. The deputy manager confirmed that none of the service users required staff assistance with eating. It was noted that plate guards had been provided for three service users. Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 Page 17 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. The quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a clear complaints procedure and the service users feel confident about making a complaint. The home also has other relevant policies and procedures to ensure that the service users are protected from abuse. However, the home needed to demonstrate that a more robust response would be taken to any complaints received and to any incidents of alleged or suspected abuse. EVIDENCE: The home had a satisfactory complaints procedure. The home also maintained a record of the complaints that had been made against the home. The home had continued to receive a series of complaints since the previous key inspection. Four complaints against the home had been made direct to the CSCI since the last key inspection in December 2006. The complaints included allegations about poor care practice, insufficient staff, unsatisfactory medication procedures, the employment of a child of compulsory school age, inappropriate use of medical equipment and various safety concerns relating to the environment. The four complaints had been referred to the registered provider for investigation. However, the letters sent to the CSCI in response to the complaints were limited in their contents and did not provide sufficient details of the action that had been taken to investigate the complaints, or of the outcome of the investigation or of any remedial action taken as a result of the findings. The home needs to be able to demonstrate that all complaints are taken seriously and responded to robustly as part of its complaints procedure. The service users with whom discussions were held felt confident about making a complaint and said that any complaint made would be taken Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 Page 18 seriously and dealt with quickly. One service user said, ‘There’s a new manager now and I feel now that if I make a suggestion it will be taken up. We are treated much better now’. Three service users expressed their confidence in the deputy manager and confirmed that she was approachable. A requirement was made in regard to Standard 18 as a result of the previous key inspection. The requirement was that all of the home’s policies and procedures on the protection of vulnerable adults from abuse must be brought together into one clear, comprehensive and accessible document. The requirement had been implemented. The general contents of the copies of the relevant policies and procedures that were made available for inspection were satisfactory. However, the home’s policy on ‘Adult Abuse’ should include the address and telephone number of the Adult Protection Coordinator to whom all incidents of suspected or alleged abuse must be reported. The same policy should also include a clear statement that all such incidents must be reported to the CSCI without delay. It was also noted that the home’s whistle blowing policy referred in several places to Highclear Homes Ltd. This reference is regarded as incorrect and should be replaced with a name that is appropriate to the home. The area manager confirmed that she had no concerns about the treatment of any of the service users and that no incidents of alleged or suspected abuse had occurred within the home or been reported to her or had otherwise come to her attention since the previous key inspection. It was also confirmed that there had been no reason to refer any member or former member of staff for consideration for inclusion on the POVA register. The home had a copy of the ‘Adults at Risk’ guidance as part of the Worcestershire Vulnerable Adults – Protection Policy and Procedures. Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 Page 19 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 and 26. The quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. Progress is being made to upgrade various aspects of the physical environment. However, there is still a need to improve the standard of decoration and maintenance and to provide good infection and odour control. The amount of communal space is limited for the care of the people using the service. EVIDENCE: It was pleasing to note that, since the previous key inspection, improvements had continued to be made to the environment. The premises had been replumbed and a zoned heating system installed on the different floors. The pipe work was in the process of being completely boxed. The fire alarm system was also being upgraded with new smoke detectors, a new control unit and new wiring. It was anticipated that this work would be completed before the end of May 2007. Automatic closing devices and intumescent strips had been fitted to bedroom doors. A gully and drain had been installed in the ground floor shower room. It was intended that the work to remove wiring in the lift shaft that remained from the old installation would be completed before the end of Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 Page 20 May 2007. New taps were being fitted and parts of the premises were being painted. Following the completion of the work that was in progress, it was intended that new carpets would be laid. Part of the outside of the premises was in need of repainting, some drainage should be replaced and some of the woodwork refurbished. The garden needed to be tidied and some rubbish removed. The entrance to the home also needed to be improved. All of the work to improve the environment must be completed for the safety and benefit of the service users and staff. Two requirements were made in regard to Standard 19 as a result of the previous inspection. The first requirement was that a programme of routine maintenance and renewal of the fabric and decoration of the premises must be produced. It was noted that there was no programme of routine maintenance for the home available at the time of the inspection. However, the project manager subsequently provided a copy of a six-month maintenance programme. Further time is needed to enable the acting manager to provide evidence to show that the maintenance programme has been implemented. Therefore, the wording of the requirement has been amended accordingly. The second requirement was that the car parking area at the front of the premises must be made safe. This requirement had been implemented. The two recommendations that were also made as a result of the previous key inspection regarding the provision of a permanent ramp at the front entrance and a new cooker had not been implemented and still stand. A tour of part of the premises was carried out. It was noted that the standard of furniture and decoration in some of the bedrooms was poor and uncoordinated. The dining room had recently been refurbished and a new floor covering and new, matching dining tables and chairs had been provided. This was a significant improvement on the previous furnishings. However, the dining room still appeared ‘institutional’ and lacked the usual domestic standards. For example, there were no pictures or prints on the walls and the ceiling lights were in the form of fluorescent tubes. The recommendation that was made in regard to Standard 22 as a result of previous inspections concerning the provision of disability equipment and environmental adaptations had not been implemented and still stands. A requirement was made as a result of previous inspections that all of the items of furniture specified in Standard 24 must be provided in rooms occupied by service users. It was noted that work to upgrade the environment and to improve the facilities in the home was still in progress. The work to refurbish the service users’ bedrooms had also not been completed. One of the service users with whom discussions were held said that he would prefer to have a carpet in his bedroom rather than linoleum. He said, ‘You’re not so likely to slip on carpet as you are on this’. The home’s response to the above requirement will be assessed during the next planned inspection. In the meantime, the requirement still stands. Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 Page 21 The recommendation that was made in regard to Standard 25 as a result of the previous inspection that the service users should be able to control the heating in their own bedrooms had been implemented. During the partial inspection of the premises it was noted that there was an offensive odour in two bedrooms in particular. The area manager said that the bedrooms were cleaned regularly. The area manager felt that the only way to maintain good odour control in these bedrooms was to replace the carpets. The laundry was inspected and it was noted that the floor was in need of repainting. The laundry walls showed signs of dampness and were in need of repainting/resurfacing. A requirement was made as a result of the previous inspection that the recommendations for improving the standards on infection control as outlined in the Infection Control Audit dated 28 June 2006 must be implemented. Each of the recommendations contained in the Infection Control Audit were discussed with the area manager. The issues that are still outstanding and needed to be addressed were as follows, • A bathroom on the second floor needed to be upgraded or converted into a wet room. • Liquid soap and paper towel dispensers must be provided in all of the bathrooms. • Commodes that are rusty or have split seat covers should be replaced immediately. Disposable commode pots should be used. • The carpet in the landing on the second floor that is the cause of the strong smell of urine must be replaced. The area manager said that this would be done as part of the home’s refurbishment programme. • The floor in the laundry should be covered with a washable surface. This issue is also referred to above. • Spray bottles must be completely emptied at the end of each day, washed out thoroughly and allowed to dry before refilling. • A senior member of staff should attend the next infection control training course. The area manager agreed to provide a full, written report of the home’s response to all of the issues contained in the Infection Control Audit including the matters referred to above. The requirement had not been fully implemented and still stands. It was confirmed that posters on correct hand washing techniques had been displayed and that a pedal bin had been placed in each communal area for the disposal of clinical waste. The service users with whom discussions were held confirmed that their rooms were kept clean and that they were satisfied with the standard of laundering of their clothes. Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 Page 22 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. The quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. The staff recruitment procedures are satisfactory and the deployment of staff is sufficient to meet the service users’ needs. However, action is needed to maintain the staff training records and to ensure that staff receive further training. EVIDENCE: Two requirements were made in regard to Standard 27 as a result of the previous inspection. The first requirement was that the staff duty rota must show the names, designated position and hours worked in respect of all the staff employed to work at the home. A list of the staff that were employed at the home and the number of hours for which they were employed each week and a copy of the home’s staff rota were made available for inspection. The staff rota did not include the hours worked by the acting manager. Therefore, the requirement had not been fully implemented and still stands. The second requirement was that the records of the training provided for or to be undertaken by staff as detailed in the individual training and development assessments and profiles must be accurately maintained at all times in accordance with Schedule 4. The requirement had not been implemented and still stands. It was noted that the training records were not up to date and that some training had been undertaken that had not been recorded on the staff training matrix or in the individual staff training profiles. However, the information provided by the area manager indicated that the overall level and deployment of staff was satisfactory. The service users with whom discussions were held spoke positively about the staff. One service user described the Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 Page 23 staff as ‘friendly but respectful’. The same service user, commenting about the behaviour of another service user, said ‘The staff don’t rise to his anger’. Another service user said, ‘The staff seem to be with the residents more and not wandering aimlessly around’. Another service user said, ‘The staff are very kind. They do all they can to help me. They’re very tolerant’. The home employed a total of 19 members of staff who were involved in the provision of care. Eight of the staff members had completed the NVQ level 2 training. This is slightly below the ratio of 50 trained members of care staff set by the National Minimum Standards. However, it was pleasing to note that a further four members of staff had commenced NVQ level 2 training. The acting manager also said that he was intending to appoint staff to cover an additional 50 care hours per week and that the staff he was intending to appoint had already completed the NVQ level 2 training. Two requirements and one recommendation were made in regard to Standard 29 as a result of the previous inspection. The first requirement was that disclosure checks from the Criminal Records Bureau (CRB) must be obtained for all new staff prior to the commencement of their employment. The area manager confirmed that the home had obtained an enhanced disclosure check from the CRB in respect of all the staff. The staff files that were inspected also contained evidence to show that the requirement had been implemented. The second requirement was that staff files must contain a full employment history, a declaration about health etc (as normally included in an application form), an up to date list of training, including induction training, two relevant, written references and proof that an enhanced disclosure check had been obtained from the CRB prior to the commencement of employment at the home. The area manager stated that all the staff had confirmed in writing that they had read their job description, had made a health declaration and had been issued with a contract. The staff files that were inspected also contained evidence to show that the requirement had been implemented. The recommendation was that the staff files should contain a copy of the contract of employment and evidence to show that staff had been issued with a copy of the code of conduct and practice set by the GSCC. It was stated that all the staff had been issued with a copy of their contract but not all of the staff had been issued with a copy of the code of conduct and practice. The recommendation had not been fully implemented. The area manager was advised to maintain a record of the reasons for the decision to appoint any person that has a conviction/caution in order to demonstrate that the service users have not been placed at any unnecessary risk. Two recommendations were made in regard to Standard 30 as a result of the previous inspection. The first recommendation was that formal training on key working should be provided for all the staff. The recommendation had not been implemented. It was agreed that the recommendation would best be implemented through training on person centred planning. The wording of the recommendation has been amended to reflect this. The second Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 Page 24 recommendation was that the process of introducing an effective staff induction programme that meets the Skills for Care specified standards should continue. The recommendation had been implemented. It was noted that a staff induction programme produced by the company had been introduced. It was confirmed that the induction programme met the Skills for Care standards. One member of staff was currently undertaking the induction training. Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 Page 25 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, 36 and 38. The quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are starting to benefit from the appointment of a new acting manager. However, sustained improvements are needed to ensure that they are safe and assured good quality care. EVIDENCE: Since the previous inspection it had been confirmed that the former registered manager was no longer employed at the home. A new acting manager had been appointed at the beginning of April 2007. The acting manager had relevant experience and had been registered as the manager in respect of other residential care homes in the recent past. The acting manager had completed the NVQ level 4 training in September 2005 and the Registered Managers’ Award (RMA) training in January 2006 at Evesham College. The acting manager is required to make an application to the CSCI to become the registered manager. A requirement was made in regard to Standard 31 as a Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 Page 26 result of the previous inspection. The requirement was that the deputy manager must undertake training in the protection of vulnerable adults from abuse at an appropriate level for managers. It was confirmed that the deputy manager had undertaken the basic awareness training ‘Protecting Clients from Abuse’ on 5 February 2007. The acting manager said that he would ensure that he and the deputy manager attended training in the protection of vulnerable adults from abuse at an appropriate level in the near future. The requirement had not been fully implemented. However, in recognition of the training that has been undertaken, the requirement now becomes a recommendation. One of the service users with whom discussions were held said, ‘It’s a different style of management now, it’s more open’. One requirement and three recommendations were made in regard to Standard 33 as a result of the previous inspection. The requirement was that the home’s quality assurance system must become fully operational and effective. It was stated that various audits had been undertaken in the home including infection control on 30/01/07, medication on 05/02/07 and 30/04/07 and furniture, the date of which was not known. It was stated that the issues that were highlighted were brought to the attention of the responsible individual. The area manager stated that ‘the company had developed all the paperwork, the process had begun but the information had not been analysed and a full, quality assurance system was not yet in place’. Therefore, the requirement had not been fully implemented. The first recommendation was that the results of service user surveys should be published and made available to current and prospective service users, their representatives and other interested parties, including the CSCI. It was stated that questionnaires had been issued to service users, their relatives and also to GPs in February 2007. The area manager said that although the contents of the feedback had been ‘quite good’ there had been only eight responses. The area manager said that when all of the responses had been returned the results would be analysed and published. The recommendation had not been fully implemented and still stands. The second recommendation was that the home should be able to demonstrate a commitment to lifelong learning and development for each service user, linked to implementation of their individual care plans. It was noted that the service users’ interests were being recorded. However, the recommendation had not been fully implemented and still stands. The third recommendation was that staff meetings should continue to be held on a regular and frequent basis with minutes kept. It was confirmed that staff meetings had been held in March and April 2007 with minutes kept. The acting manager stated that he intended to continue to hold regular staff meetings. The recommendation was regarded as having been implemented. A recommendation was made in regard to Standard 34 as a result of the previous inspection that a business and financial plan for the establishment should be drawn up, made open to inspection and reviewed annually. The recommendation had not been implemented and still stands. Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 Page 27 It was confirmed that no one connected with the running of the home acted as an agent or appointee on behalf of any of the service users. However, money was held in safekeeping by the home on behalf of twenty-six service users. The money and the corresponding accounts were maintained individually and kept in separate folders in a lockable cabinet. Access to the cabinet was restricted. The money and accounts maintained on behalf of two of the service users was checked at random. The money and accounts were correct. A recommendation was made in regard to Standard 35 as a result of the previous inspection that the financial accounts maintained on behalf of the service users should be regularly and independently audited at least every two months. The recommendation had been implemented. The home also held chequebooks and bank account books on behalf of four service users. Valuables were held in a safe on behalf of two service users. Two requirements were made in regard to Standard 36 as a result of the previous inspection. The first requirement was that care staff, including the deputy manager, must receive formal supervision at least six times a year that includes all aspects of practice, philosophy of care in the home and career development needs. It was stated that most of the staff had attended one supervision meeting since the beginning of April 2007. However, not all of the staff had received formal supervision including the deputy manager. The home needed more time to implement the requirement fully. The requirement still stands. The second requirement was that the registered manager, deputy manager and any other senior member of staff responsible for undertaking formal supervision must receive appropriate supervision training. The requirement had not been implemented. However, the requirement is now referred to in this report as a recommendation. A requirement was made in regard to Standard 37 as a result of the previous inspection. The requirement was that a visit to the home by the registered provider must take place at least once a month and a written report on the conduct of the home supplied to the registered manager and made available for inspection at all times in accordance with the requirements of Regulation 26. The requirement had not been implemented and still stands. The area manager stated that a quality assurance audit had been carried out on 9 February 2007. However, no visits or reports had been made in accordance with Regulation 26. The area manager said that the requirement would be implemented in the near future. Five requirements and one recommendation were made in regard to Standard 38 as a result of the previous inspection. The first requirement was that risk assessments must be carried out and recorded for all safe working practice topics covered in Standards 38.2 and 38.3 including infection control, servicing of boilers and window restrictors. The requirement was fully implemented during the inspection. The second requirement was that the home’s fire safety risk assessment must be updated periodically by a competent person to reflect any changes to fire risk, signed and dated. A fire risk assessment had been Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 Page 28 carried out and recorded by the acting manager on 10 April 2007. The requirement was regarded as having been implemented. It was noted that a new fire alarm system was being installed. It was stated that the home had never been without a fully operational fire alarm system and that the installation of the new system would be completed ‘within two weeks’. The third requirement was that a valid electrical safety certificate for the home provided by a qualified electrician must be obtained and made available for inspection. The requirement had been implemented. A valid electrical safety certificate dated 3 November 2006 was made available for inspection. It was stated that the certificate did not arrive at the home until 24 January 2007. The fourth requirement was that the records that are maintained in regard to fire safety must be kept in the home and made available for inspection at all times. The requirement had been implemented. The fire safety records were made available for inspection. However, it was noted that there was a gap in the records between 23 March and 23 April 2007 when the weekly fire alarm tests had not been carried out. The fifth requirement was that updated moving and handling training must be provided for all the staff. It was noted that some members of staff had undertaken moving and handling training in March 2007. It was confirmed that the remainder of the staff would undertake the training in May 2007. The requirement was regarded as having been implemented. The recommendation that all portable electrical appliances should be PAT tested had not been implemented and still stands. There had been a fault on the passenger lift. The project manager said that the fault had been caused by a dirty contact and had been rectified by Chase Lifts Ltd. The lift was in working order and had a safety certificate. A number of staff had undertaken first aid training on 20 April 2007. However, it was noted that some staff still needed to complete first aid training and training in dementia care, food hygiene and infection control. The bath hoists had been serviced on 3 April 2007. The passenger lift had been serviced on 29 September 2006 and re-examined on 16 February 2007. It was stated that the lift was in proper working order. The home had relevant documentation in regard to COSHH and RIDDOR. It was confirmed that opening restrictors had been fitted to all of the windows and that thermostatically controlled mixer valves had been fitted to all of the hot water outlets used by service users. Water samples had not been checked for traces of Legionella since July 2005. Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 Page 29 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 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 X X X X X X 1 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X 3 2 X 2 Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 Page 30 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 Requirement The care plans in respect of each service user must be reviewed every month and any changes recorded, signed and dated. The date of the reviews must be recorded in full. The care plans must set out in detail the action to be taken by the staff to ensure that all aspects of the service users’ needs are met including needs relating to dementia care. (Previous timescales 30/06/06 and 28/02/07 not met). Risk assessments must be carried out in respect of all the service users for whom bed rails are provided and any necessary action taken to ensure their safety. Action must be taken to ensure that all the staff address the service users appropriately and in a manner which respects their dignity at all times. (Previous timescale 28/02/07 not met). The programme of routine maintenance and renewal of the fabric and decoration of the premises must be implemented DS0000018654.V335042.R01.S.doc Timescale for action 31/05/07 2 OP8 12,13 31/05/07 3 OP10 12 31/05/07 4 OP19 23 30/06/07 Gold Hill Residential Home Version 5.2 Page 31 5 OP24 16 6 OP26 16 7 8 OP26 OP26 23 13,23 9 OP27 17 10 OP27 17 with particular attention to the coordination of the furnishings and the décor/colour including all the work that is referred to in Standard 19 of this report and the provision of domestic lighting in the dining room. (Previous timescales 30/06/06 and 28/02/07 not met). All of the items of furniture specified in Standard 24, as outlined in this report, must be provided in rooms occupied by service users. If the provision of any item poses an unacceptable risk to the service user or they decline the provision, details of the discussions and decision about this should be recorded in the assessment of the service users needs. (Previous timescales 30/06/06 and 31/03/07 not met). Action must be taken to ensure that all parts of the home are kept free from offensive odours at all times. The laundry floor and wall finishes must be impermeable and readily cleanable. The action that is needed to improve the standards on infection control as outlined in the Infection Control Audit dated 28 June 2006 must be carried out. (Previous timescale 28/02/07 not met). The staff duty rota must show the names, designated position and hours worked of all the staff employed to work at the home. (Previous timescales 31/05/06 and 28/02/07 not met). The records of the training provided for or to be undertaken by staff as detailed in the individual training and development assessments and DS0000018654.V335042.R01.S.doc 30/06/07 30/06/07 30/06/07 30/06/07 31/05/07 31/05/07 Gold Hill Residential Home Version 5.2 Page 32 11 OP28 18 12 OP31 8,9 13 OP33 24 14 OP36 18 15 OP37 26 16 OP38 13,23 17 OP38 12,18 profiles must be accurately maintained at all times in accordance with Schedule 4. (Previous timescales 31/05/06 and 28/02/07 not met). Arrangements must be made for staff to receive training that will enable a minimum of 50 of the care staff to attain a qualification at NVQ level 2 or equivalent. The acting manager must make an application to the CSCI to become the registered manager of the home. The home’s quality assurance system must become fully operational and effective. (Previous timescales 30/06/06 and 31/03/07 not met). Care staff, including the deputy manager, must receive formal supervision at least six times a year that includes all aspects of practice, philosophy of care in the home and career development needs. (Previous timescales 30/06/06 and 31/03/07 not met). A visit to the home by the registered provider must take place at least once a month and a written report on the conduct of the home supplied to the manager and made available for inspection at all times in accordance with the requirements of Regulation 26. (Previous timescales 31/05/06 and 31/01/07 not met). Fire alarm tests must be carried out and recorded each week in accordance with the recommendations of the Fire Safety Officer. All the staff must receive training in core areas including first aid, food hygiene, infection control and dementia care. DS0000018654.V335042.R01.S.doc 31/12/07 31/05/07 30/06/07 31/07/07 31/05/07 31/05/07 30/06/07 Gold Hill Residential Home Version 5.2 Page 33 18 OP38 12 Legionella tests must be carried out on the water supply. 30/06/07 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 OP1 Good Practice Recommendations The statement of purpose should be amended so that it includes all the information detailed in Regulation 4 and Schedule 1 as outlined in the guidance given in this report. (Previous timescale 28/02/07 not met). The service users’ guide should be amended to include information about how to contact the local social services and healthcare authorities and details of the physical environment (room sizes) as referred to in Standard 1 of the National Minimum Standards. Any hand- written medicine charts should be doublechecked and signed by a second member of staff to confirm that the medication details recorded are correct. All items of clothing belonging to the service users should be appropriately marked or labelled with the name of the individual service user. The service users’ guide should include details of the local advocacy service, a reference to the service users entitlement to bring personal possessions with them when they are admitted to the home and their right of access to the records held about them by the home. Action should be taken to ensure that cooked food is served at the correct temperature. A wider variety of food should be introduced in accordance with the service users’ individual preferences and dietary needs. The staff who are involved in the investigation of complaints should receive relevant training. The home’s policy on ‘Adult Abuse’ should include the address and telephone number of the Adult Protection Coordinator and a clear statement that all incidents of alleged or suspected abuse must be reported to the CSCI without delay. DS0000018654.V335042.R01.S.doc Version 5.2 Page 34 2 OP1 3 4 5 OP9 OP10 OP14 6 7 8 9 OP15 OP15 OP16 OP18 Gold Hill Residential Home 10 11 12 13 OP18 OP19 OP19 OP22 14 15 OP29 OP29 16 17 18 OP30 OP31 OP33 19 20 21 OP33 OP34 OP36 22 OP38 The reference in the home’s whistle blowing policy to Highclear Homes Ltd should be replaced with a reference that is more relevant and appropriate. An appropriate means of access i.e. a permanent ramp, should be provided at the front of the home for people who use wheelchairs and people with mobility problems. A new cooker should be provided in the main kitchen. The advice of a qualified occupational therapist should be sought in order to ensure that the home provides all of the recommended disability equipment and environmental adaptations to meet the needs of the service users. The staff files should contain evidence to show that staff have been issued with a copy of the code of conduct and practice set by the GSCC. A record should be maintained of the discussions held at staff interviews regarding the circumstances surrounding any convictions/cautions that prospective staff may have and the reasons for the decision to appoint any person that may have a conviction/caution. Formal training on person centred planning that includes key working should be provided for all the staff. The deputy manager should undertake training in the protection of vulnerable adults from abuse at an appropriate level for managers. The results of service user surveys should be published and made available to current and prospective service users, their representatives and other interested parties, including the CSCI. The home should be able to demonstrate a commitment to lifelong learning and development for each service user, linked to implementation of their individual care plans. A business and financial plan for the establishment should be drawn up, made open to inspection and reviewed annually. The manager, deputy manager and any other senior members of staff responsible for undertaking formal supervision should undertake appropriate supervision training. (Previous timescale 31/03/07 not met). All portable electrical appliances should be PAT tested. Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 Page 35 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Gold Hill Residential Home DS0000018654.V335042.R01.S.doc Version 5.2 Page 36 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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